H& N Flashcards
(58 cards)
0
Q
2nd arch bobe, cartilage, lig?
A
HRS Face n muscles
1
Q
1st arch cartilage/bone/mus?
A
MMMMIT (mandibular) v2, V3
not V1 frontal nasal prominence
2
Q
3rd Arch bone, cartilage, lig?
A
Stylopharngeus, rest Hyoid, 9
3
Q
4th & 6th arches bone/cart/lig?
A
-Laryngeal bones,
outside mus- 4- ex. laryngeal mus, pharyg mus and veli palatine (except)
6- inside deep mus- only in. esp
-CN10
4
Q
1st phary pouch, membrane, groove in order?
A
- pouch:tympanic cavity/tube/ recess
- groove- ex acousticmeatus/cervical sinus
- membrane ((tympanic membrane.))
5
Q
2nd pharyngeal pouch?
A
palatine tonsil/tonsillar sinus
6
Q
3rd pharyngeal pouch?
A
- dorsal: inferior parathyroid
- ventral: thymus gland
7
Q
4th pharyngeal pouch?
A
-dorsal(superior parathyroid)
ventral(ultimopharyngeal/C cells thyroid)
5th pouch rudimentary
8
Q
Parotid duct enters oral where?
A
upper second molar
9
Q
infection in face veinage bad if?
A
near facial vein –> orbital by sup opthalmic vein–> cavernous sinus. danger triangle
10
Q
lymp drainage? lateral face $ scalp upper lip corner lip chin/lower lip
A
parotid, submandibular, submental
11
Q
lymph area only in h and n?
A
pericervical collar- parotid buccal. s,s,p,o,e
deep cervical lymph node by IJV
12
Q
superior and inf ganglion CN 9 branch?
A
CN9– parotid, post tongue 1/3, middle pharyg constrictor, carotid
13
Q
parotid inn?
A
SA- greater auricular invest sheath(C2,C3), auriculartemp
para-post otic gang, symp ECA plexus, VA
serous, largerst, 1st,
14
Q
Parotid plexus are? clinical?
A
facial n under parotid. TZBMC, parotidectomy danger, fxn: Mimetic, post digastric, stylohyoid muscles
15
Q
retroman makes?
common facial vein?
IJv on face at jug formane?
pterygoid plexus drains?
A
- max+ sup temp
common facial vein- ant+ facial
IJV- post+ post auricular, inferior petrosus, sigmoid sinus
deep facial vein
16
Q
artery of scalp? SCALP stands for, infection where what part?clicicals
A
occipital, post auricular, superficial temp, opthalmic (suprorbiral/supratrochlear profuse bleeding(limit blood const), cut paralle to fibers for healing
17
Q
2 terminal branches of ECA!
A
sup temp, maxillary
18
Q
artery supplies temporal
parotid gland, skin?
A
transverse facial, facial a
19
Q
Cutanation inn of face.
A
supraorbforamen(ISSL), infraorb(iZZ), Mental(MAB) –>SA except auricolotemp (para,symp-post VA,SA)
sides of back of neck– greater auricular- lesser occipital (ventral ramiC2-C3), transverse cervical??
back-of scalp– greater occipital (dorsi rami c2-C3)
20
Q
trigemelia?
A
anomalous a (middle meningle) by V2/V3 (SA)ganglion- pulsation PAIN BAD, TRIGMELIA
21
Q
The inferior alveolar ?
A
(BM) and (SA) until the mylohyoid nerve branches off SA. supply all
the mandibular teeth. mental innervates the chin (SA).
•
22
Q
The buccal nerve inn? auricular temp?
A
SA- skin and oral mucosa of the cheeks and adjacent gingiva
SA-somatic sensory (SA) fibers to the anteriorear and temporal regions.
23
Q
Tmj? type jt? articular surface?articular jt? movements?
A
hinge synovial, three different planes.
articular-mandibular fossa, mandibular condyle and the
articular tubercle of the temporal fibrocartilage rather than hyaline cartilage as in a typical synovial joint.
articular disc-
sup(big open) (slide/glide) (ant dislocation) (pterygoid
inf joint cavities- slight gravity
24
3 mand lig? 1 part of capsule
lateral lig(temporomandibular)- strengthen TMJ & postglenoid tubercle
sphenomandibular lligament
stylomandibular lig little support jt capsul
25
jaw spasam?
Tetanus (or “Lockjaw”) is caused by the bacterium Clostridium toxin massteric/ temporalis
26
4 parts thyroid? lobe not spcimmon?
~50% of the population have apyramidal lobe present.
27
careful for trachiotectomy?
nick inf thyroid or throid ima artery ( c10%)from (brachiocephalc artery) ppulses bc really closese to heart
28
thyroid veins?
Superior & middle thy vein (IJV)
| inf ty vein drain brachicep ( biiggest an most variable)
29
recurrent laryngeal nerves? fxn comp?
left recurrent wraps around aorta
right recurrent wraps right subclavian artery.
(BM, SA) (VE-para/pre) mucosa and mucus glands below the
vocal folds.
30
Sympathetic trunk injury?
ptosis, miosis, anhydrosis, hyperema
| injury (central, pregang, or post ganglionic) 2nd to disease or 1
31
Stellate gangion n block?
- block cervical and superior thoracic n block
- ganglion block may relieve vascular spasms in brain and upper limb
- esp to see if resection good for excess vasoconstriction of the ipsilateral upper limb.
- right behind subclavian is stellate ganglion
32
```
2nd part swallowing vs thrid?
long muscle fxn, inn?
constrictor fxn, inn?1st const of esphogus?
popcorn stuck?
chicken bone stuck?- clinical?
```
- long/suprahy vs constrictors
-salpingo(10), palatopharyngeus(10), stylopharyngeus( CN9)
elevate layrnx(thus epig drop cover) , pharynx-speak/swallow
-suprahyoid- ant dig+ myhloid(v3), post dig(cn7)
elevate layrnyx, hyoid,
- 1st cons at circopharyngeus
-vallecula side not over epiglottis food
-space btwn layrnyx and pharynx. chicken bone damage recurrent/sup layrngeal n bc skeletal muscle thin
33
RCL, &RCA?
LC?
difference from true back muscles?
RCA- vent rami C1-C2-ant/lateral flex head on neck(atlato-occipt jt)
RCL- ven ramiC1-C2 ( on transverse foramen)- flex head/stabilize
L capitus - vent rami C1-C3, flex head on neck(atlato-occipt jt)
Longus coli- @ C1-T3 --ramiinn C2-C6 - ant/lateral flexing neck part C2-C6
ant. vetebral mus(LC,RCA,Ant.Scalaene)
lateral vetebral(RCL, mid& post scalaene, (((splenius, levator scapulae) dorsi rami))
34
Scalanes?
lateral flexors/1st rib forced insp
middle- c3-c8
ant-C4-c6
post-c7-c8
35
Root neck?
C C6 tubercle?
Pyramidal space?
arteries, nerve block stellate, compression c
36
neural crest, ectoderm placode, paraxial mesoderm, lateral plate mesoderm,? weeks form arches?
```
pia/arachnois/sensory neuron/ CT/dentin
senory neuron 7,5,9,10, w neural crest cells
voluntary muscles somites,
laryngeal mus, cartilage ct
4-5 week
```
37
CC/ECA/ R subclavian/left part aorta make ? derived(ICA/ECA)? 7th intersegmental make?
- cc-/ECA3rd, -R subclavian/left aorta- r/L 4th arch,
- aortic sac, r horn aortic sac
- distal R and left subclavian
- 4 pouches, 5th arch dissappears
38
tongue ant/pos origin? muscle? Lingual papillae/inn? cervical cyst forms? sclera, cornea origin?
-lateral lingual swelling fuse (1st arch) & post (3-4arch) hyophargyneal eminence (terminal sulcus),mucosa/submucosa only SS/VA vs occipital somites/CN12 muscle, papillae (4 types)-filliform only senation no taste. foliate, vallate(arch 3) & fungiform(arch 2/chorda tympani)
-thyroglyossus duct closes in back to foramen cecum
sclera- dura, choriod - arachnoid .
39
frontonasal prominence facial prom in n? chonea, hard/soft palate, nostrils,nasolacrimal, conchas, ? cleft palate cause by? eye detachment sig? main sources food for eye? myelination optic n, maxilllary sinus? cornea layer(ect, endo, neural crest/ cip mig endo),
forehead, nasal part, front stomedum and the nose. V1 not part phary arch
nasal placode->nasal pit(nostrils) -->lateral(nasalacrimal groove) /medial nasal prominence-> intermaxillary prominence -> oral sac-- oroalnasal memebrane disintegrates (primordial choanae) -->lateral/medial palatine prominence( fuse 1 palate) -- lateral zippering in back ( 2nd palate, soft palate) --> choane now in nasopharynx separation nose from mouth
- sup and middle ethmoid but inf by self lateral palatine promence not zippering ( mouth or palate only)
- retinal fissure stalk-->hyaloid blood--> distal portion digenerate--> central a/v optic nerve
- 1st eye only fed of aqueous humer, until later, inner layer neural and outer pigmented layer retinal epithelium
40
Mandibulofacial dystostosis. Treacher-Collins Syndrome and Pierre Robin Syndrome , DiGeorge Syndrome
neural crest cell mig bad thus arch bad 1/2, 1 syndrome(malnormal eepm )or 3/4(1)craniofacial defe. micrognathia (small jaw), low set ears, auricular abnormalities, and cleft palate; (2)agenesis 3rd & 4th pharyngeal pouches (thymus &
parathyroid glands) (3) cardiovascular defects. partial monosomy of chromosome 22, or children of alcoholic women.
73
gray communicion fxn?
spinal n get to head neck how?
white commion location?
cardiopulmonary?
- location- base skull - ganglion impur,
@bifurcation of ventral/dorsal ramifor symp-post
- always sympost distally accompany muscle, but arteries periartierlias
- T1-L2
- sympost-VA
74
cut artery fxn ?
ganglion missing/small, that are fused, highest sympost/symppre level?
ganglion branches?
```
sympost VA
middle cervical gang( level C1-C2), inn(C1-4)
thoriocervical(stellate) C6, C5-6
superior cervical ganglion, C7, C7-C8
cardiopulmonary (sympost, VA)
```
75
pharyngeal layer clinical space dangerous? para-pre becomes post what layer? tonsil/lympoid circle called?
Danger - btn prever/alar --post mediastinum/ spreads up T12
retros- btw buccapharyngeal/ alar-- and tied down sup mediastianum
MRI/clinically-retropharygnealdanger space bc no alar seen
muscle-pharygnbasilar fascia- submucosa-para-ganglion-mucosa
Waldeyerʼs Ring(4 tonsils) incomplete circle on sup pharynx
76
otis media?
nasopharyx infection spread ear inflammation maybe permenent hear lose- risk adenoids
77
gaps btwn constrictors? 1st, 2nd, 3rd, 4th?
1. nothing bc pharyngealbasilarfascia covers it?
2. stlopharyngeus, stylohyoid ligament, cn9, (3)
3. tyro-hyoid membrane hole--
internal laryngeal , superior laryngeal a/v (3)
4. under cricopharyngeus mus
recurrent n, inf laryngeal a/v (3)
```
blood supply pharynx- ECA/ICA mainly
• Ascending pharyngeal
• Facial
• Lingual
• Pharyngeal artery branches (branch of inferiorthyroid artery)
```
78
pharynx SA, VE inn? skeketal motor inv? blood supply?
1.) symp& para post, VA, SA --->pharyngeal branch
upper 1/2 phary pharynx
rest pharyngeal plexus w buccopharyngeal fascia
2.) sympost fibers from near by vessels, vasoconst
sensation mucosa
V2(SA) 1/2 sup naso, CN 9 (SA) 1/2 inf naso/ oro, CN10 (VA) larygnealphayrnx
--------/-------SA from CN 9 not apart of pharygneal plexus
Mucosa gland
Pharyngeal branch of PPG- para-post sup 1/2 phary
( para-post( CN 7 via PPG)
Pharyngeal plexus-CN10- para-pre synapse @ submucosa para post-rest of pharynx
( parap-post , .........symp-post artery, VA, CN10 BM/SA for pharygneal mus)
BM/SA- dont go through pharyngeal plexus
blood- FLAP
• Ascending pharyngeal
• Pharyngeal artery branches (branch of inferiorthyroid artery)
79
Deglutition (the act of swallowing) occurs in three stages?
1. break food w palate, tongue brings it back space
2. swallow by suprahyoid, and pharyngeal long elevate phanyx, hyoid or/ larynx--- causes epiglotissis to passively fold, widen pharnyx, to recieve food bolus
3. pharynx conx food down to espohagu
80
parathyroids are highly variable ? thyroglossus duct? frenulum not deep almost not attached?? causes of diff cleft palates?coloboma?
2-6, anywhere near or within the thyroid gland or thymus.
-superior constant but inferior near bifurcation CC or down w/ thymus in superior mediastinum
- • infection,perforation forming thyroglossal duct sinus ( back tongue or ant neck)
- ankyloglossia (tongue-tie).
- Cleft palate-common in females
• Clefts of the anterior palate -primary palate (F).
• Clefts of the posterior palate -result from lateral palatine processes to fuse, the nasal septum.
• Clefts of the anterior & posterior-lateral palatine processes fuse with the primary palate, with each other, and with nasal septum
chromosomal syndrome like trisomy 13.
• Clefts can include uvula, soft and hard;severe cases cleft in the palate extends through alveolar of maxilla, lips both sides
- Infants defect in iris or pupillary keyhole appearance.can extend deeper and involve the ciliary body & retina.
-failure of closure of the retinal fissure during in 6th week.
81
tear journey? ligaments/fascia of eye fxn? bone boundaries? 7 ocular muscles fxn? layers of eyelid? angle of eye?
gland, duct,fornix,lake,punctum,cancuoa,sac,lacrimalduct, inf meatus
check lig expan of fascial sheath(AD/AB) supspensory (too down)
LPS, every except sup olblique and lateral rectus CN3,opticalaxis(fovea), orbital axis(back optic--23 degres sep axis
82
Up? down?
AB?AD?
LR rotation? MR? cornea is how much of sclera?
optic n/cn 3 fxn comp/nasocillary? cornea v1
dilator, & const pupilla inn, cillary body, LPS/tarsal mus? order of nerves ID?
Sup rec/infoblique(horiz),
lateral rectus, obliques, (vertical axis)
inferior (anteroposterior axis), 1/6 of cornea is 5/6 of sclera(choriod 5/6 of eye retina) mus att
SS -see, ((inf division-para-post after cillary ganglion, VA, SE/SA-constictit/cill body)) ((sup division-sympost(fromICA) va,SA/SE)), VA/sympost/SE/SA
long, short cillary, superior divsion,
TFL,N(4), O
83
inflammation of mucous?teeth? greater palatine and lesser palatine? mucosa on hard palate, pharaynx, or nasal inn by parasym?
inn soft palate? muscles soft palate? space leads to naspho or oropha? m
rhinntis, 4 incisors, 2canins, 4- premolars, 6 molars. hard (ant 2/3) vs soft palate (1/3)some overlap, ex palatoglossus, tensor veli, levator veli
skeletal(V3/CN10) not lesser palatine(taste(geniculate ganglion, mucousa, SA blood vessels)
- fauces( palatoglossus/back of tongue)choane
-
84
CN10 branches ?
CN 10- recurrent, suplary,
BM/SA- in. lary, esp ex. lary, consts, long (ex stylo) palantin(ex. tesnor)
VE - 1/2 inf nasophary and rest phary
VA- laryngopharynx,
85
CN9 branches?
- tympanic n (VA/VE-para-pre)---> auroc ( SA, symp-post/para-post, VA)
- 1/3 post (SA/SS) tongue
- SA 1/2 sup. nasopharynx not part of pharyngeal plexus or pharyngeal of PLG
- BM/SA sytlopharyngeus
- caroid sinus/body
86
CN7 branches ?
- greater petrosal(VA-para-pre, VE, SS, ) -->sympost w vividian and PPG after para- post, SA ( atone of branches but only lesser ends up w ss)
- BM/SAmotor face, stapeduis, supryhyoid
- chorda tympani-- VA-para pre/VE/SS-- > after # 1 parapost, SA, VE, , only here sympost from periarterial
87
nosebleed area,vasculature,causes? inflamation nose spread 4?
ant 1/3, kiesselbach's area (anastomsis greater and spenopalatine a in incisive foramen), nose picking-(veins), cause infection, HPTN
rhinnitis(upper resp infect/hay fever allergy)
ant cranial cribiform plate fossa,middle ear--nasopharynx --> retropharyngeus , parasinuses, lacrimal apparatus /conjucrive,
88
musculus uvulae?palatoglossu?
sup elevates, and shortens uvula
| elevate post tongue, and dpresses soft palate
89
Medial orbital wall clinical? inferior orbital wall? optic septum tag ? 2 types CN palsy? CN of Corneal reflex and pupillary reflex? shlem or aqueous humor block? old age eyes/lense? high CSF pressure? eyelid infection?
medial wall ( MEL) & inf wall (ZM) - Max sinus
dilated, pitosis, no reflex, unopposed CN 3+ 4
-partial palsy gone/blown pupila. INO subd/epidhemotoma, aneurysm
V1 & CN 7
CN1/CN 3
gluacoma? open angle iris and cornea angle not blocked, most common
presbyobia- flat lense, cataract
papillaedema
chalazia(tarsal), sty (cillary body)
