Head and neck leftovers

Question 1

Which age do the cranial sutures ossify by?

Answer 1

18-24 months

Question 2

By which age does the mastoid bone develop?

Answer 2

2 years

Question 3

Tear to which vessel might cause subdural haematoma?

Answer 3

Cerebral vein and bridging veins

Question 4

Answer 4

Question 5

What tissues go through foramen magnum

Answer 5

Nerves
-Spinal root accessory nerve
-Lower end of medulla

Tissues
-Tectorial membranes
-Apical ligament of the dens

Question 6

What goes through foramen lacerum?

Answer 6

-ICA: passes along superior surface but does not traverse it
-Nerve of pterygoid canal (vidian nerve) –> deep petrosal + superficial greater petrosal

Question 7

What goes through optic canal?

Answer 7

-Optic nerve + 3 layers of dura –> infection of meninges is seen as papilledema
-Opthalmic artery (end artery)
-Sympathetic nerves

Question 8

What goes through carotid canal?

Answer 8

SIDE
-Sympathetic plexus around arteries
-Internal carotid artery
-Deep petrosal nerve
-Emissary vein

Question 9

What goes through jugular foramen?

Answer 9

-Anterior: inferior petrosal sinus
-Intermediate: glossopharyngeal, vagus and accessory nerves
-Posterior: sigmoid sinus (becoming internal jugular vein) and some meningeal branches from occipital and ascending pharyngeal arteries

Question 10

What goes through the stylomastoid foramen?

Answer 10

-Stylomastoid artery
-Facial nerve

Question 11

43, 44

Answer 11

Question 12

15, 17, 20, 23

Answer 12

Question 13

What are the causes of lytic skull lesions?

Answer 13

-Lytic skeletal metastasis
-Multiple myeloma
-Paget’s disease
-Sarcoidosis
-Osteomyelitis
-Haemangioma

Question 14

Where do the cavernous sinuses drain blood from?

Answer 14

-Superior opthalmic veins
-Facial vein
-Emissary veins from pterygoid plexus
-Sphenoparietal sinuses

Question 15

Where do the cavernous sinuses drain blood to?

Answer 15

-Superior and inferior petrosal sinuses
-IJV
-Intercavernous sinus

Question 16

What are the contents of the cavernous sinus?

Answer 16

OTOMCAt

Lateral wall components (top to bottom)
-Oculomotor nerve
-Trochlear nerve
-Opthalmic nerve
-Maxillary nerve

Contents of the sinus (medial to lateral)
-Internal carotid artery (and sympathetic plexus)
-Abducens nerve

Question 17

What is the clinical significance of cavernous sinus drainage?

Answer 17

-Infections are drained from dangerous area of the face (by opthalmic and facial veins) may spread to cavernous sinus as the draining veins are valveless

Question 18

Answer 18

Question 19

What is the major vein draining the brain parenchyma?

Answer 19

Great cerebral vein

Question 20

Describe the location of the the straiht sinus

Answer 20

Junction of tentorium cerebelli and falx cerebri

Question 21

What is the blood supply to temporalis?

Answer 21

Deep temporal arteries (anterior and posterior) from maxillary artery

Question 22

Whatartery supplies scalp over temporalis muscle?

Answer 22

-Superficial temporal artery from ECA

Question 23

What regions are drained by the pre-auricular lymph nodes?

Answer 23

-Upper half of face
-Temporal region
-Auricle and external auditory meatus
-Gums

Question 24

What is the roof of the middle ear?

Answer 24

Tegmen tympani

Question 25

How do middle ear infections cross the skull?

Answer 25

By direct erosion of tegmen tympani, may also spread to mastoid air cells causing mastoiditis

Question 26

Why does a patient with acoustic neuroma hear sounds loudly on the affected side?

Answer 26

-Facial nerve palsy with paralysis of stapedius

Question 27

5, 6, 8, 9, 13, 14, 15-18, 19, arrows

Answer 27

Question 28

Answer 28

Question 29

What is a chiari malformation?

Answer 29

-Condition affecting the brain. Consists of downward displacement of the cerebellar tonsils through the foramen magnum causing non-communicating hydrocephalus as a result of obstruction of CSF outflow

Question 30

Answer 30

Question 31

Describe the vertebral arteries

Answer 31

-They enter the cranial cavity via foramen magnum -Lie in subarachnoid space -Ascend on anterior surface of medulla oblongata -Unite to form basilar artery at the base of the pons

Question 32

What are the branches of the vertebral arteries?

Answer 32

-Posterior spinal artery -Anterior spinal artery -Posterior inferior cerebellar artery

Question 33

What are the branches of the basilar artery?

Answer 33

-Anterior inferior cerebellar artery -Labyrinthine artery -Pontine arteries -Superior cerebellar artery -Posterior cerebral artery

Question 34

What are the branches of the internal carotid?

Answer 34

-Ophthalmic artery -Posterior communicating artery -Middle cerebral artery -Anterior cerebral artery

Question 35

How does the vertebral artery enter the skull?

Answer 35

-Via foramen magnum -Crosses transversely across posterior arch of atlas

Question 36

What does the vertebral artery and basilar artery supply in the brain?

Answer 36

-Medulla, cerebellum, pons, midbrain, thalamus, occipital cortex

Question 37

Which vein drains the danger triangle of the face?

Answer 37

Inferior ophthalmic vein

Question 38

What branch is given off by the ICA before ACA, MCA?

Answer 38

Ophthalmic artery

Question 39

What signs would you get with MCA infarct?

Answer 39

-Contralateral hemiparesis -Contralateral hemisensory loss -Hemianopia -Aphasia if in dominant hemisphere -Neglect if in non dominant hemisphere

Question 40

Answer 40

Question 41

What is the anterior attachment of the tentorium cerebelli?

Answer 41

-Superior angle of the petrous part of the temporal bone

Question 42

What blood vessel supplies the inner table of the temporal bone?

Answer 42

-Middle meningeal artery

Question 43

If there is a tumour in the precentral gyrus, what is the bone to penetrate?

Answer 43

Parietal bone

Question 44

What structure is the oculomotor nerve pressed against?

Answer 44

Petrous part of temporal bone and tentorium cerebelli

Question 45

Answer 45

Question 46

1, 5, 8, 19, 23, 24, 26, 36

Answer 46