Head and Neck Anatomy Flashcards
(129 cards)
1
Q
What cranial nerve supplies the muscles of facial expression?
A
Facial nerve (the terminal 5 motor branches of the facial nerve)
2
Q
Which pharyngeal arch do the muscles of facial expression come from?
A
2nd pharyngeal arch
3
Q
What is the innervation of the buccinator muscle?
A
Facial – it is not a muscle of mastication (and therefore innervated by trigeminal nerve)
4
Q
How does the facial nerve exit the skull base?
A
Internal acoustic meatus
5
Q
How does the facial nerve exit the skull?
A
Stylomastoid foramen
6
Q
What are the 5 terminal motor branches of the facial nerve?
A
Temporal, Zygomatic, Buccal, Marginal Mandibular + cervical
7
Q
The facial nerve gives off a branch named ‘nerve to stapedius’ which innervates the stapedius muscle. What is the function of this muscle?
A
To contract and dampen down vibrations
8
Q
The facial nerve is one of our four parasympathetic nerves. What structures does it innervate for it to be given this title?
A
Submandibular + Sublingual salivary glands + Lacrimal gland
9
Q
How does the facial nerve innervate the tongue?
A
Special sensation to the anterior 2/3 via the chorda tympani branch
10
Q
At what vertebral level does the hyoid bone lie?
A
C3
11
Q
How many cervical spinal nerves do we have?
A
8 (and 7 vertebrae)
12
Q
What is the innervation of the posterior belly of the digastric muscle?
A
Facial nerve
13
Q
What is the innervation to the sternocleidomastoid muscle?
A
Accessory nerve (CNXI)
14
Q
What is the function of the SCM muscle?
A
Bilateral contraction: Neck extension.
Unilateral contraction: Contralateral rotation + Ipsilateral neck flexion
15
Q
What nerve roots create the ansa cervicalis?
A
Ventral rami of C1-C3
16
Q
What structures lie within the carotid sheath?
A
- Common carotid artery
- Internal jugular vein
- Vagus nerve (CN X)
17
Q
What are the borders of the anterior triangle of the neck?
A
Midline of the neck, anterior border of SCM, inferior surface of the mandible
18
Q
What are the borders of the posterior triangle of the neck?
A
Posterior border of the SCM, anterior border of trapezius, middle third of the clavicle
19
Q
What part of the thyroid gland connects to the two lobes?
A
Isthmus
20
Q
What vertebral level does the thyroid span?
A
C4🡪 C7/T1
21
Q
What is the blood supply to the thyroid gland?
A
Superior thyroid artery (from E. Carotid) + Inferior thyroid artery (from Thyrocervical trunk 🡪 from subclavian)
22
Q
At what vertebral level does the common carotid bifurcate?
A
C4
23
Q
If a patient presents with a midline neck lump that produces on tongue protrusion, what is the diagnosis?
A
Thyroglossal cyst
24
Q
How do olfactory nerve fibres pass into the nasal cavity?
A
Through Cribiform plate of the ethmoid bone
25
What nerves deliver general sensation to the nasal cavity?
V1 (ophthalmic division) + V2 (maxillary division)
26
What sinuses drain via the middle meatus?
FAM – Frontal, Anterior ethmoid, Maxillary
27
Through which meatus does the posterior ethmoid sinus drain to get into the nasal cavity?
Superior meatus
28
Through which opening does the sphenoid sinus drain to get into the nasal cavity?
Sphenoethmoid recess (above superior turbinate)
29
The lacrimal gland drains via the nasolacrimal duct. Through which meatus will the nasolacrimal duct empty its secretions into the nasal cavity?
Inferior meatus
30
What is the medical term for a nosebleed?
Epistaxis
31
What type of epithelium lines the paranasal sinuses and bronchial tree?
Pseudostratified ciliated columnar epithelium
32
At what vertebral level does the cricoid cartilage lie?
C6
33
What is the only muscle to abduct (open) the vocal cords?
Posterior cricoarytenoid
34
The cricoid thyroid muscle tenses the vocal cords allowing an increase in pitch (often referred to as the singer’s muscle). What is the innervation of this muscle?
External branch of the superior laryngeal nerve
35
What is the anatomical name of the false vocal cords?
Vestibular folds
36
What is the function of the internal branch of the superior laryngeal nerve?
Sensory innervation of the mucosa above the vocal cords
37
Why do we need to adduct (close) the vocal cords?
Phonation
38
How can we differentiate between the true and false vocal cords?
True vocal cords lie below the false and are responsible for sound production (unlike the false cords which serve a protective function)
39
What muscle lies on the posterior aspect of the trachea functioning to expel a foreign body if it ends up in the trachea?
Trachealis
40
Which structure does the right recurrent laryngeal nerve loop underneath on its way up to the larynx?
Right Subclavian artery
41
Which structure does the left recurrent laryngeal nerve loop underneath on its way up to the larynx?
Arch of aorta
42
What is the sensory and motor innervation of the recurrent laryngeal?
Sensory: Mucosa below the vocal cords. Motor: All muscles other than cricothyroid
43
If a foreign body enters the respiratory tract which bronchi is it most likely to become lodged in?
Right main bronchus – it is more vertical + wider (and shorter)
44
What two additional features is the left lung going to have?
Cardiac notch + lingula
45
How many lobes in the right lung?
3 (divided by two fissures – horizontal + oblique)
46
What is the relationship of the Vagus and Phrenic nerves to the hilum?
Phrenic nerve travels anterior to the hilum. Vagus nerve travels posterior to the hilum
47
The pleura surround the root/hilum of the lung is going to continue inferiorly as what structure?
The Pulmonary ligament
48
Where does the apex of the lung project?
Above the first rib
49
What nerves pass through the superior orbital fissure?
Cranial Nerve 3, 4, 5(1), 6
50
How does the maxillary division of trigeminal get out of the skull?
Foramen rotundum
51
How does the mandibular division of the trigeminal get out of the skull?
Foramen ovale
52
What passes through the foramen spinosum?
Middle meningeal artery
53
The middle meningeal artery passes behind which structure?
Pterion
54
Rupture of the middle meningeal artery causes what type of haemorrhage?
Extradural haemorrhage
55
What structures pass out the skull through the stylomastoid foramen?
Facial nerve
56
Where is the anterior fontanelle located in infants?
Bregma (where sagittal suture meets coronal anteriorly)
57
Where is the posterior fontanelle located in infants?
Lambda – where the sagittal suture meets the lambdoid suture
58
What nerves pass out through the internal acoustic meatus?
7 (Facial) and 8 (Glossopharyngeal). Acoustic – needs to have something to do with the auditory pathway
59
What is the only cranial nerve to leave then re-enter the skull – describe its path?
Spinal accessory nerve (CNII). Nerve originates from the spinal cord between C1-C5 and runs superiorly to enter the cranial cavity through the foramen magnum. It then exists the skull through the jugular foramen
60
What is the name of the division between the two hemispheres of the brain?
Longitudinal fissure
61
What is the name of the division between frontal and parietal lobe?
Central sulcus
62
What is the name of the division between the temporal and frontal/parietal above it?
Sylvian fissure/lateral sulcus
63
What is the function of the pre-central gyrus?
Primary motor cortex
64
What parts of the homunculus would you find on the medial surface of the brain?
Lower limb and genitalia
65
What artery supplies the medial surface of the brain?
Anterior cerebral artery
66
What artery supplies the lateral surface of the brain?
Middle cerebral artery
67
Where would you find Broca’s area?
Inferior frontal lobe
68
What is the function of Broca’s area?
Motor aspect of speech
69
What would you see in a Broca’s aphasia?
Inability to make the motor movements needed for speech. Slurring making sounds that are incomprehensible.
70
What would you see in a Wernicke’s aphasia?
Can make sounds that can be made out as ‘words’ but the understanding is gone. They reply with responses that make no sense.
71
Where would you find Wernicke’s area?
Superior temporal lobe
72
What is the name of the connection between Wernicke’s and Broca’s?
Arcuate fasciculus
73
What structure lies close to the optic chiasm?
Pituitary gland
74
What type of visual loss would you therefore get with a pituitary adenoma?
Bitemporal hemianopia
75
What structures connect the two hemispheres of the brain?
Corpus callosum
76
What is the superior colliculus responsible for?
Integrating visual eye movements (sends information to lateral geniculate nucleus)
77
What is the function of inferior colliculus?
Involved in the auditory pathway
78
What skull foramina does the olfactory nerve pass through to get to the nasal cavity?
Cribriform plate of the ethmoid bone
79
What does the optic nerve pass through?
Optic canal
80
What nerves do the afferent and efferent limb of the direct and consensual light reflex?
Afferent – optic Efferent – Oculomotor
81
If a patient has a positive RAPD (relative afferent pupillary defect) – where could the issue be?
Optic nerve + retina
82
How many of the 7 extra-ocular muscles does the oculomotor nerve innervate?
5
83
What innervates the lateral rectus?
Abducens
84
What innervates the superior oblique?
Trochlear nerve
85
Where would you ask the patient to look to test the superior oblique?
Down and in
86
What would a patient with an oculomotor nerve lesion look like?
1. Ptosis 2. Pupil looking down and out 3. Mydriasis (dilated pupil)
87
What is the function of the trigeminal (include both sensory and motor)?
Sensory – sensory. Motor: Muscles of mastication (specifically V3 – mandibular division of trigeminal)
88
What is the afferent and efferent limb of the corneal reflex?
Afferent: V1 (ophthalmic branch of trigeminal) Efferent: Facial
89
How does the maxillary division of trigeminal get out of the skull?
Foramen rotundum
90
How does the mandibular division of the trigeminal get out of the skull?
Foramen ovale
91
What does the facial nerve do?
Muscles of facial expression
92
What innervates the motor movements of the tongue?
Hypoglossal
93
In a right sided hypoglossal nerve lesion which side will the tongue be deviated towards?
Right side
94
How does the facial nerve exit the skull?
Stylomastoid foramen
95
What innervates the posterior 1/3 of the tongue (both general and special sensation)?
Glossopharyngeal
96
What innervates the special sensation to the anterior 2/3 of the tongue?
Chorda tympani branch of facial
97
What innervates the general sensation to the anterior 2/3 of the tongue?
Lingual branch of the trigeminal
98
At what vertebral level does the spinal cord end?
L1
99
What do we call the above site where the spinal cord ends?
Conus Medullaris
100
What landmark do we use to avoid the spinal cord when doing a lumbar puncture?
Iliac crest (highest point is at L4)
101
Where does CSF lie?
Subarachnoid space
102
What nerve fibres run within the ventral nerve root?
Motor nerves only
103
What nerve fibres run within the ventral and dorsal rami?
Motor AND sensory
104
What type of sensory information is carried by the dorsal column?
Proprioception, fine (discriminative) touch + vibration
105
Which limb of the internal capsule do the corticospinal tract fibres travel in?
Posterior limb
106
Through which portions of the brainstem do the corticospinal tract fibres travel in?
Crus cerebri (of midbrain), Basilar pons, Pyramids of medulla (motor tract travelling in the anterior aspect of the brainstem as motor is always anterior)
107
What happens to the remaining 10% of the corticospinal tract fibres that do not decussate?
Remain anterior as the anterior corticospinal tract (supplies the axial musculature)
108
What type of sensory information is carried by the spinothalamic tract?
Pain, temperature + crude touch (in anterior)
109
At what point does the spinothalamic tract decussate?
At the point at entry in the spinal cord.
110
At what point does the dorsal column and corticospinal tract decussate?
Thalamus
111
Fibres from the lower half of the body below T6 will ascend in which part of the dorsal column?
Gracile fasciculus (above T6 – cuneate fasciculus)
112
What is the function of the dural venous sinuses?
Drain the head and neck into the internal jugular vein
113
Why do we call it with dural venous sinuses?
Dural venous sinuses because the sinuses run within the two layers of the dura (endosteal and meningeal layers)
114
How does the CSF drain back into the venous circulation?
Arachnoid granulations
115
What two blood vessels come up to create the circle of Willis?
Vertebral artery and internal carotid
116
What does the internal carotid artery become (going to supply the convexity of the brain)?
Middle cerebral artery
117
What does the basilar artery supply?
Brainstem
118
An anterior cerebral artery stroke is going to cause disproportionate weakness in which part of the body?
Lower limbs
119
What are the two main types of stroke?
Ischaemic (85%) and haemorrhagic
120
Why can the corticospinal tract also be called the pyramidal tract?
Because the corticospinal tracts run through the pyramids (which sit anterior and remember the motor tracts run anterior) of the medulla.
121
Which part of the basal ganglia is affected in Parkinson’s disease?
Substantia nigra
122
Through which part of the internal capsule do they motor tracts run?
Posterior limb of the internal capsule (no motor fibres run in the anterior limb)
123
What cells secrete CSF?
Ependymal cells of the choroid plexus
124
What part of the ventricular system connects lateral ventricle to the third ventricle?
Interventricular foramen (Foramen of Monroe)
125
What part of the ventricular system connects the third to the fourth ventricle?
Cerebral aqueduct
126
What structures connect the 4th ventricle to the central canal?
Foramen of Lushke and Foramen of Magendie
127
What is the name of the nerve that emerges in between the posterior cerebral artery and the superior cerebellar artery?
Oculomotor nerve
128
What 3 structures (nuclei) make up the corpus striatum?
Caudate nucleus, putamen, and globus pallidus
129
What term do we use when referring to the caudate nucleus and the putamen?
Striatum
