Head Flashcards

Question

lateral pterygoid

Answer 1

origin - greater wing of sphenoid and lateral pterygoid plate of sphenoid insertion - neck of mandible innervation - CN5iii

Answer 2

origin - greater wing of sphenoid and lateral pterygoid plate of sphenoid insertion - ramus of mandible innervation - CN5iii

Answer 3

Articulation between 3 surface - mandibular fossa, articular tubercle and head of mandible Separated by articular disc 3 Ligaments - lateral, stylomandibular, sphenomandibular

Answer 4

Allocated in submandibular triangle anterior and posterior belly of digastric muscle and mandible In relations to mylohyoid muscles Hypoglossal (deep), lingual, marginal mandibular nerve

Answer 5

almond shaped under the tongue, laterally on mandible, medially by genioglossus muscle around lingual frenulum

Answer 6

Superior & deep gland separated by facial nerve, ECA Superior - zygomatic arch inferior - inferior border of mandible posterior - external ear/SCM anterior - masseter **Stensen duct - 2nd upper molar** Sensory nerve - CN9, otic ganglion

Answer 7

**Anterolaterally:** skin, fascia, SCM, sternohyoid **Posteriorly:** Transverse processes of 4 cervical vertebrae, prevertabral muscles, sympathetic trunk **Medially:** Larynx and pharynx, lobe of throid gland **Laterally:** IJV Posterolateral - vagus nerve Branches are Internal carotid artery and External carotid artery

Answer 8

Bifurcates from CCA at C4 **S**he **A**lways **L**ikes **F**riends **O**ver **P**apa, **M**ama and **S**ister * *S**uperior thyroid * *A**scending pharyngeal * *L**ingual * *F**acial * *O**ccipital * *P**osterior auricular * *M**axillary * *S**uperficial temporal

Answer 9

**Anterolaterally:** At beginning anterior border of SCM Superiorly by skin and fascia Crossed by the **hypoglossal nerve** Within the parotid gland is crossed by the **facial nerve** **Medially:** **Internal Carotid artery** Glossopharyngel nerve and pharyngeal branch of vagus pass inbetween ECA and ICA

Answer 10

Bifurcates from CCA at C4 no extracranial branch enters via carotid canal **C**alming **V**oices **M**ake **I**ntra-**O**perative **S**urgery **P**leasurable **A**nd Almost **M**emorable **C**: caroticotympanic artery (C2) **V**: Vidian artery (C2) **M**: meningohypophyseal trunk (C4) **I**: inferolateral trunk (C4) **O**: ophthalmic artery (C6) **S:** superior hypophyseal artery (C6) **P**: posterior communicating artery (C7) **A:** anterior choroidal artery (C7) **A**: anterior cerebal artery (C7) **M**: middle cerebral artery (C7) - **forms circle Willis**

Answer 11

**Anterolaterally:** Below the digastric: lie the skin, fascia and anterior border of SCM Above the digastric: stylohyoid, stylopharyngeus, glossopharyngeal nerve, pharyngeal branch of the vagus, parotid gland **Posteriorly:** Sympathetic trunk Transverse process of upper three cervical vertebrae **Medially:** Pharyngeal wall and sup laryngeal nn. **Laterally:** IJV and vagus nerve

Answer 12

Arises from the Subclavian artery, passes through foramen transversarium of C6 Gives off anterior & posterior spinal arteries Enters via foramen magnum Gives off PICA Forms the basilar artery

Answer 13

gives off AICA, pontine arteries, Superior cerebellar artery, labyrinthine artery Forms Circle of Willis

Answer 14

Superior sagittal sinus Inferior sagittal - straight sinus Confluence of sinus - Transverse sinus Carvernoous sinus - Superior/Inferior petrosal sinus Sigmoid sinus IJV

Answer 15

Dorsal column Spinothalamic Spinocerebellar

Answer 16

Medial lemniscal pathway Fasciculus cuneatus - upper limb Fasciculus gracilis - lower limb Decussate in medulla (2nd order neurones)

Answer 17

Anterior Crude touch & pressure Lateral - pain and temperature Decussate at level of spinal cord

Answer 18

Proprioception anterior and Posterior cerebellar - lower limbs rostral and cunecerebellar - upper limbs

Answer 19

corticospinal tract - cortex - internal capsule - crus cerebri Corticobulbar - CN7 and CN12 contralateral innervation Pyrimidal - medullary pyramids Extrapyrimidal - involuntary movement - vestibulospinal/reticulospinal tract

Answer 20

Skin Connective tissue epicranial Aponeurosis Loose connective tissue Periosteum (at sutures lining bones the periosteum from the outside is continuous with the periosteum on the inside)

Answer 21

On sella turcica: Anterior - FSH/LH, GH, ACTH, TSH Posterior ADH, Oxytocin

Answer 22

A sudden onset severe headache (peak pain almost **immediately**). Worst headache ever. Usually in the occipital region. May be focal neurology and meningisms\* Most commonly due to a ruptured berry aneurysm in teh circle of willis. \*Neck stiffness, photophobia and headache.

Answer 23

Berry aneurysms: congenital weakness in the elastic lamina of aa, often develop at weak branch points in the circle of willis. Arteriovenous malformations: Congenital defect in which there are abnormal anastomoses between the arterial and venous system without capillaries due to the abnormal pressure difference these are more likely to bleed.

Answer 24

Berry aneurysms: congenital weakness in the elastic lamina of aa, often develop at weak branch points in the circle of willis. 40% occur at the ant. communicating aa 30% occur at the middle cerebral artery bifurication 20% occur at the posterior communicating aa origin

Answer 25

CT scan without contrast as soon as possible, high sensitivity within the 1st 24hrs. Lumbar puncture can be done if history is suggestive but CT scan is negative as it CT can give a false negative rate in 2% of cases.

Answer 26

Initial management of SAH aims to prevent further bleeding and reduce the risk of complications. A-E assessment Transfer to a specialist neurosurgical unit is needed. Patients will often need an ITU bed also and may be intubated and NG fed. Maintaining BP, electrolytes and BMs in a normal range is important. Rebleed rates are high and devastating therefore neurosurgical intervention is needed either by: - a craniotomy and clipping (placing clips around the neck of the aneurysm) OR - coiling performed through femoral catherisation (platinum coils obliterate the aneurysm by forming a coil inside) Nimodopine (Ca antagonist) is used to prevent secondary vasopspasm

Answer 27

* Raised ICP due to blood spreading through the arachnoid space. * Vasospasm in response to the bleeding causing secondary ischaemia. * Rebleed risk. * Permanent neurological defect due to infarction at the site of rupture. * Death.

Answer 28

Infants and the elderly. Anything increasing bleeding risk: - Anticoagulants - Liver failure - Alcoholism (poor clotting and brain atrophy) - Inherited haemophilias

Answer 29

Acute: Usually presents shortly after a moderate to severe head trauma. There may be a loss of consciousness. There may be a lucid period of a few hours where the patient seems relatively well before deteriorating and losing consciousness as a haematoma forms.

Answer 30

It is a haemorrhage that occurs between dura and arachnoid mater.

Answer 31

Chronic: Usually presents 2-3 weeks after the trauma, which may have been relatively uneventful (think of this in groups with a high bleeding risk) Often a hx of progressive symptoms including: Anorexia, nausea and vomiting. Focal neurology such as limb weakness, speech difficulties, confusion or personality change. May be a progressively worsening headache (should really raise suspicion)

Answer 32

Right sided acute SDH Unilateral. Hyperdense (brighter) therefore acute. Cresenteric appearnce contiunous with outline of the brain.

Answer 33

Chronic left sided SDH Hypodense (darker) therefore chronic

Answer 34

Subdural haemorrhages are typically unilateral (85%) and follow a crescent-like distribution around the periphery of the brain. They can cross suture lines. In acute bleeds haemorrhage appears hyperdense (brighter) Overtime (chronic subdurals) haemorrhage may dissapear leaving behind a hypodense (darker) area.

Answer 35

A-E assessment and stabilisation Consider mannitol if intercranial pressure is raised Referral to neurosurgery treatment is emergency craniotomy and clot evacuation.

Answer 36

Arteriovenous malformations. (abnormal anastomoses between arteries and veins) Cerebral amyloid angiopathy: accumulation of amyloid in the tunica media and adventivia of vessels making them increasingly fragile. This is the major cause in lobar intrecerebral haemorrhage. Tumours which are often highly vascular.

Answer 37

A metal stereotactic frame with for pins (screws) is attached to he patients head. A CT scan is taken with the frame on allowing the surgeon to pinpoint the exact coordinates of the haematoma. The surgeon drills a small hole directly into the the haematoma and the clot is aspirated with a needle.

Answer 38

Hypertension: is the major cause in deep intracerebral bleeds Anticoagulant therapy Ilicit drugs: sympathomimmetics aka cocaine, amphetamine and ecstasy

Answer 39

Shearing of the middle meningeal aa just underlying the temporal bone. (inside the skull but outside the dura mater) An associated skull fracture is present in 75% of cases.

Answer 40

Initial investigation should be a head CT which will demonstrate the haemorrhage. Prognosis is usually good even in large haemorrhage as long as there is prompt evacuation of the clot by using burr holes. In small haemorrhages they can be treated conservatively with monitoring. If there is worry about raised ICP mannitol can be given.

Answer 41

A bleed within to the brain itself it is classified as either: Deep or Lobar (within the lobes)

Answer 42

The classic presentation of ICH is sudden onset of focal neurological deficit progressing over hours with accompanying headache, nausea, vomiting, altered consciousness, and elevated blood pressure.

Answer 43

CT angiography has the advantage over CT as it can be used to indicate still active bleeding. Initial treatment: Resus, reduce ICP, prep for surgery. Management is needed in an ITU setting. A: Intubated B: Hyperventialte to reduce ICP. CO2 causes vasodilation therefore low levels cause relative constriction therefore reduced cerebral blood flow and lower pressures. C: Maintain euvolaemia. Surgical management: Insertion of a VP (ventricular peritoneal shunt) to reduce ICP and allow room for the haematoma to grow with out damaging brain tissue. Main surgical aim is to remove the clot and stop further bleeding can be done by: Stereotactic aspiration (preferred for large deep seated haematomas) Or Craniotomy (only when the bleed is more superficial)

Answer 44

Typically there is a clear history of head trauma with a potential transient loss of conciousness. Following this there is usually a lucid period in which they regain consciousness but usually have an ongoing severe headache. Over the next few hours a haematoma forms and cause a mass effect herniation which presents clinically as gradual loss of consciousness. **Abducens nn** is first nerve affected on side of injury sec. to herniation

Answer 45

Optic nn Optic Chaism Optic tract (superior and inferior fibres together) Lateral Geniculate nucleus Optic Radiations **Visual cortex** (Travels to the occipital lobe broadman's area 17. )

Answer 46

Optic tract lesion. If it is a left sided homomynous hemianopia then the lesion will be in the right optic tract. Can't see out the left as lesion is on the right posterior tract.

Answer 47

Optic Chiasm

Answer 48

The optic radiations of the geniculocalcarine tract. If the visual loss is on the left then the lesion is on the right. **PITS - Parietal Inferior, Temporal Superior** If it is in the upper visual field it is from the superior retinal fibres running through the Temporal lobe. If it is in the lower visual field the lesion is from the inferior retinal fibres running through the Parietal lobe. So if you have a left inferior homomynous hemianopia then the lesion will be in right parietal retinal fibres of the geniculocalcarine tract. If the lesion was a right sided superior homomynous hemianopia then the lseion would be in the left temporal lobe retinal fibres of the geniculocalcarine tract.

Answer 49

The forehead is spared in UMN facial nn weakness. This is because there is bilateral cortical representation of the forehead muscles.

Answer 50

**UMN:** Hypertonia Hyper-reflexia Upward babinski **Pyrimidal muscle weakness** (A pattern of weakness in the extensors (upper limbs) or flexors (lower limbs), is known as 'pyramidal weakness') Clasp knife reflex Pronator drift (if arm pronates indicated lesion)

Answer 51

**LMN:** Hypotonia Hypo-reflexia Muscle Weakness Muscle Wasting Fasiculations

Answer 52

CN I Olfactory: sense of smell CN II Optic: Vision CN III Occulomotor: All the muscles moving the eye except for superior oblique and abducent also controls the muscle responsible for the eyelid. CN IV Trochlea: Superior oblique CN V Trigeminal: 3 branches; opthalmic, maxillary and mandibular, sensation of the face and muscles of mastication. CN VI Abducent: Controls lateral rectus muscle which pulls the pupil laterally (aka abducts) CN VII Facial: 5 branches involving movements in the face. Temporal, zygomatic, buccal, mandibular, cervical. Taste to the anterior 2/3 of the tounge via the chorda tympani. CN VIII Vestibulocochlea: hearing and balance CN IX Glossopharyneal: Taste to the posterior 1/3 of the tounge. Sensation to the oropharynx. CN X Vagus: Parasympathetic stimulation to most of the body including the heart and GI notably, test with gag reflex. Controls the movement of the palate. CN XI Accessory: Motor innervation to SCM and trapezius. CN XII Hypoglossal: Muscles of the tounge.

Answer 53

CN III: The eye will be looking down and out, only the lateral rectus and superior oblique will be working. There will be a near complete ptosis and mydriasis. CN IV: Patients present with vertical diplopia usually worse on downwards gaze. CN VI: Usually occurs unilaterally one eye will not be able to look laterally and therefore will cause a binocular diplopia.

Answer 54

UMN lesions are forehead sparing due to there being bilateral innervation. This is

Answer 55

Uvula deviates away from the lesion aka if uvula is deviated towards the left indicates a right sided CN IX & X palsy. Tounge deviates towards the lesion, aka a tounge deviated towards the left indicates a left sided CN XII palsy.

Answer 56

Rhine's test: Twang a tuning fork and place it on the mastoid process, and then immediately in front of the ear. In a normal person it should be louder in front of the ear indicating that air conduction \> bone conduction. If this is not the case the patient has a conductive hearing loss. Weber's Test A tuning fork is twanged and placed in the centre of the patients head and asked which ear the sound is loudest in, it should be equal. If the hearing deficit is conductive then it will be louder in the affected ear. If the hearing deficit is sensorineural then it will sound louder in the patients good ear. Without Rhine's test you cannot tell the deficit in Weber's test.

Answer 57

Location: Anterior cranial fossa Cranial bone: Ethmoid bone Contents: * Olfactory nerve (CN I) * Anterior ethmoidal nerves

Answer 58

Location: Middle cranial fossa Cranial bone: Sphenoid bone Contents: * Optic nerve (CN II) * Opthalmic artery (located inferolaterally within the canal)

Answer 59

Location: Middle cranial fossa Cranial bone: Sphenoid bone Contents: **L**azy **F**rench **T**arts **S**it **N**akedly **I**n **S**exual **A**nticipation * Lacrimal nerve * Frontal nerve (branch of opthalmic nerve of trigeminal nerve (CN V)) * Trochlear nerve (CN IV) * Superior opthalmic vein * Nasociliary nerve (branch of opthalmic nerve (CN V1)) * Inferior division of the oculomotor nerve (CN III) * Superior dividion of the oculomotor nerve (CN III) * Abducens nerve (CN VI) (+ A branch of the inferior opthalmic vein)

Answer 60

Location: Middle cranial fossa Cranial bone: Sphenoid bone Contents: * Maxillary branch of trigeminal nerve (CN V2) * Artery of foramen rotundum * Emissary veins

Answer 61

Location: Middle cranial fossa Cranial bone: Sphenoid bone Contents: **OVALE** * **O**tic ganglion (inferior) * **V**3 cranial nerve (mandibular branch of the trigeminal nerve) * **A**ccessory meningeal artery * **L**esser petrosal nerve * **E**missary veins

Answer 62

Location: Middle cranial fossa Cranial bone: Sphenoid bone Contents: **MMA fighters break your SPINE** * **M**iddle **M**eningeal **A**rtery * Middle Meningeal Vein * Meningeal branch of CN V3/Nervus Spinosus

Answer 63

Location: Middle cranial fossa Cranial bone: Petrous part of temporal bone Contents: * Facial nerve (CN VII) * Vestibulocochlear nerve (CN VIII) * Vestibular ganglion * Labrynthine artery **EXTRA:** There are 4 regions within the IAM: anterio-superior/anterio-inferior/postero-superior/postero-inferior **...Seven UP, Coke DOWN** * Facial nerve (**CN VII**) located superiorly * Vestibulo**coch**lear nerve located inferiorly

Answer 64

Location: Posterior cranial fossa Cranial bone: * Anterior aspect= Petrous portion of temporal bone * Posterior aspect= Occipital bone Contents: **If someone hits you with a glass JUG call 9-11** * Glossopharyngeal nerve (CN **IX**) * Vagus nerve (CN **X**) * Accessory nerve (CN **XI**) * Jugular bulb * Inferior petrosal and sigmoid sinuses

Answer 65

Location: Posterior cranial fossa Cranial bone: Occipital bone Content: * Hypoglossal nerve (CN XII)

Answer 66

Location: Posterior cranial fossa Cranial bone: Occipital bone Contents: **S**pecial **M**eninges **M**ake **A S**pecial **V**ertical **S**heath * Spinal cord * Meninges * Meningeal lympthatics * Accessory nerve * Sympathetic plexus on vertebral arteries * Vertebral arteries * Spinal branch of vertebral arteries

Answer 67

Strokes involving the vertebral and basilar arteries have a high incidence of mortality due to affecting supply of the brainstem.

Answer 68

Ischaemia in the lateral part of the medulla oblongata in the brainstem Symptoms: * *Contralateral loss** of temp + sensation * *Ipsilateral loss** of **pain and temp** on face * *Dysphagia, hoarseness & loss gag reflex** * *Ipsilateral horners syndrome**

Answer 69

Parietal bones articulate with each other in the midline via the **saggital suture** **Coronal suture** divides the parietal and frontal bones **Lamboid suture** is articulation between the parietal bones and the occipital bones

Answer 70

**External Occipital Protuberance** gives attachment to the muscles and ligamentum nuchae

Answer 71

Directly related to side of body of sphenoid Contents: **CNIII + IV + V1 & V2 of CNV + CNVI Internal carotid artery**

Answer 72

Damage to the cribiform plate of the ethmoid bone - leads to **epistaxis** and **cerebrospinal rhinorrhea** Fractures involving the orbital plate of the frontal bone leads to haemorrhage beneath the conjunctiva into the orbital cavity causing **exompthalus**

Answer 73

Weakest part base of skull ergo common Leakage of CSF and blood from EAM is common 3rd, 4th, 6th, 7th and 8th cranial nn may be damaged Can also get blood and CSF leaking from nose

Answer 74

Blood may escape down nape of neck deep to postvertebral muscles In fractures involving the jugular foramen 9th, 10th and 11th cranial nerves may be damaged

Answer 75

Le Fort fractures: **Type 1:** Transverse fracture through maxillary sinuses, lower nasal septum and pterygoid plates **Type 2:** Floating maxilla (pyramidal) **Type 3:** Floating space (transverse)

Answer 76

**Endosteal layer:** Periosteum covering the inner surface of bones of the skull **Meningeal layer:** dura mater proper Covers the brain and is continuous through foramen magnum with dura mater of spinal cord Continuations of the dura mater include: * *Falx Cerebri:** sickle shaped fold of dura mater that lies in midline between the two cerebral hemispheres * *Tentorium Cerebri:** crescent fold of dura mater that roofs over the posterior cranial fossa. Supports the occipital lobes of cerebral hemispheres

Answer 77

Lies between pia mater internally and dura mater externally Seperated from Dura by a potential space - **subdural space** Seperated from pia by **Subarachnoid space -** filled with CSF NB the arachnoid bridges over the sulchi in certain areas

Answer 78

Where the arachnoid projects into venous sinuses - where CSF is reabsorbed into the blood stream

Answer 79

Tearing of the sup. cerebral veins at their point of insertion into superior sagital sinus Cause - usually a blow on front or back of the head Blood begins to accumulate in the potential spaces between dura and arachnoid

Answer 80

Results from leakage / rupture of aneurysm at circle of Willis Sudden onset, severe headache with stiffness of neck and loss of consciousness

Answer 81

Usually caused by rupture of thin walled lenticulostriate artery - a branch of the middle cerebral artery Haemorrhage involves the vital corticobulbar and corticospinal fibres therefore leading ti contralateral hemiplegia

Answer 82

Lies on lateral side of the body of the sphenoid bone Anteriorly the sinus receives the inferior opthalmic vein and the central vein of the retina. Drains posteriorly into the transverse sinus.

Answer 83

Opening: Levator palpebrae superioris raises the upper eyelid & orbicularis oculi relaxes Closing: Orbicularis oculi contracts and levator pa,pebrae contracts

Answer 84

Derived from the lacrimal nucleus of the facial nerve. Zygomaticotemporal branch - gives rise to lacrimal nerve.

Answer 85

Arrises from the opthalmic division of the trigeminal nerve Enters through the superior orbital fissure and passes forward along the upper border of the lateral rectus muscle Supplies **sensory innervation** to the lacrimal gland and conjunctiva. Supplies skin of the lateral part of the upper lid.

Answer 86

**Orbital opening:** Lies anteriorly About 1/6 of the eye is exposed **Supraorbital notch Infraorbital fissure Supraorbital fissure** **Optic canal:** Located posteriorly on lesser wing of sphenoid Transmits optic nerve and opthalmic artery

Answer 87

Arises from the opthalmic division of the Trigeminal nerve Enters orbit through the upper part of the superior orbital fissure Further divides into the **supratrochlear** (skin of forehead) and **supraorbital nn** (mucous membrane of frontal air sinus)

Answer 88

Parasymp. ganglion Situated in posterior part of the orbit Receives its **preganglionic** parasympathetic fibres from the oculomotor nn via the nn to the inf obliue **Postganglionic fibres** leave the ganglion in the **short ciliary nn** which enter the back of the eye and supply the **sphincter pupillae (CONSTRICTED PUPIL) and the ciliary muscle**

Answer 89

Contraction pulls the ciliary body forward This makes the lens more convew. Innervation occurs from the parasympathetic fibres of the oculomotor nn.

Answer 90

Superficial parotid, mastoid and superficial cervical lymph nodes

Answer 91

Emerges on the anterior surface of the hindbrain between the pons and the medulla Roots pass laterally into the posterior cranial fossa with the vestibulocochlear nn. and enter the **internal acoustic meatus** At the bottom of the meatus the nerve enters the **facial canal** that runs lat in the inner ear On reaching the medial wall of the inner ear the nerve swells to form the sensory **geniculate ganglion.** The nerve descends behind the pyramid and emerges from the temporal bone through the **stylomastoid foramen.**

Answer 92

**Greater petrosal nerve** (arises from nn at the geniculate ganglion. Secretomotor function of the lacrimal gland and glands of nose and palate) **Nerve to stapedius** **Chordae Tympani** (arises in the facial canal. Enters infratemporal fossa and joins the lingual nn. Contains parasymp. fibres to submandibular and sublingual salivary glands and taste to ant. 2/3 tongue.) **Posterior auricular** * *Temporal (**ant. and sup. auricular muscles, frontal belly of occipito-frontalis) * *Zygomatic** (orbicularis oculi - sphincter muscles of eyelid) * *Buccal** (Buccinator muscle, muscles upper lip and nostril) * *Mandibular** (muscles lower lip) * *Cervical (**supplies platysma)

Answer 93

Anterior scalp and forehead - drains into submandibular lymph nodes Lateral part of the scalp above the ear - superficial parotid Lymph vessels in the scalp above and behind the ear - mastoid Vessels in the back of the scalp drain into occipital nodes

Answer 94

**Lacrimal nerve:** supplies the skin and the conjunctiva of the lat. part of the upper eyelid. **Supraorbital nerve:** Skin on the forehead Skin and conjunctiva over central part of eyelid **Supratrochlear nerve:** Skin and conjunctiva over the medial part of eyelid Skin over lower part of forehead **Infrattrochlear:** Supplies the skin and conjunctiva on the medial part of the upper eyelid and adjoining part of the side of the nose **External nasal nerve:** Supplies the skin on **tip of the nose**

Answer 95

**Infraorbital nerve:** exits thru infraorbital foramen Supply skin of lower eyelid & cheek Side of nose and upper lip **Zygomaticofacial nerve:** Supplies skin over prominence of cheek **Zygomaticotemporal:** Supplies skin over the temple

Answer 96

Mandibular nerve is both sensory and motor Mandibular root (both sensory and motor branches) leaves the trigeminal ganglion at **foramen ovale** Main trunk: Meningeal branch Nerve to medial pterygoid muscle Anterior division: Massteric nerve Deep temporal nerves Nerve to lateral pterygoid Buccal nerve Posterior Division: Auriculotemporal nerve Lingual nerve Inferior alveolar nerve Communicating branches

Answer 97

**Greater Occipital nerve:** Skin overlying trapezius muscle and back of the scalp as high as the vertex **Lesser occipital nerve:** Lateral occipital region and skin over medial surface of auricle **Great Auricular nerve (C2, 3):** Supplies skin over the **angle of mandible** Parotid gland and both surfaces of the auricle

Answer 98

Accompanied by the **external laryngeal nerve** - supplies cricothyroid muscle Sup thyroid artery supplies upper pole of thyroid gland

Answer 99

2nd branch of ECA Supplies pharyngeal wall

Answer 100

3rd branch of ECA Supplies the tongue

Answer 101

4th branch of ECA Loops upward - lies deep the submandibular gland Emerges and bends around lower border of the mandible Supplies the tonsill, submandibular salivary gland, and muscles and skin of face

Answer 102

Branch of ECA Supplies the back of the scalp

Answer 103

Branch of ECA Supplies the auricle and scalp

Answer 104

Branch of ECA Accompanied by auricotemporal nerve and supplies the scalp

Answer 105

Branch of ECA Enters pterygopalantine fossa of the skull Branches supply upper and lower jaws, muscles of mastication, nose, palate and meninges inside the skull

Answer 106

Emerges on anterior surface of the midbrain Continues into middle cranial fossa in **lateral wall of cavernous sinus** Enters orbital canal through **superior orbital fissure** Supplies the extrinsic muscles of the eyes and the intrinsic muscles of the eye - enables eye movement and **constriction of pupil**

Answer 107

**Mental**: Supplies skin over lower lip and chin **Buccal**: Supplies skin over small area of cheek **Auricotemporal nerve:** Ascends from upper border of parotid gland Supplies the EAM, skin of the auricle, outer surface of the tympanic membrane and the skin of the scalp above the auricle

Answer 108

**Masseteric nerve**: masseter muscle **Deep temporal nerves**: temporalis muscle **Nerve to lateral pterygoid** **Buccal nerve**: NB **sensory branch only (**does not supply buccinator muscle)

Answer 109

NB **sensory** other than nerve to mylohyoid muscle (branch of inf. alveolar nn.) **Auriculotemporal nerve:** Supplies skin of auricle, EAM, TMJ and scalp * *Lingual nerve:** * *Sensation to ant 2/3 tongue and floor of mouth** **Inferior alveolar nn:** Supplies teeth of the lower jaw (enters through mandibular canal) **Communicating branch:** Runs from inf. alveolar nerve to lingual nerve.

Answer 110

Parasympathetic ganglion located medial to mandibular nn Post ganglion - parotid gland with secretomotor function Innervated by the **glossopharyngeal nn.**

Answer 111

Swallowing, salivation, control BP and HR and nn supply to post 1/3 tongue **Carotid branch:** Supply from carotid sinus **Pharyngeal branches** **Lingual branches** Sensation to post 1/3 tongue

Answer 112

Anterior surface of medulla oblongata Passes laterally through posterior cranial fossa and leaves skull through jugular foramen Descends in neck alongside Carotid arteries and IJV in Carotid sheath

Answer 113

**Pharyngeal branch:** Supplies all of the muscles of the **pharynx** (except stylopharyngeus) and of **soft palate** **Superior laryngeal nn:** Divides into **internal & external** laryngeal nn (**Internal laryngeal:** sensory to mucous membrane of piriform fossa and larynx as far down as the vocal chords **External laryngeal:** motor and located close to sup thyroid artery - **cricothyroid muscle**) **Recurrent laryngeal nn:** Right side nerve hooks around **first part subclavian artery** ascends in groove between trachea and oesophagus Left side nerve hooks around **arch of aorta** Nerve is closely related to inferior thyroid artery and supplies **all muscles of the layrnx** (except cricothyroid), mucous membrane of layrnx below vocal chord and mucous membrane in upper part trachea.

Answer 114

Consists of a cranial root and a spinal root **Cranial root:** Emerges from the anterior surface of the medulla oblongata. Nerve runs laterally in post. cranial fossa and joins the spinal root **Spinal root:** Arises from anterior gray horn of upper five segments of teh cervical part of the spinal cord. Nerve enters skull through **foramen magnum** **Cranial & spinal root** leave skull through **jugular foramen** **Spinal root** enters deep surface of **SCM** and crosses posterior triangle of neck to supply **trapezius**

Answer 115

**Tip**: Submental lymph nodes **Sides of anterior 2/3**: submandibular and deep cervical lymph nodes **Posterior 1/3**: Deep cervical lymph nodes

Answer 116

**Palatoglossus -** supplied by pharyngeal plexus Pulls roots of tongue upward and backward

Head Flashcards

(143 cards)