Anatomy Exam 4

Front 1

piriform aperture

Back 1

opening (behind nose)
Maxillae surround it

Front 2

muscles of facial expression

Back 2

-frontalis
-orbicularis oculi
-corrugator supercili
-orbicularis oris
-levator labii superioris alaeque nasi
-zygomaticus major
-buccinator
-depressor anguli oris
*all CN VII innervated

Front 3

orbicularis oculi

Back 3

-two portions:
-- orbital (peripheral): clench eyes shut
-- palpebral (eyelid): blinking
-protects eye/cornea
-CN VII innerv

Front 4

orbicularis oris

Back 4

-sphincter; closes & protrudes lips
-helps keep food btwn the teeth

Front 5

buccinator muscle

Back 5

-presses cheeks vs teeth (helps w/ chewing)
-expel air when playing instrument
-parotid gland duct pierces
-CN VII innerv

Front 6

frontalis

Back 6

-part of occititofrontalis muscle
-wrinkles forehead, surprise
CN VII innerv

Front 7

corrugator supercilii

Back 7

-draws eyebrows together as in frowning
-vertical wrinkling above nose
- CN VII innerv

Front 8

depressor anguli oris

Back 8

-depressing corner of mouth as in frowning
-CN VII innerv

Front 9

zygomaticus major

Back 9

-laughing & smiling
-CN VII innerv

Front 10

Levator labii superioris alaeque nasi

Back 10

-raises upper lip
-CN VII innerv

Front 11

3 items that pass through parotid gland

Back 11

1. facial nerve CN VII (*but DOESN'T innervate parotid; CN IX [glossopharyngeal] innervs)
2. Retromandibular vein
3. External carotid artery

Front 12

lympatic drainage of head & neck:
-where drain to
-nodes

Back 12

-drain to deep cervical nodes (along IJV)
superficial nodes:
-occipital
-mastoid
-parotid
-submandibular
-submental

Front 13

lymph flow, head & neck

Back 13

1. superficial cervical nodes
2. deep cervical nodes
3. R: right lymphatic duct
L: thoractic duct

Front 14

branchiomotor fibers

Back 14

-CNs V, VII, IX & X
-for muscles from pharyngeal arches

Front 15

parasympathetic nerves (cranial)

Back 15

CNs III, VII, IX & X
(visceral motor)
*VII (facial) does 80% of parasymp in head

Front 16

parasympathetic ganglia

Back 16

(paired)
1. ciliary (CN III) [lacrimal gl]
2. pterygopalatine (CN VII) [pupil constriction]
3. otic (CN IX) [parotid gl]
4. submandibular (CN VII) [salivary glands]

Front 17

trigeminal ganglion

Back 17

-lg sensory ganglion w/in cranial cavity for cell bodies of CN V's sens nerves

Front 18

muscles of mastication

Back 18

1. masseter
2. temporalis
3. pterygoids
4. mylohyoid
5. anterior digastric
[tensor veli palatini & tensor tympani = from 1st pharyngeal arch & innerv by V3 also)

Front 19

Fractures of calvaria

Back 19

- linear: @ point of impact, fx lines radiate away in 2+ directions; most frequent type of fx
- depressed: fragment of bone depresses inward to compress brain
- comminuted: bone broken in several pieces
- basilar: bones of base fx'd (due to severe blunt trauma or force); usually connects dural venous sinuses --> fluid/air entry into inside of skull --> infection
- contrecoup (counterblow): fx @ opposite side of skull from actual impact

Front 20

Scalp layers

Back 20

S: skin
C: connective tissue (dense; VAN here)
A: aponeurosis (occipitalis & frontalis muscles)
L: loose connective tissue (infections localize/spread here)
P: pericranium (external layer of periosteum)

Front 21

skull bone layers

Back 21

external table: compact
diploe: spongy (cancellous)
internal table: compact

Front 22

scalp infection "danger area"

Back 22

-loose connective tissue: pus/blood spreads easily w/in it
-infection here --> cranial cavity via emissary veins (thru parietal foramina)
-pus/blood can enter eyelids & root of nose = black eyes
-pus/blooc can NOT spread to neck (b/c occipitalis musc) or cheeks (b/c temporal fascia)

Front 23

membranous layers surrounding brain

Back 23

1. dura mater
2. arachnoid mater
3. pia mater

Front 24

dura mater notes

Back 24

- 2 layers:
1. inner meningeal (closest to brain); close contact w/ arachnoid, continuous w/ spinal dura mater through foramen magnum
2. outer periosteal (closer to skull); attaches to skull, continuous w/ periosteum at foramen magnum & other intracranial for.
btwn layers = sinuses (eg: sup sag sin)
-also make dural partitions (eg: falx cerebri)
-- innerv: V1 = anterior cranial fossa/falx cerebri/tentorium cerebelli
V2 & 3 = middle cranial fossa
X & C1-3 = posterior cranial fossa
- vascularization: middle meningeal artery (mostly)

Front 25

dural partitions

Back 25

- falx cerebri
- tentorium cerebelli
- falx cerebelli
- diaphragma sellae

Front 26

falx cerebri

Back 26

- meningeal dura (vertical)
- btwn 2 cerebral hemispheres
- attached to crista galli of ethmoid bone
- innerv by CN V1

Front 27

tentorium cerebelli

Back 27

- meningeal dura (horizontal)
- separates cerebrum from cerebellum
"tentorium = tent"
- innerv by CN V1

Front 28

falx cerebelli

Back 28

- meningeal dura (vertical)
- projects btwn 2 cerebellar hemispheres

Front 29

diaphragma sellae

Back 29

- meningeal dura (horizontal)
- covers hypophyseal fossa in sella turcica of sphenoid bone

Front 30

middle meningeal artery
-origin
-course
-distribution

Back 30

-from maxillary art (ECA)
-ascends vertically, runs w/in periosteal (outer) dura layer, passes thru foramen spinosum into cranial cavity
-vasc to dura mater, bone, bone marrow
*can be damaged by lateral blows to head (eg at pterion) = epidural hematoma

Front 31

C1 general sensory area

Back 31

posterior cranial fossa (along w/ CN X & C2-3)
**NO C1 dermatome

Front 32

arachnoid mater

Back 32

- thin, avascular memebrane
- next to surface of dura (meningeal)
- trabeculae = from inner surface, beams cross subarachnoid space & become contin w/ pia mater
** does NOT invaginate into sulci like pia

Front 33

pia mater

Back 33

- thin, delicate membrane
- invaginates surface of brain
- closely applied to CN roots
- leptomeninges = arachnoid + pia

Front 34

epidural (extradural) space

Back 34

- potential space btwn bone & periosteal (outer) dura
- epidural hematoma = when bleeding can accumulate in this space (eg: if middle meningeal art lacerated) --> loss of conscioiusness, lucid period, drowsiness & coma
= compression of brain as blood mass increases

Front 35

subdural hematoma

Back 35

- bleeding beneath dura = makes potential space a real space
- btwn dura & arachnoid
- can happen when head trauma suddenly moves brain inside = tears cerebral veins

Front 36

subarachnoid hemorrhage

Back 36

- blood collecting in subarachnoid space (usu from cerebral arts)
- from rupture of aneurysm or trauma
- = meningeal irritation, headache, stiff neck, loss of consciousness

Front 37

Sections of the brain

Back 37

1. telencephalon
2. diencephalon
3. mesencephalon (midbrain)
4. metencephalon
5. myelencephalon

Front 38

Telencephalon

Back 38

- cerebral hemispheres
- surrounds lateral ventricles
- 4 lobes: frontal, parietal, occipital, temporal
- all lobes involved w/ integ & proc of sensory data, & proc/initiating motor activities

Front 39

Diencephalon

Back 39

- thalamus
- hypothalamus
- pituitary gland
- surrounds 3rd ventricle
- sometimes considered part of brainstem

Front 40

Mesencephalon/midbrain

Back 40

- cerebral peduncles
- superior & inf colliculi (corpora quadrigemina)
- part of brainstem
- surrounds cerebral aqueduct

Front 41

Metencephalon

Back 41

- cerebellum
- pons
- part of brainstem
- surrounds 4th ventricle

Front 42

Myelencephalon

Back 42

- medulla oblongata
- part of brainstem
- surrounds 4th ventricle

Front 43

frontal lobe (telencephalon, cerebrum)

Back 43

- voluntary control of skeletal muscles

Front 44

parietal lobe (telencephalon, cerebrum)

Back 44

- conscious perception of touch, pressure, vibration, pain, temperature, taste

Front 45

occipital lobe (telencephalon, cerebrum)

Back 45

- conscious perception of visual stimuli

Front 46

temporal lobe (telencephalon, cerebrum)

Back 46

- conscious perception of auditory & olfactory stimuli

Front 47

cerebral cortex

Back 47

- two cerebral hemispheres
- gyri = elevations
- sulci = depressions
*central sulcus: runs continuously vertically
*lateral sulcus: also continuous horiz
-- precentral gyrus = motor
-- postcentral gyrus = sensory
- general cerebral fcn:
1. conscious thought processes, intellectual fcns
2. memory storage & processing
3. voluntary & invol reg of somatic motor patterns

Front 48

Diencephalon (anterior)

Back 48

- infundibulum (pituitary stalk)
- mamillary bodies: part of limbic system (emotions)
- olfactory tract
-optic tract & optic chiasm

Front 49

Diencephalon (posterior)

Back 49

- pineal body (endocrine, pdc melatonin, reg circadian rhythms)

Front 50

Diencephalon (midsagittal)

Back 50

- thalamus: relay & processing ctr for sensory info
- hypothalamus: ctr controls emotions, autonomic fcns, hormone pdc'n

Front 51

Mesencephalon (anterior)

Back 51

- cerebral peduncles (crura): form most of midbrain; motor fiber relays, generate invol somatic motor responses
- interpeduncular fossa: space btwn peduncles w/ perforated substance
- oculomotor (III) n.
- trochlear (IV) n.

Front 52

Mesencephalon (posterior)

Back 52

Colliculi = PAIRED
- superior colliculi: hand-eye coord
- inferior colliculi: auditory pathways
- corpora quadrigemina = 4 colliculi together
**Trochlear (IV) n. orig below inf colliculi & curves out & anteriorly

Front 53

Metencephalon (pons)

Back 53

- pons: relays sensory info to cerebellum & thalamus; somatic & visceral motor centers
- trigeminal (V) n.
- abducens (VI) n.
- facial (VII) n.
- vestibulocochlear (VIII) n.
*all CN here emerge from anterior side

Front 54

Metencephalon (cerebellum)

Back 54

- cerebellum: (anterior & posterior lobes) coord complex somatic motor patterns; adjusts output of other somatic motor ctrs in brain & spinal cord
- vermis = worm-shaped depression btwn cerebellar hemispheres
- flocculus = "lock of unspun wool" runs btwn pons & cerebellum

Front 55

Myelencephalon

Back 55

- medulla oblongata: relays sensory info to thalamus
-- autonomic ctrs for reg of visceral fcn (CV, resp, digestive)
-portions: olive, pyramid, C1 ventral roots
- glossopharyngeal (IX) n.
- accessory (XI) n.
- hypoglossal (XII) n. [runs over olive]

Front 56

CN I - olfactory

Back 56

- synapse w/ 2ndary neurons in olfactory bulbs
- olfact bulbs = on inf surf of cerebrum
~ special sensory

Front 57

CN II - optic

Back 57

- orig in retina of eye, cross @ optic chiasm, continue as optic tracts to diencephalon
~ special sensory

Front 58

CN III - oculomotor

Back 58

- orig in midbrain, leaves anterior surf of brainstem btwn midbrain & pons (lateral to mammary & infundibulum)
~ somatic motor (5 extraoc musc)
~ visceral motor para (ciliary body, sphincter pupillae, glands)

Front 59

CN IV - trochlear

Back 59

- arises in midbrain, ONLY CN to exit from posterior surf of brainstem
- LONGEST intracranial (subarachnoid) trajectory
- susceptible to damage during head trauma
- innervates ONE muscle of eye (superior oblique)
~ somatic motor (super oblique)

Front 60

CN V - trigeminal

Back 60

- orig in pons, exits anterolateral surf of pons as large sensory & small motor root
- 3 main divisions (1: opthalmic, 2: maxillary, 3: mandibular)
~ general sensory (skin of face, cornea, sinuses, nasal/oral cav, palate, teeth, ant 2/3 tongue, dura)
~ branchial motor (arch 1: mastication musc, mylohyoid, ant digastric, tensor tympani, tensory vili palatine)

Front 61

CN VI - abducens

Back 61

- arise from pons, exit brainstem @ pontomedullary jcn
- longest interdural trajectory
-more medial than VII; just ant to pyramid of medulla obl.
~ somatic motor (lateral rectus)

Front 62

CN VII - facial

Back 62

- arise from pons & exit brainstem @ pontomedullary jcn
- does 80% of parasymp to head
- 5 main branches: TZBMC
~ gen sensory (ext aud meatus)
~ visc motor para (glands [lacrimal, nasal, palatine, pharyngeal, submandib, subling])
~ visc sens (palate)
~ special sens (taste ant 2/3 tongue, palate)
~ branchiomotor (arch 2: facial expr musc, post digastric, stapedius, stylohyoid)

Front 63

CN VIII - vestibulocochlear

Back 63

- arise from pons & exit brainstem @ pontomedullary jcn
- splits into vestibular & cochlear branches
~ special sens: hearing, equilibrium

Front 64

CN IX - glossopharyngeal

Back 64

- arises from medulla
~ gen sens: external ear
~ visc motor para: parotid gland
~ visc sens: middle ear, tonsils, pharyngeal mucosa, post 1/3 tongue, carotid sinus/body
~ special sens: taste post 1/3 tongue
~ branchiomotor: arch 3: stylopharyngeus

Front 65

CN X - Vagus

Back 65

- arises from medulla
~ gen sens: external ear, external aud meatus, dura
~ visc motor para: THORAX (heart, lungs, GI tract thru TV colon)
~ visc sens: mucosa of pharynx & larynx, heart, lungs, GI tract thru TV colon
~ special sensory: taste (valleculae)
~ branchiomotor: arch 4 (palate, pharynx, criocothyroid musc) & arch 6 (intrinsic laryngeal musc)

Front 66

CN XI - spinal accessory

Back 66

- arises from spinal cord C1-5, ascends thru for. magnum
- sometimes joins w/ cranial accessory (CN X)
- exits via jugular foramen w/ IX, X
~ somatic motor: SCM, trapezius

Front 67

CN XII - hypoglossal nerve

Back 67

- arises from medulla (lateral)
- goes underneath tongue to innerv tongue muscles
- exits via hypoglossal canal
~ somatic motor: tongue musc (3 extr, 3 intr)

Front 68

6 potential nerve fiber types of cranial nerves

Back 68

1. somatic motor
2. general sensory
3. visceral motor (para!)
4. visceral sensory
5. special sensory
6. branchiomotor

** NO visceral symp-- those orig in thoracolumbar (T1-L2) & ascend via symp chain

Front 69

Ventricles of brain

Back 69

4 ventricles, pdc & hold CSF
- choroid plexus = produces CSF
- interventricular foramen (1-2)
- cerebral aqueduct (3-4)
- lateral aperture (4)
- median aperture (4)
* HOLD CSF

Front 70

choroid plexus

Back 70

- mass of capillaries, invested by modified ependymal cells
- makes CSF
- CSF circ in subarachnoid space in brain & spinal cord

Front 71

otorrhea

Back 71

- CSF leakage into ear
- usually after basilar skull Fx

Front 72

rhinorrhea

Back 72

- CSF leakage into nose
- usually after basilar skull fx

Front 73

basic CSF circulation

Back 73

- lateral ventricles --> 3rd v (via interventric for. of Monro)
- 3rd ventr --> 4th (via cerebral aqueduct of Sylvius)
- 4th ventr --> subarachnoid space (via 1 median & 2 lateral apertures)
- subarach space --> venous sinuses
- CSF recycled back to venous sinuses via arachnoid granulations

Front 74

hydrocephalus

Back 74

- overpdc'n of CSF, obstruction of CSF flow, interference w/ CSF absorption
- excess CSF dilates ventricles, thins cerebral cortex, separates bones of calvaria in infants
-blockage in cerebral aqueduct or interventricular for.

Front 75

cingulate gyrus

Back 75

- runs on top of corpus callosum

Front 76

septum pellucidum

Back 76

separates ventricle from ?

Front 77

Separation of oral cavity & oropharynx

Back 77

-palatoglossal arch
(posterior to arch = palatine tonsil, then palatopharyngeal arch)

Front 78

contents of nasopharynx

Back 78

- cartilaginous eustacian tube (covered superiorly by torus tubarius)
- pharyngeal recess
- salpopharyngeal fold (over musc)
[nasopharynx = base of skull to soft palate]

Front 79

contents of oropharynx

Back 79

- posterior 1/3 of tongue
- valleculae
- lingual & palatine tonsils
- palatoglossal & palatopharyngeal arches (pillars of fauces)
[orophar = soft palate to base of tongue]

Front 80

valleculae

Back 80

- depression btwn base of tongue & epiglottis
- bordered by glossoepiglottic folds

Front 81

contents of laryngopharynx

Back 81

- opening of esophagus
- piriform recesses (lateral to larynx opening, outpouchings where foreign obj can lodge)
[laryngopharynx = behind larynx]

Front 82

tonsils

Back 82

- collections of lymphoid tissue
- form incomplete circle around pharyngeal inlet
- regress as get older
- 4 types:
1. pharyngeal (in pharyng recess in nasophar)
2. tubular (over eustacian tube in nasophar)
3. palatine (btwn palatoglossal & palatopharyngeal arches in orophar [=tonsilar fossa])
4. lingual (post 1/3 of tongue in orophar)

Front 83

tonsillectomy
- which tonsil group (usually)
- risk for nerve damage (which nerve)?

Back 83

- usu palatine tonsils
- can damage lingual branch of glossopharyngeal n (CN IX) ==> altered sensation to posterior 1/3 of tongue

Front 84

Tonsiloliths

Back 84

- debris stuck in tonsils, can become calcified
- can be cause of bad breath
- usually only found in ppl who still have palatine tonsils

Front 85

adenoiditis

Back 85

- enlarged/inflamed pharyngeal & tubal tonsils (in nasophar)
- can cause breathing probs b/c blockage of choanae
- Sx/probs:
~ mouth breathing
~ dental probs
~ middle ear infections (b/c fluid backed up & Eust tube can't drain)
~ hearing loss

Front 86

Pharyngeal raphe

Back 86

- where sup, mid & infer pharyngeal constrictors meet
- posterior midline

Front 87

superior pharyngeal constrictor

Back 87

- common attachment w/ buccinator at pterygomandibular raphe
- posterior to buccinator

Front 88

pterygomandibular raphe

Back 88

- from pterygoid hamulus to just posterior to 3rd molar
- where superior pharyngeal constrictor & buccinator muscles meet

Front 89

middle pharyngeal constrictor

Back 89

- from pharyngeal raphe to hyoid bone

Front 90

inferior pharyngeal constrictor

Back 90

- from pharyngeal raphe to thyroid & cricoid cartilages
- cricopharyngeus portion = sphincter for superior end of esophagus

Front 91

Longitudinal pharyngeal muscles

Back 91

- stylopharyngeus (from styloid, passes btwn sup & mid phar constr to end at thyroid cartilage)
- salpingopharyngeus (Eust tube along salpingopharyng fold, blends w/ palatopharyngeus inferiorly)
- palatopharyngeus (palatopharyngeal fold: one of pillars of fauces)

Front 92

Innervation of pharyngeal muscles

Back 92

- Motor: all are Vagus (CN X)
- *exception = stylopharyngeus: CN IX, 3rd arch muscle
- sensory: glossopharyngeal (CN IX)
- pharyngeal plexus = CN IX & X

Front 93

gag reflex: which nerves?

Back 93

- CN IX (glossopharyng)- posterior 1/3 of tongue/oropharynx v sensitive to touch
- causes contraction of IX & X muscles

Front 94

Tensor veli palatini muscle
- location
- fcn
- innervation

Back 94

- temporal bone & auditory tube, descends & swings around hamulus of medial pterygoid plate; tendon flattens & meets that from other side = palatine aponeurosis
- tenses soft palate: closes naso from oropharynx when swallow, opens auditory tube when yawn/swallow
- TRIGEMINAL (V3), 1st arch muscle

Front 95

Levator veli palatini muscle
- location
- fcn
- innervation

Back 95

- temporal bone & auditory tube, descends & inserts into palatine aponeurosis (doesn't wrap around hamulus = posterior to tensor veli palatini)
- elevates soft palate: closes naso from orophar, helps open aud tube
- VAGUS, 4-6th arch

Front 96

Palatoglossus muscle
- loc
- fcn
- innerv

Back 96

- palatine aponeurosis to lateral side of tongue
- depresses soft palate, narrows pharyngeal inlet
- (vagus?)
- * = palatoglossal arch when covered by mucosa (= ant pillar of fauces)

Front 97

Palatopharyngeus muscle
- loc
- fcn
- innerv

Back 97

- palatine aponeurosis to lateral pharyngeal wall
- depresses soft palate, narrows pharyngeal inlet (same as palatoglossus)
- (vagus?)
- * = palatopharyngeal arch when covered by mucosa (= post pillar of fauces)

Front 98

Innervation of soft palate muscles

Back 98

- All Vagus (CN X)
- *except: tensor veli palatini (V3)

Front 99

Larynx- structures/spaces (as move down)

Back 99

- vestibule
- vestibular fold (false vocal cord)
- ventricle
- vocal fold (true vocal cord, has vocal ligament)

Front 100

Spaces of larynx

Back 100

- vestibule: sup to vestib/false folds, entrance to larynx
- ventricle: btwn vestibular & vocal cords (false & true)
- glottis: vocal cords & space btwn true cords, V-shaped

Front 101

Arytenoid cartilages
- location
- portions
- fcns

Back 101

- posterior superior cricoid surface
- lateral process = muscle attachment (goes to thyroid or cricod cart)
- anterior process = vocal (vocal ligament, also to inner thyroid cart)

Front 102

Epiglottis

Back 102

- cartilage at base of tongue
- sep from tongue by valleculae
- connects to arytenoid cart via aryepiglottic folds
- superior to quadrangular membrane

Front 103

Quadrangular membrane (laryngeal)

Back 103

- btwn epiglottis & arytenoid cartilages
- upper border = aryepiglottic folds
- lower border = vestibular (false) ligament

Front 104

conus elasticus (laryngeal)

Back 104

- btwn cricoid & thyroid cartilages
- upper border = true vocal cord
- lower border = cricoid cartilage

Front 105

laryngeal muscles: 2 major fcns

Back 105

1. close laryngeal inlet (keep food out of airway, effort closure = closing both false & true, increase abd pressure)
2. move vocal cords (open airway, pdc

Front 106

laryngeal muscles

Back 106

- posterior cricoarytenoid (PCA): abduct vocal cords, open airway (glottis)
- oblique & transverse arytenoids: adduct vocal cords, close airway; sup to PCA
- cricothyroid: stretches cords, changes pitch of voice; anterior
- lateral cricoarytenoid: adducts
- vocalis: fine changes; parallel/overlay vocal cords

Front 107

Sensory innervation of larynx

Back 107

- above vocal cords = internal laryngeal (of superior br of vagus)
- below vocal cords = recurrent laryngeal of vagus

Front 108

Vagus branches

Back 108

superior branch: splits into internal laryngeal (thyrohyoid membr, sup laryng mucosa) & external laryngeal (cricothyroid muscle)
recurrent laryngeal: sensory below vocal cords, motor to all laryng muscl (except cricothyroid)

Front 109

motor innervation of larynx

Back 109

-VAGUS: recurrent laryngeal
(except cricothyroid, which external laryngeal off superior br of vagus)

Front 110

recurrent laryngeal nerve

Back 110

- travels btwn trachea & esophagus
- recurs around subclavian (R) & aortic arch (L)
- innervates motor of larynx & sensory below vocal cords

Front 111

Infratemporal fossa
-location/boundaries
-contents

Back 111

- roof & medial wall = sphenoid bone
- anteriorly = back of maxilla
- foramen: ovale, spinosum,
- muscles of mastication
- TMJ (temporomandibular joint)
- maxillary artery
- pterygoid venous plexus
- V3 branches
- otic ganglion
- chorda tympani (from VII)

Front 112

muscles of mastication

Back 112

- all 1st pharyngeal arch
- innerv = V3
- all move mandible at TMJ
= masseter, temporalis, pterygoids (medial & lateral), mylohyoid, anterior digastric

*tensor veli palatini & tensor tympani also 1st arch but NOT mastication

Front 113

Masseter
-fcn
-origin
-insertion
-innervation

Back 113

- (both) elevate mandible; (one) = ipsilateral excursion (same side)
- orig: zygo arch
- ins: angle of mandible
- innerv = V3 motor

Front 114

Temporalis
- fcn
-origin
-insertion
-innervation

Back 114

- (both) elevate mandible, posterior fibers retract mandible, (one) ipsilateral excursion
- orig: temporal fossa & fascia
- ins: coronoid process
- V3

Front 115

Medial pterygoid

Back 115

- elevates mandible, (one) contralateral excursion (opp side)
- orig: MEDIAL side of LATERAL pterygoid plate
- ins: internal surf of mandib ramus
- V3
* like mirror image of masseter, just on inside of mandible instead of outside

Front 116

Lateral pterygoid

Back 116

- (both) protrusion of mandible, (one) contralateral excursion
- TWO orig: 1) infratemporal crest of sphenoid, 2) LATERAL side of LATERAL pterygoid
- ins: neck of condyle, pterygoid fovea, articular disc/capsule of TMJ
- V3
* fibers horiz; (long) buccal n. of V3 emerges from btwn two lateral heads
-middle meningeal artery deep to lat pteryg

Front 117

Movement at TMJ

Back 117

1. sliding = upper joint space (protraction, retraction; eg by lat pterygoid, )
2. hinge = lower joint space (elevation, depression)
3. lateral excursion (contraction on one side of pterygoids, masseter, temporalis)

*upper & lower joint spaces separated by articular disc

Front 118

Opening the mouth: which muscles involved?

Back 118

1. mylohyoid & ant digastric (suprahyoid musc) initiate via depr mandible (lower joint space)
2. lateral pterygoids protrude mandible (upper joint space)
Fully open = condyle sits under articular eminence of zygom

Front 119

Closing the mouth: which muscles?

Back 119

= elevation & retraction of mandible
- masseter, temporalis, medial pterygoids pull condyle back into resting place

Front 120

Maxillary artery
- location
- vascularizes which structures?

Back 120

- branch of external carotid
- deep to ramus of mandible in infratemporal fossa --> pterygopalatine fossa
- supplies: all teeth, palate, nasal cavity, musc of mastic, bones, midface
*main artery of deep facial structures
sometimes deep to lateral pterygoids too

Front 121

Major branches of maxillary artery

Back 121

- inferior alveolar artery (to lower mandible teeth, in mandibular canal)
- posterior superior alveolar (to maxillary teeth, pierces maxilla)
- middle meningeal artery (skull bones, meninges)

Front 122

middle meningeal artery

Back 122

- branch of maxillary artery
- enters mid cran fossa of skull via foramen spinosum
-supplies skull bones, meninges
-on surface of sphenoid, deep to lat pteryg musc
- splits auriculotemporal nerve
* torn = epi/extradural hematoma

Front 123

veins leading to cavernous sinus

Back 123

- pterygoid venous plexus
- opthalmic veins
- facial veins
*infections in facial/dental area can spread to cranial cavity

Front 124

V3 motor branches

Back 124

- all muscles of mastication (temporalis, masseter, lateral & medial pterygoid)
- mylohyoid br (mylohyoid & ant digastric)
- tensor veli palatini & tensor tympani

Front 125

V3 sensory branches (general sensory)

Back 125

- nervous spinosus (mid cran fos dura)
- buccal ("long", to lateral gum, inner cheek, skin lower cheek)
- lingual (ant 2/3 tongue, floor of mouth; joined by chorda tympani of VII) *emerges btwn med & lat pterygoids
- inf alveolar (lower teeth, --> mental nerve)
- auriculotemporal (hairy temporal skin; parasymp from IX lesser petrosal to parotid) * splits over mid meningeal art

Front 126

sphenomandibular ligament

Back 126

- from sphenoid to mandibular ramus
- inf alv n. & art pass btwn this & ramus to enter mandibular fossa

Front 127

oral vestibule

Back 127

- area btwn teeth & cheeks
- contains parotid papilla (near 2nd max molar)

Front 128

oral cavity

Back 128

- internal to teeth
- extends to oropharynx
- tongue, frenulum, floor = mylohyoid

Front 129

mylohyoid muscle
- fcn
- origin
- insertion
- innerv

Back 129

- depresses mandible or elevates hyoid depends on which one fixed
- orig: mylohyoid line of mandible
- ins: hyoid bone
- V3
- deep to ant digastric, superficial to geniohyoid

Front 130

Sublingual salivary gland
- location
- duct opening(s)
- innervation

Back 130

- under tongue
- ducts open along floor of mouth (can't really see them)
- parasymp chorda tympani (VII) synapses in submandib gangl

Front 131

Submandibular salvary gland

Back 131

- wraps around posterior border of mylohyoid muscle, ant & inf to parotid gland
- long duct runs over lingual n. & ends in sublingual caruncle/papilla at base of frenulum, the duct that can squirt saliva from beneath tongue
- parasymp chorda tymp (VII) synapses in submandib gangl
*chorda tymp hitch hiking on V3 lingual at this point

Front 132

extrinsic tongue muscles

Back 132

- origin outside tongue, insert in tongue
- 3 pairs:
1. hyoglossus: hyoid-lateral side of tongue, depresses tongue
2. styloglossus: styloid process-posterior part of tongue; retracts tongue
3. genioglossus: genial/mental tubercles -fans out; protrudes/sticks out tongue
-innerv = hypoglossal (XII)

Front 133

intrinsic tongue muscles

Back 133

- origin & insertion within tongue
- change shape of tongue & produce complex movements
- 3 paired muscles
- innerv = hypoglossal (XII)

Front 134

dorsum of tongue: terminal sulcus

Back 134

- separates ant 2/3 from post 1/3
- V shaped; apex = foramen cecum (orig thyroglossal duct)
-lingual papillae = bumps on ant 2/3 assoc w/ tastebuds (but arent buds themselves)

Front 135

tongue

Back 135

- apex = tip
- base = in oropharynx
- ant 2/3 in oral cavity
- underside = ventral
- top side = dorsum

Front 136

tongue innervation

Back 136

- MOTOR: hypoglossal (XII)
- general sensory: ant 2/3 = V3; post 1/3 by glossopharyngeal (IX)
- special sensory: ant 2/3 by chorda tympani (VII); post 1/3 by glossopharyngeal (IX)
- epiglottis & valleculae = special sens of X
*taste fibers from VII, IX & X meet at solitary tract nucleus in brainstem