Anatomy Flashcards
(128 cards)
1
Q
What are the functions of the nasal cavity
A
Patent conduit for air to pass to nasopharynx
Filters particles from air - small hairs
Humidifies air
Warms inspired air
Sense of smell
2
Q
Which part of the nasal cavity is responsible for smell
A
Olfactory epithelium
3
Q
The nose is made entirely of bone - true or false
A
False
Only the root is bone, the rest is cartilage
4
Q
Which bones make up the nose
A
Ethmoid bone Vomer Nasal bone Nasal process of Maxilla Palatine bone Inferior concha
5
Q
Which two bones form the septum
A
Perpendicular plate of the ethmoid
Vomer
6
Q
Describe the structure of the ethmoid bone itself
A
Perpendicular plate is the mid section - forms septum
Has crista galli on top which separates hemispheres
Either side has the superior and middle concha
Lots of air cells either side
7
Q
What structures is the ethmoid bone a part of
A
Septum
Roof
Lateral walls
of nasal cavity
8
Q
Which class of fracture can disrupt the ethmoid bone
A
Le Fort II and III
Affects the cribiform plate
9
Q
What are the potential nasal consequences of Le Fort fractures
A
Loss of smell - anosmia
Can disrupt the sinuses
This can allow infection to spread
10
Q
What type of epithelium lines the nose
A
In the vestibule (outermost) it is stratified squamous
Then becomes respiratory
Superior part has olfactory
11
Q
Describe the olfactory pathway
A
Signal picked up by receptor cells in the olfactory epithelium
Passes up through cribiform plate
Synapses with olfactory bulb
Neurons pass along the olfactory tract
Pass to temporal lobe and olfactory areas
12
Q
What is the innervation of the nasal cavity
A
Olfactory nerve cells in the olfactory mucosa
V1 for superior part - anterior ethmoid nerve
V2 for posterior part - nasopalatine nerve
13
Q
What is Kiesselbach’s area
A
Site of artery anastomoses in the nose
Located anteroinferiorly on the septum
14
Q
Which arteries supply the nasal cavity
A
Anterior and posterior ethmoidal arteries - branch of ophthalmic
Sphenopalatine and greater palatine - branch of maxillary
Lateral nasal and septal - facial artery
15
Q
What is epistaxis
A
Nose bleed
16
Q
How many conchae are found in the lateral nasal wall
A
3
Superior, Middle and Inferior
17
Q
which recess is found in the lateral nasal wall
A
Sphenoethmoidal recess
18
Q
What is the function of the nasal conchae
A
Create turbulent airflow through the nasal cavity
This increases the chance of humidifying, warming and filtering the air
19
Q
List the 4 pairs of sinuses associated with the nasal cavity
A
Frontal sinuses - frontal bone
Ethmoidal air cells
Maxillary sinuses - cheeks
Sphenoid sinuses - back of nose
20
Q
What lines the paranasal sinuses
A
Respiratory epithelium
21
Q
What drains through the sphenoethmoidal recess
A
The sphenoid sinus
22
Q
Which sinus drains through the superior meatus
A
Posterior ethmoidal air cells
23
Q
Which sinus drains through the middle meatus
A
Frontal sinus
Maxillary sinus
Anterior ethmoidal air cells
24
Q
Which sinus drains through the ethmoidal bulla
A
Middle ethmoidal air cells
25
Which sinus drains through the inferior meatus
Nasolacrimal duct
26
What is sinusitis
Inflammation of the mucosa in 1 or more of the paranasal sinuses
Will get excess mucus
May lead to swelling and build up of pressure
27
The maxilliary sinus is predisposed to infection - true or false
True
Ostium sits superior to it's cavity
Cilia must work against gravity to clear the sinus
28
How can tooth problems affect the sinuses
Tooth infection can lead to sinus infections if the roots pierce upwards into maxillary sinus
29
List the parts of the temporal bone
```
Squamous part
Petrous part
Pterion
External acoustic meatus
Mastoid process
Styloid process
Zygomatic process
```
30
Which nerves are found 'in' the temporal bone
Facial (CNVII)
| Vestibulocochlear - CNVIII
31
What does the facial nerve supply
Motor to face
Motor to stapedius
Taste to Ant. 2/3rds of tongue
Secretomotor to salivary glands and lacrimal gland
General sensation to posterior part of external ear - posterior auricular branch
32
What is the function of the vestibulocochlear nerve
Roles in balance and hearing
33
Where does the labyrinthine artery come from
Branch of anterior, inferior cerebellar artery
| This comes from the circle of Willis
34
What passes through the internal acoustic meatus
Facial nerve
Vestibulocochlear nerve
Labyrinthine artery
35
How is the ear divided anatomically
External ear - auricle to tympanic membrane
Middle ear - tympanic membrane to oval window
Inner ear - oval window to internal acoustic meatus
36
What is the function of the external ear
Collects and conveys sound waves to tympanic membrane
37
What is the function of the middle ear
Amplifies and conducts sound waves to the internal ear
| Includes the eustachian tube
38
What is the function of the inner ear
Converts special sensory information Into fluid waves, then APs and then conducts APs to brain
39
Describe the structure of the ear canal
Composed of 1/3 cartilage, 2/3 bones
Lined with skin - squamous epithelium with some hair cells
Produces earwax via ceruminous glands
40
The external cartilage of the ear it avascular- true or false
True
41
List the innervation to the auricle
C2,3 spinal nerves innervate most of it via the greater auricular nerve- lobe to helix and some of posterior area
Lesser occipital branch supplies lateral aresa
Mandibular branch of the trigeminal innervates superior part of the external acoustic meatus and most of the ear drum
CNX innervates inferior EAM and tympanic membrane
The facial nerve gives sensation to the concha part of the ear (posterior)
42
List the lymphatic drainage of the auricle
Lateral part of superior auricle drains to parotid nodes
Medial part of superior half goes to mastoid nodes
The rest (inc. lobe) goes to superficial cervical node
All will eventually end up in the deep cervical nodes
43
List the parts of the tympanic membrane
Pars flaccida - thin part of membrane at the top
Par tensa - thicker, inferior part
Umbo - handle of malleus
Cone of light - anterior and inferior
44
List the nerve supply to the tympanic membrane
External surface is CNV3
| Internal is CNIX
45
What parts of the ENT system does the glossopharyngeal nerve supply
Internal surface of tympanic membrane
Middle ear cavity
Eustachian tube
The branch to these structures is called the Jacobson's nerve
Nasopharynx
Oropharynx
Tonsils
46
What are the 3 bones of the middle ear
Malleus
Incus
Stapes
47
Which muscles are found in the middle ear
Stapedius
| Tensor tympani
48
How to the ossicles articulate
Via synovial joints
49
What is the oval window
Connection between middle and inner ear
| Stapes fits into it
50
Which nerve supplies sensation to the naso/oropharynx
CNIX - glossopharyngeal
51
Which nerve supplies sensation to the laryngopharynx
Mostly CNX - vagus
52
What does the eustachian tube connect
Connects anterior wall of the middle ear cavity to nasopharynx
Allows air to get into the middle ear to control pressure
53
Describe the path of the facial nerve
```
Leaves brain at pontomedullary junction
Passes through the internal acoustic meatus
Enters the facial canal
Gives off chorda tympani
Passes through stylomastoid foramen
Supplies face
```
54
What does the chorda tympani supply
Taste buds of the anterior 2/3rds of the tongue (may lose taste if damaged)
Parasympathetic supply to the submandibular & sublingual salivary glands (salivation)
55
What is the function of the stapedius muscle
Reduces stapes movement to protect the internal ear from excessive noise
56
What happens to facial fat as we age
Atrophy
57
Which nerve supplies the inner ear
CNVIII - vestibulocochlear
In 2 parts
Cochlear nerve - hearing
Vestibular nerve - balance
58
What is contained in the bony labyrinth
Filled with perilymph fluid
| Semi-circular canals are suspended in the fluid
59
What fills the semi-circular canals
Endolymph
60
Which AP's travel via the vestibular nerve
Those originating in the semi-circular ducts
61
Which AP's travel via the cochlear nerve
Those originating in to cochlear duct
62
How is movement detected in the inner ear
Hair cells are stimulated by movement of endolymph
Semi-circular canals detect angular movement
Utricle detects horizontal
Saccule detects vertical
63
How is sound transmitted in the ear
Sound waves make the tympanic membrane vibrate
Transmit through ossicles
Stapes vibrates the oval window
This creates pressure waves in perilymph of the inner ear
Hair cells in cochlea move and stimulate AP's
Pressure waves become vibration again and are dampened at round window
64
What detects auditory stimuli
Receptor cells in the organ of Corti
| Found in the cochlear duct
65
Describe the path of the vestibulocochlear nerve
Leaves brain at pontomedullary junction
Passes through internal acoustic meatus
Contacts the cochlear and semi-circular duct
66
At what level is the hyoid bone found
Level of C3
67
Where does the submandibular gland secrete saliva
Sublingual caruncle - bump under tongue
68
Where does the sublingual gland secrete saliva
Beneath the sublingual folds (under the tongue)
69
Which muscles make up the floor of the mouth
Mylohyoid
| Geniohyoid - connects chin and hyoid
70
What innervates the mylohyoid
CNV3
71
What innervates the geniohyoid
C1 - via hypoglossal nerve
72
Where does the parotid gland secrete salvia
By the upper 2nd molar
73
Which nerves innervate the salivary glands
Parotid - glossopharyngeal (CNIX)
Piggybacks on CNV3
Other 2 is the facial nerve
74
Which nerves supply the tongue
Posterior 1/3 - taste and sense by CNIX
Anterior 2/3 - sensory from V3 and taste from CNVII
75
List the muscles of the tongue and their innervation
Palatoglossus - vagus
| Styloglossus, Genioglossus and Hyoglossus - hypoglossal nerve
76
Describe the path of the hypoglossal nerve
Leaves from medulla
Passes through hypoglossal canal
Descends lateral to carotid sheath
Passes towards tongue at level of hyoid
77
How can you test CNXII - hypoglossal
Ask patient to stick their tongue straight out
In unilateral CN XII damage the tongue tip will POINT TOWARDS
the side of the injured nerve
78
List the blood supply to the tongue
Lingual artery - branch of external carotid
79
Which bones form the hard palate
Palatine process of the maxilla
Palatine bone
Pterygoid hamulus from sphenoid
80
List the muscles of the soft palate
```
Tensor veli palatini
Palatophrygeus
Levator veli palantini
Musculus uvulae
Palatoglossus
```
81
What is the innervation of the soft palate muscle
All CNX apart from tensor veli palatini which is CNV3
82
What are the functions of the soft palate
Stops food entering the nose during swallowing
Directs air into the nose or the mouth during speech, sneezing, coughing & vomiting
Helps to close off the entrance into the oropharynx in the gag reflex
83
How can you test CNX
Ask patient to say ahhh
If there is a unilateral nerve damage the uvula will be pulled away from the non-functioning side
Get them to swallow a small amount of water - does the larynx move, do they splutter?
Listen to speech - is it hoarse
Can they produce a powerful cough
84
Describe the muscles of the pharynx
3 constrictor muscles in the outer layer
3 paired vertical muscle in the inner layer
All skeletal and all innervated by CNX
85
What is the gateway to the mouth
The gap between the superior and middle circular muscle of the pharynx
CNIX, lingual artery and the stylopharyngeus muscle pass through here
86
Which nerve supplies the Stylopharyngeus
glossopharyngeal nerve
87
Name the 3 longitudinal muscles of the pharynx and their innervation
Stylopharyngeus - CNIX
Palatopharygeus - CNX
Salpingopharygeus - CNX
88
What are the components of Waldeyer's tonsillar ring
Adenoid
Tubal tonsil
Palatine tonsil
Lingual tonsil - back of tongue
89
How do lymph nodes appear in infection
Swollen
Painful
Soft and smooth
Not fixed
90
How do lymph nodes appear in cancer
Swollen
Not painful
Hard and irregular
Fixed
91
What are the functions of the larynx
Contains the voice box
It acts as a sphincter in the respiratory tract - regulates airflow and protects from aspiration
Warming and humidifying air and also for filtration of infection
Needs to stay open - patent URT
92
Where is the larynx found
Between the pharynx and trachea
Between C4 and C6
Between the two carotid sheaths
Enclosed in the pretracheal fascia
93
What structure does the Adam's apple indicate
The top of the thyroid cartilage
94
How does the larynx help protect you from aspirating
It raised up when we swallow to reduce chance of material getting in
Epiglottis also moves to close the inlet
95
What forms the 'skeleton of the larynx
```
Hyaline cartilage that is suspended from the hyoid bone:
Epiglottis
Thyroid cartilage
Cricoid cartilage
Arytenoid cartillages
```
96
Name the joint between the thyroid and cricoid cartilages
Cricothyroid joint
97
What happens when you put pressure on the cricoid cartilage
It compresses the oesophagus
Larynx stays open
Can be used in ventilation
98
What are the true vocal cords
Vocal process of arytenoid cartilage to thyroid cartilage
Covered in connective tissue
Movement of them allows us to make sound
99
What are the false vocal cords
Sit either side of the true ones
| They connect the arytenoid cartilage to epiglottis
100
What is the vallecula
The space between the epiglottis and tongue
| Laryngoscope is placed here
101
Describe how different movements of the vocal cords affect speech
Tension - increased pitch
Relaxation - decreased pitch
Adduction - quiet
Abduction - loud
102
Which intrinsic muscles act as tensors of the larynx
Cricothyroid muscles
103
Which intrinsic muscles act as relaxers of the larynx
Thyroarytenoid muscles
104
Which intrinsic muscles act as adductors of the larynx
Lateral crico-arytenoid muscles
| Arytenoid muscles
105
Which intrinsic muscles act as abductors of the larynx
Posterior Crico-arytenoid muscles
106
When vocalising the vocal cords are close together - true or false
True
For voice production you need the vocal cords to come together and vibrate
Also needs the lungs to create normal air pressure
107
How do glottic tumours present
On the cords - 95% will stay here
| Present with voice changes and airway obstruction
108
Where do supra-glottic tumours spread to
Superior, deep cervical nodes
109
Where do sub glottic tumours spread to
Paratracheal nodes
| less room to spread before causing an issue
110
How can you speak after the larynx is removed
Tracheo-oesophageal puncture - button thing
Oesophageal speech - learn to force air up through oesophagus to create speech, fit a prosthetic valve
Electrolarynx - machine used to generate sound
111
What nerve supplies the intrinsic laryngeal muscles
Inferior laryngeal nerve
| Branch of recurrent laryngeal
112
Describe what the branches of the laryngeal nerve supply
Superior branch splits into internal and external
Internal - sensory to muscos above cords
External - motor to criciothyroid muscle
Inferior branch = intrinsic muscles
113
Which abnormalities can be seen in the external auditory meatus
Genetic problems: - underdevelopment or atresia of the canal
- underdevelopment of the ear itself (ear will look unusual)
Severity of these can vary from mild to severe
Leads to conductive hearing loss
114
Describe the structure of the tympanic membrane
External layer is squamous epithelium, middle fibrous layer and then inner resp epithelium
115
Which branch of the vagus nerve supplies the external ear canal
Arnold's nerve
116
What is the nerve supply to the face
Trigeminal - ophthalmic, maxillary and mandibular (general sensation to the face)
Rest of the head/neck is supplied by branches of the cervical plexus - greater occipital, lesser occipital, greater auricular, transverse cutaneous (anterior neck), supraclavicular nerve (laternal neck)
Posterior neck = c3 c4
117
What causes referred ear pain
The pathways of the nerves supplying the ear converge or overlap in places which is why pain from elsewhere can refer to the ear - e.g. larynx, pharynx
118
What are the 3 anatomical areas of the larynx
Above the true cords - supraglottic
Around the cords is the glottis
Below this is the subglottic
119
What separates the larynx and the oesophagus
Epiglottis
120
Where are tracheostomies usually placed
- Usually placed between 2nd and 3rd tracheal rings
However, need to place below the level of obstruction in order to oxygenate properly so may move slightly
121
What forms the anterior triangle of the neck
Bordered by the mandible superiorly, SCM laterally, clavicle inferiorly and the vertical midline of the neck marks the anterior border
122
How is the anterior triangle of the neck divided
Into 4 smaller triangles
Submandibular
Submental
Muscular triangle - contains strap muscles
Carotid/jugular triangle - common carotids and bifurcation, hypoglossal and vagus nerves
123
What are the branches of the common carotid artery
Internal and external
124
What forms the posterior triangle of the neck
Bordered by the SCM anteriorly, lateral part of the clavicle inferiorly and the trapezius posteriorly
125
How is the posterior triangle of the neck divided
Subdivided into two more triangles - subclavian and occipital
126
List the 7 levels of head/neck lymph nodes
1 - submental and submandibular - drains oral cavity and floor of mouth
2,3,4 - anterior cervical chain
2 - angle of mandible to hyoid - drain from tonsils, oropharynx
3 - between hyoid and cricoid cartilage - primary drain sites include oropharynx and larynx
4 - below cricoid and above sternal notch - drains larynx
5 - posterior triangle - associated with nasopharynx
7 - supraclavicular nodes, typically a upper GI tract - Virchow's node
127
What does the internal carotid artery supply
It courses up to the cranial cavity and supplies the brain (joins the circle of WIllis)
128
What does the external carotid artery supply
External supplies the face, scalp and neck
Branches include superior and inferior thyroid artery, ascending pharyngeal, lingual artery (oral and tongue), facial artery, occipital artery (scalp and back of head), post auricular, maxillary and temporal
