Anatomy Head And Neck Laitman Lab Q's Vol I

Front 1

What is the difference between the "skull" and the "cranium"?

Back 1

Skull: all 22 bones listed below.
Cranium: the skull minus the mandible

8 Cranial Bones: Occipital, Two Parietal, Frontal, Two Temporals, Sphenoid, Ethmoid

14 Facial Bones: 2 Nasal, 2 Maxillae, 2 Lacrimal, 2 Zygomatic, 2 Palatine, 2 Inferior Nasal Conchae, Vomer, Mandible

Front 2

What is a "branchial arch"? What is the nerve of the first branchial arch? The nerve of the second branchial arch?

Back 2

What is a "branchial arch"? What is the nerve of the first branchial arch? The nerve of the second branchial arch?

First Branchial Arch: Mandibular Arch → Muscles of mastication → Mandibular n. (CN V3 – one of three branches of Trigeminal n.)
Second Branchial Arch: Hyoid Arch → Facial muscles (expression) → Facial n. (CN VII)

Front 3

What is the major sensory nerve of the face? What are the divisions of this nerve? What type of nerve fibers are found in each division?

Back 3

Trigeminal n. (CN V) – major sensory n. of face with three large groups of peripheral processes from n. cell bodies comprising trigeminal ganglion (large sensory ganglion of CN V)
Opthalmic n. (CN V1) – all sensory GSA
Maxillary n. (CN V2) – all sensory GSA
Mandibular n. (CN V3) – sensory GSA and special motor SVE (skeletal muscles of branchiomeric origin rather than originating from somites)

Front 4

What nerve exits the skull through the foramen ovale?

Back 4

Mandibular n. (CN V3)

Front 5

5) What nerve supplies the muscles of facial expression?

Back 5

Facial n. (CN VII)

Front 6

What nerve traverses the parotid duct? Why is this of clinical importance?

Back 6

Parotid gland – largest salivary gland
Parotid duct – passes anteriorly and horizontally from the anterior edge of the gland

Facial n. (CN VII) traverses duct; must be identified and preserved in parotidectomy

Front 7

7) What is the distinguishing physical characteristic of the facial artery that will enable you to identify it easily?

Back 7

Winding path along anterior border of masseter muscle on mandible

Front 8

What larger artery is the facial a direct branch off of?

Back 8

External carotid a.

Front 9

Where is the mental foramen? What specific nerve emerges from it? What cranial nerve is it a branch of? What type of fibers are in this nerve?

Back 9

Mental foramina – inferior to second premolar teeth;
Mental n. passes through mental foramen to supply skin and mucous membrane of lower lip, skin of chin and vestibular gingiva of mandibular incisor teeth;
- branch of Mandibular n. (CN V3) which is a branch of Trigeminal n. (CN V);
- GSA and GVA (?) – not sure about this

Front 10

What is a suture? Why can we not always see them in adult skulls?

Back 10

Suture: fibrous joint where bones are close together and united by fibrous tissue, often interlocking along a wavy line; Not always seen in adults due to closure of suture

Front 11

Besides identifying complete bones (e.g., the "mandible", the "frontal" bone) begin to recognize both specific parts of bones, and the foramina that traverse them. It will become particularly important for you to identify foramina and the structures that pass through them.

Back 11

OK

Front 12

In preparation for the lab, we have "removed" part of the calvarium. What specific bones did we cut through in this procedure?

Back 12

Calvarium: dome-like roof of the neurocranium consisting of following bones. . .
Front: Frontal bone
Sides: Parietal bones
Rear: Occipital bone

Front 13

There are three different types of "hollow" spaces found in the head. Two are called "sinuses" the third "ventricles". What are these, and what is found in each?

Back 13

Dural Venous Sinuses (deoxygenated blood): endothelial lined spaces between the periosteal and meningeal layers of the dural mater. Large veins from surface of brain empty into these and all blood from brain ultimately drains through them into internal jugular veins.
See p. 518-9 Baby Moore

Paranasal Sinuses (Air): Air filled extensions of the respiratory part of the nasal cavity into the following cranial bones: frontal, ethmoid, sphenoid, and maxilla. See p. 577 Baby Moore

Ventricular System of Brain (CSF): Consists of four ventricles that house choroid plexuses (area of CSF formation) and drain cerebrospinal fluid (CSF) into subarachnoid space, where it nourishes and cushions brain.

Front 14

What are the arachnoid granulations? What is the name of the corresponding indentations that they produce on the skull?

Back 14

Arachnoid Granulations: protrusions of arachnoid villi into walls of dural venous sinuses; main site of CSF absorption into venous system, especially the superior sagittal sinus and its lateral lacunae;
Foveolae Granulares: small shallow depressions on inner aspect of calvaria usually in vicinity of sulcus for superior sagittal sinus caused by release of CSF by arachnoid granulations.

Front 15

What are the three major dural folds? Where are they?

Back 15

Dural Folds: internal meningeal layer of dura drawn away from external periosteal layer of dura to form folds that separate the regions of brain from each other.

Falx Cerebri: largest; sickle shaped (L. Falx) partition that lies in longitudinal cerebral fissure and separates right and left cerebral hemispheres

Tentorium Cerebelli: second largest; wide crescenteric septum that separates occipital lobes of the cerebral hemispheres from the cerebellum.

Falx Cerebelli: vertical dural infolding that lies inferior to the tentorium cerebelli in posterior part of posterior cranial fossa; partially separates cerebellar hemispheres.

Front 16

What is the major artery that supplies the dura with blood? Where does it arise from?

Back 16

Meninges supplied by anterior, middle and posterior meningeal arteries of which middle meningeal a. is largest, a branch of maxillary artery.

Front 17

Please review the organization of the cerebroarterial circle (of Wills). Why is the anatomy of this circle of such great clinical importance?

Back 17

Circle of Willis: important anastomosis at base of brain between four arteries (two vertebrals and two internal carotids) that supply brain. Circle formed by posterior cerebral, posterior communicating, internal carotid, anterior cerebral and anterior communicating arteries. Important means of collateral circulation in event of blockage of one of contributing arteries.

Front 18

Upon which cranial bone does the olfactory "bulb" lie? What is the specific name of the part of the bone the bulb rests on?

Back 18

Olfactory bulb lies on cribriform plate of ethmoid bone.

Front 19

What structures pass through the optic canal? Superior orbital fissure? Internal acoustic meatus? Jugular Foramen? Hypoglossal canal?

Back 19

Optic Canal: optic nerve, opthalmic artery

Superior Orbital Fissure: Oculo-motor nerve (CN III)
Trochlear n. (CN IV)
Opthalmic division of Trigeminal n. (CN V)
Abducens n. (CN VI)
Superior and Inferior opthalmic veins

Internal Acoustic Meatus: Facial n. (CN VII)
Branches of Vestibulocochlear n. (CN VIII)
*divides to cochlear n. and vestibular n. @ lateral end of internal acoustic meatus
Labrynthine a. and v.

Jugular Foramen: Posterior part: internal jugular v.
Middle part: glossopharyngeal n. (CN IX), vagus n. (CN X), Accessory n. (CN XI)
Anterior part: Inferior petrosal sinus

Hypoglossal Canal: Hypoglossal n. (CN XII)

Front 20

What and where is the "cavernous sinus"? What traverse the sinus? Why is this such an important area clinically?

Back 20

Cavernous Sinus: situated bilaterally on each side of the stella turcica on the upper body of sphenoid bone; extends from superior orbital fissure anteriorly to the apex of the petrous part of the temporal bone posteriorly; receives blood from sup/inf. Opthalmic veins, superficial middle cerebral v., and sphenoparietal sinus that is eventually drained to pterygoid plexuses

Traversing Sinus: Oculomotor n. (CN III), Trochlear n. (CN IV), Opthalmic n. (CN V1), and Maxillary n. (CN V2), Internal Carotid a., Abducent n. (CN VI)

Clinical Relevance: Thrombophlebitis (inflammation of vein with secondary thrombus formation) of facial v. → thrombophlebitis of cavernous sinus; because facial v. has no valves blood may pass superiorly to superior opthalmic v. and enter cavernous sinus;

Front 21

What bones contribute to the formation of the orbit?

Back 21

Superior: Frontal Bone (orbital part)

Medial: Ethmoid Bone
Also contribtions from: Frontal Bone, Lacrimal Bone, Sphenoid Bone

Lateral: Zygomatic Bone (frontal process)
Also contribution from: Sphenoid Bone (greater wing)

Inferior: Maxilla
Also contributions from: Zygomatic Bone, Palatine Bone

Front 22

Which paranasal (air) sinuses are contiguous with which walls of the orbit?

Back 22

*not sure about this*
Frontal Sinuses: superior orbit

Ethmoidal Sinuses

Sphenoidal Sinuses

Maxillary Sinuses: inferior orbit

Front 23

What is the branch of the trigeminal nerve that you will find in the orbit? What branches of this division are there?

Back 23

Opthalmic Nerve (CN V1) Branches:
- Tentorial n.
- Lacrimal n.: lacrimal gland, sensory to conjunctiva and skin of superior eyelid
- Frontal n.: sensory to superior eyelid, scalp, forehead via two branches below
Supratrochlear n.
Supraorbital n.
- Nasociliary n.: sensory to eyelids, conjunctiva, skin of nose, lacrimal sac
Short Ciliary nn.
Long Ciliary nn.
Infratrochlear n.:
Anterior and Posterior Ethmoidal nn.

Front 24

What type of nerve fibers are found in the trigeminal branches?

Back 24

Opthalmic n. (CN V1) – all sensory GSA
Maxillary n. (CN V2) – all sensory GSA
Mandibular n. (CN V3) – sensory GSA and special motor SVE (skeletal muscles of branchiomeric origin rather than originating from somites)

Front 25

What nerves innervate specific muscles of the orbit?

Back 25

Levator Palpebrae Superioris Oculomotor n. (CN III)
Superior Rectus Oculomotor n. (CN III)
Inferior Rectus Oculomotor n. (CN III)
Lateral Rectus Abducent n. (CN VI)
Medial Rectus Oculomotor n. (CN III)
Superior Oblique Trochlear n. (CN IV)
Inferior Oblique Oculomotor n. (CN III)