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exam II Flashcards

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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
styloglossus
- CN XII - retraction, cupping - originates on styloid process & attaches to lateral side of tongue
26
intrinsic tongue muscle function
- modulate tongue shape for language | - no bony attachments
27
hypoglossal nerve direction
- passes over occipital arter, external to carotids & hyoglossus, & dives under mylohyloid
28
big round papillae on tongue?
- vallate papillae
29
what is the dividing line for tongue sensory innervation?
- terminal sulcus converging at foramen cecum
30
what provides general sensation to anterior 2/3 of tongue?
- lingual nerve (V3)
31
what provides taste sensation to anterior 2/3 of tongue?
- chorda tympani (CN VII) | * joins lingual nerve
32
what provides general sensation to posterior 1/3 of tongue?
- CN IX
33
what provides taste sensation to posterior 1/3 of tongue?
- CN IX
34
tongue blood supply
- lingual artery: medial to hyoglossus | - dorsal, deep, & sublingual branches
35
salivary glands
- major (2x each): parotid, submandibular, sublingual | - minor: labial, palatine, pharyngeal
36
sublingual duct passes over what nerve?
- lingual
37
pharynx divisions
- nasopharynx (choanae to soft palate end) - oropharynx (soft palate to epiglottis) - laryngopharynx (epiglottis to cricoid cartilage)
38
circular muscles of pharynx
- superior, middle, & inferior constrictors
39
superior constrictor
- CN X - originates on pterygoid hamulus & pterygomandibular raphe - attaches on pharyngeal tubercle & raphe
40
middle constrictor
- CN X - originates on greater horn of hyoid - attaches on pharyngeal raphe
41
inferior constrictor
- CN X - originates on oblique line of thyroid cartilage - attaches on pharyngeal raphe
42
longitudinal muscles of pharynx
- salpingopharyngeus - palatopharyngeus - stylopharyngeus - elevate & shorten pharynx during swallowing
43
salpingopharyngeus
- CN X | - salpinx (eustachian tube) to pharynx
44
palatopharyngeus
- CN X | - palate to pharynx
45
stylopharyngeus
- CN IX | - styloid process to pharynx
46
what passes above superior constrictor?
- eustachian tube | - levator veli palitini
47
what passes between superior & middle constrictors?
- stylohyoid ligament - stylopharyngeus - CN IX
48
what passes between the middle & inferior constrictors?
- internal laryngeal n. & superior laryngeal a. | * location of thyrohyoid membrane
49
what passes below inferior constrictor?
- recurrent laryngeal n. & inferior laryngeal a.
50
functions of the larynx
- phonation - acts as sphincter for respiratory system - swallowing
51
larynx boundaries
- 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)
52
cartilages of larynx
- 3 unpaired: epiglottis, thyroid, cricoid | - 3 paired: arytenoid, corniculate, cuneiform
53
anatomy of thyroid cartilage
- laryngeal prominence - superior thyroid notch - superior horn (articulates w/ hyoid) - inferior horn (connects w/ cricoid & allows pivot) - oblique line (thyrohyoid, sternothyroid, inferior constrictor)
54
thyroid cartilage in males vs. females
- males: more narrow angle between lamina (90˚) | - females: 120˚
55
anatomy of cricoid cartilage
- 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
56
anatomy of arytenoid cartilages
- small, pyramidal - base articulates w/ cricoid - apex supports corniculate cartilage - vocal process (anterior) attaches to vocal ligaments - muscular process (lateral) attaches to intrinsic muscles
57
name of space between vocal cords
- rima glottidis
58
anatomy of epiglottis
- leaf shaped - hyoepiglottic ligament connects to hyoid - thyroepiglottic ligament connects to thyroid cartilage back - anterior surface: 3 glossoepiglottic folds & 2 valleculae
59
the epiglottis deflects food into ____.
- the piriform recess (upper part of pharynx leading to esophagus)
60
____ close off space between epiglottis & arytenoid cartilages.
- aryepiglottic folds
61
____ is the space between the posterior tongue & anterior surface of the epiglottis.
- vallecula | - has tastes buds supplied by CN X
62
anatomy of corniculate cartilages
- small conical nodules | - sit on top of arytenoid cartilages & prolong them
63
anatomy of cuneiform cartilates
- small rod shaped | - located w/in aryepiglottic fold to provide support
64
membranes & ligaments of larynx
- thyrohyoid membrane w/ median & lateral thyrohyoid ligaments (opening for superior laryngeal n) - cricothyroid membrane (cricothyroidotomy) - cricotracheal membrane
65
membrane that extends between epiglottis & arytenoid cartilages
- quadrangular membrane - lower edge is vestibular fold (false vc) - upper edge is aryepiglottic fold
66
membrane that extends from upper cricoid to form vocal ligament
- conus elasticus | - attaches anteriorly to laryngeal prominence & posteriorly to arytenoids
67
conus elasticus functions
- sound production (produces vibration) | - closes rima glottidis
68
____ is the space between the quadrangular membrane & the conus elasticus.
- the ventricle
69
vocal cords (definition)
- combination of vocal ligaments, thyroarytenoid, & vocalis muscles & mucosa covering them
70
glottis (definition)
- combination of vocal cords & rima glottidis
71
____ is the slanted area that opens into the laryngeal part of the pharynx
- laryngeal inlet
72
____ is the space between the vestibular folds.
- rima vestibuli
73
____ is the recess between the vestibular fold & the vocal fold. This extends to become the ____.
- sinus of the larynx | - saccule of the larynx
74
the dilation of the saccule of the larynx, forming a pocket of air is a ____. Symptoms include: ____. This can be congenital or caused by ____.
- laryngocele - coughing, hoarseness, pain, upper airway obstruction - excessive blowing
75
extrinsic muscles of larynx
- suprahyoid & infrahyoid muscles (elevators & depressors of larynx)
76
intrinsic muscles of larynx
- muscles controlling size of laryngeal inlet | - muscles controlling vocal cords
77
aryepiglottic muscle
- upper portion of oblique arytenoid | - draws aryepiglottic folds inward, narrowing laryngeal inlet during swallowing
78
transverse/oblique interarytenoid muscles
- connect posterior & lateral surface of arytenoid cartilages - narrows laryngeal inlet & adducts vocal cords
79
cricothyroid muscle
- 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
all muscles of the larynx are innervated by ____, except the ____, which is supplied by the ____ (which also innervates ____).
- recurrent laryngeal n - cricothyroid - external branch of superior laryngeal n - inferior constrictor
81
thyroarytenoid muscle
- decreases length & tension of vocal cords - originates on laryngeal prominence & attaches to muscular process of arytenoid - lowers pitch of voice
82
the medal part of the thyroarytenoid muscle is the ____. It is responsible for ____.
- vocalis | - fine control of vocal cords (directly contacts)
83
thyroepiglottic muscle
- increases size of laryngeal inlet | - originates on laryngeal prominence & attaches to aryepiglottic fold/epiglottis
84
transverse arytenoid
- vocal cord adductor | - pulls arytenoids closer together
85
lateral cricoarytenoid
- vocal cord adductor - medially rotates arytenoids & leaves space posterior -> whispering - originate on lateral cricoid & attach to muscular process of arytenoids
86
posterior cricoarytenoid
- vocal cord abductor - laterally rotates arytenoids - originate on posterior cricoid & attache to muscular process of arytenoids - paralysis can lead to suffocation
87
the r. recurrent laryngeal n loops under ____. the l. recurrent laryngeal n loops under ____.
- right subclavian | - arch of aorta
88
sensory innervation above vocal cords is provided by ____ & below the vocal cords is provided by ____.
- internal laryngeal nerve | - recurrent laryngeal nerve
89
sensation to the piriform recess is provided by ____.
- internal laryngeal n.
90
the cough reflex is started by ____. It is suppressed by ____ nerve block during ____.
- internal laryngeal n. - superior laryngeal - laryngoscopy or bronchoscopy
91
a foreign object in the larynx causes the laryngeal muscles to ____. The Heimlich maneuver resolves this by ___.
- spasm | - expelling air from trachea into larynx to dislodge object
92
____ is a forceful expiratory effort against a closed airway. This ____.
- valsalva maneuver | - increases abdominal pressure
93
injury to superior laryngeal nerve causes:
- loss of sensation from upper part of larynx & piriform recess, inactivating cough reflex - paralysis of cricothyroid muscle, resulting in monotonous voice
94
injury to recurrent laryngeal nerve causes:
- 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
blood supply to the upper & lower larynx
- upper: superior laryngeal artery (branch of superior thyroid) - lower: inferior laryngeal artery (branch of inferior thyroid)
96
larynx lymphatics above & below vocal cords
- above: superior deep cervical lymph nodes | - below: pretracheal or paratracheal nodes to inferior deep cervical nodes
97
____ is inflammed vocal cords. symptoms include: ____. causes include: ____.
- laryngitis - hoarsness, dry, burning throat, coughing, difficulty swallowing - viral, bacterial, excessive use of voice, smoking, alcohol, trauma
98
____ are benign epithelial tumors of larynx caused by ____. May eventually cause ___.
- laryngeal papillomas - HPV - difficulty breathing
99
vocal cord ____ are swellings in mucous membranes of vocal chords caused by ____. Usually ____.
- polyps - voice abuse, chronic allergies/inhalation of irritants - unilateral
100
vocal cord ____ are smal inflammatory or fibrous growths caused by ____. Usually ____.
- nodules - strain voice - bilateral
101
____ is placement of flexible plastic tube into trachea to maintain open airway & facilitate lung ventilation.
- endotracheal intubation
102
external ear components
- auricle (pinna): helix, antihelix, concha, antitragus, tragus, lobule - external acoustic meatus
103
injury to external ear can cause ____.
- auricular hematoma (cauliflower ear)
104
arnold's reflex
- induction of cough reflex by stimulating branch of vagus nerve that innervates ear
105
somatic sensory innervation of external ear
- anterior: auriculotemporal branch of mandibular - posterior: lesser occipital - inferior: greater auricular - inside: facial, then vagus more central
106
auricular muscles
- superior, anterior, posterior auricular muscles | - innervated by VII (posterior auricular branch & temporal branch)
107
bloody supply to external ear
- superficial temporal & posterior auricular a.
108
venous drainage of external ear
- superficial temporal v to retromandibular | - posterior auricular to external jugular
109
lymphatic drainage of external ear
- lateral top: superficial partoid - medial top: mastoid - bottom: superficial cervical
110
external acoustic meatus is lined with skin containing ____ and ____ glands.
- sebaceous | - ceruminous
111
tympanic membrane
- 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
sensory innervation to tympanic membrane
- V3, VII, X to lateral surface | - IX to medial surface
113
forms roof over middle ear cavity
- tegmen tympani
114
elevated area of middle cranial fossa overlying semicircular canals
- arcuate eminence
115
bones of the middle ear
- malleus (ice cream on xray; handle forms umbo) - incus (cone on xray) - stapes (base is oval - oval window)
116
attenuation of loud sounds happens via which muscles?
- tensor tympani | - stapedius
117
tensor tympani
- 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
stapedius
- CN VII - originates on pyramidal eminence & inserts onto neck of stapes - pulls stapes away from oval window
119
excessive acuteness of hearing possibly due to CN VII lesion
- paralysis of stapedius
120
middle ear blood supply
- anterior tympanic
121
middle ear lymphatic drainage
- superior deep cervical nodes
122
middle ear innervation
- CN IX: sensory to inner tympanic membrane - CN V, IX, X - CN VII: parasympathetic
123
middle ear walls
- 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
swelling of mucosal membrane can easily lead to blockage of what? (esp. in children)
- pharyngotympanic tube
125
poor drainage of the middle ear, leading to infection
- otitis media | - myringotomy tube
126
infections traveling through the aditus into the mastoid air cells cause what?
- mastoiditis
127
1st arch ear derivatives
- malleus - incus - tensor tympani
128
2nd arch ear derivatives
- stapes | - stapedius
129
1st cleft ear derivatives
- external acoustic meatus
130
1st pouch ear derivatives
- pharyngotympanic tube | - middle ear cavity
131
the tympanic membrane forms at:
- interface of 1st pouch and 1st cleft
132
inner ear contents
- vestibule: semi-circular canals, utricle, saccule | - cochlea
133
CN VIII ganglion
- spiral ganglion (cochea) | - vestibular ganglion (vesibule)
134
inner ear blood supply
- labyrinthine artery (from anterior inferior cerebellar artery through internal acoustic meatus)
135
canals within the inner ear form the ____. Within it is the ____.
- bony labyrinth | - membranous labyrinth
136
Fluid in the bony labyrinth is called ____. Fluid in the membranous labyrinth is called ____.
- perilymph (connects to CSF via cochlear aqueduct) | - endolymph
137
excess endolymph production or blockage of endolymphatic duct is called ____. This results in ____.
- Meniere's Syndrome | - recurrent tinnitus, hearing loss, vertigo
138
parts of membranous labyrinth
- vestibular labyrinth: semicircular ducts, utricle, saccule | - cochlear labyrinth: cochlear duct
139
utricle and saccule
- 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
hair cell horizontal and vertical planes
- horizontal plane: utricle macula | - vertical plane: saccule macula
141
semicircular ducts
- anterior (yes), posterior (no), & lateral (cartwheel) ducts - sensitive to rotational movement of head - hair cells concentrated in ampullary crest w/in ampulla
142
constant rate turning can result in ____. disconnect between vestibulocochlear and visual system can result in ____.
- dizziness | - motion sickness
143
Sound waves in the inner ear travel from ____, up the ____ to the ____, then come back down through ____, which ends at ____.
- oval window - scala vestibuli - helicotrema - scala tympani - round window
144
the inner core of bone that houses the spiral ganglion
- modiolus
145
organ of corti
- 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
basilar membrane
- resonant structure - basal end: narrow, stiff (high frequency) - apical end: wide, floppy (low frequency)
147
sensorineural hearing loss
- 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
conductive hearing loss
- loss of sound conduction from external or middle ear | - impaired movement of oval or round window

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