Written Exam 1 Flashcards

1
Q

Which joints are immovable or slightly movable?

A

Synarthrosis

(skull = suture, teeth = gomphorsis)

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2
Q

Name and describe the two divisions of the synarthrosis joints

A

Immovable or very slightly movable

  1. Suture = joints between bones in the skull
  2. Gomphosis = joint in between the roots of the teeth into the alveolar processes
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3
Q

What are slightly moveable joints?

A

Amphiarthrosis

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4
Q

What are two types of amphiarthrosis joints?

A

slightly movable

  1. Fibrocartilaginous discs = between vertebral bodies
  2. Fibrocartilaginous disc = between pubis symphysis
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5
Q

What are Diarthrosis joints?

A

freely movable joints

= most joints in body

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6
Q

What are the two types of synovial joints?

A

Joint cavity that produces a synovial fluid for lubrication

  1. Typical - ends of two bones are covered in articular cartilage, ligaments join the bones together, capsular ligaments, and joint cavity (lined by synovial membrane that produces synovial fluid)
  2. With articular Discs = Everything the same except there is an articular disc separating the two bones (knee and TMJ)
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7
Q

What type of joint is in plane or gliding

A

Plane or gliding

Acromioclavicular joint

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8
Q

What type of joint is a hinge?

A

Ginglymus

Hinge: motion in one plane (elbow)

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9
Q

What type of joint rotates on an axis?

A

Trochoid (pivot)

Rotation about an axis

dens of axis and atlas joint

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10
Q

What type of motion is in two plants, no rotation?

A

Condyloid

(occipital atlas joint when skull sits on your spine, rock head back and forth and side to side)

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11
Q

What type of joint has motion in all planes, plus rotation?

A

Enarthrodial (ball and socket)

Ex: hip joint

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12
Q

What type of joint is motion in two planes, some axial rotation

A

Sellar (saddle or Ellipsoid)

Example: Thumb joint

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13
Q

What bone features make up the TMJ?

A

Mandibular fossa

Articular eminence

Head of mandibular condyle

Articular surfaces covered by dense fibrous tissue

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14
Q

What type of joint classification is the TMJ?

A

ginglymoarthrodial - (hinge and gliding combination)

bilateral - (both sides of jaw)

Synovial Joint - (secretes synovial fluis)

Contains articulating disc

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15
Q

Explain the anatomy of the condyle of the mandible head and neck

A

1. Head = anterior articular surface (front of head), medial pole (inside), lateral pole (outside, and pterygoid pit (depression on medial side where lateral pterygoid muscle attaches)

2. Neck - below the condylar head

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16
Q

In the articular disc, what is the superior compartment responsible for?

A

sliding motion down the articular eminence

superior = gliding

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17
Q

In the articular disc, what is the inferior compartment responsible for in the TMJ?

A

hinge motion

inferior = hinge

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18
Q

What does the central region of the articular disc of the TMJ contain?

A

fibrocartilage

** important **

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19
Q

What does the posterior region of the articular disc of the TMJ contain?

A

elastic fibers

pressure bearing

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20
Q

Name and describe the ligaments in the TMJ area, where they connect and function

A
  1. Temporomandibular (lateral) ligament
    1. Covers capsular ligament
    2. Zygomatic process of temporal -> neck of mandibular condyle
    3. Prevents posterior displacement and excess lateral displacement of condyle
  2. Sphenomandibular ligament
    1. Spine of sphenoid -> lingula of mandible
    2. Prevents excessive opening
  3. Stylomandibular ligament
    1. Styloid process to angle of mandible
    2. Prevents excessive protrusion
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21
Q

Name and describe the nerves that innervate the TMJ

A

Mandibular branch of trigeminal (V3)

  1. Auriculotemporal = articular branches to most of joint
  2. Masseteric = to small anterior portion
  3. Deep temporal = to small anterior portion (highly painful)
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22
Q

What is the major nerve that innervates the TMJ?

A

Trigeminal V3 (mandibular branch)

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23
Q

What are the major blood supplies to the TMJ area?

A

1. superficial temporal artery = numerous branches supply posterior capsule. Terminal branch of external carotid

2. Maxillary artery = runs deeper to the mandibular space. Terminal branch of external carotid artery (into pterygoid space)

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24
Q

What are the 5 main motions involved with the TMJ, name, describe, state the muscles

A

1. Protrusion = condyles move forward, lateral pterygoid

2. Retrusion = condyles move back, posterior and horizontal temporalis, masseter

3. Depression = condyles rotate anteriorly and articular disc glides down. Wide opening = protrusion and depression, Suprahyoid, infrahyoid, lateral pterygoid

4. Elevation = discs glide back up eminence and condyles rotate posteriorly, masseter, medial pterygoid, temporalis

5. Lateral deviation = excursion - move mandible right or left causing discs on one side to glide down eminence and the other side to rotate anteriorly, opposite lateral pterygoid

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25
Q

What are the is the motion and muscles involved with protrusion

A

Protrusion = condyles move forward,

  • lateral pterygoid
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26
Q

What are the motions and actions involved in Retraction?

A
  1. Retrusion = condyles move back,
    - posterior and horizontal temporalis, masseter
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27
Q

What are the muscles and actions involved in Elevation

A
  1. Elevation = discs glide back up eminence and condyles rotate posteriorly,
    - masseter, medial pterygoid, temporalis
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28
Q

What are the muscles and actions involved in Depression

A
  1. Depression = condyles rotate anteriorly and articular disc glides down.

Wide opening = protrusion and depression,

  • Suprahyoid, infrahyoid, lateral pterygoid (wide)
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29
Q

What are the muscles and actions involved in lateral deviation

A
  1. Lateral deviation = excursion - move mandible right or left causing discs on one side to glide down eminence and the other side to rotate anteriorly,
    - opposite lateral pterygoid
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30
Q

On the condyle of the TMJ, what is the most common fracture?

What is the name for a partial dislocation of the TMJ?

A

neck = 30%

Angle = 25%

Chin = 22%

Subluxation (partial dislocation)

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31
Q

What features make up the roof of the orbit?

A
  1. orbital plate of frontal
  2. Lesser wing of sphenoid
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32
Q

What features make up the floor of the orbit?

A
  1. orbital surface of maxilla
  2. Orbital surface of zygomatic
  3. Orbital process of palatine
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33
Q

What features make up the medial wall of the orbit?

A
  1. frontal process of Maxilla
  2. Lacrimal bone
  3. Orbital plate of ethmoid
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34
Q

What features make up the lateral wall of the orbit?

A
  1. Orbital surface zygomatic
  2. Greater wings of the sphenoid
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35
Q

What features make up the base of the orbit (of the cone)

A

Orbital margin - outlines/surroundings the opening to the eye socket

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36
Q

What features make up the Apex of the cone of the orbit?

A

Optic canal/foramen

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37
Q

What features make up the boundaries for the Inferior Orbital Fissure?

A
  • Zygomatic bone
  • Maxilla
  • Sphenoid
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38
Q

What are the following features that make up the superior orbital fissure boundaries?

A
  • Palatine bone
  • Sphenoid
  • Ethmoid
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39
Q

What are the following features that make up the optic canal boundaries?

A
  • sphenoid
  • Ethmoid
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40
Q

What are the three branches of the trigeminal nerve?

A

V1 = ophthalmic

V2 = maxillary

V3 = mandibular

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41
Q

What features run through the optic canal?

A

CN II = Optic nerve

Ophthalmic artery

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42
Q

What features run through the superior orbital fissure?

A

Nerves 3, 4, 5/1, 6

CN III = Oculomotor nerve

CN IV = Trochlear Nerve

CN V1 = Trigeminal, ophthalmic

CN VI = Abducens Nerve

Superior ophthalmic vein

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43
Q

What features run through the Inferior orbital fissure?

A

Infraorbital nerve (V2 - trigeminal, maxillary)

Infraorbital artery, vein

Zygomatic nerve (V2 - trigeminal, maxillary)

Inferior opthalmic vein

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44
Q

What features run through the supraorbital foramen?

A

Superior orbital nerve (V1 - Trigeminal, Ophthalmic)

Superior orbital vein and artery

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45
Q

What features run through the infraorbital canal?

A

Infraorbital nerve (V2 - trigeminal, maxillary)

Infraorbital vein and artery

Nerve runs through infraorbital groove and into the infraorbital canal and out front of face through the infraorbital foramen

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46
Q

What features run through the Anterior ethmoidal foramen?

A

Anterior ethmoidal nerve (V1 - Trigeminal, Ophthalmic)

Nerve called nasociliary nerve

Medial wall of the orbit/superior boarder - anterior

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47
Q

What features run through the Posterior ethmoidal foramen?

A

Poster ethmoidal nerve (V1 - Trigeminal, Ophthalmic)

Nerve called nasociliary nerve

Medial wall of the orbit/superior boarder - Posterior

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48
Q

What features run through the zygomaticofacial foramen?

A

Zygomaticofacial nerve (V2 - trigeminal, maxillary)

zygomaticofacial artery and vein

branch off the zygomatic nerve that ran through the infraorbital fissure into the orbital cavity

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49
Q

What features run through the zygomaticotemporal foramen?

A

Zygomaticotemporal nerve (V2 - trigeminal, maxillary)

zygomaticotemporal artery and vein

branch off the zygomatic nerve that ran through the infraorbital fissure into the orbital cavity

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50
Q

Where do the extrinsic muscles of the eye originate from?

A

All from the annular tendon

EXCEPT for the inferior oblique, that originates from the maxilla

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51
Q

What is the function of the Levator palpebrae and where is it located?

Which nerve innervates this muscle?

A

Elevates upper eyelid

located above the eye

Inserts into the eyelid (blinking and open eye)

Nerve III = oculomotor nerve

52
Q

What is the function and location of the Superior rectus?

Which nerve innervates this muscle?

A

directs eye superiorly and medially, rectus means straight

CN III = oculomotor nerve

53
Q

What is the function of the inferior rectus?

Which nerve innervates this muscle?

A

directs eyes inferiorly and medially

CN III = Oculomotor nerve

54
Q

What is the function of the Medial rectus?

Which nerve innervates this muscle?

A

close to the midline,

directs eyes medially (adduction)

CN III = Oculomotor Nerve

55
Q

What is the function of the lateral rectus?

Which nerve innervates this muscle?

A

lateral side of orbit

directs eyes laterally (abduction)

Nerve VI (6) = Abducens

Recall: LR6SO4

56
Q

What is the function of the superior oblique?

Which nerve innervates this muscle?

A

Directs eye inferiorly and laterally

Comes in at an oblique angle

Nerve IV (4) = trochlear

Recall: LR6SO4

57
Q

What is the function of the Inferior oblique?

Which nerve innervates this muscle?

A

Directs eyes superiorly and laterally

Originated from floor of the maxilla and inserts into the lateral/inferior portion of the eye at an oblique angle

CN III = oculomotor nerve

58
Q

What muscles must work together to look up with your eye?

A

Inferior oblique (up and out)

and

Superior Rectus (up and in)

59
Q

What muscles must work together to look straight down?

A

Superior oblique (down and out)

and

Inferior rectus (down and in)

60
Q

What are the major nerves that innervate the eye?

A

1. Optic = CN II

2. Oculomotor = CN III

3. Trochlear = CN IV for SO

4. Abducens = CN VI for LR

5. Ophthalmic division of trigeminal V1

  • primary sensory nerve for face and goes into the supraorbital fissure and spits into three branches
61
Q

What are the three branches of the ophthalmic division of the trigeminal nerve (V1) and what are their main functions and locations

A

1. Frontal nerve

  • Located: just above levator palpebrae muscle, frontal nerve splits into supraorbital and supraochlear nerves (sensory for scalp and upper eyelid)

2. Lacrimal nerve

  • Sensory nerve through the lacrimal gland, eye conjunctiva, and lateral upper eyelid

3. Nasociliary Nerve

  • Most of the branches travel in a medial fashion and branch includes:
    • Anterior ethmoidal nerve - sensory to ethmoidal sinus and outer nose
    • Posterior ethmoidal nerve - sensory to ethmoidal sinus
    • Infratrochlear nerve “hook” - trochlea, anterior part of face
    • Long ciliary nerves back of eyeball - sensory from back of eyeball
62
Q

Explain the path of the frontal nerve into the optic canal

A

Frontal nerve leads to three branches:

  1. Supratrochlear Nerve
  2. Medial branch of supraorbital nerve
  3. Lateral branch of supraorbital nerve
63
Q

Explain the path of the lacrimal nerve

A

Lacrimal nerve -> lacrimal gland

64
Q

Explain the path of the Nasociliary nerve

A
65
Q

Explain the path for the artery that supplies the optic canal

A

Internal carotid artery -> ophthalmic artery (from optic foramen with optic nerve)

branches to:

  1. Posterior ethmoidal artery
  2. Anterior ethmoidal artery
  3. supraorbital artery
  4. lacrimal artery
66
Q

Explain the location of the ciliary ganglion

A

Located off the nasociliary nerve

67
Q

Explain the short ciliary nerves

A
  • Run between the ciliary ganglion to the back of the eye
  • Contain sensory fibers serving the eye and cornea that are part of the nasociliary nerve, may travel through the ciliary ganglion from the eye via the short ciliary nerve
68
Q

Explain the long ciliary nerves

A
  • Branches running between the back of the eye and the nasociliary nerve
  • Contain sensory fibers innervating the eye and cornea
69
Q

Explain the ophthalmic vein pathway

A

Superior ophthalmic vein and inferior ophthalmic vein drains into the cavernous sinus

  • Tributaries from orbital contents and facial vein
  • Drainage to cavernous sinus = clinical significance = lots of communication and pathway for infection spreading
70
Q

Explain the lacrimal gland

A
  • Gland = located in lacrimal fossa on lateral aspect under the eyebrow. Tear production
  • Puncta = small holes that suck up tears
  • Canals = lead tears from puncta to nasolacrimal duct
  • Lacrimal sac = collects and stores tears
  • Nasolacrimal duct = empties tears into nasal cavity
71
Q

What is the fat called that fills the space between the muscles, arteries, and nerves and protects the eye from trauma?

A

retrobulbar fat

72
Q

Which of the following nerves is an anatomical marker for dissection?

A

Frontal nerve of the ophthalmic division of the trigeminal V1

Largest nerve of the branches and runs along the levator palpebrae superiors

73
Q

What are the divisions of the maxillary portion of the trigeminal nerve?

A

Infraorbital NAV

Zygomatic

Posterior superior alveolar NAV

74
Q

What are the nerves that make up the ophthalmic division of the trigeminal nerve (V1)?

A
  • frontal = largest and anatomical marker (forehead and eyebrows)
  • Lacrimal = to lacrimal gland
  • Nasociliary = inferior, nose, long and short ciliary and infratrochlear nerve
75
Q

What are the nerves that make up the maxillary division of the trigeminal nerve (V2)?

A
  • Infraorbital = floor of orbit, infraorbital NAV
  • Zygomatic = ZO and ZT
  • Posterior superior alveolar NAV
76
Q

What are the nerves that make up the mandibular portion of the trigeminal nerve (V3)?

A
  • Auriculotemporal nerve = TMJ condyle
  • Masseter = Anterior TMJ capsule
  • Deep temporal = Anterior TMJ
  • Inferior Alveolar Nerve = innervates the mandibular teeth through the mandibular foramen/canal, mental foramen then to teeth
77
Q

The muscles of mastication were derived from what during fetal development?

A

first (mandibular) pharyngeal/branchial arch

78
Q

Which nerve innervates all of the structures derived from the first (mandibular) arch?

A

Trigeminal nerve (CN V)

Therefore all muscles of mastication = CN V

79
Q

What is the origin, insertion, and action of the lateral pterygoid muscle?

A

O = superior = Infratemporal crest (greater wings)

O = Inferior = Lateral surface of lateral pterygoid

I = pterygoid pit of head of the mandible

A = protrusion (jetting) out and jaw depressor, lateral deviation

80
Q

What is the origin, insertion, and action of the medial pterygoid muscle?

A

O = Medial surface of lateral pterygoid

I = fills pterygoid foss and then continues by inserting into the mandibular ramus

A = Elevates (closes) mandible, lateral deviation

81
Q

What are the origin, insertion, and action of the temporalis muscle?

A

Fan-shaped with horizontal and vertical fibers

O = temporal lines

I = coronoid process of mandible and coracoid notch (anterior border of ramus)

A = Vertical fibers = elevate; horizontal = retrusion/back

contain a resting tonus

82
Q

What are the origin, insertion, and action of the masseter muscle?

A

Two parts = superficial and deep of the muscle

Superficial:

O = zygomatic process of the maxilla and anterior 2/3 of the zygomatic arch

I = angle and lower part of ramus of mandible

A = powerful elevator, slight retraction

Deeper:

O = posterior 1/3 of zygomatic arch

I = ramus

A = powerful elevator, slight retraction

“sling”

83
Q

What is an accessory muscle of mastication?

What is it innervated by?

A

Buccinator muscle

  • Makes up part of cheek and manages food bolus
  • Innervated by = Facial nerve CN VII (7)
84
Q

What are the important contents in the pterygomandibular space?

A
  • Lingual nerves

Inferior alveolar nerve and artery

85
Q

To anesthetize the lingual and inferior alveolar nerve, you must puncture this structure?

A

Pterygomandibular raphe (sheet of CT)

86
Q

If you put the needle too far back, what feature will you pierce and what will result?

A

parotid gland

Facial paralysis of the facial nerve

(temporal, zygomatic, buccal, mandibular and cervical)

87
Q

What feature was derived from the second pharyngeal/branch arch during fetal development?

A

Muscles of facial expression

88
Q

What innervates the facial expression muscles?

A

facial nerve (VII)

89
Q

What is the function of the orbicular oculi?

A

eye socket encircled, palpebral portion closes eye

90
Q

What is the function of the orbicular oris

A

encircles the lips, involved with lip movement

91
Q

What is the function of the procerus

A

midline (between eyes) and inserts on the naison, involved in transverse wrinkling of skin between eyes (frowning)

92
Q

What is the function of the nasalis

A

stretches over bridge of nose, involved in compression and dilation of the nostrils

93
Q

What is the function of the zygomaticus major

A

runs from cheek to angle to the mouth, involved in smiling

94
Q

what is the function of the zygomaticus minor

A

runs from cheek to angle to the mouth, involved in smiling

95
Q

What is the function of the levator labii superioris

A

raise the upper lip, located laterally to the nose

96
Q

What is the function of the levator labii superioris alaeque nasi

A

raises the upper lip, runs from the lip and along the nose “wings of the nose” also involved in dilation of the nostrils

97
Q

What is the function of the levator anguli oris?

A

elevates the angle of the mouth, associated with smiling

98
Q

what is the function of the depressor anguli oris?

A

depresses the angle of the mouth associated with frowning

99
Q

What is the function of the depressor labii inferioris

A

depresses the lower lip, associated with pouting

100
Q

What is the function of the mentalis?

A

deeper in the face, helps with protruding the lower lip, wrinkles over skin over the chin, associated with pouting

101
Q

What is the function of the buccinator?

A

involved with compression the check and managing the food bolus

102
Q

What is the function of the risorius?

A

thin muscle that comes straight transverse line to angle of the mouth, draws angle of mouth posteriorly

103
Q

What is the function of the frontalis?

A

muscle runs over entire top of skull, connects to the epicranial apaneurotica

104
Q

What is the function of the occipitalis?

A

draws scalp posteriorly

105
Q

What is the function of the platysma?

A

superficial fibers that sweep down from the mandible to the neck

106
Q

What is the function of the corrugator supercilli?

A

part of the eyebrow, moves the eyebrow down and medially, associated with frowning

107
Q

What are the muscles involved with smiling?

A

Zygomaticus major

Zygomaticus minor

Levator anguli oris

108
Q

What are the facial muscles involved in frowning?

A

depressor anguli oris

corrugator supercilli

109
Q

What are the facial muscles involved in pouting?

A

depressor labii inferioris

Mentalis

110
Q

Explain the trigeminal innervation branches

A
111
Q

What are the two arteries that branch off the external carotid for the facial vascular supply?

A

Facial artery

Superficial temporal Artery

** both from external carotid artery

112
Q

What are the two veins that are required to know for facial vascular structures?

A
  • facial vein = drains into internal jugular vein
  • superficial temporal vien
    • frontal and parietal branches
113
Q

What are the common features found in C3 - C6?

A

Contain bodies, transverse process

  1. Bifid spines: split, sometimes C2
  2. Transverse processes: vertebral artery through foramen
  3. Articular facets: horizontal plane for rotation
114
Q

Explain the features of the Atlas (C1)

A
  • No vertebral body. Just anterior arch and little bumps
  • No spinous process. just posterior tubercle
  • _Anterior and posterior arches with lateral mas_s
    • very broad because receive the condyles of the occipital bone of the cranium
115
Q

Explain the unique features of the Axis (C2)

A
  • Dense: stole the verbral body of C1.
    • articulates with anterior arch of C1
  • Pivot joint with atlas: articulation between dens and anterior arch. Allow you to shake head back and forth
116
Q

Explain the unique feature of vertebra prominens C7

A

non-bifid spine - very prominent spinous process. bump that sticks out at base of neck

117
Q

Explain the features that make up the Anterior Triangle

A
  • Submandibular Triangle
    • Inferior boarder of mandible
    • Anterior digastric
    • posterior digastric
  • Submental Triangle
    • Midline
    • Anterior digastric
    • Hyoid bone
  • Carotid Triangle
    • Sternocleidomastoid
    • Posterior digastric
    • Superior belly Omohyoid
  • Muscular Triangle
    • Sternocleidomastoid
    • Superior belly omohyoid
    • Midline
118
Q

What are the borders of the anterior triangle?

A

Sternocleidomastoid (posterior)

Midline (anterior)

Superior border of the mandible (superior)

119
Q

What are the Muscles found in the Anterior triangle? and what are the actions?

A
  • Infrahyoid muscles
    • Omohyoid
    • Sternohyoid
    • Sternothyroid
    • Nerves: ansa hypoglossi (cervicalis) from C 1, 2, 3. Innervates every little infrahyoid muscle. A loop that surrounds vasculature
    • Action: depress hyoid bone, larynx and mandible
  • Suprahyoid Muscles
    • Posterior digastric (CN VII)
    • Stylohyoid (CN VII) - bifurcates around tendon
    • Anterior digastric (CN V)
    • Mylohyoid (CN V) - originates from mylohyoid line and meets in middle to form floor of mouth
    • Geniohyoid (spinal nerve C1)
    • Action = elevate hyoid, larynx and depress mandible
120
Q

What are the nerves and vessels visible in the anterior triangle?

A
  • External/internal carotid artery
  • Anterior jugular vein - located medially within anterior triangle
  • Vagus nerve (CN 10)
  • Accessory nerve (CN 11)
    • continues to posterior triangle to innervate the trapezius muscle
  • Hypoglossal nerve (CN 12) - to tongue
  • Ansa cervicalis
  • Cervical plexus “branches
121
Q

What are other non-nerve/muscular structures visible within the anterior triangle?

A
  • Thyroid cartilage
  • Thyroid prominence “adam’s apple”
  • Thyroid gland
  • Cricoid cartilage
  • Submandibular gland - in submandibular triangle
122
Q

Describe the features of the posterior triangle

A
  • Occipital Triangle
    • Omohyoid inferior (bottom)
    • Sternocleiodomastoid (medial)
    • Trapezius (distal) = CN XI (11) intervation
  • Subclavian Trangle
    • Clavical (bottom)
    • Omohyoid Inverior (top)
    • Sternocleiodomastoid (medial)
123
Q

What are the 5 muscles that make up the floor of the posterior triangle?

A

Scalenes (anterior, middle, superior)

Levator scapulae

Splenus capitis

124
Q

What are the nerves and blood vessels that are located in the posterior triangle?

A

Nerves

  • Accessory CN XI (11) - innervates trapezius
  • Phrenic Nerve - made of C3, 4, 5 = stay alive
  • Brachial plexus - conduit

Blood

  • Subclavian vein and artery
125
Q
A