Head, Neck, Back Flashcards by Eliana Gropman

skull vs cranium

skull: bony skeleton of head
- consists of cranium, facial skeleton, & mandible
- cranium = neurocranium
neurocranium: bony case of brain
- calvaria: dome-like roof (‘skullcap’)
- basicranium/cranial base: floor
  - where brain sits
  - lots of foramina/holes to allow for neurovasculature to travel
viscerocranium: facial skeleton

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frontal bone (1)

unpaired in adults (only have 1)
- in juvenile period: 2 bones that will completely fuse together
- may have remnant frontal suture (metopic)
supra-orbital margin: boundary between squamous & orbital parts

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parietal bones (2)

pariet = wall
paired parietal bones ⇢ one on each side
flat, nondescript
protection of frontal bone ⇢ brain & surrounding meninges

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temporal bones (2)

tempor = temple

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temporal bones – zygomatic process

articulates with temporal process of zygomatic bone
- forms zygomatic arch
- palpate ear to ear
- important muscles under region

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temporal bones – articular tubercle

inferior projection of zygomatic process
anterior to mandibular fossa
dislocations of TMJ

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temporal bones – external acoustic opening ⇢ meatus

meatus = passageway
allows sound waves (vibrations) to reach tympanic membrane
- ear sits in that region
- colloquial term for tympanic membrane = eardrum

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temporal bones – styloid process

styl = stake or pole
inferior projection
attachment point for muscles and ligaments of tongue and neck

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temporal bones – mastoid process

mastoid = breast-shaped
contains mastoid air cells – hollow
superior attachment site for sternocleidomastoid (SCM) muscle

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clinical connection: mastoiditis

inflammation of mastoid air cells
often caused by middle ear infection spreading into air cells

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temporal bones – mandibular fossa

articulates with condyle of mandible
temporomandibular joint (TMJ)

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temporal bones – petrous part/apex

petrous = rock
contains middle & inner ear
- cochlea, semicircular ducts
ear ossicles ⇢ smallest bone of body within petrous part

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ear (auditory) ossicles – within temporal bone

malleus (2)
- attached to tympanic membrane
incus (2)
- middle ossicle
stapes (2)
- towards the inner ear
  - sits in oval window ⇢ leads into inner ear
  - smallest bone in body

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temporal bones – internal acoustic opening ⇢ meatus

transmits:
- facial nerve (CN VII)
  - goes into petrous portion but eventually moves its way out of skull
- vestibulocochlear nerve (CN VII)
  - important for hearing
  - goes into petrous portion & never comes out
- allows cranial nerves to travel through the bone

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temporal bones – jugular foramen

between/formed by temporal bone & occipital bone
the venous sinuses associated w/ brain in that area will drain into and be called internal jugular vein
transmits:
- internal jugular vein
  - located in neck ⇢ drain & make way down – bringing deoxygenated blood back to heart
- glossopharyngeal nerve (CN IX)
- vagus nerve (CN X)
- accessory nerve (CN XI)
  - CN IX, X, XI ⇢ cranial nerves that exit the skill via jugular foramen
irregularly shaped ⇢ bone will form around neurovasculature

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occipital bone (1)

occipit = back of head

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occipital bone – external occipital protuberance

prominent projection on posterior surface
- palpable
attachment site for trapezius muscle

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occipital bone – foramen magnum

medulla oblongata (brainstem) ⇢ spinal cord
vertebral arteries and accessory nerve (CN XI)

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occipital bone – occipital condyles

articulate with C1
- atlanto-occipital joints formed by condyles
- articulation between skull and vertebral column

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sphenoid bone (1)

sphenoid = wedge-shaped

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sphenoid bone – optic canal; hypophysial fossa

lots of foramina ⇢ means by which neurovasculature travels
optic canal: optic nerve (CN II)
- ophthalmic artery ⇢ supply things associated with the orbit
hypophysial fossa: pituitary gland

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sphenoid bone – superior orbital fissure

oculomotor nerve (CN III)
trochlear nerve (CN IV)
opthalmic division of trigeminal nerve (CN V₁)
abducens nerve (CN VI)

all nerves going to the orbit: innervate extra-ocular eye muscles ⇢ move eye around; provide sensory innervation

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ethmoid bone (1)

ethmoid = sieve-like
cribriform foramina ⇢ axons pass through on way to brain (small holes)
- cribri = sieve
- olfactory nerve (CN I)

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nasal septum

ethmoid + vomer + cartilage

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nasal conchae/turbinates

* thin bones lined w mucous membrane * highly vascularized * concha = shell * increase vascular & mucous membrane surface area in nasal cavity * allow for things to not go into/past nasal cavity (eg pathogens) * warms, moistens, and humidifiers inhaled air * **superior & middle nasal conchae** * parts of ethmoid bone * **inferior nasal conchae (2)** * separate paired bones

nasal bones (2)

bridge of nose

maxillae (2) = maxillary bones

* maxilla = jawbone * upper jaw * maxillary teeth – upper teeth

hard palate

* maxillae ⇢ play biggest role * palatine processes * horizontal plates of palatine bones (2)

clinical connection: cleft palate

faire of palatine process to unite during embryonic development ⇢ hard + soft

zygomatic bones (2)

zygo = yokelike ⇢ cheekbones

lacrimal bones (2)

lacrim = teardrops

paranasal sinuses

* para = beside * muscous membrane-lined cavities * hollow areas ⇢ lightening skull * drain into lateral nasal wall * located in 4 bones: * maxillae * frontal * sphenoid * ethmoid

clinical connection: sinusitis / sinus infection

inflammation of mucous membrane of 1+ paranasal sinus

cranial fossae

* cranial bones form around developing brain * create a mold that approximates brain shape * ‘stepping down stairs’ – deeper as you go posterior * anterior, middle, & posterior cranial fossae

mandible (1)

* mand = to chew * only movable skull bone * lower jaw

mandible – mandibular condyle; coronoid process

* mandibular condyle * articulates with mandibular fossa of temporal bone * TMJ * more posteriorly located * coronoid process * anterior to condyle (more toward teeth) * inferior attachment (insertion): temporalis muscle ⇢ chewing

mandibular foramen

transmits infeior alveolar neurovasculature ⇢ IAN block: knock out sensation from one half of mandibular teeth

types of teeth

* incisor * thin, cutting edges * canine * one on each quadrant * single, prominent cones * premolar/bicuspid * 2 cusps * molar * most posterior teeth * 3+ cusps

adult dentition

* 32 permanent teeth * 2:1:2:3 * types of teeth per quadrant * 2 incisors, 1 canine, 2 premolars, 3 molars

sutures

immovable (in adults; children ⇢ growth) fibrous joints

coronal/frontal suture

“crown location” unites frontal bone & both parietal bones

saggital suture

saggit = arrow unites parietal bones in midline

squamous sutures

squam = flat, like flat ovedrlapping scales of a snake unite parietal & temporal bones

pterion – craniometric point

* articulation point of Frontal, Parietal, Temporal & Sphenoid bones * branches of middle meningeal artery travel deep to this spot * epidural hematoma ⇢ b/w blood & dura mater

lambdoid(al) suture

unites both parietal bones & occipital bone

fontanels

* soft spots * fontanels = little fountains * dense CT regions between incompletely formed cranial bones * juvenile skulls (~1-6) * Eventually replaced by bone via intramembranous ossification

temporomandibular joint (TMJ)

* synovial joint * bony parts: * mandibular condyle of mandible * mandibular fossa of temporal

TMJ articular discs; actions

* _articular disc_ – complete fibrocartilaginous disc * divides joint cavity into 2 cavities (superior & inferior) ⇢ allowing actions to occur separately * _actions_: * **elevation** (closing mouth)**/depression** (opening mouth) * inferior compartment * hinge joint * more dominant movement * **protraction** (jutting out mandible)**/retraction** (bringing it back) * superior compartment * gliding joint

clinical connection: TMJ syndrome

* symptoms: * dull pain around ear * tenderness of mastication muscle – chewing * crepitus = joint clicking * causes: * misaligned teeth * grinding/clinching teeth * trauma * arthritis

muscles of facial expression

* located in subcutaneous tissue and fascia of scalp, face, and neck * allows for movement of skin ⇢ changing facial expression * innervation: **facial nerve (CN VII)**

clinical connection: facial paralysis (Bell palsy)

facial nerve compromised (pinched, severed) ⇢ unilateral paralysis of facial muscle

muscles of facial expression – **orbicularis oculi muscle**

sphincteric muscle (surrounding an opening) _action_: closes eyelids

muscles of facial expression – **buccinator muscle**

* buccae = cheek * majority of muscular portion of cheek * deeper plane - deep to subcutaneous tissue * _actions_ * presses cheek against molar teeth * with tongue, keeps food out of oral vestibule * resists distension (when blowing)

muscles of facial expression – **orbicularis oris muscle**

* sphincteric muscle * _actions_: closes oral fissure; protudes/purses lips

muscles that move eyeball (extrinsic eye muscles/extra-occular eye muscle)

attached to sclera (whites of eye) innervation: most by **oculomotor nerve (CN III)**

extrinsic eye muscle actions

* elevation (looking up) / depression (looking down) * abduction (looking towards side) / adduction (looking towards nose)

muscles of mastication

* thickest muscles of the head * move the mandible (TMJ) * innervation: **mandibular nerve/V₃** * actions: * elevation (closing the mouth) * depression * protraction/retraction

temporalis muscle

* bony attachments: * superior & inferior temporal lines * coronoid process of mandible ⇢ distal attachment – movable bone * palpable

masseter muscle

* mirrors medial pterygoid muscle on superficial side of ramus of mandible * palpable

medial pterygoid muscle

mirrors masseter muscle on deep side of ramus of mandible

lateral pterygoid muscle

* has 2 heads (superior & inferior) * superior ⇢ direct attachment to articular capsule & a bit on articular disc of TMJ * actions: * stabilization of TMJ * depression of mandible\*\* * inferior head ⇢ only muscle that will depress mandible

muscles of soft palate

* 5 muscles * actions: * elevation/depression * making palate taut * innervation: **vagus nerse (CN X)** * parasympathetic innervation * except 1

muscles of tongue

* tongue is a mass of muscles * covered by mucosa * extrinsic muscles (4) * alter position of tongue – stick out, move * originate outside tongue & attach to it distally * intrinsic muscles (4) * alter shape of tongue – smaller/precise movements * attachments entirely within tongue * innervation: **hypoglossal nerve (CN XII)** * except 1

hyoid bone (1)

* does not articulate with any other bone * suspended in anterior neck by ligaments & muscles * between mandible and larynx * supports tongue * moving hyoid out of way ⇢ allow things to move through GI system

vertebrae

* vertebral column = vertebrae + CT * functions: * protects spinal cord ⇢ bony encasement * allows movement (some more movable; some not movable) * flexion/extention/lateral flexion * rotation * point of attachment for bones & muscles * ex: ribs on thoracic vertebrae

types of vertebrae

* _cervical (7)_: **C1-C7** * cervic = neck * _thoracic (12)_: **T1-T12** * thorax = chest * attachment to ribs * _lumbar (5)_: **L1-L5** * lumb = loin * largest vertebrae * sacrum (5 fused vertebrae) * sacrum = sacred bone * attachment to hip bones * no movement * coccyx (4 fused vertebrae) * coccyx = cuckoo * no movement

structures common to most vertebrae: vertebral body; pedicles

* **vertebral body** * main weight-bearing component * anteriorly-placed * spongy bone – compact bone externally * **pedicles** * pedicle = little feet * project posteriorly from body to unite with laminae

structures common to most vertebrae: laminae, transverse processes, spinous process

* **laminae** * flat portion of bone * = thin layer * **transverse processes** * extend posterolaterally * points of attachment for muscle and bone * muscle ⇢ all vertebral column * bone ⇢ some vertebral column - thoracic * **spinous process** * extends posteriorly (palpable) * can be bifid (split into 2) – in _cervival_ region

structures common to most vertebrae: notches, intervertebral foramen

* **notches** (superior & inferior) * indentations on pedicles * form foramen when articulate together * **intervertebral foramen** * opening between adjacent vertebrae * superior + inferior notch * passage of spinal nerves/branches * spinal nerves exit to innervate rest of body

cervical vertebrae (C1-C7)

* considerable range of movement * smalest movable vertebrae * unique characteristics: * **transverse foramina** * allows for vertebral artery & vein to traverse this region * vertebral artery: branch of subclavian artery: ascend neck ⇢ get into skull ⇢ one of dominant arterial supplies of the brain * bifid spinous processes * C2-C6

cervical vertebra: C1 – Atlas

* ring of bone * lacks vertebral body & spinous process * superior articular facets * articulate with occipital condyles * atlanto-occipital joint - yes (nodding)

cervical vertebra: C2 – Axis

* dens/odontoid process * dens = tooth * projecting from vertebral body up towards C1 * articulates with C1 (atlanto-axial joint) * arrangement allows rotational movement - shaking head no * pivot joint

cervical vertebra: C7 – vertebra prominens

* most proinent spinous process (non-bifid) * seen/felt at base of the neck * clinically important: count vertebrae

thoracic vertebrae – T1-T12

* get progressively larger * costal facets/demifacets * attachment of ribs – unique to thoracic vertebrae * body of vertebrae * transverse processes * longer transverse processes * less mobility than cervical & lumbar vertebrae ⇢ bc ribs attached

lumbar vertebrae: L1-L5

* identifiable by: * large size ⇢ bearing lots of weight * lack of transverse foramina & costal facets * prominent superior articular processes

curvatures of vertebral column

* adults have 4 curvatures: * **thoracis & sacral kyphoses** * concave anteriorly * **cervical & lumbar lordoses** * concave posteriorly * functions of curvatures: * flexibility * shock-absorbing resilience

primary vs secondary curvatures

* primary curvatures * develop during fetal period in relationship to fetal (flexed) position * thoracic and sacral ) * secondary curvature * result from extension from fetal position * cervical and lumbar ( * developmental landmarks helping to develop these curvatures ⇢ babies hold head up on their own; beginning to walk

clinical connections: abnormal curvatures

* excessive thoracic kyphosis * Dowager's hump * often caused by effects of osteoporosis ⇢ microfractures associated with vertebral bodies * excessive lumbar lordosis * hollow back/sway back * characterized by anterior tilting of pelvis * often associated with weakened trunk musculature or sudden weight gain (ex: pregnancy)

clinical connections: scoliosis

* scoliosis: abnormal lateral curvature * rotation of vertebrae * structural vs idiopathic causes * structural ⇢ issues w muscles/ligaments in vertebral column * idiopathic ⇢ don't know reason

intervertebral discs (ex joints of vertebral bodies)

* symphyses – cartilaginous joints * located between each vertebral body, except: * between C1 & C2 ⇢ rotational joint * non-movable vertebrae (sacral & coccygeal) * there is one between L5 & S1 – most inferior one * vary in thickness in different regions * increases inferiorly

components of intervertebral discs

* anulus fibrosus – protective * outer component * fibrocartilage * thinner posteriorly * nucleus pulposus * pulpa = fleshy * inner component * semifluid ⇢ fluidity varies w health and age

clinical connection: herniation of nucleus pulposus ('slipped disc')

* herniation = something's moving out of the place that it should be through another structure * herniation through anulus fibrosus * typically occurs posteriorlaterally ⇢ * anulus fibrosus thinner posteriorly * L4-L5 or L5-S1 levels most common * generally around intervertebral foramen region ⇢ pinching of spinal nerve – sensory & motor implications

sternocleidomastiod muscle attachments

superior attachments: * mastiod process of temporal bone * occipital bone inferior attachments: * manubrium of sternum * clavicle crosses cervical vertebral joints

sternocleidomastoid muscle actions – cervical vertebral joints

* bilateral contractions: * flexion of cervical vertebrae (aka neck flexion) * unilateral contraction: * lateral flexion of neck * rotation of head (in opposite direction)

sternocleidomastoid muscle innervation

efferent (motor): accessory nerve (CN XI) afferent (sensory): C2 & C3

supra- and infra-hyiod muscle

superior & inferior to hyoid bone * supra-hyoid muscle (4) * support and elevate hyoid * floor of mouth * infra-hyoid muscle (4) * supports and depresses hyoid & larynx * during swallowing and speaking

erector spinae muscles

* action: * extension of vertebrae * lateral flexion (side to side) of vertebrae * commonly strained * improperly lifting something * 3 parts: (lateral ⇢ medial) * **_i_**liocostalis muscle (lateral) * **_l_**ongissimus muscle (middle) * **_s_**pinalis muscle (medial) * “i love spaghetti”

Head, Neck, Back Flashcards

(87 cards)