Anatomy

Question 1

What effect can pituitary tumours have on vision?

Explain why

Answer 1

Can lead to bitemporal hemianopia -> pituitary compresses optic chiasmia -> compresses optic nerves coming from nasal retina -> affects sight in temporal visual fields

Question 2

What part of the brain processses visual stimuli?

Answer 2

Visual cortex in occipital lobe

Question 3

What lies directly superior to the pituitary gland?

Describe what it is

Answer 3

Diaphragma sellae

Tought sheet of dura matter

Question 4

What is the name of the dura mater that covers the cerebellum?

Answer 4

Tentorium cerebelli

Question 5

The pituitary gland forms off the hypothalamus.

The hypothalamus and thalamus together form what?

Answer 5

Diencephalon

Question 6

For each of the following parts of the pituitary gland. Identify if they are in the anterior or posterior lobe:

Pars nervosa
Pars tuberalis
Pars distalis
Pars intermedia

Answer 6

Pars nervosa - posterior lobe

Anterior lobe

• pars tuberalis
• pars distalis
• pars intermedia

Question 7

What is the name of the stalk that leads from the hypothalamus to the pituitary gland?

Answer 7

Infundibulum

Question 8

Where is the pituitary gland found?

Answer 8

Pituitary fossa -> sella turcica -> sphenoid bone

Question 9

How is venous blood transported in the brain/cranial cavity?

Answer 9

Venous sinuses

- made of foldings of dura mater -> internal jugular veins

Question 10

How can you tell the difference between the internal and external carotid arteries?

Answer 10

External has branches unlike internal

Question 11

What sinuses surround the pituitary gland?

Where is the internal carotid artery in relation to this?

Answer 11

Cavernous and intercavernous sinuses

Internal artery passes from cavernous sinuses

Question 12

When performing pituitary surgery on a relatively uncomplicated case, the TRANSSPHENOIDAL method is used.
What must be disected through to reach the pituitary?

Answer 12

Nasal septum

Floor and roof of sphenoid sinus

Question 13

Name the 4 paranasal sinuses found in the skull

What is found within paranasal sinuses?

Answer 13

Frontal sinus
Ethmoid air cells
Sphenoid sinus
Maxillary sinus (antrum)

Resp mucosal lining -> secrete mucus

Question 14

What muscle splits the neck into anterior and posterior triangle?

What muscle is found posterior to the posterior traingle?

What nerve innervates both these muscles?

Answer 14

Sternocleidomastoid

Trapezius

CN XI - spinal accessory nerve

Question 15

What is the offical name for the Adam’s apple?

Answer 15

Larngeal prominance of the thyroid cartilage

Question 16

Where is the thyroid gland found?

Describe its appearance?

Answer 16

Anterior of the larynx

Two lateral lobes joined by an ISTHMUS

Question 17

What is a pyramidal lobe in relation to the thyroid?

What embryological remnant does it originate from?

Answer 17

Extra growth of thyroid that is often found originating from left lateral lobe (but not always) and growing superiorly

Not in everyone

Thyroglossal duct

Question 18

If recurrent larngeal nerves become damaged what effect does this have.

Unilaterally affected
Bilaterally affected

Answer 18

Effects the ability of the rima glottis to move

Unilateral - hoarse voice

Bilateral - no sound at all - Aphonia

Question 19

Where do the left and right recuurent laryngeal nerves wrap around

Answer 19

Left = arch of aorta

Right = sublavian artery

Question 20

Where does the vagus nerve (CN X) exit the cranium?

Answer 20

Jugular foramen

Question 21

What is found in the carotid sheath?

Answer 21

• Vagus nerve
• Lymph nodes
• Common carotid artery
• Internal jugular vein

Question 22

What is the name of the fascia that encompasses the whole neck and covers the trapezius and sternocleidomastoid muscle?

Answer 22

Investing fascia

Question 23

What muscle is most superfical in the neck?

What is it innervated by?

Answer 23

Platysma muscle - found in superfical fascia (subcutaneous tissue)

CN VII - facial nerve - part of muscles of facial expression

Question 24

What is the name of the fascia which surrounds the cervical verterbrae and postural neck muscles?

Answer 24

Prevertebral

which dissecting from anterior found before vertebrae

Question 25

What does the pretracheal fasica encompass?

Answer 25

- Thyroid - Trachea - Oesphagus - Recurrent larnygeal nerves - Strap muscles

Question 26

Where does the thyroid get its blood supply; aterial and venous?

Answer 26

Arterial - supperior thyroid artery from external carotid - inferior thyroid artery from thyrocervical trunk (branch of subclavian) Venous - superior, middle and inferior thyroid veins

Question 27

Which of the veins that drain the thyroid flows straight into the brachiocephalic vein?

Answer 27

Inferior thyroid vein

Question 28

Where are the parathyroid glands found and how many are there? What must be noted about them when perfroming surgery of thyroid?

Answer 28

4 - 2 superior + 2 inferior Posterior surface of thyroid gland They have very variable positioning so need to be carefully disected

Question 29

What is the most superfical strap muscle? Name them all from lateral to medial What innervates these?

Answer 29

Sternohyoid Omohyoid Sternohyoid Sternothyroid Thyrohyoid C1-3 = ansa cervicalis Look at diagram in onenote NOE

Question 30

Through what vessel do hormones secreted by the hypothalamus pass into the anterior pituitary cells? These hormones can be either stimulating or inhibitory

Answer 30

Hypophyseal portal veins

Question 31

What 3 arteries supply the pancreas?

Answer 31

``` Dorsal pancreatic (branch of splenic) Superior pancreaticoduodenal (branch of gastroduodenal -> common hepatic artery) Inferior pancreaticoduodenal (branch of SMA) ```

Question 32

Where are the adrenal glands found?

Answer 32

Superior to the kidneys retroperitoneal

Question 33

The adrenal glands are in 2 distinct sections: name them what do they secrete?

Answer 33

Adrenal cortex (outer) - gluccocorticoids - mineralcorticoids - androgens Adrenal medulla (inner) - noradrenaline - adrenaline

Question 34

What is important to note about the vascular of the right and left adrenal glands? Name the 3 arteries and 1 vein that supply them where on the abdominal artery do these arteries appear?

Answer 34

Asymmetry between right and left Arteries - Superior suprarenal artery - above coeliac trunk - Middle suprarenal artery - above coeliac trunk - Inferior suprarenal artery - below SMA Vein - suprarenal vein

Question 35

The ovary is supplied by an anastomosis between the SMA and internal iliac artery. Name them.

Answer 35

Ovarian artery - SMA - from most lateral | Uterine artery - internal iliac artery - from most medial

Question 36

What nerve is found in the posterior triangle?

Answer 36

Spinal accessory nerve (CN XI)

Question 37

After the waves from the temporal visual fields have reached the nasal retina what is their pathway?

Answer 37

``` Nasal retina Optic nerve (CN II) Optic chiasma Optic tract Occipital lobe ```

Question 38

When accessing the pituitary gland for surgery during the common transsphenoidal method, what bones must be broken?

Answer 38

Nasal septum | Floor and roof of the sphenoid sinus

Question 39

What kind of incision is made to access the larynx?

Answer 39

"Collar" incision - superior to the clavicles and jugular notch In the natural crease of the neck

Question 40

Is it left or right vagus nerve that wraps around the arch of the aorta?

Answer 40

Left

Question 41

What nerves are found in the cavernous sinus?

Answer 41

3, 4, V1, V2 and VI

Question 42

``` Match the cell type to the pituitary hormone they secrete: Somatrope Corticotroph Lactotroph Thyrotroph Gonadotroph ```

Answer 42

``` Somatrope - GH Corticotroph - ACTH Lactotroph - Prolactin Thyrotroph - TSH Gonadotroph - LH + FSH ```

Question 43

Inside the thyroid there are follicles filled with a sticky substance called colloid. What makes up the main component of colloid?

Answer 43

Thyroglobulin

Question 44

What cell type makes up 50% of the anterior pituitary?

Answer 44

Somatropes (so much atrope) - excess also = GH