Head and Neck Flashcards
(555 cards)
1
Q
what are the borders of the anterior triangle
A
superior: inferior border of mandible
lateral: anterior border of SCM
medial: imaginary line down the midline of the neck
2
Q
which layers of fascia form the roof and floor of the anterior triangle
A
roof: investing fascia
floor: visceral fascia
3
Q
what are the general contents of the anterior triangle
A
muscles
nerves
blood vessels
lymph nodes
4
Q
which groups of muscles are in the anterior triangle
A
supra hyoid
infra hyoid
5
Q
what are the supra hyoid muscles
A
stylohyoid
digastric
mylohyoid
geniohyoid
6
Q
what are the infra hyoid muscles
A
omohyoid
sternohyoid
thyrohyoid
sternothyroid
7
Q
which nerves are found in the anterior triangle of the neck
A
cranial nerves CN VII CN IX CN X CN XI CN XII
8
Q
which blood vessels are found in the anterior triangle
A
common carotid artery, which bifurcates into the internal and external carotids
internal jugular vein
9
Q
what are the subdivisions of the anterior triangle
A
carotid triangle
submental triangle
submandibular triangle
muscular triangle
10
Q
borders of the carotid triangle
A
superior: posterior belly of digastric
lateral: medial border of SCM
inferior: superior belly of omohyoid
11
Q
what are the contents of the carotid triangles
A
common carotid artery and its bifurcation
internal jugular vein
hypoglossal, accessory and vagus nerves
12
Q
where is the submittal triangle
A
underneath the chin
13
Q
contents of the submental triangle
A
submental lymph nodes
beginning of anterior jugular vein
14
Q
boundaries of the submental triangle
A
inferior: hyoid
medial: midline of neck
lateral: anterior belly of digastric
15
Q
what forms the floor of the submental triangle
A
mylohyoid muscle, from the mandible to the hyoid bone
16
Q
contents of the submandibular triangle
A
submandibular salivary gland lymph nodes facial artery and vein carotid sheath hypoglossal nerve
17
Q
borders of the submandibular triangle
A
superior: body of mandible
anterior: anterior belly of digastric
posterior: posterior belly of digastric
18
Q
borders of the muscular triangle
A
superior: hyoid
medial: imaginary midline of neck
superolateral: superior belly of omohyoid
inferolateral: inferior part of SCM
19
Q
attachments of platysma
A
from fascia above pectoralis major and clavicle to lateral neck and onto mandible
20
Q
innervation of platysma
A
facial nerve CN VII
21
Q
describe the course of the jugular veins in relation to SCM
A
external jugular vein runs anterior/superficial to SCM
internal jugular vein runs posterior/deep to SCM
anterior jugular runs in the midline
22
Q
which nerve roots make up the cervical plexus
A
anterior rami C1-C4
23
Q
within which fascial layer do the branches of the cervical plexus lie
A
prevertebral fascia
24
Q
which modalities are carried in the cervical plexus
A
somatic motor and sensory
sympathetic
25
what are the main sensory branches of the cervical plexus
lesser occipital
great auricular
transverse cervical
supraclavicular
26
what are the main motor branches of the cervical plexus
nerves to geniohyoid and thyrohyoid
ansa cervicalis
phrenic nerve
27
which muscles are innervated by branches from C1
geniohyoid
| thyrohyoid
28
with which nerve do fibres from C1 travel to reach geniohyoid and thyrohyoid
hypoglossal nerve
29
what roots make up the ansa cervicalis
C1-C3
30
which muscles are supplied by ansa cervicalis
omohyoid
sternohyoid
sternothyroid
(infra hyoid muscles apart from thyrohyoid)
31
nerve roots of greater auricular nerve
C2-C3
32
what does the greater auricular nerve supply
sensation to skin of external ear and skin over parotid gland
33
nerve roots of transverse cervical nerve
C2-C3
34
what does the transverse cervical nerve supply
sensation to skin of anterior and anterolateral neck and upper sternum
35
nerve toots of lesser occipital nerve
C2
36
what does the lesser occipital nerve supply
posterosuperior scalp
37
nerve roots of supraclavicular nerves
C3-C4
38
what do the supraclavicular nerves supply
skin overlying the supraclavicular fossa and upper thoracic region and sternoclavicular joint
39
which muscles does the cervical plexus supply with proprioception
SCM C2-C3
| trapezius C3-C4
40
nerve roots of phrenic
C3,4,5
41
what does the phrenic nerve supply
diaphragm
42
course of phrenic nerve in neck
travels on the anterior surface of the anterior scalene and through the thoracic inlet
43
what are the actions of the supra hyoid muscles
elevate hyoid bone
| necessary for swallowing
44
attachments of stylohyoid
styloid process of temporal bone
TO
lateral aspect of hyoid bone
45
action of stylohyoid
initiates swallowing action by pulling hyoid posterosuperiorly
46
innervation of stylohyoid
facial nerve CN VII
47
attachments of digastric
anterior belly from digastric fossa or mandible
posterior belly from mastoid process of temporal bone
intermediate tendon attaches both bellies to hyoid via fibrous sling
48
actions of digastric
depress mandible and elevates hyoid
49
innervation of digastric
anterior belly: CN V3
| posterior belly: CN VII
50
attachments of mylohyoid
mandible
TO
hyoid
51
actions of mylohyoid
elevate hyoid bone and floor of mouth
52
innervation of mylohyoid
CN V3
53
attachments of geniohyoid
inferior mental spine of mandible
TO
hyoid bone
54
actions of geniohyoid
depresses the mandible and elevates hyoid bone
55
innervation of geniohyoid
C1 nerve roots via hypoglossal nerve
56
actions of infra hyoid muscles
depress hyoid and thyroid cartilage
57
attachments of omohyoid
inferior belly: scapula
superior belly: hyoid
intermediate tendon attach to clavicle by deep cervical fascia
58
actions of omohyoid
depresses the hyoid
59
innervation of omohyoid
ansa cervicalis (C1-C3)
60
attachments of sternohyoid
sternum
TO
hyoid bone
61
actions of sternohyoid
depress the hyoid
62
innervation of sternohyoid
ansa cervicalis, C1-C3
63
attachments of sternothyroid
sternum (manubrium)
TO
thyroid cartilage
64
actions of sternothyroid
depresses the thyroid cartilage
65
innervation of sternothyroid
ansa cervicalis, C1-C3
66
attachments of thyrohyoid
thyroid cartilage
TO
hyoid
67
actions of thyrohyoid
depresses the hyoid and elevates larynx when hyoid is fixed
68
innervation of thyrohyoid
C1 via hypoglossal nerve
69
which roots contribute to the superior and inferior roots of ansa cervicalis
superior root = C1
| inferior root = C2,3
70
where does the left common carotid arise from
arch of aorta
71
where does the right common carotid arise from
brachiocephalic
72
what are the branches of the common carotid arteries in the neck
NO BRANCHES U FOOL
| terminates by dividing into internal and external carotids
73
general supply of they internal and external carotids
internal: brain and intracranial structures
external: head, face, neck
74
what does the common carotid travel within in the neck
carotid sheath
| along with internal jugular and vagus nerve
75
which branches of the external carotid are found in the anterior triangle
facial artery
lingual artery
superior thyroid artery
76
which other artery (not a carotid) gives branches to supply the neck
subclavian artery via thyrocervical trunk
77
branches of the thyrocervical trunk
inferior thyroid artery
transverse cervical artery
supra scapular artery
78
which cranial nerve descends in the carotid sheath
vagus nerve
79
which branches of the vagus nerve are given off in the neck
recurrent laryngeal branches
- left wraps around the arch of aorta
- right wraps around subclavian artery
internal and external laryngeal branches
80
what are the main parts of the thyroid gland
2 lobes
isthmus
capsule
81
borders of the thyroid gland
from lamina of thyroid cartilage to 6th trachea ring
82
where is the isthmus located
over tracheal ring 2/3
83
arterial supply of thyroid
superior thyroid artery: branch of external carotid
| inferior thyroid artery: thyrocervical trunk of subclavian artery
84
venous drainage of thyroid
superior thyroid vein: internal jugular
middle thyroid vein: internal jugular
inferior jugular: left bracnhiocephalic
85
where is the submandibular salivary gland located
inferior to mylohyoid
| with part in floor of mouth superior to mylohyoid
86
where fo the ducts of the submandibular salivary gland open
between first and second lower incisor
| either side of frenulum
87
borders of posterior triangle
anterior: posterior border of SCM
posterior: anterior border of trapezius
inferior: middle 1/3 of clavicle
88
what makes up the roof and floor of posterior triangle
roof: investing fascia
floor: prevertebral fascia
89
contents of posterior triangles
```
external jugular vein
roots of brachial plexus
accessory nerve
cervical and supraclavicular lymph nodes
supraclavicular nerves
```
90
which nerves can be found the posterior triangle
lesser occipital C2
greater auricular C2,3
supraclavicular (lateral, intermediate and medial) C3,4
transverse cervical C2,3
91
which nerve supplies the upper, posterior scalp
greater occipital
92
which nerve supplies the lateral scalp, posterior to ear
lesser occipital
93
which nerve supplies the outer ear, and skin over parotids
great auricular
94
which nerve supplies the anterior neck
transverse cutaneous nerve
95
which nerves supply the lower lateral neck and upper shoulders
supraclavicular nerves
96
which veins join to form the external jugular
posterior auricular and retromandibular veins
97
which veins form the retromandibular vein
maxillary and superficial temporal veins
98
where does the external jugular vein form
posterior to the angle of mandible
| inferior to the outer ear
99
where does the external jugular vein travel within the neck
descends in superficial fascia
| runs anterior to SCM, crosses it in a posteroinferior direction
100
which vein does the external jugular drain into
subclavian vein (passes under clavicle)
101
attachments of sternocleidomastoid
sternum and clavicle
| mastoid process of temporal bone
102
innervation of SCM
motor via CN XI
| pain/proprioception via C2/3
103
attachments of trapezius
```
superior nuchal line
nuchal ligament
spinous process T1-T12
TO
lateral clavicle, acromion and spine of scapula
```
104
innervation of trapezius
CN XI
| proprioception via C3,4
105
attachments of levator scapulae
transverse processes of C1-C4
TO
medial border of scapula at scapular spine
106
innervation of levator scapulae
C3,4,5 via dorsal scapular nerve
107
attachments of anterior scalene
transverse processes C3-6
TO
rib 1 at scalene tubercle
108
attachments of middle scalene
transverse processes of C2-7
TO
rib 1, behind subclavian artery
109
attachments of posterior scalene
transverse processes of C4-6
TO
rib 2
110
innervation of anterior scalene
anterior rami C4-7
111
innervation of middle scalene
anterior rami C3-7
112
innervation of posterior scalene
anterior rami C5-7
113
nerve root of sub occipital nerve
posterior ramus of C1
114
course of suboccipital nerve
runs between cranium and C1 vertebra to reach sub occipital triangle
115
what does the sub occipital nerve innervate
muscles of the sub occipital triangle
116
nerve roots of the greater occipital nerve
posterior ramus of C2
117
course of the greater occipital nerve
emerges inferior to obliquus capitis inferior and ascends to posterior scalp
118
what does the greater occipital nerve innervate
skin over posterior neck and occipital bone
119
nerve roots of lesser occipital nerve
anterior rami C2-3
120
course of the lesser occipital nerve
passes directly to skin
121
what does the lesser occipital nerve innervate
skin of superior posterolateral neck and scalp posterior to external ear
122
what do the posterior rami of C3-C7 innervate
intrinsic muscles of the back and overlying skin
123
attachments of splenius capitis
ligamentum niche and C7-T3 spinous processes
TO
superior nuchal line and mastoid process
124
attachments of splenius cervicis
T3-T6 spinous processes
TO
C1-C2 transverse processes
125
innervation of splenius muscles
posterior rami C1-C6
126
actions of splenius muscles
bilateral: extension of head and neck
unilateral: ipsilateral rotation and flexion of neck
127
attachments of semispinalis capitis
C4-T7 transverse processes
TO
occipital bone between nuchal lines
128
actions of semispinalis capitis
extension of cervical spine
ipsilateral lateral flexion
contralateral rotation
129
attachments of longissimus capitis
T1-T3 plus C4-C7 transverse processes
TO
mastoid process
130
actions of longissimus capitis
extension of head
| ipsilateral flexion and rotation
131
what are the sub occipital muscles
rectus capitis posterior major
rectus capitis posterior minor
obliquus capitis inferior
obliquus capitis superior
132
attachments of rectus capitis posterior major
C2 spinous process
TO
inferior nuchal line
133
attachments of rectus capitis posterior minor
C1 posterior tubercle (no no spinous process on C1)
TO
inferior nuchal line
134
actions of rectus capitis posterior muscles
extension of head
| ipsilateral rotation
135
innervation of rectus capitis posterior muscles
suboccipital nerve C1 posterior rami
136
attachments of obliquus capitis superior
C1 transverse process
TO
occipital bone above inferior nuchal line
137
actions of obliquus capitis superior
extension of head
ipsilateral lateral flexion
contralateral rotation
138
attachments of obliqqus capitis inferior
C2 spinous process
TO
C1 transverse process
139
action of obliquus capitis inferior
extension of head
| ipsilateral rotation
140
innervation of obliquus capitis muscles
suboccipital nerve posterior rami C1
141
the occipital artery is a branch of
external carotid
142
the vertebral artery is a branch of
subclavian artery
143
what is the course of the vertebral artery
ascends neck in foramen transversarium of cervical vertebrae (C6-C1)
crosses the superior surface of C1 to enter foramen magnum
unite to form basilar artery
144
which structure runs along with the sub occipital nerve
deep cervical vein
145
which veins drain into the deep cervical vein
occipital veins
146
where does the deep cervical vein end
near transverse process of C7 in vertebral vein
147
what are the vertebral veins
vertebral veins are small veins of the internal vertebral plexus, which form a vessel passing through the foramen transversarium
148
where do the vertebral veins drain
runs until C6 when it leaves foramen to joint brachiocephalic vein
149
which ligaments are associated with the atlantoaxial and atlantooccipital joints
cruciate ligament
alar ligament
anterior/posterior Atlanto-axial membrane
anterior/posterior Atlanto-occipital membrane
150
which ligaments are associated with the entire cervical vertebra
anterior and posterior longitudinal ligament
151
what are the main muscles flexing the neck at the atlantooccipital joint
longus capitis
recuts capitis anterior
anterior fibres of SCM
supra hyoid and infra hyoid muscles
152
main muscles extending the neck at the atlantooccipital joint
```
rectus capitis posterior (major and minor)
obliquus capitis superior
splenius capitis
longissimus capitis
trapezius
```
153
muscles laterally flexing the neck at the atlantooccipital joint
```
SCM
obliquus capitis superior
reactus capitis lateralis
longissimus capitis
splenius capitis
```
154
muscles creating ipsilateral rotation at atlantoaxial joint
obliquus capitis inferior
rectus capitis posterior (major and minor)
longissimus capitis
splenic capitis
155
muscles creating contralateral rotation at atlantoaxial joint
SCM
| semispinalis capitis
156
main muscles flexing the cervical IV joints
bilateral action of longus coli, scalene and SCM
157
main muscles extending the cervical IV joints
```
deep neck muscles
semispinalis cervicis and iliocostalis cervicis
splenius cervicis and levator scapulae
splenius capitis
multifidus
longissimus capitis
semispinalis capitis
trapezius
```
158
main muscles of lateral flexion of the cervical IV joints
```
unilateral action of
iliocostalis cervicis
longissimus capitis and cervicis
splenius capitis and cervicis
intertransversari and scalene
```
159
main muscles rotating the cervical IV joints
```
unilateral action of
rotatores
semispinalis capitis and cervicis
mutifidus
splenius cervicis
```
160
what its he stylomandibular ligament made of
| what is its purpose
extension of dense fibrous capsule surrounding parotid gland
separates parotid and submandibular glands
161
where is the parotid duct located
1 fingers breadth below the zygomatic arch
162
describe the course of the parotid duct
crosses masseter
| takes a sharp, medial turn to pierce buccal fat pad and buccinator to enter oral cavity at upper second molar
163
which nerve divides into its terminal branches within the parotid gland
facial nerve
164
what are the main branches of the facial nerve arising within the parotid gland
```
posterior auricular (behind the ear)
temporal (anterior to ea, superior)
zygomatic (along zygoma)
buccal (across cheeks)
marginal mandibular (along border of mandible)
cervical (down neck)
```
165
transverse facial artery is a branch of...
superficial temporal artery (terminal branch of external carotid)
166
what is the course of the transverse facial artery
arises from superficial temporal artery
| crosses cheek, close to parotid duct
167
terminal branches of external carotid artery
superficial temporal and maxillary arteries
168
which veins join to form retromandibular vein
superficial temporal and maxillary veins
169
which nerve divides the parotid gland into deep and superficial parts
facial nerve
170
which neurovascular structures pass through the parotid gland
auriculotemporal nerve (CN V3)
external carotid artery
retromendibular vein
facial nerve
171
which muscles are innervated by the facial nerve before it passes through the parotid gland
stylohyoid
| posterior belly of digastric
172
describe how parasympathetic fibres reach the parotid gland
parasympathetic fibres of CN IX travel in tympanic branch, through tympanic plexus (without synapsing)
via the lesser petrosal nerve, they pass through the foramen ovale to the otic ganglion, where they synapse
they are then carried to the parotid by the auriculotemporal branch of the CN V3
173
which structure do the two roots of the auriculotemporal nerve wrap around on their way to the parotid gland
middle meningeal artery
174
what are the muscles of mastication
temporalis
masseter
medial pterygoid
lateral pterygoid
175
innervation of muscles of mastication
CN V3
176
what are the movement of the mandible
```
elevation
depression
protrusion
recursion
lateral sliding
```
177
how is depression of the mandible achieved
gravity or against force using the supra hyoid muscles
178
temporalis is covered in
temporalis fascia
179
attachments of temporals
temporal fossa and fascia
TO
coronoid process and anterior border of ramus of mandible
180
actions of temporalis
anterior and superior fibres elevate mandible
| posterior fibres retract mandible
181
innervation of temporalis
deep temporal nerve (x2) from anterior division of CN V3
182
attachments of masseter
zygomatic arch
TO
lateral aspect of ramus of mandible
183
action of masseter
elevated mandible
184
innervation of masseter
masseteric nerve from anterior division of CN V3
185
attachments of lateral pterygoid
upper head: infratemporal surface of greater wing of sphenoid
lower head: lateral surface of lateral pterygoid plate
TO
neck of mandible and articular disc
186
actions of lateral pterygoid
bilateral: protrusion (pulls neck of mandible forwards with articular disc)
unilateral: helps in lateral chewing movements with medial pterygoid
187
innervation of lateral pterygoid
nerve to lateral pterygoid from anterior division of CNV3
188
attachments of medial pterygoid
superficial head: tubercle of maxilla
deep head: medial surface of lateral pterygoid plate
TO
medial surface of angle of mandible
189
action of medial pterygoid
assists in elevation
190
innervation of medial pterygoid
nerve to medial pterygoid from main trunk of CN V3
191
what occurs during elevation of the mandible
head of mandible and disc move backward and head rotates on lower surface of disc
192
which muscles elevate the mandible
temporalis
masseter
medial pterygoid
193
what occurs during depression of the mandible
head of mandible rotates on undersurface of articular disc and middle is pulled forward
194
which muscles cause depression of mandible
```
lateral pterygoid
digastric
geniohyoid
mylohyoid
GRAVITY
```
195
what occurs during protrusion of the mandible
articular disc and head of mandible move forward
| movement occurs in the upper part of the cavity
196
which muscles cause protrusion of the mandible
lateral pterygoid
| medial assists
197
what occurs during retrusion of the mandible
articular disc and head of mandible are pulled backwards into mandibular fossa
198
which muscles retract the mandible
posterior fibres of temporalis
199
what occurs during lateral chewing
protrusion and retraction combined
200
which muscles cause lateral chewing
pterygoids
201
briefly describe the branches of CN V3
main nerve trunk: meningeal branch, nerve to medial pterygoid, tensor tympani and tensor vela palatini
anterior division: masseteric, nerve to lateral pterygoid, deep temporal (x2), buccal
posterior division: auriculotemporal, lingual, inferior alveolar (with mylohyoid branch)
202
which branch of CN V3 passes through the otic ganglion
part of nerve to medial pterygoid
no synapse
passes on to tensor veli palatini and tensor tympani
203
which branches of CN V3 act as carriers of parasympathetic fibres
auriculotemporal
| lingual
204
the auriculotemporal nerve carries parasympathetic fibres
| where do they originate and where are they travelling
fibres originate from CN IX
| auriculotemporal nerve carries them from the otic ganglion to the parotid gland
205
the lingual nerve carries parasympathetic fibres
| where do they originate and where are they travelling
they originate from the chordates tympani (CN VII)
| carried to the submandibular and sublingual glands
206
what are the posterior branches of the external carotid artery
occipital
| posterior auricular
207
course of occipital artery
posterior branch of ECA
origin close to facial artery
passes under posterior belly of digastric to enter posterior triangke
208
what does the occipital artery supply
back of scalp
209
describe course of posterior auricular artery
posterior branch of ECA
originates superior to occipital artery
passes posterior to ear
210
what does the posterior auricular artery supply
scalp
211
which artery arises from deep surface of ECA
ascending pharyngeal
212
describe course of ascending pharyngeal artery
deep/medial branch of ECA
ascends between internal carotid and pharynx
gives branches to pharynx
213
what are the anterior branches of the ECA
superior thyroid
lingual
facial
214
describe the course of the superior thyroid artery
anterior branch of ECA
arises near origin of ECA
gives branches to SCM and superior laryngeal artery
215
describe the course of the lingual artery
anterior branch of ECA
arises between superior thyroid and facial arteries, at level of hyoid bone
passes deep to hyoglossus
crossed by the hypoglossal nerve
216
what does the lingual artery supply
oral cavity
217
describe the course of the facial artery
anterior branch of ECA
arises above level of hyoid
passes deep to posterior belly of digastric
218
which branches does the facial artery give off
superior and inferior labial branches
| angular artery to face
219
what is the angular artery of the face
branch of facial
| reaches up to medial corner of eye
220
what are the terminal branches of the ECA
superficial temporal
| maxillary
221
describe the course of the superficial temporal artery
smaller terminal branch of ECA
ascends anterior to auricle
gives off transverse facial artery below zygoma
divides into anterior and posterior branches
222
supply of the superficial temporal artery
skin over frontal and temporal regions
223
describe the course of the maxillary artery
larger terminal division of ECA
arises behind neck of mandible
passes through infra temporal fossa
passes between 2 heads of lateral pterygoid to go into pterygomaxillary fissure/fossa
224
supply of maxillary artery
branches to muscles of mastication, tympanic membrane, upper and lower teeth, palate, nasal cavity, nasopharynx and meninges
225
what are the main lymph nodes of the head/neck
```
occipital
parotid
submandibular
submental
superficial cervical
deep cervical
```
226
what is the infra temporal fossa
space beneath the base of the skull between the skull and the ramus of the mandible
227
what are the boundaries of the infra temporal fossa
anterior: posterior surface of maxilla
posterior: styloid process
superior: infratemporal surface of the greater wing of sphenoid bone
meidal: lateral pterygoid plate
lateral: ramus of the mandible
228
what are the contents of the infra temporal fossa
```
pterygoids
mandibular division of CN V
maxillary artery and branches
pterygoid venous plexus
chordates tympani
otic ganglion
```
229
branches of anterior division of CN V3
x2 deep temporal
masseteric
nerve to lateral pterygoid
buccal
230
branches of posterior division of CN V3
lingual
inferior alveolar
mylohyoid
auriculotemporal
231
pre-division branches of CN V3
meningeal branch
nerve to medial pterygoid
communicating branch (tensors tympani and deli palatini)
232
describe the course of they inferior alveolar nerve
arises from anterior division of CN V3
descends infra temporal fossa and passes through mandibular fossa
gives of nerve to mylohyoid as a branch
233
what does the inferior alveolar nerve innervate
sensory: lower teeth and gums
motor: mylohyoid and anterior belly of digastric via nerve to mylohyoid
234
describe the course of the lingual nerve
posterior division of CNV3
| descends infra temporal fossa
235
what is innervated by the lingual nerve
general sensory: anterior 2/3 tongue and oral cavity
| carries special sensory to anterior 2/3 of tongue from cord tympani
236
innervation of buccal nerve
sensory to inside of cheek
237
what are the three parts of the maxillary artery
mandibular
pterygoid
pterygopalatine
238
what branches arise from the mandibular part of the maxillary artery
deep auricular and anterior tympanic arteries
middle meningeal
inferior alveolar (gives off mylohyoid artery)
239
where does the middle meningeal artery travel
through the foramen spinosum to reach the meninges
240
branches of the pterygoid part of maxillary artery
deep temporal X2
| buccal branches
241
branches of pterygopalatine part of maxillary artery
posterior superior alveolar
infraorbital
anterior superior alveolar branches
palatine, pharyngeal and sphenoplatine branches
242
where its he pterygoid venous plexus
surrounds lateral pterygoid
243
which areas drain into the pterygoid venous plexus
veins from orbit, nasal and oral cavities
244
which vein drains the pterygoid venous plexus
maxillary vein
245
which other venous structures does the pterygoid venous plexus communicate with and why is this clinically relevant
cavernous sinus
facial vein
route for infection
246
which nerve carries parasympathetic fibres from chordates tympani to the tongue
lingual nerve of CN V3
247
what type of joint is the TMJ
synovial joint between head of mandible and mandibular fossa and articular tubercle on squamous part of temporal bone
248
what are the articular surfaces of the TMJ covered in
fibrocartilage
249
which nerves supply the TMJ
auriculotemporal and masseteric
250
which ligaments support the TMJ
lateral: tempormandibular ligament
medial: sphenomandibular and stylomandibular ligaments
251
what is the purpose of the articular disc of TMJ
increases congruity of articular surfaces and is involved in movements
head of mandible and disc: elevation and depression
disc and mandibular fossa/articular process: protrusion and retraction
252
describe movements of the disc/mandible duding opening of the mouth
depression and protrusion of both sides to slide disc and condyle forwards towards tubercle
253
describe movement of disc/mandible to close mouth
elevation and fracture pull condyle and disc backwards
254
the mastoid and styloid processes are features of which bone
temporal bone
255
what are the two parts of the temporal bone
petrous (strong, houses middle/inner ear)
| squamous (thin)
256
where do the muscles of facial expression insert
into the skin
257
what is covered by the deep cervical fascia (in the face)
masseter is covered
| invests parotid gland
258
where is frontalis
forehead
259
what is frontalis also known as and why
anterior belly of fronto-occipitalis
| attached to occipitalis via aponeurosis which forms layer of scalp
260
which nerve innervates the muscles of facial expression
CN VII
261
action of frontalis
raises eyebrows
262
where is corrigator supercili
deep to frontalis
| runs obliquely from lateral bridge of nose skin of medial eyebrow
263
action of corrigator supercilious
brings eyebrows together (eg frowning)
264
function of platysma
tenses skin of neck
265
where is procerus
over superior part of bridge of nose, between eyebrows
| vertically orientated fibres
266
action of procerus
wrinkles top of nose, and eyebrows
267
where is nasalis
over bridge and nose and extends down alas of nose
transverse part = across bridge of nose
alar part = around alae
268
actions of nasalis
transverse part = wrinkles nose
| alar part = flares nostrils
269
where is buccinator
deep to muscles of mastication
| forms lateral wall of oral cavity
270
action of buccinator
aids chewing by pushing food towards teeth
271
which structure pierces buccinator
parotid duct
272
where is orbiculares oculi
around eye
273
function of orbicularis oculi
circular fibres contract around eye to tightly shit eyelid
274
where are zygomaticus major and minor
originate from maxilla and insert near corner of mouth
275
action of zygomaticus muscles
does little smirky Elvis face
276
where is orbicularis oris
around mouth
277
action of orbicularis oris
purses lips
278
where is levator labii superioris
lateral to nose, medial to zygomaticus muscles
279
action of levator labii superioris
raises upper lip
280
where is levator anguli superioris
deep to levator labii superioris, inserts to corner of mouth
281
action of levator anguli superioris
lifts corner of mouth
282
where is risorius
transverse fibres from ramus of mandible to corner of mouth
283
action of risorius
pulls corners of mouth out
284
where is levator labii superioris alaeque naise
runs from top of nose, down its sides to below nostrils
285
what does levator labii superioris alaequae nase do
flares nostrils and lifts top lip a bit
286
where is depressor anguli oris
attaches along lower border of mandible to corner of mouth
287
action of depressor anguli oris
pulls down corner of mouth
288
where is depressor labii inferiors
from anterior mandible to bottom lip
289
action of depressor labii inferiors
pulls down lower lip
290
where is mentalis
deep to depressor labii inferioris
291
action of mentalis
elevates and protrudes lower lip (pouting)
292
which muscles are innervated by the posterior auricular branches of facial n.
occipitalis
stylohyoid
posterior belly of digastric
293
which muscles are innervated by the temporal branches of facial n
frontalis
| orbicularis oculi
294
which muscles are innervated by the zygomatic branch of facial nerve
orbicularis oculi
295
which muscles are innervated by the buccal branch of facial n.
```
zygomaticus major and minor
levator labii superioris
levator anguli oris
buccinator
orbicularis oris
nasalis
```
296
which muscles are innervated by the marginal mandibular branch of facial nerve
depressor anguli oris
depressor labii oris
mentalis
297
which muscles are innervated by the cervical branch of facial nerve
platysma
298
describe the course of the facial artery
goes through anterior triangle of neck, around angle of mandible, courses superomedially across face towards inner eye
299
branches of the facial nerve
submental
superior and inferior labial
lateral nasal
angular
300
what are the layers of the scalp
```
skin
connective tissue
aponeurosis (between frontalis and occipitalis)
loose areolar connective tissue
periosteum (pericranium)
```
301
describe the blood supply of the scalp
supratrochlear (medial forehead)
supratrochlear (lateral forehead)
superficial temporal (temporal region, anterolateral scalp)
posterior auricular (posterolateral scalp, behind ear)
occipital (posterior scalp)
302
what are emissary veins
serve communication between superficial veins of the scalp (in connective tissue layer) and dural venous sinuses
303
what is the clinical significance of the emissary veins
possible route for infection to spread to intracranial structures
304
describe nerve supply to the scalp
supratrochlear and supraorbital: forehead and medial scalp (from anterior to posterior)
zygomaticotemporal: anterior temporal region
auriculotemporal: temporal region in front of ears
lesser occipital: behind ears
greater occipital: posterior scalp/occipital region
305
lobes of the brain
```
frontal
temporal
parietal
occipital
(cerebellum)
```
306
where is the longitudinal fissure
along the sagittal midline of the brain
| splits it into 2 hemispheres
307
where is the lateral fissure
between the frontal/parietal and temporal lobes
308
where is the central sulcus
runs from longitudinal fissure to lateral fissure, dividing the frontal and parietal lobes
309
define:
sulcus
gyrus
fissure
```
gyrus = outward 'bump' of brain
sulcus = inward 'groove' of brain
fissure = deeper sulcus
```
310
which structure connects the two hemispheres
corpus callous (white matter tract)
311
where are the primary motor and sensory cortices
primary motor: anterior to central sulcus aka pre-central gyrus
somatosensory: posterior to central sulcus aka post-central gyrus
312
where is the auditory cortex
superior gyrus of temporal lobe, inferior to lateral fissure
313
where is Broca's area
frontal lobe, above middle part of lateral fissure
314
what is the function of Broca's area
motor part of speech
| expressive, production of speech
315
where is werneke's area
posterior aspect of lateral fissure
316
what is the function of werneke's area
recognition of speech
| understanding
317
where is the visual cortex
occipital lobe
318
what is connected by association tracts
between gyro of the same hemisphere
319
what is connected by commissural tracts/fibres
corresponding regions of different hemispheres
320
what is connected by projection fibres
cerebrum to thalamus/brainstem etc
321
what is the main action of the basal ganglia
regulate initiation and termination of body movements
| also maybe involved in memory, planning and emotional response
322
what are the main parts of the basal ganglia
caudate nucleus
putamen
globus pallidum
substantia nigra
323
which structures make up the lenitform nucleus
globus pallidus and putamen
324
where are the basal ganglia located
deep in the bran
| except substantia nigra which is in the brainstem
325
which structures does the substantia nigra communicate with
caudate nucleus and putamen
326
which structure do sub-thalamic nuclei communicate with
globus pallidus
327
what is the internal capsule
white matter pathway
328
which basal ganglia are separated by the internal capsule
putamen and globus pallidus (lentiform nucleus) separated from the caudate nucleus
329
what are the three areas of the diencephalon
thalamus
hypothalamus
pineal gland
330
function of the thalamus
sensory relay station
signals pass from spinal cord/midbrain through thalamus then to cerebral hemispheres
also motor pathways
331
function of the hypothalamus
regulation of autonomic nerve system and homeostasis (body temp, thirst etc)
production of hormones (connection to pituitary)
332
where is the pineal gland
posterior aspect of thalamus
333
function of pineal gland
produces melatonin to regulate body clock
| contain habenular nucleus (olfaction and emotional response)
334
pineal gland aka
epithalamus
335
which cranial nerve originate from midbrain
CN III and CN IV
336
external features of midbrain
superior and inferior colliculi
337
what is the function of the superior colliculi
visual scanning, tracking
338
function of inferior colliculi
auditory startle reflex
339
which part of the basal ganglia is found in the midbrain
substantia nigra
340
function o substantia nigra
control of subconscious muscle action
341
where are the red nuclei located
| what is their function
midbrain
| coordinate muscle movement
342
function of pons
coordination and maximising voluntary motor output
| pneumotaxic tract to control breathing
343
which cranial nerve originate from pas
CN V, VI, VII and vestibular part of CN VIII
344
functions of medulla
```
contains pyramids (motor tracts)
CV centra (rate/force heartbeat and diameter of vessels)
breathing centres
sensory nuclei (touch, pressure, vibration)
olives = proprioception
```
345
which CNs originate from medulla
CN IX, X, XI, XII and cochlear part of CN VIII
| not spinal part of CN XI
346
where are the olives of the medulla
lateral to pyramids
347
what are the parts of the cerebellum
vermis (midline)
| 2 lobes
348
function of cerebellum
controls subconscious aspects of skeletal muscle movements and coordinates complex sequences
regulates posture and balance
349
how does the cerebellum communication with the rest of the brain
via peduncles
350
which cerebellar peduncles communicate with which bit of brain
superior: midbrain
middle: pons
inferior: medulla
351
what are the folds of the cerebellum called
folia
352
where is the pituitary gland located
connected to hypothalamus via pituitary stalk
| sits in pituitary fossa beneath dural covering (sella turcica)
353
function of pituitary gland
produces hormones to regulate endocrine system
354
which arteries contribute to circle of willis
```
internal carotids
basilar artery (vertebral arteries)
```
355
what are the main branches of the circle of willis
```
anterior cerebral (from internal carotids)
middle cerebral (from internal carotids)
posterior cerebral (from basilar)
```
356
how are the main bracnhes of the circle of willis connected
anterior communicating branch between anterior cerebral arteries
posterior communicating branches (x2) between posterior cerebral and internal carotids
357
where do the anterior cerebral arteries supply
frontal and parietal lobes
| runs in longitudinal fissure
358
where do the middle cerebral arteries supply
temporal lobes
| runs in lateral fissure
359
where do the posterior cerebral arteries supply
occipital lobe and base of brain
360
what other branches of the basilar artery are there
cerebellar, pontine and medullary branches
361
layers of the meninges
```
pia mater (covers neural tissue, run over/between sulci/gyri)
arachnoid mater (middle layer, SAS is deep to it)
dura mater (outer layer, fought connective sheath covering inside of skull)
```
362
what is the falx cerebri
fold of dura that lies between the cerebral hemispheres
363
what is carried in the falx cerebri
inferior sagittal venous dural sinus
364
where is the falx cerebelli
sits on top of the cerebellum
| separates cerebellum from cerebrum
365
blood supply to the meninges
anterior meningeal: from ethmoid branch of ICA (anterior fossa)
middle meningeal: from maxillary artery (major vessel)
posterior meningeal: branch fo occipital artery (posterior fossa)
366
how does the middle meningeal artery enter the cranium
foramen spinosum
367
damage to the MMA leads to
extradural haematoma and compression of brain
368
what is the main nerve supply to the dura
trigeminal nerve
369
describe innervation of dura of anterior fossa
anterior meningeal of ethmoidal (CN V1): anterior, medial
meningeal branch of maxillary (CN V2): middle part of anterior fossa/bit of middle fossa
meningeal branch of mandibular (CN V3): most of middle fossa + lateral edge of anterior fossa
370
describe innervation of dura of middle fossa
mostly meningeal branches of mandibular nerve CNV3
371
describe innervation of dura of falx cerebelli
tentorial nerve (recurrent meningeal branch of ophthalmic nerve, CN V1)
372
describe innervation of dura of posterior fossa
fibres of C2,3
| some distributed by CN XII/X
373
what is the function of the dural venous sinuses
act as veins of the meninges and brain
374
how are the dural venous sinuses related to spread of infection
connection between the cavernous venous sinus, pterygoid venous plexus, ophthalmic veins and facial veins allow spread of bacteria from superficial veins to venous sinuses
375
where do the dural venous sinuses drain to
internal jugular vein
376
how are the dural venous sinuses formed
between periosteum of skull and dura (eg sigmoid sinus)
| between two layers of dura (inferior sagittal sinus)
377
describe flow of CSF though the ventricles
```
lateral ventricles
through inter ventricular foramina of monro
third ventricle
cerebral aqueduct
4th ventricles
lateral and median apertures
SAS/central canal of spinal cord
```
378
where is CSF made
ependymal cells of choroid plexus
379
how is CSF drained
arachnoid granulations to the dural venous sinuses
380
what is the purpose of CSF
mechanical and physical protection of the brain and spinal cord
381
how does the frontal bone contribute to the borders of the bony orbit
roof, parts of medial and lateral
382
what other features of the orbit are on the frontal bone and what are their function
supraorbital ridges: protects orbit from direct trauma
| supraorbital notch: passage of supraorbital nerve and artery
383
how does the anterior orientation of the orbit affect the field of view
allows eyes to face more forward and allows overlap of field of view
can compare each visual field to create depth perception
384
how does the zygoma contribute to the borders of the bony orbit
lateral wall
385
how does the maxilla contribute to the borders of the bony orbit
forms the floor of the orbit
386
which foramen passes through the maxilla (associated with the orbit)
and what structures pass through
infraorbital foramen
| infraorbital branch of CN V2 passes through it
387
how does the lacrimal bone contribute to the bony orbit
associated with the lacrimal apparatus and nasolacrimal duct that carries excess lacrimal fluid into the nasal cavity
388
how does the ethmoid bone contribute to the bony orbit
forms part of medial wall and contributes to nasal cavities
389
how does the sphenoid bone contribute to the bony orbit
forms optic canal and superior orbital fissure
| contributes to inferior orbital fissure
390
what structures support the eye
```
tarsal plates
orbital septum
palpebral ligament
check ligaments
suspensory ligaments
```
391
what are the tarsal plates and what is their function
dense connective tissue plates that support the eyelid
| contain glands that release oily and watery secretions to lubricate surface of eye
392
where is the orbital septum found and what is it made of
deep to skin and orbicularis oculi
| strong connective tissue
393
where are the palpebral ligaments and what is their function
medial and lateral palpebral ligaments at corners of eye
| support corners of eye
394
where are the check ligaments found and what is their function
close to insertion of medial and lateral rectus muscles
| restrict movements of extra ocular muscles
395
where is the suspensory ligament found int he orbit and what is its function
creates a hammocky band under the eyeball
| supports position of eyeball
396
what are the three layers of the orbit
outer fibrous layer
middle vascular layer
inner photoreceptive layer
397
what structures make up the outer layer of the eye
cornea (anteriorly, over iris and pupil)
| sclera (white part of eye)
398
what structures make up the middle vascular layer of the eye
iris
ciliary body
choroid (blood vessels)
399
what makes up the inner layer of the eye
```
retina
contains photoreceptors (rods and cones)
```
400
what are some features of the retina
optic disc = point optic nerve leaves retina (no rods or cones = blind spot)
macula = area rich in rods and cones (fovea in centre)
401
where is the anterior chamber of the eye and what is it filled with
space between lens and cornea
| aqueous humour
402
where is aqueous humour of the anterior chamber produced, and how is it removed
ciliary body
| recycled into veins at the junctions of the cornea and sclera
403
where is the posterior chamber of the eye and what is it filled with
```
posterior to the lens
vitreous humour (gel-like)
```
404
what is the function of the vitreous humour
supports retina by pressing it up against the choroid
| choroid contains blood vessels so helps prevent damage to them
405
what are the intraocular muscles of the eye
dilator pupillae
sphincter pupillae
ciliary muscles
406
describe dilator pupillae (attachments, action, innervation)
small radial fibres attaching from edge of pupil to outer margin of iris
contraction to pull iris out and increase diameter of pupil
sympathetic
407
describe sphincter pupillae (attachments, action, innervation)
circular fibres around edge of pupil
contraction narrows the pupil
parasympathetic fibres from CN III
408
how is the ciliary muscle attached to the lens
circular fibres around lens, attached by radial fibres
409
describe the effect of relaxation of the ciliary muscle
when muscle is relaxed, the distance between the muscle and lens is greatest, so the fibres between them are taut
this pulls the edges of the lens out, making it flat and wide
410
describe the effect of contraction of the ciliary muscle
when muscle contracts, the distance between the lens and the muscle decreases so the fibres are relaxed
due to internal pressure, lens becomes more spherical
411
how does the shape of the lens affect vision
shape of lens changes how light is refracted and focused on the retina
flat lens is better for distance vision
round lens better for close up
412
innervation of the ciliary muscle
parasympathetic via CN III
413
what are the extra ocular muscles
levator palpebrae superioris
superior, inferior, medial and lateral rectus
superior and inferior oblique
414
what is the equator of the eye and how does it affect the action of the extra ocular muscles
its a circle around the diameter of the eye in the coronal plane
muscles attaching anterior to the equator pull the eye in its expected direction
muscles posterior to it pull it in the opposite direction (eg inferior oblique elevates the eye)
415
describe levator palpebrae superioris (attachments, action, innervation)
roof of orbit to upper eyelid
raises upper eyelid
CN III
416
describe superior rectus (attachments, action, innervation)
annular ring to superior sclera, anterior to equator
elevates, adducts, intorts eye
CN III
417
describe medial rectus (attachments, action, innervation)
annular ring to medial sclera, anterior to equator
adducts eye
CN III
418
describe lateral rectus (attachments, action, innervation)
annular ring to lateral sclera, anterior to equator
abducts eye
CN VI
419
describe inferior rectus (attachments, action, innervation)
annular ring to inferior sclera, anterior to equator
depresses, extorts and adducts eye
CN III
420
describe inferior oblique (attachments, action, innervation)
floor of orbit to inferior sclera, posterior to equator
elevates, extorts and abducts eye
CN III
421
describe superior oblique (attachments, action, innervation)
lesser wing of sphenoid to superior sclera, posterior to equator (via trochlea)
depresses, intorts and abducts eye
CN IV
422
what is the annular ring
common insertion for rectus muscles
423
what mnemonic helps remember the actions of extra ocular muscles
```
RADSIN
Rectus Adducts (apart from lateral rectus)
Superior Intorts (inferior extorts)
```
424
describe the course of the optic nerve
enters cranial cavity in the optic canal (sphenoid bone)
nasal fibres cross over above pituitary fossa to form chiasm
optic tracts extend posteriorly to lateral geniculate nucleus (thalamus)
optic radiations travel to primary visual cortex (occipital lobe)
425
what is the purpose of association areas in the visual cortex
give images context
426
which nerves pass through the superior orbital fissure
CN III, CN IV, CN V1 and CN VI
427
describe the course of cranial nerves through the cavernous sinus
CN III, CN IV and CN V1 pass close to lateral wall
| CN VI passes through middle with internal carotid artery
428
which nerves pass through the annular ring and which dont
frontal, lacrimal (CN V1) and CN IV DO NOT
CN III, rest of CN V1 and CN VI DO PASS
429
how does CN V1 leave skull
superior orbital fissure
430
which branches of CN V1 is most easily visualised and what are its branches
frontal branch
| divides into supraorbital and supratrochlear which leave via supraorbital notch
431
what are the branches of CN V1
frontal: lies superior to extraocular muscles
nasociliary: passes through ethmoid bone to supply nasal cavities
lacrimal: travels to lacrimal gland
432
what are the divisions of the CN III
superior: LPS and SR
inferior: MR, IR, IO and parasympathetic fibres
433
how do parasympathetic fibres of CN III reach the ciliary muscles
travel in inferior division to ciliary ganglion
| then via short ciliary nerves
434
what is the main blood supply of the orbit and where is its origin
ophthalmic artery
ICA
enters in optic canal
435
branches of the ophthalmic artery
forehead and scalp: supraorbital, supratrochelar and zygomaticotemproal
nose: dorsal nasal and. ethmoidal
436
describe venous drainage of the orbit
superior ophthalmic vein drains to cavernous sinus
inferior ophthalmic vein drains to pterygoid venus plexus
communicated via the inferior orbital fissure with the facial vein = spread of infection
437
what is the puropse of the lacrimal gland
secretes thin watery fluid to lubricate surface of eye and remove debris
438
where is the lacrimal gland
lateral edge of orbit
439
how is lacrimal fluid drained from eye
tears wash across surface of eye and gathered though lacrimal punctum into the lacrimal canaliculi
drains via lacrimal sac to inferior meatus of nose via nasolacrimal duct
440
innervation of the lacrimal gland
parasympathetic secretomotor fibres from CN VII via CN V1 and CN V2
facial nerve branches to form greater petrosal nerve carrying parasympathetic fibres
joins deep petrosal nerve (sympathetic fibres from internal carotid plexus) to form nerve of pterygoid canal
passes to pterygopalatine ganglion to join CN V2 (zygomatic branch) which joins the lacrimal nerve (CN V1) to reach lacrimal gland
441
which muscles of facial expression overlie the nose
nasalis
levator labii superioris alaeque nasi
procerus (superior bridge)
442
what are the named bits of nasal cartialge
septal cartilage separates nasal cavities
| alar cartialge makes up nostrils
443
blood supply of the external nose
anterior and posterior ethmoidal (ophthalmic)
sphenopalatine and greater palatine (maxillary)
septal branches of labial artery (facial)
lateral nasal (facial)
444
nerve supply of external nose (skin of nose)
bridge: CN V (infratrochlear and anterior ethmoidal)
alae: CN V2 (nasal branches of infraorbital)
445
what structures make up the nasal septum
cartilage anteriorly
perpendicular plate of ethmoid superiorly
vomer inferiorly
sphenoid posteriorly
palatine and maxilla contributes to nferior part
446
which bones make up the lateral wall of nasal cavity
maxilla, sphenoid, ethmoid, frontal
447
which bones make up the conchae
ethmoid: superior and middle
| inferior concha is separate bone
448
describe passage of air through the nasal cavity
in nostrils to vestibule of nose
| air passes between conchae/meati towards choanae to nasopharynx
449
what is the choanae
posterior part of nasal canal, at entrance of nasopharynx
450
the opening of which structure is found in the nasopharynx and what is its purpose
(related to ear)
auditory tube
| leads to middle ear and allows passage of air to equalise pressure on either side of the tympanic membrane
451
what is the purpose of the conchae
create air turbulence, which swirls air around the nasal cavity and helps to warm it
452
what is the nasal cavity lined with
respiratory epithelium
| olfactory epilthelium in roof
453
what are features of respiratory epithelium
has cili and produces mucous to trap airborne particles and filter air
454
what are the spaces underneath the conchae called
meatus
455
what is the sphenoethmoidal recess
space above the superior concha
456
where are the paranasal sinuses found
frontal
maxillary
ethmoid
sphenoids
457
what is the function of the paranasal sinuses
makes head lighter so is easier to balance on top of VC
| can absorb force from direct trauma to help protect cranial cavity
458
describe the paranasal sinuses
frontal: may be 2 separate cavities or 1 large one
sphenoid: in body of sphenoid bone
maxillary: either side of nasal cavities
ethmoid: made up of many small air cells instead of 1 large space
459
what can be visualised if the conchae are removed
openings of the paranasal sinuses and nasolacrimal duct
460
where does the nasolacrimal duct open into
inferior meatus
461
where do the sinuses open into
```
frontal: middle meatus
anterior and middle ethmoidal: middle meatus
maxillary: middle meatus
posterior ethmoidal: superior meatus
sphenoidal: sphenoethmoidal recess
```
462
innervation of the paranasal sinuses
frontal: supraorbital CN V1
all ethmoidal: nasociliary CN V1
maxillary: superior alveolar CN V2
sphenoidal: posterior ethmoidal CN V1
463
how does sinusitis occur
sinuses create mucous which can become backed up if the openings to the nasal cavity are blocked by inflammation
464
blood supply of the lateral wall of nasal cavity
anterior and posterior ethmoidal branches (ophthalmic)
sphenopalatine (maxillary)
lateral nasal (facial)
greater palatine (maxillary
465
blood supply to medial wall of nasal cavity
anterior and posteiror ethmoidal (ophthalmic)
sphenopalatine and greater palatine (maxillary)
septal branch of superio labial artery (facial)
466
what is Kiesselbach's area
area of anastomosis in the medial wall of nasal cavity (septum)
467
nerve supply of nasal cavities
anterosuperior: CN V1
posteroinferior: CN V2
olfactory mucosa: CN V1
468
describe venous drainage of the nasal cavities
facial, sphenopalatine and ophthalmic viens
| communicates with pterygoid plexus and cavernous sinus
469
what is a frenulum
fold of tissue attaching upper lip and under tongue
470
what are the names of the arch of the oral cavity
```
palatoglossal arch (anterior)
palatopharyngeal arch (posterior)
```
471
what is found in the space between the arches of the oral cavity
palatine tonsil
472
what is the fauces
opening of the oral cavity aka mouth
473
lateral wall of the oral cavity
buccinator
474
what makes up the floor of the oral cavity
mylohyoid
digastric below
geniohyoid above
475
describe mylohyoid (attachments, innervation and action)
hyoid line of mandible to hyoid bone
mylohyoid branch CN V3
elevates the hyoid and oral floor OR depresses the mandible
476
describe anterior belly of digastric (attachments, innervation and action)
digastric fossa of mandible to hyoid via fibrous sling
mylohyoid branch CN V3
elevate hyoid or depress mandible
477
describe stylohyoid (attachments, innervation and action)
styloid process to hyoid bone
facial nerve CN VII
elevates hyoid
478
describe posterior belly of digastric (attachments, innervation and action)
mastoid process to hyoid bone via fibrous sling
| facial nerve CN VII
479
describe geniohyoid (attachments, innervation and action)
inferior genial tubercle of mandible to hyoid bone
C1 carried by hypoglossal nerve
elevates hyoid bone
480
where does the parotid duct open
at upper second molar
481
innervation of parotid duct
CN IX parasympathetic fibres
482
where is the submandibular gland
outer part posterior to mandible, inner part crosses hylohyoid to lie in floor of the mouth
483
where does the submandibular duct open in the oral cavity
opens between 1st and 2nd incisors either side of the frenulum
484
where is the sublingual gland
entirely in the floor of the mouth
| under the tongue
485
where does the sublingual gland open
many small ducts that open directly into the floor of the mouth
486
what are the vallate papillae
```
largest papillae (detect taste)
form a line 2/3 of the way along tongue
```
487
describe the surface of the posterior tongue
| why is it like this
bumpy appearance
| presence of lingual tonsil
488
innervation of the anterior 2/3 of tongue
general sensation from lingual nerve CN V3
| taste from chorda tympani CN VII via lingual nerve CN V3
489
where does chorda tympani meet the lingual nerve
infra temporal fossa
490
innervation of posterior 1/3 of tongue
general sensory and taste from CN IX
491
what is the function of the intrinsic muscles of the tongue
| how are they oriented
change the shape of the tongue
| fibres in different orientations, but all within the tongue
492
what are the extrinsic muscles of the tongue
| what are their general function
palatoglossus, styloglossus, genioglossus, hyoglossus
change position of tongue in mouth
originate in oral cavity and insert into mouth
493
describe palatoglossus (attachments, innervation and action)
palatine aponeurosis to tongue
CN X
elevates tongue, moves soft palate
494
describe styloglossus (attachments, innervation and action)
styloid process to tongue
CN XII
elevates and retracts tongue
495
describe genioglossus (attachments, innervation and action)
superior genial tubercle of mandible to tongue
CN XII
depresses tongue, protrude
496
describe hyoplgossus
| attachments, innervation and action
hyoid bone to tongue
CN XII
depress tongue
497
blood supply of the tongue
| what is its course
via lingual artery (branch of external carotid artery)
| arises from ECA, is crossed by hypoglossal nerve, passes under hyoglossus and enters floor of mouth
498
venous drainage of the tongue
lingual vein to internal jugular
| dorsal, deep and sublingual branches
499
what is the course of the hypoglossal nerve
passes from hypoglossal canal at the base of the skull and passes over hyoglossus but under mylohyoid to enter the floor of mouth
500
describe lymph drainage of the tongue
tip: submental nodes
lateral edges: submandibular nodes
central/posterior: deep cervical
501
which bones make up the hard palate
mostly maxilla
| palatine bones contribute posteriorly
502
features of the hard palate
glands embedded in mucosa (produce mucus)
rugae at anterior part of hard palate
palatine raphe in midline
503
innervation of the mucus glands of hard palate
CN VII
504
innervation of hard palate
greater palatine nerve
branch of CN V2
descends in palatine canal and enter greater palatine foramen
505
arterial supply of the hard palate
greater palatine artery (branch of maxillary artery)
| descends in palatine canal to enter palate via greater palatine foramen
506
what is the soft palate
muscular core covered in mucous lining hanging from posterior border of hard palate
507
what is the palatine aponeurosis
| what is its function
tough connective tissue attaching soft palate to hard palate
strengthens soft palate and site of muscle attachment
508
how many muscles are associated with the sfot palate
| what are they
```
5
palatoglossus
palatopharyngeus
levator veli palatini
tensor veli palatini
musculus uvulae
```
509
describe levator veli palatini (attachments, innervation and action)
petrous temporal bone and cartilage of auditory tube to palatine aponeurosis
CN X
raises soft palate
510
musculus uvuluae
| attachments, innervation and action
palatine bone to palatine aponeurosis
CN X
elevates/retracts uvula
511
palatoglossus (attachments, innervation and action)
palatine aponeurosis to tongue
CN X
elevates tongue/closes oropharynx
forms anterior arch of oral cavity
512
palatopharyngeus (attachments, innervation and action)
wall of pharynx to palatine aponeurosis
CN X
elevates pharynx and moves pharyngeal wall towards soft palate
forms posterior arch in oral cavity
513
tensor veli palatini (attachments, innervation and action)
cartilage of auditory tube, wraps a tendon around pterygoid hamulus to palatine aponeurosis
CN V3
tenses soft palate
514
blood and nerves supply of soft palate
lesser palatine branches of greater palatine artery/nerve
| uvula sensroy innervation by CN IX
515
how does the facial nerve innervate the mucus glands of the palate
sends fibres to pterygopalatine ganglion (via greater petrosal nerve) which joins CN V2 to supply glands
516
how do missing teeth affect the bony structure of the face
alveolar bone that supported the tooth is resorbed
517
how many permanent teeth
32
518
innervation of teeth
top teeth: CN V2 superior alveolar branches
| bottom teeth: CN V3 inferior alveolar branches
519
blood supply of teeth
anterior and posterior alveolar
inferior alveolar
branches of maxillary artery
520
where is the pharynx located
runs from the base of skull to the oesophagus C6
| posterior to nasal and oral cavities and larynx
521
what are the layers of the pharynx
mucosa
fibrous layer
muscular layer
522
where is the fibrous layer connected
base of skull and submucosal layer of oesophagus
523
what are the divisions of the pharynx and where are they located
nasopharynx: posterior to nasal cavities, above soft palate
oropharynx: posterior to oral cavity, between soft palate and epiglottis
laryngopharynx: posterior to larynx, meet oesophagus at C6
524
borders of the nasopharynx
roof: sphenoid and occipital bone, pharyngeal tonsil
floor: soft palate
anterior: nasal passages
posterior: roof and C1 level
lateral: auditory tube, salpingoparyngeal fold
525
borders of the oropharynx
roof: soft palate
floor: posterior 1/3 tongue, lingual tonsil, glossoepiglottic folds
anterior: motuh
posterior: C2/3 level
lateral: palatoglossal and palatopharyngeal arches and palatine tonsil
526
borders of the laryngopharynx
anterior: larynx
posterior: C3-6 vertebral bodies
lateral: thyroid cartilage, aryepiglottic flods and thyrohyoid membrane
527
what are the two subdivisions of pharyngeal muscles
constrictors (x3) and longitudinal muscles (x3)
528
describe superior constrictor muscle (attachments, action and innervation)
lower medial pterygoid plate, hamulus, pterygomandibular ligament, mandible, side of tongue TO pharyngeal tubercle of occipital bone, fibrous raphe and middle constrictor
push food towards middle constrictor and upper fibres pull pharynx anteriorly to close nasopharynx
vagus nerve via pharyngeal plexus
529
describe middle constrictor
| attachments, action and innervation
lower part of stylohyoid ligament, hyoid bone TO raphe and blend with other constrictors
propel food to lower constrictor
vagus via pharyngeal plexus
530
describe inferior constrictor
| attachments, action and innervation
lamin of thyroid and cricoid cartilages TO raphe and middle onstrictor/oesophagus
propel food to oesophagus
vagus nerve via phasryngeal plexus
531
what are the two parts of inferior constrictor
```
thyropharyngeus = fibres that pass to midline
cricopharynxgeus = circular fibres at inferior part (act a bit like a sphincter)
```
532
what are the longitudinal muscles of pharynx
stylopharyngeus
salpingopharyngeus
palatopharyngeus
533
describe stylopharyngess (attachments, action and innervation)
styloid TO thyroid cartilage
elevates larynx and pharynx in swallowing
CN IX
534
describe salpingopharyngeus (attachments, action and innervation)
cartialge of auditory tube TO palatopharyngeus
elevates pharynx and forms lateral wall of nasopharynx
vagus via pharyngeal plexus
535
describe palatopharyngeus (attachments, action and innervation)
hard palate and palatine aponeurosis TO lamina of thyroid cartilage
elevates pharynx and forms lateral wall of oropharynx
vagus nerve via pharyngeal plexus
536
describe the movements of soft palate/pharynx etc involved in swallowing
food moulded by togue/hard palate and pushed to back of mouth
soft palate raised and pharynx elevates to keep food away from nasopharynx
larynx raised and epiglottis passively bends over opening to larynx
aryepiglottic folds move toether to ensure food doesnt go down larynx
peristalsis
537
course of recurrent laryngeal nerve in pharynx
travels between oesophagus and trachea and then passes deep to inferior constrictor of pharynx
538
which nerve runs alongside stylopharyngeus
CN IX
539
what is the innervation of the lymphoid tissue associated with each region of the pharynx
nasopharynx: CN V2
oropharynx: CN IX
laryngopharynx: CN X
540
which nerves are involved in the pharyngeal plexus
CN IX and CN X fibres supply he pharynx
| cranial part of CN XI joins and supply soft palate via vagus nerve
541
arterial supply of pharynx
greater palatine and pharyngeal branches of maxillary artery
ascending pharyngeal branches of facial
ascending pharyngeal branches of external carotid
542
venous drainage of pharynx
pharyngeal plexus to internal jugular vein
543
lymphatic drainage of pharynx
retropharygneal and paratracheal nodes
| deep cervical nodes
544
were are prevertebral structures located and what are they
posterior to pharynx, anterior to vertebrae
| muscles and sympathetic ganglia
545
what are the prevertebral muscles
longus capitis
longus colli
rectus capitis anterior
rectus capitis lateralis
546
describe longus capitis
| attachments, action and innervation
transverse processes of C3-6 to base of occipital bone
flexion of head
anterior rami C1-3
547
what are the parts of longus colli and what are their attachments
inferior oblique: T2-3 bodies TO anterior tubercle of transverse processes C5/6
superior oblique: anterior tubercle C3-5 to anterior tubercle of atlas
vertical: anterior aspect T1-3 to C4-6
548
describe longus colli (attachments, action and innervation)
atlas to T3
flexion of neck
contrlateral rotation by inferior obliue part
anterior rami C2-6
549
describe rectus capitis anterior
| attachments, action and innervation
anterior sruface and root of transverse processes of atlas to occipital bone
flexion of atlanto-occipital joint
anterior rami C1-2
550
describe rectus capitis lateralis (attachments, action and innervation)
transverse process of atlas to occipital bone
lateral flexion of head
anterior rami C1-2
551
where are the cervical sympathetic ganglia found
embedded in deep fascia between carotid sheath and fascia over longus capitis and longus colli
552
describe superior cervical ganglia
large, immediately below skull
C1-4
internal carotid nerve to internal carotid plexus
pharyngeal branches to pharyngeal plexus
superior cardiac branch to cardiac pelxus
553
describe middle cervical glanlgion
level of cricoid cartilage
C5/6
thyroid branches along inferior thyroid artery to gland
middle cardiac branch to cardiac pelxus
554
describe inferior cervical ganglion
usually fused with 1st thoracic ganglion (stellate ganglion)
behind vertebral artery between C7 TP and head of 1st rib
C7/8
arterial branches to subclavian nand vertebral arteries
inferior cardiac branch to cardiac plexus
555
what is the ansa subclavia
nerve cord connecting the middle and inferior cervical sympathetic ganglia
loops around subclavian artery
