Anatomy - HNS

Question 1

What are the three main herniations you need to know

Answer 1

1) Subfalcine herniation 2) Uncal herniation 3) Tonsillar herniation

Question 2

Which part of the brain herniates in a subfalcine herniation ?

Answer 2

Frontal lobe herniates under the falx cerebri This is not clinically significant

Question 3

Which part of the brain herniates in an uncal herniation

Answer 3

The uncus of the temporal lobe herniates below the tentorium cerebelli and compresses the midbrain This can lead to loss of consciousness

Question 4

Which part of the brain herniates in a Tonsillar herniation

Answer 4

The cerebellar tonsils move downward through the foramen magnum possibly causing compression of the medulla This can lead to cardiorespiratory arrest

Question 5

Outline the drainage of CSF

Answer 5

The choroid plexi create CSF in each lateral ventricle Lateral ventricles->inter ventricular foramina ->the third ventricle ->cerebral aqueduct ->the fourth ventricle Then into the subarachnoid space

Question 6

The internal carotid artery enters the cranium through which foramen?

Answer 6

Carotid canal

Question 7

Answer 7

Question 8

Answer 8

Question 9

Answer 9

Question 10

Answer 10

Question 11

Answer 11

Question 12

Answer 12

Question 13

Answer 13

Question 14

Answer 14

Question 15

Lis the nerves (5) and artery that run through the cavernous sinus

Answer 15

CN3
CN4

Opthalmic and maxillar CN 5¹ CN5²

CN6

Internal carotid

Question 16

Answer 16

—Anterior longitudinal ligament – covers and connects the anterior aspect of the vertebral bodies

Question 17

Answer 17

—Ligamentum flava – between vertebral arches

Question 18

Answer 18

—Posterior longitudinal ligament – runs within the vertebral canal on the posterior aspect of the vertebral bodies

Question 20

Answer 20

—Interspinous – between adjacent spinous processes

Question 21

Answer 21

—Supraspinous – between the tips of the spinous processes

Question 22

Which ligament is often injured in whiplash injures

Answer 22

Anterior longitudinal

Question 23

Describe the cough afferent and efferent pathways and what controls it

Answer 23

• Vagus afferents trigger inhalation ->
• Glottis closed and contracting abdominals
• >raised intra-thoracic pressure
• soft palate raised and tensed against posterior wall of pharynx by
• *-levator veli palantini CN X**
• *-superior constrictor, CN X**
• *-tensor veli palantini CN V3**
• -> abduction of vocal cords releasing intra-thoracic pressure through mouth

Question 24

Name cranial nerves that have a parasympathetic function

Answer 24

Oculomotor III

Facial VII

Glossopharyngeal IX

Vagus X

Question 25

What are the two small muscles of the ear and what are their actions?

Answer 25

—Tensor tympani muscle (V3): Pulls the handle of the malleus medially. This tenses the tympanic membrane, reducing the force of vibrations in response to loud noises —Stapedius (VII): Pulls the stapes posteriorly to prevent excessive oscillation

Question 26

Which nerve is the a fferent divions of the sneeze reflex?

Answer 26

V2

Question 27

Which nerve is the a fferent divions of the cough reflex?

Answer 27

X

Question 28

Which muslces depress the soft paalte agains the tongue in a sneeze?

Answer 28

Palatopharyngeus/palatoglossus (X)

Question 29

Which muslces raise the soft palate against the posterior wall of the pharynx in a cough ?

Answer 29

Levator veli palatine (X), Tensor veli palatine (V3), Superior constrictor (X)

Question 30

Name 6 functions of the facial nerve ?

Answer 30

—Salivation: VII provides GVE fibres from the superior salivary nucleus destined for submandibular and sublingual salivary glands via the SUBMANDIBULAR ganglion —Lacrimation: VII provides GVE fibres from the superior salivary nucleus destined for LACRIMAL gland via PTERYGOPALATINE ganglion. —Facial expression; SVE fibres to facial muscles. —Tension on middle ear bones; innervation to stapedius —Taste; SVA fibres from anterior two thirds of tongue to the solitary nucleus via the geniculate ganglion —Mastication and swallowing: SVE fibres to the buccinator (mastication), raising larynx during swallowing, innervates stylohyoid and posterior belly of digastric —General sensation: To the external auditory meatus

Question 31

Describe the major branches of the external carotid artery

Answer 31

Superior thyroid Ascending Pharyngeal Lingual Facial Occipital Posterior auricular Maxillary Superficial temporal —

Question 32

What are the limits of the pharynx?

Answer 32

Sup: Base of skull Inferior limit CV1

Question 33

Which nerve innervates all the extrinsic muscles of the tongue and what is the exception?

Answer 33

—hypoglossal nerve (XII) —EXCEPTION: Palatoglossus, innervated by the Vagus (X)

Question 34

What are the 3 borders of the anterior triangle?

Answer 34

—Anterior border of sternocleidomastoid —Midline —Inferior border of mandible

Question 35

Muscles in the anterior triangle

Answer 35

—The giant muscle, the platysma, covers the entire anterior of the neck in the superficial fascia ——TOSS My Gravy Spoon Darling Otherwise there are 2 main muscle groups: **—Suprahyoid (x4)** —above the hyoid bone – consist of the * **m**ylohyoid, * **g**eniohyoid * stylohyoid, * **d**igastric. —**Infrahyoid (x4)A.k.a strap muscles** —below the hyoid bone – * thyrohyoid muscles * omohyoid, * sternothyroid and * sternohyoid,

Question 36

Which muscles are both innervated by C1 fibres from the hypoglossal nerve

Answer 36

: The geniohyoid and the thyrohyoid

Question 37

Borders of posterior triangle?

Answer 37

—Posterior border of sternocleidomastoid —Anterior border of trapezius —Middle 1/3 clavicle

Question 38

What is the contents of the posterior triangle of the neck?

Answer 38

—4 vessels and 4 nerves —External + internal jugular veins —Subclavian arteries + subclavian veins —Trunks of brachial plexus —Spinal accessory —Phrenic nerve —Vagus nerve

Question 39

What muscles does the Spinal accessory nerve innervate?

Answer 39

—Innervates sternocleidomastoid and trapezius

Question 40

indicate the landmarks for insertion of a central line into the internal jugular vein

Answer 40

—Palpate common carotid —Go lateral and insert needle at 30 degree angle —Aim at apex of the triangle of the sternal and clavicular heads of the SCM —Direct towards nipple