Exam 1: Part 1 Flashcards

1
Q

Epitaxis

A

1) Nosebleed
2) Kiesselbach are = anterior two thirds of nose
3) Trauma = most likely cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the major landmarks of the neck

A

1) C7 Vertebra
2) Hyoid Bone ~ at C3-4
3) Thyroid and Cricoid Cartilages ~ Cricoid at C6
4) Clavicle and Sternum
5) Mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the mnemonic for branches of the ECA?

A

Some Anatomist Like Freaking Out Poor Medical Students

1) Superior Thyroid a.
2) Ascending pharyngeal a.
3) Lingual a.
4) Facial a.
5) Occipital a.
6) Posterior Auricular a.
7) Maxillary a.
8) Superficial Temporal a.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Post-synaptic fibers of superior ganglia form what?

A

Internal carotid periarterial plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Subclavian A. and Scalene muscles at root of neck relationship

A

1) Medial to anterior scalene and at apex of lung and cervical pleura
2) Behind anterior scalene
3) Lateral to anterior scalene and anterior to brachial plexus within posterior triangle. comes into contact w/ 1st. rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Contralateral Homonymous Hemianopsia

A

Temporal vision loss on contralateral side

Nasal vision loss on the ipsilateral side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CN X injury and Clinical Presentation

A

1) Brainstem lesion or deep laceration of neck

2) Deviation of uvula to normal side; hoarseness owing to paralysis of vocal fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the borders of the anterior triangle of the neck

A

1) Midline of the neck
2) Anterior Border of Sternocleidomastoid
3) Inferior border of mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pressure on optic pathway; laceration or intracerebral clot in temporal, parietal, or occipital lobes of brain causes what kind of injury?

A

Visual Field Defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain how lesions associated with Herpes zoster (shingles) distribute themselves when following terminal branches of V1, V2, and V3.

A

1) Most common division affected = Ophthalmic Division
- Cornea involved –> painful corneal ulceration and scarring

2) MOA: Eruption of groups of vesicles following course of affected nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or False: Facial Nerve Innervates the Parotid Gland

A

False; CN IX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Coronal Suture

A

Articulation between Frontal and both Parietal Bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CN I Function

A

Smell and the only type of nervous tissue to regenerate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the ansa cervicalis innervate

A

1) Sternohyoid
2) Sternothyroid
3) Thyrohyoid
4) Omohyoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does the CSF surround>

A

Brain and Spinal Cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Jugular Foramen (Vernet) Syndrome

A

1) CN IX, CN X, CN XI

2) Symptoms: Dysphagia (Difficulty in swallowing) and Dysarthria (motor difficulty in speaking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the course of the Facial a.

A

Enters submandibular triangle adj. to submandibular gland before passing over mandible border to face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Injury to the base of brain or fracture involving cavernous sinus or obit causes injury to what nerve?

A

CN VI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical Significance of the Retropharyngeal Space

A

Easy route for upper respiratory or oral infections to spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

True or False: The Trigeminal nerve carries parasympathetic fibers

A

FALSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the course Ascending Pharyngeal

A

Medial aspect of external carotid near bifurcation of common carotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the first sign of CN III compression

A

Ipsilateral slowness of the pupillary response to light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the parasympathetic function of CN III

A

1) Innervates Sphicter pupillae muscle of iris to make pupil constrict
2) Contracts ciliary muscles to make the lens of eye more spherical (needed for near vision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the sensory component of the parotid gland?

A

Auriculotemporal N. Branch of CN V3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Trigeminal Neuralgia

A

Principal disease affecting sensory root of CN V, produces excruciating pain restricted to maxillary and/or mandibular divisions of the nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does the trigeminal nerve CN V distribute parasympathetic

A

Post-ganglionic fibers from ciliary, pterygopalatine, otic, and submandibular nuclei piggy back off a branch of the trigeminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which cranial nerve is most commonly used in Dental Anesthesia?

A

CN V; Superior alveolar isn’t readily available so have to inject to surrounding tissue, but the inferior alveolar is.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Clinical presentation of CN VI injury

A

1) Eye fails to move laterally (medial deviation)

2) Diplopia (double vision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Function of Muscles of Mastication

A

1) Masseter and Medial Pterygoid: Elevate and Protrusion of mandible
2) Temporalis: Elevates and Retrusion of Mandible

3) Lateral Pterygoid:
- Protracts and Depresses
- Unilaterally swings jaw toward contralateral side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Fracture of temporal bone (CN VII)

A

1) As in laceration or contusion in parotid region, but also associated involvement of cochlear nerve and chorda tympani; dry cornea; loss of taste on anterior two thirds of tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the branch of the facial n. that gives parasympathetic to CN V to innervate lacrimal gland

A

Greater Petrosal N.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the tension of vocal cords regulated by?

A

intrinsic muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Because of their relationship with the cavernous sinus, which CN’s are susceptible to injury via infections, thrombophlebitis?

A

CN III, CN IV, CN V1, CN VI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

List the Infrahyoid Muscles

A

1) Sternohyoid
2) Omohyoid
3) Sternothyroid
4) Thyrohyoid
5) Cricothyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Describe the pathway of the parasympathetic glossopharyngeal n.

A

Travel to otic ganglion and then to parotid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Maxillary A. Branches 1

A

1) DAM I AM Piss Drunk But Stupid Drunk I Prefer, Must Phone Alcoholics Anonymous

2)
D: deep auricular artery
A: anterior tympanic artery
M: middle meningeal artery
I: inferior alveolar artery
A: accessory meningeal artery
M: masseteric artery
P: pterygoid artery
D: deep temporal artery
B: buccinator artery
S: sphenopalatine artery
D: descending palatine artery
I: infraorbital artery
P: posterior superior alveolar artery
M: middle superior alveolar artery
P: pharyngeal artery
A: anterior superior alveolar artery
A: artery of the pterygoid canal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Symptoms of Cavernous sinus thrombosis

A

1) high fever
2) Periorbital edema and chemosis (conjunctival edema)
3) Cranial nerve palsies (CN VI (lateral gaze) most common)
4) Decreased Visual Acuity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Patient comes in with a loss of smell. Describe testing and Differential.

A

1) Test each nostril w/ patient blind folded and one nostril blocked
- occurs unilaterally

2) Differential
- Fractured Cribriform Plate –> Anosmia (loss of smell)

  • Fracture of Cranial Base –> Anosmia and Cerebrospinal Fluid Rhinorrhea
  • Meningioma –> Tumor of the meninges
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Laceration or contusion in parotid region (CN VII)

A

Paralysis of facial muscles
Eye remains open
Angle of mouth droops
Forehead doesn’t wrinkle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Describe the pathway for the parasympathetic Facial N.

A

Nuclei w/ pons (Superior Salivatory Nucleus) –> Internal Auditory Canal –> Travel to autonomic ganglion before innervating respective glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Describe the function, innervation, and blood supply to the intrinsic laryngeal muscles

A

1) Function: Control Tension of and spacing between vocal folds
2) Innervation: Vagus nerve via superior and inferior laryngeal n.
3) Blood supply: Superior Laryngeal A. and Inferior Laryngeal A.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Olfactory Hallucinations

A

Lesion of Temporal Lobe of Cerebral Hemisphere –> Temporal lobe epilepsy or uncinate fits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Treatment for Hydrocephalus

A

1) Ventriculoperitoneal shunt
- Drains Abdominal Cavity

2) Ventriculostomy
- Creates a hole in the flow of the third ventricle that drains into subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

List the Fontanelles

A

1) Anterior Fontanelle
2) Sphenoid Fontanelle
3) Mastoid Fontanelle
4) Posterior Fontanelle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Describe the location of the Thyroid Gland

A

1) Deep to sternothyroid and sternohyoid from levels of C5-T1
2) 2 Lobes: anterolateral to larynx and trachea
3) Isthmus unites lobes over 2nd and 3rd tracheal rings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are the prevertebral muscles innervated by?

A

Cervical and/or Brachial Plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

OI and A of Prevertebral muscles

A

1) Posterior Scalene ~ Laterally Flex Neck and Elevates Ribs during Deep Inspiration
- O&I: Posterior Tubercles (C5-C7) to 2nd Rib

2) Middle Scalene ~ Laterally flexes neck and elevates rib during deep inspiration
- Posterior Tubercles (C2-C7) to Superior 1st rib

3) Anterior Scalene ~ Laterally flexes and rotates neck; Elevates ribs during deep inspiration
- Anterior C3-6 TP to 1st Rib

Longus Capitis and Coli

Rectus Capitis Lateralis and Anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Describe the circulation of CSF

A

1) Circulates in the ventricles and the subarachnoid space and then resorbed via Dural venous sinuses

2) Arises via Ependymal cells of the of choroid plexus in each ventricle
- Drains into the Subarachnoid space –> Resorbed into Dural Venous Sinuses via arachnoid granulations
- Dural Venous Sinuses have a lower pressure gradient that allows for the flow into the sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the most common form of visual field loss and is often observed in patients with strokes?

A

Contralateral Homonymous Hemianopsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are Ventricular Folds

A

1) Brought together when holding breath while straining

2) Don’t contain vocal ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What’s contained within the carotid sheath?

A

1) IJV = most lateral
2) Vagus = most posterior
3) Carotid and its bifurcation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Describe the borders of the carotid triangle

A

1) SCM
2) Superior Belly of Omohyoid
3) Posterior Belly of Digastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Describe relational anatomy of parotid duct

A

1) Runs over masseter muscle –> pierces buccinator and opens on surface of oral cavity near upper second molar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Hypoglossal m. action and inervation

A

1) Depresses tongue and shortens it

2) Innervated via CN XII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the GVE modality

A

Parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Describe the location of the parathyroid gland

A

Posterior aspect of thyroid gland in own capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Describe the Greater Petrosal n. and the Pterygopalatine ganglion

A

1) Greater Petrosal n. + Deep Petrosal n. = nerve to pterygoid canal
2) Fibers go to pterygopalatine ganglion and the parasympathetic synapse here while sympathetic use the ganglion as a round about

3) Post-ganglionic fibers leave via multiple routes
- Pharynx
- Nasal cavity and Palate
- Lacrimal Gland

4) To the lacrimal gland, the parasympathetic hop onto the Zygomaticotemporal branch of the maxillary nerve and from there onto the lacrimal gland via communicating branch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Mnemonic for maxillary artery

A

DAM I AM Piss Drunk But Stupid Drunk I Prefer, Must Phone Alcoholics Anonymous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Describe the Phrenic N.

A

Formed via C3 and C4 of cervical plexus and ventral rami of C5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Describe the Retromandibular V.

A

1) Superficial temporal v. and maxillary v. together form the retromandibular v.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

List the different fascial layers of the neck

A

1) investing Fascia
2) Pretracheal Fascia
3) Prevertebral Fascia
4) Carotid Sheath
5) Retropharyngeal Space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Medial Wall of Orbit

A

1) Frontal Process of Maxilla
2) Lacrimal Bone
3) Lateral Mass of Ethmoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Bitemporal Hemianopsia

A

1) Complete section of optic chiasm

2) Loss of temporal view in both eyes

64
Q

Which layer of the scalp can infection spread through quickly

A

Loose CT = danger area

  • Spread into cranium via small emissary veins
  • Emissary veins anastomose between intra- and extracranial v.
65
Q

List the bones of the Nasal Complex

A

1) Nasal Bone
2) Lacrimal Bone
3) Inferior Nasal Concha
4) Maxilla
5) Sphenoid Bone
6) Palatine Bone

66
Q

Contents of Prevertebral Fascia

A

Vertebral Column

Prevertebral Muscles

67
Q

Mylohyoid m. action and innervation

A

1) Supports and elevates tongue and hyoid bone during swallowing, speaking, and in tongue protrusion
2) Innervated via Mylohyoid nerve

68
Q

Describe the innervation of the infrahyoid muscles

A

1) Sternohyoid, Omohyoid, and Sternothyroid are innervated via ansa cervicalis
2) Thyrohyoid is innervated via C1 via hypoglossal n.
3) Cricothyroid is innervated via external laryngeal nerve via Vagus

69
Q

How is the CN IV injured and what can it lead to?

A

1) Stretching of nerve during its course around brainstem; Fracture of orbit
2) Inability to look down when eye is adducted

70
Q

List Cranial Nerves and their Foramen

A

1) CN I: Olfactory –> Cribriform Plate
2) CN II: Optic –> Optic Canal
3) CN III: Oculomotor –> Superior Orbital Fissure
4) CN IV: Trochlear –> Superior Orbital Fissure
5) CN V: Trigeminal
- V1: Ophthalmic –> Superior Orbital Fissure
- V2: Maxillary –> Foramen Rotundum
- V3: Mandibular –> Foramen Ovale
6) CN VI: Abducens –> Superior Orbital Fissure
7) CN VII: Facial –> Internal Acoustic Meatus
8) CN VIII: Vestibulocochlear –> Internal Acoustic Meatus
9) CN IX: Glossopharyngeal –> Jugular Foramen
10) CN X: Vagus –> Jugular Foramen
11) CN XI: Accessory –> Jugular Foramen
12) CN XII: Hypoglossal –> Hypoglossal Canal

71
Q

Congenital Torticollis

A

Fibrous tissue tumor within SCM that develops in utero

2) Causes head to turn to side and the face to turn away from affected side – shortens SCM

72
Q

Clinical relationship of Subclavian a. and 1st. rib

A

Compression of subclavian a. against rib can control bleeding in upper limb

73
Q

Describe the relational anatomy of the Facial nerve and parotid gland

A

1) Exits stylomastoid Foramen –> Innervates stylohyoid and posterior digastric –> enters parotid gland

74
Q

Digastric m. action and innervation

A

1) Depress mandible, raises hyoid bone and steadies it during swallowing and speaking
2) Innervated via CN V (anterior via 1st arch) and CN VII (Posterior via 2nd arch)

75
Q

What are the two sub-triangles of the posterior triangle

A

Occipital Triangles

Supraclavicular Triangles

76
Q

Describe the Investing Fascia

A

1) Most superficial and surrounds entire neck

77
Q

Contents of the pretracheal fascia

A

Infrahyoid muscles

Buccopharyngeal fascia

78
Q

What does CN III innervate?

A

1) Upper eyelid
2) 4/6 extrinsic eye muscles
- Superior Rectus
- Inferior Rectus
- Medial Rectus
- Inferior Oblique

79
Q

Describe the Retropharyngeal Space

A

Posterior to pharynx/esophagus and extends from base of skill to mediastinum

80
Q

Which CN transmit through the superior orbital fissure

A

1) CN III
2) CN IV
3) CN V1
4) CN VI

81
Q

CN IX injuries and clinical presentations

A

1) Brainstem lesion or deep laceration of neck

2) Loss of taste on posterior third of tongue; loss of sensation on affected side of soft palate; dry mouth

82
Q

Describe the Pretracheal Fascia

A

Anterior of neck and blends with pericardium

83
Q

Describe the nuclei, nerves and course of the innervation of the sublingual, submandibular and parotid salivary glands, the lacrimal glands, the tarsal muscle, dilator and sphincter pupillae muscles and the ciliary muscles.

A

1) Superior Salivatory Nucleus –> CN VII –> All glands of head except integumentary
2) Inferior Salivatory Nucleus –> CN IX –> Parotid
3) Edinger-Westphal –> CN III –> Ciliary Muscle, Constrictor Pupillae, tarsal muscle

84
Q

Describe the blood supply of thy Parathyroid glands

A

Inferior Thyroid a.

85
Q

Describe the general venous drainage of the face via the orbit and cavernous sinus

A

1) Cavernous sinus recieves blood from
- Superior and Inferior Ophthalmic Veins
- Superior Middle Cerebral Vein
- Sphenoparietal Sinus

2) Delivers blood to Superior/Inferior Petrosal Sinus and Emissary V., Basilar Plexus and Pterygoid venous plexus
3) Superior/Inferior Petrosal Sinus dumps into the Sigmoid Sinus

86
Q

Describe CN VI injury

A

Base of brain fracture involving cavernous sinus or orbit

87
Q

Somatic motor function of CN III

A

1) Supplies 4/6 extrinsic eye muscles

2) Supplies levator palpebrae superioris muscle to elevate eyeli

88
Q

CN XII injury and clinical presentation

A

1) Neck laceration, fractures of cranial base

2) Protruded tongue deviates toward affected side; moderate dysarthria (disturbance of articulation)

89
Q

Where do the loops of the Cervical plexus lie?

A

Anterolateral to levator scapulae and middle scalene

90
Q

List the paired cartilages

A

1) Arytenoid
2) Corniculate
3) Cuneiform

91
Q

Describe the Chorda Tympani Nerve

A

1) Branch of Facial
2) Taste anterior 2/3 tongue
3) Parasympathetic to submandibular and sublingual

92
Q

Vocal Folds

A

1) Between thyroid and arytenoid cartilages
2) Generates sound via vibrating as air passes by
- Force of air controls volume and tension of folds determines pitch

93
Q

Write out the modalities

A

:)

94
Q

What branches does the Vagus nerve give off?

A

Recurrent Layngeal Ns.

95
Q

Describe the pathway for the parasympathetic n. Vagus

A

Motor Nuclei in medulla oblongata –> Jugular Foramen –> Dorsal Vagus Nuclei –> Branch neck, thoracic, and abdomen

96
Q

What is the blood supply of the thyroid gland?

A

Inferior and Superior Thyroid A/V

97
Q

What makes up the floor of the Orbit?

A

1) Perpendicular plate of palatine bone
2) Orbital surface of maxilla
3) Zygomatic Bone

98
Q

What are the vocal cords attached to?

A

Arytenoid cartilages

99
Q

What are the subtriangles of the Anterior Triangle

A

1) Carotid
2) Submandibular Triangle
3) Muscular
4) Submental

100
Q

Cervical Plexus (Ventral Rami of C1-4) Functions

A

1) Forms cutaneous nerves of posterior triangle
2) Supplies adjacent prevertebral muscles
3) Forms Phrenic N. w/ C5 of Brachial Plexus
4) Forms Ansa Cervicalis (C1-3) which supplies infrahyoid and geniohyoid m.
- C1 = Superior Root
- C2-3 = Inferior Root

101
Q

Lateral Wall of Orbit

A

1) Zygomatic Process of Frontal Bone
2) Greater Wing of Sphenoid Bone
3) Orbital Surface of Zygomatic Bone

102
Q

What happens when there is severance of phrenic or phrenic nerve block

A

Paralysis of that side of diaphragm

103
Q

Describe the course of the occipital a.

A

Hooked around the hypoglossal n. near vessel origin

104
Q

CN XI Injury and Clinical Presentation

A

1) Laceration of neck

2) Paralysis of sternocleidomastoid and descending fibers of trapezius; drooping shoulder

105
Q

Why can Demyelination of the Optic Nerve occur without other Peripheral nerves in MS?

A

1) Apart of CNS and uses Oligodendrocytes (Glial Cells) rather than schwann cells

106
Q

Direct Trauma to the orbit or eyeball causes injury to what nerve and what does it present with?

A

1) CN II

2) Loss of pupillary Constriction

107
Q

Explain why cuts to the scalp bleed profusely

A

1) Scalp holds cut vessels open due to arterial walls being firmly in adherence to Dense CT
- This limits their ability to constrict when cut
2) Contraction of Occipitofrontalis m. can form the gaping wound via pull

108
Q

Bell Palsy

A

Unilateral facial paralysis of sudden onset resulting from a lesion of CN VII

109
Q

Course of Phrenic N.

A

1) Anterior to Anterior Scalene and descends w/ IJV
2) Posterior to Suprascapular and Transverse Cervical
3) Posterior to Subclavian V. and anterior to internal thoracic as it enters thoracic cavity

110
Q

What is comprised of the roof of the Orbit?

A

1) Frontal bone

2) Lesser Wing of Sphenoid

111
Q

Contents of Investing Fascia

A

SCM
Trapezius
Parotid
Submandibular Glands

112
Q

Intracranial Hematoma (Stroke)

A

Forehead wrinkles because of bilateral innervation of frontalis ,muscle, otherwise paralysis of contralateral facial muscles

113
Q

Describe Dysphonia, Hoarseness, and laryngitis

A

1) Dysphonia: Disorder of voice
2) Hoarseness: Inflammation of vocal cords
3) Laryngitis: Inflammation of vocal cords where no longer vibrate

114
Q

Border of the Posterior Triangle

A

1) Posterior Border of Sternocleidomastoid
2) Anterior Border of Trapezius
3) Superior Border of Clavicle
4) Floor = Prevertebral Fascia
5) Roof = Deep investing fascia

115
Q

What branches of the Facial nerve carry parasympathetic

A

Greater Petrosal N.

Chorda Tympani Branch

116
Q

Describe the course of the internal carotid

A

1) Runs inside the cranial cavity and posterior of the orbit giving rise to the ophthalmic a.
2) Ophthalmic a. goes through the orbit and gives rise to supratrochlear and supraorbital a.

117
Q

What creates the sub-triangles of the posterior triangle

A

Inferior belly of omohyoid m.

118
Q

What do the post-ganglionic fibers of the inferior cervical sympathetic chan enter?

A

Brachial plexus

119
Q

What structures are found within the Parotid Gland

A

1) Parotid Duct
2) Facial N.
3) Retromandibular V.
4) External Carotid A.
5) Auriculotemporal N. (CN V3)

120
Q

List the motor branches of Facial N.

A

** Ten Zebras Bit My Cock

Ten ~ Temporal 
Zebras ~ Zygomatic 
Bit ~ Buccal 
My ~ Mandibular 
Cock ~ Cervical
121
Q

What is Hydrocephalus

A

1) “Water on the Brain”

- Obstruction of CSF flow and prevents resorption

122
Q

Blood Supply of the nasal cavity

A

1) Opthalmic a.
- Anterior Ethmoid a.
- Posterior Ethmoid a.

2) Maxillary a.
- Sphenopalatine a.
- Greater palatine a.

3) Facial a.
- Superior Labial a.

123
Q

Describe the structures with in the Cavernous sinus

A

1) ICA
2) CN III, IV, V1, V2, V3, VI
3) Pituitary Gland

124
Q

Cavernous Sinus Thrombosis

A

1) Caused via retrograde spread of bacteria into cavernous sinus via ophthalmic veins from the sphenoidal air sinus

125
Q

Innervation of nasal cavity

A

1) Anterosuperior portion of nasal cavity supplied via Ophthalmic a. and n.
2) Posteroinferior portion supplied via maxillary a. and n.
3) Mucosa of roof and adj. areas of walls and septum receive from olfactory

126
Q

What 7 bones comprise the Orbit

A

1) Maxilla
2) Lacrimal Bone
3) Ethmoid Bone
4) Frontal
5) Zygomatic
6) Sphenoid
7) Palatine Bone

127
Q

Botox Injections

A

1) Inhibits acetylcholine release thus blocking neuromuscular transmission
- Treats eye disorders, migraines, muscle spasms or used cosmetically

128
Q

Describe the general venous drainage of the brain, head and neck

A

1) Superior Cerebral Veins –> Superior Sagittal Sinus
2) Inferior Sagittal Sinus + Great Cerebral V. –> Straight Sinus
3) Occipital Sinus communicates inferiorly w/ internal vertebral venous plexus
4) Confluence of Sinuses = occipital + Superior + Straight + Transverse
5) Transverse receives from the others turns into sigmoid sinus and the sigmoid sinus turns into IJV as it passes through the jugular foramen

129
Q

List the sinuses

A

1) Frontal
2) Sphenoid
3) Ethmoid
4) Maxillary

130
Q

Injury to terminal branches in roof of maxillary sinus or trigeminal ganglion affects which CN? What abnormal findings are present?

A

1) CN V

2)
- Loss of pain and touch sensations; paresthesia;
- masseter and temporalis muscles dont contract;
- deviation of mandible to side of lesion when mouth is open

131
Q

Describe the prevertebral fascia of the neck

A

Extends laterally as axillary sheath into arm

132
Q

What creates the retropharyngeal space

A

1) Prevertebral
2) Buccopharyngeal fascia
3) Carotid Sheath

133
Q

Squamous Suture

A

Articulation between Temporal and Parietal Bones

134
Q

Aneurysym of Posterior Cerebral or Superior Cerebellar a. exert pressure on what nerve?

A

CN III

135
Q

What is the name of the depression for the Pituitary gland?

A

Sella Turcica (Hypophyseal Fossa)

136
Q

Describe the pathway of the parasympathetic Oculomotor nerve

A

Superior Orbital Fissure –> Ciliary Ganglion –> Iris and Ciliary m.

137
Q

Sagittal Suture

A

Articulation between both parietal bones

138
Q

Bell’s Palsy

A

1) CN VII injury

2) Muscle weakness/paralysis including inability to close eyelids

139
Q

Describe parotid gland

A

1) Parotid Gland = Large serous gland encapsulated via tough fascia

140
Q

List the Muscles of Mastication

A

1) Masseter
2) Temporalis
3) Medial Pterygoid
4) Lateral Pterygoid

141
Q

Diagram the Trigeminal Nerve!

A

DO It. You want to Pass right?

142
Q

Complete section of an optic nerve causes what?

A

Blindness in the temporal and nasal visual fields of the ipsilateral eye

143
Q

Bone Flaps

A

Allows surgical access and optimal healing. Incorporates overlaying tissue (skin, muscle, and fascia)

144
Q

Geniohyoid m action and innervation

A

1) Pulls hyoid anterosuperior, shortens floor of mouth and widens pharynx

145
Q

Describe the Epidural, Subdural, and Subarachnoid hematoma

A

1) Epidural ~ Ruptured middle meningeal a. usually due to fracture
- between skull and dura mater

2) Subdural ~ Due to rupture of cortical veins overlying the subdural space
- between the dura and arachnoid mater

3) Subarachnoid ~ usually rupture of an aneurism
- Between arachnoid and pia mater

146
Q

Muscular Torticollis

A

1) Injured during difficult birth and leads to hematoma that develops into fibrotic mass that entraps CN 11
2) Stiffness of neck then results rom fibrosis and shortening of SCM. May require surgical detaching of SCM

147
Q

Stylohyoid m. action and innervation

A

1) Elevates and retracts hyoid bone

2) Innervated via CN 7

148
Q

CN VIII and Acoustic Neuroma

A

Tumor of CN VIII

Progressive unilateral hearing loss; tinnitus (noises in ear)

149
Q

Describe the course of the Superior Thyroid

A

Descends toward the thyroid gland and gives off superior laryngeal a.

150
Q

Organization of the Scalp

A
S~ Skin (Integument)
C~ Dense CT
A~ Aponeurosis
L~ Loose Areolar CT
P~ Pericranium
151
Q

Lambdoid suture

A

Articulation between parietal and occipital bones

152
Q

Describe the cutaneous innervation (sensory) of the scalp and face including the major branches, the foramina that they traverse and the skin area each nerve supplies.

A

1) Posterior Scalp
- Greater Occipital (Dorsal Ramus)
- Lesser Occipital (Ventral Ramus)

2) Anterior
- Supraorbital .
- Supratrochlear.

3) Lateral Scalp
- Zygomaticotemporal n.
- Auriculotemporal n.

153
Q

Describe the difference in location between pharyngeal and palatine tonsils

A

1) Pharyngeal Tonsils are located within the roof of the nasopharynx
2) Palatine tonsils are on either side of the oropharynx bounded via palatopharyngeal arches and tongue

154
Q

List the bony fissures or foramens that are associated with the Sphenoid

A

1) Superior Orbital Fissure
2) Foramen Rotundum
3) Foramen Ovale
4) Foramen Spinosum

155
Q

Describe the innervation of the muscles of mastication

A

*** They are all innervated via CN V3

1) Masseter: Masseteric N. of CN V3
2) Temporalis: Deep Temporal Branches of CN V3
3) Medial Pterygoid: Medial Pterygoid N. CN V3
4) Lateral Pterygoid: Lateral Pterygoid N. CN V3

156
Q

Describe the course of the Lingual A.

A

Arches superoanteriorly and then passes deep to hypoglossal n., stylohyoid m., and posterior belly of digastric before reaching hyoglossus

157
Q

List the unpaired cartilages of the larynx

A

1) Thyroid
2) Epiglottis
3) Cricoid