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Final Dissection Notecards Flashcards

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1
Q

What structures pass through the foramen magnum

A

Brainstem, vertebral arteries, cervical roots of the accessory nerves

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2
Q

Retropharyngeal space

A

Behind carotid sheath, medially meet posterior to the cervical viscera
Superior limit- basilar part of occipital bone
Superior thoracic aperture- inferiorly
Extends into the thorax

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3
Q

Anterior surface of the cervical vertebral column

A

Sympathetic trunk and the most cranial superior cervical ganglion (supplies head)
Superior to the superior cervical ganglion, the chain narrows again before entering the skull- internal carotid nerve

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4
Q

Prevertebral fascia and muscles

Lateral vertebral muscles

A

Longus colli and longus capitis- sympathetic trunk runs longitudinally on these
Anterior, middle and posterior scalene muscles

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5
Q

What connects the sympathetic ganglia with the ventral rami of cervical spinal nerves

A

Gray rami communicates

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6
Q

Vertebral artery route

A

Into the transverse foramen of vertebra C6 and observe where it emerges from the transverse foramen of atlas (C1)

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7
Q

The airway crosses the digestive tract in the

Tract

A

Pharynx

Extends from the base of the skull to the inferior border of the cricoid cartilage (C6 level)

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8
Q

The pharyngeal wall consists of 3 layers (from outside to inside)

A

Buccopharyngeal fascia- the adventitia of the pharynx that is continuous with the connective tissue that covers the buccinator muscle
Muscular layer- composed of an outer circular part and an inner longitudinal part
Mucous membrane

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9
Q

Inferior pharyngeal constrictor muscle

A

Anterior attachments are the oblique line of the thyroid cartilage and lateral surface of the cricoid cartilage. The posterior attachment of the inferior pharyngeal constrictor muscle is the pharyngeal raphe

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10
Q

Middle pharyngeal constrictor muscle

A

Anterior attachments of the middle pharyngeal constrictor muscle are the greater horn of the hyoid bone and the inferior portion of the stylohyoid ligament
The posterior attachment is the pharyngeal raphe
*the inferior part of the middle pharyngeal constrictor muscle lies deep to the inferior pharyngeal constrictor muscle

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11
Q

What separates the inferior and the middle pharyngeal constrictor muscle

A

The superior laryngeal nerve- internal laryngeal branch

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12
Q

Superior pharyngeal constrictor muscle

A

Anterior attachment is the pterygomandibular raphe and its posterior attachments are the pharyngeal raphe and pharyngeal tubercle of the occipital bone
*the inferior part of the superior pharyngeal constrictor muscle lies deep to the middle pharyngeal constrictor muscle

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13
Q

Border between the middle and superior pharyngeal constrictor muscle

A

Stylopharyngeus muscle

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14
Q

What attaches the superior edge of the superior pharyngeal constrictor muscle to the base of the skull

A

The pharyngobasilar fascia- dense connective tissue

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15
Q

The stylopharyngeus muscle

A

Attached to the medial surface of the styloid process superiorly and to the inner aspect of the pharyngeal wall inferiorly. It enters the wall by passing between the superior and middle pharyngeal constrictor muscles.
Can be palpated 1/2 inch above the greater horn of the hyoid bone

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16
Q

What crosses the posterior and lateral surfaces of the stylopharyngeus muscle to enter the pharynx

A

Glossopharyngeal nerve- CN IX

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17
Q

The most inferior fibers of the inferior constrictor muscle are continuous with the circular fibers of

A

The esophagus

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18
Q

The pharyngeal plexus is located at the posterolateral aspect of the pharynx and receives branches from:

A

Glossopharyngeal nerve- sensory to the pharyngeal mucosa
Vagus nerve- motor to the pharyngeal constrictor muscle
Superior cervical sympathetic ganglion- vasomotor

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19
Q

Glossopharyngeal nerve tract out of jugular foramen

A

Passes between the internal and external carotid arteries as it approaches the stlyopharyngeus muscle

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20
Q

Vagus nerve tract out of the jugular foramen

Branches

A

Lies posterior to the internal carotid artery and internal jugular vein in the carotid sheath.
Superior laryngeal nerve arises from the vagus 2.5cm inferior to the base of the skull- internal and external branch to the larynx
The pharyngeal branch of the vagus nerve arises near the base of the skull to the pharyngeal plexus

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21
Q

Accessory nerve tract out of jugular foramen

A

Passes between internal jugular vein and the internal carotid artery to reach the deep surface of the SCM

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22
Q

The hypoglossal nerve passes

A

Lateral to the internal and external carotid arteries

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23
Q

Superior cervical sympathetic ganglion and trunk lie

A

Posterior and medial to the carotid sheath

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24
Q

Cartilages that compose the laryngeal skeleton

A

Epiglottic, cricoid, thyroid, arytenoid

Corniculate and cuneiform

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25
Posterior cricoarytenoid muscles
Proximal attachment is the lateral margin and the posterior lamina of the cricoid cartilage Distal attachments are the muscular processes of the arytenoid cartilages Abducts the vocal folds to open the rima glottidis
26
Arytenoid muscle
Attaches both arytenoid cartilages and has transverse and oblique fibers Adducts the vocal folds to close the rima glottidis
27
The recurrent laryngeal passes
Posterior to the cricothyroid joint | At this point the nerve becomes the inferior laryngeal nerve
28
Cricothyroid muscle and vocalis muscle function
Tightens the vocal folds
29
Thyroarytenoid, transverse arytenoid and lateral cricoarytenoid muscle function
Adducts vocal fold to close the rima glottidis
30
What is the only extrinsic laryngeal muscle
Cricothyroid muscle
31
The larynx has 3 spaces/cavities
The vestibule, ventricle, and infraglottic cavity | The vestibule is the space superior to the vestibular folds
32
False vocal folds True vocal folds Space between the true vocal folds
Vestibular folds- lie superolateral to the vocal folds (true folds) Rima glottidis
33
Conus elasticus
Lateral cricothyroid ligament | The thickened upper margin of the conus elasticus forms the vocal ligament
34
The aryepiglottic folds
Bound the upper border of the laryngeal inlet Quadrangular membrane under its mucosa- the membrane extends from the lateral border of the epiglottis cartilage to the arytenoid cartilage and that it becomes thickened inferiorly to help form the vestibular folds
35
The cricothyroid joint
Synovial joint reinforced by short ligaments The recurrent laryngeal enters the larynx by passing posterior to the cricothyroid joint, and at this point it becomes the inferior laryngeal nerve
36
Sensory innervation to the mucosa that lines the interior of the larynx below and including the vocal folds
Recurrent laryngeal nerve
37
Mucosa above the vocal folds is supplied by
The internal branch of the superior laryngeal nerve
38
Find what nerve along the lateral border of the thyrohyoid membrane
Internal branch of the superior laryngeal nerve and the superior laryngeal nerve
39
What supplies the cricothyroid muscle
External branch of superior laryngeal nerve
40
Superior laryngeal artery origin
Superior thyroid artery | Enters the larynx by penetrating the thyrohyoid membrane alongside the internal branch of the superior laryngeal nerve
41
The superior 1/3 of the nasal mucosa | The remainder of the nasal mucosa
Is olfactory in nature | Is respiratory in nature
42
Separates the right and left nasal cavities and forms the anterior part of the nasal septum
The septal cartilage | The lateral nasal cartilage is an extension of the septal cartilage
43
Lateral to the septal cartilage
Alar cartilage- gives shape to the nostril
44
The lumen of the pharynx communicates anteriorly with 3 cavities
Nasal, oral, and larynx. | Parts of the pharynx: nasopharynx, oropharynx, laryngopharynx.
45
The nasopharynx lies | The transition region form the nasal cavity to the nasopharynx is the
Posterior to the nose and superior to the soft palate | Posterior nasal aperture (Choana). The choana of the two sides are separated by the posterior end of the nasal septum
46
On the lateral wall of the nasopharynx- opening of the
Pharyngotympanic tube (auditory, Eustachian tube)
47
Superior to the opening of the pharyngotympanic tube is the: | What extends from it
Torus tubarius- the cartilage of the pharyngotympanic tube that is covered by mucosa The salpingopharyngeal fold extends posteroinferiorly from the torus tubarius
48
Superior and posterior to the torus tubarius is
The pharyngeal recess. | The pharyngeal tonsil (adenoid) is located in the mucous membrane above the pharyngeal recess
49
The oropharynx is bound by What forms a dividing line between the oral cavity and the oropharynx What connects this dividing line
Superiorly the soft palate and extends inferiorly to the level of the epiglottis The palatoglossal fold- extends from the tongue to the palate. The transitional region between the right and left palatoglossal folds is called the fauces
50
What fold is posterior to the palatoglossal fold | What is between them
Palatopharyngeal fold- descends along the lateral wall of the oropharynx The palantine tonsil is between them
51
The laryngopharynx extends
Posterior to the larynx | Extends from the hyoid bone to the lower border of the cricoid cartilage
52
In the midline of the laryngopharynx | Then the space farther inferiorly and laterally is the
Epiglottis and the laryngeal inlet (aditus) Piriform recess, which is lateral to the midline. Borders of the piriform recess are the larynx medially, thyroid cartilage laterally, and inferior pharyngeal constrictor muscle posteriorly.
53
In the clinic: adenoids
Enlarged pharyngeal tonsils | Obstruct the flow of air from the nose through the nasopharynx, making mouth breathing necessary.
54
Boundaries of the nasal cavity
Roof- a narrow region bounded by the nasal septum and by the nasal bone, cribiform plate of ethmoid bone, and sphenoid bone. Floor- palatine process of the maxilla and horizontal plate of the palatine bone Medial- nasal septum Lateral wall- maxilla, lacrimal bone, ethmoidal bone, inferior nasal concha, and perpendicular plate of palatine
55
Embedded in the mucosa of the nasal septum
``` Nasopalatine nerve (V2) and sphenopalatine artery Pass diagonally down the septum from the sphenopalatine foramen to the incisive canal. They supply the nasal septum and a portion of the oral mucosa that covers that hard palate ```
56
Mucosa near the cribiform plate is the
Olfactory area- extends down the lateral wall of the nasal cavity for a short distance Supplies by anterior ethmoidal nerve- V1
57
Lateral wall of the nasal cavity structures
Sphenoethmoidal recess- above the superior concha Superior concha Superior meatus- inferior to the superior concha Middle concha Middle meatus- inferior to the middle concha Inferior concha Inferior meatus- inferior to the inferior concha Vestibule- the area superior to the nostril and anterior to the inferior meatus Atrium- the area superior to the vestibule and anterior to middle meatus
58
Underneath the anterior 2/3 of the inferior concha
Opening of the nasolacrimal duct
59
Underneath the anterior 2/3 of the middle concha in the middle meatus
The semilunar hiatus | Posterior to the curvature of the semilunar hiatus is the ethmoidal bulla
60
Within the semilunar hiatus
Opening of the frontal sinus Opening of the anterior ethmoidal cells Opening of the maxillary sinus
61
Opening of the middle ethmoidal cells are | Opening of the posterior ethmoidal cells are
On the summit of the ethmoidal bulla | In the superior meatus
62
The opening of the sphenoidal sinus
In the sphenoethmoidal recess | The sphenoidal sinus lies directly inferior to the hypophyseal fossa and pituitary gland
63
The ethmoidal cells are located between the
Nasal cavity and the orbit
64
The roof of the maxillary sinus is the: The floor of the sinus is the: The opening of the sinus The roots of the maxillary teeth
Floor of the orbit and the infraorbital nerve innervates the mucosa of the maxillary sinus Alveolar process of the maxilla Is near its roof Project into the sinus
65
In the clinic: sphenoidal sinus
Surgical approaches to the pituitary gland take advantage of the fact that the sphenoidal sinus and nasal cavity provide a direct approach
66
In the clinic: maxillary sinus
When the head is in an upright position, the maxillary sinus cannot drain. If infections of the maxillary sinus persist, an opening was sometimes made surgically through the inferior meatus near the floor of the sinus to promote drainage- low efficacy When the roots of the maxillary teeth project into the sinus, they are covered only by mucosa. During extraction of a maxillary molar or premolar tooth, the mucosa superior to the projecting root may be torn and a fistula may be formed between the oral cavity and the maxillary sinus
67
Oral vestibule | Oral cavity proper
Bounded externally by the lips and cheeks and internally by the teeth and gums The area between the alveolar arches and teeth. The largest content of this cavity is the tongue.
68
Parts of the tongue
Root- posterior 1/3 Body- anterior 2/3 Apex Dorsum- entire extent of tongue Terminal sulcus- divides anterior from posterior thirds Lingual tonsil- posterior to the terminal sulcus Foramen cecum- in the midline at the point of the terminal sulcus Median sulcus Lingual papillae- vallate, filliform, fungiform, foliate
69
Root of the tongue structures
Median glossoepiglottic fold- a midline fold of mucosa between the dorsum and epiglottis Lateral glossoepiglottic fold- between the dorsum of the tongue and the lateral border of the epiglottis Epiglottic vallecula- a depression between median and lateral glossoepiglottic folds
70
Geniohyoid muscle
Deep to the mylohyoid. Anterior attachment is the inferior mental spine of the mandible Posterior attachment is the body of the hyoid Pulls the hyoid bone anteriorly
71
Genioglossus muscle
Anterior attachment is the superior mental spine of the mandible and its posterior attachment is the tongue Protrudes the tongue Innervated by the hypoglossal nerve
72
The sublingual mucosa on the mandible- immediately deep to this is the
Sublingual gland- Rests on the mylohyoid muscle Along the medial side of the sublingual gland is the submandibular duct where it opens anteriorly on the sublingual caruncle and posteriorly to the deep part of the submandibular gland (deep to the mylohyoid)
73
The lingual nerve in the sublingual region
Beings lateral to the submandibular duct, crosses it inferiorly and goes into the the tongue medial to the duct. Supplies the mucosa of the anterior 2/3 of the tongue with general sensation and taste fibers
74
Near the third mandibular molar tooth is the
Submandibular ganglion that is suspended below the lingual nerve
75
The hypoglossal nerve in the sublingual region
Passes between the submandibular gland and the hypoglossus muscle *both the hypoglossal and the lingual nerve pass between the hypoglossus and mylohyoid muscle to enter the sublingual region. The hypoglossal nerve course is inferior to the lingual's. Innervates the intrinsic muscles of the tongue and 3 extrinsic muscles of the tongue- styloglpossus, genioglossus, and hypoglossus.
76
Hypoglossus muscle
Deep to the mylohyoid muscle Inferior attachment are the body and greater horn of the hyoid Superior attachment is the lateral side of the tongue Depresses and retracts the tongue
77
Styloglossus muscle
Near the superior end of the hypoglossus muscle Proximal attachment is the styloid process and its distal attachment is the lateral side of the tongue. Retracts the tongue and draws it superiorly
78
The lingual artery passes medial to the hypoglossus muscle and is renamed
The deep lingual artery
79
In the clinic: hypoglossal nerve
Genioglossus protrudes the tongue If one genioglossus muscle does not function, the tongue cannot be protruded midline. The functional side of the tongue protrudes normally and the side with the dysfunctional nerve is protruded less or not at all. The protruded tongue deviates toward the side of the nerve lesion
80
Palatoglossus muscle
Proximal attachment is the palatine aponeurosis Distal attachment- side of the tongue Elevates posterior part of tongue and draws the soft palate onto the tongue Innervated by CN X
81
The pterygopalatine fossa
Small boney space located medial to the infratemporal fossa and lateral to the wall of the nasal cavity Accessed from the infratemporal fossa through the pterygomaxillary fissure
82
The pterygopalatine fossa contains
Pterygopalatine ganglion- receives its preganglionic afferents, which traveled via CN VII, the greater petrosal nerve, and the nerve of the pterygoid canal, and supplies every exocrine gland in the head except saliva and sweat glands.
83
The pterygopalatine fossa is a major crossroad for
Terminal branches of the maxillary artery and branches of the maxillary division of the trigeminal nerve
84
Branches of the sphenopalatine artery
Posterior lateral nasal artery- to the lateral nasal wall | Posterior septal artery- to the nasal septum
85
Greater palatine canal contents
Greater palatine nerve, lesser palatine nerve, and descending palatine artery (one of the terminal branches of the maxillary artery) At the inferior end of the canal, the descending palatine artery divides to give rise to the greater palatine artery and lesser palatine artery
86
Where the lesser and greater palatine nerve converge superiorly
Inferior extent of the pterygopalatine ganglion- location for the synapse for the preganglionic axons of the facial nerve that course first in the greater petrosal nerve and then in the nerve of the pterygoid canal (Vidian nerve) Postganglionic fibers that arise from the ganglion distribute with the branches of the maxillary division of the trigeminal nerve. This ganglion stimulates secretion from the mucosa of the nasal cavity, paranasal sinuses, nasopharynx, roof of mouths and soft palate, and stimulates the lacrimal gland.
87
The nerve of the pterygoid canal
Vidian nerve Enters the pterygopalatine fossa from posteriorly Contains preganglionic parasympathetic axons from the greater petrosal and postganglionic sympathetic axons from the deep petrosal nerve
88
Maxillary artery in the pterygomaxillary fissure
Sphenopalatine artery- passes through the pterygopalatine fossa and then through the sphenopalatine foramen to enter the nasal cavity Descending palatine artery- enters the greater palatine canal and splits into the greater and lesser palatine arteries Infraorbital artery- passes through the inferior orbital fissure to enter the infraorbital canal and emerge on the face at the infraorbital foramen
89
CN V2
Courses from the foramen rotundum to the inferior orbital fissure, passes through the pterygopalatine fossa and gives off pterygopalatine branches that will form the greater and lesser palatine nerves
90
Deep to the mucosa covering the palatopharyngeal fold are
Delicate fibers of the palatopharyngeus muscle Superior attachments are the hard palate and palatine aponeurosis Inferior attachment are the thyroid cartilage and pharyngeal wall Elevates the larynx during swallowing
91
Deep to the mucosa of the salpingopharyngeal fold are
The delicate fibers of the salpingopharyngeus muscle Superior attachment is the cartilage of the pharyngotympanic tube. It's distal attachments and action are the same as the palatopharyngeus muscle, with which it blends. (Thyroid cartilage and pharyngeal wall/elevates the larynx) These two muscles contribute to the inner longitudinal muscle layer of the pharynx
92
The gap between the superior border of the superior pharyngeal constrictor muscle and the base of the skull is closed by the
Pharyngobasilar fascia | Passing through this gap are the pharyngotympanic tube and the levator veil palatine muscle
93
Levator veli palatini muscle
Superior attachments are the cartilage of the pharyngotympanic tube and the adjacent part of the temporal bone It's distal attachment is the palatine aponeurosis Elevates the soft palate during swallowing and yawning
94
Tensor veli palatini muscle
Lies lateral to the medial plate of the pterygoid process just anterior to the levator veli palatini muscle Superior attachment is the scaphoid fossa The belly of the muscle is between the medial and lateral plates of the pterygoid process. It's tendon turns medially around the harmful us of the medial pterygoid plate and forms the palatine aponeurosis. Tenses the soft palate and opens the mouth of the pharyngotympanic tube during swallowing and yawning
95
Five muscles of the soft palate and pharynx are innervated by the
Vagus nerve via the pharyngeal plexus- salpingopharyngeus, levator veli palatini, palatoglossus, palatopharyngeus, and musculoskeletal uvulae. The tensor veli palatini is innervated by V3.
96
The nasopalatine nerve
Descending through the incisive foramen from the nasal septum to supply the sensory innervation to the mucosa over the anterior part of the hard palate beyond the sensory field of the greater palatine nerve
97
Boundaries of the tonsilar bed
Anterior- palatoglossal fold Posterior- palatopharyngeal fold Lateral- superior pharyngeal constrictor muscle
98
Deep to the mucosa covering the palatoglossal fold
Delicate fibers of the palatoglossus muscle Superior attachment is the palatine aponeurosis and its inferior attachment is the lateral side of the tongue. Elevates tongue and depresses the soft palate
99
What nerve passes between the superior and middle pharyngeal constrictor muscles to enter the tonsillar bed
Glossopharyngeal nerve- innervates the mucosa of posterior 1/3 of tongue and posterior wall of the pharynx
100
Musculus uvulae muscle
Proximal attachment is the posterior nasal spine and palatine aponeurosis Distal attachment is the mucosa of the uvula Shortens the uvula and pulls it superiorly

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