Head & Neck

Question 0

Neurocranium bones?

Answer 0

• frontal
• parietal
• occipital
• temporal
• sphenoid
• ethmoid

Question 1

How many bones in the skull? How many ‘associated’ bones?

Answer 1

-22 bones in the skull, 7 associated bones

Question 2

Viscerocranium bones?

Answer 2

-mandible
-maxilla
-zygoma
-vomer
-lacrimal
-nasal
-palatine
inferior nasal concha

Question 3

Calvaria (cranial vault) made up of?

Answer 3

• frontal, parietal & occipital bones
• bones formed by intramembranous ossificiation
• convex shape resists impact

Question 4

What are fontanelles for?

Answer 4

• allow for passage of head through birth canal & accommodate growth of brain
• cranial bones do not articulate in the newborn
• soft spots (fontanelles)= membrane covered parts of the skull where sutures form, usually exist until about 7-19 months
• bulging or tense fontanelles may= increased intracranial P

Question 5

What are the 3 cranial fossae?

Answer 5

-anterior, middle, posterior

Question 6

What is the anterior fossa?

Answer 6

-anterior: frontal bone, crista galli & cribiform plate of ethmoid & lesser wings of sphenoid; contains frontal lobe & CN#1

Question 7

What is the posterior fossa?

Answer 7

-posterior: sphenoid, temporal & occipital bones; contains occipital lobe, cerebellum, brainstem; number of ‘holes’ namely foramen magnum, hypoglossal canal, jugular foramen & internal auditory meatus

Question 8

What is the middle fossa?

Answer 8

-middle: sphenoid & temporal bones; contains sella tursica, chiasmic groove, optic canal, superior orbital fissure, foramen rotundum, foramen ovale, foramen spinosum, foramen lacerum & cavernous sinus; structures provide for pituitary, optic chiasm, optic n., internal carotid artery & CNs III, IV, V1, V2 & VI; temporal lob of brains rests in middle fossa

Question 9

Where can sinuses be found?

Answer 9

• ethmoid
• sphenoid
• maxilla
• frontal
• temporal (mastoid air cells)
• all are potential sites of infection

Question 10

What does the mandible articulate with?

Answer 10

• temporal bones at the tempomandibular joint

- 1/5 of facial injuries involve mandibular fracture

Question 11

What does the mandible hold? What n. are the gums and teeth innervated by?

Answer 11

• holds lower row of teeth in gomphosis joint at alveolar processes
• gums/teeth innervated by inferior alveolar n.

Question 12

Temporomandibular joint is what kind of joint? Between what? Innervated by what n.?

Answer 12

• synovial jt with an articular disc
• articulation is b/w condylar portion of the mandible & mandibular fossa & articular tubercle of temporal bone
• innervated by mandibular branch of trigeminal n.

Question 13

Hyoid bone is what kind of bone? Suspended from what? Attachment point for what?

Answer 13

• U-shaped bone
• suspended from temporal bone by stylohyoid ligaments from styloid processes of temporal bones
• has a body, 2 lesser cornua, & 2 greater cornua
• only bone in the human body that does not articulate with any other bone
• attachment point for muscles responsible for speech & swallowing

Question 14

The bony orbit is made up of what bones?

Answer 14

• frontal
• maxillary
• ethmoid
• sphenoid
• lacrimal
• zygomatic
• palantine

Question 15

Nostrils open up into the?

Answer 15

nasal cavity

Question 16

The lateral wall of the nasal cavity has?

Answer 16

bumpy projections, conchae (turbinates)

Question 17

The names of the conchae?

Answer 17

-superior, middle & inferior conchae

Question 18

Superior & middle are made up of what bones? Inferior?

Answer 18

• superior and middle conchae are part of the ethmoid bone

- inferior conchae are individual bones

Question 19

Roof of the nasal cavity contains receptors from what nerve?

Answer 19

Olfactory n.

Question 20

Nostrils separated by?

Answer 20

nasal septum, which consists of perpendicular plate of the ethmoid, vomer, & cartilage; all covered w/mucosa

Question 21

What are the conchae for?

Answer 21

warm & filter inhaled air, mucosa serves immune function by trapping foreign particles & exposing them to Ag presenting cells

Question 22

What are the sutures?

Answer 22

• fibrous joints b/w bones of the skull
• coronal: b/w frontal & parietal
• sagittal: b/w parietals
• lambdoidal: b/w parietal & occiput
• squamosal: b/w parietal & temporal
• bregma: jxn of corona & sagittal sutures
• lambda: jxn b/w lambdoidal & sagittal structures
• pterion: jxn of frontal, parietal, temporal & sphenoid bones
• sutural ligs connect the cranial bones that are the remaining, unossified sheets of mesenchyme from intramembranous ossification

Question 23

Muscles of facial expression?

Answer 23

• sphincter muscles: orbicularis oculi, orbicularis ori
• all other muscles may be considered dilator muscles
• innervated by facial n. (CN VII)

Question 24

Muscles of mastication?

Answer 24

- temporalis - masseter - medial pterygoid - lateral pterygoid - all innervated by trigeminal n. (CN V) - movements of the jaw: elevation, depression, protraction, retraction

Question 25

Medial ptygoid does what?

Answer 25

elevation & protrusion

Question 26

Lateral ptygoid does what?

Answer 26

depression & protrusion

Question 27

Temporalis does what?

Answer 27

elevation & retraction

Question 28

Masseter does what?

Answer 28

elevation & protraction

Question 29

What are the two divisions of the anterior neck?

Answer 29

anterior & posterior triangles

Question 30

What borders the anterior triangle?

Answer 30

sternocleidomastoid, inferior border of the mandible & anterior midline of the neck

Question 31

What borders the posterior triangle?

Answer 31

sternocleidomastoid, clavicle & trapezius

Question 32

Muscles of deglutition/speech & nerve?

Answer 32

- digastric, anterior belly (trigeminal) - digastric, posterior belly (facial) - mylohyoid (trigeminal) - sternohyoid (ansa cervicalis) - omohyoid (ansa cervicalis) - cricothyroid (vagus) - thyrohyoid (1st cervical n., via hypoglossal) - sternothyroid (ansa cervicalis)

Question 33

The facial nerve exits where and branches into? What does it provide innervation to?

Answer 33

- Exits skull via stylomastoid foramen - branches into 5 divisions: temporal, zygomatic, buccal, mandibular & cervical - provides motor innervation to muscles of facial expression

Question 34

What does the trigeminal nerve provide innervation to? What are the 3 branches?

Answer 34

- sensory innervation to face - 3 branches, each provides sensation to a separate region of the face - ophtalmic division (V1), maxillary division (V2) & mandibular division (V3)

Question 35

What artery supplies the face with blood? Where does it arise from?

Answer 35

- the facial artery - arises from external carotid artery & travels superiorly around lower border of the mandible towards midline of the face - superficial temporal artery also arises from external carotid artery ascending to the mandible but anterior to the ear

Question 36

Where does the facial vein begin & where does it go?

Answer 36

Just under the bony orbit, descends obliquely towards inferiolateral border of the mandible

Question 37

Where does the facial vein drain to? And what other vein does it communicate with?

Answer 37

- drains to internal jugular vein - communicates with superior ophthalmic vein & thus deeper into the cavernous sinus - possible route of infection from face to cranial dural sinus

Question 38

Lymphatics of the face follow what? Can you normally palpate?

Answer 38

- the major bvs in this area as they drain inferiorly towards the heart - not normally palpable but may be enlarged in infection or inflammatory states