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Head and Neck > Parotid, Eyes, Mouth, Ears, and Nose Anatomy > Flashcards

Parotid, Eyes, Mouth, Ears, and Nose Anatomy Flashcards

1
Q

Outline the bounds of the parotid region

A
  • Superior = Zygomatic arch
  • Posterior = External ear and anterior border of SCM
  • Medial = ramus of mandible
  • Anterior = masseter
  • Inferior = angle and inferior border of mandible
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2
Q

List the structures passing through the parotid gland

A
  • Facial nerve and branches (Temporal zygomatic, buccal, mandibular, cervical)
  • External carotid artery
  • Retromandibular vein
  • Auriculotemporal nerve
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3
Q

What encloses the parotid gland

A

Parotid sheath

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4
Q

How does the parotid duct (Stensen’s duct) enter the oral cavity

A

Pierces Buccinator to enter cavity opposite 2 maxillary molar tooth

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5
Q

What is the most superficial structure embedded in the parotid gland

A

Facial nerve

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6
Q

What nerve supplies the skin over the parotid gland

A

Greater auricular nerve

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7
Q

Describe the secretomotor innervation of the parotid gland

A

Parasympathetic - Glossopharyngeal to otic ganglion - post-synaptic via auriculotemporal nerve

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8
Q

What type of joint is the TMPJ

A

Modified hinge-type synovial

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9
Q

Arterial supply of the parotid gland

A

Branches of the external carotid

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10
Q

Venous drainage of the parotid gland

A

Retromandibular vein

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11
Q

Lymphatic drainage of the parotid gland

A

Deep cervical nodes

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12
Q

Describe the differences in saliva output with sympathetic vs parasympathetic stimulation of the parotid

A
  • Parasympathetic = water-rich, serous saliva

- Sympathetic = low-volume, enzyme rich

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13
Q

List the ligaments that attach the mandible to the cranium

A
  • Stylomandibular

- Sphenomandibular

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14
Q

Describe the distribution of the auriculotemporal nerve

A
  • Supplies sensory fibres to auricle and temporal regions
  • Sends articular fibres to TMJ
  • Conveys postsynaptic parasympathetic fibres to parotid gland
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15
Q

Describe the distribution of the inferior alveolar nerve

A
  • Supplies lower molar and premolar teeth

- Ends as mental nerve

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16
Q

Describe the distribution of the mental nerve

A
  • Supplies skin and mucous membranes of lower lip

- Skin of the chin

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17
Q

What nerve supplies the canines and incisor teeth

A

Incisor branch of mental/inferior alveolar nerve

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18
Q

Describe the distribution of the lingual nerve

A
  • Sensory to the anterior 2/3rd of the tongue

- Sensory to floor of the mouth and mandibular gums

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19
Q

Describe the course of the lingual nerve

A
  • Arises from posterior trunk of the mandibular nerve (branch of trigeminal)
  • Runs past tensor veli palatani and lateral pterygoid where it is joined by chorda tympani
  • Runs formward from mylohyoid
  • Winds around submandibular duct
  • Eventually reaches periosteum of 3rd molar tooth
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20
Q

Where is the otic ganglion situated

A

Infratemporal fossa - just inferior to foramen ovale

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21
Q

Temporalis (OIIA)

A 
O = floor of temporal fossa 
I = coronoid process and anterior border of ramus 
I = CN V3 via deep temporal branches 
A = elevates mandible
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22
Q

Masseter (OIIA)

A 
O = Inferior border of maxillary process of zygomatic bone 
I = Angle and lateral surface fo ramus of mandible 
I = CN V3 via masseteric nerve 
A = elevates mandible
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23
Q

Lateral Pterygoid (OIIA)

A 
O = two heads 1) infratemporal surface of greater wing of sphenoid, 2) lateral surface of pterygoid plate 
I = Joint capsule and pterygoid fovea on neck of condyloid process of mandible 
I = CN V3 via lateral pterygoid nerve 
A = protracts mandible and depresses chin
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24
Q

Medial Pterygoid (OIIA)

A 
O = two heads 1) medial surface of lateral pterygoid plate, 2) tuberosity of maxilla 
I = Medial surface of ramus of mandible 
I = CN V3 via medial pterygoid nerve 
A = acts synergistically with masseter to elevate jaw, grinds jaw
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25
Q

What muscle forms the floor of the mouth

A
  • Mylohyoid - joins at the midline raphe

- Reinforced by geniohyoid superiorly

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26
Q

What connects the tongue to the mandible

A

Frenulum

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27
Q

Where are the sublingual papilla situated

A

Either side of the frenulum

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28
Q

What opens into the sublingual papilla

A

Submandibular (Wharton’s) duct

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29
Q

Origin of the lingual nerve

A

Mandibular division of the trigeminal nerve

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30
Q

When is the lingual nerve typically damaged

A

3rd molar tooth extraction

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31
Q

Which muscles does the hypoglossal nerve innervate

A
  • Supplies superior limb of ansa cervicalis (C1) to innervate infrahyoid muscles
  • Supplies all muscle of the tongue except palatoglossus
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32
Q

Describe the sulcus terminalis

A
  • V-shaped groove that separates the buccal and pharyngeal parts of the tongue
  • Foramen caecum lies at the apex
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33
Q

Histological structure of the tongue

A

Covered by thick stratified squamous epithelium bearing papillae on the anterior 2/3rd

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34
Q

Where are the taste buds situated

A

Within the papillae of the surface epithelium of the tongue

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35
Q

List the extrinsic muscle of the tongue

A
  1. Genioglossus
  2. Styloglossus
  3. Hyoglossus
  4. Palatoglossus
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36
Q

Describe the attachments and function of Genioglossus

A

Attachments: Arises from the mandibular symphsis. Inserts into the body of the hyoid bone and the entire length of the tongue.
Function: Inferior fibres protrude the tongue, middle fibres depress the tongue, and superior fibres draw the tip back and down

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37
Q

Describe the attachments and function of Styloglossus

A

Attachments: Originates at the styloid process of the temporal bone and inserts into the side of the tongue
Function: Retracts and elevates the tongue

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38
Q

Describe the attachments and function of Hyoglossus

A

Attachments: Arises from the hyoid bone and inserts into the side of the tongue
Function: Depresses and retracts the tongue

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39
Q

Describe the attachments and function of palatoglossus

A

Attachments: Arises from the palatine aponeurosis and inserts broadly across the tongue
Function: Elevates the posterior aspect of the tongue

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40
Q

What innervates palatoglossus

A

Vagus nerve

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41
Q

Blood supply of the tongue

A

Lingual branch of the external carotid artery

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42
Q

Outline the lymphatic drainage of the tongue

A
  • Anterior 2/3 shows minimal communication across the midline (unilateral nodal disease)
  • Posterior 1/3 have communicating networks (bilateral disease)
  • Tip drains to submental nodes to deep cervical nodes
  • Mid-portion drains to submandibular nodes to deep cervical nodes (more centrally located tumours will likely have bilateral nodal disease)
43
Q

Outline the innervation of the tongue

A 
Anterior 2/3:
- Sensory = lingual branch of V3
- Taste = chorda tympani of CN 7
Posterior 1/3:
- Sensation and taste = CN 9
44
Q

Describe the result of hypoglossal nerve damage

A
  • Wasting of the tongue on the SAME SIDE of the lesion

- Deviates towards the lesion

45
Q

Describe the superficial relations of the submandibular gland

A
  • Platysma
  • Marginal mandibular branch of facial nerve
  • Cervical branch of facial nerve
  • Facial vein
46
Q

Describe the deep relations of the submandibular gland

A
  • Mylohyoid
  • Hyoglossus
  • Lingual nerve
  • Hypoglossal nerve
47
Q

What nerve crosses the submandibular (Wharton’s) duct

A

Lingual nerve

48
Q

Where are the submandibular lymph nodes located

A

Between the gland and the mandible

49
Q

What is the most superficial structure faced on approach to the submandibular gland

A

Facial vein

50
Q

Where is the incision made to access the submandibular gland

A

Incision 3cm below the mandible to avoid the mandibular branch of the facial nerve

51
Q

What nerve innervates the tonsillar fossa

A

Glossopharyngeal nerve

52
Q

Where is the sublingual gland located

A
  • Immediately below the mucosa of the floor of the mouth
  • Immediately in front of the deep part of the submandibular gland
  • Separated from base of tongue medially by lingual nerve and submandibular duct
  • Laterally rests on the sublingual groove of the mandible
53
Q

From where is the ear derived

A

6 hillocks of His (derived from the first and second branchial arches)

54
Q

Where is the thyroid derived

A

Foramen caecum (between 1st and 2nd branchial pouches)

55
Q

Where are the parafollicular C cells derived

A

5th branchial pouch

56
Q

Auricle cartilage type

A

Elastic

57
Q

Outline the innervation of the auricle

A
  • Upper lateral surface = auriculotemporal nerve

- Lower lateral and medial surface = great auricular nerve

58
Q

How long is the EAC

A

3cm

59
Q

What produces ear wax

A

Cerumen wax-producing glands (modified sweat glands)

60
Q

Outline the sensory supply to the EAC

A
  • Auriculotemporal nerve
  • Auricular branch of vagus
  • Facial nerve via tympanic plexus
61
Q

Origin of the eustachian tube, middle-ear cleft, and its extension to the mastoid antrum

A

First branchial pouch

62
Q

External ear origin

A

First branchial cleft

63
Q

Outline the 3 layers of the tympanic membrane

A
  • Outer ectodermal layer = squamous epithelium
  • Inner endodermal layer = respiratory-like epithelium
  • Middle mesodermal layer = fibrous layer
64
Q

How is the tympanic membrane divided

A
  • Pars flaccida (the attic)

- Pars tensa (lower part)

65
Q

What connects the tympanic membrane to the tympanic annulus of the temporal bone

A

Fibrous annulus

66
Q

Outline the external nerve supply of the tympanic membrane

A
  • Auriculotemporal (CN 5)
  • Vagus
  • Facial
  • Glossopharyngeal
67
Q

Outline the internal nerve supply of the tympanic membrane

A

Tympanic branch of the glossopharyngeal nerve (Jacobsen’s nerve)

68
Q

Which muscle protects the ear when loud noise is present

A

Tensor tympani - inserts into the malleus (tenses the tympanic membrane)

69
Q

Describe the roof of the middle ear

A

Thin layer of bone called the tegmen tympani separates the MEC from the dura of the middle cranial fossa

70
Q

Describe the promontory of the MEC

A

Bulge into the MEC formed by the basal turn of the cochlea - it is covered by the tympanic plexus (from the glossopharyngeal nerve)

71
Q

What type of joint is between the ossicles

A

Synovial joint

72
Q

Describe the course of Chorda tympani

A
  • Arises from the descending portion of the facial nerve (in the mastoid)
  • Passes posteriorly between the layers of tympanic membrane
  • Exits the MEC through the petrotympanic fissue
  • Joins the lingual nerve and supplies taste to anterior 2/3 of tongue
73
Q

Describe the tympanic plexus

A
  • Formed from CN 9 and CN 7
  • Forms Jacobsen’s nerve (CN 9) which forms the lesser petrosal nerve as it leaves the MEC
  • Joins the auriculotemporal nerve and is parasympathetic to the parotid gland
74
Q

Origin of the inner ear (labyrinth)

A

Otic placode of ectoderm at 3 weeks gestation

75
Q

List the semicircular canals of the inner ear

A
  1. Anterior
  2. Posterior
  3. Lateral
76
Q

Blood supply to the inner ear

A

Labyrinthine artery (branch of the basilar artery)

77
Q

Outline the blood supply to the nose

A
  • Lateral nasal artery (branch of facial artery)
  • Nasal dorsal artery (terminal branch of ophthalmic artery)
  • External nasal artery (from anterior ethmoidal artery)
78
Q

How is the nasal cavity divided

A
  1. Vestibule
  2. Respiratory region
  3. Olfactory region
79
Q

What innervates the septum and lateral walls of the nose

A
  • Nasopalatine nerve (branch of the maxillary nerve)

- Nasociliary nerve (branch of ophthalmic nerve)

80
Q

What innervates the external skin of the nose

A

Trigeminal nerve

81
Q

Where do the paranasal sinuses drain

A

Middle meatus of the nasal cavity

82
Q

List the paranasal sinuses

A
  1. Maxillary
  2. Frontal
  3. Ethmoid
  4. Sphenoid
83
Q

What divides the tongue into anterior 2/3rd and posterior 1/3rd

A

Sulcum terminalis

84
Q

What forms the anterior tonsillar pillar

A

Palatoglossus muscle

85
Q

What forms the posterior tonsillar pillar

A

Palatopharyngeus muscle

86
Q

Define the bounds of the oral cavity

A

Vermillion border of the lips to the anterior tonsillar pillar

87
Q

What are circumvillate papillae

A

Taste receptors

88
Q

Name the space between the base of the tongue and the epiglottis

A

Vallecula

89
Q

Origin of the posterior 1/3rd of the tongue

A

3rd branchial arch

90
Q

Function of genioglossus

A

Protrudes the tongue

91
Q

Function of styloglossus

A

Retracts the tongue

92
Q

Function of hyoglossus

A

Rolls the tongue

93
Q

Function of palatolgossus

A

Closes the oropharyngeal isthmus when swallowing

94
Q

Blood supply and venous drainage of the tongue

A
  • Lingual artery

- Directly to internal jugular vein

95
Q

Blood supply of the hard palate

A

Greater palatine artery

96
Q

Lymphatic drainage of the hard palate

A

Retropharyngeal nodes

97
Q

Innervation of hard palate

A

Branches of maxillary nerve:

  • Nasopalatine nerve (via incisive foramen)
  • Greater palatine nerve (vial greater palatine foramen)
98
Q

List the 4 main muscles of the soft palate

A
  1. Tensor veli palatani (forms posterior edge)
  2. Levator veli palatani (superior surface)
  3. Palatoglossus (anterior edge)
  4. Palatopharyngeus (posterior pillar)
99
Q

List the divisions of the ophthalmic branch of the trigeminal

A
  • Lacrimal
  • Supraorbital
  • Supratrochlear
  • Infratrochlear
  • External nasal
100
Q

List the divisions of the maxillary branch of the trigeminal

A
  • Zygomaticotemporal
  • Zygomaticofacial
  • Infraorbital
101
Q

List the divisions of the mandibular branch of the trigeminal

A
  • Auriculotemporal
  • Buccal
  • Mental
102
Q

Secretomotor fibres of the lacrimal apparatus

A

Parasympathetic fibres of the pterygopalatine ganglion:

  • Pre-ganglionic = greater petrosal nerve, branch of facial nerve
  • Post-ganglionic = zygomaticotemporal nerve
103
Q

Arterial supply of the lacrimal glands

A

Lacrimal branch of ophthalmic artery

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