Head and Neck II Flashcards Preview

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Flashcards in Head and Neck II Deck (248):
0

What are the prevertebral muscles? (X4)

Rectus capitis lateralis,
Rectus capitis anterior,
Longus colli,
Longus capitis,
Anterior, middle, and posterior scalenes

1

Why are the rectus capitis anterior and longus capitis clinically relevant?

They are often weak and found in patients suffering from lots of headaches. This is because the suboccipital muscles are often too tight.

2

What prevertebral muscle runs from vertebral body to vertebral body?

Longus colli

3

What is a large, general function of the scalene muscles?

Give stability to the neck.

4

What emerge through the scalene muscles? Specifically which of the two?

The roots of the brachial plexus (specifically through the anterior and middle scalenes.

5

What are the three ganglion of the sympathetic trunk?

Superior cervical ganglion, middle cervical ganglion, and the stellate ganglion.

6

What makes up the stellate ganglion?

A combination of the inferior cervical and superior thoracic ganglion.

7

True or false:
The inferior cervical sympathetic ganglion is bound up within a membrane with the superior thoracic sympathetic ganglion.

True. This is what makes up the stellate ganglion.

8

What is the function of the sympathetic (peri-arterial) plexus?

It is what gets sympathetic fibers to the head.

9

Where do the fibers to the peri-arterial plexus arise from?

The T1 to T3/4 cord levels.

10

True or false:
The fibers from the peri-arterial plexus synapse with the cervical sympathetic ganglia as they ascend to the head.

False. They do not synapse with the cervical sympathetic ganglion.

11

How do the fibers from the peri-arterial plexus ascend to the destinations in the head?

They hitchhike on the carotid vasculature and their branches.

12

What type of outflow does the sympathetic nervous system have?

A thoracolumbar outflow.

13

True or false:
The sympathetic nervous system distribution is more widespread in distribution and function as compared to the parasympathetic nervous system.

True.

14

In terms of sympathetic innervation, what is the thorax innervated by?

Pulmonary and cardiac nerves and plexuses.

15

In terms of sympathetic innervation, what is the foregut innervated by?

Greater thoracic splanchnic nerve (T5-T9)

17

In terms of sympathetic innervation, what is the midgut innervated by?

Lesser thoracic splanchnic nerve (T10-T11)

18

In terms of sympathetic innervation, what is the hindgut innervated by?

Least thoracic splanchnic nere (T12) and the lumbar splanchnic nerves.

19

In terms of sympathetic innervation, what is the pelvis and pernineum innervated by?

Pelvic splanchnic nerves

20

Which of the communicans is located more laterally? More medially?

Lateral= white rami communicans
Medial=grey rami communicans

21

Describe the pathway for sympathetic fibers to their effector organs.

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

What are the 3 options for sympathetic fibers to choose after exiting the sympathetic trunk?

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

What do the sympathetic fibers of the peri-arterial plexus hitch-hike on?

Internal and external carotid arteries.

24

What is innervated by the peri-articular plexus?

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)

Hard palate
Soft palate
Tongue (genioglossus muscle)
Geniohyoid and mylohyoid muscles
Epiglottis
Oropharynx
Nasopharynx
Laryngopharynx
Palatine tonsil

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