Head and neck

Question 1

What are the divisions of the ear?

Answer 1

External - auricle, external auditory meatus, external surface of the tympanic membrane.

Middle- Internal surface of tympanic membrane, tympanic cavity, ossicles, pharyngotymapnic tube

Internal- Auditory apparatus, vestibular apparatus, internal auditory meatus, vestibulococchlear nerve (CN VIII)

Question 2

External ear

Answer 2

Elastic cartilage

Lymph to parotid and cervical lymph nodes

Question 3

External auditory meatus

Answer 3

Lateral 1/3rd- elastic cartilage, hair follicles, sweat and sebaceous glands.

Medial 2/3- Bone lined with stratified squamous epithelium

Nerves- Mainly auriculotemporal but also auricular branches

Question 4

Tympanic membrane

Answer 4

Outer- stratified squamous, inner mucous membrane
Chorda tympani across medial surface
Malleus attached to inner surface

Lateral surface- auriculotemporal nerve and auricualr branch

Medial surface- tympanic branches from glossopharyngeal

Question 5

Chorda tympani

Answer 5

Crosses medial surface of tympanic membrane and handle of melleus
Leaves tympanic cavity through petrotympanic fissure

Is a branch of the facial nerve

Joins lingual nerve
Parasympathetic= sub-lingual and sub- mandibular salivary glands

Special sense of taste for ant 2/3 of tongue

Question 6

Auditory tube

Answer 6

Connects nasopharynx with tympanic membrane

Lateral- bony canal lined with mucosa
Medial- cartilagenous and membranous
Normally closed, but when tensor veli tymapni contract, lumen opens

Equalises pressure on both sides of tympanic membrane

Sensory via CN IX

Question 7

Middle ear arterial supply

Answer 7

Anterior tympanic artery from 1st part of the maxillary artery.

Contributions from ascending pharyngeal, middle meningeal

Question 8

Bony labyrinth

Answer 8

Surrounded by optic capsule
Otic capsule is very dense within petrous temporal bone - NOT bony labyrinth but surrounds it

A system of canals with with perilymph

Cochlea
Vestibule
Semicircular canals

Question 9

Membranous labyrinths

Answer 9

Continuous system of ducts and sacs inside bony labyrinth

Suspending in perilymph but contains endolymph

Question 10

Perilymph and endolymph

Answer 10

Conduct sound vibrations and respond to mechanical forces

Question 11

Semicircular canals

Answer 11

Lie posterior and lateral to vestibule
Anterior, posterior and lateral parts
Anterior and posterior parts sit and right angles and the lateral parts sit horizontal
Contain semi-circular ducts (continuous with utricle)
Each duct swells at end = ampullae

Question 12

Ampullae

Answer 12

Each ampulla houses equilibrium receptor called crista ampullaris which respond to angular movements of the head

Question 13

Vestibule

Answer 13

Bony labyrinth
inside are 2 membranous sacs- utricle and saccule

House equilibrium receptors called maculae= respond to pull of gravity and changes in head position

Question 14

Inner ear arterial supply

Answer 14

Main supply from internal auditory
Internal auditory branches form common cochlear and vestibular arteries
Internal auditory usually a branch of anteroinferior cerebellar a or basilar a

Question 15

Larynx

Answer 15

Voice production, hyaline cartilage and small synovial plane joints

Question 16

Cuneiform

Answer 16

within aryepiglottic folds to support them

Question 17

Corniculate

Answer 17

Attach to aryepiglottic folds

Question 18

Epiglottis

Answer 18

Elastic cartilage
Anterior connections with hyoid bone and posterior surface of thyroid cartilage.
Posterior connections with arytenoid cartilages via aryenepiglottic folds

Question 19

Quadrangular ligament

Answer 19

Arytenoid cartilages to epiglottis

Free edge - vestibular ligament- false vocal cord

Question 20

Vocal fold movements

Answer 20

Quiet respiration
Forced inspiration
Phonation (sound production via change in air flow through larynx )

Question 21

Cricothyroid

Answer 21

Tense and elongate vocal folds
Increase distance between thyroid cartilage and vocal processes of arytenoid.

Thyroid tilted forward and cricoid tilted back.

External laryngeal branch of CN X

Question 22

Thyroarytenoid

Answer 22

Upper fibres run alongside vocal fold - vocalis
Fibres shorten and relax vocal ligaments
Pull arytenoid forwards towards thyroid

Recurrent laryngeal branch of CN X

Question 23

Posterior circoarytenoid

Answer 23

Abduct vocal folds
Pulls muscular process of arytenoid backwards - rotating vocal process laterally

Recurrent laryngeal branch of CN x

Question 24

Lateral cricoarytenoid

Answer 24

Adduct vocal fold
Pulls muscular process of arytenoid forwards and medially rotates vocal process

Recurrent laryngeal branch of CNX

Question 25

Oblique arytenoid

Answer 25

Acts as a sphincter to laryngeal inlet Muscular process of arytenoid cartilage to apex of opposite arytenoid cartilage Recurrent laryngeal branch of CN X

Question 26

Transverse arytenoid

Answer 26

Closes post part of rima glottis | Recurrent laryngeal branch of CN X

Question 27

Pharynx

Answer 27

Upper end funnel shaped at end of skull, joins oesophagus at C6 Fibrous and muscular layers

Question 28

Nasopharynx

Answer 28

Behind nasal cavities and above soft palate Roof= sphenoid, occipital and pharyngeal tonsil Floor- soft palate- pharyngeal isthmus Ant= nasal passages Post - roof and C1 level Lateral - auditory tube, salpignopharyngeal fold

Question 29

Oropharynx

Answer 29

From soft palate to upper border of epiglottis ``` Roof- soft palate Floor = post 1/3 tongue, lingual tonsil Ant= mouth Post- C2/3 Lateral - Palatoglossal and palatopharyngeal folds with palatine tonsil. ```

Question 30

Laryngeopharynx

Answer 30

Behind larynx and laryngeal opening Anterior = larynx Post - C3-6 Lateral = supported by thyroid cartilage, aryepiglottic fold and thyrohyoid membrane

Question 31

Superior constrictor

Answer 31

``` To fibrous raphe and middle constrictor Propel food towards middle constrictor Pharyngeal plexus (vagus) ```

Question 32

Middle constrictor

Answer 32

To raphe, blends with middle and inferior constrictors ``` Propel food towards inferior constrictor pharyngeal plexus (Vagus) ```

Question 33

Inferior constrictor

Answer 33

``` To raphe, blend with middle constrictor and oesophagus Propel food towards oesophagus Pharyngeal plexus (Vagus) ```

Question 34

Stylopharyngeus

Answer 34

Base of styloid process to post thyroid cartilage Across internal carotid artery Passes between sup and middle constrictors Elevates larynx and pharynx during swallowing Glossopharyngeal nerve

Question 35

Salpingopharyngeus

Answer 35

Cartilage of auditory tube to blend with palatopharyngeus Elevate pharynx Pharyngeal plexus (vagus)

Question 36

Palatopharyngeus

Answer 36

hard palate - lamina of thyroid cartilage elevate pharynx pharyngeal plexus

Question 37

Arterial supply to pharynx

Answer 37

Pharyngeal branches from maxillary a (nasopharynx) Ascending pharyngeal a from medial surface of external carotid.

Question 38

Suprahyoid muscles

Answer 38

Raise hyoid bone and depress mandible Ant belly digastric and mylohyoid are innervated by the mandibular division of the trigeminal n. post belly digastric and stylohyoid - facial nerve CN VII Geniohyoid - innervated by C1 via hypoglossal nerve

Question 39

Salivary glands

Answer 39

Submandibular - Facial Parotid- Glossopharyngeal Sub-lingual - Facial

Question 40

Nerve innervation to the tongue

Answer 40

Post 1/3rd both taste and sensory - glossopharyngeal | Ant 2/3rd - taste = facial and general sensory = trigeminal (CNV3)

Question 41

Intrinsic muscles

Answer 41

- change shape of tongue - All fibres within tongue - Fibres in different orientations - Hypoglossal nerve XII

Question 42

Extrinsic muscles

Answer 42

- All originate outside tongue and insert in. - Change shape of tongue in mouth - Genioglossus- protrudes tip, drepress tongue - Styloglossus- elevate and retract tongue - Hypoglossus- depress tongue - Palatoglossus - elevate tongue - All hypoglossal nerve except palatoglossus- Pharyngeal plexus (vagus)

Question 43

Blood supply to tongue

Answer 43

Lingual artery- 2nd branch of external carotid a.

Question 44

Nerve supply

Answer 44

``` Motor- hypoglossal sensory- Post tongue glossparyngeal apart from patch in middle- internal laryngeal. Front of tongue- lingual Taste buds- chorda tympani ```