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0

When does the face develop?

during the 4th-5th week of development, neural crest and ectoderm cells form the branchial arches = pharyngeal arches

1

What two prominences form the 1st branchial arch?

maxillary and mandibular

2

These separate the branchial arches.

pharyngeal cleft (groove) externally and pharyngeal pouch internally

3

The branchial apparatus consists of:

branchial arches (mesoderm), branchial grooves or clefts (ectoderm), pharyngeal pouches (endoderm), branchial membranes (ectoderm and endoderm)

4

1st Branchial Arch

CN V, muscles of mastication

5

2nd Branchial Arch

CN VII, muscles of facial expression

6

3rd Branchial Arch

CN IX, stylopharyngeus (swallowing)

7

4th and 6th Branchial Arches

CN X, superior and recurrent laryngeal nerves and XI, all infrahyoid muscles except stylopharyngeus

8

5th Branchial Arch

rudimentary, nothing develops from this

9

Direction of facial development.

rostral to caudal

10

Develops from frontonasal prominence.

V1 - opthalmic division of trigeminal, forehead and dorsum apex of nose

11

Develops from lateral nasal prominences.

sides (alae) of the nose

12

Develops from medial nasal prominences.

nasal septum

13

Develops from the maxillary prominences.

V2 - maxillary division of trigeminal, upper cheek region and most of the upper lip, nasal placodes and lateral aspects of face

14

Develops from the mandibular prominences.

V3 - mandibular division of trigeminal, chin, lower lip, and lower cheek regions, innervates mylohyoid, masseter, temporalis

15

Develops from the mesenchyme in the facial prominences.

fleshy derivatives and various bones

16

What develops from the ectodermal stomodeum (ventral)?

mouth

17

The pinna of the ear arises from:

otic placode

18

What failure results in cleft palate?

philtrum (medial nasal prominences) to fuse with mandibular prominences, medial palatine processes fail to fuse with another, not all will have cleft lip

19

Microtia

deformation of the ear, accompanied by deafness

20

What results in cleft lip?

maxillary process fails to fuse with medial nasal process

21

What is more common: cleft lip or cleft palate?

cleft lip (1:1000) vs. cleft palate (1:2500); also cleft lip is much more common in men

22

Coronal section of the head will reveal these layers of the SCALP.

skin, connective tissue, aponeurosis and muscle, loose connective tissue, periosteum

23

Branches of CN VII Facial.

posterior auricular, temporal, zygomatic, buccal, marginal mandibular, cervical

24

Branches of V1 of the trigeminal nerve.

supraorbital, supratrochlear, infratrochlear, external nasal, lacrimal

25

Branches of V2 of trigeminal nerve.

infraorbital, zygomaticofacial, zygomaticotemporal

26

Branches of V3 of trigeminal nerve.

buccal, mental, auriculotemporal

27

Nerve to lateral and medial pterygoid is a branch of what nerve?

V3 - mandibular branch of trigeminal nerve

28

Branchial disorders associated with malformation from 1st and 2nd arches.

cleft lip and palate, craniofacial microsomia (CFM), Treacher-Collins syndrome (TCS), micrognathia, otomandibular dysostosis, micrognathia, microtia

29

What branches of CN VII are associated with Bell's palsy?

cervical, mandibular, buccal, zygomatic, temporal

30

What is associated with Bell's palsy?

damage to the facial nerve terminal branches, depending on location of the lesion may see symptoms such as loss of motor, taste, and autonomic function (lacrimal secretions if damaged near pontine origin or geniculate ganglion), paralyzed platysma, orbicularis oris, buccinator, orbicularis oculi

31

Which arteries arise from the external carotid artery to irrigate the face?

facial (inferior labial, superior labial, lateral nasal, angular), transverse facial, infraorbital, mental

32

Which arteries arise from the internal carotid artery to irrigate the face?

supraorbital, supratrochlear

33

Which two arteries primarily irrigate the face?

arteries arising from the external and internal carotid arteries

34

Most of the lymphatics of the face drain into which vein?

external jugular

35

Parotid region contents.

parotid gland and duct, CN IX, auriculotemporal nerve, external carotid plexus, branches of the greater auricular nerve, facial branches forming the parotid plexus, external carotid artery, external jugular vein, retromandibular vein, masseter, lymph nodes

36

Auriculotemporal Nerve

sensory and GVE to parotid gland to increase salivation, branch of V3 of trigeminal nerve

37

Which cranial nerves pass through the superior orbital fissure?

III, IV, V1 of trigeminal, VI

38

What artery passes through the optic canal in addition to CN II?

opthalmic artery

39

Ganglia involved in the autonomic innervation of the lacrimal gland.

pterygopalatine ganglion (CN VII to greater petrosal nerve), superior cervical sympathetic ganglion (T1 & T2 spinal cord segments)

40

Flow of tears:

lacrimal gland-->excretory lacrimal ducts-->superior or inferior lacrimal canal-->lacrimal sac-->nasolacrimal duct-->nasal cavity

41

Lacrimal apparatus autonomics:

superior salivatory gland-->CN VII-->greater petrosal nerve-->pterygoid canal nerve-->pterygopalatine ganglion-->to lacrimal gland via zygomatic and lacrimal nerves

42

Muscles associated with the infratemporal fossa:

primary - lateral and medial pterygoids; secondary - temporalis, masseter, buccinator

43

Which nerve innervates ALL of the muscles of mastication?

V3 of trigeminal (from 1st branchial arch don't forget)

44

Chorda tympani is a branch of the facial nerve but it also is associated with which other nerve?

V3

45

Which artery supplies the infratemporal fossa?

maxillary artery (branch of external carotid), 3 parts

46

The 2nd part of the maxillary artery is sandwiched between which muscles?

medial and lateral pterygoid muscles

47

Arteries of the 1st part of the maxillary artery.

deep auricular, anterior tympanic, accessory meningeal, middle meningeal, inferior alveolar

48

Arteries of the 2nd part of the maxillary artery.

deep temporal, buccal, branches to masseterics and pterygoids

49

Arteries of the 3rd part of the maxillary artery.

sphenopalatine, infraorbital, posterior superior alveolar, pharyngeal, descending palatine

50

The __________ prominence contributes most of the otic placode.

mandibular

51

With Bell's palsy, what will determine whether or not the patient has lacrimal secretion function intact?

Damage to the nerve close to its pontine origin or nearby the geniculate ganglion (loss of motor, taste and autonomic functions - lacrimal secretions); Damage to the nerve distal the geniculate ganglion, proximal to the chorda tympani, lacrimation is preserved

52

Most of the veins of the face drain into which vein?

external jugular

53

What serves the function of lymph nodes intracranially?

glial cells

54

Sensory information of parotid gland is contained in this nerve.

auriculotemporal (CN V3)

55

What passes through the superior orbital fissure?

CN III, IV, V1, VI

56

Opthalmic division of the Trigeminal nerve includes:

lacrimal, frontal, nasociliary

57

Caldwell view

frontal view of head for fractures or sinusitis

58

Waters view

chin on table, used for fractures of facial bones/nerves, used for maxillary sinuses, x-ray runs superior to inferior

59

SMV view

tangential view, used to see if the pt. has corrected alveolar plates (cleft palate surgery), used to diagnosis deviated septum/supported by CT of skull

61

Lateral view (of skull)

fractures for zygomatic bones, frontal bones; used to look for sphenoid sinusitis

62

The superior sagittal sinus lies between what two layers?

dura and arachnoid

63

What is found between the arachnoid and pia?

CSF

64

Although most of the face blood flows into the internal jugular veins, there is some drainage into the ________ _____ and ________ ______ plexuses deep to the petrous ridges of the temporal bones.

cavernous sinus; pterygoid venous

65

Retromandibular, facial veins are directly associated with superficial temporal vein; and they all drain into?

external jugular vein

66

GVE and GVA for the parotid gland?

auriculotemporal branch of CN V3

67

The _________ nerve, branch of (CN IX), carries the presynaptic nerve for the parotid gland.

tympanic

68

Pre- and post-synaptic fibers for otic ganglion?

presynaptic - CN IX; postsynaptic - auriculotemporal nerve (CN V3)