Last Min Stuff

Question 1

Tarsal Muscle (of Muller) Innervation

Answer 1

Postganglionic sympathetic fibers of T1

Question 2

Levator Palpebrae Superioris innervation

Answer 2

CN III

Question 3

Orbicularis Oculi Innervation

Answer 3

Facial Nerve

Question 4

Portions of the Orbicularis Oculi

Answer 4

1) Palpebral Portion~ Gentle closing of lid

2) Lacrimal Portion~ Increases amount of lid contact to the surface of the eyeball and dilates the lacrimal sac

Question 5

What portion of the orbicularis Oculi Dilates the Lacrimal Sac

Answer 5

Lacrimal Portion

Question 6

What muscle is associated with Horner’s Syndrome

Answer 6

Tarsal Muscle (of Muller)

Question 7

Describe the symptoms of Horner’s Syndrome

Answer 7

1) Slight Ptosis
2) Miosis~ Pupillary constriction due to paralysis of the dilator pupillae muscle
3) Enophthalmos~ due to paralysis of the orbitalis muscle of muller which has a slight protrusion function
4) Anhidrosis and Blushing of Skin

Question 8

Partial vs Complete Ptosis

Answer 8

1) Complete Ptosis = Oculomotor nerve palsy

2) Dysfunction of sympathetic pathway leading to paralysis of Muller Muscle

Question 9

What is Ptosis

Answer 9

Drooping of falling of the upper eyelid

Question 10

Describe the structures involved in draining tears from surface of the eye

Answer 10

1) Lacrimal Canaliculi –> Drains into the lacrimal sac via sinus of Maier
2) Lacrimal sac is continuous with the nasolacrimal duct that opens into the nasal cavity

3

Question 11

What is the name of the opening of the lacrimal canaliculi?

Answer 11

Lacrimal Punctum

Question 12

Traumatic Optic Neuropathy

Answer 12

1) Secodary ischema of Optic Nerve

Question 13

What does Traumatic Optic Neuropathy affect

Answer 13

1) Optic Nerve
2) Ophthalmic a.
3) Central Retinal a.

Question 14

What does a Blow-out fracture of the Orbit cause

Answer 14

Zygomatic Bone is displaced medially which causes:

1) Herniation of: Periorbita, Inferior oblique and rectus muscles, or orbital fat pad into maxillary sinus

Question 15

Le Forte Fractures

Answer 15

1: Transverse Fractures of the Maxillae just above the alveolar Processes
2: Pyramidal-shaped fractures of the maxillae usually involving part of the medial margin of one of the orbits

3) Extensive transverse fractures of the face involving many facial bones and both orbits (panda bear appearance).
- Face has been separated from the base of the skull

Question 16

Functions of Extraocular Muscles and Innervation

Answer 16

CN III:

1) Superior Rectus~ up and Out
2) Inferior Recuts~ Down and Out
3) Middle rectus~ Adduction
4) Inferior Oblique~ Up and in

CN IV:
1) Superior Oblique ~ Up and In

CN VI:
1) Lateral rectus~ Abduction

Question 17

What does the superior division of CN III innervate?

Answer 17

1) Levator Palpebrae Superioris

2) Superior Rectus

Question 18

What occurs when the superior division of CNIII is severed

Answer 18

1) Levator Palpebrae Superioris: Complete Ptosis

2) Superior Rectus: Inability to abduct and elevate the affected eye

Question 19

What is innervated by the inferior division of CNIII

Answer 19

Medial Rectus
Inferior rectus
Inferior Oblique

Question 20

Superior Oblique Innervation and clinical

Answer 20

1) Trochlear N. (CN IV)

2) Inability to adduct and depress the affected eye

Question 21

Lateral Rectus Innervation and Clinical

Answer 21

1) Abducens (CN VI)
2) Inability to abduct the affected eye
- Increased intracranial pressure may compress the abducens n. and result in paralysis of the lateral rectus m.

Question 22

Describe how the Ophthalmic N. (CN V1) innervates the eye

Answer 22

1) Lacrimal n. ~ Lacrimal Gland

2) Nasociliary: Main Sensory of eyeball

Question 23

What is the main sensory of the eyeball

Answer 23

Nasociliary n. which is a branch of CN V1

Question 24

Which nerves are important for Direct and Consensual Corneal Reflexes

Answer 24

1) Nasociliary n.
- esp. long ciliary n. (CN V1)

2) Facial n. Zygomatic Branch (CN VII)

Question 25

What occurs when there is a injury to the oculomotor nucleus of CN III

Answer 25

1) External Strabismus
2) Complete Ptosis
3) Dilated and unreactive pupils

Question 26

What occurs when there is injury to the trochlear nucleus

Answer 26

1) inability to adduct and depress the affected eye

2) Patient tends to tilt his head away form the affected eye

Question 27

What occurs when there is injury to the abducens nucleus

Answer 27

1) Inability to abduct affected eye

Question 28

What is the chief blood supply to of the orbit and retina?

Answer 28

1) Orbit: Ophthalmic a.
- Supplies optic nerve via posterior ciliary and central retinal a.

2) Retina: Central Retinal a.

Question 29

Papilledema

Answer 29

1) Increased intracranial pressure frequently restricts venous return from retina
2) Increased venous pressure results in edema or swelling of the optic disc

Question 30

What is the opening of the sphenoid sinus

Answer 30

Spheno-ethmodial recess

Question 31

What is the opening of the ethmodial sinuses

Answer 31

Superior nasal sinus

Question 32

Opening of ethmodial sinuses

Answer 32

Superior Nasal Meatus

Question 33

Opening of Frontal Sinus

Answer 33

1) Middle Nasal Meatus

Question 34

Where does the Maxillary sinus open up into.

Answer 34

Middle nasal meatus in posterior part of Semilunar hiatus at maxillary ostium (bellow ethmoid bulla)

Question 35

Inferior nasal meatus opening

Answer 35

Nsaolacrimal Duct

Question 36

Venous Drainage of the Nasal Cavity

Answer 36

1) Sphenopalatine
2) Facial
3) Ophthalmic veins

Question 37

Waldeyer’s Lymphatic Ring

Answer 37

1) Palatine, Pharyngeal, and Lingual tonsils

2) Drain into Deep Cervical Lymphatics

Question 38

Innervation of Parotid Gland

Answer 38

Parasympathetic CN IX

Question 39

Submandibular Gland and Sublingual Gland innervation

Answer 39

Parasympathetic CN VII

Question 40

Sublingual Gland duct opening

Answer 40

1) Open onto inferior surface of oral cavity posterior to submandibular duct papilla

Question 41

Submandibular duct opening

Answer 41

Opens form each gland through papilla in the floor of the mouth

Question 42

List the Pharynges

Answer 42

1) Nasopharynx ~ Nasopharynx pharyngeal tonsils –> Uvula

2) Oropharynx ~ Uvula –> Epiglottis
- Will expand when swallow and epiglottis is pushing up

3) Laryngopharynx

Question 43

Where does the middle constrictor insert on?

Answer 43

Hyoid bone

Question 44

What is the posterior 1/3 of the tongue innervated by?

Answer 44

Glossopharyngeal

Question 45

What branches do you need to look out for during tonsillectomy

Answer 45

1) Tonsilar Brannch of Acscending Palatine

2) Tonsilar branch of Facial

Question 46

Tensor Veli Palatini innervation and function

Answer 46

1) CN V3

2) Tenses soft palate and acts on pharyngotympanic tube for depressurizing middle ear

Question 47

Levator Veli Palatini innervation and Function

Answer 47

1) CN X via Pharyngeal Plexus

2) Elevates tensed palate and acts on pharyngotympanic tube

Question 48

What occurs when there is paralysis of Tensor or Levator Veli Palatini

Answer 48

1) Leads to reflux or oral contents into nasal cavity

2) Pharyngotympanic tube dysfunction

Question 49

What does the Pharyngeal Plexus supply

Answer 49

1) Sensory to oropharynx and laryngopharynx via CN IX and X

)

Question 50

What is the Nasopharynx Supplied by?

Answer 50

CN V2 (Maxillary division)

** NOTE that the Nasopharynx is above the pharyngotympanic tube and torus tubaris