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ENT SOH > Anatomy > Flashcards

Anatomy Flashcards

(167 cards)

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1
Q

Which structure gives rise to the cupid’s bow?

A

Philtrum

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2
Q

From which part of the nasal cavity to we get sense of smell?

A

Olfactory epithelium

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3
Q

Nasal septum - anterior component

A

Hyaline cartilage

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4
Q

Nasal septum - posterior compartment

A

Bony

  • perpendicular place of ethmoid bone (superiorly)
  • vomer (inferiorly)
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5
Q

What divides the nasal cavity from the anterior cranial fossa?

A

Cribiform plate of ethmoid bone

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6
Q

Where is the crista galli of the ethmoid located?

A

medially and superiorly.

Superior to the nasal septum

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7
Q

Which conchae are part of the ethmoid bone?

A

Superior and middle

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8
Q

Where are the conchae located?

A

In the lateral wall of the nasal cavity

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9
Q

Function of conchae?

A

They create turbulence of the nasal cavity which ultimately creates better gas exchange

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10
Q

Where are the meatuses in relation to the conchae?

A

The space under each concha where the paranasal sinuses drain into

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11
Q

What are paranasal sinuses?

A

Extensions of the nasal cavities which aim to make the skull lighter

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12
Q

Name the 4 paranasal sinuses

A

Frontal sinus (2)
Maxillary sinus - antra (2)
Ethmoidal air cells (2)
Sphenoid sinus (2)

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13
Q

Where do frontal sinuses drain to?

A

Middle meatus

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14
Q

Where do maxillary sinuses drain to?

A

Middle meatus

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15
Q

Where do ethmoidal air cells drain to?

A

Anterior and middle drain into middle meatus

Posterior drains into superior meatus

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16
Q

Where do sphenoid sinuses drain to?

A

Sphenoethmoidal recess

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17
Q

What drains into the inferior meatus?

A

Nasolacrimal duct

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18
Q

3 types of mucosa in the nasal cavities

A

Keratinised stratified squamous epithelium
Respiratory epithelium
Olfactory mucosa

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19
Q

Keratinised stratified squamous epithelium in the nasal cavities

A

Located at the entrance of the nostril

The verbose hairs here start to filter foreign objects out of the air that you are breathing in

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20
Q

Respiratory epithelium in nasal cavities

A 
This makes up the majority of the nasal cavity mucosa 
Columnar, glandular 
Warms the air 
Humidifies the air 
Secretes mucous 
Traps foreign bodies
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21
Q

Special sensory nerve supply to the nasal cavities (e.g. for smell)?

A

CN I (olfactory)

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22
Q

Where does CN 1 leave the brain?

A

Cribriform plate of ethmoid bone

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23
Q

Somatic nerve supply to the nasal cavities (e.g. for ho, cold, touch, pain)?

A

CNV1 (ophthalmic division) supplies anterosuperiorly

CNV2 (maxillary division) supplies posteroinferiorly

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24
Q

Which arteries does blood supply to the nasal cavities originate from?

A

External and internal carotid arteries

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25
Branching of internal carotid artery which supplies the nasal cavities
Internal carotid artery -> Ophthalmic artery -> Anterior and Posterior ethmoidal artery -> supplies the medial and lateral walls of the nasal cavity
26
Branching of external carotid artery which supplies the nasal cavities
External carotid artery -> facial artery and maxillary artery Facial artery -> lateral and septal branch Maxillary artery -> sphenopalatine artery (lateral and medial walls), greater palatine (medial wall only)
27
What is Kiesselbach's area
The anastamotic site of the nasal arteries in the nasal septum. It is the most common site of epistaxis (nosebleed)
28
NG tube is passed through the SUPERIOR/INFERIOR aspect of the nasal cavity
Inferior
29
How do you ensure an NG tube has been correctly inserted into a patient?
X-ray | - NG tube should remain in the midline down to the level of the diaphragm and the tip should be seen in the diaphragm
30
Temporal bone 2 parts
Squamous (flat) | Petrous (stony/rocky)
31
What is the pterion
H shaped structure connecting 4 bones of the skull | It is the thinnest part of the skull
32
Which 4 bones does the pterion connect?
Temporal Frontal Parietal Sphenoid
33
Which CN exit at the anterior cranial fossa ?
CN I
34
Which CN exit at the middle cranial fossa ?
CN II, CN III, CN IV, CNV1,V2,V3, CN VI
35
Which CN exit at the posterior cranial fossa ?
CN VII, CN VIII, CN IX, CN X, CN XI, CN XII
36
External ear
Collects sound and processes sound waves to the tympanic membrane
37
What are the 2 sections of the external ear
Auricle | External acoustic meatus
38
External ear: Auricle - function
Captures and transmits sound to the external acoustic meatus
39
External ear: Auricle - structure
Helix - outer curvature of ear Tragus Lobe - ear piercing site
40
External ear: Auricle - innervation
Mainly C2, C3 spinal nerve | CN VII - just posterior to tragus
41
External ear: EAM - function
Tube which extends to the tympanic membrane
42
External ear: EAM - innervation
CN V3 - superior part of EAM | CN X - inferior part of EAM
43
External ear: EAM - shape (adult vs children)
Adult: Curved Child: short and straight
44
Middle ear - function
Amplifies and conducts sound waves (by transmitting vibrations) to the inner ear
45
Middle ear - which type of mucosa is present
Change from squamous epithelium -> columnar glandular mucosa
46
Middle ear: tympanic membrane
The connection between the external and middle ear
47
Middle ear: tympanic membrane - innervation
External surface: CN V3 - most of tympanic membrane CN X - inferior part of tympanic membrane Internal surface CN IX
48
Middle ear: tympanic membrane - umbo
ost inwardly depressed part of tympanic membrane | Created from handle of malleus
49
Middle ear: tympanic membrane - what is the thick part called?
Pars tensa
50
Middle ear: tympanic membrane - what is the thin part called?
Pars flaccida
51
Middle ear: tympanic cavity
Medial to tympanic membrane | Contains most of the bones of the middle ear
52
Middle ear: epitympanic recess
Superior to tympanic membrane | Near mastoid air cells
53
Middle ear: What are the bones of the middle ear called?
Auditory ossicles
54
Middle ear: name the 3 bones which link the tympanic membrane to the oval window
Malleus Incus Stapes (looks like a horses stirrup)
55
What is the smallest bone in the human body
Stapes
56
Middle ear: how do the auditory ossicles articulate with each other?
Synovial joints
57
Middle ear: aditus
The doorway from the epitympanic recess -> mastoid antrum
58
Where are mastoid air cells located
Posterior to epitympanic recess
59
Internal ear: location
From the oval window to the internal acoustic meatus (IAM)
60
Internal ear: function
Maintain balance Convert mechanical signals from middle ear into electrical signals which transfer info to the auditory pathway of the brain
61
Internal ear: innervation
CN VIII (vestibulocochlear nerve) 2 parts - vestibular nerve (balance) - cochlear nerve (hearing)
62
Internal ear: bony labyrinth
``` A series of bony cavities Composed of: - cochela - vestibule - 3 semicircular canals All of these structures contain perilymph fluid ```
63
Internal ear: bony labyrinth - vestibule
In the middle of the bony labyrinth. Communicates with cochlea (anteriorly) and semicircular canals (posteriorly)
64
Internal ear: bony labyrinth - cochlea
Looks like a snails shell Contains cochlea duct (responsible for hearing) If it is unrolled you can visualise the basilar membrane
65
Internal ear: semicircular canals
Anterior, lateral, posterior | Contains semicircular ducts (responsible for balance)
66
Internal ear: Membranous labyrinth
Continuous system of sacs and ducts which is suspended within the bony labyrinth. Filled with endolymph Surrounded by perilymph of bony labyrinth
67
At the apex of the cochlea (most internal turn) you hear high/low frequency sound
Low
68
At the bottom of the cochlea you hear high/low frequency sound
High
69
Internal ear: Membranous labyrinth - Cochlear duct
Situated within the cochlea | It is the organ of hearing
70
Where is the organ of corti located
Basilar membrane
71
Internal ear: Membranous labyrinth - saccule
Membranous sac located in the vestibule | Receives the cochlear duct
72
Internal ear: Membranous labyrinth - utricle
Membranous sac located in the vestibule | Receives the 3 semicircular ducts
73
Internal ear: Membranous labyrinth - semicircular ducts
Located within semicircular canals | Processes balance
74
Summary of sound transmission in the ear
1. Sound waves travel along EAM and make the tympanic membrane vibrate 2. Vibrations are transmitted through ossicles to the oval window 3. Vibration of oval window creates pressure waves in perilymph 4. Hair cells in cochlea are moved, neurotransmitter is released, AP's are stimulated and conveyed to the brain via cochlear nerve
75
What is the eustachian tube
Connects the tympanic cavity (middle ear) to the lateral wall of the nasopharynx.
76
Eustachian tube common nerve supply
CN IX
77
Eustachian tube - function
Conroe's the pressure within the middle ear, making it equal with the air pressure outside the body
78
Which 2 muscles open and raise the eustachian tube?
Tensor Veli Palatine | Levator Palatine
79
Where does CN VIII connect with the brainstem?
Junction between pons and medulla
80
Functions of CN VIII
Hearing and balance
81
Where does CN VII connect with the brainstem?
Junction between pons and medulla
82
What does CN VII supply
Muscles of facial expression Special sensory to taste buds Parasympathetic innervation to sublingual and submandibular glands Parasympathetic to lacrimal gland
83
Chorda tympani
Branch of CN VII Passes over tympanic membrane Carries special sensory fibres to anterior 2/3rds of tongue (taste buds) Carries parasympathetic motor supply to submandibular and sublingual salivary glands
84
Which nerve does chords tympani 'hitch a ride' on ?
CN V3
85
Muscles of facial expression - frontalis action
Wrinkling forehead | Raising eyebrows
86
Muscles of facial expression - orbicularis oculi action
Screwing eyes shut
87
Muscles of facial expression - orbicularis iris action
Prevents drooling
88
Which structures are located in the pre-tracheal fascia? (5)
``` Larynx and trachea Pharynx and oesophagus Strap muscles Thyroid gland Recurrent laryngeal nervs ```
89
Larynx location (vertebral levels)
C4-C6
90
Where is the hyoid bone located (vertebral level)
C3
91
What vertebral level is cricoid cartilage located?
C6
92
How is aspiration prevented when eating food?
Pharynx lifts the larynx up and raises it towards the mandible. Epiglottis covers larynx to prevent food from entering lung
93
What is the body's response if something IS aspirated?
Cough reflex | - vocal cords produce a strong jet of air to move the foreign object
94
Epiglottis - which type of cartilage is it?
Elastic (as it moves)
95
Epiglottis - function
flaps over and covers the larynx when food is being swallowed to prevent aspiration
96
Thyroid cartilage features
Superior horn | Inferior horn - articulates with cricothyroid joint
97
Cricoid cartilage
The only real component of the cartilage that is a full ring (thin anteriorly, thick posteriorly)
98
Arytenoid cartilage - location
Posterior
99
Arytenoid cartilage - function
Important for movement of vocal cords
100
Cricothyroid joint
Articulation of inferior horn of thyroid cartilage with posterior aspect of cricoid cartilage
101
Cricothyroid joint - function
Allows the thyroid to move forwards and backwards which changes the dynamics of the vocal cords
102
When does a vocal ligament become a vocal cord?
When mucosa is aded : | Ligament + Mucosa = cord
103
True vocal cords
Lower folds of tissue in the larynx Movement of true vocal cords impacts sound The space between the true VCs is the rima glottidis
104
False vocal cords (vestibular fold)
Folds of tissue found above true vocal cords in the larynx | Located superolaterally to the true vocal cords
105
Intrinsic muscles of larynx - location
Between cartilages
106
Intrinsic muscles of larynx - function
Cause movement of vocal cords
107
Intrinsic muscles of larynx - cricothyroid muscle
Tensor - tenses vocal ligament | Stretches (lengthens) the VC to produce a higher pitch (high voice)
108
Intrinsic muscles of larynx - cricothyroid muscle (attachments)
Anterolateral cricoid cartilage -> inferior horn of thyroid cartilage
109
Intrinsic muscles of larynx - thyroarytenoid muscle (vocalis muscle)
Relaxor - relaxes vocal ligament Brings the VC together to produce a lower pitch (low voice) Placed just next to true vocal cords
110
Intrinsic muscles of larynx -thyroarytenoid muscle (attachments)
Posterior thyroid cartilage -> anterior arytenoid cartilage
111
Intrinsic muscles of larynx - lateral circo-arytenoid muscle
Adductors - brings vocal ligaments together which narrows rim glottidis and means less air will be able to cross This makes the voice quieter
112
Intrinsic muscles of larynx - lateral circo-arytenoid muscles (attachments)
Muscular process of arytenoid -> anterior cricoid cartilage
113
Intrinsic muscles of larynx - arytenoid muscles
Adductors - brings the vocal ligaments closer together | which narrows rima glottidis and makes the voice quieter
114
Intrinsic muscles of larynx - arytenoid muscles (attachments)
One arytenoid cartilage to another cricoid cartilage | looks like a scottish flag
115
Intrinsic muscles of the larynx - posterior crico-arytenoid muscles
Abductors - spreads VCs further apart which widens rima glottidis Makes voice louder
116
Intrinsic muscles of larynx - posterior crico-arytenoid muscles (attachments)
Posterior cricoid cartilage -> muscular process of arytenoid cartilage
117
______ is a relaxor and makes the voice HIGHER/LOWER pitch
Thyroarytenoid | Lower
118
______ is a tensor and makes the voice HIGER/LOWER pitch
Cricothyroid muscle | Higher
119
______ and ______ are adductors and make the voice LOUDER/QUIETER
Lateral crico-arytenoid muscle Arytenoid muscle Quieter
120
______ is an abductor and makes the voice LOUDER/QUIETER
Posterior crico-arytenoid muscle | Louder
121
At the level of the circathyroid joint, the left recurrent laryngeal nerve becomes the ______ nerve
Inferior laryngeal nerve
122
______ nerve supplies all of the muscles of the larynx apart from the cricothyroid muscle
Inferior laryngeal nerve
123
The cricothyroid muscle is supplied by ______ nerve
External laryngeal nerve
124
Which nerve supplies sensory innervation to the mucosa above the vocal folds?
Internal laryngeal nerve
125
Which nerve supplies sensory innervation to the mucosa below the vocal folds
Inferior laryngeal nerve
126
How does the voice make sound
When subglotal pressure threshold is reached then air crosses the VC's causing a vibration (from inferior -> superior). This produces a sound in the larynx
127
Production of oral sounds
Tense soft palate (CN V3) and elevate soft palate (CN X). This closes off the entrance into the nasopharynx and allows a direct stream of air through the oral cavity
128
Production of nasal sounds
Tense soft palate (CNV3) and descend soft palate (CNX) to close off the entrance into the oropharynx and allow a stream of air directed through nasal cavities Produces "m", "n" and "ing" sounds
129
The soft palate is anterior/posterior to the hard palate ?
Posterior
130
Name 3 muscles of the floor of the mouth
Mylohyoid Geniohyoid Anterior belly of digastric
131
What is the frenelum of the tongue ?
Thin dangly part seen when you put the tongue towards the roof of the mouth
132
3 major salivary glands and their nerve supply
Parotid gland - CN IX Submandibular gland - CN VII Sublingual gland - CN VII
133
Parotid gland location
Superficial to masseter muscle Parotid duct crosses the masseter and pierces medially through the buccinator and then opens on the buccal mucosa at upper 2nd molar
134
Parotid gland is palpable - true or false?
False
135
Submandibular gland location
Duct is deep to the mucosa of the floor of the mouth and opens on the sublingual papillae
136
Submandibular gland is palpable - true or false?
True
137
Sublingual gland location
Deep to the mucosa of the floor of the mouth
138
Sublingual gland is palpable - true or false?
False
139
Anterior 2/3rds of tongue innervation
General sensory - CN V3 | Special sensory - CN VII
140
Posterior 1/3rd of tongue innervation
General and sensory supply - CN IX
141
What is the foramen caecum (in the tongue)
Division between the anterior and posterior portions of the tongue
142
Name 4 papillae
Filliform Fungiform Vallate Folate
143
Which papillae doesn't have taste buds
Filliform
144
Name the 4 skeletal extrinsic tongue muscles and their nerve supply
Palatoglossus - CN X Styloglossus - CN XII Hyoglossus - CN XII Genioglossus - CN XII
145
Hypoglossal nerve - route
Passes through the hypoglossal canal in the posterior cranial fossa. Descends in the neck lateral to the carotid sheath. Passes towards the lateral aspect of the tongue and supplies most tongue muscles
146
CN XII clinical testing
Ask patient to stick tongue out | If both CN XII are functioning properly, tip of tongue remains in midline position
147
CN XII - unilateral CN XII damage findings
Tongue will point towards the side of the injured nerve | - if right CN XII deficit then tongue will point to the right
148
Blood supply of the tongue
Lingual artery (branch of external carotid artery)
149
Where is the palatine tonsil located?
In the space between the arches of the soft palate
150
Which bones are located in the hard palate
Palatine bones
151
Soft palate - function
Stops food entering nose when swallowing
152
5 pairs of muscles of soft palate
``` Levator veli palatine Tensor veli palatine Palatoglossus Palatopharyngeus Musculus uvulae ```
153
Soft palate muscles: Levator veli palatine (function, nerve supply)
Lifts soft palate towards base of skull | CN X
154
Soft palate muscles: Tensor veli palatine (function, nerve supply)
Tenses the soft palate | CN V3
155
Soft palate muscles: palatoglossus (function, nerve supply)
Forms the first arch of the soft palate | CN X
156
Soft palate muscles: palatopharyngeus (function, nerve supply)
Pulls the soft palate down | CN X
157
Soft palate muscles: musculus uvulae
Uvulae, dangles down from the back
158
CN V3 and CN X soft palate clinical testing
Get patient to say "ahhhh" and open mouth wide | If the nerves are functioning normally then the uvula should lift straight up in the midline
159
CN V3 and CN X soft palate clinical testing - unilateral nerve pathology
The uvulae will be pulled AWAY from the non-functioning side (towards the opposite side of damage) eg: if there is damage to the right CN X or CN V3 then the uvula will be pulled towards the left side
160
Constrictor muscles of the pharynx are innervated by which CN ?
CN X
161
Longitudinal muscles of the pharynx (3)
Stylopharyngeus Salpingeopharyngeus Palatopharyngeus
162
Innervation of the longitudinal muscles of the pharynx
Stylopharyngeus - CN IX Salpingeopharyngeus - CN X Palatopharyngeus - CN X
163
What is waldeyer's ring of lymphoid tissue?
Defence ring around the larynx/pharynx which prevents infection from getting into GI or resp tract
164
3 main tonsils involved in waldeyer's ring of lymphoid tissue
Palatine tonsil Lingual tonsil - in mucosa of posterior 1/3rd of tongue Pharyngeal tonsil "adenoid" - in the mucosa of the roof of the nasopharynx
165
Regional lymph nodes
They first receive the lymph that has drained from a given structure
166
What is the only part of the oral cavity that drains to submental lymph nodes first
tip of the tongue
167
Which lymph node drains the palatine tonsil
jugulo-digastric node

ENT SOH (9 decks)

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