HaN

Question 0

What do the following develop from: facial skeleton, muscles of mastication and muscles of facial expression?

Answer 0

Neural crest cells of 1st pharyngeal arch
Mesoderm of 1st pharyngeal arch
Mesoderm of 2nd pharyngeal arch

Question 1

What are neural crest cells?

Answer 1

Specialised population of cells from the neuroectoderm

Question 2

What does the buccopharyngeal membrane become?

Answer 2

Stomatodeum

Question 3

Outline the development of the nose

Answer 3

Nasal placodes sink to become nasal pits
Medial and lateral prominences form on either side of pits
Maxillary prominences grow and push the nasal prominences towards the midline
Maxillary and medial prominences all fuse in the middle

Question 4

How can a cleft lip +/- palate occur?

Answer 4

Medial nasal prominence doesn’t fuse with the maxillary prominence

Palatal shelves also don’t fuse

Question 5

How are the nasal and oral cavities separated?

Answer 5

Palate - maxillary prominence forms two palatal shelves which fuse in the midline

Question 6

How does the eye develop?

Answer 6

Forebrain out pockets and contacts the ectoderm to become the lens placode which invaginates and pinches off. The retina is formed from the forebrains. Eyes originally on the side but move round to the middle

Question 7

What makes the external auditory meatus and the auricles

Answer 7

1st cleft
Proliferation if 1st and 2nd arch
Develop in the neck then move up

Question 8

What cartilage lines the temporomandibular joint?

Answer 8

Fibrocartilage

Question 9

What ligaments are in the temporomandibular joint?

Answer 9

Lateral ligament - prevent posterior dislocation
Sphenomandibular
Stylomandibular - support weight

Question 10

What movements can the TMJ do? What muscles do each one?

Answer 10

Protrusion - lateral pterygoid
Retraction - genie hyoid and digastric
Elevation - temporalis, masseter and medial pterygoid
Depression - gravity and if needed, digastric, geniohyoid and mylohyoid

Question 11

What is the most likely direction for the TMJ to dislocate, why and what can it damage?

Answer 11

Anterior
Posterior protected by lateral ligament
Facial and auriculotemporal nerve

Question 12

What bones make up the borders of the orbit?

Answer 12

Roof-frontal/sphenoid
Floor-maxilla/zygomatic
Medial-ethmoid/maxilla/lacrimal
Lateral-zygomatic/sphenoid

Question 13

What is in the superior orbital fissure?

Answer 13

Lacrimal nerve, frontal nerve, trochlear nerve, superior branch of oculomotor nerve, nasociliary nerve, inferior branch of oculomotor, abducens nerve, ophthalmic vein, sympathetic nerve

Question 14

What is in the optic canal and the infra orbital fissure?

Answer 14

Optic nerve

Infra orbital nerve

Question 15

Explain the structure of the optic nerve

Answer 15

Covered by pia, arachnoid and dura mater of the meninges

Central artery and vein

Question 16

Explain orbital fractures

Answer 16

Usually along the sutures
Medial and inferior walls (thinner)
Can involve sinuses
Blow out fracture displaces walls and contents

Question 17

What are the muscles of eye movement and what directions do they look in?

Answer 17

Superior, inferior, medial and lateral recti - look in direction they say
Inferior oblique (up and out) superior oblique (internal rotation, down and in)

Question 18

What is the nerve supply to the muscles of eye movement?

Answer 18

Lateral rectus - CNVI abducens
Superior oblique - CNIV trochlear
Rest - CNIII oculomotor

Question 19

What is the blood supply to the eye?

Answer 19

Internal carotid–>opthalmic–>carotid artery of the retina
External carotid–>infra orbital

Superior/inferior opthalmic veins–>cavernous sinus
Central vein of the retina–>cavernous sinus

Question 20

What is the danger triangle?

Answer 20

There is communication between the facial vein and cavernous sinus so retrograde infections can spread to the brain
Cavernous sinus thrombosis, meningitis, brain abscess

Question 21

What is the function of the eyelids?

Answer 21

Protect from light and injury

Prevent drying

Question 22

What is a stye?

Answer 22

Blockage of the ciliary glands

Question 23

What stimulates the blink reflex?

Answer 23

Dry eyes

Irritated/contact

Question 24

What muscles open and close the eyelids and what is their respective nerve supply?

Answer 24

Close - orbicularis oculi - CNVII Open - levator palpebrae superiorid -CNIII Superior tarsal muscles - sympathetic nerves

Question 25

What can cause lesions of sympathetic nerve fibres, CNVII and CNIII and how can this affect the eyelids?

Answer 25

CNVII - Bell's palsy - lose blinking reflex, dry eyes and infection common CNIII - ptosis, compromise vision Sympathetic - horners syndrome

Question 26

What nerve stimulates lacrimation?

Answer 26

Parasympathetic part of CNVII

Question 27

What are the four parts of the temporal bone?

Answer 27

Squamous part Petromastoid part Tympanic plate Styloid process

Question 28

Which parts of the temporal bone would the external acoustic meatus, middle ear and inner ear be found?

Answer 28

Tympanic plate Petromastoid Petromastoid

Question 29

What is the external ear composed of?

Answer 29

Auricle | External acoustic meatus

Question 30

Which part of the external acoustic meatus are bony and which are cartilaginous

Answer 30

Bony - medial | Cartilage - lateral

Question 31

What is found within the middle ear?

Answer 31

Ossicles Eustachian tube opening Mastoid air cells opening Oval window

Question 32

Is the Eustachian tube usually open or closed? What makes it change?

Answer 32

Closed | When swallowing the palate muscles open it

Question 33

What are the three ossicles and what do they interact with?

Answer 33

Malleus - tympanic membrane and incus Incus - malleus and stapes Stapes - incus and inner ear via oval window

Question 34

Why is the facial nerve easily damaged with middle ear infections?

Answer 34

It lies in the facial canal which only has a very thin bony separation from the middle ear

Question 35

What is found within the inner ear?

Answer 35

Vestibule - balance Semicircular ducts/canals Cochlea - hearing Spiral organ of corti

Question 36

What are the functions of the nose?

Answer 36

Olfaction Respiration Filter and humidification Drain and eliminate paranasal sinus/nasalacrimal duct secretions

Question 37

What arteries supply the nose?

Answer 37

Facial, maxillary and opthalmic

Question 38

What drains the nose of blood?

Answer 38

Cavernous sinus, facial vein and pterygoid plexus

Question 39

What is the innervation to the nose?

Answer 39

Olfactory - special sensory Opthalmic and maxillary (V1 and V2) Infra orbital and external nasal (V2 and V1)

Question 40

What are the four paranasal sinuses? Where do they drain?

Answer 40

Maxillary - middle meatus Frontal - middle meatus Sphenoid Ethmoid - middle and superior meatus

Question 41

How can infections spread to the anterior cranial fossa, middle ear and lacrimal apparatus?

Answer 41

Crib rifle plate Eustachian tube Nasolacrimal duct

Question 42

How is epistaxis treated?

Answer 42

Pressure Cauterise Packing Surgical ligation

Question 43

What clinical signs will be seen in a patient with oculomotor nerve palsy?

Answer 43

Down and out eye Upper eyelid ptosis Possible dilated pupil

Question 44

Explain harlequin syndrome

Answer 44

Lesion of autonomic fibres of CNV. Lack of sweating and red on half of face

Question 45

How can the facial nerve be damaged?

Answer 45

Forceps, parotiditis, inflammation

Question 46

What symptoms are seen with Bell's palsy?

Answer 46

Ptosis, loss of oral continence

Question 47

How do you test CNV?

Answer 47

Test sensory in all areas | Test opening and closing the jaw

Question 48

What are the five branches of the facial nerve?

Answer 48

Temporal, zygomatic, buccal, marginal mandibular, cervical

Question 49

What are the typical cervical vertebrae and their features?

Answer 49

C3-6 transverse foramen and bifurcated spinous process

Question 50

What is different about the atypical cervical vertebrae?

Answer 50

C1 - atlas - no body or spinous process C2 - axis - Odontoid peg C7 - non bifid spinous process

Question 51

Explain two types of neck fracture

Answer 51

Burst fracture - fall head first - break atlas | Hangmans - hyperextended - axis break

Question 52

What are the three main sutures and what bones do they join?

Answer 52

Coronal suture - frontal and parietals Sagittal - parietals Lamboid - occipital and parietals

Question 53

What are the layers of the deep fascia and what do they enclose?

Answer 53

Investing layer - all structures Pretracheal - trachea, oesophagus, thyroid, infrahyoid Prevertebral - vertebral column and muscles Carotid sheath - common, external, internal carotid. Internal jugular vein, vagus nerve and lymph

Question 54

How can infection spread via fascial planes?

Answer 54

Posterior to prevertebral and enter retropharyngeal space Investing to pretracheal and enter anterior mediastinum

Question 55

What are the borders of the anterior triangle?

Answer 55

Superior - mandible Medial - imaginary midline Lateral - SCM

Question 56

What are the borders of the posterior triangle?

Answer 56

Anterior - SCM Posterior - trapezius Inferior - clavicle

Question 57

What are the contents of the anterior triangle?

Answer 57

4 supra hyoid and 4 infrahyoid CN VIII, IX, X, XI, XII Carotid arteries and internal jugular vein

Question 58

What are the contents of the posterior triangle?

Answer 58

Omohyoid, external jugular vein, subclavian artery/vein, CN XI and the cervical and brachial plexuses

Question 59

List the branches of the external carotid artery

Answer 59

Superior thyroid, lingual, facial, ascending pharyngeal, occipital, posterior auricular, maxillary, superficial temporal

Question 60

What arteries ascend via the transverse foramina?

Answer 60

Internal carotid | Vertebral

Question 61

What is in the carotid triangle and what are its borders?

Answer 61

Internal jugular vein, bifurcation of common carotid artery Posterior - digastric Lateral - SCM Medial - omohyoid

Question 62

What is the arterial blood supply to the scalp? Where are they derived from?

Answer 62

Supra-orbital and supra-trochlear: internal carotid | Superficial temporal, posterior auricular, occipital: external carotid

Question 63

What are the layers of the scalp?

Answer 63

``` Skin Connective tissue (loose) Aponeurosis Loose connective tissue Periosteum ```

Question 64

How can the middle meningeal artery and what can this cause?

Answer 64

Pterion fracture | Extradural haematoma