Head and Neck II Flashcards
(248 cards)
0
Q
Why are the rectus capitis anterior and longus capitis clinically relevant?
A
They are often weak and found in patients suffering from lots of headaches. This is because the suboccipital muscles are often too tight.
1
Q
What are the prevertebral muscles? (X4)
A
Rectus capitis lateralis, Rectus capitis anterior, Longus colli, Longus capitis, Anterior, middle, and posterior scalenes
2
Q
What prevertebral muscle runs from vertebral body to vertebral body?
A
Longus colli
3
Q
What is a large, general function of the scalene muscles?
A
Give stability to the neck.
4
Q
What emerge through the scalene muscles? Specifically which of the two?
A
The roots of the brachial plexus (specifically through the anterior and middle scalenes.
5
Q
What are the three ganglion of the sympathetic trunk?
A
Superior cervical ganglion, middle cervical ganglion, and the stellate ganglion.
6
Q
What makes up the stellate ganglion?
A
A combination of the inferior cervical and superior thoracic ganglion.
7
Q
True or false:
The inferior cervical sympathetic ganglion is bound up within a membrane with the superior thoracic sympathetic ganglion.
A
True. This is what makes up the stellate ganglion.
8
Q
What is the function of the sympathetic (peri-arterial) plexus?
A
It is what gets sympathetic fibers to the head.
9
Q
Where do the fibers to the peri-arterial plexus arise from?
A
The T1 to T3/4 cord levels.
10
Q
True or false:
The fibers from the peri-arterial plexus synapse with the cervical sympathetic ganglia as they ascend to the head.
A
False. They do not synapse with the cervical sympathetic ganglion.
11
Q
How do the fibers from the peri-arterial plexus ascend to the destinations in the head?
A
They hitchhike on the carotid vasculature and their branches.
12
Q
What type of outflow does the sympathetic nervous system have?
A
A thoracolumbar outflow.
13
Q
True or false:
The sympathetic nervous system distribution is more widespread in distribution and function as compared to the parasympathetic nervous system.
A
True.
14
Q
In terms of sympathetic innervation, what is the thorax innervated by?
A
Pulmonary and cardiac nerves and plexuses.
15
Q
In terms of sympathetic innervation, what is the foregut innervated by?
A
Greater thoracic splanchnic nerve (T5-T9)
17
Q
In terms of sympathetic innervation, what is the midgut innervated by?
A
Lesser thoracic splanchnic nerve (T10-T11)
18
Q
In terms of sympathetic innervation, what is the hindgut innervated by?
A
Least thoracic splanchnic nere (T12) and the lumbar splanchnic nerves.
19
Q
In terms of sympathetic innervation, what is the pelvis and pernineum innervated by?
A
Pelvic splanchnic nerves
20
Q
Which of the communicans is located more laterally? More medially?
A
Lateral= white rami communicans
Medial=grey rami communicans
21
Q
Describe the pathway for sympathetic fibers to their effector organs.
A
Exit the IML grey cell column (lateral horn) at C8-L2/3 levels, out the ventral root, through the spinal nerve, through the white rami communicans (pre-ganglionic fibers), into the sympathetic trunk to their 3 options.
22
Q
What are the 3 options for sympathetic fibers to choose after exiting the sympathetic trunk?
A
1) Synapsing at the same level & joining the spinal nerve
2) Ascending/descending and then synapsing and joing the vessels or spinal nerves at that level
3) Pass through without synapsing as thoracic splanchinc nerves(pre-ganglionic) and then synapse in the ganglia to innervate the
23
Q
What do the sympathetic fibers of the peri-arterial plexus hitch-hike on?
A
Internal and external carotid arteries.
24
Q
What is innervated by the peri-articular plexus?
A
Eye
Mucousal lining of the mouth
Salivary glands
Vasculature
25
What is the isthmus of the thyroid gland?
The connection between the two lobes
26
What is the pyramidal lobe of the thyroid gland?
The finger-like superior projection extending off the gland
27
What two types of cells make up the thryoid gland tissue? What does each of these cells secrete?
```
Follicular cells (iodine containg hormones--throxine (T3) and triiodothronine (T4))
Parafollicular cells (calcitonin)
```
28
What thryoid hormones are important in metabolism? Blood calcium levels?
T3 and T4; calcitonin
29
What other hormone does calcitonin work with to help regulate blood calcium levels?
PTH (parathryoid hormone)
30
Where are the parathryoid glands located? How many are there usually?
Embedded in the thyroid gland. Typically 4 but can have 2-6.
31
True or false:
| The parathyroid glands are essential to life.
True
32
What does the parathyroid glands produce? What does it do?
PTH (parathyroid hormone) that helps regulate blood calcium levels.
33
PTH is important for regulating blood calcium levels. This is because function of four things need these levels regulated for normal function. What are the four things?
Heart
Nervous system
Kidneys
Bone
34
What type of feedback runs PTH?
Negative feedback--so as the blood calcium levels rise, the higher levels will cause a stop in secretion of the hormone.
35
What nerve runs close to the carotid?
Vagus nerve
36
What does the superior laryngeal nerve branch off from?
Vagus nerve
37
What innervates the muscles of the larynx?
Recurrent laryngeal nerves
38
What does the superior thyroid artery branch off from? Then what does it do?
External carotid; it gives off the superior laryngeal artery and then continues as the superior thyroid artery.
39
Where does the superior thyroid artery run to?
Thyroid gland
40
What runs with the superior laryngeal artery?
The internal branch of the superior laryngeal nerve
41
What does the external branch of the superior laryngeal nerve run with?
The superior thyroid artery
42
What does the superior laryngeal artery pierce?
The thryo-hyoid membrane (the membrane between the hyoid bone and thyroid cartilage
43
What does the left recurrent laryngeal nerve wrap around?
Ligamentum arteriosus
44
What does the right recurrent laryngeal nerve wrap around?
Right subclavian artery
45
What does the inferior thyroid artery come from?
It branches off the thryocervical trunk (with is a branch of the subclavian)
46
What are the three major lymph nodes that the doctor palpates during a visit?
Jugulo-digastric
Subparotid
Internal jugular (superior deep lateral cervical lymph node)
47
What is the flap that covers the top of the larynx?
Epiglottis
48
What are the two cartilagtes of the larynx?
Thyroid and cricoid cartilage
49
Name the outer structures of the larynx from superior to inferior. (x6)
```
Epiglottis
Hyoid Bone
Thryohyoid membrane
Thyroid cartilage
Cricothyroid membrane
Cricoid cartilage
```
50
What are the intrinsic muscles of the larynx?
Cricothyroid
Arytenoid (transverse, oblique, & ary-epiglottic parts)
Crico-arytenoid (lateral & posterior parts)
Thryo-arytenoid
Vocalis
51
What muscle makes up the anterolateral aspect between the cricoid and thryoid cartilages?
Cricothyroid muscle
52
What is the action of the cricothyroid muscle?
Lengthens the vocal ligaments to increase tension on the cords
53
What is the action of the posterior part of the crico-arytenoid muscle?
Abduct the vocal ligaments to allow more airflow in
54
What is the action of the lateral part of the crico-arytenoid muscle?
Adduct the vocal ligaments to decrease the amount of airflow in
55
What is the action of the transverse and oblique parts of the arytenoid muscle?
Adduct the vocal ligaments/folds to decrease the amount of airflow in
56
What is the action of the vocalis and thryo-arytenoid muscles?
Shorten the vocal ligaments to decrease tension on the cords
57
What does tightening the vocal cords do? What about lengthening them?
Higher tones; lower tones
**Tightening the vocal cords occurs by stretching and lengenthing them; loosening the vocal cords occurs by allowing them to slack**
58
What innervates all the intrinsic laryngeal muscles except the cricothryoid?
Recurrent laryngeal nerve
59
What innervates the cricothyroid muscle?
External branch of the superior laryngeal nerve
60
What does the internal branch of the superior laryngeal nerve innervate?
It supplies sensory to the mucousal linings superior to the vocal cord
61
What does the external branch of the superior laryngeal nerve innervate?
Cricothyroid muscle and the inferior pharyngeal constrictor muscle (which is not an intrinsic laryngeal muscle)
62
Which is the tough, fibrous outermost layer of the meningeal layers?
Dura mater
63
What meningeal layer encases the venous sinuses?
Dura mater
64
Where is the epidural space?
Between the dura mater and the bone of the cranium
65
Where is the sub-arachnoid space?
Between the arachnoid mater and the pia mater
66
Where is the subdural space located?
Between the dura mater and the arachnoid mater
67
Which of the meninges is a thin, transparent membrane that is deep to the dura?
Arachnoid mater
68
What is the arachnoid villa?
Projections of the arachnoid mater that project though the dura mater (as arachnoid granulations) into the venous sinuses
69
What are the venous sinuses encases by?
Dura mater
70
What are the tuft like collections of arachnoid villa that project through the dura?
Arachnoid granulations
71
What are the fovea granularis?
Pits in the bone caused by the projections of the arachnoid granulations that go through the dura mater and into the periosteum
72
Where is CSF located?
Subarachnoid space
73
True or false:
| The arachnoid granulations protrude into the dural sinuses.
True because the project through the dura and the dura is what encases the venous sinuses
74
True or false:
| The dura mater reflects and folds to form the dural (venous) sinuses
True
75
What is the largest infolding of the dura mater?
Faux cerebri
76
What does the faux cerebri do? What does it attach to?
It is located between the two cerebral hemispheres and attaches to the crist gali of the ethmoid bone (anteriorly) and the internal occipital protuberance posteriorly. It is continuous with the tectorium cerebelli
77
What does the tectorium cerebelli do?
Separates the occipital lobes from the cerebellum.
78
What are the dura venous sinuses?
Endothelium-lined spaces between the periosteal and meningeal layers of the dura mater. They form where the dural septa attach along the free edge of the faux cerebri. Large veins from the surface of the brain drain into these.
79
What is the confluence of the sinuses?
A convergence of four dural sinuses (superior sagittal, occipital, straight, and transverse) located at the posterior aspect of the occipital
80
What runs in the borders of the dural folds?
Dural venous sinuses
81
Name the dural sinuses (x7)
```
Superior sagittal
Inferior sagittal
Sigmoid
Superior petrosal
Inferior petrosal
Transverse
Straight
```
82
What sinus is located at the same level as the inferior nuchal line?
Transverse
83
Where does the inferior sagittal sinus end?
In the straight sinus
84
What is the straight sinus formed by?
The union of the inferior sagittal sinus and the great cerebral vein
85
What two sinuses are associated with the rocky portion of the temporal bone?
Superior and inferior petrosal (rocky) sinuses
86
What two sinuses drain into the sigmoid sinus?
Superior and inferior petrosal
87
What does the sigmoid sinus drain into?
Transverse sinus
88
What houses the pituitary gland?
Sella tursusica
89
What dural folding extends around the occipital bone?
Tectorium cerebelli
90
What is special about the petrosal portion of the temporal bone?
The ossicles are located here
91
What are the dural sinuses continuous from? Why is this significant?
From the internal jugulars vein to the branches of the facial vein and the vertebral vein plexus. There is the possibility for infections to spread from the cutaneous tissues of the face into the dural sinuses.
92
What are the two branches of the facial vein?
Superior and inferior ophthalmic veins
93
How could a cutaneous infection travel into the cavernous sinus? Why is this bad?
Via the ophthalmic veins..the cavernous sinus houses the cranial nerves therefore the infection could spread into the nervous system
94
Where are the internal arteries and the cranial nerves bathed in venous blood?
Cavernous sinus
95
What can be found in the cavernous sinus?
Internal carotid arteries and cranial nerves 3, 4, V1, V2, and 6,
96
Where does and epidural hemorrhage typically occur?
Unilateral and adjacent to a fracture site...usually in the temporal or parietal bones
97
True or false:
| Epidural hemorrhages cross suture lines.
False, subdural hematomas cross suture lines.
98
90% of epidural hemorrhages are this...
Arterial
99
From what structure does epidural hemorrhages typically occur?
Middle meningeal artery
100
True or false:
| A subdural hematoma has a rapid onset of symptoms.
False, an epidural hemorrhage has a rapid onset of symptoms
101
What are some of the symptoms of an epidural hemorrhage?
Worsening headache, nausea/vomiting, loss of balance/decreasing consciousness, hemiparesis, and basinski sign
102
True or false:
| Subdural hematomas are not usually associated with a fracture.
True
103
What usually causes a subdural hematoma? Is it arterial or venous?
Tearing of bridging emissary veins; venous
104
Where do subdural hematomas usually occur? (95%)
Supratentorial (tent odium cerebelli)
105
What are some of the symptoms of a subdural hematoma? When do they occur?
Confusion, inability to concentrate, low grade HA;
They have a gradual onset...from days to weeks
106
What innervates the dura mater?
The dural branches of V1, V2, & V3
| C2 and C3 fibers via cranial nerve 10 & 12
107
How are sensory fibers carried out onto the dura?
Meningeal branches of V1 and V2 jump onto the middle meningeal artery and ride it out into the dura
108
What are the main functional components of the eye? (x5)
Cornea, iris, lens, vitreous humor, and retina
109
What part of the retina deals with distinguishing black and white?
Rods
110
What part of the retina is used for visual acuity (and seeing colors)?
Cones
111
What is the indentation in the retina? What is its center that contains only cones? Why is this significant?
Indentation= macula
Center of macula that has only cones = fovea centralis (which is significant because since it contains only cones, it is the spot of the highest visual acuity)
112
What is the optic disc?
Your blind spot---it's where the optic nerve enters the eye (it has neither rods nor cones)
113
What is the origin of the extraoccular eye muscles?
A common tendinous ring
114
What are the 7 eye muscles?
```
Levator palprebre superioris
Superior rectus
Inferior rectus
Medial rectus
Lateral rectus
Superior oblique
Inferior oblique
```
115
Which of the eye muscles make you look up or down or side to side.
The straight rectus muscles
116
What does the common tendinous ring of the extraoccular eye muscles surround?
Optic nerve
117
What is the most medial extraoccular eye muscle?
Superior oblique
118
What is the most superficial extraoccular eye muscle?
Levator palpabrae superioris
119
What is unique about the superior oblique eye muscle?
It goes through a tendinous sling (trochlea) and then attaches to the eye
120
What is the tendinous sling for the superior oblique eye muscle called?
Trochlea
121
What is the action and innervation of the levator palprebrae superioris eye muscle?
Elevates eyelid
| GSE from CN 3
122
What is the action and innervation of the superior oblique muscle?
Draws eye down and in
| GSE from CN 4
123
What is the action and innervation of the inferior oblique muscle?
Draws eye up and in
| GSE from CN 3
124
What is the action and innervation of the superior rectus muscle?
Elevates eye
| GSE from CN 3
125
What is the action and innervation of the inferior rectus muscle?
Depresses eye
| GSE from CN 3
126
What is the action and innervation of the medial rectus muscle?
Draws eye medially
| GSE from CN 3
127
What is the action and innervation of the lateral rectus muscle?
Draws the eye laterally
| GSE from CN 6
128
The ophthalmic artery is a branch from what artery?
Internal carotid
129
What does the ophthalmic artery supply? (x5)
Eye, extraoccular eye muscles, lacrimal gland, skin over eye & forehead, and ethmoid sinus
130
What are the branches of the ophthalmic artery? (x6)
```
Retinal
Muscular
Supraorbital
Supratrochlear
Lacrimal
Nano illite
```
131
Where in relation to the transverse axis of rotation for elevation and depression of the eye does the superior and inferior oblique muscles attach? Why is this important?
Posterior to the axis; this is important because the SO will depress the eye (and draw it in) and the IO will elevate the eye (and draw it in)
132
What are the nerves of the orbit? (x7)
```
Ophthalmic (CN V1)
-lacrimal, frontal, and nasocillary
Oculomotor (CN 3)
Trochlear (CN 4)
Abducens (CN 6)
**note, the frontal nerve gives off the supraorbital and supratrochlear cutaneous nerves
```
133
What are the three main branches if the ophthalmic artery?
Lacrimal nerve
Frontal nerve
Nasocillary nerve
134
What two types of fibers does the lacrimal nerve (branch of ophthalmic -V1) carry? To where?
1) GVE fibers from the greater petrosal nerve (branch of CN 7-facial) to the lacrimal gland
2) GSA fibers from the conjunctiva and skin of the upper eyelid
135
What type of fiber does the frontal nerve (branch of ophthalmic-V1) carry?
GSA fibers from the supraorbital and the supratrochlear (cutaneous) nerves
136
What two types of fibers does the nasocillary nerve (branch of the ophthalmic-V1) carry?
1) GSA from the eye
| 2) GVE sympathetic fibers to the eye
137
True or false:
| The trigeminal ganglion is filled with just nerve cell bodies and has no synapses.
True
138
What is the cillary ganglia?
Where GVE pre-ganglionic parasympathetic fibers traveling to the eye synapse
139
Where do the GVE pre-ganglionic parasympathetic fibers that synapse in the cillary ganglia run from and to? What do they travel on?
From the midbrain (Edinger-Westphal Nuc) to the eye; they travel on the oculomotor nerve (CN 3)
140
Where is the cillary ganglia located?
On top of the optic nerve deep to the levator palprebrae superioris and superior oblique muscles
141
What controls the thickness of the lens of the eye?
Ciliary body
142
Where do the post-ganglionic fibers that synapse in the cillary ganglia travel to as receptor organs?
The cillary body and constrictor pupil muscle
143
Is the constrictor pupil muscle have sympathetic innervation or parasympathetic innervation? The dilator pupil muscle?
Parasympathetic (constrictor);
| Sympathetic (diltaor)
144
What do the sympathetic fibers that innervate the dilator pupil muscle travel on?
Opthalamic artery
145
What does the long cillary nerve run from?
Nasocillary nerve to the eye
146
What does the short cillary nerve run from?
Cillary ganglia to the eye
147
What does the sensory root of the cillary ganglian run from?
Nasocillary nerve to the cillary ganglia
148
What does the motor root of the cillary ganglia run from?
CN 3 (oculmotor) to the cillary ganglia
149
What does the sympathetic root of the ciliary ganglia run from?
Opthalmic artery to the ciliary ganglia
150
What is the ciliary muscle innervated by?
GVE fibers of CN 3 (oculomotor)
151
What is the accommodation reflex?
Increasing the thickness of the lens due to the eye focusing on things up close
152
What does the constrictor pupil muscle do? What is it innervated by?
Constricts the pupil to decrease the amount of light entering the eye--innervated by the GVE parasympathetic fibers of CN 3
153
What does the dilator pupil muscle do? What is it innervated by?
Dilates the pupil to allow for more light to enter the eye--innervated by GVE sympathetic fibers (in a fight or flight situation, you would want more light to be in your eyes to see better)
154
Where is the sphenopalatine (ptygeropalatine) ganglia located?
In the sphenopalatine fossa (located through the ptygeromaxillary fissure--between the lateral ptygeroid plate and the maxilla)
155
What does the sphenopalatine (ptygeropalatine) ganglia hang off of?
The inferior aspect of V2
156
What is the function of the sphenopalatine (ptygeropalatine) ganglia?
Synapse site for GVE preganglionic fibers of the greater petrosal nerve (from CN 7) heading out to the lacrimal gland, mucosa of the nasal cavity, soft palate, and the superior nasopharaynx.
157
What is the curve of CN 7 called? Where does this bend occur?
The genu...occurs in the petrosal portion of the temporal bone and then CN 7 will emerge through the stylomastoid foramen
158
What is the nerve of the pterygopalatine canal formed by?
Greater petrosal nerve and deep petrosal nerve
159
What is the greater petrosal nerve?
GVE pre-ganglionic parasympathetic fibers
160
What is the deep petrosal nerve?
GVE post-ganglionic sympathetic fibers
161
What is the function of the greater and lesser palatine nerves?
Carry GVE post-ganglionic parasympathetic and sympathetic fibers to the palate mucuosa
162
What is the function of the posterior superior and posterior inferior nasal nerves?q
Carry GVE post-ganglionic parasympathetic and sympathetic fibers to the nasal mucuosa
163
The greater petrosal nerve and deep petrosal nerve come together to form what? Why do they go through the canal?
They come together to form the nerve of the pterygopalatine canal; to get to the ptygeropalatine ganglion
164
Is the greater petrosal nerve sympathetic or parasympathetic?
Parasympathetic
165
Is the deep petrosal nerve sympathetic or parasympathetic?
Sympathetic
166
What is the greater petrosal nerve a branch of?
CN 7 (facial nerve)
167
What are the two major nerves of the ptygeropalatine ganglia?
Greater petrosal nerve and the deep petrosal nerve
168
The greater petrosal nerve provides what kind of innervation? To what structures does it provide this innervation? Would it stimulate or inhibit these structures?
Parasympathetic innervation to the lacrimal gland, nasal cavity mucousa, palate, and the superior pharynx/auditory tube; stimulate
169
The deep petrosal nerve provides what kind of innervation? To what structures does it provide this innervation? Would it stimulate or inhibit these structures?
Sympathetic innervation to the lacrimal gland, nasal cavity mucousa, palate, and the superior pharynx/auditory tube; inhibitatory
170
What are the three divisions of the ear?
External (ottis externa), middle (ottis media), and internal
171
What are the structures of the external ear? (x3)
Auricle (what you see), external auditory (acoustic) meatus, and the tympanic membrane (eardrum)
172
What are the structures of the middle ear? (x4)
Tympanic cavity
Muscles
Ossicles
Auditory tube
173
What is housed within the tympanic cavity?
Muscles and ossicles
174
What are the three ossicles?
Malleus, incus, and stapes
175
What are the two structures of the inner ear?
Cochlea and semicircular canal
176
What structure of the inner ear houses CN 8? What portion does it house?
Cochlea--cochlear portion
177
Which structure of the inner ear has a bony labyrinth? A membranous labyrinth?
Cochlea=bony
| Semicircular canals= membranous
178
What are the components of the outer ear (ottis externa)? (x3)
Pinna (auricle)
External auditory meatus (ear canal)
Tympanic membrane
179
What are the components of the middle ear (ottis media)? (x4)
Ossicles (malleus, incus, stapes)
Muscles (tensor tympani & stapedius)
Oval window
Round window
180
What are the components of the inner ear (ottis interna)? (x4)
Cochlea
Endolymph
Series of connecting ducts
Semicircular canals
181
What part of the inner ear contains receptors for auditory function? For the vestibular organs?
Cochlea; semicircular canal
182
What is the other name for the Organ of Corti? Where is it housed?
Spiral organ; cochlea
183
What does the Organ of Corti (Sprial Organ) contain?
Hair cells
184
What type of hair cells are found in the apex of the sprial organ? What do they help detect?
Longer, wider, more flexible; low pitch
185
What type of hair cells are found in the base of the spiral organ? What do they help detect?
Shorter, narrower, more taught; high pitch
186
What does the semicircular canal house?
Vestibular organ
187
What are the three connecting ducts found in the inner ear?
Scala vestibuli, scala media, scala tympani
188
What is associated with the scala vestibuli?
Vestibular (Reissner) membrane
189
What is the scala media?
Cochlear duct with the basilar membrane that contains the spiral organ in which hair cells are embedded
190
What nerve courses through the incus and mallelous and runs over the stapedes?
Chorda tympani (branch of CN 7)
191
What nerves can be found within the ear anatomy?
CN 8 (inner ear)
Genu of facial nerve (CN 7)
Greater petrosal nerve (branch of CN 7)
Chorda tympani nerve (branch of CN 7)
192
How many semicircular canals are there? What are their orientations?
3:
Anterior-vertical
Posterior-vertical
Lateral-horizontal
193
What are the swellings at the end of the semicircular canals called?
Ampulae
194
What does the vestibule contain?
The receptor Otolith organs that give rise to the primary neuron
195
What is the ampulae?
A swelling at the end of a semicircular canal that contains the hair cells that are embedded in the cupula
196
What do the hair cells in the cupula sense?
Angular acceleration
197
What causes the action potential that helps the CNS to understand the propriception of the head?
Mechanical deformitites of the hair cells
198
What are the otolith organs? Where are they found?
Utricle and saccule; the vestibule
199
What do the otolith organs do?
Sense head displacement (linear acceleration) so they are sensitive to the rate of movement or speed of motion
200
What is the sensory epithelium found in the otolith organs called?
Macula
201
What is special about the macula?
They contain hair cells embedded in jelly that is full of CaCo3 crystals. The crystals cause mechanical deformation of the hair cells that allow for the proproception of the head.
202
How are the hair cells orientated in the utricle? Saccule?
```
Utricle= horizontally
Saccle= vertically
```
203
Describe the path of CN 7.
It first enters the internal auditory meatus and then takes a sharp turn as the Genu of CN 7. It heads inferiorly to exit at the stylomastoid foramen.
204
What are the two branches of CN 7?
Chorda tympani and the greater petrosal nerve
205
When does the greater petrosal nerve branch off of CN 7?
Within the petrous portion of the temporal bone at the genu of CN 7--it exits the greater petrosal hiatus and joins the sympathetic fibers (deep petrosal nerve) to form the nerve to the ptygeroid canal as it heads to the sphenopalatine ganglia.
206
When does the chorda tympani branch off of CN 7?
Prior to CN 7 exiting the temporal bone and exits through the petrotympanic fissure--it then heads to the lingular nerve off of V3
207
Where do the greater and lesser petrosal nerves come together?
Ptyergoid canal
208
Where do the greater and lesser petrosal nerves run to?
Sphenopalatine ganglion
209
How does the chorda tympani course through the inner ear?
Passes between the incus and malleus
210
In the innner ear, a branch of what nerve innervates the stapedius?
Chorda tympani
211
What is the proper name for the eustachian tube?
Pharyngotympanic tube
212
What is the cartilagenous tube passing from the tympanic cavity of the middle ear to the nasopharynx?
Pharyngotympanic tube
213
How many nasal conchi are there?
3-superior, middle, and inferior
214
What are the nasal conchi?
Bony folds from the lateral walls of the left and right nasal cavities
215
True or false:
| There are passageways to the sinuses located above the nasal conchi.
False--the passages are located below the nasal conchi
216
What makes up the hard palate?
The horizontal plates of the maxilla and palatine bones
217
What supports the soft palate?
Tensor veli palatine and levator palatine muscles
218
What hangs off the back of the soft palate?
Uvula
219
What is the primary intrinsic muscle of the tongue? What is it innervated by?
Genioglossus--GSE fibers from CN 12
220
Where is the palatine tonsil located?
Just below the uvula
221
What are the main contents of the oral cavity? (x10)
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Hard palate
Soft palate
Tongue (genioglossus muscle)
Geniohyoid and mylohyoid muscles
Epiglottis
Oropharynx
Nasopharynx
Laryngopharynx
Palatine tonsil
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222
What inervates the geniohyoid muscle?
C1
223
What innervates the mylohyoid muscle?
SVE from V3 (CN 5)
224
What three things provide sensory innervation to the nasal cavity and palate? What about the motor innervation?
GSA via the:
- Anterior and posterior ethmoidal branches of V1
- Posterior Superior and posterior inferior lateral nasal branches of V2
- Anterior and superior alveolar branches of the infraorbital nerve
The motor innervation: SVE via the:
- Posterior superior and posterior inferior nasal nerves (preganglionic from greater petrosal)
- Greater and lesser palatine nerves (preganglionic from greater petrosal)
225
What are the three divisions of the pharynx?
Nasopharynx
Oropharynx
Laryngopharynx
226
What is the nasopharynx?
From the base of the skull to the uvula
227
What is the oropharynx?
From the uvula to the epiglottis
228
What is the larygnopharynx?
From the epiglottis to the esophagus
229
Where are the muscles of the pharynx located?
Under the folds
230
What innervates the muscles of the pharynx?
CN 10 (SVE fibers to the larynx, pharynx, and soft palate)
231
What muscle separates the superior and middle pharyngeal constrictor muscles? What innervates it?
Stylopharyngeus (SVE from CN 9--pharyngeal arch #3)
232
To what does the superior pharyngeal constrictor muscle insert on?
Ptygermandibular raphe
233
What does the middle pharyngeal constrictor attach to?
Greater wing of the hyoid bone
234
Where do all three of the pharyngeal constrictors attach to?
The midline
235
What provides sensory innervation to the pharyngeal constrictor muscles? Motor innervation?
Sensory= GVA fibers from CN 10 (GVA to the larynx, pharynx, and soft palate, foregut/midgut, and baroreceptors)
Motor= SVE fibers from CN 10 (pharyngeal arch muscles #4 & 6, muscles of larynx, pharynx, and soft palate, palatoglossus & glossopharyngeus)
**BOTH SENSORY AND MOTOR ARE PROVIDED BY THE PHARYNGEAL PLEXUSES!
236
What is the innervaton of the tensor veli palatini muscle?
SVE fibers from V3 (CN 5)
237
What is the innervation of the levator veli palatini muscle?
CN 10 (SVE fibers)
238
What is the innervation of the superior pharyngeal constrictor? Middle? Inferior?
SVE from CN 10
239
What is the innervation of the glossopharyngeus muscle?
SVE from CN 10
240
What is the innervation of the stylopharyngeus muscle?
SVE from CN 9
241
What is the innervation of the styloglossus muscle?
GSE from CN 12
242
What is the innervation of the hyoglossus muscle?
GSE from CN 12
243
What is the innervation of the genioglossus muscle?
GSE from CN 12
244
Describe the events during swallowing.
1) Muscles of the palate push the bolus into the oropharynx
2) The tensor veli palatini and the levator veli palatini contract to close the nasopharynx
3) The pharyngeal muscles contract to raise the walls of the pharynx
4) The suprahyoid muscles elevate the hyoid and close the opening to the trachea
245
What begins the swallowing reflex?
The bolus of food
246
True or false:
| The voluntary and reflexive act of swallowing is completed through coordinated motions of the tongue,pharynx, and larynx
True---these coordinated actions act as a "wave of contractions" to move the food
247
What is the difficulty of swallowing?
Dysphagia
248
How do you diagnose dysphagia?
Barrium swallow study
