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AN 1107 - Head & Neck > Module 4 > Flashcards

Module 4 Flashcards

(101 cards)

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1
Q

Cribiform foramina (1)

A

olfactory nerve (CN I)

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2
Q

Optic canal (2)

A 
optic nerve (CN II)
ophthalmic arteries (from internal carotid)
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3
Q

Superior orbital fissure (5)

A 
oculomotor nerve (CN III)
trochlear nerve (CN IV)
ophthalmic division (CN V1)
superior + inferior ophthalmic veins
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4
Q

Foramen rotundum (1)

A

maxillary division (CN V2)

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5
Q

Foramen ovale (3)

A

mandibular division (CN V3)
lesser petrosal nerve (CN IX)
accessory meningeal artery

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6
Q

Foramen spinosum (2)

A

meningeal branch of CN V3

middle meningeal artery/vein

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7
Q

Internal opening of carotid canal + foramen lacerum (4)

A

greater petrosal nerve (CN VII)
internal carotid artey
sympthetic nerve plexus
deep petrosal sympathetic nerve

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8
Q

Internal acoustic meatus (3)

A 
facial nerve (CN VII)
vestibulocochlear nerve (CN VIII)
labyrinthine artery/vein (from vertebral artery)
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9
Q

Jugular foramen (4)

A 
glossopharyngeal nerve (CN IX)
vagus nerve (CN X)
hypoglossal nerve (CN XII)
vertebral artery/vein
sympathetic post-ganglionic plexus C2C3
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10
Q

CN V: Mandibular nerve - muscular innervations

A

CNV: Mandibular nerve

Mastication mm (4 pairs)

Mylohyoid m
anterior belly of digastric m
Tensor veli palatini m
Tensor tympani m

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11
Q

CN VII: Facial nerve muscular innervations

A

CN VII: Facial n

Facial expression mm

Stylohyid m
Posterior belly of digastric m
Stapedius m

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12
Q

CN X - Vagus muscular innervations

A

CN X: Muscles of pharynx (except stylopharyngeus) soft palate (except tensor veli palatini) & Larynx.
By pharyngeal branches/plexus:
Mm of pharynx (except stylpharyngeous) +
Mm of soft palate (except tensor veli palatini m)
By inferior laryngeal n: all Mm of Larynx, except cricothyroid (by external laryngeal n)

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13
Q

Longus capitis and longus colli innervations

A 
L-cap  = C1-C3
L-colli = C2-C6
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14
Q

Sensory innervation of the superior, middle, and inferior nasal concha/meatus

A

CN V2 (V1 - towards sup-ant aspect)

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15
Q

Describe the passage of the accessory nerve (CN XI)

A

Accessory nerve roots come from spinal nerves C1-C4, up the foramen magnum, SPINAL PART goes through the CAROTID SHEATH goes down and out the jugular foramen  SCM, trap;; CRANIAL PART – joins vagus nerve (exits jug foramen)

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16
Q

Describe the passages of the (ansa cervicalis - superior and inferior roots)

A

Spinal (APRs 1-3) – travels with the hyoglossal nerve – then branches to the external carotid and anterior cervical muscles.
- APR C1 = going towards geniohyoid, thyrohyoid + carotid sheath (aka. ansa cervicalis)

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17
Q

Sensory somatic general:______
Sensory somatic special:________
Sensory visceral general:_______
Sensory visceral special:_______

Motor somatic: \_\_\_\_\_\_\_\_\_\_\_\_\_ 
Motor visceral general: \_\_\_\_\_\_\_\_\_\_  
Motor visceral parasympathetic:\_\_\_\_\_\_
Motor visceral special: \_\_\_\_\_\_\_\_\_\_\_\_ 
Motor visceral branchial:\_\_\_\_\_\_\_\_\_
  1. Taste, Smell
  2. Skeletal striated muscles
  3. Striated mm developed from the pharyngeal arches
  4. Smooth muscles
  5. Glands
  6. Vision, hearing, balance
  7. Pain, temperature, proprioception from the muscles, joints
  8. Vibration, pressure from stomach
  9. Blood pressure from baroreceptors
  10. O2/CO2 blood concentration from chemoreceptors
A

Sensory somatic general:___7___
Sensory somatic special:____6____
Sensory visceral general:___8, 9,10_____
Sensory visceral special:____1___

Motor somatic: \_\_\_\_\_2\_\_\_\_\_\_\_\_ 
Motor visceral general: \_\_\_\_4,5\_\_\_\_\_\_  
Motor visceral parasympathetic:\_\_4,5\_\_\_\_
Motor visceral special: \_\_\_\_\_\_3\_\_\_\_\_\_ 
Motor visceral branchial: \_\_\_\_\_3\_\_\_\_\_\_
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18
Q

General visceral sensory innervation of the tongue: (4)

Special visceral sensory taste of the tongue: (3)

A

general sensation: V2, V3, IX, X

taste: VII (chorda tympani - vallate papillae; anterior 2/3), IX (posterior 1/3), X

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19
Q

Innervations of :

Lower teeth

Upper teeth

parotid gland

parasympathetic eyeball - ciliary mucles - (sphincters/constrictors)

sublingual + submandibular gland

A

lower teeth = V2

upper teeth = V3

inferior salivatory nucleus - lesser petrosal - otic ganglion - hitchhikes auricotemporal nerve of V3 to innervate the parotid gland (parasympathetic)

E-W nucleus - follows CN III - ciliary ganglion (posterior orbit) - ciliary bodies and sphincters

superior salivatory nucleus - travels with chorda tympani - submandibular gangliln - directly to the glands

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20
Q

If there was a lesion around the pterygo-canal, what kind of physiological symptoms would you see in the patient?

A 
imparted lacrimal gland, nasal cavity, palate
#dry
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21
Q

T or F: Sympathetic fibres from the superior cervical chain pass through the otic ganglion. They travel with the middle meningeal artery to innervate the parotid gland.

A

T

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22
Q

Superior cervical sympathetic ganglion

Cervical level?

Intimate structures?

A

C1- C3 vertebral level

Coalescence of C1-C4 cervical ganglia

Postg. fibers form internal carotid artery + external carotid artery symp. postg. n./pl.

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23
Q

Middle cervical sympathic ganglion

Cervical level?

Intimate structures?

A

C6 vertebral level

Coalescence of C5-C6 cervical ganglia

Postg. fibers form inferior thyroid artery symp. postganglionic nerve plexus.

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24
Q

Inferior cervical sympathic ganglion

Cervical level?

Intimate structures?

A

Anterior to C7 TVP & neck 1 st rib

Posterolateral to origin of Vertebral a.

Coalescence of C7,C8,T1 ganglia
Postg. fibers form vertebral & subclavian symp. postganglionic nerve plexuses.

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25
Which fontanelles? What can these things tell you? 28 days after birth 1 year 18 months 2-8th year
sphenoid/mastoid, posterior, anterior, frontal Anterior fontanelle – clinically relevant (protruding – meningitis, intracranial pressure; depressed – dehydration)
26
Scaphoncephaly vs. oxycephaly
long, narrow (saggital suture) high, tower-like (coronal suture)
27
T or F: mastoiditis can be a result of Otitis externa
F - media not externa
28
Corneal reflex testing with a common swab - testing for integrity of.....
V1 - nasociliary
29
Name some symptoms of a LMN lesion
``` weakness paralysis atrophy fasciculation loss of tendon reflexes ```
30
T or F: facial nerve innervates the parotid gland
F (facial going through the facial canal via the stylomasoid foramen....enters inside the parotid gland to form the parotid plexus....though does not innervate it
31
Muscles of facial expression: ``` surprise concern anger blowing cheeks smile kissing sadness pouty lip ``` eyes closed gently...tightly?
occipitofrontalis corrugator supercilli lev. lab. sup. + alar nasalis buccinator + orbicularis oris risorius orbicularis oris dep. anguli oris mentalis orb. oculi = palp; orbital part if tightly
32
Bell's palsy - LMN lesion Signs/symptoms?
decreased tone of orb. oculi (droopy eyelid), orb, oris (cannot keep mouth closed - drool), paralysis of stapedius (failure to dampen sound)
33
What two nerves pass deep to the maxillary artery and vein? What passes superficial to maxillary artery?
inferior alveolar (V3), lingual nerve (V3) buccal nerve (V3)
34
What nerve passes through the folds of mylohyoid? What nerve passes on the underside of the sublingual gland?
hypoglossal lngual nerve
35
What vessels do the auricotemporal nerve (V3) wrap around?
middle meningeal a/v
36
When you scratch your nose - what may be perforated and lead to a nose bleed?
kisselback septal area (anastamoses) | and or/ anterior/posterior ethmoidal aa
37
All the constrictors of the pharynx attach where?
pharyngeal median raphe
38
What structure do you target when yawning on a plane?
pharyngotympanic tube (innervated by maxillary nerve) eustachian tube There are four muscles associated with the function of the Eustachian tube: Levator veli palatini (innervated by the vagus nerve) Salpingopharyngeus (innervated by the vagus nerve) Tensor tympani (innervated by the mandibular nerve of CN V) Tensor veli palatini (innervated by the mandibular nerve of CN V) The tube is opened during swallowing by contraction of the tensor veli palatini and levator veli palatini, muscles of the soft palate
39
What innervates the voice box?
internal and laryngeal nerve of vagus nerve
40
3 muscles of the soft palate
PUP palatoglossus palatopharyngeus uvula innervation: pharyngeal branch of CN X (helps with swallowing)
41
Which one of these are innervated by the medial pterygoid nerve of CN V3? levator veli palatini tensor veli palatini
tensor veli palatini
42
LMN lesion of left CN X - leads to deviation of the uvula to which side?
right side
43
Level of the hyoid bone
C3-C4 IVD
44
CN IX, lingual artery, and stylohyoid are all.....
deep to hyoglossus muscle
45
lingual nerve and hypoglossal nerve is superficial....
hyoglossus muscle
46
branchial arches 1 2 3 4-6
CN V3 (muscles of mastication) CN VII (muscles of facial expression) CN IX - stylopharyngeus CN X - pharynx, larynx, soft palate, upper 2/3 of esophagus (speech/swallowing)
47
wtf is the fauces? what is that visible vein under the tongue?
space between oral cavity and oropharynx deep lingual vein
48
Injury to CN XII on the right side would lead to deviation of the tongue to....
ipsi side - right side When the tongue is protruded, its apex deviates toward the paralyzed side because of the unopposed action of the genioglossus.
49
Innervations of extraocular muscles lev. palp. sup. sup. oblique inf. oblique superior rectus inferior rectus medial rectus lateral rectus
all are oculomotor except: lateral rectus = abducens (CN VI) superior oblique = trochlear nerve (CN IV)
50
Actionsof extraocular muscles lev. palp. sup. sup. oblique inf. oblique superior rectus inferior rectus medial rectus lateral rectus
EL of upper lid ROT down + medial, depression of the eye ABD, rotation up and lateral, elevation of adducted eye EL + ADD of eye DEP + ADD of eye ADD of eye ABD of eye
51
T or F: CN III is the only CN that passes through the SOF
F - also CN IV
52
T or F: all 3 branches of V1 pass through the SOF
T - frontal, nasociliary, lacrimal
53
CN V2 how many foramen do the post-synaptic branches of the pterygopalatine ganglion go through?
4 lesser + greater palatine foramina palatovaginal canal sphenopalatine foramen
54
What nerve travels through the sphenomandibular ligament? Mental nerve of V3 goes through which foramen?
mylohyoid nerve to m and ant. diagastric mental foramen
55
2 main branches of CN III?
superior branch inferior branch
56
3 main branches of CN V1
frontal lacirmal nasociliary
57
6 main branches of CN V2
infraorbital alveolar nerves (4) zygomatic roots to pterygopalatine ganglion greater/lesser paaltine nasopalatine nerve
58
4 main branches of CN V3
auriculotemporal buccal lingual inferior alveolar --> mental
59
7 main branches of CN VII
``` temporal zygomatic buccal mandibular cervical post. auricular greater petrosal ```
60
Lesser petrosal nerve is from which CN?
CN IX
61
branches of vagus nerve
The right vagus nerve passes anterior to the subclavian artery and posterior to the sternoclavicular joint, entering the thorax. The left vagus nerve passes inferiorly between the left common carotid and left subclavian arteries, posterior to the sternoclavicular joint, entering the thorax. Several branches arise in the neck: Pharyngeal branches – Provides motor innervation to the majority of the muscles of the pharynx and soft palate. Superior laryngeal nerve – Splits into internal and external branches. The external laryngeal nerve innervates the cricothyroid muscle of the larynx. The internal laryngeal provides sensory innervation to the laryngopharynx and superior part of the larynx. Recurrent laryngeal nerve (right side only) – Hooks underneath the right subclavian artery, then ascends towards to the larynx. It innervates the majority of the intrinsic muscles of the larynx. In the Thorax
62
facial vein drains into..... posterior auricular v + posterior branch of the retromandibular v. = ............. superficial temporal v + maxillary v. = ..............
Facial vein provides primary drainage of superficial face into Internal Jugular Vein (latter drains dural sinuses). External Jugular V is formed by union of Posterior Auricular V & posterior branch of Retromandibular V. Retromandibular V is formed by union of Superficial temporal V with Maxillary V (latter drains pterygoid venous plexus of temporal fossa)
63
dysphagia - difficulty swallowing....due to injury to what nerve?
pharyngeal branch of vagus
64
dysarthria - difficulty speaking - due to injury of what?
recurrent laryngeal n
65
CN III palsy signs/symptoms
1. ipsi ptosis (dysfunctional lev. palp. sup) 2. downward, ABD eye due to unopposed superior oblique + lateral rectus 3. dilation and accomodation of ipsi pupill
66
CN IV palsy signs/symptoms
upward, ADD of eye (unopposed inferior oblique and medial rectus)
67
CN VI palsy signs/symptoms
eye deviates medially (unopposed lateral rectus)
68
Horner's syndrome injury to what? signs/symptoms?
blockage of symp. nerve. plexus at the cavernous sinus dilation of skin vessels - flushed look ptosis hypersecretion of lacrimal gland (parasympathetic is working unopposed) miosis (vasoconstriction) - note that vasodilation is a sympathetic reaction
69
Referral cardiac pain - spinal levels
T1-T5
70
Sympathetic NS Pregang axons - long or short? Postgang ganglia - close or far from CNS? cholinergic or cathecholaminergic?
short close to CNS cathechol.
71
Parasympathetic NS Pregang axons - long or short? Postgang ganglia - close or far from CNS? cholinergic or cathecholaminergic
long close to viscera cholinergic.
72
T or F: parasympathetic preganglionic neurons are located around T1-L2(L3)
F - that's sympathetic
73
Parasympthetic ganglion ``` CN III (3) CN VII (7) CN IX (9) CN X (10) ```
E-W nucleus - ciliary (intimate with ICA) Superior salv nucleus - pterygopalatine (intimate with ICA) + submandibular (intimate with facial artery) inferior salv nucleus - otic (intimate with maxillary artery) dorsal vagal - MULITPLE close to the target organ
74
Symp. fibers reach the tongue by way of ..... lingual nerve lingual artery hypoglossal nerve glossopharyngeal nerve
lingual artery
75
Which nerve is at risk if you were to remove a stone around the submandibular region? What vessel is also around there? (within the submandibular triangle)
lingual nerve facial artery
76
What muscle separates the submandibular triangle from the paralingual space?
mylohyoid
77
Loss of sensation from temporal region + secretion of parotid; which nerve is affected?
auriculotemporal nerve (V3)
78
T or F: buccinator/buccal stuff is associated with the facial nerve (facial expressions)
F - NO! BUCCINATOR, BUCCAL BRANCHES ALL ASSOCIATED WITH MANDIBULAR V3 buccal nerve passes anterior to TMJ + squished between heads of lateral pteryo.
79
5. The fibrous capsule of TMJ (temporomandibular joint) is innervated by the _______________________ (3/4 answers) a. Auriculotemporal nerve b. Inferior alveolar nerve c. Buccal nerve d. Parotid nerve branches e. Masseter nerve f. Deep anterior temporal nerves g. Deep posterior temporal nerves h. Lateral pterygoid nerve i. Medial pterygoid nerve j. Facial nerve k. Chorda tympani nerve l. Mylohyoid nerve
A E (F,G)
80
15. The blood supply to which of the following structures/regions would be affected as a result of the blockage of the artery labelled A (artery A is Inf. Alv. A) a) TMJ (temporomandibular joint) b) Calvaria c) Otic ganglion d) Chin region e) Infratemporal fossa
d
81
Wtf is a bregma?
bregma - anterior font. closure (tip top of head) the point or area of the skull where the sagittal and coronal sutures joining the parietal and frontal bones come together.
82
What innervates the buccinator muscle?
BUCCAL BRANCHES OF THE FACIAL NERVE (note: not the BUCCAL NERVE OF V3 buccal nerve = The buccal nerve (long buccal nerve) is a nerve in the face. It is a branch of the mandibular nerve (which is itself a branch of the trigeminal nerve) and transmits sensory information from skin over the buccal membrane (in general, the cheek) and from the second and third molar teeth.
83
T or F: lateral ptery m. attaches to the temporal bone
F - sphenoid bone
84
T or F: medial ptery m. attaches to the sphenoid bone
T - sphenoid, maxilla
85
Horner syndrome results from an interruption (block) of sympathetic innervations on the ipsilateral side of the head. All of the following symptoms would occur, EXCEPT: A. Miosis (constricted pupil) B. Ptosis (partial drooping of the eyelid) C. Anhidrosis (loss of hemifacial sweating ) D. Redness of the skin (vasodilation) E. Paler of the skin (vasoconstriction) F. Hypersecretion of the lacrimal gland
E
86
Sphincter pupillae m: preganglionic = ??? postganglionic = ???
Sphincter pupillae m: preganglionic = CN III postganglionic = ciliary ganglion
87
Dilator pupillae m: ``` preganglionic = ?? postganglionic = ?? ```
Dilator pupillae m: preganglionic = T1-T3 spinal cord segments postganglionic = sympathetic internal carotid plexus
88
Ciliary m : preganglionic = postganglionic =
Ciliary m : preganglionic = CN III postganglionic = ciliary ganglion
89
Levator palp. Superioris deep/smooth fibers: postganglionic = ???
Levator palp. Superioris deep/smooth fibers: postganglionic fibers of internal carotid sympathetic nerve plexus via long ciliary nerve
90
All statements regarding the lingual nerve are correct, EXCEPT: A. Emerges from the cover of the lateral pterygoid; joint by chorda tympani B. It proceeds down & forwards lying on the surface of medial pterygoid C.It is intimately relates to the bone posterior to the third molar D.It lies anterior to & slightly deeper than the inferior alveolar nerve E. It passes downward & forward on the deep surface of mylohyoid m F. It passes medial to hyoglossus m G. It descends on the medial surface of deep portion of the submandibular gland H. It runs below the submandibular duct, and then crosses it from lateral to medial.
H
91
Temporal fossa contents: nerves (5)
Nerves: Zygomatictemporal (CN V2) Auriculotemporal (CN V3): superficial temporal branch Lesser occiptal Deep temporal (CN V3) Temporal branches of facial nerve to facial expressions
92
Temporal fossa contents: vessels (2)
SUPERFICIAL TEMPORAL ARTERY + VEIN
93
What nerve most likely to be injured during the extraction of the third lower molar tooth? ``` A. Auriculotemporal nerve B. Buccal nerve C. Mylohyoid nerve D. Lingual nerve E. Inferior alveolar nerve F. Masseteric nerve G. Infraorbital nerve ```
D
94
2. Which of the following emerges from the tympanomastoid fissure? a) Auriculotemporal nerve: parotid branches b) Auriculotemporal nerve: auricular branches c) Great auricular nerve: auricular branches d) Occipital artery: auricular branches e) Superficial temporal artery: auricular branches f) Maxillary artery: deep auricular branches g) Glossopharyngeal nerve: lesser petrosal nerve h) Vagus nerve: auricular branches
H
95
4. Which muscle found on the face shares a common origin with a muscle of the pharynx? (PTERYGOMANDIBULAR RAPHE) ``` Orbicularis oris Depressor anguli oris Risorius Buccinator Mentalis Depressor labii inferioris ```
buccinator
96
5. Which of the following structures is located deep to the hyoglossus muscle: ``` Hypoglossal nerve Glossopharyngeal nerve Submandibular duct Lingual nerve Submandibular gland ```
Glossopharyngeal nerve
97
7. Spasm of the left sternocleidomastoid muscle (torticollis or wry neck) results in: Elevation and rotation of the chin to the left Elevation and rotation of the chin to the right Depression and rotation of the chin to the left Depression and rotation of the chin to the right Flexion of the neck and elevation of the chin
Elevation and rotation of the chin to the right
98
Question # 9: choose 2 correct answers: 9. All of the following are enclosed by or embedded in the carotid sheath, EXCEPT: ``` Common carotid artery Internal carotid artery External carotid artery Internal jugular vein Vagus nerve Glossopharyngeal nerve Hypoglossal nerve Superior root of the ansa cervicalis Inferior root of the ansa cervicalis Spinal accessory nerve Cervical sympathetic trunk ```
Superior root of the ansa cervicalis External carotid artery
99
Which of the following is the function of the pharyngeal dilators? ``` Elevation of the pharynx Shortening of the pharynx Widening of the pharynx Elevation of the larynx Promotion of the swallowing Promotion of the speech All of the above ```
all of the above
100
Fracture of the apex of styloid process would affect which of the following? ``` Superior pharyngeal constrictor Middle pharyngeal constrictor Inferior pharyngeal constrictor Digastric muscle: posterior belly Pterygo-mandibular raphe ```
middle pharyngeal constrictor
101
If a patient experiences Horner’s Syndrome, what aspect of the nerve is affected? ``` Ciliary parasympathetic ganglion Superior cervical trunk (ganglion) Middle cervical trunk (ganglion) Sympathetic nerve plexus of internal carotid artery Inferior cervical trunk (ganglion) ```
Sympathetic nerve plexus of internal carotid artery

AN 1107 - Head & Neck (1 decks)

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