Week 4 - head and neck (eyes and ears) Flashcards

1
Q

What is the posterior nasal aperture?

A

Choana - between nasal cavity and nasopharynx

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2
Q

What are the functions of the eustachian tube/pharyngotympanic tube?

A

Aeration of middle ear, equalisation of pressure, clearance of secretions, protection of the middle ear

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3
Q

What is the torus tubarius?

A

The cartilaginous portion of the eustachian tube, and a arch-shaped prominence over the opening into the nasopharynx

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4
Q

Where is the pharyngeal recess/ fossa of Rosenmuller?

A

On the posterolateral aspect of the nasal cavity, lateral to the superior nasal conches

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5
Q

Where are the adenoids?

A

On the posterosuperior wall of the nasopharynx

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6
Q

What are the two mucosal folds at the back of the soft palate?

A

Palatoglossal arch (anteriorly)
Palatopharyngeal arch (posteriorly)

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7
Q

Where do the palatine tonsils sit?

A

Between the palatoglossal and palatopharyngeal arches

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8
Q

What is the fauces?

A

The transitional region between the oral cavity and the oropharynx

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9
Q

Which muscles helps to open the eustachian tube?

A

levator veli palatini, tensor veli palatini, (salpingopharyngeus)

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10
Q

How much of the palate is hard and soft?

A

2/3rds hard palate, posterior 1/3rd = soft

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11
Q

What is the name of the foramen on midline of the maxilla behind the front teeth?

A

Incisive foramen

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12
Q

Where are the greater and lesser palatine foramina?

A

Either side, between the lateral aspect of the palatine bone and the maxillary bone (greater is anterior to lesser)

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13
Q

What happens to the soft palate during swallowing?

A

It rises and completely blocks the nasal cavity from the mouth

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14
Q

Which part of speech is the soft palate involved in?

A

Pronunciation of consonants

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15
Q

What is the innervation to the muscles of the soft palate?

A

Pharyngeal plexus (from vagus)- except tensor veli palatini (mandibular branch of the trigeminal nerve)

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16
Q

What are the five palatine muscles?

A

Palatoglossus, palatopharyngeus, tensor veli palatini, levator veli palatini, musculus uvulae

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17
Q

What are the actions of tensor veli palatini and levator veli palatini?

A

Levator - elevates the soft palate
Tensor - broadens the soft palate

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18
Q

Where is the pterygoid hamulus?

A

A hook at the point where the palatine and sphenoid bones meet - acts as a pulley for tensor veli palatini

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19
Q

Which muscle elevates the uvula?

A

The musculus uvulae

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20
Q

Which muscles contract to close off the nasopharynx?

A

musculus uvulae and levator veli palatini

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21
Q

What are the attachments of the palatopharyngeus muscles?

A

O: posterior hard palate
I: posterior border of thyroid cartilage

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22
Q

What does the palatoglossus muscle do?

A

Elevates the tongue

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23
Q

Where are the palatine tonsils?

A

Between the palatoglossal arch anteriorly and the palatopharyngeal arch posteriorly

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24
Q

Which nerve does the greater and lesser palatine nerves come from?

A

Maxillary division of Trigeminal

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25
Q

What does the greater palatine nerve supply?

A

Majority of gingiva, mucosa and glands of the hard palate

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26
Q

What does the lesser palatine nerve supply?

A

Soft palate, with contributions from glossopharyngeal, and taste with contributions from greater petrosal nerve (from facial nerve)

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27
Q

Where are the greater palatine foramina?

A

At the lateral edge of the join of the palatine and maxillary bones. lesser palatine foramina are just posterior to it.

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28
Q

What structures pass through the greater palatine foramina?

A

Greater palatine nerves and vessels

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29
Q

Where is the palatine raphe?

A

The midline of the palate, on the underside

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30
Q

Where are the sublingual and submandibular salivary gland orifices?

A

Under the tongue, submandibular is more central to sublingual

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31
Q

What are the three divisions of the tongue?

A

apex, body, root

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32
Q

Where is the terminal sulcus?

A

A horizonal line across the upper surface of the back of the tongue, dividing the body with the root of the tongue

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33
Q

Where are the lingual tonsils?

A

Posterior to the terminal sulcus on the root of the tongue

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34
Q

Where are the sublingual glands?

A

Bilateral structures, under the tongue, bordered by mandible anteroinferiorly and genioglossus muscle posteroinferiorly, myohyoid inferiorly.

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35
Q

Which nerve innervates the sublingual gland?

A

Facial nerve via chorda tympani

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36
Q

Where are the submandibular glands?

A

Paired structures in the submandibular fossa of each side of the mandible

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37
Q

What is the submandibular duct?

A

(Wharton’s duct) drains the submandibular gland contents into the floor of the mouth,

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38
Q

What is the sublingual caruncle?

A

The opening papilla of the submandibular duct either side of the frenulum

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39
Q

Which nerve does the lingual nerve come from?

A

Mandibular division of the trigeminal nerve

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40
Q

What does the lingual nerve supply?

A

Sensory: mucosa of anterior 2/3rds of the tongue, floor of the mouth and lingual gingiva
Special sensory: anterior 2/3rds of the tongue
Parasympathetic: submandibular and sublingual glands

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41
Q

What does the lingual nerve supply?

A

Sensory: mucosa of anterior 2/3rds of the tongue, floor of the mouth and lingual gingiva
Special sensory: anterior 2/3rds of the tongue
Parasympathetic: submandibular and sublingual glands

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42
Q

What is the submandibular ganglion?

A

The parasympathetic ganglia suspended from the lingual nerve, inferior to submandibular duct - near 3rd molar, supplies secretomotor fibres to sublingual and submandibular glands

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43
Q

What are the intrinsic muscles of the tongue?

A

Superior longitudinal, inferior longitudinal, transverse and vertical muscles

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44
Q

What are the extrinsic muscles of the tongue?

A

Genioglossus, hyoglossus, styloglossus and palatoglossus (get high stop pain)

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45
Q

What is the innervation to the muscles of the tongue?

A

Hypoglossal nerve for all except palatoglossus which is innervated by vagus

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46
Q

What is the pathway for taste in the anterior 2/3rds of the tongue?

A

facial nerve (CN VII) → chorda tympani → geniculate and otic ganglia → anterior solitary tract nucleus→ central tegmental tract → thalamus → gustatory cortex

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47
Q

What is the pathway for taste in the posterior 1/3rd of the tongue?

A

superior laryngeal and glossopharyngeal (CN IX) nerves → inferior glossopharyngeal and inferior vagal ganglia → anterior solitary tract nucleus→ central tegmental tract → thalamus → gustatory cortex

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48
Q

What do the intrinsic muscles of the tongue do?

A

Alter the shape of the tongue

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49
Q

What do the extrinsic muscles of the tongue do?

A

Alter the position of the tongue

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50
Q

What are the attachments of genioglossus?

A

O: superior mental spine of mandible
I: dorsum of tongue, body of hyoid bone

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51
Q

What is the action of genioglossus?

A

Depresses and protrudes tongue (bilateral contraction), Deviates tongue contralaterally (unilateral contraction)

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52
Q

What are the attachments of hyoglossus?

A

O: body and greater horn of hyoid bone
I: interior parts of the lateral tongue

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53
Q

What are the actions of hyoglossus?

A

Depresses and retracts tongue

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54
Q

What are the attachments of styloglossus?

A

O: anterolateral aspect of styloid process, stylomandibular ligament
I: blends with inferior longitudinal muscle and hyoglossus muscle

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55
Q

What are the actions of styloglossus?

A

Retracts and elevates lateral aspect of the tongue

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56
Q

What are the attachments of palatoglossus?

A

O: palatine aponeurosis of soft palate
I: Lateral margins of tongue, blends with intrinsic muscles

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57
Q

What are the actions of palatoglossus?

A

Elevates root of tongue

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58
Q

Which nerve innervates palatoglossus?

A

Vagus nerve

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59
Q

Where does the hypoglossal nerve lie in relation to the lingual nerve?

A

Inferior to it

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60
Q

Which two muscles does the hypoglossal nerve run between?

A

Hypoglossus and mylohyoid

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61
Q

Which artery is the sublingual artery a branch of?

A

The lingual artery - from external carotid

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62
Q

What are the four types of papilla found on the tongue?

A

Fungiform, filiform, vallate, foliate

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63
Q

What do the filiform papillae look like?

A

Tiny irregularities

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64
Q

What do the fungiform papilla look like?

A

White bumps

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65
Q

What do the foliate papilla look like?

A

Ridges (at the side of the tongue)

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66
Q

What do vallate papilla look like?

A

red ulcers - at the back of the tongue

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67
Q

What are the internal nares/naris?

A

the choana - posterior nasal opening into nasopharynx

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68
Q

What are the cartilages that make up the external nose?

A

Septal cartilage, lateral nasal cartilages (sides of nose), alar cartilages (nostrils and front of nose)

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69
Q

What are the three structures that separate the left and right nasal cavities?

A

Nasal septum, perpendicular plate of ethmoid and vomer

70
Q

Which two ridges separate the left and right floor of the nasal cavities?

A

Nasal crest of maxilla and nasal crest of palatine bone

71
Q

Where is the sphenoethmoidal recess?

A

On the lateral wall of the nasal cavity, posterior to the superior nasal conchae

72
Q

What is the difference between the meatuses and the conchae?

A

Conchae are the scroll-shaped bones, and the meatuses are the spaces underneath the scrolls

73
Q

What is the sphenoethmoidal recess for?

A

It drains the posterior ethmoid air cells and sphenoid sinuses into the superior meatus

74
Q

Where do the maxillary paranasal sinuses open into?

A

The middle meatuses

75
Q

Which bones make up the roof of the orbit?

A

Lesser wing of sphenoid, orbital plate of frontal bone

76
Q

Which bones make up the lateral wall of the orbit?

A

Zygomatic process of frontal bone, greater wing of sphenoid bone, orbital surface of zygomatic bone

77
Q

Which bones make up the medial wall of the orbit?

A

Sphenoid body, orbital plate of ethmoid bone, frontal process of maxilla, lacrimal bone

78
Q

Which bones make up the floor of the orbit?

A

Orbital process of palatine bone, orbital surface of maxillary bone, zygomatic bone

79
Q

What are the medial and lateral palpebral commisures?

A

The medial and lateral corners of the eye

80
Q

Where is the lacrimal caruncle?

A

the medial corner of the eye

81
Q

What is the lacrimal caruncle?

A

Consists of sebaceous glands, sweat glands and lacrimal tissue

82
Q

Where are the lacrimal papillas?

A

On the medial aspect of the upper and lower eyelids

83
Q

What do the lacrimal papillas do?

A

Allow tears to drain into the nasal cavity through the lacrimal cannaliculi

84
Q

What are the lacrimal punctum?

A

The holes inside the lacrimal papilla, that tears drain into

85
Q

What are the medial and lateral canthis of the eye?

A

The angles in the medial and lateral corners of each eye

86
Q

What is the sclera?

A

The white part of the eye - a fibrous protective layer

87
Q

What is the cornea?

A

The transparent front part of the eye that covers the iris, pupil and anterior chamber

88
Q

What does the cornea do?

A

Refracts light and contributes to the focussing power of the eye

89
Q

What is the iris?

A

The pigmented area of the eye which is responsible for controlling the diameter and size of the pupil

90
Q

What is the pupil?

A

The hole in the centre of the iris that allows light to reach the retina

91
Q

What is the ciliary body?

A

An inner eye structure at the lateral border of the iris, medial to the choroid. Contains ciliary muscle, ciliary processes and ciliary vessels

92
Q

What do the ciliary processes do?

A

Produce aqueous humor

93
Q

What do the ciliary muscles do?

A

Change the shape of the lens

94
Q

What are the three parts of the orbicularis oculi muscle?

A

Orbital part - closes eyelids tightly
Palpebral part - closes eyelids gently
Deep palpebral/lacrimal part - compresses lacrimal sac

95
Q

What are the tarsal plates?

A

Dense connective tissue structures in the upper and lower eyelids that act as a scaffolding for the eyelids

96
Q

where are the medial and lateral palpebral ligaments?

A

from the corners of the eyes to the corresponding bones lateral to them

97
Q

Where does the lacrimal gland sit?

A

In the upper-outer aspect of each orbit

98
Q

What is the pathway of tears?

A

Lacrimal gland - lacrimal duct - ocular surface - lacrimal puncta - lacrimal canaliculi - lacrimal sac - nasolacrimal duct - inferior nasal meatus

99
Q

What are the two main branches of the frontal division of the ophthalmic nerve (CN5)?

A

Supratrochlear and supraorbital nerve

100
Q

Which muscle does the trochlear nerve innervate?

A

Superior oblique

101
Q

Where does the trochlear nerve sit in relation to the frontal nerve as it comes through the superior orbital fissure?

A

Trochlear is Medial to frontal (superior part of the fissure)

102
Q

Which eye muscles do internal rotation of the eye?

A

Superior rectus and superior oblique

103
Q

Which eye muscles do external rotation of the eye?

A

Inferior rectus and inferior oblique

104
Q

Which eye muscles abduct the eye?

A

lateral rectus, superior and inferior oblique

105
Q

Which eye muscles adduct the eye?

A

Medial rectus, superior and inferior rectus

106
Q

Which eye muscles elevate the eye?

A

Superior rectus and inferior oblique

107
Q

Which eye muscles depress the eye?

A

Inferior rectus and superior oblique

108
Q

What is the origin of the four rectus muscles?

A

The common tendinous ring (Anulus of Zinn)

109
Q

What is the origin of the oblique muscles of the eye?

A

superior: sphenoid bone
inferior: maxilla

110
Q

What are the attachments of levator palpebrae superioris?

A

O: lesser wing of sphenoid bone
I: anterior surface of tarsal plate, skin of upper eyelid

111
Q

What is the innervation to levator palpebrae superioris?

A

Oculomotor nerve

112
Q

On which side of eye is the trochlear for superior oblique?

A

Medial side

113
Q

Which nerves are surrounded by the annulus of Zinn?

A

Optic canal, optic nerve, nasociliary nerve, oculomotor nerve and abducent nerve

114
Q

Which vein does the superior ophthalmic vein anastamose with?

A

The angular vein - which drains into facial vein

115
Q

Which vessel enters the orbit through the common tendinous ring?

A

The ophthalmic artery

116
Q

Why is the optic nerve unusual in terms of structure?

A

It is surrounded by all three meningeal layers

117
Q

What is the vitreous body?

A

The clear gel fluid that fills the eyeball

118
Q

What are the three layers of the eye?

A

Outer - fibrous
Middle - vascular
Inner - nervous

119
Q

What structures are within the fibrous layer of the eye?

A

Sclera and cornea

120
Q

What structures are within the vascular layer of the eye?

A

choroid, ciliary body, iris

121
Q

What structures are in the nervous layer of the eye?

A

Retina

122
Q

What is the macula?

A

The central part of the posterior retina responsible for visual acuity

123
Q

What is the tegmen tympani?

A

A small plate of bone that covers the middle ear space - part of the floor of the middle cranial fossa

124
Q

What is the helix?

A

The outermost ring of the pinna

125
Q

What is the antihelix?

A

The curve that runs parallel to the helix, immediately medial

126
Q

Where is the tragus?

A

The cartilaginous prominence superior and medial to the lobule, closest to the face

127
Q

Where is the antitragus?

A

The cartilaginous prominence immediately superior and attached to the lobule

128
Q

Where is the concha?

A

The bowl of the pinna

129
Q

What is the tympanic cavity?

A

The middle ear space - air filled with the bones

130
Q

What is the tympanic membrane?

A

The eardrum

131
Q

Where is the groove for the greater petrosal nerve?

A

Just anterior to the ridge of the petrous part of the temporal bone

132
Q

What is the greater petrosal nerve from?

A

It is a branch of the facial nerve that supplies the lacrimal gland

133
Q

Where does the greater petrosal nerve come off the facial nerve?

A

At the geniculate ganglion

134
Q

What are the two branches that the facial nerve gives off in the middle ear?

A

Stapedius and chorda tympani

135
Q

Where does the facial nerve exit the middle ear space?

A

Through the stylomastoid foramen

136
Q

Where does the greater petrosal nerve exit the skull?

A

Through the carotid canal

137
Q

What is the geniculate ganglion?

A

An enlargement of the facial nerve as it makes an anterior to posterior turn

138
Q

What are the three ossicle bones (from outer to inner)?

A

Malleus, Incus, Stapes

139
Q

What does the tensor tympani attach to?

A

Attaches the eustachian tube and sphenoid bone to the handle of malleus

140
Q

What does the tensor tympani muscle do?

A

Contracts during loud noises, which tightens the tympanic membrane and reduces the amplitude of the sound before it reaches the inner ear

141
Q

What is the function of the auditory/eustachian/pharyngotympanic tube?

A

Equalises pressure within the tympanic cavity and atmosphere

142
Q

At what level does the eustachian tube open out into the nasopharynx?

A

At the inferior nasal concha

143
Q

What are the two parts of the eustachian tube?

A

Bony part - bony canal within temporal bone
Cartilaginous part - fibrocartilage tube between greater wing of sphenoid and petrous part of temporal bone

144
Q

What is the resting state of the eustachian tube?

A

Closed

145
Q

Which muscles open the eustachian tube?

A

Levator veli palatini and tensor veli palatini

146
Q

Which two other muscles are involved in eustachian tube functioning?

A

Salpingopharyngeus and tensor tympani

147
Q

Where is the jugular foramen in relation to the middle ear space?

A

The roof of the jugular foramen is the floor of the middle ear space

148
Q

Where is the carotid canal in relation to the middle ear space?

A

The anterior wall of the tympanic cavity is the posterior wall of the carotid canal

149
Q

What are the features of the tympanic membrane?

A

Umbo - central depression where malleus attaches
Handle of malleus - behind membrane to 1 O’clock position
Cone of light - at 5 O’clock position
Pars flaccida - top part of the membrane
Pars tensa - bottom part of the membrane

150
Q

What does the foot-plate of the stapes sit over?

A

The oval window

151
Q

What are the main components of the inner ear?

A

Cochlear (hearing)
Vestibular - utricle and saccule (balance while stationary)
Semi-circular canals (balance while in motion)

152
Q

The inner ear is embedded within which bone?

A

The petrous part of the temporal bone

153
Q

Which fluid flows between the osseous and the membranous labyrinth?

A

Perilymph

154
Q

What fluid flows within the membranous labyrinth?

A

Endolymph

155
Q

What are the three spaces within the cochlear called?

A

Scala vestibuli (top)
Scala media/cochlear duct
Scala tympani (bottom)

156
Q

What is the bony core of the cochlear called?

A

The modiolus

157
Q

What is the round window between?

A

The cochlear canal and the middle ear space - although is covered by the secondary tympanic membrane

158
Q

Where does endolymph enter the cochlear duct?

A

from the saccule via the ductus reuniens

159
Q

Are the scala tympani and scala vestibuli connected?

A

Yes at the apex of the modiolus at the helicotrema. The cochlear duct is not connected.

160
Q

Where does perilymph from the cochlear canal drain into?

A

The subarachnoid space by IAM, via cochlear aqueduct and cochlear canaliculus

161
Q

What are the two membranes that separate the three sections of the cochlear?

A

Reissner’s - between scala vestibuli and media
Basilar membrane - between scala tympani and media

162
Q

where is the tectorial membrane?

A

Overlying the hair cells of the organ of corti in the cochlear duct

163
Q

What are the six orifices that open into the vestibule?

A

5 from the semi-circular canals and one from the scala vestibuli

164
Q

What does the oval window connect?

A

The middle ear space with the vestibule

165
Q

What do the utricle and saccule communicate with?

A

They are membranous sacs within the bony vestibule.
Saccule - communicates with cochlear duct vis ductus reuniens
Utricle - communicates with semi-circular ducts

166
Q

Where do the utricle and saccule lie in relation to each other?

A

Utricle = posterosuperior
Saccule = anteroinferior

167
Q

What does the endolymphatic duct and sac do?

A

From the utricle and saccule, drain endolymph to be reabsorbed by epithelia

168
Q

What do the utricle and saccule do?

A

utricle detects horizonal acceleration
saccule detects vertical acceleration

169
Q

What are the three semicircular canals?

A

Superior (anterior) - detects nodding
Posterior - detects head tilt to left/right
Lateral - detects shaking head

170
Q

Which artery supplies the inner ear?

A

Labyrinthine artery - branch of the basilar
also some from stylomastoid artery from external carotid

171
Q

Which nerves is the pharyngeal plexus made up from?

A

Motor component - from vagus nerve
Sensory component - from glossopharyngeal (primarily)