Zill Review Flashcards
Anterior Cleft Palate
Same as cleft lip. Do not fuse medial nasal process and maxillary process
Posterior Cleft Palate
Failure to fuse secondary palate (maxillary processes of each side)
Complications of tonsillectomy
1) post-operative bleeding of tonsillar branch of facial artery
2) damage to CN IX (Glossopharyngeal)
True/false: Veins of the spinal cord have no valves
TRUE
Example of cancer which can metastasize to vertebral column
Carcinoma of prostate (in the pelvis)
Symptom of maxillary sinus infection
toothache
How is pressure in the middle ear equalized
Tensor and Levator Palati transiently open auditory tube when swallowing
Torticollis
contracture of sternocleidomastoid (congenital or acquired); face to OPPOSITE side
Structure forming a lingual thyroid
Thyroglossal ducts remnants
Innervation of muscles of the tongue
Hypoglossal Nerve (CN XII)
Internal and External Jugular Veins: which descends in the carotid sheath and which descends on the outer surface of sternocleidomastoid?
Internal Jugular Vein is in the carotid sheath. External Jugular Vein descends on the outer surface of sternocleidomastoid
Lateral Cricoarytenoid muscles
close rima glottidis
Upper motor neuron lesion of hypoglossal nerve
Protruded tongue deviates AWAY from side of lesion to cortex, etc.. (control only contralateral). This is all due to unopposed action of the genioglossus muscle
Action of cricothyroid muscle
Stretches vocal ligament, increasing pitch
Anaphylactic shock
Acute allergic reaction. Swelling of vestibular folds; can constrict airway and lead to suffocation.
mucosa is tightly attached to vocal folds thats why it happens in the false not true vocal folds
Symptoms of parotid tumors and mumps
1) Ear (outer) ache due to compression of Auriculotemporal Nerve (V3)
2) Facial Paralysis – Compress VII
Innervation of mucous glands of nose and palate
Parasympathetics from CN VII
Sensory innervation to Post 1/3 of tongue
CN IX
Ludwig’s Angina
Infection of floor of mouth (submandibular space), often due to spread from abscessed mandibular tooth. Infection may obstruct airway and push up tongue
Plaque at carotid bifurcation
Can give rise to emboli in internal carotid artery and cause cerebrovascular occlusion STROKE
Sensory innervation of the dura
- V1, V2, V3
- CN X (Vagus)
- Sensory branches of C1/C2
Highly anastomosed artery leading into nasal cavity
Sphenopalatine Artery (from maxillary artery)
Sensory and branchiomotor innervation to all muscles of larynx except cricothyroid muscle
Recurrent Laryngeal Nerve
Action of tensor palati
tenses soft palate
rima glottidis
opening between the true vocal cords and the arytenoid cartilages of the larynx
“Popcorn 1”; First pharyngeal structure causing difficulty swallowing
Valleculae (in the oropharynx)
Constrictor muscle continuous anteriorly with buccinator
superior constrictor
Symptoms of nerve damage/tumor at stylomastoid foramen or in parotid gland
Facial (VII) paralysis only (as opposed to Neurinoma which damages VIII as well)
Blood supply to palatine tonsil
Tonsillar branch of facial artery
Inlet into the larynx found above the false vocal folds
Vestibule
Sensory innervation of nasal cavity
V1 and V2
Posterior Cricoarytenoid muscles
open rima glottidis
Symptoms of Obstruction of Radicular Artery (of Adamklewicz)
1) paraplegia (corticospinal tracts, bilateral voluntaryparalysis of legs and lower body)
2) bilateral loss of pain and temperature sense (spinothalamic tract)
3) loss of sphincter control
4) sparing of vibration and position sense (dorsal columns; sensory)
Contents of the carotid sheath
1) common and internal carotid arteries
2) internal jugular vein
3) CN X (Vagus)
Lower motor neuron lesion of hypoglossal nerve
Protruded tongue deviates TOWARD side of lesion. Unopposed action of the genioglossus muscle of one side.
Can occur during clamping for heart surgery or by a dissecting aortic aneurysm; causes infarction (tissue death in spinal cord) similar to an anterior spinal artery syndrome
Obstruction of Radicular Artery (of Adamklewicz)
Action of thyroarytenoid muscle
Relax vocal ligament, decreasing pitch
Sensory innervation of floor of mouth
V3
Clinical intervention in anaphylactic shock
Insert tube into cricothyroid membrane (in between thyroid and cricoid cartilages) to allow air in. This results in less bleeding that tracheotomy
Innervation of tensor palati
CN V
What are surgeons cautious about damaging in (neck) posterior triangle surgery?
Brachial plexus and the phrenic nerve
Damage can occur to this nerve in thyroid surgery, paralyzing all muscles on one side except cricothyroid; permanent hoarse voice
Recurrent Laryngeal Nerve
Why can tongue cancer spread to opposite side easily?
Lymph vessels of tongue cross the midline; lesion may spread to the opposite side
Suboccipital muscles and actions
1) Rectus Capitis Posterior Minor (Extend head)
2) Rectus Capitis Posterior Major (Extend/Rotate)
3) Obliquus Capitis Superior (Extend)
4) Obliquus Capitis Inferior (Rotate; has stretch receptors to sense neck rotation)
Three Pharynx constrictor muscles
Superior, Middle, and Inferior Constrictor
Visceral sensory endings of this nerve monitor blood pressure and chemoreception. Damage to it can lead to cardiac-pulmonary dysfunction
CN IX
Sensory innervation to Ant 2/3 of tongue
V3 (lingual nerve; somatic sensory touch) and CN VII (chorda tympani - taste)
Area between true and false vocal folds; Lateral extension is Laryngeal Sinus
Ventricle
Damage to lingual nerve in floor of mouth
Lose taste (CN VII) and Touch (V) to anterior 2/3 of tongue
angina
A condition with intense pain
Two folds overlying vestibular ligaments (superior to inferior)
Vestibular (false vocal) and Vocal (true vocal) folds
Significance of veins of spinal cord having no valves
Metastasis to Vertebral Column
Disease processes can spread to spinal cord and vertebra by intervertebral veins.
Motor innervation to muscles of palate
Vagus (CN X) for all muscles of the palate except Trigeminal (CN V) for tensor palati
The Superior Laryngeal Nerve divides into Internal/External Laryngeal Nerves. What do they do?
Internal Laryngeal Nerve - sensory
External Laryngeal Nerve - branchiomotor to Cricothyroid muscle
Sensory supply to Maxillary sinus and the teeth
Anterior and Posterior Superior Alveolar Nerves (from V2)
Sensory innervation of palate
V2
Origin and Insertion of Tensor Palati
Origin: Auditory Tube
Insertion: Palatine Aponeurosis
Steps of swallowing
Voluntary:
1) Form bolus [Palate down by Palatoglossus]
2) Push bolus back [contract mylohyoid and styloglossus]
Involuntary:
3) Elevate soft palate [contract Tensor Palati, Levator Palati, and Stylopharyngeus]
4) Down tube [contract pharyngeal constrictors; pull larynx forward with hyoid muscles]
Artery arising from carotid siphon
opthalmic artery
Why is a retropharyngeal abscess difficult to diagnose and life-threatening?
There’s no external swelling. Abscess can block the airway.
Hangman’s Fracture
Fracture of dens of C2
Location of palatine tonsil
located between palatoglossal and palatopharyngeal arches
Acoustic Neuroma (Neurinoma)
Tumor at Internal Auditory Meatus (Blocks CN VII, VIII)
Air sinuses in the skull we need to know, all named for the adjacent bone
1) frontal sinus
2) sphenoid sinus
3) ethmoid sinus
4) maxillary sinus
Result of damaged tympanic membrane or Petrotympanic fissure
1) loss of taste to anterior 2/3 of tongue
2) loss of parasympathetics to submandibular and sublingual salivary glands
A cause of meningitis. CSF leaks into nose
Fracture of nose can break the cribriform plate, which is part of the floor of anterior cranial fossa
“Popcorn 2”; Found lateral to inlet of larynx
piriform recess
Cleft lip
failure of fusion of medial nasal process and maxillary process
