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Head and Neck > exam II > Flashcards

exam II Flashcards

1
Q

hard bumps on inside of mandible

A
  • mandibular tori
  • usually bilateral & asymptomatic
  • often associated w/ tooth grinding
  • also can have torus palatinus
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2
Q

what passes through apical foramen of tooth?

A
  • alveolar nerves (sympathetic)

- can only experience pain

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3
Q

palatine tonsils exist between which 2 structures?

A
  • palatoglossal arch & palatopharyngeal arch
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4
Q

what tonsils are at the back of the tongue?

A
  • lingual tonsils
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5
Q

what tonsils are near nasopharynx?

A
  • pharyngeal tonsils

- adenoid if enlarged

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6
Q

what is the boundary between oral cavity & oropharynx?

A
  • palatoglossal arch
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7
Q

arteries supplying the tonsils?

A
  • tonsillar & ascending palatine (from fascial)

- dorsal lingual, ascending pharyngeal, descending palatine (from external carotid)

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8
Q

what is the small bump at front of hard palate?

A
  • incisive papilla
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9
Q

central line on hard palate?

A
  • palatine raphe
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10
Q

ridges on hard palate?

A
  • transverse palatine folds or palatine rugae
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11
Q

muscles of the soft palate?

A
  • tensor veli palatini
  • levator veli palatini
  • uvula
  • palatopharyngeus
  • palatoglossus
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12
Q

palatoglossus

A
  • CN X
  • elevates/retracts tongue, pulls down soft palate (sealing oropharynx)
  • velar consonants, isolates vestibule saliva, assists in swallowing
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13
Q

uvula

A
  • CN X
  • seals nasopharynx
  • uvular consonants
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14
Q

shortened or bifid uvula

A
  • may lead to middle ear infections due to nasal regurgitation
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15
Q

tensor veli palatini

A
  • CN V3
  • flattens palate & opens eustachian tube
  • has shiny tendon
  • originates in scaphoid fossae, hooks around pterygoid hamulus (2 bellies)
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16
Q

levator veli palatini

A
  • CN X
  • elevates palate
  • looks like it’s going into eustachian tube
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17
Q

palate sensory innervations

A
  • most anterior: nasopalatine
  • hard palate: greater palatine
  • posterio-lateral hard palate: lesser palatine
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18
Q

alveolar mucosa innervation (lingual side)

A
  • greater palatine (maxilla)

- lingual (mandible)

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19
Q

alveolar mucosa innervation (oral vestibule side)

A
  • posterior/middle/anterior alveolar from infraorbital (maxilla)
  • inferior alveolar (mandible)
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20
Q

labial mucosa innervation

A
  • upper: labial branches of infraorbital (V2)

- lower: labial branches of mental (V3)

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21
Q

tongue functions

A
  • taste, speech, manipulate/digest food, absorption
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22
Q

extrinsic tongue muscles

A
  • styloglossus
  • hyoglossus
  • genioglossus
  • palatoglossus
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23
Q

genioglossus

A
  • CN XII
  • protrusion & depress central portion
  • originates on mental spine & inserts on tongue/body of hyoid
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24
Q

hyoglossus

A
  • CN XII
  • depression of tongue
  • originates on body/greater horn of hyoid & attaches to lateral/dorsal surface of tongue
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25
Q

styloglossus

A
  • CN XII
  • retraction, cupping
  • originates on styloid process & attaches to lateral side of tongue
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26
Q

intrinsic tongue muscle function

A
  • modulate tongue shape for language

- no bony attachments

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27
Q

hypoglossal nerve direction

A
  • passes over occipital arter, external to carotids & hyoglossus, & dives under mylohyloid
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28
Q

big round papillae on tongue?

A
  • vallate papillae
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29
Q

what is the dividing line for tongue sensory innervation?

A
  • terminal sulcus converging at foramen cecum
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30
Q

what provides general sensation to anterior 2/3 of tongue?

A
  • lingual nerve (V3)
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31
Q

what provides taste sensation to anterior 2/3 of tongue?

A
  • chorda tympani (CN VII)

* joins lingual nerve

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32
Q

what provides general sensation to posterior 1/3 of tongue?

A
  • CN IX
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33
Q

what provides taste sensation to posterior 1/3 of tongue?

A
  • CN IX
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34
Q

tongue blood supply

A
  • lingual artery: medial to hyoglossus

- dorsal, deep, & sublingual branches

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35
Q

salivary glands

A
  • major (2x each): parotid, submandibular, sublingual

- minor: labial, palatine, pharyngeal

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36
Q

sublingual duct passes over what nerve?

A
  • lingual
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37
Q

pharynx divisions

A
  • nasopharynx (choanae to soft palate end)
  • oropharynx (soft palate to epiglottis)
  • laryngopharynx (epiglottis to cricoid cartilage)
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38
Q

circular muscles of pharynx

A
  • superior, middle, & inferior constrictors
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39
Q

superior constrictor

A
  • CN X
  • originates on pterygoid hamulus & pterygomandibular raphe
  • attaches on pharyngeal tubercle & raphe
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40
Q

middle constrictor

A
  • CN X
  • originates on greater horn of hyoid
  • attaches on pharyngeal raphe
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41
Q

inferior constrictor

A
  • CN X
  • originates on oblique line of thyroid cartilage
  • attaches on pharyngeal raphe
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42
Q

longitudinal muscles of pharynx

A
  • salpingopharyngeus
  • palatopharyngeus
  • stylopharyngeus
  • elevate & shorten pharynx during swallowing
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43
Q

salpingopharyngeus

A
  • CN X

- salpinx (eustachian tube) to pharynx

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44
Q

palatopharyngeus

A
  • CN X

- palate to pharynx

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45
Q

stylopharyngeus

A
  • CN IX

- styloid process to pharynx

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46
Q

what passes above superior constrictor?

A
  • eustachian tube

- levator veli palitini

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47
Q

what passes between superior & middle constrictors?

A
  • stylohyoid ligament
  • stylopharyngeus
  • CN IX
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48
Q

what passes between the middle & inferior constrictors?

A
  • internal laryngeal n. & superior laryngeal a.

* location of thyrohyoid membrane

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49
Q

what passes below inferior constrictor?

A
  • recurrent laryngeal n. & inferior laryngeal a.
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50
Q

functions of the larynx

A
  • phonation
  • acts as sphincter for respiratory system
  • swallowing
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51
Q

larynx boundaries

A
  • located in lower part of pharynx (around inferior constrictor & cricopharyngeus)
  • begins at tip of epiglottis (C3-C4)
  • ends at lower border of cricoid cartilage (C6)
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52
Q

cartilages of larynx

A
  • 3 unpaired: epiglottis, thyroid, cricoid

- 3 paired: arytenoid, corniculate, cuneiform

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53
Q

anatomy of thyroid cartilage

A
  • laryngeal prominence
  • superior thyroid notch
  • superior horn (articulates w/ hyoid)
  • inferior horn (connects w/ cricoid & allows pivot)
  • oblique line (thyrohyoid, sternothyroid, inferior constrictor)
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54
Q

thyroid cartilage in males vs. females

A
  • males: more narrow angle between lamina (90˚)

- females: 120˚

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55
Q

anatomy of cricoid cartilage

A
  • forms a complete ring (1st tracheal ring): narrow anterior arch & broad posterior lamina
  • articular facet on lateral surface for inferior horn of thyroid cartilage
  • articular facet on upper surface for base of arytenoid cartilages
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56
Q

anatomy of arytenoid cartilages

A
  • small, pyramidal
  • base articulates w/ cricoid
  • apex supports corniculate cartilage
  • vocal process (anterior) attaches to vocal ligaments
  • muscular process (lateral) attaches to intrinsic muscles
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57
Q

name of space between vocal cords

A
  • rima glottidis
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58
Q

anatomy of epiglottis

A
  • leaf shaped
  • hyoepiglottic ligament connects to hyoid
  • thyroepiglottic ligament connects to thyroid cartilage back
  • anterior surface: 3 glossoepiglottic folds & 2 valleculae
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59
Q

the epiglottis deflects food into ____.

A
  • the piriform recess (upper part of pharynx leading to esophagus)
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60
Q

____ close off space between epiglottis & arytenoid cartilages.

A
  • aryepiglottic folds
61
Q

____ is the space between the posterior tongue & anterior surface of the epiglottis.

A
  • vallecula

- has tastes buds supplied by CN X

62
Q

anatomy of corniculate cartilages

A
  • small conical nodules

- sit on top of arytenoid cartilages & prolong them

63
Q

anatomy of cuneiform cartilates

A
  • small rod shaped

- located w/in aryepiglottic fold to provide support

64
Q

membranes & ligaments of larynx

A
  • thyrohyoid membrane w/ median & lateral thyrohyoid ligaments (opening for superior laryngeal n)
  • cricothyroid membrane (cricothyroidotomy)
  • cricotracheal membrane
65
Q

membrane that extends between epiglottis & arytenoid cartilages

A
  • quadrangular membrane
  • lower edge is vestibular fold (false vc)
  • upper edge is aryepiglottic fold
66
Q

membrane that extends from upper cricoid to form vocal ligament

A
  • conus elasticus

- attaches anteriorly to laryngeal prominence & posteriorly to arytenoids

67
Q

conus elasticus functions

A
  • sound production (produces vibration)

- closes rima glottidis

68
Q

____ is the space between the quadrangular membrane & the conus elasticus.

A
  • the ventricle
69
Q

vocal cords (definition)

A
  • combination of vocal ligaments, thyroarytenoid, & vocalis muscles & mucosa covering them
70
Q

glottis (definition)

A
  • combination of vocal cords & rima glottidis
71
Q

____ is the slanted area that opens into the laryngeal part of the pharynx

A
  • laryngeal inlet
72
Q

____ is the space between the vestibular folds.

A
  • rima vestibuli
73
Q

____ is the recess between the vestibular fold & the vocal fold. This extends to become the ____.

A
  • sinus of the larynx

- saccule of the larynx

74
Q

the dilation of the saccule of the larynx, forming a pocket of air is a ____. Symptoms include: ____. This can be congenital or caused by ____.

A
  • laryngocele
  • coughing, hoarseness, pain, upper airway obstruction
  • excessive blowing
75
Q

extrinsic muscles of larynx

A
  • suprahyoid & infrahyoid muscles (elevators & depressors of larynx)
76
Q

intrinsic muscles of larynx

A
  • muscles controlling size of laryngeal inlet

- muscles controlling vocal cords

77
Q

aryepiglottic muscle

A
  • upper portion of oblique arytenoid

- draws aryepiglottic folds inward, narrowing laryngeal inlet during swallowing

78
Q

transverse/oblique interarytenoid muscles

A
  • connect posterior & lateral surface of arytenoid cartilages
  • narrows laryngeal inlet & adducts vocal cords
79
Q

cricothyroid muscle

A
  • increases length & tension of vocal cords
  • originates on cricoid & inserts on deep surface of thyroid cartilage
  • innervated by superior laryngeal nerve
  • bow-tie muscle
  • raises pitch of voice
80
Q

all muscles of the larynx are innervated by ____, except the ____, which is supplied by the ____ (which also innervates ____).

A
  • recurrent laryngeal n
  • cricothyroid
  • external branch of superior laryngeal n
  • inferior constrictor
81
Q

thyroarytenoid muscle

A
  • decreases length & tension of vocal cords
  • originates on laryngeal prominence & attaches to muscular process of arytenoid
  • lowers pitch of voice
82
Q

the medal part of the thyroarytenoid muscle is the ____. It is responsible for ____.

A
  • vocalis

- fine control of vocal cords (directly contacts)

83
Q

thyroepiglottic muscle

A
  • increases size of laryngeal inlet

- originates on laryngeal prominence & attaches to aryepiglottic fold/epiglottis

84
Q

transverse arytenoid

A
  • vocal cord adductor

- pulls arytenoids closer together

85
Q

lateral cricoarytenoid

A
  • vocal cord adductor
  • medially rotates arytenoids & leaves space posterior -> whispering
  • originate on lateral cricoid & attach to muscular process of arytenoids
86
Q

posterior cricoarytenoid

A
  • vocal cord abductor
  • laterally rotates arytenoids
  • originate on posterior cricoid & attache to muscular process of arytenoids
  • paralysis can lead to suffocation
87
Q

the r. recurrent laryngeal n loops under ____. the l. recurrent laryngeal n loops under ____.

A
  • right subclavian

- arch of aorta

88
Q

sensory innervation above vocal cords is provided by ____ & below the vocal cords is provided by ____.

A
  • internal laryngeal nerve

- recurrent laryngeal nerve

89
Q

sensation to the piriform recess is provided by ____.

A
  • internal laryngeal n.
90
Q

the cough reflex is started by ____. It is suppressed by ____ nerve block during ____.

A
  • internal laryngeal n.
  • superior laryngeal
  • laryngoscopy or bronchoscopy
91
Q

a foreign object in the larynx causes the laryngeal muscles to ____. The Heimlich maneuver resolves this by ___.

A
  • spasm

- expelling air from trachea into larynx to dislodge object

92
Q

____ is a forceful expiratory effort against a closed airway. This ____.

A
  • valsalva maneuver

- increases abdominal pressure

93
Q

injury to superior laryngeal nerve causes:

A
  • loss of sensation from upper part of larynx & piriform recess, inactivating cough reflex
  • paralysis of cricothyroid muscle, resulting in monotonous voice
94
Q

injury to recurrent laryngeal nerve causes:

A
  • if bilateral, inability to abduct, adduct, relax vocal cords, resulting in hoarseness & difficulty breathing during forced respiration (stridor)
  • inability to close laryngeal inlet during swallowing, resulting in food aspiration
95
Q

blood supply to the upper & lower larynx

A
  • upper: superior laryngeal artery (branch of superior thyroid)
  • lower: inferior laryngeal artery (branch of inferior thyroid)
96
Q

larynx lymphatics above & below vocal cords

A
  • above: superior deep cervical lymph nodes

- below: pretracheal or paratracheal nodes to inferior deep cervical nodes

97
Q

____ is inflammed vocal cords. symptoms include: ____. causes include: ____.

A
  • laryngitis
  • hoarsness, dry, burning throat, coughing, difficulty swallowing
  • viral, bacterial, excessive use of voice, smoking, alcohol, trauma
98
Q

____ are benign epithelial tumors of larynx caused by ____. May eventually cause ___.

A
  • laryngeal papillomas
  • HPV
  • difficulty breathing
99
Q

vocal cord ____ are swellings in mucous membranes of vocal chords caused by ____. Usually ____.

A
  • polyps
  • voice abuse, chronic allergies/inhalation of irritants
  • unilateral
100
Q

vocal cord ____ are smal inflammatory or fibrous growths caused by ____. Usually ____.

A
  • nodules
  • strain voice
  • bilateral
101
Q

____ is placement of flexible plastic tube into trachea to maintain open airway & facilitate lung ventilation.

A
  • endotracheal intubation
102
Q

external ear components

A
  • auricle (pinna): helix, antihelix, concha, antitragus, tragus, lobule
  • external acoustic meatus
103
Q

injury to external ear can cause ____.

A
  • auricular hematoma (cauliflower ear)
104
Q

arnold’s reflex

A
  • induction of cough reflex by stimulating branch of vagus nerve that innervates ear
105
Q

somatic sensory innervation of external ear

A
  • anterior: auriculotemporal branch of mandibular
  • posterior: lesser occipital
  • inferior: greater auricular
  • inside: facial, then vagus more central
106
Q

auricular muscles

A
  • superior, anterior, posterior auricular muscles

- innervated by VII (posterior auricular branch & temporal branch)

107
Q

bloody supply to external ear

A
  • superficial temporal & posterior auricular a.
108
Q

venous drainage of external ear

A
  • superficial temporal v to retromandibular

- posterior auricular to external jugular

109
Q

lymphatic drainage of external ear

A
  • lateral top: superficial partoid
  • medial top: mastoid
  • bottom: superficial cervical
110
Q

external acoustic meatus is lined with skin containing ____ and ____ glands.

A
  • sebaceous

- ceruminous

111
Q

tympanic membrane

A
  • separates external & middle ear
  • set in sulcus of temporal bone
  • oriented laterally, anteriorly, inferiorly
  • cone shaped w/ apex attached to handle of malleus at umbo
  • captures changes in air pressure & transfer to middle ear bones
112
Q

sensory innervation to tympanic membrane

A
  • V3, VII, X to lateral surface

- IX to medial surface

113
Q

forms roof over middle ear cavity

A
  • tegmen tympani
114
Q

elevated area of middle cranial fossa overlying semicircular canals

A
  • arcuate eminence
115
Q

bones of the middle ear

A
  • malleus (ice cream on xray; handle forms umbo)
  • incus (cone on xray)
  • stapes (base is oval - oval window)
116
Q

attenuation of loud sounds happens via which muscles?

A
  • tensor tympani

- stapedius

117
Q

tensor tympani

A
  • V3
  • originates on cartilaginous portion of pharyngotympanic tube and inserts onto handle of malleus
  • pulls handle back to diminish vibration transmitted to other bones
118
Q

stapedius

A
  • CN VII
  • originates on pyramidal eminence & inserts onto neck of stapes
  • pulls stapes away from oval window
119
Q

excessive acuteness of hearing possibly due to CN VII lesion

A
  • paralysis of stapedius
120
Q

middle ear blood supply

A
  • anterior tympanic
121
Q

middle ear lymphatic drainage

A
  • superior deep cervical nodes
122
Q

middle ear innervation

A
  • CN IX: sensory to inner tympanic membrane
  • CN V, IX, X
  • CN VII: parasympathetic
123
Q

middle ear walls

A
  • membranous: tympanic membrane
  • tegmental: tegmen tympani
  • labyrinthine: lateral semicircular canal, facial canal, oval window, promontory w/ tympanic n., round window
  • jugular: jugular fossa
  • mastoid: aditus, pyramidal eminence
  • carotid: carotid canal, pharyngotympatic tube
124
Q

swelling of mucosal membrane can easily lead to blockage of what? (esp. in children)

A
  • pharyngotympanic tube
125
Q

poor drainage of the middle ear, leading to infection

A
  • otitis media

- myringotomy tube

126
Q

infections traveling through the aditus into the mastoid air cells cause what?

A
  • mastoiditis
127
Q

1st arch ear derivatives

A
  • malleus
  • incus
  • tensor tympani
128
Q

2nd arch ear derivatives

A
  • stapes

- stapedius

129
Q

1st cleft ear derivatives

A
  • external acoustic meatus
130
Q

1st pouch ear derivatives

A
  • pharyngotympanic tube

- middle ear cavity

131
Q

the tympanic membrane forms at:

A
  • interface of 1st pouch and 1st cleft
132
Q

inner ear contents

A
  • vestibule: semi-circular canals, utricle, saccule

- cochlea

133
Q

CN VIII ganglion

A
  • spiral ganglion (cochea)

- vestibular ganglion (vesibule)

134
Q

inner ear blood supply

A
  • labyrinthine artery (from anterior inferior cerebellar artery through internal acoustic meatus)
135
Q

canals within the inner ear form the ____. Within it is the ____.

A
  • bony labyrinth

- membranous labyrinth

136
Q

Fluid in the bony labyrinth is called ____. Fluid in the membranous labyrinth is called ____.

A
  • perilymph (connects to CSF via cochlear aqueduct)

- endolymph

137
Q

excess endolymph production or blockage of endolymphatic duct is called ____. This results in ____.

A
  • Meniere’s Syndrome

- recurrent tinnitus, hearing loss, vertigo

138
Q

parts of membranous labyrinth

A
  • vestibular labyrinth: semicircular ducts, utricle, saccule

- cochlear labyrinth: cochlear duct

139
Q

utricle and saccule

A
  • contain hair cells sensitive to gravity and linear movement of head
  • hair cells concentrated in maculae & embedded in jelly containing otoliths
  • sensitive to movement in same plane as macula
140
Q

hair cell horizontal and vertical planes

A
  • horizontal plane: utricle macula

- vertical plane: saccule macula

141
Q

semicircular ducts

A
  • anterior (yes), posterior (no), & lateral (cartwheel) ducts
  • sensitive to rotational movement of head
  • hair cells concentrated in ampullary crest w/in ampulla
142
Q

constant rate turning can result in ____. disconnect between vestibulocochlear and visual system can result in ____.

A
  • dizziness

- motion sickness

143
Q

Sound waves in the inner ear travel from ____, up the ____ to the ____, then come back down through ____, which ends at ____.

A
  • oval window
  • scala vestibuli
  • helicotrema
  • scala tympani
  • round window
144
Q

the inner core of bone that houses the spiral ganglion

A
  • modiolus
145
Q

organ of corti

A
  • scala media contains inner & outer hair cells
  • inner hc: afferent innervation; in endolymph
  • outer hc: afferent & efferent innervation; embedded in tectorial membrane; acoustic amplifiers
146
Q

basilar membrane

A
  • resonant structure
  • basal end: narrow, stiff (high frequency)
  • apical end: wide, floppy (low frequency)
147
Q

sensorineural hearing loss

A
  • defects or damage to cochlea or cochlear nerve
  • inner hair cells most susceptible
  • presbycusis & high tone hearing loss
  • difficult to hear consonants & in loud situations
148
Q

conductive hearing loss

A
  • loss of sound conduction from external or middle ear

- impaired movement of oval or round window

Head and Neck (3 decks)

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