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Exam 2 Head And Neck Flashcards

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1
Q

CN? Motor to somite derived muscles

A

CN III, IV, VI - Eyes
CN XI - Sternocleidomastoid, and Trapezius
CN XII - Tongue

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2
Q

CN? Motor to muscles of pharyngeal arches

A

CN V - Muscles of Mastication (Masseter, Temporalis, Medial and Lateral Paterygoid)

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3
Q

CN? Motor to organs- parasympathetics

A

CN III - Contract Iris and Ciliary body
CN VII - Lacrimal, Submandibular, Sublingual glands
CN IX - Parotid gland
CN X - Thoracic and Abdominal Organs

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4
Q

Kiesselbach’s Area

A

Nasal anastomosis fed by:
-Nasal branch off of Sphenoplatine
- Ophthalmic artery
- Palatine artery through incisive canal
* fracture of nasal septum or lateral ________ wall can be a real pain to control
* To stop EPISTAXIS = Packing of the nose

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5
Q

Waldeyer’s Ring

A

Tonsils in nasopharyngeal and oropharynx, between external environment and upper ends of respiratory and alimentary tracts

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6
Q

Epidural hematomas occur _______(speed) and from what source?

A

Fast and Arterial blood

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7
Q

Epidural hematomas common occurrence site?

A

Pterion, with the Middle Meningeal Artery deep to it.

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8
Q

How to identify/ differentiate a Epidural hematoma on a CT?

A

They DO NOT extend past the sutures of the skull. Sutures act as spot weld.

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9
Q

Epidural hematomas occurs between which layers?

A

Between the Dura matter and Skull

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10
Q

Subdural Hematomas occur _________(Speed) and source is _________?

A

Slow
Bridging veins

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11
Q

Subdural hematomas occur between which layers?

A

Between the Dura Matter and Arachnoid matter.

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12
Q

Venous drainage from skull?

A

Superior Sagittal Sinus and Straight sinus (which is a combo of Interior Sagittal Sinus and Basilar Vein) -> Confluence of Sinuses (1) -> Transverse Sinus (2) -> Sigmoid Sinus (2) -> Internal Jugular Vein (2) and Subclavian vein -> Superior Vena Cava

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13
Q

Lymph drainage from Submental Node vs Submandibular Nodes

A

-Middle lower lip. -Rest of lower lip
-Anterior gums. - upper lip
-Anterior tongue -sublingual gland
Clinical significance: Smokeless tobacco users will get inflammation and cancer or these nodes.

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14
Q

Lymph drainage for the superficial fascia of the face and scalp

A

Pericervical Lymph Collar -> Superficial Cervical Lymph Collar -> Deep Cervical Lymph Nodes (that run along the internal jugular vein) -> Subclavian Vein

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15
Q

MALT

A

Mucosa-associated lymphatic tissue

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16
Q

Bridging veins

A

Take blood from the cortex to the superior Sagittal sinus

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17
Q

Subarachnoid hematoma occurs _______(speed) and from what source?

A

Fast
Artery (most frequently from burst aneurysms)

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18
Q

Subarachnoid hematomas occurs between which layers?

A

Under the arachnoid layer, in the CSF (cerebral spinal fluid).
* will increase pressure in skull, and patient will complain of “Worst Headache of their Life”.

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19
Q

Cerebral hemorrhage

A

Rupture or blockage of vessels = result in stroke
*if you have blood clot in the left ventricle, arch of the aorta, or carotid artery those can break loose and get lodged in the cerebral vascular use, depriving everything down stream and cause clinical signs.

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20
Q

Microscopic one way gates that allow CSF to pass into the blood but never in reverse is ______?

A

Arachnoid Granulation

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21
Q

Lesions to Broca’s area would cause?

A

Expressive Aphasia
(-) inability to form spoken language coherently
(+) Ability to understand language unaffected

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22
Q

Lesion to Wernicke’s Area would cause?

A

Receptive Aphasia
(-) inability to understand spoken language
(+) ability to speak intelligibly is intact

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23
Q

Primary language cortex for most people is on the _______?

A

Left

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24
Q

Vision Decussation will cause the Right hemisphere to interpret the left visual field and Left hemisphere to interpret the right visual field, but because the Left Hemisphere is busy with language, the Right hemisphere will take on most of tracking movement, motion and shapes. Stroke on the left side will cause________?

A

Left Hemineglect
-Caused by stroke in the Left hemisphere’s middle cerebral artery lesion.

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25
Describe the path/ branches from the External Carotid Artery as it travels into the brain.
External Carotid Artery ^ Superior Thyroid Artery v Occipital Artery ^ Lingual Artery ^ Facial Artery v Posterior Auricular Artery< Maxillary Artery and Superficial Temporal Artery
26
Describe the path/ branches of the Maxillary Artery as it travels from the External Carotid Artery to the face:
External Carotid Artery < Superficial temporal Artery and Maxillary Artery v Inferior Alveolar Artery ( which branches into the Mental branch of the Inferior Alveolar) ^ Middle Meningeal Artery ^ Sphenopalatine Artery ( which branches into the Nasal branch of the Sphenopalatine) v Greater and Lessor Palatine Artery < Superior Alveolar Artery and Infra Orbital Artery
27
The 1st half of the Maxillary Artery supplies all the blood to the muscles of mastication:
Masseter Temporalis Pterigoid (medial and lateral)
28
Describe the path/ branches of the Ophthalmic Artery as it travels from the Internal Carotid Artery to the Eye and eyebrow/ scalp.
Internal Carotid Artery v Ophthalmic Artery ^ Central Artery of the retina thenOphthalmic Artery does a 3 way split (1) Lacrimal Artery, (2) Posterior Ciliary Arteries, (3) Supratrochlear Artery (which splits off into the Supra Orbital Artery and the Anterior and Posterior ethmoid arteries)
29
Scalp is made up of 5 layers:
S =Skin C=Connective Tissue A=Aponeurosis (tendon between occipitalis and frontal is muscle) L= Loose (areolar) connective tissue (reason scalp slides around) P=Periosteum
30
What surrounds the Hypothalamus and Optic nerve?
Circle of Willis
31
Arteries that make the Circle of Willis?
Posterior circulation: - Posterior Cerebral Artery (2) Anterior circulation: -Posterior Communicating Artery (2) -Anterior Cerebral Artery (2) -Anterior Communicating Artery (1)
32
If a stroke wipes out both temporal lobes (especially the hippocampus) then the patient would have?
Korsakoff’s syndrom - retrograde amnesia - loss of memories back to a point -anterograde amnesia - can’t form new memories -usually results from chronic alcoholism -or due to poor nutrition
33
Basil Ganglia is composed of ?
-Caudate nucleus (motor planning and invitation) -Putamen -Globus pallidus
34
More direct pathway to the thalamus with result in _________?
More movement overall
35
More indirect pathway to the thalamus will result in ________?
Less activity overall
36
Huntingtons disease
Will result in degeneration of the striatum (= caudate and putamen) which will result in more activity coming in the direct pathway and less activity coming through the indirect pathway.
37
Parkinson’s is the
Loss of Substanti Nigra which will result in a lack of willful motion.
38
Cerebella’s dysfunction: Ataxia, Dysmetria, Dysdiadochokiesia
Ataxia- inability to make coordinated and accurate movements Dysmetria- movements are too short or too long and are adjusted after completion Dysdiadochokiesia- inability to make rapidly altering movements
39
Oculomotor nerve (motor to the muscles of eye movement) except:
Superior Oblique (innervated by the Trochlear Nerve) and Lateral Rectus (innervated by the Abducents Nerve)
40
CN? Sensory
CN V - Facial Sensation CN VII, IX, X - Ear Canal CN IX - Pharynx
41
CN? Special Sensory
CN I - Smell CN II- Vision CN VIII - Hearing and Balance CN CII, IX, X - Taste
42
Cranial Nerve I
Olfactory Nerve -Smell sensation -Travel through plate of the ethmoid bone to reach the superior nasal cavity. -Olfactory stria go directly to the temporal lobe which is responsible for memory (passing up the thalamus)
43
Cranial Nerve II
Optic Nerve -The retina of they eye is a direct extension of diencephalon, and as such, is part of the CNS. -Retina sends axons through the left and right optic nerve, which travels in the optic canal. These converge and swap axons at the optic chias and synapses in the lateral geniculate nuclei of the thalamus -> occipital lobe where vision information is processed.
44
Fovea
unimpeded pathway for light to reach cones. Humans have pigmented epithelium (vs. animals have reflective epithelium = eyes glow).
45
Visual Fields -axons from the nasal retina and the Temporal retina
*Nasal retina cross over, where as the Temporal retina does not. -Lesion of the optic nerve before the optic chiasm will result in visual deficits affecting one eye on the same side as the lesion. -Lesion of the optic nerve after the optic chiasm will result in visual deficits affecting 1/2 visual field (opposite of the side the lesion is on) in both eyes (Homonymous hemianopsia). -Lesion at the Optic chiasm will result in a narrowing of visual field (Bitemporal hemianopia). -Lesion of a single optic radiation results in loss of visual field quadrant (Quadrantanopia).
46
1
Superior Rectus
47
2
Superior Oblique
48
3
Medial Rectus
49
4
Inferior Rectus
50
5
Inferior Oblique
51
6
Lateral Rectus
52
1
Superior Oblique
53
2
Superior Rectus
54
3
Inferior Oblique
55
4
Lateral Rectus
56
5
Levator Palpebrae Superioris (lifts eye lid)
57
6
Inferior Rectus
58
7
Medial Rectus
59
1
Levator palpebrae superioris (CN III)
60
2
Superior Rectus (CN 3)
61
3
Superior Oblique (CN IV)
62
4
Lateral Rectus (CN VI)
63
5
Medial Rectus (CN III)
64
6
Inferior Rectus (CN III)
65
7
Inferior Oblique (CN III)
66
Testing rectus muscle of the eye- Test obliques muscle of the eye -
-patient looks laterally (because axis of vision is not the same as axis of orbit) then Superior for Superior, Inferior to Inferior, then medially. - patient looks medially and opposite of their name (so inferior oblique look medially and superiority).
67
Loss of Oculomotor nerve would result in eye directing_________?
Down and out
68
Loss of Trochlear Nerve presents as __________?
Double vision when looking down.
69
Loss of Abducens presents as ________?
Persistently adducted pupil. (Abducens CN VI innervated the lateral rectus).
70
Loss of _______________ innervation of an eye is an early sign of increased intracranial pressure as the Oculomotor Nerve is pushed against dura matter.
Parasympathetic
71
Cavernous Sinus
CN III, IV, VI, 2 branches of V all travel through the Cavernous sinus - a Dural venous sinuses that is on either side of the pituitary gland in the sphenoid sinus area.
72
Sphincter muscle of pupil is _________________.
Parasympathetic and innervated by CNIII. (Dilator muscle of the pupil = sympathetic)
73
1
Posterior Belly of Digastric
74
2
Stylohyoid (pulls up when muscles contract)
75
3
Hyoid bone
76
4
Mylohyoid
77
5
Anterior Belly of the Digastric
78
1
Sternothyroid
79
2
Omohyoid (superior belly)
80
3
Omohyoid (inferior belly)
81
4
Sternum
82
5
Sternohyoid
83
6
Thyrohyoid
84
7
Hyoid Bone
85
1 Name, Origin, Insertion and Function
Mylohyoid Origin: Body of right and left mandible Insertion: Midline raphe Function: Elevate hyoid bone during swallowing
86
2 Name, Origin, Insertion and Function
Stylohyoid Origin: Styloid process of temporal bone Insertion: Hyoid Bone Function: Elevated Hyoid Bone during swallowing
87
3 and 5 Name, Origin, Insertion, and Fuction
Omohyoid (3: superior belly and 5: inferior belly) Origin: Superior scapula Insertion: Hyoid bone Function: Depressed the Hyoid Bone
88
4 Name, Origin, Insertion, and Function
Sternohyoid Origin: Posterior sternum Insertion: Hyoid Bone Function: Depress the hyoid bone
89
6 Name, Origin, Insertion, and Function
Sternothyroid Origin: Posterior sternum Insertion: Thyroid cartilage Function: Depress Hyoid Bone
90
7 Name, Origin, Insertion, and Function
Thyrohyoid Origin: Thyroid Cartilage Insertion: Hyoid Bone Function: Depress hyoid bone
91
8 and 9 Name, Origin, Insertion, and Function
Digastric ( 8: Posterior belly, and 9: Anterior belly) Origin: Mastoid Process of temporal bone Insertion: Genu of mandible and hyoid bone Function: Elevate hyoid bone during swallowing

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