Week 4 - head and neck (eyes and ears) Flashcards
1
Q
What is the posterior nasal aperture?
A
Choana - between nasal cavity and nasopharynx
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
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
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
5
Q
Where are the adenoids?
A
On the posterosuperior wall of the nasopharynx
6
Q
What are the two mucosal folds at the back of the soft palate?
A
Palatoglossal arch (anteriorly)
Palatopharyngeal arch (posteriorly)
7
Q
Where do the palatine tonsils sit?
A
Between the palatoglossal and palatopharyngeal arches
8
Q
What is the fauces?
A
The transitional region between the oral cavity and the oropharynx
9
Q
Which muscles helps to open the eustachian tube?
A
levator veli palatini, tensor veli palatini, (salpingopharyngeus)
10
Q
How much of the palate is hard and soft?
A
2/3rds hard palate, posterior 1/3rd = soft
11
Q
What is the name of the foramen on midline of the maxilla behind the front teeth?
A
Incisive foramen
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)
13
Q
What happens to the soft palate during swallowing?
A
It rises and completely blocks the nasal cavity from the mouth
14
Q
Which part of speech is the soft palate involved in?
A
Pronunciation of consonants
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)
16
Q
What are the five palatine muscles?
A
Palatoglossus, palatopharyngeus, tensor veli palatini, levator veli palatini, musculus uvulae
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
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
19
Q
Which muscle elevates the uvula?
A
The musculus uvulae
20
Q
Which muscles contract to close off the nasopharynx?
A
musculus uvulae and levator veli palatini
21
Q
What are the attachments of the palatopharyngeus muscles?
A
O: posterior hard palate
I: posterior border of thyroid cartilage
22
Q
What does the palatoglossus muscle do?
A
Elevates the tongue
23
Q
Where are the palatine tonsils?
A
Between the palatoglossal arch anteriorly and the palatopharyngeal arch posteriorly
24
Q
Which nerve does the greater and lesser palatine nerves come from?
A
Maxillary division of Trigeminal
25
What does the greater palatine nerve supply?
Majority of gingiva, mucosa and glands of the hard palate
26
What does the lesser palatine nerve supply?
Soft palate, with contributions from glossopharyngeal, and taste with contributions from greater petrosal nerve (from facial nerve)
27
Where are the greater palatine foramina?
At the lateral edge of the join of the palatine and maxillary bones. lesser palatine foramina are just posterior to it.
28
What structures pass through the greater palatine foramina?
Greater palatine nerves and vessels
29
Where is the palatine raphe?
The midline of the palate, on the underside
30
Where are the sublingual and submandibular salivary gland orifices?
Under the tongue, submandibular is more central to sublingual
31
What are the three divisions of the tongue?
apex, body, root
32
Where is the terminal sulcus?
A horizonal line across the upper surface of the back of the tongue, dividing the body with the root of the tongue
33
Where are the lingual tonsils?
Posterior to the terminal sulcus on the root of the tongue
34
Where are the sublingual glands?
Bilateral structures, under the tongue, bordered by mandible anteroinferiorly and genioglossus muscle posteroinferiorly, myohyoid inferiorly.
35
Which nerve innervates the sublingual gland?
Facial nerve via chorda tympani
36
Where are the submandibular glands?
Paired structures in the submandibular fossa of each side of the mandible
37
What is the submandibular duct?
(Wharton's duct) drains the submandibular gland contents into the floor of the mouth,
38
What is the sublingual caruncle?
The opening papilla of the submandibular duct either side of the frenulum
39
Which nerve does the lingual nerve come from?
Mandibular division of the trigeminal nerve
40
What does the lingual nerve supply?
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
41
What does the lingual nerve supply?
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
42
What is the submandibular ganglion?
The parasympathetic ganglia suspended from the lingual nerve, inferior to submandibular duct - near 3rd molar, supplies secretomotor fibres to sublingual and submandibular glands
43
What are the intrinsic muscles of the tongue?
Superior longitudinal, inferior longitudinal, transverse and vertical muscles
44
What are the extrinsic muscles of the tongue?
Genioglossus, hyoglossus, styloglossus and palatoglossus (get high stop pain)
45
What is the innervation to the muscles of the tongue?
Hypoglossal nerve for all except palatoglossus which is innervated by vagus
46
What is the pathway for taste in the anterior 2/3rds of the tongue?
facial nerve (CN VII) → chorda tympani → geniculate and otic ganglia → anterior solitary tract nucleus→ central tegmental tract → thalamus → gustatory cortex
47
What is the pathway for taste in the posterior 1/3rd of the tongue?
superior laryngeal and glossopharyngeal (CN IX) nerves → inferior glossopharyngeal and inferior vagal ganglia → anterior solitary tract nucleus→ central tegmental tract → thalamus → gustatory cortex
48
What do the intrinsic muscles of the tongue do?
Alter the shape of the tongue
49
What do the extrinsic muscles of the tongue do?
Alter the position of the tongue
50
What are the attachments of genioglossus?
O: superior mental spine of mandible
I: dorsum of tongue, body of hyoid bone
51
What is the action of genioglossus?
Depresses and protrudes tongue (bilateral contraction), Deviates tongue contralaterally (unilateral contraction)
52
What are the attachments of hyoglossus?
O: body and greater horn of hyoid bone
I: interior parts of the lateral tongue
53
What are the actions of hyoglossus?
Depresses and retracts tongue
54
What are the attachments of styloglossus?
O: anterolateral aspect of styloid process, stylomandibular ligament
I: blends with inferior longitudinal muscle and hyoglossus muscle
55
What are the actions of styloglossus?
Retracts and elevates lateral aspect of the tongue
56
What are the attachments of palatoglossus?
O: palatine aponeurosis of soft palate
I: Lateral margins of tongue, blends with intrinsic muscles
57
What are the actions of palatoglossus?
Elevates root of tongue
58
Which nerve innervates palatoglossus?
Vagus nerve
59
Where does the hypoglossal nerve lie in relation to the lingual nerve?
Inferior to it
60
Which two muscles does the hypoglossal nerve run between?
Hypoglossus and mylohyoid
61
Which artery is the sublingual artery a branch of?
The lingual artery - from external carotid
62
What are the four types of papilla found on the tongue?
Fungiform, filiform, vallate, foliate
63
What do the filiform papillae look like?
Tiny irregularities
64
What do the fungiform papilla look like?
White bumps
65
What do the foliate papilla look like?
Ridges (at the side of the tongue)
66
What do vallate papilla look like?
red ulcers - at the back of the tongue
67
What are the internal nares/naris?
the choana - posterior nasal opening into nasopharynx
68
What are the cartilages that make up the external nose?
Septal cartilage, lateral nasal cartilages (sides of nose), alar cartilages (nostrils and front of nose)
69
What are the three structures that separate the left and right nasal cavities?
Nasal septum, perpendicular plate of ethmoid and vomer
70
Which two ridges separate the left and right floor of the nasal cavities?
Nasal crest of maxilla and nasal crest of palatine bone
71
Where is the sphenoethmoidal recess?
On the lateral wall of the nasal cavity, posterior to the superior nasal conchae
72
What is the difference between the meatuses and the conchae?
Conchae are the scroll-shaped bones, and the meatuses are the spaces underneath the scrolls
73
What is the sphenoethmoidal recess for?
It drains the posterior ethmoid air cells and sphenoid sinuses into the superior meatus
74
Where do the maxillary paranasal sinuses open into?
The middle meatuses
75
Which bones make up the roof of the orbit?
Lesser wing of sphenoid, orbital plate of frontal bone
76
Which bones make up the lateral wall of the orbit?
Zygomatic process of frontal bone, greater wing of sphenoid bone, orbital surface of zygomatic bone
77
Which bones make up the medial wall of the orbit?
Sphenoid body, orbital plate of ethmoid bone, frontal process of maxilla, lacrimal bone
78
Which bones make up the floor of the orbit?
Orbital process of palatine bone, orbital surface of maxillary bone, zygomatic bone
79
What are the medial and lateral palpebral commisures?
The medial and lateral corners of the eye
80
Where is the lacrimal caruncle?
the medial corner of the eye
81
What is the lacrimal caruncle?
Consists of sebaceous glands, sweat glands and lacrimal tissue
82
Where are the lacrimal papillas?
On the medial aspect of the upper and lower eyelids
83
What do the lacrimal papillas do?
Allow tears to drain into the nasal cavity through the lacrimal cannaliculi
84
What are the lacrimal punctum?
The holes inside the lacrimal papilla, that tears drain into
85
What are the medial and lateral canthis of the eye?
The angles in the medial and lateral corners of each eye
86
What is the sclera?
The white part of the eye - a fibrous protective layer
87
What is the cornea?
The transparent front part of the eye that covers the iris, pupil and anterior chamber
88
What does the cornea do?
Refracts light and contributes to the focussing power of the eye
89
What is the iris?
The pigmented area of the eye which is responsible for controlling the diameter and size of the pupil
90
What is the pupil?
The hole in the centre of the iris that allows light to reach the retina
91
What is the ciliary body?
An inner eye structure at the lateral border of the iris, medial to the choroid. Contains ciliary muscle, ciliary processes and ciliary vessels
92
What do the ciliary processes do?
Produce aqueous humor
93
What do the ciliary muscles do?
Change the shape of the lens
94
What are the three parts of the orbicularis oculi muscle?
Orbital part - closes eyelids tightly
Palpebral part - closes eyelids gently
Deep palpebral/lacrimal part - compresses lacrimal sac
95
What are the tarsal plates?
Dense connective tissue structures in the upper and lower eyelids that act as a scaffolding for the eyelids
96
where are the medial and lateral palpebral ligaments?
from the corners of the eyes to the corresponding bones lateral to them
97
Where does the lacrimal gland sit?
In the upper-outer aspect of each orbit
98
What is the pathway of tears?
Lacrimal gland - lacrimal duct - ocular surface - lacrimal puncta - lacrimal canaliculi - lacrimal sac - nasolacrimal duct - inferior nasal meatus
99
What are the two main branches of the frontal division of the ophthalmic nerve (CN5)?
Supratrochlear and supraorbital nerve
100
Which muscle does the trochlear nerve innervate?
Superior oblique
101
Where does the trochlear nerve sit in relation to the frontal nerve as it comes through the superior orbital fissure?
Trochlear is Medial to frontal (superior part of the fissure)
102
Which eye muscles do internal rotation of the eye?
Superior rectus and superior oblique
103
Which eye muscles do external rotation of the eye?
Inferior rectus and inferior oblique
104
Which eye muscles abduct the eye?
lateral rectus, superior and inferior oblique
105
Which eye muscles adduct the eye?
Medial rectus, superior and inferior rectus
106
Which eye muscles elevate the eye?
Superior rectus and inferior oblique
107
Which eye muscles depress the eye?
Inferior rectus and superior oblique
108
What is the origin of the four rectus muscles?
The common tendinous ring (Anulus of Zinn)
109
What is the origin of the oblique muscles of the eye?
superior: sphenoid bone
inferior: maxilla
110
What are the attachments of levator palpebrae superioris?
O: lesser wing of sphenoid bone
I: anterior surface of tarsal plate, skin of upper eyelid
111
What is the innervation to levator palpebrae superioris?
Oculomotor nerve
112
On which side of eye is the trochlear for superior oblique?
Medial side
113
Which nerves are surrounded by the annulus of Zinn?
Optic canal, optic nerve, nasociliary nerve, oculomotor nerve and abducent nerve
114
Which vein does the superior ophthalmic vein anastamose with?
The angular vein - which drains into facial vein
115
Which vessel enters the orbit through the common tendinous ring?
The ophthalmic artery
116
Why is the optic nerve unusual in terms of structure?
It is surrounded by all three meningeal layers
117
What is the vitreous body?
The clear gel fluid that fills the eyeball
118
What are the three layers of the eye?
Outer - fibrous
Middle - vascular
Inner - nervous
119
What structures are within the fibrous layer of the eye?
Sclera and cornea
120
What structures are within the vascular layer of the eye?
choroid, ciliary body, iris
121
What structures are in the nervous layer of the eye?
Retina
122
What is the macula?
The central part of the posterior retina responsible for visual acuity
123
What is the tegmen tympani?
A small plate of bone that covers the middle ear space - part of the floor of the middle cranial fossa
124
What is the helix?
The outermost ring of the pinna
125
What is the antihelix?
The curve that runs parallel to the helix, immediately medial
126
Where is the tragus?
The cartilaginous prominence superior and medial to the lobule, closest to the face
127
Where is the antitragus?
The cartilaginous prominence immediately superior and attached to the lobule
128
Where is the concha?
The bowl of the pinna
129
What is the tympanic cavity?
The middle ear space - air filled with the bones
130
What is the tympanic membrane?
The eardrum
131
Where is the groove for the greater petrosal nerve?
Just anterior to the ridge of the petrous part of the temporal bone
132
What is the greater petrosal nerve from?
It is a branch of the facial nerve that supplies the lacrimal gland
133
Where does the greater petrosal nerve come off the facial nerve?
At the geniculate ganglion
134
What are the two branches that the facial nerve gives off in the middle ear?
Stapedius and chorda tympani
135
Where does the facial nerve exit the middle ear space?
Through the stylomastoid foramen
136
Where does the greater petrosal nerve exit the skull?
Through the carotid canal
137
What is the geniculate ganglion?
An enlargement of the facial nerve as it makes an anterior to posterior turn
138
What are the three ossicle bones (from outer to inner)?
Malleus, Incus, Stapes
139
What does the tensor tympani attach to?
Attaches the eustachian tube and sphenoid bone to the handle of malleus
140
What does the tensor tympani muscle do?
Contracts during loud noises, which tightens the tympanic membrane and reduces the amplitude of the sound before it reaches the inner ear
141
What is the function of the auditory/eustachian/pharyngotympanic tube?
Equalises pressure within the tympanic cavity and atmosphere
142
At what level does the eustachian tube open out into the nasopharynx?
At the inferior nasal concha
143
What are the two parts of the eustachian tube?
Bony part - bony canal within temporal bone
Cartilaginous part - fibrocartilage tube between greater wing of sphenoid and petrous part of temporal bone
144
What is the resting state of the eustachian tube?
Closed
145
Which muscles open the eustachian tube?
Levator veli palatini and tensor veli palatini
146
Which two other muscles are involved in eustachian tube functioning?
Salpingopharyngeus and tensor tympani
147
Where is the jugular foramen in relation to the middle ear space?
The roof of the jugular foramen is the floor of the middle ear space
148
Where is the carotid canal in relation to the middle ear space?
The anterior wall of the tympanic cavity is the posterior wall of the carotid canal
149
What are the features of the tympanic membrane?
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
What does the foot-plate of the stapes sit over?
The oval window
151
What are the main components of the inner ear?
Cochlear (hearing)
Vestibular - utricle and saccule (balance while stationary)
Semi-circular canals (balance while in motion)
152
The inner ear is embedded within which bone?
The petrous part of the temporal bone
153
Which fluid flows between the osseous and the membranous labyrinth?
Perilymph
154
What fluid flows within the membranous labyrinth?
Endolymph
155
What are the three spaces within the cochlear called?
Scala vestibuli (top)
Scala media/cochlear duct
Scala tympani (bottom)
156
What is the bony core of the cochlear called?
The modiolus
157
What is the round window between?
The cochlear canal and the middle ear space - although is covered by the secondary tympanic membrane
158
Where does endolymph enter the cochlear duct?
from the saccule via the ductus reuniens
159
Are the scala tympani and scala vestibuli connected?
Yes at the apex of the modiolus at the helicotrema. The cochlear duct is not connected.
160
Where does perilymph from the cochlear canal drain into?
The subarachnoid space by IAM, via cochlear aqueduct and cochlear canaliculus
161
What are the two membranes that separate the three sections of the cochlear?
Reissner's - between scala vestibuli and media
Basilar membrane - between scala tympani and media
162
where is the tectorial membrane?
Overlying the hair cells of the organ of corti in the cochlear duct
163
What are the six orifices that open into the vestibule?
5 from the semi-circular canals and one from the scala vestibuli
164
What does the oval window connect?
The middle ear space with the vestibule
165
What do the utricle and saccule communicate with?
They are membranous sacs within the bony vestibule.
Saccule - communicates with cochlear duct vis ductus reuniens
Utricle - communicates with semi-circular ducts
166
Where do the utricle and saccule lie in relation to each other?
Utricle = posterosuperior
Saccule = anteroinferior
167
What does the endolymphatic duct and sac do?
From the utricle and saccule, drain endolymph to be reabsorbed by epithelia
168
What do the utricle and saccule do?
utricle detects horizonal acceleration
saccule detects vertical acceleration
169
What are the three semicircular canals?
Superior (anterior) - detects nodding
Posterior - detects head tilt to left/right
Lateral - detects shaking head
170
Which artery supplies the inner ear?
Labyrinthine artery - branch of the basilar
also some from stylomastoid artery from external carotid
171
Which nerves is the pharyngeal plexus made up from?
Motor component - from vagus nerve
Sensory component - from glossopharyngeal (primarily)
