Unit 4 comprehensive Flashcards
(183 cards)
1
Q
What does investing fascia sourround
A
SCM and trapezius
2
Q
What are the 3 parts of pretracheal fascia
A
Visceral
Muscular
Buccopharyngeal
3
Q
Which fascia wraps around infrahyoid m
A
Musclar part of pretrachial fascia
4
Q
What are key contents of posterior triangle of neck
A
EJV
Roots of brachial plexus
Accessory nerve
Cervical and supraclavicular lymph nodes
5
Q
EJV is(superficial/deep) to SCM
A
Superficial
6
Q
IJV is (superficial/deep) to SCM
A
Deep
7
Q
The Phrenic nerve descends vertically across which muscle?
A
Anterior scalene
8
Q
The phrenic nerve is crossed anteriorly by which arteries
A
Transverse cervical and sprascapular
Both branches of thyrocervical trunk
9
Q
The phrenic nerve enters the thorax between which artery and vein
A
Between Subclavian artery and vein
10
Q
The phrenic nerve travels along what structure to supply the diaphragm
A
the pericardial sac
11
Q
Where do the scalene muscles insert
A
First rib (anterior and middle scalene) and second rib (posterior scalene)
12
Q
The retromandibular vein is formed by which veins
A
Superficial temporal and maxillary
Facial and posterior auricular veins flow into it
13
Q
Where does the retromandibular vein drain into
A
Anterior division joins facial vein to make common facial vein, and then drains to IJV.
Posterior division joins with posterior auricular and drains into EJV
14
Q
Which veins make up the common facial vein
A
Anterior division of retromandibular vein, facial vein.
Drains into internal jugular vein
15
Q
Which cranial nerves are in the anterior cervical triangle
A
Facial (7)
Glossopharyngeal (9)
Vagus (10)
Accessory (11)
Hypoglossal (12)
16
Q
All of the Infrahyoid muscles insert at the hyoid bone besides….
A
Sternothyroid muscle- insesrts at thyroid cartilage
17
Q
What are the 3 posterior branches of the external carotid artery
A
- Ascending Pharyngeal
- Occipital
- Posterior Auricular
18
Q
What are the 3 anterior branches of the external carotid artery
A
- Superior Thyroid
- Lingual
- Facial
19
Q
The mylohyoid nerve off CNV3 suppplies which 2 muscles
A
Mylohyoid and anterior belly of digastric
20
Q
The superior and middle thyroid veins drain into the __________ vein while the inferior thyroid vein drains into the __________ vein.
A
- internal jugular vein
- brachiocephalic vein
21
Q
The vertebral vein drains into the
A
Brachiocephalic vein
22
Q
The vertebral artery is posterior to the ___ v and ___ in the neck
A
Posterior to the vertebral vein, deep in the neck
23
Q
The Vertebral artery arises from the ___ artery prior to the ___trunk
A
Subclavian artery, Thyrocervical trunk
24
Q
The vertebral artery enters the transverse foramen of which vertebrae
A
C6 and superior
25
The sympathetic trunks of the neck are located anterior to which muscles
prevertebral muscles ( Longus colli, longus capitis, rectus capitis anterior, anterior scalene)
26
3 sympathetic ganglia are found in the cervical region. Name them
Superior cervical, middle cervical, and Cervical thoracic (stellate) ganglia
27
The superior cervical ganglia is anterior to which muscle
Longus capitis
28
The middle cervical ganglia is posterior to which gland
thyroid gland
29
The cervicothoracic ganglia is inside of what
thoracic inlet
30
The junction of the sphenoid, frontal , parietal, and temporal bones is significant for which reason
It is the junction of many bones merging, and it is a thin and weak area. The middle meningeal artery sits under here, which can cause a Epidural hematoma
31
Most of the muscles of facial expression originate on ___ and insert into ___
Facial bones
Skin and connective tissue of the face
32
Fascia in the scalp blends with what in the neck posteriorly?
Superficial fascia, extends into temporal regions laterally
33
Parotid fascia covers which muscle and invests the parotid gland?
Masseter
34
Which muscle lifts the eyebrows
Frontalis
35
Which muscle closes the eyelids and squints the eyebrows
Orbicularis oculi
36
Which muscle brings the eyebrows together
Corrugator supercilli
37
Which muscles lift the side of the mouth into a passive smile?
Zygomaticus major and minor
38
The parotid duct crosses over which muscle and pierces through which muscle
Crosses over masseter and pierces buccinators
39
The parotid duct opens into the oral cavity where
Maxillary 2nd molar
40
Which nerve innervates the parotid gland
Glossopharyngeal (9)
Facial runs through it, but glossopharyngeal innervates it w parasymp innervation
41
Which artery and vein are related to the parotid gland
Maxillary artery and Maxillary vein
42
The chorda tympani provides sensory innervation where
Taste to the anterior 2/3 of the tongue
43
Which nerve innervates
- Zygomaticus major & minor
- Levator labii superioris
- Levator anguli oris
- Buccinator
- orbicularis oris Nasalis
Buccal branch of facial nerve
44
If your patient is unable to raise their eyebrows, which nerve is likely implicated?
Temporal branch of facial nerve- innervates Frontalis and orbicularis oculi
45
A parotid gland tumor can cause what
paralysis of the facial muscles- the facial nerve is under/within the parotid gland, so can cause paralysis
46
Which layer of the scalp are emissary veins in
Loose areolar connective tissue
47
_____ veins are a communication between superficial veins of the scalp (in connective tissue layer) and dural venous sinuses
Emissary
48
The olfactory nerve exits through which foramena
Cribiform plate in anterior cranial fossa
49
The pituitary gland sits in which fossa
Hypophyseal fossa
50
If you see only veins, you are looking at the _______________ mater
If you only see sulca and gyra, you are looking at the __________ mater
Arachnoid mater
Pia mater
51
An epidural hematoma is caused by what most commonly
Skull to dura mater middle meningeal artery bleed
52
Which nerve supplies sensory information above the vocal cord to the pharynx
Internal branch of superior laryngeal nerve ( Not recurrent laryngeal)
53
Which nerve supplies sensory information below the vocal cord to the pharynx
Recurrent laryngeal nerve
54
Which muscle is most important for elongating the vocal cords
Cricothyroid
- Innervated by external branch of superior laryngeal nerve
55
Which muscle is responsible for abduction of the vocal cords
Posterior cricoarytenoid (recurrent laryngeal)
56
Which muscles are responsible for closing the vocal cords
Lateral cricoarytenoid adducts
Transverse Cricoarytenoid closes rima glottis
57
What is the attachment of the vocalis muscle
Right on the vocal ligament- provides very specific and fine control of tone because of insertion on the vocal ligament
58
The constrictor muscles of the pharynx are innervated by which nerve
Pharyngeal plexus- Vagus (X)
59
The Innervation to the pharynx and larynx is all done by one nerve, with the exception of one muscle. Which nerve provides the majority of innervation to this region, and what is the exception
Vagus provides most of the innervation through pharyngeal plexus. Stylopharyngeus is innervated by glossopharyngeal.
60
Which nerves provides sensory innervation to the pharynx
Nasopharynx- CN V2 (Maxillary of trigeminal)
Oropharynx- Glossopharyngeal
Laryngopharynx- Vagus
61
Which nerve runs with the inferior thyroid artery
Recurrent laryngeal nerve
62
Which nerve and artery pierce through the thyrohyoid membrane
Superior laryngeal (External laryngeal) nerve and artery
63
Which artery is in close proximity to the recurrent laryngeal nerve during a thyroidectomy
Recurrent laryngeal nerve crosses inferior thyroid artery
64
Which artery runs with the superior laryngeal nerve(External laryngeal)
Superior laryngeal artery
65
Where does the pretracheal space run
from the thyroid cartilage to the anterior mediastinum
66
Where does the prevertebral danger space run
Between alar fascia and prevertebral fascia
From the skull to the posterior mediastinum
-Eating sharp food can damage the esophagus and cause a problem here
- Common place for inferior infections to spread
67
Where does the retropharyngeal space run
Base of skull to superior mediastinum
68
What spaces are anterior/posterior to alar fascia
Retropharyngeal space is ANTERIOR, from skull base to superior mediastinum
Prevertebral (danger) space is POSTERIOR, running from skull to POSTERIOR mediastinum
Split by alar fascia
69
If there is blood pooling in the carotid sheath, what structure can this implicate
The heart- blood pooling in the carotid sheath puts pressure on the heart.
70
After the bifercation of the common carotid artery into the external and internal carotid arteries, which one still runs in the carotid sheath?
Internal carotid- external has to split to supply face and scalp blood supply
71
Subclavian artery runs between which muscles and in which groove
Between anterior scalene and middle scalene muscles via the subclavian artery groove of the 1st rib
72
C1 from the ansa cervicalis joins which nerve on its way to where
C1 joins hypoglossal nerve to get to Thyrohyoid-- Nerve to thyrohyoid innervates it- Not ansa cervicalis.
73
External carotid artery terminates as what
maxillary artery and superificial temporal artery
74
The superior cervical ganglion is located anterior to which muscle
longus capitis
75
The middle cervical ganglion is located posterior to what
thyroid gland
76
The cervicothoracic (stellate) ganglion is located inside of what
the thoracic inlet
77
The pterion is the point where which bones meet
Parietal, Frontal, Sphenoid, Temporal bones.
78
What does a breakage of the pterion commonly cause
Epidural hematoma-- Middle meningeal artery runs right deep to it.
79
Skull bones are connected via which joints
suture joints
80
The Buccinator muscle is pierced by what
the parotid duct
81
What provides motor innervation to the muscles of facial expression
Facial nerve branches (CN 7)-- NOT buccal nerve from Trigeminal nerve.
Zygomatic- Smile
Orbicularis Occuli-- Close eyes
Temporalis-- Raise eyebrows-- temporal branch
82
The Chorda tympani nerve branches from the facial nerve where
As the facial nerve exits the stylomastoid foramen
83
What does the chorda tympani provide and what nerve does it travel with
Travels with the mandibular (V3) branch of trigeminal to get to the tongue where it provides special sensory innervation (taste)
84
Which veins travel through the bones of the skull connecting the deep connective tissue to the dural venal sinuses
emmissary veins
85
Where do emmissary veins run
between the deep connective tissue and dural venous sinuses
86
Where do bridging veins run
From brain surface to venous sinuses
Can cause subdural hematoma (Between Dura mater and arachnoid mater)
87
Where is an epidural hematoma
Between Skull and Dural mater
Epidural hematoma is more superifcial than subdural hematoma
88
Which muscle is responsible for ensuring that food does not go into the nasopharynx when swallowing
The levator veli palatini closes off the nasopharynx to food when elevating the soft palate.
Innervated by Pharyngeal branch of Vagus from pharyngeal plexus
89
Which papillae on the tongue do not have taste buds
filiform pipillae
90
What protects the larynx when swallowing
Epiglottis moves when swallowing to cover pharynx
False vocal cords cover larynx when food is swallowed
91
Which nerves provide sensation to the anterior 2/3 of the tongue
Special sensation (taste)- 7- Facial- chorda tympani
Sensory- V3- Lingual nerve
92
What nerve provides sensation to the posterior 1/3 of the tongue
Glossopharyngeal (9)
General sensation and taste
93
Which muscle does the parotid duct run over
masseter
94
Which muscle does the parotid duct pierce
buccinator
95
Where does the parotid duct enter the mouth
parotid papillae
96
Which nerve innervates muscles of mastication
V3 Mandibular of trigeminal
97
The lingual artery travels deep to which muscle on its way to the tongue
hyoglossus
98
The submandibular ganglion sits on top of which muscle
Hyoglossis- sits superficially to hyoglossus inbetween Lingual nerve and Hypoglossal nerve
99
If you get an infection in your posterior tongue and Lingual tonsil, where will your lymph nodes swell?
Superior deep cervical lymph nodes-- Posterior 1/3 of tongue drain to superior deep cervical lymph nodes
100
Where will the anterior tip of your tongue drain if infected
submental lymph nodes
101
Where will the middle of your tongue (midline and in the middle 1/3) drain?
To Inferior deep cervical lymph nodes
102
Where will the lateral 1/3 in the medial 1/3 of your tongue drain (outside edges in the middle)
To submandibular lymph nodes
103
Which muscle does the hypoglossal nerve run on top of (superficially to) when going to the tongue
They hyloglossus
104
The lingual nerve (V3) and Chorda tympani (7) travel to which ganglion
Submandibular ganglion
- Preganglionic parasympathetic travel from 7 to submandibular gland and then to sublingual gland and submandibular glands
Lingual originates from V3 and provides general sensory to anterior 2/3 of tongue
chorda tympani provides parasympathetic innervation and taste sensation to the anterior 2/3 of the tongue
105
The chorda tympani serves what functions
Taste
Parasympathetic
106
The hard palate is formed by which bones
Maxilla (anterior) and Palatine bone (posteriorly)
107
Which muscle runs from the soft palate to the tongue
Palatoglossus
108
Which muscle runs from the soft palate to the pharynx
Palatopharyngeus
109
The hypoglossal nerve is inferior to which nerve when running to the tongue
Lingual nerve
110
The lingual nerve runs deep to what structure right below the tongue
The Sublingual and submandibular gland sits below the tongue, the lingual nerve runs to these glands, and the submandibular duct crosses over the lingual nerve
111
The mental foramen is located where and which nerve/artery travels through it
Located between 1st and 2nd premolars, the Mental nerve (branch off inferior alveolar, terminal branch of Mandibular nerve) pierces it.
Inferior alveolar artery runs through it ( Off maxillary artery)
112
Is the deep petrosal nerve sympathetic or parasympathetic
Sympathetic- Innervation goes from the spinal cord to the superior cervical ganglion, and postsynaptic sympathetic innervation travels on the deep petrosal nerve
113
Is the Greater petrosal nerve sympathetic or parasympathetic
Parasympathetic innervation. Parasympathetic from Facial (Saliva and tears) travel on this nerve. The
114
From the sympathetic trunk, where does the sympathetic innervation synapse before going to travel along the internal carotid artery
At the superior cervical ganglion, postsynaptic sympathetic innervation begins
115
Where does the Greater petrosal nerve's parasympathetic innervation become postsynaptic
At the pterygopalatine ganglion in the pytergopalatine fossa-- Parasympathetic innervation traveled from the superior salivatory nucleus (Facial nerve) along the greater petrosal nerve to synapse in the pytergopalatine ganglion
116
What seperates the external and middle ear
Tympanic Membrane
117
Where is the pharyngotympanic tube connecting in the ear
Middle ear
118
Which branch of the external carotid artery supplies the ear
Superficial temporal
Branches into anterior auricular, posterior auricular
119
Which nerve innervates the external surface of the ear CANAL
9 and 10
120
Which nerve runs across the medial surface of the tympanic membrane
Chorda tympani
121
Where does the chorda tympani merge with the lingual nerve
By the medial and Lateral ptyergoid muscles, deep to Masseter, Risorius and buccinator
122
A middle ear infection can spread where that it is very hard to treat
Mastoid antrum (air filled space), extremely hard to fix if this happens.
123
Which muscles tense the tympanic membrane and what are they innervated by
Both reduces vibration to delicate inner ear
Tensor Tympani-- Innervated by Mandibular of Trigeminal
Stapedius-- Innervated by CN 7
124
What is the parasympathetic function of chorda typani
Sublingual and submandibular salivary glands
125
What is the special sense for chorda tympani
Taste for anterior 2/3 of tongue (along w Lingual nerve from trigeminal that gives general sensory)
126
Is chordatympani presynaptic or postsynaptic
Presynaptic, travels to submandibular ganglion to synapse
127
What happens when the tensor veli palatini contracts
For soft palate, tenses, so that food doesn't enter nasopharynx
For ear, When we yawn, the tensor veli tenses and the lumen opens the auditory tube to equalize pressure between middle ear and nasopharynx
128
What makes up the chochlea
Scala vestibuli, cochlear duct, scala tympani
129
The membranous labyrinth is suspended in what and contains what
suspended in perilymph, contains endolymph
- Conduct sound vibrations, respond to mechanical forces (movement and accleeration)
130
The bony labyrinths are sourrounded by what and filled with what
Sourrounded by otic capsule (dense bone)
Suspended in Perilymph
131
Sound comes in which window and out which window
In through oval windown, to Vestibulocochlear (8) nerve, and out through scala tympani--> round window
132
The anterior and posterior semicircular canals are at what angle, and the lateral is at what angle?
Anterior and posterior are at a right angle
Lateral is horizontal
133
Where are equilibrium receptors housed and what are they called
Ampulla has crista ampullaris that responds to rotation
Utricle and Saccule have maculae (receptors) that respond to gravity and changes in head position
134
What structures run between the base of the skull and superior constrictor
Pharyngotympanic tube
135
What structures run between superior and middle constrictor
Glossopharyngeal nerve, stylopharyngeus muscle
136
What strcutres are between middle and inferior constrictor muscles
Superior laryngeal vessels and Internal laryngeal nerve (Superior laryngeal nerve) (Sensory abvove VF)
137
What does salpingopharyngeus connect to
Opening of eustacian tube- Elevate pharynx
138
A CT scan shows a skull fracture and an accumulation of blood between dura and the cranial bone. What type of hemmorhage is this considered
Epidural- between dura and skull. Typically caused by rupture of middle meningeal artery, which supplies blood to the dura mater and bones of cranium.
139
A CT scan shows a skull fracture and an accumulation of blood between pia mater and the arachnoid mater. What type of hemmorhage is this considered
Subarachnoid hemorrhage
140
Which structure connects the third and fourth ventricles
Cerebral aquaduct
141
Which structure connects the lateral ventricles with the 3rd ventricle
Interventricular foramen
142
Where does CSF flow in relation to the layers of the meninges. Why do we care?
Between the pia and arachnoid mater (Subarachnoid space)
This is clinically relevent because meningitis is bacteria in the CSF between these layers.
143
Where does the middle meningeal artery supply blood to
The dura mater and cranial vault bones
144
Where does the middle cerebral artery supply blood to
The lateral surface of the cerebral hemispheres, most of temporal lobe.
145
Where does the anterior cerebral artery supply blood
medial and superior surfaces of brain- frontal pole
146
Where does the posterior cerebral artery supply the brain
Inferior surface of brain and occipital pole
147
A sixty-four-year old man was diagnosed with an acoustic neuroma (tumor of the VIIIth cranial nerve) where it entered the temporal bone. What other cranial nerve might also be affected since this nerve uses the same foramen as the VIIIth in its course?
Facial! Runs through the internal acoustic meatus.
148
The danger zone of the scalp is which layer?
Loose connective tissue- can pass quickly into brain and meninges.
Scalp layers are Skin, Connective tissue, Aponeurosis, Loose connective tissue, and Pericranium.
149
The presence of blood in a spinal tap taken from an individual with a closed head injury signals arterial bleeding into which brain space?
Subarachnoid space- CSF is taken for a spinal tap, and CSF runs in the brain in the subarachnoid space.
150
The most likely source of blood in a patient with an epidural hemorrhage is:
Middle meningeal artery
151
Vertebral arteries travel through the transverse foramina of which vertebral levels
C1-C6
152
Which cranial nerve runs under the Posterior inferior cerebellar artery
Spinal accessory nerve (CN 11)
153
An aneurysm of the superior cerebellar artery is in close proximity to which cranial nerve that might cause vision deficits?
CN 3- occulomotor
154
An aneurysm of the anterior communicating or anterior cerebellar arteries are in close proximity with which nerves and could cause which deficits?
Close to olfactory, could change smell. Close to Optic nerve- could change visual accuity and visual fields.
155
The posterior inferior cerebellar artery is in very close proximity to which nerve if it is ruptured
Accessory Nerve (CN 11)
156
You have been asked to assess the neurological deficit that might exist in a patient diagnosed with cavernous sinus thrombosis. You will focus your examination on cranial nerves related to the sinus, and that examination includes examination of which nerves?
CN 3
CN 4
CN V1/V2
6
157
The cavernous sinus is lateral to the body of which bone
Sphenoid bone
158
The structures that pass through which skull foramina enter the cavernous sinus
The superior orbital fissure
- Occulomotor nerve, trochlear nerve, Abducens nerve, V1 and V2.
159
During childbirth, an excessive anteroposterior compression of the head may tear the anterior attachment of the falx cerebri from the tentorium cerebelli. The bleeding that follows is likely to be from which of the following venous sinuses?
Straight sinus
- Drains the deep cerebrum- lies in junction of falx cerebri and tentorium cerebelli
160
Which sinus drains the cerebellum
Occipital sinus- lies in dura mater at base of falx cerebelli (inferior to straight sinus)
161
The inferior sagittal sinus is found in the free edge of what structure?
Falx cerebri- Sagital fold of dura mater lying between cerebral hemispheres.
Inferior saggital sinus runs on inferior margin of falx cerebri.
162
The superior orbital fissure is a fissure in which bone
Sphenoid bone
163
The optic canal is a fissure in which bone
Sphenoid bone
164
What are the sensory detectors in the semicircular canals
Ampulla has crista ampullaris that respond to rotational movements
Utricle and saccule have maculae that respond to changes in head position
165
What drains into the middle meatus
Frontal sinus
Maxillary sinus
Anterior ethmoid cells
Middle ethmoid cells (ethmoid bulla of middle meatus)
166
What drains into the sphenoethmoid recess
Sphenoid recess
167
What drains into the superior meatus
Posterior ethmoid cells
168
Which nerve loops around the middle meningeal artery
auriculotemporal nerve
Branch off the mandibular nerve (CN V3)
169
What structure does the tentorium cerebelli divide
Cerebellum from cerebrum
170
How many meatuses are in the nose
3
171
What is the piriform recess and its clinical significance
Food gets stuck in it and need surgery to remove from the laryngopharynx
172
The hypoglossal nerve sits on top of which muscle in the mouth, and what is the function of this?
the hyoglossus muscle
Innervated by hypoglossal
Depresses and sticks out tongue
173
What is the artery most commonly implicated in an ischemic stroke?
MCA-->arises from Internal carotid
Supplies lateral surfaces of frontal, parietal, and temporal lobes
174
In the case of a tympanic membrane rupture, what is the most common nerve that is injured?
Chorda tympanie--> runs over TM
175
Which spinal nerves create the cervical plexus
C1-C4--> Ventral rami
176
What is the motor component of the cervical plexus
The ansa cervicalis
177
What does the ansa cervicalis sit on top of
the carotid sheath
178
Ansa cervicalis innervates every infrahyoid muscle except which one
thyrohyoid
179
Which layer of meninges sourrounds the pituitary
Diaphragma sellae
180
Vagus nerve provides motor innervation to all of the muscles of larynx and pharynx and palate muscles except for which 2 exceptions
Stylopharyngeus (innervated by CN 9) and tensor villi palatini (innervated by V3--> nerve to medial ptyergoid)
181
What is the carotid body innervated by
Glossopharyngeal nerve--> carotid branch
182
Which nerve innervates all of the tongue muscles except for palatoglossus
Hypoglossal
Palatoglossus innervated by vaugs in pharyngeal plexus
183
