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52 Cards in this Set

  • Front
  • Back
What are the connections of the posterior wall of the pterygopalatine fossa?
1. Vidian canal: connects middle cranial fossa
2. Foramen rotundum - CNV2
3. Palatovaginal canal connects nasopharynx
What is the arterial supply of the nasal cavity?
1) External carotid artery:
- Branches of maxillary artery (sphenopalatine, greater palatine ).
- Branches of facial artery (superior labial, and lateral nasal).
2) Internal carotid artery:
- Branches of ophthalmic artery (anterior and posterior ethmoidal arteries).
What is Kiesselbach’s plexus (little’s area)?
Common site of anterior nose bleeds in the anterior and inferior nasal septum, supplied by branches of sphenopalatine, greater palatine and facial arteries.
Which bones make up the lateral wall of the nasal cavity?
Nasal, Maxillary (frontal process), Ethmoid (labyrinth), lacrimal bone, inferior concha,
Palatine (perpendicular plate) & Sphenoid bones (from which superior and middle concha arise).
Communications:
SPHENOETHMOIDAL RECESS
Receives the opening of the sphenoid sinus
Communications:
SUPERIOR MEATUS
Posterior ethmoid sinuses open by one or more orifices
Communications:
MIDDLE MEATUS
1. Anterior ethmoidal infundibulum communicating with frontal sinuses
2. Semilunar hiatus posteriorly drains the frontal and maxillary sinuses
Communications:
INFERIOR MEATUS
Drains the anterior lacrimal duct
Which ligaments support the TMJ?
Intrinsic lateral ligament (formed by articular capsule) and extrinsic stylomandibular and sphenomandibular ligaments support the TMJ
Boundaries and closure:
Posterior fontanelle?
two parietal bones adjoin the occipital bone (at the lambda- junction lambdoid and sagittal suture).

Usually closes by 6-8 months.
Boundaries and closure: Anterior fontanelle?
largest diamond shaped fontanelle (about 2cm) where the two frontal and two parietal bones join (coronal and sagittal sutures). Usually closes by 15-18 months.
Boundaries and closure:
Sphenoid fontanelle?
Between the sphenoid, parietal, temporal, and frontal bones

2-3 months
Boundaries and closure:
Mastoid fontanelle?
between the temporal, occipital, and parietal bones

2-3 months
Describe the nasolacrimal apparatus.
Superolateral orbit lateral to levator palpabrae which divides gland into small anterior palpebral lobe and larger posterior orbital lobe. Lies within the lacrimal fossa of the zygomatic process of the frontal bone. Secretes tears into upper fornix (between eyelid and upper eye) by several ducts.
Lacrimal Puncta on medial margin of each eyelid -> drain tears into the superior and inferior lacrimal canniculi -> lacrimal sac (within deep groove formed by lacrimal bone and frontal process of maxilla) -> nasolacrimal duct within its own bony canal -> inferior meatus of the nasal cavity.
What are the major surface markings of the mandible?
Mental foramen: passage of mental vessels and mental nerves inferior to 2nd premolar.

Mental protruberance: at the lower edge of the symphysis.

Alveolar borders (sup/inf): for reception of 16 teeth.

Mandibular foramen: medial surface of ramus, for the entrance of the inferior alveolar vessels and nerve (branch of V3).
What is the course of the left recurrent laryngeal nerve?
Winds around aortic arch (from anterior) and ascends in tracheoesophageal groove
What is the course of the right recurrent laryngeal nerve?
Winds around right subclavian artery and ascends along superior lobe of pleura approaching the tracheosophageal groove behind the common carotid artery.
What structures pass through the superior thoracic apperture?
• trachea
• oesophagus
• thoracic duct
• apexes of the lungs
• nerves
o phrenic nerve, vagus nerve, Recurrent laryngeal nerves, sympathetic trunks
• vessels
o arteries
- left and right common carotid arteries, left and right subclavian arteries
o veins
- internal jugular veins, brachiocephalic veins, subclavian veins
• lymph nodes and lymphatic vessels
What is the arterial supply of the thyroid gland?
Superior Thyroid Artery - branch of ECA
Inferior Thyroid Artery - branch of thyrocervical trunk
Thyroid Ima Artery in 10% of people - usually from brachiocephalic trunk
What parts make up the temporal bone?
• A flat squamous part, which forms part of the vault and part of the skull base
• A pyramidal petrous part, which houses the middle and inner ears and forms part of the skull base
• An aerated mastoid part
• An inferior projection known as the styloid process
• Zygomatic process continuous with zygomatic arch of zygoma
Name the four (4) foramen which pierce the greater wing of sphenoid and what they transmit.
1. Superior orbital fissure (between GWS and LWS): CN III,IV,VI, V1, sympathetic fibres, opthalmic viens
2, Foramen rotundum - CNV2 into pterygopalatine fossa
3. Foramen ovale - V3 and accessory meningeal artery into infratemporal fossa
4. Foramen spinosum - middle meningeal vessels and meningeal branch of mandibular nerve
What are the three (3) branches of CNV1 (opthalmic nerve)
Nasociliary
Lacrimal
Frontal
What are the five (5) terminal branches of the facial nerve
Branches within parotid gland
- Temporal
- Zygomatic
- Buccal
- Marginal Mandibular
- Cervical
What structure lie within the parotid gland?
From superficial to deep
- facial nerve and its branches
- retromandibular vein
- external carotid artery
Parotid lymph nodes on sheath and within gland receive lymph from lateral face
What is the path of the parotid duct?
Passes horizontally from anterior edge of gland -> pierces buccinator at anterior edge of masseter -> orifice opposite 2nd maxillary molar tooth
What is the course of the middle meningeal artery?
Branch of the maxillary artery (terminal branch of ECA) which enters middle cranial fossa via foramen spinosum -> runs laterally dividing into anterior and posterior branches.
What is the pterion?
What is its clinical significance?
Thin H shaped formation of sutures of frontal, parietal, sphenoid (GWS) and temporal bone.

Frequent fracture site overlying anterior branch of middle meningeal artery -> epidural haematoma.
The optic canal is within which bone?
Lesser wing of sphenoid
What are the contents of the infratemporal fossa?
- Inferior part of temporal muscle
- Lateral and medial pterygoid muscles
- Maxillary artery
- Pterygoid venous plexus
- Mandibular, inferior alveolar, lingual, buccal, and chorda tympani nerves
- Otic ganglion
Name the secondary teeth.
Medial incisor
Lateral incisor
Canine
Two premolar
Three molar
Which bones make upper the hard palate?

What three (3) foramen open on the oral aspect?
Palatine processes of maxilla and horizontal plate of palatine bone.

1. Incisive fossa (posterior to central incisor): nasopalatine nerves
2. Greater palatine foramen (medial to 3rd molar): greater palatine vessels and nerve
3. Lesser palatine foramen (pyramidal process of palatine bone): inferior palatine vessels and nerves.
Describe the location and contents of the inferior orbital fissure.
Anterior wall of the pterygopalatine fossa.

Maxillary nerve becomes infraorbital nerve on passing through fissure.
Describe the vocal ligament.
Medial free edge of the lateral cricothyroid ligament passing between the thyroid cartilage and vocal process on the arytenoid cartilage.
Describe the structure, relations and contents of the parotid gland.
Small deep part and large superficial part continuous around the posterior ramus via the isthmus.
Deep part extends medially to carotid sheath and lateral wall of pharynx.
Superficial part anterior to tragus, SCM and mastoid process posteriorly, posterior ramus and masseter anteriorly.
Tail around angle of mandible.
Contents
ECA bifurcating into maxillary and superficial temporal.
Facial nerve from stylomastoid foramen into 5 branches
Retromandibular vein.
What are the borders of the middle ear?
Lateral (membranous) wall: tympanic membrane attached to scutum
Medial (labrynthine) wall: Promotory of cochlea, oval and round window, third part of facial nerve
Superior (tegmental) wall: thin layer of bone called tegmen tympani
Inferior (jugular) wall: seperates superior bulb of IJV
Anterior (Carotid) wall: seperates cavity from ICA, has opening for auditory canal
Posterior (Mastoid) wall
What are the contents of the middle ear?
Ossicles (Malleus, Incus, Stapes)
Stapedium and tensor tympani muscles
Chorda Tympani nerve (from CN VII), tympanic plexus
What is the aditus to the mastoid antrum?
Opening in the posterior tympanic cavity connecting to mastoid air cells
What is the bony labyrinth?
- Contains cochlea, vestibule and semicircular canals.
- Contains perilymph surrounding by dense opic capsule of petrous temporal bone.
- suspends membranous labyrinth containing endolymph
What is the vestibule of the inner ear?
- The vestibule lies posterior to the cochlea, abutting the internal auditory canal medially.
- The stapes footplate transmits vibrations to the vestibule at the oval window.
- The 3 semicircular canals emanate from the vestibule.
What is the facial canal?
- Runs from anterior IAM to stylomastoid foramen
- passes lateral to cochlea and vestibule then U-bends behind tympanic cavity
- fibres from motor nerve and intermediate nerve for the geniculate plexus within the U-bend
- the greater petrosal, chorda tympani and nerve to stapedius arise within the facial canal
What are the components of the vestibule of the inner ear?
Utricle connects to semicircular canals

Saccule connects to cochlear canal

Connected by utriclosaccular duct from which the endolymphatic duct arises
Describe the greater palatine canal.
Runs inferiorly from pterygopalatine fossa between palatine bone and maxilla.
Contains descending palatine artery -> greater and lesser palatine
- enters medial to 3rd molar in the greater palatine foramen
What are the contents of the pterygopalatine canal?
- Terminal maxillary artery and branches (posterior superior alveolar, descending palatine, artery of pterygoid canal, sphenopalatine, infraorbital)
- Maxillary nerve - enters f. rotundum and leaves IOF as infraorbital nerve
- Nerve to pterygoid canal
- Pterygopalatine ganglion from maxillary nerve and greater petrosal branch of CNVII
In regards to the larynx, decribe the
a) arterial supply
b) venous drainage
c) lymphatic drainage
d) nerve supply
a) superior and inferior laryngeal arteries off the superior and inferior thyroid.
b) accompany arteries (same naming)
c) split into superior and inferior by true vocal cord. Superior accompany vein into superior deep cervical. Some inferior accompary vein into inferior deep cervical and some via prelaryngeal, pretracheal and paratracheal.
Cartilage of the larynx?
1. Thyroid superiorly with laryngeal prominence anteriorly
2. Cricoid attaching to thyroid superiorly and trachea inferiorly. Signet ring shaped.
3. Epiglottis - thin stem is attached to thyroid cartilage anteriorly. Protects glottis.
4. Paired arytenoids - pyramid shaped upper border of cricoid posteriorly. Attach vocal cord.
5. Paired Corniculate - superior to arytenoids
6. Paired Cuneiform - anterior to arytenoids (no articulation) in aryepiglottic fold
Write short notes on the sphenoid sinuses
• Paired cavities in the body of the sphenoid
• Closely related to the ethmoid air cell anteriorly
• Each opens into the corresponding sphenoethmoidal recess via an aperture of the sinus
• Main development occurs after puberty
• Usually separated by a septumthat deviates from the midline in 75% - unequal in size and form

• Anatomical relations:
o Superiorly: Sella turcica bearing the pituitary gland with the optic chiasm
o Lateral walls: cavernous sinus and its contents
o Floor of the sphenoid sinus forms the roof of the nasopharynx

Vascular supply, lymphatics, innervation:
• Receive arterial supply from the posterior ethmoidal branches of the ophthalmic arteries and nasal branches of the sphenopalatine arteries
• Venous drainage through the posterior ethmoidal veins
• Lymphatic drainage: retropharyngeal nodes
• Innervated by the posterior ethmoidal branches of ophthalmic nerves, pterygopalatine ganglia (parasympathetic fibers)
Write short notes on the maxillary sinuses
• Largest of the paranasal sinuses
• Described has having a body and four processes
1. Orbital process – contributes to the medial rim of the orbit
2. Zygomatic process – continuous with the zygomatic arch
3. Alveolar process – bears the teeth
4. Palatine process – forms the roof of the mouth and floor of the nasal cavity
• Ostiomeatal complex:
• Refers to the area that includes the maxillary sinus ostium, ethmoid infundibulum and the hiatus semilunaris
• Common pathway for drainage of secretions from the maxillary and anterior group of ethmoidal sinuss

Vascular supply, lymphatic drainage and innervation:
• Maxillary arteries via the superior anterior, middle and posterior alveolar branches, infraorbital and palatine branches
• Veins corresponding to the arteries drain into the facial vein or pterygoind venous plexus on either side
• Lymph drainage is to the submandibular nodes
• Innervated by the infraorital and anterior, middle and posterior superior alveolar branches of the maxillary nerves, pterygopalatine ganglia (parasympathetic)
• Imaging:
o CT defines the anatomical variations
Write short notes on the ethmoid sinuses
• Labyrinth of bony cavities or cells situated between the medial walls of the orbit and the lateral walls of the upper nasal cavity
• Vary from 3 large to 18 small sinuses on each side
• Pneumatization may extend into the wing of the sphenoid bones
• Divided clinically into anterior and posterior groups
• These groups are separated by the basal lamella of the middle concha
• Anterior group:
- Anterior ethmoidal cells drain into either the ethmoidal infundiculum or the frontonasal duct
- Agger nasi cells – enlargement of the anterior cells towards the frontal bone
- Haller’s cells – are larger anterior/middle cells below the apex of the orbit
• Posterior group:
- Up to seven ethmoidal air cells usually drain into superior meatus
- Lie very close to the optic canal
- Onodi cell – present in 3-51% of people depending on racial groups, most posterior ethmoid cell that pneumatizes – intimately associated to optic nerve

Vascular supply, innervation, lymphatics:
• Arterial supply from nasal branches of the sphenopalatine artery and anterior, posterior ethmoidal branches of ophthalmic artery.
• Venous drainage by the corresponding veins
• Lypmhatics – anterior group submandibular nodes, posterior group – retropharyngeal nodes
• Innervated by anterior and posterior ethmoidal branches of ophthalmic nerves
Write short notes on the frontal sinuses
• Lie between the inner and outer tables of the frontal bone, above the nose and medial part of the orbits, posterior to the superciliary arches
• Each sinus may be further divided into a number of communicating recesses by incomplete bony septa
• Vary greatly in size and are often asymmetrical
• May extend into the orbital plate of the frontal bone
• Drainage:
- Aperture of each frontal sinus either opens into the anterior part of the corresponding middlemeatus by the ethmoidal infundibulum or
- Medial to the hiatus semilunaris
• Absent at birth, developed during the 7th and 8th years, reach full size after puberty
• More prominent in males

Vascular supply, innervation, lymphatics:
• Arterial supply from supraorbital and anterior ethmoidal arteries
• Veins drain into an anastomotic vein in the supraorbital notch  connects ophthalmic veins
• Lymphatic drainage is to the submandibular nodes
• Innervated by branches of the supraorbital nerves and pterygopalatine ganglia (parasympathetic fibers)
What are the four divisions of the anterior triangle of the neck and their boundaries/ contents?
1. Submental - unpaired median space between mandible and hyoid bounded by anterior digastrics. Contains submental LNs
2. Submandibular triangle - between mandible and anterior and posterior bodies of digastric. Contains submandibular gland, hypoglossal nerve, facial artery.
3. Carotid triangle - between omohyoid, posterior digastric and SCM. Contains carotid sheath and contents, accessory nerve, deep cervical LNs.
4. Muscular (or omohyoid) triangle - superior belly of omohyoid and anterior border of SCM. Contains infrahyoid strap muscles. Visceral layer of fascia.
What are the infrahyoid spaces?
Write short notes on the posterior triangle of the neck
Bounded by anterior trapezius, posterior SCM and clavicle. Overlies prevertebral fasia.
Divided by inferior belly of omohyoid into occipital and supraclavicular triangles.
Contents: accessory nerve and LN chain, brachial plexus trunks, 3rd part of subclavian artery, fat, dorsal scapular nerve