Week 8 - Head and Neck Anatomy Flashcards
Be able to identify/outline bones of the skull:
Draw out/label diagram
What is the rule of 4’s RE cranial nerve origins?
First 4 = above the pons
Middle 4 = Pons
Last 4 = below pons
What artery supplies the majority of the face?
External carotid
What are the branches of the external carotid artery?
S: superior thyroid artery
A: ascending pharyngeal artery
L: lingual artery
F: facial artery
O: occipital artery
P: posterior auricular artery
M: maxillary
S: superficial temporal artery
What are the arteries that anastomose at the Kiesselbach plexus to supply the nose?
- Anterior ethmoidal
- Posterior ehtmoidal
- Sphenopalatine
- Superior labial
- Greater palatine
Where do the terminal branches of the facial nerve appear in the face?
Parotid gland (anterior border)
What are the branches of the facial nerve from superior to inferior?
**To Zanzibar by motor car
Temporal
Zygomatic
Buccal
Marginal mandibular
Cervical
What muscles in the face are NOT supplied by the facial nerve?
Medial pterygoid
Lateral pterygoid
Masseter
Temporalis
**Muscles of mastication
What bones make up the orbit?
Roof = frontal
Medial = maxilla + ethmoid, sphenoid, lacrimal
Inferior = zygomatic and zygomatic process of maxilla
Lateral = zygomatic bone
What supplies sensory innervation to the face?
Trigeminal nerve - V1, V2, V3
Ophthalmic
Maxillary
Mandibular branches
Describe the venous drainage of the face?
Veins follow the path of arteries, eventually terminating the external jugular vein –> subclavian vein
How does the optic nerve enter the cranium? What travels with it?
Optic canal, ophthalmic arteries
What structures traverse the superior orbital fissure?
Oculomotor nerve
Trochlear nerve
Ophthalmic division of trigeminal nerve
Abducens nerve
Where do V2 and V3 of trigeminal nerve traverse?
Think round!
V2 = foramen rotundum
V3 = foramen ovale
Where does CN VII exit?
Through internal acoustic meatus in temporal bone and out through stylomastoid foramen
What structures pass via the jugular foramen?
CN IX, X, XI
Jugular vein
Where does the hypoglossal nerve leave the skull?
Hypoglossal canal
What is the innervation of the extra ocular muscles of the eye?
Superior oblique = Trochlear nerve
Lateral rectus = Abducens
The rest = oculomotor
What are the actions of superior rectus?
Elevates eye, intorsion, adduction
What are the actions of inferior rectus?
Depression, extorsion, adduction
What is the action of medial and lateral rectus?
Medial = adduction
Lateral = abduction
What is special about the superior oblique?
It passes through the trochlear on medial aspect of orbital wall before changing direction to insert onto orbit
What are the actions of the superior oblique?
Abduction, depression, intorsion
What are the actions of the inferior oblique muscle?
Abduction, elevation, extorsion
What is the anterior chamber?
Space between cornea and iris
What is the posterior chamber?
Area between iris and lens posteriorly
Where is aqueous humor produced?
Posterior chamber of eye
What are the layers of the eyeball from superficial to deep?
1) Connective tissue layer
2) Fibrous layer - sclera and cornea
3) Vascular layer - choroid, ciliary body and iris
4) Inner layer - retina
What paraympathetically controlled muscles in the eye?
Sphincter pupillae and ciliary muscle
What is the sympathetically controlled muscle of eye?
Dilator pupillae
What is the position of the lens relative to the iris?
Posterior to the iris
What cranial nerve is responsible for movement of the tongue?
Hypoglossal - CNXII
What is the distribution of taste sensation in the tongue?
Anterior 2/3 via V2 chora tympani nerve, posterior 1/3 via glossopharyngeal
What are the cartilages of the larynx?
3 single:
- Thyroid
- Cricoid
- Epiglottis
3 paired:
- 2x Arytenoids (pitcher shaped, sitting on top of the cricoid)
- 2x corniculates (pointy bits on top of the arytenoids)
- 2x cuneiforms ( on top of corniculates, part of quadrangular membrane which attaches the arytenoids to the epiglottis)
What are the 3 layers of the deep fascia of the neck?
1) Investing (‘all the way round’)
2) Pre-tracheal/buccopharyngeal (anterior aspect)
3) Prevertebral (enclosing vertebrae and surrounding muscles)
What constitutes the retro-pharyngeal space?
Space between pre-tracheal and pre-vertebral fascia.
Extending from base of skull to posterior mediastinum
What are the contents of the carotid sheath?
Common + internal carotid arteries
Internal jugular vein
Vagus nerve
Sympathetic nerve fibres
What are the 9 cartilages which make up the larynx?
3 paired
3 single
Paired:
- Arytenoid
- Corniculate
- Cuneiform
Single:
- Thyroid
- Cricoid
- Epiglottic
What is the function of extrinsic laryngeal muscles? What are they?
To move larynx as a whole
Infrahyoid and suprahyoid muscles
What is the only airway muscles that ABduct the vocal cords?
Posterior crico-arytenoid muscles
What muscles adduct the vocal cords?
Lateral crico-arytenoids
Transverse and oblique arytenoids
What muscle stretches and tenses vocal ligaments?
Cricothyroid muscle
What muscle relaxes the vocal ligaments?
Thyro-arytenoids
Vocalis
What is the innervation of the muscles of the airway?
CN X - Vagus
All by recurrent laryngeal nerve except for the cricothyroid muscle which is innervated by external branch of the superior laryngeal nerve
What are the branches of the external carotid artery?
SALFOPMS - Some anatomists love freaking out medical students
Superior thyroid artery
Ascending pharyngeal artery
Lingual artery
Facial artery
Posterior auricular artery
Maxillary artery
Superficial temporal artery
What is the course of the right and left phrenic nerves?
Originate C3,4,5 (keep the diaphragm alive!)
Forms lateral border of anterior scalene
Descends with IJV across anterior scalene
LEFT = cross anterior to first part of subclavian
RIGHT = lies on anterior scalene and cross second part of subclavian
Both sides then run posterior to subclavian vein and enter superior mediastinum
RIGHT = passes over brachiocephalic artery, crosses anterior to root of R lung and leaves thorax via caval hiatus
LEFT = descends between subclavian and LEFT common carotid, crossing anterior to arch of aorta, ANTERIOR to left vagus nerve, anterior to root of L lung and runs across fibrous pericardium to to diaphragm
Outline course of right and left vagus nerves?
R vagus nerve enters thorax anterior to right subclavian artery, gives of recurrent laryngeal.
Continues to run posteroinferiorly through superior mediastinum on right side of trachea, then posteriorly to R brachiocephalic vein, SVC and root of right lung
R vagus nerve forms pulmonary plexus and then reforms as single nerve to traverse diaphragm and then for oesophageal plexus
L vagus nerve descends to enter mediastinum behind left common carotid and left subclavian artery
Posterior to root of L lung, and does the same as the right to pass through diaphragm
What is the lymphatic drainage of the neck?
Superficial cervical LN –> inferior deep cervical LN –> supraclavicular LN –> jugular lymphatic trunk –> thoracic duct on LEFT or junction of internal jugular and subclavian veins on right
