NBDE: ANTATOMICAL SCIENCES: Nerves Flashcards
(365 cards)
1
Q
Preganglionic parasympathetic fibers reach the otic ganglia thru which nerve?
A
lesser petrosal nerve
2
Q
the glossopharyngeal nerve is a mixed nerve (motor and sensory) T/F
A
true
3
Q
what 3 CNs come from the medulla oblangata
A
IX, X, XI
4
Q
- The _ nerve provides the efferent (motor) limb of the gag reflex
- The _ nerve provides the afferent limb of the gag reflex
A
- CNX
2. CNIX
5
Q
your most recent patient presents to your office complaining of severe pain in his jaws around the TMJ joint. He chews 3 packs of gum a day and he grinds his teeth what nerve provides major sensory innervation to the TMJ?
A
auriculotemporal nerve
from posterior division of V3
6
Q
auriculotemporal nerve
(from posterior division of V3) supplies the anterior/posterior portion of the TMJ?
A
posterior
7
Q
the nerve to the masseter (massetric nerve) is a branch of
A
V3
8
Q
3 branches of V3 carry sensory fibers to the TMJ:
- _ carries sensory fibers to the posterior portion of the TMJ
- _ and _ carries sensory fibers to the anterior portion of the TMJ
A
- auriculotemporal nerve
2. deep temporal nerve and massetric nerve/nerve to the masseter
9
Q
pain impulses from a patient’s fractured condylar neck are carried by the _ nerve
A
auriculotemporal nerve
10
Q
pain (TMJ) is transmitted in the capsule and periphery of the disc by the _ nerve
A
auriculotemporal nerve
11
Q
the auriculotemporal nerve
carries some secretory fibers from __ ganglion to the parotid gland
A
otic ganglion
12
Q
All joints (including the TMJ) receive _ motor innervation
A
no.
the muscles that move the joint receive motor innervation
13
Q
the arterial supply to TMJ (2)?
A
superficial temporal and maxillary branches of the external carotid artery
14
Q
when walking to his car late at night a guy hears footsteps behind him, his sympathetic response that results for the head and neck is mediated by cell bodies in the _ ganglion
A
superior cervical ganglion
15
Q
paravertebral sympathetic ganglia lie on both sides of the vertebrae and are connected forming the _
A
sympathetic chain or trunk
16
Q
how many pairs of the paravertebral sympathetic ganglia are there that form the sympathetic trunk?
A
21 or 23 pairs: 3 in cervical, 12 in thoracic, 4 in lumbar, 4 in sacral and a single unpaired ganglion in front of the coccyx called the ganglion impar
17
Q
ganglion impar
A
the only unpaired sympathetic ganglia that lies in front of the coccyx
18
Q
superior cervical ganglion (sympathetic ganglia) is the uppermost and largest stretching from what level?
A
C to level C2 or C3
19
Q
the superior cervical ganglion lies bw the _ and _
A
ICA and IJV
20
Q
the superior cervical ganglion (sympathetic ganglia)innervates viscera of the _
A
head
21
Q
the middle cervical ganglion (sympathetic ganglia) is located at the level of the
A
cricoid cartilage.
22
Q
the middle cervical ganglion (sympathetic ganglia) innervate viscera of the
A
neck, thorax, and upper limb
ie. bronchi and heart
23
Q
the inferior cervical ganglion (sympathetic ganglia) occurs at _ level
A
C7
24
Q
the inferior cervical ganglion (sympathetic ganglia) most commonly is fused to the first thoracic sympathetic ganglion to form a _ ganglion
A
stellate
25
the inferior cervical ganglion (sympathetic ganglia) innervates the
viscera of the neck and thorax and upper limb (same as the middle cervical ganglion (sympathetic ganglia). ie bronchi and heart
26
the three cervical sympathetic ganglia are
superior (largest) @ C1 to C2-C3
middle (@ cricoid cartilage)
inferior (@C7)
27
the thoracic chain ganglia (sympathetic ganglia) sends postganglionic fibers to the _ up to the
entire GI tract up to the upper colon
28
the lumbar and sacral ganglia ((sympathetic ganglia)) send postganglionic sympathetic fibers to the
GI tract below the upper colon, including the rectum, and smooth muscle glands of the bladder and external genitalia
29
_ syndrome = combo of drooping of the eyelid (ptosis) and constriction of the eye (miosis) sometimes accompanied by decreased sweating of the face on the same side; redness of the conjunctiva of the eye is also often present
Horner's
30
the gray/white rami connect the sympathetic trunk to the spinal nerve
gray
31
the white rami are limited to the spinal cord segments bw
T1 and L2
32
the cell bodies of the visceral efferent fibers in visceral branches of the sympathetic trunk are located in the _ of the spinal cord
intermediolateral cell column (aka lateral horn)
33
the cell bodies of visceral AFFERENT fibers are located in the
dorsal root ganglia
34
which trigeminal nuclei is involved in proprioception of the face?
mesencephalic (midbrain)
35
the 3 sensory nuclei for CN V
mesencephalic -proprioception (midbrain)
pontine aka main sensory nucleus or chief nucleus-touch (pons)
nucleus of spinal tract -pain and temp (pons/SC)
36
mesencephalic is involved in proprioception of the face = feeling of position of muscles. unlike many nuclei in CNS this nucleus contains no _ but is electrically coupled
chemical
37
neurons of the mesencephalic nucleus are _ polar cells, receiving info from the mandible and sending its projections to the motor trigeminal nucleus to mediate monosynaptic jaw jerk reflexes.
pseudounipolar
38
the main sensory nucleus of CN V is a group of __ order neurons which have cell bodies in the
second
| dorsal pons
39
which nucleus of CN V receives info about discriminative sensation and light touch of the face as well as conscious proprioception of the jaw via first order neurons?
the main sensory nucleus aka chief nucleus aka pontine nucleus
40
info into the main sensory nucleus aka chief nucleus aka pontine nucleus (CN V) from the oral cavity travels to the _ of the thalamus via the DORSAL trigeminothalmic tract
ipsilateral ventral posteromedial (VPM) of the thalamus
41
most the info into the main sensory nucleus aka chief nucleus aka pontine nucleus (CN V) other than from the oral cavity travels to the _ of the thalamus via the VENTRAL trigeminothalmic tract
contralateral ventral posteromedial (VPM) of the thalamus
42
which nucleus of CN V mediates pain and temperature from the head and neck
spinal nucleus aka nucleus of the spinal tract
43
the spinal nucleus of CN V have 3 segments name them
subnucleus oralis (closest to the mouth), subnucleus interpolaris (middle) and subnuclues caudalis (near tail)
44
in which segment of the spinal nucleus of CN V do pain fibers synapse
subnuclues caudalis (near tail)
45
the trigeminal motor nucleus contains motor neurons that innervate muscles of the _ branchial arch
1st.
46
the trigeminal motor nucleus is located where in the brainstem
pons
47
all nucleus of CN V are in the pons except
the mesencephalic = midbrain
48
identify the CN V nucleus based on its function:
| supplies of the first branchial arch
motor nucleus
49
identify the CN V nucleus based on its function:
| pain/temp to face
spinal nucleus
50
identify the CN V nucleus based on its function:
| discriminative touch of face
pontine/main/chief sensory nucleus
51
identify the CN V nucleus based on its function: proprioception of the face
mesencephalic
52
```
preganglionic parasympathetic axons are associated with all of the following CN except
III
VII
V
IX
X
```
V
53
name the 4 paired parasympathetic ganglia that innervate the head and neck
ciliary, pterygopalatine, submandibular, otic
54
each parasympathetic ganglia of CNs has a ___ root that carries PREsynaptic parasympathetic nerve fibers that terminate in the ganglion by synapsing with the postsynaptic fibers that travel to target organs
motor
55
each parasympathetic ganglia of CNs has a ___ root that carries POSTsynaptic sympathetic fibers that traverse the ganglion w/o synapsing.
sympathetic
56
each parasympathetic ganglia of CNs has a ___ root that carries general sensory fibers that also do not synapse in the ganglion
sensory
57
the ciliary ganglion is in the posterior part of the orbit on the lateral side of the optic nerve. what fibers are in there?
preganglionic PNS fibers from the oculomotor nerve
postganglionic PNS fibers leave ganglion in the short ciliary nerves
sympathetic fibers from the internal carotid plexus
58
the pterygopalatine ganglion in the pterygopalatine fossa has what fibers in there?
1.preganglionic secretomotor fibers arise in the lacrimal nucleus of the facial nerve.
postganglionic
2. parasympathetic fibers reach the maxillary nerve by one of tits ganglionic branches-these reach the lacrimal gland. others run in the palatine and nasal nerves to the palatine and nasal glands
3. sympathetic fibers reach the ganglion via the internal carotid plexus
59
submandibular ganglion is located
on the hyoglossal muscle
60
submandibular ganglion fibers?
1. preganglionic PNS fibers reach the ganglion from the superior salivatory nucleus of the facial nerve via the chorda tympani and lingual nerves
2. postganglionic PNS fibers pass to the submandibular gland. others pass to sublingual gland
3. sympathetic fibers are vasomotor to the BV's of glands
61
the otic ganglia is located
below foramen ovale medial to the mandibular nerve (V3)
62
Fibers in otic ganglia?
preganglionic PNS fibers originate in the inferior salivatory nucleus of the glossopharyngeal nerve
Postganglionic PNS fibers leave the ganglion and join the auriculotermporal nerve, fibers are secretomotor to the parotid gland
63
only one CN emerges from the dorsal aspect of the brainstem. which one?
trochlear nerve (IV)
64
what nerves exit the cranium thru the superior orbital fissure
oculomotor, trochlear, and abducens (III, IV, VI) = all the eye related
65
oculomotor, trochlear, and abducens (III, IV, VI) innervate the intrinsic/extrinsic ocular muscles?
extrinsic = result in movement of the eyeball
66
the trochlear nerve supplies the _ muscle that turns the eyeball?
superior oblique muscle: turns the eyeball inferiorly and laterally
67
which nerve is the smallest cranial nerve of all
trochlear nerve (IV) = also the only one that exits the dorsal aspect of the brainstem.
68
trochlear nerve innervates ipsilateral/contralateral structures
contralateral only
69
the oculomotor nerve supplies what extraocular muscles (5)
medial, superior, inferior recti. inferior oblique and levator palpebrae superioris
70
the oculomotor nerve sends preganglionic PNS fibers to the _ ganglion
ciliary
71
the postganglionic fibers leave the ciliar ganglion in the _ nerve to supply the sphincter pupillae and the ciliary muscle
short ciliary
72
in most cases, ptosis is caused by what 2 things?
a weakness of the levator muscle (muscle that raises the lid) or a problem with the oculomotor nerve
73
__nucleus contains the PNS ganglionic cells whose efferent axons in the oculomotor nerve travel to the ciliary ganglion
Edinger Westphal
74
The pupillary light reflex: the _ nerve is responsible for the AFFERENT limb of the pupillary reflex.
the efferent limb of the pupillary reflex is the _ nerve
optic nerve
efferent: oculomotor
75
The fovea/macula = very high density of __
cones and no rods
76
Highest area of visual acuity in the eye is the.
fovea
| When we move our eyes around, we are trying to get light to hit the fovea
77
diabetic retinopathy
Diabetic retinopathy: long term diabetes: go blind: blood leaks into vitrous humor and clouds it. If humor clouds up, light doesn’t get thru like it is supposed to
78
the splanchnic nerves (greater, lesser, and least) arise from the _ sympathetic ganglion (chain): cervical/thoracic/lumbar/sacral
thoracic sympathetic ganglion (chain)
79
paravertebral sympathetic ganglia lie on each side of the vertebrae and are connected to form the
sympathetic chain or trunk
80
sympathetic ANS is a _ system
motor
81
sympathetic chain origin starts bw
T1 and L2
82
sympathetic chain ganglia is aka
paravertebral sympathetic ganglia
83
the greater splanchnic sympathetic fibers arise from which vertebral levels and end in the _ ganglion
T5-T9 = pass thru diaphragm and into celiac ganglia
84
the lesser splanchnic sympathetic fibers arise from which vertebral levels and end in the _ ganglion
T10 and T11 = passes thru diaphragm with the greater splanchnic to end in the aorticorenal ganglion
85
the least splanchnic sympathetic fibers arise from which vertebral levels and end in the _ ganglion
T12 = pierce diaphragm and ends in the renal plexus
86
the greater, lesser and least splanchnic nerves are pre ganglionic sympathetic and all pierce the
diaphragm
87
```
which nerve penetrates the cricothyroid membrane:
recurrent laryngeal nerve
facial nerve
accessory nerve
internal laryngeal nerve
```
recurrent laryngeal nerve
88
both recurrent laryngeal nerves pass deep to the lower margin of the inferior constrictor muscle to innervate the _ muscles of the larynx responsible for controlling the movements of the vocal folds
intrinsic
89
the right recurrent laryngeal nerve innervates all the muscles of the larynx except the
cricothyroid
90
the cricothyroid muscle is supplied by the _
external laryngeal branch of the superior laryngeal nerve
91
the mucous membrane of the larynx below the vocal folds, the mucous membrane of the upper part of the trachea
right recurrent laryngeal nerve
92
the left recurrent laryngeal nerve innervates the same muscles and mucous membranes as the right recurrent laryngeal except
on the left side
93
the right recurrent laryngeal nerve splits from the right vagus before entering the _ mediastinum at the level of the right subclavian artery
superior
94
the left vagus gives rise to the _ nerve
left recurrent laryngeal nerve
95
_ nerves are vulnerable during thyroid surgery. if one of these nerves are damaged =will be affected
recurrent laryngeal nerves
| quality of voice = resulting in hoarseness (rough voice)
96
which is longer the left/right laryngeal nerve
left
97
the _ laryngeal nerve branches from the vagus and loops under the arch of the aorta
left
98
the right laryngeal nerve loops where?
around the right subclavian artery
99
the hypoglossal nerve travels from the carotid triangle into the submandibular triangle of the neck. T/F
true
100
a unilateral lesion to the hypoglossal nerve results in the deviation of the protruded tongue toward the affected side. this is due to the lack of function of the _ muscle on the diseased side
genioglossus muscle
101
injury to hypoglossal nerve eventually produces paralysis and atrophy of the tongue on the affected side with the tongue deviated to the affected side. Dysarthria may also be found. what does that mean
inability to articulate
102
if the __ muscle is paralyzed the tongue has a tendency to fall back and obstruct the oropharyngeal airway with risk of suffocation.
genioglossus (innervated by CN XII)
103
after depositing enough lidocaine to anesthetize the nerve entering the mandibular foramen a dental student removes the needle to approximately half the depth of the initial target hereupon another bolus of anesthetic is deposited. hat nerve is most likely anesthetized by the second bolus?
a. hypoglossal
b. long buccal nerve
c. inferior alveolar nerve
d. lingual nerve
e. glossopharyngeal nerve
lingual nerve
104
the _ nerve supplies the general sensation for the anterior 2/3 of the tongue, the floor of the mouth, and mandibular lingual gingiva
lingual nerve
105
what nerve crosses the submandibular duct twice
lingual
106
the lingual nerve descend deep to the _ muscle where it is joined by the _ which is a branch of the _ nerve
lateral pterygoid
chorda tympani
facial nerve VII
107
if you cut the lingual nerve after its junction with the chorda tympani, the tongue would _
lose taste and tactile sense to the anterior 2/3
108
the chorda tympani emerges from a small canal in the posterior wall of the tympanic membrane, the ___
petrotympanic fissure
109
the chorda tympani joins the lingual nerve where
in the infratemporal fossa
110
the chorda tympani nerve conveys _ fibers (motor fibers) of the parasympathetic division of the autonomic nervous system to the submandibular ganglion. It also carries ____ for taste
general visceral EFFERENT
| special visceral AFFERENT fibers for taste
111
the lesser petrosal nerve carries preganglionic parasympathetic fibers to which ganglia
otic
112
the only muscle supplied by the glossopharyngeal nerve is
stylopharyngeus muscle (via the muscular branch)
113
the stylopharyngeus muscle is the landmark for locating the _ because as the nerve enters the pharyngeal wall it curves posteriorly around the lateral margin of this muscle
glossopharyngeal nerve
114
glossopharyngeal nerve provides somatic motor innervation to the sylopharyngeus muscle and supplies preganglionic parasympathetic motor fibers to the _ ganglion which synapse w postganglionic fibers in the ganglion to supply the _
parotid gland
115
the preganglionic nerves leave the glossopharyngeal nerve as the _ which enters the _ and participates in the formation of the tympanic plexus
tympanic nerve
| middle ear cavity
116
postaganglionic fibers exiting the otic ganglion are carried by the _ nerve to the parotid gland
auriculotermporal nerve (V3)
117
THE GLOSSOPHARYNGEAL nerve visceral sensory branches:
1. lingual branches - 2 branches that supply?
2. pharyngeal
3. carotid sinus nerve
1. one supplies the vallate papillae and mucous membrane of the base of the tongue. the other supplies the mucous membrane and follicular glands of the posterior one third of the tongue and communicates with the lingual nerve
118
THE GLOSSOPHARYNGEAL nerve visceral sensory branches:
1. lingual branches
2. pharyngeal -????
3. carotid sinus nerve
distributed to mucous membrane of the pharynx. it is the SENSORY limb of the GAG REFLEX
119
THE GLOSSOPHARYNGEAL nerve visceral sensory branches:
1. lingual branches -
2. pharyngeal
3. carotid sinus nerve ???
```
to carotid sinus (baroreceptor)
carotid body (chemoreceptor)
```
120
the cervical plexus consists of anterior rami from C1-C4; some of these fibers reach the hyoid muscles by running concurrently with which cranial nerve?
hypoglossal nerve
121
adjacent _ rami will form interwoven network of nerve fibers (axons) known as nerve plexus
ventral
122
four plexus: cervical, brachial, lumbar, and sacral emerging from each plexus will be specifically named _nerves which contain fibers from multiple spinal cord levels.
peripheral
123
the cervical plexus is what level?
C1-C4
124
ansa cervicalis, phrenic nerve, and great auricular nerve are all part of the
cervical plexus
125
the cervical plexus: ansa cervicalis is what level?
C1-C3
126
ansa cervicalis supplies ___muscles except the _
infrahyoid
| except thyrohyoid
127
the thyrohyoid is supplied by
C1 ONLY
128
mnemonic to remember the ansa cervicalis muscles (infrahyoid)
"Gene THought SOmeone STupid SHot Irene":
```
Geniohyoid
Thyrohyoid
Superior Omohyoid
Sternothyroid
Sternohyoid
Inferior omohyoid
```
129
the phrenic nerve of the cervical plexus are what nerves? supplies?
C3-C5 supplied diaphragm = C3, 4, 5 keeps your diaphragm alive
130
great auricular nerve of the cervical plexus is what nerves and supplies what?
C2 and C3= provides sensory innervation for the skin over parotid and mastoid process and both surfaces of the outer ear
131
the brachial plexus are what nerves
C5-C8 and T1
132
the brachial plexus is formed in the_ triangle of the neck, and extends onto the axilla supplying the nerves to the upper limb
posterior
133
name the 3 cords of the brachial plexus
posterior
lateral
medial
134
the posterior cord of the brachial plexus has what 2 main branches
axillary and radial nerves
135
the lateral cord of the brachial plexus has what main branch
musculocutaneous nerve
136
the medial cord of the brachial plexus has what main branch
ulnar
137
the median nerve forms its two heads (medial and lateral) from the _ and _ cords
medial and lateral
138
the lumbar plexus is what nerves
L1-L4
139
the lumbar plexus is formed in the _ muscle
psoas
140
the lumbar plexus is formed in the psoas muscle and supplies the _
lower abdomen and parts of the lower limb
141
the main branches of the lumbar plexus = _ and _
femoral and obturator nerves
142
sacral plexus is at hat levels
L4-L5 and S1-S4
143
sacral plexus lies in the _ in front of the _ muscle
posterior pelvic wall in front of the piriformis muscle
144
the sacral plexus supplies the _
lower back, pelvis, and parts of the thigh, leg and foot
145
the main branch of the sacral plexus is the
sciatic
146
the sciatic nerve is unique bc
it is the largest nerve in our body
147
the branch of the trigeminal nerve that innervates the midface, palate, and paranasal sinuses exits the cranial cavity thru which structure?
foramen rotundum- the nerve is the maxillary nerve (V2)
148
the ophthalmic division (V1) enters the orbit thru the _ and provides _ innervation to the eyeball, tip of nose, skin over the upper eyelid, and skin of the face above the eye
superior orbital fissure
| sensory
149
1. the skin of the lower eyelid is supplied by __
| 2. the rest is supplied by branches of the _
1. branches of the infratrochlear at the medial angle
| 2. infraorbital nerve of the maxillary division
150
during a sinus attack, painful sensation from the ethmoid cells is carried in the _ nerve
nasociliary
151
the ophthalmic nerve is pure_
sensory
152
1. the ophthalmic nerve is often infected with _, whereas involvement of the lower two divisions is rare
herpes zoster virus
153
the maxillary division (V2) passes thru the foramen _ and provides _ innervation to the midface (below the eye and above the upper lip), palate, paranasal sinuses, and the maxillary teeth
rotundum
154
name the 7 main branches of V1
lacrimal, frontal, nasociliary, supraorbital, supratrochlear, infratrochlear, and external nasal nerves
155
give path for branchial motor v3
Cell body of LMN in Trigeminal motor nucleus (pons) ==> foramen ovale ==> infratemporal fossa ==> branches to muscles
156
The Sensory cell bodies for V1, V2 and V3 are in the __ Ganglion. V1, V2 and V3 then branch from the Trigeminal Ganglion in the Cranial Cavity
Trigeminal
157
give the route for v1
Sensory Cell bodies in Trigeminal Ganglion, V1 branches from the ganglion in the cranial cavity, cavernous sinus, superior orbital fissure, orbit BRANCHES into the sensory nerves
158
name all the sensory branches of V1
1. Lacrimal nerve – lateral upper eyelid, lacrimal gland and some conjunctiva
2. Frontal nerve branches into:
- Supraorbital nerve – upper eyelid, forehead and scalp
- Supratrochlear nerve – upper eyelid, forehead and scalp
3. Nasociliary nerve branches:
- Long cilliary nerves - eyeball
- Posterior ethmoidal nerve – sphenoid sinus, ethmoid air cells and nasal cavity
- Anterior ethmoidal nerve – ethmoid air cells and nasal cavity
- External nasal branches – bridge of nose
- Infratrochlear nerve – medial upper eyelid and lacrimal sac
159
what muscles does V3 supply branchial motor to?
MUSCLES OF MASTICATION:
Medial pterygoid, lateral ptergoid, masseter, temporalis
OTHER MUSCLES:Tensor tympani, tensor veli palatini, mylohyoid, anterior belly of
digastric muscles
160
HOME OF V1 is the _ V1 branches from the trigeminal ganglion
orbit.
161
the tickling sensation felt in the nasal cavity just prior to sneezing is carried by the _
maxillary division of trigeminal (V2)
162
the branches of V2 are
infraorbital, zygomaticofacial, and zygomaticotemporal nerves
163
give path for V2
Sensory cell bodies in trigeminal ganglion => V2 branches from the ganglion in the cranial cavity => cavernous sinus => foramen rotundum => pterygopalatine fossa => V2 has some BRANCHES in the pterygopalatine fossa => V2 continues on as the infraorbital nerve => inferior orbital fissure => orbit => infraorbital canal => V2 has some BRANCHES in the infraorbital canal => infraorbital foramen => the TERMINAL BRANCHES of V2 (now the infraorbitla nerve) emerge from the infraorbital foramen.
164
Name the branches in the pterygopalatine fossa of V2:
BRANCHES IN THE PTERYGOPALATINE FOSSA
1. Posterior superior alveolar nerve - max. sinus and max molars, gingiva and bone
2. Zygomatic nerve - enters the orbit to branch into two nerves:
- Zygomaticofacial – skin over zygomatic arch
- Zygomaticotemporal – skin over ant. temple
3. Greater palatine nerve – hard palate distal to canines
4. Lesser palatine nerve – soft palate
5. Nasoopalatine nerve – nasal septum and hard palate
ant. to canines
6. Posterior lateral nasal nerves – lateral nasal wall
7. Pharyngeal nerve - nasopharynx
165
the maxillary nerve is solely _
sensory
166
which nerve is most frequently affected by tic doulourex?
tic doulourex = trigeminal neuralgia = V2
167
sensory innervation of the mandibular division (V3) is to the
skin of the cheek, skin of mandible, lower lip and side of head, TMJ, mandibular teeth, mucous membranes of the check, the floor of the mouth, and the anterior tongue.
168
mental, buccal, and auriculotemporal nerves are branches of what nerve
V3
169
does the trigeminal nerve contain parasympathetic component at its origin?
no
170
what nerve branches use the trigeminal nerve to distribute THEIR PARASYMPATHETIC preganglionic fibers?
CN III, VII, IX
171
the mylohyoid nerve is derived from the inferior alveolar nerve just before it enters the mandibular foramen. the mylohyoid nerve descends in a groove on the deep surface of the ramus of the mandible, to supply the mylohyoid and what other muscle?
anterior digastric
172
functions of mylohyoid? (3)
elevates hyoid bone, base of tongue and the floor of the mouth
173
origin of mylohyoid muscle is the _ found on the _ of the mandible
mylohyoid line on the BODY of the mandible
174
the sublingual gland is located superior/inferior to the mylohyoid muscle?
superior
175
when film is placed for a periapical vie of the mandibular molars, it is the _ muscle that gets in the way if it is not relaxed
mylohyoid (forms the floor of the mouth)
176
the mylohyoid muscle is one muscle or paired?
paired, flat, and triangular
177
swelling at the angle of the mandible and the lateral neck is often the result of exudates from what muscle
mylohyoid
178
name the suprahyoid muscles (5)
digastric muscles (ant and post), mylohyoid, genohyoid, stylohyoid
179
Suprahyoid muscle innervations:
1. anterior belly of digastric muscle
2. posterior belly of digastric muscle
3. mylohyoid
4. genohyoid
5. stylohyoid
1. V3 (My, Ass, Touches, TheToilet) = nerve to the mylohyoid
2. Facial nerve VII
3. V3 nerve to mylohyoid
4. geniohyoid: first cervical nerve thru the hypoglossal nerve
5. stylohyoid = facial nerve
180
REMEMBER!
1. the thyrohyoid (infrahyoid muscle) is supplied by
2. the geniohyoid (suprahyoid) is innervated by
1. C1
2. first cervical nerve thru the hypoglossal nerve
think you have one thyroid and you get one wish for the genie
181
the three muscles innervated by ansa cervicalis C1, C2 and C3 are?
SOS:
| sternohyoid, omohyoid, and sternothyroid
182
the first cervical nerve accompanies the _ CN to the suprahyoid region, and then it branches from it to reach the _ muscle
XII hypoglossal, thyrohyoid muscle
183
the mylohyoid nerve arises from the _ nerve, which is a branch of
inferior alveolar nerve, V3 (mandibular division)
184
which nerve innervates the medial rectus muscle of the eyeball
oculomotor (III)
185
the olfactory nerve (CNI) exits the skull from the _ of the _ bone
cribriform plate of ethmoid bone
186
the optic CNII nerve exits the skull via the _ in the _ bone
optic foramen (right above the Superior orbital fissure) = leads into optic canal = in lesser wing of the sphenoid bone
187
the oculomotor CN exits the skull from the _ in the _ bone
SOF
| sphenoid bone
188
trochlear and abducens nerves exit the skull from the _ in the _ bone
SOF
| sphenoid bone
189
which muscle and nerve of the eye is responsible for lateral gaze
abducens CN VI = lateral rectus
| contracts it so that the eye is abducted
190
a lesion in the abducens nerve results in
medial strabismus (cross eyed) and diplopia (double vision)
191
every cranial nerve that innervates the eye passes thru the SOF except for the
optic nerve = optic foramen
192
the corneal reflex is aka
blink reflex = involuntary blinking of eyelids elicited by the stimulation of the cornea (touching it), or by bright light, or any peripheral stimulus. this reflex should elicit a direct and consensual response (response of the opposite eye). 0.1sec reflex.
193
the corneal reflex (blinking reflex) is mediated by what 2 nerves?
V1 ophthalmic branch sensing the stimulus on the cornea, lid or conjunctive (afferent), and the VII facial nerve initiating the motor response (efferent)
194
the principal types of nerves found in the dental pulp are:
1. sympathetic and efferent
2. sympathetic and afferent
3. parasympathetic and efferent
4. parasympathetic and afferent
sympathetic and afferent fibers
195
the sensory nerve fibers in the dental pulp originate in the _ ganglion
trigeminal
196
place the sensory nerve fibers in the dental pulp in order of largest to smallest diameter
A beta > A delta > C fibers
197
A-delta fibers are myelinated/unmyelinated
myelinated
198
which fibers in the pulp are responsible for the first pain signal?
A-delta fibers
| think Delaram comes 1st and I am myelinated bc I am fast =
199
C-fibers are myelinated/unmyelinated and smallest in diameter
unmyelinated therefore small
200
C-fibers are called polynodal bc they
respond to multiple different stimuli such as mechanical, chemical, or thermal stimulation of the pulp.
201
which fibers mediate the "second pain signal" in the pulp
C-fibers
202
the pulp contains myelinated/unmyelinated fibers?
both
203
tooth pulp consists of dense/loose type of CT
loose = thin collagenous fibers arranged symmetrically plus a ground substance w/GAGs
204
Tooth pulp is highly innervated and vascularized tissue. Numerous fibroblasts are present. surrounding the pulp and separating it from the dentin are the
odontoblasts
205
pain originates in the pulp due to
free nerve endings (afferent fibers) which are the only type of nerve endings found in pulp and are specific receptors for pain.
206
vasomotor _ fibers in the pulp end on BVs
sympathetic
207
functions of pulp (3)
nutritive - very rich blood supply that surround the odontoblasts
formative - odontoblasts in peripheral layer form dentin
sensory - free nerve ending that make contact w odontoblasts
208
which of the CN's have visceral sensory innervation
CN IX and X
209
vagus nerve is a mixed nerve that leaves the brain from the _ and passes out the cranial cavity thru the
medulla
| jugular foramen
210
the vagus nerve descends in the neck in the _, and behind or infront of the ICA and common carotid arteries and IJV
carotid sheath
| behind the ICA and common carotid arteries and IJV
211
both right and left vagal trunks pass thru the _ mediastinum on the ___ and enter the abdominal cavity thru the diaphragm with the _
posterior
esophagus
esophagus
212
the vagus nerve supplies the viscera of the neck, thorax, and abdomen to the _ of the large intestine
left colic (splenic) flexure
213
the abdominal viscera BELOW THE LEFT COLIC FLEXURE and the pelvic and genitalia are supplied with preganglionic parasympathetic fibers from the _nerves
pelvic splanchnic
214
the pharyngeal plexus of nerves contains both motor and sensory components. the motor nerves come from the _ nerve
vagus
215
the vagus nerve forms the _ limb of the gag reflex
efferent (motor)
216
which is a component of the optic disc aka optic papilla?
```
central artery
cones
sensory efferent fibers
mylinated nerve fibers
oculomotor nerve
```
central artery
217
optic disc is the _ on the surface of the retina
small blind site = located to the nasal side of the macula
218
the only part of the retina that contains no photoreceptors (rods/cones) is the
optic disc
219
the optic disc/optic papilla contains myelinated/unmyelinated axons of ganglion cells exiting the retina to form the optic nerve
unmyelinated
220
the fibers of the axons of ganglion cells exiting the retina become myelinated when?
posterior to the optic disc and are accompanied by the central artery and vein of the retina
221
the optic nerve has only a _ component
special sensory = conveys visual info from the retina
222
visual signals enter the eye as light photons and are converted to electrical signals in the
retina
223
electric signals are carried via the optic nerves, chiasma and tract to the _ nucleus of each thalamus and then to the visual centers of the brain for interpretation
lateral geniculate
224
after exiting the eye at the __, the two optic nerves (one from each eye) will meet at the
optic disc
| optic chiasma
225
at the optic chiasma, which axons will cross to the opposite side?
medial (nasal) cross to opp side and lateral (temporal) stay on same side.
226
from the optic chiasma, axons that perceive the left visual field form the _ (R/L) optic tract
right
227
the primary visual cortex is in Brodmann's area _# of occipital lobe
17
228
the right visual field is interpreted in the _ hemisphere of the brain and vice versa
left
229
the __ artery of the retina (branch of the ophthalmic artery) pierces the optic nerve and gains access to the retina by emerging from the center of the optic disc.
central
230
which of the following ganglia receives fibers from the motor, sensory, and PNS components of the facial nerve and sends fibers that will innervate the lacrimal, submandibular and sublingual glands:
semilunar/geniculate/otic/ciliay
geniculate ganglion
231
the left optic tract contains:
a. fibers from the left eye only
b. fibers from the right eye only
c. fibers from the nasal half of the left eye and temporal half of the right eye
d. fibers from the temporal half of the left eye and nasal half of the right eye
fibers from the temporal half of the left eye and nasal half of the right eye
remember the optic nerve is in the optic canal in front of the optic chiasm, the tract is behind the chiasm, and radiations are in the brain.
232
the optic nerve (CN II) arises from
axons of ganglion cells of the retina which converge at the OPTIC DISC.
233
what are the only things that enter the optic canal aka optic foramen
ophthalmic artery and optic nerve
234
the optic nerves from both eyes join to form the
optic chiasma
235
the optic _ emerges from the optic chiasma and passes backward around the lateral side of the midbrain to reach the lateral geniculate body
tract
236
the left vagus nerve contributes to the anterior esophageal plexus t/f
true
237
the left vagus nerve passes in front/behind the left subclavian artery as it enters the thorax
in front
238
the left vagus nerve can be cut on the lower part of the esophagus to reduce_
gastric secretion = vagotomy
239
t/f the left vagus nerve carries parasympathetic postganglionic fibers
false
| it caries parasympathetic PREganglionic fibers
240
the left vagus nerve enters the thorax in front of the left subclavian artery and _ the left braciocephalic vein and the left lung
behind
241
the left vagus nerve enters the abdomen in front of the esophagus thru the ____of the diaphragm as the___
1. esophageal hiatus
| 2. anterior vagal trunk
242
the vagus nerves lose their identity in the esophageal plexus. At the lower end of the esophagus, branches of the plexus reunite to form an
anterior vagal trunk
243
the right vagus nerve crosses the anterior surface of the _ and enters the thorax posterior to the
right subclavian artery
| right brachiocephalic vein, azygos vein and right lung = contributing to the pulmonary plexus and esophageal plexus.
244
the azygos vein is on what side of the body
right
245
vagus supplies all of the muscles of the pharynx except the _
stylopharyngeus (IX)
246
vagus supplies motor to all the palatal muscles except for the
tensor veli palitini (V3)
247
vagus nerve provides parasympathetic to the
lungs, heart, stomach, and mysenteric plexus
248
which nerve penetrates the thyrohyoid membrane:
a. facial nerve
b. internal laryngeal nerve
c. accessory nerve
d. recurrent laryngeal nerve
internal laryngeal nerve
249
the vagus nerve possesses 2 sensory ganglia:
| name them
superior ganglion and inferior ganglion
250
the superior ganglion lies on the vagus nerve __ the jugular foramen
within
251
the inferior ganglion lies on the vagus nerve __ the jugular foramen
just below
252
the two branches that arise from the superior ganglion from the vagus nerve that entered are the (2)
meningeal = supplies dura mater
| auricular - supplies auricle, external auditory meatus
253
the branches that arise from the inferior ganglion (from the vagus nerve that enters) are (2)
pharyngeal and the superior laryngeal
254
the pharyngeal branch emerging from the inferior ganglion forms the pharyngeal plexus and supplies?
all muscles of pharynx (except stylopharyngeus CN IX) and all muscles of the palate (except the tensor veli palitini V3)
255
what CN are found in the pharyngeal plexus that form it?
IX, X and sympathetic trunk
256
the internal laryngeal branch from the inferior ganglion of the vagus nerve travels with the _ artery and pierces the _
superior laryngeal artery
| thyrohyoid membrane
257
the superior laryngeal nerve from the inferior ganglion of the vagus nerve divides into
internal laryngeal and external laryngeal nerves
258
the external laryngeal travels with the _ artery and supplies the _ muscle
superior thyroid
| cricothyroid muscle
259
the recurrent laryngeal nerve penetrates the _ membrane from behind the joint
cricothyroid
260
nucleus ambiguous is located in the
ventrolateral medulla
261
nucleus ambiguous is a sensory or motor
motor
262
what nerves use nucleus ambiguous
IX, X, XI,
263
the somatic motor part of the vagus nerve axons come from which nucleus?
nucleus ambiguous = innervates soft palate, pharynx, larynx and upper esophagus
264
what nerve innervates the uvula?
X
265
a unilateral lesion in nucleus ambiguous would produce ipsilateral/contralateral paralysis of the soft palate, deviation of the uvula ___ the lesions side, nasal regurgitation (soft palate), hoarseness (larynx) and dysphagia (pharynx and upper esophagus)
ipsilateral
| deviation of the uvula away from the lesioned side
266
which cranial nerve supplies the derivatives of the hyoid arch?
IX/X/V/VII
facial
267
1. the cranial nerves that innervate the derivatives of the branchial arches are?
2. these are the only _ CN's
3. they are all called "branchiomeric" or non-somatic in origin bc they
1. CN V, VII, IX, and X
2. mixed
(all others are either sensory or motor nerves)
3. originate from the branchial arches
268
is the ophthalmic nerve (CN V1) "branchiomeric" aka non-somatic in origin?
no. it does not innervate branchial arch derivatives. it innervates structures derived from the paraxial mesoderm found in the frontonasal process of the developing embryo
269
the first branchial arch (mandibular) will be what future nerves and muscles?
V, muscles of mastication, mylohyoid, ant belly of digastric, tensor tympani, tensor veli palatine
270
the first branchial arch (mandibular) will be what future skeletal structures and ligaments
malleus, incus of middle ear, anterior ligament of malleus, sphenomandibular ligament and portions of sphenoid bone
271
the 2nd branchial arch (hyoid) will be what future nerves and muscles?
VII nerve, stapedius, facial expression muscles, posterior belly of digastric, stylohyoid
272
the 2nd branchial arch (hyoid) will be what future skeletal structures and ligaments
stapes (think Second is Stapes), portions of malleus and incus of middle ear, stylohyoid ligament, styloid process of the temporal bone, lesser cornu of hyoid bone, upper portion of the body of the hyoid bone
273
the 3nd branchial arch will be what future nerves and muscles?
CN IX and stylopharyngeal muscle
274
the 3nd branchial arch will be what future skeletal structures and ligaments
greater cornu of hyoid bone, lower portion of body of hyoid bone
275
the 4th-6th branchial arches will be what future nerves and muscles?
superior laryngeal branch and recurrent laryngeal branch of vagus nerve, levator veli palatini, pharyngeal constrictors and intrinsic muscles of the larynx
276
the 4th-6th branchial arches will be what future skeletal structures and ligaments?
laryngeal cartilages
277
a lesion of the facial nerve just after it exits from the stylomastoid foramen would result in
a. ipsilateral loss of taste to the anterior tongue
b. decrease in saliva production in the floor of the mouth
c. sensory loss to the tongue
d. ipsilateral paralysis of facial muscles
e. contralateral paralysis of facial muscles
d. ipsilateral paralysis of facial muscles
278
the largest portion of the facial nerve is? general sensory/motor/PNS/special sensory?
branchial motor fibers
279
general sensory, PNS, and special sensory fibers of the facial nerve (all but the motor fibers) are referred to as
nervus intermedius
280
the spinal part of accessory nerve enters the skull thru _ and then it joins the cranial root. Together they leave the skull thru the _
enters via the foramen magnum
| exits the jugular foramen
281
the accessory nerve (CN XI) controls specific neck muscles. bc part of it arises in the brain it is called a CN. it is purely motor and has 2 roots:
cranial and spinal root
282
the spinal root of CNXI arises from the anterior horn cells of the _
upper 5 cervical segments
283
the spinal roots of CNXI enter the cranium via foramen magnum and join the cranial root which arises from the
nucleus ambiguous ==> leave together thru skull via jugular foramen with the vagus to distribute to larynx and pharynx. THIS PART OF THE NERVE CANNOT BE TESTED SEPARATELY
284
the spinal part of CN XI supplies
trapezius and SCM
285
a patient w/ CN XI paralysis would have difficulty
turning their head L or R and shrugging their shoulders
286
which nerve innervates the lower lip:
| facial/lingual/mental/incisive branch of IAN
mental
287
which nerve innervates the lower anterior teeth
incisive nerve (from inferior alveolar nerve)
288
which nerve innervates the lower premolars and molar teeth and buccal surfaces in the molar region
IAN (from V3)
289
which nerve innervates the buccal surfaces in the molar region only
buccal nerve (from V3)
290
which nerve innervates the upper anterior teeth and buccal surfaces in upper anterior teeth
ASA (anterior superior alveolar) nerve (branch of V2)
291
which nerve innervates the palatal side of upper anterior teeth (incisal area of palate)
nasopalatine nerve from pterygopalatine ganglion
292
which nerve innervates the palatal side of upper teeth EXCEPT for the incisal area of palate
greater palatine nerve (from pterygopalatine ganglion)
293
which nerve innervates the upper lip
infraorbital nerve (from V2)
294
which nerve supplies the taste sensation of the base of the tongue and epiglottis)
vagus
295
which nerve supplies the general taste sensation for posterior 1/3 of tongue including vallate papillae
IX
296
which nerve supplies the taste sensation of anterior 2/3 of tongue EXCEPT for vallate papillae
chorda tympani (from facial nerve)
297
which nerve supplies general sensation of anterior 2/3 of the tongue
lingual nerve (of V3)
298
which nerve supplies general sensation to the lingual gingiva of the lower arch
lingual nerve (of V3)
299
```
which of the following nerves is derived from both the medial and lateral cords of the brachial plexus:
musculocutaneous
axillary
ulnar
median
radial
```
median
300
the branchial plexus is a somatic nerve plexus formed by intercommunications among the _ rami of what nerves?
ventral rami
| of C5-C8 and T1
301
the brachial plexus is responsible for the motor innervation to all muscles of upper limb with the exception of (2)?
trapezius and levator scapula
302
brachial plexus supplies all cutaneous innervation of the upper limb with the exception of an area in the axilla which is supplied by the _ nerve
intercostobrachial nerve
303
the ventral rami of spinal nerve C5 to T1 are referred to as the _ of the plexus
roots
304
shortly after emerging from the _ foramina, the 5 roots unite to form
intervertebral
| 3 trunks
305
the ventral rami of C5 and C6 unite to form the
upper trunk
306
the ventral ramus of _ forms the middle trunk
C7
307
the ventral rami of _ unite to form the lower trunk
C8 and T1
308
each trunk splits into
an anterior and posterior division
309
the anterior divisions of the brachial plexus supply _ muscles
flexor
310
the posterior divisions of the brachial plexus supply _ muscles
extensor
311
the anterior divisions of upper and middle trunks unite to form the
lateral cord
312
the anterior division of the lower trunk forms the _ cord
medial
313
all 3 posterior divisions from each of the 3 trunks of the brachial plexus all unite to form the
posterior cord
314
the cords are named according to their position relative to the ___
axillary artery
315
the terminal branches of the brachial plexus are
```
musculocutaneous nerve
ulnar nerve
median nerve
axillary nerve
radial nerve
```
316
the "great extensor nerve" derived from the _ cord is the _
posterior cord
| radial nerve
317
the radial nerve innervates the
extensor muscles of the elbow, wrist and fingers and carries sensory info from skin on the dorsum of the hand on the radial side
318
the axillary nerve is derived from the _ cord and supplies motor innervation to the
posterior
deltoid
teres minor muscles only and caries sensory innervation from the skin just below the point of the shoulder
319
the median nerve is derived from the _ cords
lateral and medial cords
320
the median nerve supplies motor innervation to
most the flexor muscles in the forearm and intrinsic muscles of the thumb. carries sensory from the lateral (radial) 3 and 1/2 digits (the thumb and first 2.5 digits)
321
the ulnar nerve is derived from the _ cord
medial
322
ulnar nerve supplies motor innervation to the
intrinsic muscles of the hand and carries sensory innervation from the medial ulnar 1 and 1/2 digits (the 5th and 1/2 of the 4th digits)
323
the musculocutaneous nerve is derived from the _ cord
lateral
324
the musculocutaneous nerve innervates the muscles in the
flexor compartment of the arm and carries sensation from the lateral (radial) side of the forearm
325
which sensory receptor is most sensitive to linear acceleration:
crista/utricle/saccule/macula/organ of corti
macula
326
where are the nuclei of CNVIII
4 vestibular nuclei @ junction of the pons and medulla and enters the internal acoustic meatus. here it separates into the vestibular and cochlear nerve
327
the _ nerve is concerned with equilibrium
vestibular
328
the _ nerve is concerned with hearing
cochlear
329
the vestibular nerve is composed of the central processes of bipolar neurons in the vestibular ganglion. the peripheral processes of the neruons extend to the
maculae of the utricle and saccule (sensitive to line of linear acceleration relative to position of head) and to the ampullae of the semicircular ducts (sensitive to rotational acceleration)
330
the cochlear nerve is composed of central processes of bipolar neurons in the spinal ganglion. the peripheral processes of the neurons extend to the
spiral organ (organ of Corti)
331
the organ of Corti is the true organ of hearing. the hair cells convert the vibrations into nerve impulses that are transmitted by the _ portion of CN VIII to the brain (cochlear/vestibular?)
cochlear
332
what structures run relative to the hyoglossus muscle:
1. deep to it is the _
2. superficial to it are the
1. deep is lingual artery
| 2. superficial is the lingual nerve, submandibular duct, and hypoglossal nerve
333
genioglossal middle and inferior fibers produce what action
protrusion of the tongue
334
what 3 muscles retrude the tongue
styloglossus
hypoglossues
genioglossal (superior fibers)
335
what muscles depress the tongue
middle fibers of genioglossus and hyoglossus
336
what muscles elevate the tongue
palatoglossus and styloglossus
337
what muscles shorten the tongue
superior and inferior longitudinal muscles
338
what muscles narrow the tongue
transverse
339
what muscle flatten the tongue
vertical
340
Upper lip:
1. artery supply
2. motor supply
3. sensory supply
1. superior labial artery (VII) and superior labial of infraorbital
2. VII
3. V2: superior labial nerve
341
lower lip:
1. artery supply
2. motor supply
3. sensory supply
1. inferior labial artery (VII branch) and mental nerve
2. Facial nerve
3. mandibular V3: mental nerve
342
cheek:
1. artery supply
2. motor supply
3. sensory supply
1. buccal artery
2. VII: buccal branch
3. upper cheek sensory: V2 zygomaticofacial
lower half of cheek: buccal nerve (v3)
343
the maxillary sinus:
1. artery supply
2. innervation
3. drainage?
1. infraorbital artery
2. V2
3. middle meatus
344
the maxillary sinus:
1. what is superior to it?
2. medial?
3. inferior
1. orbit
2. nasal cavity
3. maxillary teeth
345
the frontal sinus:
1. artery supply
2. innervation
3. drainage?
1. anterior ethmoid (branch of ICA -->ophthalmic artery -> anterior ethmoid)
2. V1
3. middle meatus
346
ethmoidal sinus:
1. artery supply
2. innervation
3. drainage?
1. anterior/posterior ethmoid artery
2. V1
3. anterior: middle meatus, posterior: superior meatus
347
are all the paranasal sinuses paired?
yes
348
the sphenoid sinus:
1. artery supply
2. innervation
3. drainage?
1. posterior ethmoid and sphenopalatine artery
2. V1 and V2
3. sphenoethmoidal process
349
how many paranasal sinuses do we have
Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity (maxillary sinuses), above the eyes (frontal sinuses), between the eyes (ethmoidal sinuses), and behind the ethmoids (sphenoidal sinuses).
350
how are the sinuses named
The sinuses are named for the facial bones in which they are located.
351
Malignancies of the paranasal sinuses comprise approximately 0.2% of all malignancies. About 80% of these malignancies arise in the __ sinus.
maxillary
352
The spheno-ethmoidal recess, above and posterior to the __ concha, receives the opening of the __sinus
superior
| sphenoidal
353
underneath the superior concha is the _
superior meatus
354
the superior meatus drains the
receives the openings of the posterior ethmoidal cells
355
under the middle concha is the
middle meatus
356
the middle meatus receives the contents of the
the maxillary and frontal sinuses
357
Most anterior ethmoidal cells open on an elevation called the ethmoidal bulla. A curved slit (hiatus semilunaris) inferior to the bulla receives the opening of the __ sinus.
maxillary
358
The inferior meatus, which lies between the inferior concha and the palate, receives the termination of the _
nasolacrimal duct.
359
Bleeding from the nose (epistaxis) occurs usually from the junction between septal branches of the _ arteries.
superior labial and sphenopalatine
360
The paranasal sinuses are supplied by branches of the _and _ nerves
ophthalmic and maxillary
361
__ sinusitis is frequently accompanied by toothache. Infection may spread among the various sinuses, the nasal cavity, and the teeth
Maxillary
362
Anterior and posterior __ sinus groups drain into the middle and superior meatuses, respectively
ethmoid
363
The _sinus drains into the middle meatus in a variable manner directly or by a frontonasal duct, which opens into the frontal recess or the ethmoidal infundibulum
frontal
364
Its superior aspect of the _ sinus is related to the hypophysis (pituitary) and the optic nerves and chiasma and laterally to the cavernous sinus and internal carotid artery
sphenoid
365
The sphenoidal sinus drains into the spheno-ethmoidal recess superior to the __ concha. The sinus is divided into right and left parts by a bony septum.
superior
