Head and neck Flashcards

1
Q

What are the cranial bone of the head

A

Ethmoid (1)
Frontal (1)
Occipital (1)
Parietal (2)
Sphenoid (1)
Temporal (2)

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2
Q

What are the Facial bones of the head

A

Lacrimal (2)
Maxilla (2)
Nasal (2)
Inferior concha (2)
Palatine (2)
Vomer (1)
Zygoma (malar) (2)
Mandible (1)

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3
Q

What are the two major functions of the skull

A

Protection of the brain
Supporting facial structures

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4
Q

What is another name for the facial skeleton

A

Viscerocranium

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5
Q

How many bones is the viscerocranium comprised of

A

14

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6
Q

What cranial bones form the calvarium (roof)

A

Frontal
Parietal
Occipital

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7
Q

What are the sections of the skull

A

Frontal
Parietal
Occipital

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8
Q

What are the names of the suture in the skull

A

Coronal - between frontal + parietal
Sagittal - between 2 parietal bones
Lambdoid - between parietal + occipital

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9
Q

What is the anterior fontanelle

A

Hole in the skull bones between developing 2 frontal and parietal
Closes about 18months - 2 years

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10
Q

What is present in infants skull between the sagittal and lambdoid sutures until about 8 weeks

A

Posterior Fontanelle

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11
Q

What makes up the cranial base

A

Ethmoid bone
Frontal bone
Occipital bone
Sphenoid bone
Temporal bone (petrous)

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12
Q

What/where is the mastoid process

A

Contains mastoid air cells and inflammation of these can be due to acute otitis media (or middle ear infection). You can easily feel (palpate) the mastoid process behind the ear

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13
Q

What is the foramen magnum

A

Where the spinal chord appears in the skull

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14
Q

What part of the temporal bone does the middle and inner ear sit

A

Petrous

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15
Q

What cranial nerve enters through the cribriform plate of the ethmoid bone

A

Olfactory nerve

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16
Q

What is the internal auditory meatus

A

Where the nerve for hearing and balance (vestibulocochlear nerve) and the nerve that supplies the muscles of the face (facial nerve) enters

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17
Q

What does the zygoma bones form

A

Zygomatic forms the cheeks, or cheek bones and joins with the frontal (above), sphenoid (deep), temporal (side) and maxilla (antero-inferiorly)​

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18
Q

What is the purpose of the zygomatic bones

A

Form like a crash impact barrier of the face from primitive and developmental times​

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19
Q

Why do the lateral bones such as zygoma and temporal etc sit further back (posterior)

A

To allow for greater area of binocular vision hence the medial bones such as nasal sit further forward

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20
Q

What bones form the cranial vault (top of skull)

A

Frontal
Occipital
Parietal
Temporal (squamous)

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21
Q

What is the weakest point of the skull

A

Pterion any trauma at that point can lead to rupture of the blood vessels just deep to that point – the middle meningeal artery (and vein)

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22
Q

What does the rupture of the middle meningeal artery cause

A

Can cause a delay in symptoms called a lucid interval. The patient initially appears fine after trauma at this site, but as the dura is pressed off the skull, as in an extra-dural haemorrhage, then the patient will have a reduced level of consciousness, with potentially headache, nausea and vomiting

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23
Q

What is the orbit

A

Eye socket

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24
Q

What forms the roof of the orbit

A

Formed by the frontal bone and the lesser wing of the sphenoid.

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25
Q

What separates the orbit from the anterior cranial fossa

A

Frontal bone

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26
Q

What does the maxilla separate the orbit from

A

The underlying maxillary sinus

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27
Q

What forms the floor of the orbit

A

Formed by the maxilla, palatine and zygomatic bones

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28
Q

What forms the medial wall of the orbit

A

Ethmoid, maxilla, lacrimal and sphenoid bones

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29
Q

What does the ethmoid bone separate the orbit from

A

Ethmoid sinus

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30
Q

What forms the orbits lateral wall

A

Zygomatic bone and greater wing of the sphenoid

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31
Q

Where is the apex of the orbit

A

Located at the opening to the optic canal, the optic foramen

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32
Q

What is the base of the orbit also known as

A

Orbital rim

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33
Q

What openings would be found behind the eye ball in the socket

A

Optic foramen
Superior orbital fissure
Inferior orbital fissure

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34
Q

Which skull bone can be described as butterfly shaped

A

Sphenoid

35
Q

What occurs at the infraorbital foramen

A

Termination of the infraorbital nerve (maxillary division of the trigeminal nerve)

36
Q

What anaesthetising nerves lie slightly behind the infraorbital foramen in the maxilla

A

Superior alveolar nerves

37
Q

What are the sections of the maxilla

A

BACK
Maxillary sinus
Alveolar process
Incisive canal
Palatine process

FRONT
Frontal process
Notch for lacrimal bone
Infraorbital foramen
Orbital surface
Zygomatic process
Anterior nasal spine
Alveolar process

38
Q

Where is the nasal septum

A

Sits between the nasal cavities

39
Q

What forms the nasal septum

A

Septal cartilage
Vomer
Perpendicular plate of ethmoid bone

40
Q

What nerve passes through the incisive canal

A

Nasal palatine nerve

41
Q

What is the main artery which supplies head and neck

A

Common carotid artery

42
Q

What artery supplies the brain

A

Internal carotid (80%)
Vertebral (20%)

43
Q

Where does the common carotid artery arise from

A

Arch of the aorta (left) and brachiocephalic trunk (right)

44
Q

What branches of the common carotid supply the head and neck

A

External carotid (exterior)
Internal carotid (brain)

45
Q

What are the branches of external carotid artery and what do they supply

A

Ascending pharyngeal - Pharynx​

Superior thyroid – thyroid gland, alongside the inferior thyroid artery​

Lingual – tongue, sublingual salivary gland, gingiva and the oral mucosa of floor of mouth​

Facial – Facial artery​

Occipital – Muscles of the posterior neck and skull​

Posterior auricular – neck muscles, ear structures (external auditory meatus, tympanic cavity, tympanic membrane, semi-circular canals​

Superficial temporal – skin and muscles at side of face and scalp, parotid gland, temporomandibular joint.​

46
Q

What vein drains the head, neck and brain

A

Internal jugular vein

47
Q

What supplies the infra-hyoid muscles

A

Ansa cervicalis

48
Q

What do the facial artery and vein branch into

A

Inferior labial
Superior labial
Lateral nasal
Angular
Supra-orbital
Supratrochlear
Zygomaticofacial
Zygomaticotemporal

49
Q

What are the superficial temporal and maxillary arteries both terminal branches of

A

External carotid artery

50
Q

What supplies and drains the face

A

Facial artery and vein

51
Q

Where do the maxillary and superficial temporal veins drain to

A

Retromandibular vein

52
Q

What does the internal jugular vein drain

A

The cerebrum, the inside of the skull and most of the external structures of the head and neck​

53
Q

What does the external jugular vein drain

A

Some external structures eg. Posterior auricular vein/retro-mandibular vein

54
Q

What is the cavernous sinus

A

Paired dural venous sinuses within the skull/cranial cavity. It is split into septae or small caves.​

55
Q

Where is the cavernous sinus found

A

Within the middles cranial fossa on either side of the sella turcica of sphenoid bone (where the pituitary gland sits)

56
Q

What cranial nerves are found within the cavernous sinus

A

CN III - Oculomotor
CN IV - Trochlear
CN VI - Abducens
V1 - Ophthalmic division of the trigeminal nerve
V2 -Maxillary division of the trigeminal nerve

57
Q

What does V2 supply

A

(Maxillary division of the trigeminal nerve) – supplies the skin over maxillae, upper teeth​

58
Q

What does V1 supply

A

(Ophthalmic division of the trigeminal nerve) - supply the upper face (forehead) – sensory

59
Q

What is the only part of the body where an artery passes through a venous structure - Which artery

A

Cavernous sinus
Internal carotid artery

60
Q

What drains the cavernous sinus

A

Receives drainage from ophthalmic veins, central vein of retina, superficial cerebral vein (middle), pterygoid plexus

61
Q

What is cavernous sinus thrombosis

A

A clot in the cavernous sinus due to an infection which spreads from areas like the orbit, paranasal sinuses, or danger zone of face

62
Q

What could indicate cavernous sinus thrombosis

A

Features like headache, eye bulging (proptosis), photophobia, cranial nerve palsies

63
Q

Which cranial nerve is most commonly affected by cavernous sinus thrombosis

A

Abducens

64
Q

What is unusual about the dural venous sinuses

A

They don’t have valves

65
Q

What are dural venous sinuses

A

The dural venous sinuses lie between the periosteal and meningeal layers of the dura mater. They are best thought of as collecting pools of blood, which drain the central nervous system, the face, and the scalp. All the dural venous sinuses ultimately drain into the internal jugular vein

66
Q

What are the layers of meninges

A

Pia
Arachnoid
Dura

67
Q

Where would cerebrospinal fluid be found

A

In the subarachnoid space

68
Q

How many venous sinuses are there

A

11

69
Q

Where are the straight, superior and inferior sagittal sinuses found

A

In the falx cerebri of the dura matter

70
Q

Where do the straight superior and inferior sagittal sinuses converge

A

The confluence of sinuses
(overlying the internal occipital protuberance)

71
Q

How does the blood return to the internal jugular vein

A

Via superior and inferior petrosal sinuses

72
Q

What drains the ophthalmic veins

A

Cavernous sinus found either side of the sella turcica

73
Q

Where is the danger tringle of the face

A

Either corner of the mouth to the bridge of the nose

74
Q

Why is it called the danger triangle of the face

A

Possesses a great risk of cavernous sinus thrombosis, meningitis and brain abscess

75
Q

What occurs within the danger triangle of the mouth

A

Communication of the facial vein, ophthalmic veins and with deeper veins including cavernous sinus

76
Q

What are pulses

A

Pressure waves in artery caused by contraction of left ventricle/corresponds with heartbeat​

77
Q

What is a normal pulse rate

A

60-80 bpm

78
Q

What pulses can be felt in the head and neck

A

Carotid pulse – 2 fingers either side of the trachea in the soft hollow part of the neck.​

Facial arterial pulse – mid-way along the mandible​

Temporal pulse – in front of the temple, or anterior to the ear

79
Q

What nerves supply the head and neck

A

Cranial nerves and nerves of cervical plexus​

Cranial nerves V,VII,IX,XII​

80
Q

What are the three branches of the trigeminal nerve

A

Ophthalmic (sensory) Va V1
Maxillary (sensory) Vb V2
Mandibular (mixed) Vc V3

81
Q

What nerves are contained within ophthalmic section of trigeminal nerve

A

Frontal
-supratrochlear
-supraorbital

lacrimal
nasociliary

82
Q

What nerves make up the
maxillary section of the trigeminal nerve

A

zygomatic nerve/infraorbital nerve/anterior, middle and superior alveolar nerves​

83
Q

What are some nerves within mandibular division of trigeminal nerve

A

Motor to muscles of mastication​

Sensory – auriculotemporal nerve/lingual nerve/buccal nerve/inferior alveolar nerve​

84
Q

What is the Frankfurt plane

A

Passes from the inferior margin of the left orbit and upper margin of the external auditory meatus – Occlusal plane​