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(PA school) Gross Anatomy > Week 2 hitchhiker's guide > Flashcards

Week 2 hitchhiker's guide Flashcards

1
Q

What is also known as the cranial vault? Describe this structure.

A

Neurocranium; the bony case of the brain and the cranial meninges

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2
Q

What is also known as the facial skeleton? Describe how this structure develops

A

Viscerocranium; composed of facial bones that mainly develop in the mesenchyme of embryonic pharyngeal arches

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3
Q

What contains parts of the proximal parts of the cranial nerves and the vasculature of the brain?

A

Neurocranium

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4
Q

The bones surrounding the mouth, nose and most of the orbits form what?

A

The viscerocranium

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5
Q

What two things make up the neurocranium?

A

Calvaria (skullcap) and cranial base (basicranium)

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6
Q

What are the 8 bones that form the neurocranium?

A

4 unpaired: frontal, ethmoid, sphenoid, & occipital
2 paired: temporal and parietal

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7
Q

What are the 15 bones that form the viscerocranium?

A

3 unpaired midline bones: mandible, ethmoid, vomer
6 paired bones (bilateral); maxilla, inferior nasal concha (turbinate) zygomatic, palatine, nasal, lacrimal

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8
Q

What is the main role of the viscerocranium?

A

Support sensory organs (eyes, nose, mouth) of the face

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9
Q

What provides structural protection for the brain?

A

Neurocranium (cranial vault)

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10
Q

What arises from pharyngeal arches, the viscerocranium or neurocranium?

A

Viscerocranium

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11
Q

Where is the frontal bone and underlying frontal sinus?

A
  1. Frontal bone: forehead & top half of skull bone
  2. Underlying frontal sinus: under frontal bones, superior to nose
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12
Q

Where is the supraorbital notch?

A

A tiny rivet directly above the rim of the orbital bone more towards the medial side. Usually passes b/t a person’s eyebrows. Bilateral.

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13
Q

Where are the infraorbital foramen?

A

Underneath the eye socket (or orbit) and sits on the bulk of the “cheekbone”. Bilateral.

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14
Q

1) Where is the nasal bone?
2) What two things make up the boney part of the septum?

A

1) Top-bridge of nose
2) Vomer and perpendicular plate of the ethmoid.

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15
Q

1) Where is the ethmoid sinus?
2) What is the nasion?

A

1) Under the nasal bone/ superior part of nose
2) A small point superior to nasal bone

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16
Q

The _______________ form the upper jaw and are united via a suture (intermaxillary) in the median plane.

A

maxillae

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17
Q

1) What are the maxillary sinuses?
2) What is the dental arcade?

A

1) Two large pyramid shaped cavities in the maxillae (kinda near cheeks)
2) The curved row of teeth in each jaw, aka the dental arch. Top and bottom.

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18
Q

1) What does the zygomatic bone make up?
2) What bones make up the zygomatic arch?

A

1) Lateral cheek bone
2) Zygomatic process of the zygomatic bone and the temporal process of the temporal bone

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19
Q

What is the TMJ and where is it?

A

Where the temporal bone and mandibular bone meet, just anterior to each ear canal

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20
Q

Describe the locations of the following features of the mandible: head, ramus, angle, body, foramen, and dental arcade

A

1) Head: the deeper, more round process of the superior part of mandible bone
2) Ramus: the more vertical part of the mandible superior to the angle
3) Angle: the angle of the jaw (what gen alpha does mogging)
4) Body: horizontal part that makes up the chin
5) Foramen: holes on each side of the chin/ body
6) Dental arcade: where the teeth are on mandible

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21
Q

What is the temporal fossa?

A

The depression of the temporal bone inferior to the zygomatic arch

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22
Q

The pterion is the joining of what 4 bones?

A

Frontal, parietal, temporal, & sphenoid bones

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23
Q

1) What is the external auditory meatus?
2) What is the mastoid process?

A

1) Bone/ hole to the auditory canal
2) The most inferior part of the temporal bone, at the same level as the earlobe and posterior to the ear.

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24
Q

1) What is the occipital bone?
2) What is the external occipital process?

A

1) The posterior bone of the skull
2) The bump on the occipital bone, medial

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25
Q

The place where the the sagittal and coronal sutures meet is called ___________

A

bregma

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26
Q

What is lambda?

A

Where the sagittal and lambdoid sutures meet

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27
Q

Describe the 2 main paths of drainage of the orbit

A

1) Superior & inferior ophthalmic veins > superior orbital fissure > cavernous sinus
2) Inferior ophthalmic vein > inferior orbital fissure > pterygoid venous plexus

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28
Q

1) What do the occipital condyles articulate with?
2) What is the foramen magnum?

A

1) C1
2) Biggest hole in skull, where spinal cord and medulla meet and leave the skull

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29
Q

What are the 5 named muscles of facial expression? List what each controls

A

1) Occipitofrontalis frontal belly: Skin and SQ tissue of eyebrows and forehead
-Occipital belly: epicranial neurosis
2) Orbicularis oculi: orbital sphincter
3) Orbicularis oris: mouth sphincter
4) Buccinator: cheek muscle
5) Platysma: SQ tissue of infra and supraclavicular regions

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30
Q

What nerve provides motor innervation to the muscles of facial expression?

A

Facial nerve (CNVII)

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31
Q

What parts of CN7 innervate the muscles of facial expression?

A

1) Posterior auricular branch or
2) Parotid plexus’s temporal, zygomatic, buccal, marginal mandibular, or cervical branches

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32
Q

What innervates the muscles of mastication?

A

The mandibular nerve (CNV V3)

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33
Q

What nerve provides sensory innervation of the face?

A

CN5 (trigeminal)

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34
Q

What structure is only parasympathetic?

A

Ciliary body (is constricted by parasympathetic for accommodation)
*probably on quiz

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35
Q

What innervates the iris?

A

Sympathetic as well
*probably on quiz

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36
Q

Compare and contrast clinical findings from injury of the trigeminal and facial nerves.

A

Cornea touch reflex would be affected by both:
1) CN 5 V1 (ophthalmic nerve): something touches the eye (air, qtip) and it hurts. That’s the afferent response.
2) CN 7 (facial nerve): After touching the eye, we blink. That is the efferent response.

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37
Q

Compare the distribution of the common, internal, and external carotid arteries

A

1) Common carotid: extends to C4-C5 before it bifurcates
2) Internal carotid: neck, skull, and base of brain
3) External carotid: travels up the neck and ends in the parotid gland in the face.

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38
Q

Which vessels that provide blood to the scalp come from the external carotid vs. internal carotid?

A

1) External carotid artery: Superficial temporal artery, occipital artery and posterior auricular
2) Internal carotid artery: Supratrochlear artery and supraorbital

39
Q

Where does venous blood drain from around the periorbital region of the face?

A

1) The superior ophthalmic vein communicates with facial vein (both meet in the cavernous sinus).
2) The facial vein also drains into the internal jugular vein.

40
Q

How might a pre-orbital or orbital infection spread to the cavernous sinus and pterygoid venous plexus as well as the jugular veins?

A

Through the facial vein and ophthalmic veins:
1) The superior ophthalmic vein communicates with facial vein, and both meet in the cavernous sinus).
2) The facial vein also drains into the internal jugular vein
3) The pterygoid venous plexus connects with the cavernous sinus, inferior ophthalmic vein, and the facial veins.

41
Q

Locate the superficial lymph nodes

A

1) Occipital: in the back of the head (occipital region)
2) Mastoid or posterior auricular: behind ear
3) Pre-auricular or parotid: in front of ear
4) Submandibular: lateral jaw line
5) Submental: under chin
6) Anterior and posterior cervical: neck region

42
Q

1) What nerve is closely associated deep to the parotid gland?
2) The parotid duct opens in the buccal cavity where?
3) What are the clinical symptoms of parotid gland disease?

A

1) CN 7 (facial)
2) At the parotid papilla, a small bump located opposite the upper second molar tooth.
3) Pain in auricle, external acoustic meatus, temporal region, and TMJ.

43
Q

Sinus infections can extend into the orbit, resulting in an orbital abscess.
Which of the paranasal sinuses is medial to the orbit, the origin of many orbital abscesses?

A

Ethmoid sinus; located on the bridge of the nose, between the eyes, and above the nasal cavity

44
Q

Direct blunt trauma to the eye and orbit may result in a “blow-out” fracture, especially to the floor of the orbit.

Which extra ocular muscle might become trapped or tethered in an orbital floor fracture? What does this muscle do?

A

Inferior rectus muscle (limits upward gaze)

45
Q

What structure is just inferior to each of the orbits?

A

Maxillary sinuses

46
Q

What nerves and structures are in the orbit?

A

1) CNs: 2 (vision), 3 (a lot), 4 (EOMs), 6 (EOMs)
2) Vessels (including central retinal artery)
3) Globe
4) Lacrimal system
5) EOMs

47
Q

What is the origin of the central retinal artery and where does the central retinal vein drain?

A

1) Originates from the ophthalmic artery, runs along retina and wraps around optic nerve.
2) Drains into superior ophthalmic vein and into cavernous sinus

48
Q

Know how the aqueous humor flows:
1) Where is it produced?
2) Where does it flow?
3) Where does it drain?
4) What removes it?

A

1) In ciliary process in posterior chamber (b/t lens and ciliary body.)
2) Flows through pupil into anterior chamber (b/t cornea and iris/pupil)
3) Drains through trabecular meshwork at iridocorneal angle into scleral venous sinus (canal of Schlemm) (near the cornea)
4) Limbal plexus (encircles peripheral cornea), which puts it into circulatory system.

49
Q

Based on the anatomy of the upper eyelid, predict which eyelid gland infection, tarsal or ciliary glands, would cause an internal hordeolum (stye) and an external hordeolum

A

Infection of tarsal gland = internal hordeolum (stye)
Infection of ciliary gland = external hordeolum (stye)

50
Q

Based on location of the infection, which infection (pre-orbital or orbital) would cause displacement of the eyeball, diplopia, and decreased range of motion (ROM) of the eyeball?

A

Orbital

51
Q

What is the difference between pre-orbital cellulitis and orbital cellulitis?

A

1) Pre orbital: infection of the eyelid and area around the eye
2) Orbital: infection of the eyeball and the tissues around it

52
Q

What nerve provides motor to the orbicularis oculi muscles?

A

The facial nerve (CN 7)

53
Q

What is a muscle that circles the eye and plays a key role in eyelid movement and facial expression?

A

Orbicularis oculi

54
Q

1) What does the lacrimal gland do? Where is it?
2) Where is the lacrimal punctum and what does it lead to?
3) What does the lacrimal lake do?

A

1) Produces and secretes tears; by superior rim of orbit.
2) Hole at bottom of the eye lid (top and bottom) and leads to lacrimal canaliculi
3) Holds the tears until it gets full (in corner of eye, surrounding lacrimal canaliculi)

55
Q

1) What does the lacrimal canaliculi do? Where are they?
2) What does the nasolacrimal duct do when the above structure gets full?

A

1) Leads tears from papilla into lacrimal sac.
2) Once the lacrimal sac gets full, tears drain into the nasolacrimal duct and down the nasal cavity

56
Q

How can an upper respiratory infection (cold) ascend and result in a conjunctivitis?

A

Can ascend through nasolacrimal duct into lacrimal sac, through the superior lacrimal canaliculi and the superior and inferior lacrimal punctum, into the lacrimal lake and into the eye.

57
Q

What provides superficial vascular supply to the orbit and associated tissues?

A

Uveal tract (consisting of the choroid, ciliary body/process, iris/pupil)

58
Q

What provide internal arterial supply to the orbit and associated tissues?

A

1) Ophthalmic artery (branch of internal carotid)
2) Central retinal artery (only supplies neuronal layer of retina)
3) Infraorbital artery (branch of external carotid)

59
Q

When taking a flash picture, often times you get “red” eyes. Which layer of the globe is responsible for this?

A

Choroid (vascular bed b/t sclera and retina)

60
Q

Which parts of the uvea are involved in pupil reaction to light and accommodation to near vision?

A

1) Pupil reaction to light: iris
2) Accommodation: ciliary body

61
Q

What is responsible for the pupillary light reflex arc?
(i.e., what are the afferent and efferent components of the arc and muscle observed?)

A

1) Afferent: CN 2 (optic)
2) Efferent: CN 3 (oculomotor)
3) Sphincter pupillae muscle: innervated by parasympathetic fibers. Innervation of one of these fibers causes dilation of the pupil due to the sympathetic system of the dilator pupillae muscle being unopposed.

62
Q

The corneal (touch) reflex involves which nerves providing afferent and efferent components? What is the result of touching the cornea?

A

CNV1: afferent (sensory, you feel it)
CN7: efferent (eyelid closure)

63
Q

When the optometrist dilates your eyes for a complete retinal exam, they use what two types of drugs?

A

1) Parasympatholytic (blocks parasympathetic motor fibers)
2) Sympathomimetic (stimulates sympathetic motor fibers) drugs

64
Q

1) What effect does blocking the parasympathetic motor fibers to the eye cause?
2) What effect does stimulating the sympathetic motor fibers cause?
3) Which paralyses the ciliary body and affects the pupil, a parasympatholytic (inhibits para) drug or a sympathomimetic (stimulates symp) drug?
4) Which of the above only affects the pupil?

A

1) Keeps the pupil from being constricted
2) Dilation of the pupil
3) Parasympatholytic paralyses the ciliary body and affects pupil
4) Sympathomimetic; stimulates dilator muscles of iris. Ciliary only parasympathetic.

65
Q

What is the difference between the orbital axis and the visual AP axis?

A

1) Orbital: Represents anatomical axis of eye socket. Passes through center of bony orbit. Focuses on way eye moves.
2) Visual: Represents the line of sight when focusing on an object. Connects point of fixation to the fovea on the retina.

66
Q

What would CN3 palsy look like?

A

Double vision, drooping eye lid, dilated pupil

67
Q

What would CN4 dysfunction do to the eye?

A

Double vision, affected eye turns up (sitting higher than other eye), affected eye cannot turn inward or down.

68
Q

What would CN6 dysfunction do to the eye?

A

Double vision, cannot move eye outward, affected eye may turn inward when looking straight

69
Q

Where is the TMJ? Why is this significant?

A

TMJ is in front of the ear; can even feel it moving when you place your fingers inside the ear. A common symptom of TMJ disorder is ear pain.

70
Q

When you go to the dentist and have a root canal or cavity filled, they provide local anesthesia.
1) Based on anatomy, why can the dentist with a single infiltration of lidocaine anesthetize the entire one half of the mandibular arcade but has to numb each individual tooth in the maxillary arcade?
2) What nerve is routinely “blocked” on the medial aspect of the ramus at mandibular foramen?

A

1) Superior alveolar nerve is in 3 parts, and supplies the sinuses, gingivae and maxilla teeth, whereas on the mandibular arcade…
2) …The inferior alveolar nerve is blocked. It forms the inferior dental plexuses, which supply all the mandibular teeth.

71
Q

TMJ dysfunction is common due to various issues – grinding teeth, chewing excessively, arthritis, subluxation resulting in pain with opening and closing the mouth.

Pain is often referred to or mistaken to arise from what structure that is located just posterior to the TMJ?

A

Often mistaken as ear pain.

72
Q

Blunt trauma to the temporal fossa may lead to an intracranial hemorrhage (ICH).

1&2) Which vessel is most vulnerable and what type of ICH results? Why?
3) What can also be damaged?

A

1) Middle meningeal artery; epidural hematoma
2) Due to its superficial location in the temporal region.
2) Internal carotid artery may also be damaged, leading to SAH.

73
Q

Blunt trauma to the lateral head over the zygomatic arch and ramus of the mandible can impact the contents of the infratemporal fossa.

Based on the anatomy, which major vessels, nerves, and ganglia might be affected and the clinical symptoms associated?

A

1) Maxillary artery, pterygoid plexus, inferior alveolar vein
2) Mandibular nerve (CN V3)
3) Otic ganglion of the parasympathetic
4) Can cause mandibular nerve compression or go undetected

74
Q

1) What is unique about the motor innervation of the muscles of mastication?
2) What are these muscles? (4)
3) How do you clinically test this nerve?

A

1) The muscles are solely innervated by CN V3.
2) Masseter, temporalis, lateral pterygoid, and medial pterygoid muscle
3) Move hands over patient’s chin and ask if they can feel it and if it’s the same on both sides, and feel the pt clench their jaw

75
Q

What is the difference between buccal gingiva and lingual gingiva?

A

Buccal is the side of teeth closest to cheek, lingual is side closest to tongue

76
Q

What is the difference between the oral vestibule and oral cavity proper?

A

The oral vestibule is a small, horseshoe-shaped space between the lips and cheeks, while the oral cavity proper is the larger part of the mouth that contains the tongue

77
Q

What lymph nodes drain the right and left side of the oral cavity and tongue?

A

Submandibular lymph nodes

78
Q

1) What cranial nerves are used to stick the tongue out?
2) What is the afferent component of the gag reflex? What does it control and what would happen if it was injured?
3) What is the efferent component of the gag reflex? What does it control and what would happen if it was injured?

A

1) CN12
2) CN9
-Carries info from posterior pharyngeal wall, tonsillar pillars + base of tongue; results in absence of gag reflex if injured
3) CN10
-Controls bilateral contraction of pharyngeal muscles; results in difficulty swallowing if injured

79
Q

1) How do you count the teeth of the maxillary arch?
2) How do you count the teeth of the mandibular arch?

A

1) Start with rear right wisdom tooth (3rd molar) as #1. Top arch is 1-16.
2) Start with rear left wisdom tooth (3rd molar) as #17. Bottom arch is 17-32.

80
Q

What is the mnemonic to remember the innervation of the EOMs?

A

LR6SO4AO3

81
Q

Describe how to count each type of tooth, and how many of each type there are

A

1) Molars: Rear back 3 teeth.
-Count from the back to front: 3,2,1.
2) Premolars: Next 2 teeth.
-Again count back to front- 2,1.
3) Canine tooth: Next 1 tooth.
4) Incisors: Last two teeth.
-Again count backwards, 2,1.
(pertains to both top and bottom)

82
Q

1) What cranial nerves provide input to the salivary glands?
2) Compare the sympathetic vs. parasympathetic actions

A

1) CN 7 & CN 9.
2) Parasympathetic- influences saliva quantity
Sympathetic- influences saliva quality

83
Q

Describe how the parotid salivary gland is innervated (both sympathetic and parasympathetic)

A

1) Parasympathetic from CN9
2) Sympathetic from superior cervical ganglion (following external carotid).

84
Q

Describe how the submandibular and sublingual salivary glands are innervated (both sympathetic and parasympathetic)

A

1) Both get parasympathetic from CN7, which synapses at submandibular ganglion.
-Goes directly to submandibular and follows lingual nerve for sublingual glands
2) Both get sympathetic from superior cervical ganglion, follow the facial artery and other vessels.

85
Q

List the 5 lymph nodes of the head

A

Occipital, mastoid, parotid, submental, submandibular, superficial cervical

86
Q

What are the two categories of lymph nodes of the neck? Describe where each is or what their names are

A

1) Superficial cervical lymph nodes (located by EJV).
2) Deep cervical nodes: prelaryngeal, pretracheal, paratracheal, and retropharyngeal.

87
Q

1) Where does the lacrimal duct open?
2) Where does the pharyngotympanic tube open?
3) Where does the sphenoid sinus open?

A

1) Nasal cavity
2) Nasopharynx
3) Sphenoethmoidal recess

88
Q

Where do the ethmoid sinuses drain?

A

1) Anterior and middle drain to middle meatus.
2) Superior drain to superior meatus.

89
Q

Where do the frontal and maxillary sinuses drain?

A

Both drain to middle meatus

90
Q

What nerves share the sensory innervation of the ear, auditory canal, and lateral surface of the TM?

A

Auriculotemporal nerve (a branch of the trigeminal nerve, CN V3) and the auricular branch of the vagus nerve (CN X).

91
Q

Ear infections may result in adenopathy of which lymph nodes?

A

Preauricular lymph nodes (located in front of ear)
Posterior auricular lymph node (located behind ear)

92
Q

How is the middle ear connected to the pharynx?
How is this structure’s function tested clinically in adults and young children?

A

Connected via Eustachian tube.
Adults- pull ear up
Kids- pull ear down

93
Q

1) What CN are involved with hearing and balance?
2) Which inner ear structure is involved with hearing?
3) With balance?

A

1) CN8 (vestibulocochlear)
2) Cochlea
3) Vestibular system (semicircular canals esp.)

94
Q

1) To image the structures of the cranium (neuro and viscerocranium), what type of imaging is often used?
2) Why?

A

1) Advanced imaging ( CT and MRI) is often used.
2) Plain films are not very useful for detailed analysis.

(PA school) Gross Anatomy (52 decks)

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