Headand Neck Deck 3 Flashcards

1
Q

What drains into the inferior meatus?

A

tears via the nasolacrimal duct

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2
Q

What drains into the middle meatus?

A

frontal sinus, anterior ethmoidal cells, and maxillary sinus via a groove called the semilunar hiatus.

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3
Q

What bulge covers the mucosa superior to the semilunar hiatus?

A

ethmoidal bulla

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4
Q

What drains into the superior meatus?

A

posterior ethmoidal cells, sphenoid sinus (which drains via the sphenoethmoidal recess)

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5
Q

What is the frenulum?

A

The fold in the midline of the tongue.

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6
Q

How does submandibular fluid get to mouth?

A

travels in submandibular ducts, running anteriorly and draining in sublingual caruncle.

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7
Q

What bones make up the nasal septum?

A

ethmoid bone (superiorly), vomer bone (inferiorly)

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8
Q

What separates the nasal septum from the nasopharynx?

A

two choanae (separated by the vomer.

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9
Q

What forms the lateral wall of the nasal cavity?

A

ethmoid bone, including the superior and middle conchae, the inferior concha, palatine bone (posteriorly) maxillary and lacrimal bones (anteriorly).
NOTE: the sphenoid bone is posterior to the palatine bone and not part of the nasal cavity.

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10
Q

What are the four pairs of air sinuses that surround the nasal cavity?

A

superior: frontal sinus
lateral / inferior: maxillary sinus
lateral / superior: ethmoid air cells
posterior: sphenoid sinus.

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11
Q

Where does the sphenoid sinus drain?

A

sphenoethmoidal recess superior to the superior concha of the nasal cavity.

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12
Q

Where does the ethmoid air cells drain?

A

superior meatus and middle meatus

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13
Q

Where do the frontal and maxillary sinuses drain?

A

middle meatus.

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14
Q

What nerves supply para / simp / general afferent / special afferent innervation to the nasal cavity?

A
Olfactory nerve (I) - smell
Ophthalmic nerve (V1) - GA to anterior 1/3rd.
Maxillary nerve (V2) - GA to posterior 2/3rd
Fascial nerve (VII) - paraympathetic
Superior cervical ganglion - sympathetic.
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15
Q

What are the five arterial branches that supply blood to the nasal septum

A

1) anterior & posterior ethmoidal arteries (from ophthalmic artery.)
2) lateral nasal and superior labial arteries (from facial artery.)
3) sphenopalatine artery (from maxillary artery)

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16
Q

What bone separates the nasal cavity from the anterior cranial fossa?

A

cribriform plate of the ethmoid bone.

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17
Q

What plane does the perpendicular plate of the ethmoid bone lie?

A

It is in the mid-sagital plane.

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18
Q

Where are the cell bodies of the olfactory neurons located?

A

In the nasal septum (they synapse with other neurons in the olfactory bulb).

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19
Q

What nerves innervate the nasal septum?

A

anterior 1/3rd: anterior ethmoidal nerves (from nasociliary / V1)
posterior 2/3rd lateral wall: posterior nasal nerves.
posterior 2/3rd septum: nasopalatine nerve

20
Q

What are the attachments of the superior constrictor?

A

pharyngeal tubercle on the base of the skull, pterygomandibular raphe (where it meets the buccinator)

21
Q

Where does the middle constrictor attach anteriorly?

A

hyoid bone

22
Q

Where does the inferior constrictor attach anteriorly?

A

thyroid and cricoid cartilages

23
Q

Where does the salpingopharyngeus attach?

A

attaches to the torus tubarius superiorly and blends with the palatopharyngeus inferiorly.

24
Q

What innervates the mucosa of the nasopharynx?

A

maxillary nerve V2 and some glossopharyngeal for the inferior part.

25
Q

What innervates the mucosa of the oropharynx?

A

glossopharyngeal nerve IX

26
Q

What innervates the laryngopharynx and esophagus?

A

vagus nerve X and some glossopharyngeal for the superior part.

27
Q

What muscles elevate the larynx?

A

suprahyoid muscles (stylohyoid, digastric, mylohyoid, geniohyoid) and the thyrohyoid.

28
Q

What muscles depress the larynx?

A

Most of the infra hyoid muscles (omohyoid, sternohyoid, sternothyroid)

29
Q

What does the cricothyroid muscle do?

A

Pulls thyroid cartilage inferiorly, stretching and tensing the vocal ligaments.

30
Q

What is the space between the vocal ligaments called?

A

glottis

31
Q

What muscle abducts the vocal chords?

A

posterior crico-arytenoids

32
Q

What innervates the intrinsic muscles of the larynx?

A

vagus nerve X

33
Q

All intrinsic muscles of the larynx except one are innervated by the recurrent laryngeal nerve - what’s the exception?

A

cricothyroid is innervated by the external laryngeal branch of the vagus nerve.

34
Q

What innervates the mucosa of the larynx?

A

internal laryngeal nerve: superior to the vocal folds.

Inferior laryngeal nerve: inferior to the vocal folds

35
Q

What causes high vs. low pitch?

A

high pitch: tensing / lengthening vocal ligaments = cricothyroid & lowering larynx.
low pitch: relaxing / shortening the vocal ligaments = vocalis & raising the larynx.

36
Q

What are the three groups of smooth muscles within the globe of the eye

A
ciliary muscles (allows for focusing = accommodation)
sphincter pupillae (makes pupil smaller)
dilator pupillae (makes pupil bigger)
37
Q

What path do sympathetic neurons take to reach the dilator pupillae?

A

superior cervical ganglion -> ophthalmic artery -> ciliary ganglion (no synapse) -> short ciliary nerve of V1 -> muscle

38
Q

What path do the parasympathetic neurons take to reach the sphincter pupillae and ciliary muscle?

A

oculomotor (III) -> ciliary ganglion (synapse) -> short ciliary nerves of V1 -> muscle

39
Q

What is Horner’s syndrome and what symptoms does it present?

A

interruption in sympathetic innervation of the head: pupil is constricted, upper eyelid droops, decrease in sweating, flushed skin.

40
Q

What innervates the eyeball and the eyelids?

A

eye ball / upper eyelid: V1

lower eyelid: V2

41
Q

How do we look up?

A

inferior oblique (up, out, extortion) + superior rectus (up, in, intorsion)

42
Q

How do we look down?

A

superior oblique (down, out, intorsion) + inferior rectus (down, in, extortion

43
Q

How do you test the obliques?

A

1) have patient adduct the eye (medial rectus)
2) then have patient look up (inferior oblique)
3) then have patient look down (superior oblique)

44
Q

What two muscles cause forward gaze from downward gaze?

A

inferior oblique + superior rectus

45
Q

How do you test the superior and inferior rectus muscles?

A

1) have patient abduct the eye (lateral rectus)
2) have patient look up (superior rectus)
3) have patient look down (inferior rectus)