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322 Cards in this Set
- Front
- Back
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What is the mnemonic to determine whether cranial nerves carry motor innervation, sensory innervation, or both?
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Some Say Marry Money But My Brother Says Big Boobs Matter Most
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What is the mnemonic to remember the names of the cranial nerves?
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Oh, Oh, Oh...To Touch And Feel Virgin Girl Vagina...Ahh Heaven
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Which cranial nerves carry parasympathetic fibers?
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3, 7, 9, 10
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Where does the vertebral artery come from and what does it pass through on its way to the foramen magnum and brain?
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Branches off of subclavian arteries - pass through transverse foramina of C1 - C6
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What are the three facets of the atlas vertebra (C1)?
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Two superior articular facets and anterior arch has facet for dens of C2
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What is unique about the axis vertebra (C2)?
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Has dens process the projects superiorly on anterior side
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What are atlas fractures called?
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Jefferson fractures
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What type of movement is associated with the atlanto-occipital joint?
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Nodding "yes"
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What are the 2 types of synovial articulations of the atlanto-axial joint?
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1) Median joint b/w dens of C2 and arch of C1 - pivot joint
2) Lateral joints (2) between opposing articular facets - gliding joint |
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What are axis fractures called?
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Hangman's fracture - often causes spinal cord damage
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What type of movement is associated with the atlanto-axial joint?
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Shaking head "no"
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What vertebral level is the larynx located?
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C4 - C6
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What are the 3 major cartilages of the larynx?
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1) Thyroid
2) Cricoid 3) Epiglottic |
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Where does the hyoid bone originate in the embryo?
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2nd and 3rd pharyngeal arches
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What are the suprahyoid muscles (4)?
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1) Mylohyoid
2) Digastric (anterior and posterior belly) 3) Sylohyoid 4) Geniohyoid |
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What innervates the suprahyoid muscles?
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1) Trigeminal nerve (CN 5)
2) Facial nerve (CN 7) |
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What are the infrahyoid muscles? (4)
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1) Sternohyoid
2) Sternothyroid 3) Omohyoid (superior and inferior belly) 4) Thyrohyoid |
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What innervates the infrahyoid muscles?
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Ansa cervicalis - motor portion of the cervical plexus
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What is the ansa cervicalis and its roots?
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Motor portion of the cervical plexus - has superior root (C1) and inferior root (C2-C3)
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What nerve roots make up the cervical plexus?
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Ventral rami of C1 - C4 spinal nerves
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What kind of innervation does the cervical plexus provide?
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Sensory and motor
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What are the four sensory branches of the cervical plexus?
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1) Lesser occipital
2) Greater auricular 3) Transverse cervical 4) Supraclavicular |
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What movements are provided by the sternocleidomastoid?
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1) Flexes neck (acting bilaterally)
2) Turns neck to one side (acting unilaterally) |
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What innervates the sternocleidomastoid?
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Spinal Accessory Nerve - CN 11
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What is torticollis?
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"Wry Neck" - head turned and tilted
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What are the two types of torticollis and their basic causes?
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1) Muscular - from fibrous tissue tumor or scar tissue after tear
2) Spasmodic - neurological disorder of abnormal tonicity of SCM or trapezius (appears later in life) |
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What are the two broad categories of cervical fascia?
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Superficial and Deep cervical fascia
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What is contained within the superficial cervical fascia?
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Cutaneous nerves, blood vessels, fat, and platysma muscle
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What is the function and innervation of the platysma muscle?
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Function: Facial expression (pulls angles of lips down and tenses skin of neck)
Innervation: Facial Nerve (CN 7) |
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What are the three layers of deep cervical fascia?
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1) Investing Layer
2) Prevertebral Layer 3) Pretracheal Layer |
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What does the investing layer of the deep cervical fascia surround?
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Trapexius and SCM
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What does the prevertebral layer of the deep cervical fascia surround?
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Deep muscles of spoine and scalenes
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What structure does the axillary sheath arise from and what does it surround?
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Arises from prevertebral layer of the deep cervical fascia and it surrounds the brachial plexus
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What are the two layers of the pretracheal layer of the deep cervical fascia and what do they enclose?
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1) Muscular layer - surrounds infrahyoid (strap) muscles
2) Visceral Layer - surrounds thyroid gland, trachea, esophagus |
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What are the "strap" muscles?
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Infrahyoid muscles
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What makes up the carotid sheath?
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Made up of all layers of the deep cervical fascia
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What 3 structures are enclosed by the carotid sheath?
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1) Common carotid artery
2) Internal jugular vein 3) Vagus nerve (CN 10) |
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What are the two sections of the major pathway for spread of infection between the neck and thorax?
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Retropharyngeal space and danger space separated by the alar fascia
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What is the buccopharyngeal fascia?
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Posterior extension of visceral layer of pretracheal layer - major pathway for spread of infection lies between the pretracheal layer and buccopharyngeal fascia
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What are the borders of the carotid triangle?
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1) Superior belly of omohyoid
2) Anterior SCM 3) Posterior belly of digastric |
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What are the contents of the carotid triangle?
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1) Carotid sheath
2) Ansa cervicalis 3) Hypoglossal nerve (CN 12) |
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Where does the common carotid bifurcate?
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C4
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What are the branches of the external carotid artery?
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1) Superior thyroid artery
2) Lingual artery 3) Facial artery |
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What are the contents of the posterior triangle?
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1) Sensory branches of cervical plexus
2) External jugular 3) Spinal accessory nerve (CN 11) 4) Roots of brachial plexus b/w scalenes |
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What is CN 11?
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Spinal Accessory Nerve
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What does CN 11 innervate?
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SCM and trapezius
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What are the roots of CN 11?
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C1 - C5
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Where does CN 11 travel?
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Enters foramen magnum, exits jugular foramen with CN 10, crosses posterior triangle on its way to trapezius
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What is the carotid body?
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Chemoreceptor located at biforcation of common carotid artery to detect arterial O2 and CO2
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What is the carotid sinus?
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Slight dilation of the internal carotid in the area of the bifurcation - it serves as a baroreceptor to detect arterial pressure
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What are the chemoreceptors and baroreceptors located at the bifurcation of the common carotid and what innervates them?
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Carotid body and carotid sinus - both innervated by glossopharyngeal nerve (CN 9) via visceral sensory fibers
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What is the largest branch of the subclavian artery in the neck?
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Vertebral arteries
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What are the 3 divisions of the subclavian artery in the area of the scalenes?
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1) Medial to anterior scalene
2) Posterior to anterior scalene 3) Lateral to anterior scalene |
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Where does the subclavian artery become the axillary artery?
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As it passes the first rib
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What are the 3 major branches of the 1st part of the subclavian artery?
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1) Vertebral artery
2) Internal thoracic artery 3) Thyrocervical trunk |
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What are the branches from the 2nd and 3rd part of the subclaian artery?
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2nd: costocervical trunk
3rd: dorsal scapular artery |
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What is the mnemonic for the branches of the subclavian artery?
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VIT C & D
- Vertebral - Internal thoracic - Thyrocervical trunk - Costocervical trunk - Dorsal scapulary artery |
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What is the most important branch of the thyrocervical trunk?
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Inferior thyroid artery
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What is the action and innervation of the scalene muscles?
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Action: accessory breathing
Innervation: brachial plexus |
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What are the three main relationships of structures associated with the scalenes?
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1) Brachial plexus and SC artery pass b/w anterior and middle scalene
2) SC vein courses anterior to anterior scalene 3) Phrenic nerve lies on anterior surface of anterior scalene |
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What are the three major hormones produced by the thyroid gland?
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T3, T4, calcitonin
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What provides the main blood supply to the thyroid gland and where do these arteries come from?
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1) Superior thyroid artery - branch of external carotid
2) Inferior thyroid artery - branch of thyrocervical trunk of subclavian artery |
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Where do the main three veins of the thyroid gland drain?
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1) Superior and middle thyroid vein - Internal jugular vein
2) Inferior thyroid vein - brachiocephalic vein |
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Where do the parathyroid glands originate in the embryo?
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3rd and 4th pharyngeal arches
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What is the main hormone of the parathyroid?
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Parathormone or parathyroid hormone - controls phosphorous and calcium blood levels
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What two nerves arise from the vagus nerve and innervate the larynx?
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1) Superior laryngeal nerve
2) Recurrent laryngeal nerve |
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What are the two divisions of the superior laryngeal nerve and what do they innervate?
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1) Internal branch - innervates larynx above vocal cords
2) External branch - innervates cricothyroid muscle which controls voice inflection |
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What part of the larynx do the reccurent laryngeal nerves innervate?
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Below the vocal cords
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Where is the sympathetic chain/trunk located in the cervical region?
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Posterior to the carotid sheath
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What are the three main ganglia of the sympathetic chain in the cervical region?
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Superior, middle, inferior
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What kind of fibers do the sympathetic chain ganglia receive?
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Preganglionic sympathetic fibers from the spinal cord
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Where do most of the preganglionic fibers traveling to the head synapse in the cervical sympathetic chain?
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Superior cervical ganglion
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Where do the postganglionic nerves travel in the cervical region after they have synapsed with the cervical ganglia?
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Travel to target via major vessels as carotic plexuses
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Where do the sympathetic nerves arise in the spinal cord?
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Lateral horns at the levels of T1 - L2
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What muscles cover the suboccipital triangle?
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Splenious muscles
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What are the main structures located within the suboccipital triangles? (2)
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1) Vertebral artery
2) Suboccipital nerve |
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What provides cutaneous innervation to the anterior and lateral neck?
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Sensor branches of cervical plexus (ventral rami of C2, C3, C4)
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What provides cutaneous innervation to the posterior neck and scalp?
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Greater and least occipital nerve (dorsal rami of cervial nerves)
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What are the main foramen in the face and what passes through them? (4)
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1) Supraorbital notch - supraorbital nerve/vessels (from CN V1)
2) Infraorbital foramen - infraorbital nerve/vessels (from CN V2) 3) Mental foramen - mental nerve/vessels (from CN V3) 4) Sylomastoid foramen - terminal portion of facial nerve |
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What is vascularized by the internal carotid in the face?
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Eye/orbit via the ophthalmic artery
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What two main branches come from the external carotid in the face?
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1) Facial artery (branches extensively toward corner of eye)
2) Superficial temporal (gives rise to transverse facial) |
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What is the main vein in the face and where does it drain?
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Facial vein - courses diagonally along facial artery and drains into the IJV
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What is unique about the innervation of the parotid gland?
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Only gland in face that does not get its parasympathetic innervation from the facial nerve - instead it is the glossopharyngeal nerve (CN 9)
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Where does the parotid duct course?
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Over masseter and pierces buccinator before it enters the oral cavity
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What three main structures pass through the parotid gland?
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1) Facial nerve
2) Retromandinbular vein 3) External carotid |
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Where does the facial nerve exit the skull?
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Stylomastoid foramen
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What are the 5 major branches of the facial nerve and their mnemonic?
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"To Zannzibar By Motor Car"
1) Temporal 2) Zygomatic 3) Buccal 4) Mandibular 5) Cervical |
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What are the three special types of nerves carried by cranial nerves?
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1) Special sensor - taste, smell, hearing, vision, balance
2) Branchiomotor - somatic motor nerves (5, 7, 9, 10) 3) Parasympathetic - visceral motor (3, 7, 9, 10 - these nerves have additional functions as well) |
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What cranial nerves deliver parasympathetic innervation to the head and neck?
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3, 7, 9
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What cranial nerve delivers parasympathetic innervation to the thorax and abdomen?
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10 - has other functions in head and neck, but parasympathetics of 10 only go to thorax and abdoman
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What are four parasympathetic ganglia of the cranial nerves?
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1) Ciliary
2) Pterygopalatine 3) Otic 4) Submandibular |
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What cranial nerve synapses at the ciliary ganglion?
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3
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What cranial nerve synapses at the otic ganglion?
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9
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What cranial nerve synapses at the pterygopalatine and submandibular ganglia?
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7
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What are the four main functions of the facial nerve?
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1) Facial expression
2) Taste sensation 3) Parasympathetic innervation - all facial glands except palatine 4) General sensation to small part of ear/canal |
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What is the great sensory nerve of the face?
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Trigeminal nerve (CN 5)
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What is located within the trigeminal ganglion in the cranial cavity?
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Cell bodies (like dorsal root ganglia) - no synapses
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What are the three divisions of the trigeminial nerve?
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1) Opthalmic (V1)
2) Maxillary (V2) 3) Mandibular (V3) |
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Where does the opthalmic division of the trigeminal nerve exit the skull?
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Superior orbital fissure
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Where does the maxillary division of the trigeminal nerve exit the skull?
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Foramen rotundum
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Where does the mandibular division of the trigeminal nerve exit the skull?
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Foramen ovale - also carries branchiomotor fibers for mastication
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What are the three dermatomes of the face?
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CN V1 - frontal bone/nose region
CN V2 - maxillary bone region CN V3 - mandibular region |
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What are the five layers of the scalp and which ones make up the "scalp proper?"
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1) Skin
2) Connective tissue (dense) - arteries nerves and veins here 3) Aponeurosis 4) Loose connective tissue 5) Pericranium (external layer of periosteum) - First three make up the "scalp proper" |
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What are emissary veins??
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Valveless veins connecting dural venous sinuses with veins outside the cranium (typical flow is from inside to outside) - conduits for infection
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Where is the C1 dermatome?
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There isn't one
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What are the branches of the internal carotid that vasuclarize the scalp? (2 terminal)
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Opthalmic splits into supratrochlear and supraorbital
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What are the branches of the external carotid that vasucularize the scalp? (3)
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1) Posterior auricular
2) Occipital 3) Superficial temporal |
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Where can pus/blood spread within the scalp?
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It can enter eyelids and root of nose but not the neck or cheeks due to occipitalis muscle and temporal fascia, respectively
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What are the two layers of the dura mater in the brain?
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1) Periosteal layer (outer - attaches to skull)
2) Meningeal layer (inner - close contact with arachnoid) |
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What two layers separate to form dural partitions and intracranial venous sinuses?
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The two layers of dura mater - periosteal and meningeal layers
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What dural partition separates the cerebral hemispheres?
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Falx cerebri
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What dural partition separates the cerebellum and cerebrum?
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Tentorium cerebelli
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What dural partition separates the two cerebellar hemispheres?
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Falx cerebelli
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What dural partition covers the hypophyseal fossa?
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Diaphragma sellae
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What artery supplies the dura mater and what happens when it is damaged?
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Middle meningeal artery - causes epidural hematoma
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What provides sensory innervation to the dura mater?
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Trigeminal, vagus, and C1-C3 spinal nerves
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Which meningeal layer invaginates in sulci and which does not?
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Pia mater invaginates, arachnoid mater does not
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What does an epidural hematoma look like on a CT?
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Convex appearance (looks like a lens)
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What are the typical signs of an epidural hematoma?
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Loss of consciousness followed by a lucid period and then again by drowsiness and more severe loss of consciousness
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What is damaged in a subdural hematoma?
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Cerbral veins which cause blood to pool beneath dura mater
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What does a subdural hematoma look like on CT?
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Crescent shape
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Which meningeal spaces are real vs. potential?
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Real = subarachnoid space
Potential = epidural and subdural spaces |
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What is located within the subarachnoid space?
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CSF and blood vessels
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What causes a subarachnoid hematoma?
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Extravasation of blood typicall from cerebral arteries - often caused by aneurysm
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What are some symptoms of a subarachnoid hematoma?
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Meningeal irritation - headache, stiff neck, loss of consciousness
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What are the five divisions of the brain?
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1) Telencephalon
2) Diencephalon 3) Mesencephalon 4) Metencephalon 5) Myelencephalon |
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What is contained within the telencephalon?
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Cerbreal hemispheres
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What is contained within the diencephalon?
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Thalamus, hypothalamus, pituitary gland
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What is contained within the mesencephalon?
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Midbrain, cerebral peduncles, corpora quadrigemina
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What is contained within the metencephalon?
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Cerebellum, pons
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What is contained within the myelencephalon?
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Medulla oblongata
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What are the functions of the gyri around the central sulcus in the telencephalon?
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Precentral gyrus - motor
Postcentral gyrus - sensory |
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What is the infundibulum?
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The pituitary stalk
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Where is the pineal body and what is its general function?
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Posterior diencephalon - endocrine gland that produces melatonin and regulates sleep
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What are the other names for the corpora quadrigemina?
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Superior and inferior colliculi
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Which division of the brain is the midbrain?
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Mesencephalon
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What are the two primary arteries that supply the brain?
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Internal carotid and vertebral arteries
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Where do the vertebral arteries branch from?
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Subclavian arteries
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What forms the basilar artery?
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The convergence of the vertebral arteries
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What are the main components of the Circle of Willis?
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Interconnections from the vertebral arteries and internal carotid arteries - basilar branches to posterior cerebral and posterior communicating; internal continues to middle cerebral, anterior cerebral, and anterior communicating (diagram on Brain 7)
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What is the largest branch in the Circle of Willis?
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Middle cerebral artery - continuation of internal carotid
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What connects the two lateral ventricles to allow the passage of CSF?
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Interventricular foramina
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What connects the 3rd and 4th ventricles to allow the passage of CSF?
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Cerebral aqueduct
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What produces CSF in the ventricles?
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Choroid plexus
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What does CSF pass through to be recycled into venous sinuses?
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Arachnoid granulations
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What connects the 4th ventricle to the subarachnoid space?
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Lateral apertures
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Where does lymph in the brain flow?
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Drains into CSF and ultimately venous sinuses (no lymph nodes)
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What are the main foramina in the anterior cranial fossa? (3)
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1) Foramen cecum
2) Cribriform plate 3) Optic canals |
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What passes through the cribriform plate?
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Olfactory nerves pass from nasal mucosa to olfactory bulbs
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What passes through the optic canals?
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Optic nerves and ophthalmic arteries
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Where does the pituitary gland sit?
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In the hypophyseal fossa and the sella turcica
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What passes through the superior orbital fissure?
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3, 4, V1, 6
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What passes through the foramen rotundum?
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V2
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What passes through the foramen ovale?
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V3
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What passes through the foramen spinosum?
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Middle meningeal artery
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What passes through the carotid canal?
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Carotid artery and sympathetic nerves (nothing actually passes through nearby foramen lacerum)
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What passes through the foramen lacerum?
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Nothing - carotid canal is nearby and the carotid artery and sympathetic nerves pass here
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What is the adenohypophysis?
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Anterior pituitary
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What is the neurohypophysis?
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Posterior pituitary
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What passes through the foramen magnum?
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Brainstem/spinal cord, vertebral arteries, roots of spinal accessory nerve (CN 11)
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What passes through the internal acoustic meatus?
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7, 8, labyrinthine artery
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What passes through the jugular foramen?
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9, 10, 11, sinuses forming jugular vein
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What passes through the hypoglossal canal?
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12
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Where do the dural venous sinuses eventually drain?
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IJV
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Where do the diploic veins run and empty?
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In the calvaria, between internal and external tables of compact bone - empty into dural venous sinuses
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What structures pass through the cavernous sinuses?
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3, 4, V1, V2, 6
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Where does sound travel once it vibrates the ossicles?
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Stapes vibrates oval window - waves travel through scala vestibuli and scala tympani which are in contact with cochlear duct - basilar membrane of cochlea duct stimulates cells in spiral organ - impulses are sent through vestibulocochlear nerve to brain
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Which parts of the external acoustic meatus are bony and which are cartilaginous?
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Lateral 1/3: cartilaginous
Medial 2/3: bony |
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What innervation and tissue changes occur at the tympanic membrane?
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Lateral: general sensory and ectoderm
Medial: visceral sensory and endoderm |
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What structures are found in the medial wall of the middle ear? (5)
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1) Promontory (basal coil of cochlea)
2) Tympanic plexus (CN 9 - overlies promontory) 3) Oval window 4) Round window 5) Prominences of facial and lateral semicircular canals |
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What structures are found on the anterior wall of the middle ear? (4)
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1) Opening of eustachian tube
2) Tensor tympani muscle 3) Internal carotid lies in front of the wall 4) Foramen for exit of chorda tympani nerve (branch of 7) |
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What structures are found on the posterior wall of the middle ear? (3)
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1) Overslies mastoid air cells
2) Stapedius muscle 3) Opening for entrance of chorda tympany nerve (branch of 7) |
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What nerve passes through the middle ear but doesn't do anything there?
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Chorda tympani (branch of 7)
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What is connected by the pharyngotympanic or Eustachian tube?
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Middle ear and nasopharynx
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What are the two muscles of the middle ear and what is their function?
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1) Tensor tympani
2) Stapedius - Both reduce vibrations in response to loud noises |
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Where does the facial nerve synapse after it travels in the facial canal?
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Geniculate ganglion (sensory for ear, taste, palate)
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What are the main branches of the facial nerve? (3)
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1) Greater petrosal nerve
2) Nerve to stapedius 3) Chorda tympani (taste and salivary innervation) |
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Where does the facial nerve pass just before it innervates facial muscles?
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Stylomastoid foramen
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Where is the tympanic plexus located?
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On promontory of cochlea in middle ear
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What nerve forms the tympanic plexus?
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Tympanic branch of glossopharyngeal (CN 9)
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What does the tympanic plexus innervate?
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Mucus membranes of inner ear, mastoid area, eustachian tube
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What branch of the tympanic plexus eventually reaches the parotid gland?
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Petrosal nerve
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What are the components of the bony labyrinth of the internal ear? (3)
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1) Vestibule
2) Semicircular canals 3) Cochlea |
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What are the components of the membranous labyrinth of the internal ear? (4)
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1) Cochlear ducts
2) Semicircular ducts 3) Utricle 4) Saccule - Latter 3 are for balance, first is for hearing |
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What does perilymph resemble and where is it found?
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Resembles CSF and it is found within the bony labyrinth
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What does endolymph resemble and where is it found?
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Resembles intracellular fluid and is found within the membranous labyrinth
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Where does endolymph drain?
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Through the endolymphatic ducts into the dural sinuses
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Where does perilymph drain?
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Through the cochlear aqueduct into the subarchnoid space
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What are the causes and symptoms of Meniere syndrome?
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Caused by blockage of endlymphatic ducts - symptoms include ringing in ears (tinnitis, hearing loss, vertigo, pressure, noise sensitivity/distorsion)
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What is the vestibule in the ear and where do the vibrations go?
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Location where vibrations from oval window enter - vibrations go to both the cochlea and semicircular canals
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What is the origin, course, and distribution of the vestibulocochlear nerve (CN 8)?
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Origin: cochlear nucleus and vestibular nucleus
Course: through internal acoustic meatus (with CN 7) Distribution: cochlea, semicircular canals, utricle, saccule |
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Where do the 3 semicircular ducts drain?
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Into utricle
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What does the endolymphatic duct collect and where does the endolymphatic duct drain?
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Drains from utricle/saccule and into vestibular aqueduct and ultimately endolymphatic sac
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Where does the cochlear duct drain?
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Into saccule
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What are the two canals created by the scala media or cochlear duct?
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1) Scala vestibuli
2) Scala tympani |
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What muscle elevates the eyelid?
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Levator palpebrae superioris
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What are the main branches of V1? (3)
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1) Lacrimal nerve
2) Nasociliary nerve 3) Frontal nerve |
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What nerve runs on top of the levator palpebrae superior?
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Frontal nerve (branch of V1)
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What nerve runs on top of the superior oblique and optic nerve?
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Nasociliary (branch of V1)
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What is the path of reflex tears? (5 steps)
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1) Lacrimal gland with ducts (superiolateral)
2) Surface of cornea 3) Lacrimal canaliculi 4) Lacrimal sac 5) Nasolacrimal duct |
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What nerves provide parasympathetic and sympathetic innervation to the lacrimal gland?
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Para: Facial nerve (stimulates secretion of tears)
Symp: Sympathetic chain |
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What provides sensory innervation to the lacrimal gland and what piggybacks on this nerve?
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V1 - visceral motor (from facial nerve) and sympathetic nerves piggyback on it
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What is the branch of V1 that branches into the ethmoidal nerves, infratrochlear nerve, and external nasal nerve?
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Nasociliary Nerve
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Where does the optic nerve course?
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Left and right optic tracts cross and go through optic canal to eye
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What is incyclotorsion?
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Depression, abduction, medial rotation
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What is excyclotorsion?
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Elevation, adduction, lateral rotation
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How do you test the superior and inferior rectus?
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Have patient abduct eye and then look up or down
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What does the inferior oblique do?
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Elevates and abducts (up and out)
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What does the superior oblique do?
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Depresses and abducts (down and out)
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How do you test the superior rectus?
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Have patient look medially and then have patient look down
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How do you test the inferior rectus?
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Have patient look laterally and then have patient look up
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What extraocular muscles are innervated by the occulomotor nerve?
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All except lateral rectus and superior oblique
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What are innervated by the superior division of the occulomotor nerve?
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1) Levator palpebrae superior
2) Superior rectus |
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What are innervated by the inferior division of the occulomotor nerve?
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1) Medial rectus
2) Inferior rectus 3) Inferior oblique |
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What intrinsic eye muscles are innervated by the occulomotor nerve?
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1) Spincter pupillae (constriction)
2) Ciliary body (accomodation) |
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What are symptoms of Horner's syndrome? (3)
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1) Ptosis (drooping eyelid)
2) Anyhdrosis (no sweating) 3) Miosis (pupil constriction) |
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What causes Horner's syndrome?
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Interruption of the cervical trunk (from CNS problems, preganglionic neuron problems, or postganglionic neuron problems)
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What nerve fibers synapse at the ciliary ganglion and which ones pass through without synapsing?
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Only parasympathetic nerves of occulomotor synapse here - sympathetic fibers and trigeminal fibers pass through but don't synapse
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Where does the trochlear nerve leave the skull and what does it innervate?
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Exits superior orbital fissure to innervate superior oblique (remember 3(LR6, SO4)
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What is unique about the trochlear nerve (CN 4)?
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Only cranial nerve to exit dorsal brainstem - longest intracranial course and thus susceptible to damage from trauma
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Where does the abducens nerve (CN 6) course and what does it innervate?
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Exits skull via superior orbital fissure and innervates lateral rectus
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What provides the primary blood supply to the eye and where does it come from?
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Ophthalmic artery from internal carotid (gives off supraorbital branch and dorsal nasal which is why fever is checked over forehead)
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What are the two outer fibrous layers of the eyeball?
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1) Sclera (white of eye; posterior 5/6)
2) Cornea (transparent; anterior 1/6) |
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What three components of the eye make up the middle vascular layer?
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1) Choroid (blood vessels, attaches to retina)
2) Ciliary body (forms aqueous humor, controls shape of lens) 3) Iris (colored part) |
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Where is the retina located and what are its two layers?
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Located inside choroid - outer pigmented layer and inner neural layer
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Where are the anterior and posterior chambers of the eye and what kind of fluid fill them?
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Both filled by aqueous humor
Anterior: between cornea and iris Posterior: between iris and lens |
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Where is the vitreous chamber and what fills it?
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Filled by vitreous humor - located posterior to lens
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What is the term for normal vision?
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Emmetropia
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What is the term for nearsightedness?
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Myopia
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What is the term for farsightedness?
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Hyperopia
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What is presbyopia?
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Age-related progressive loss of accomodative ability (lens is less flexible)
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What is coloboma?
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Choroid fissure doesn't close which leaves a cleft in the iris or other structures of the eye
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What is the optic disc of the retina?
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Location where optic nerve leaves the retina - branches of central retinal artery spread out from here - lighter than surrounding retina
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What is the macula lutea of the retina?
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Thinnes area of retina - sensitive to light due to fewer rods and more cones - "yellow spot"
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How does central retinal artery occlusion present?
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- Pale area at optic disc due to poor circulation
- Retinal whitening due to ischemia and swelling of retinal ganglion - Cherry red spot at macula |
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What are complications of diabetic retinopathy?
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Vitreous hemorrhage, retinal edema, retinal detachment
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What are the three intrinsic muscles of the eye?
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1) Ciliary muscle (accomodation of lens)
2) Sphincter pupillae (constricts pupil) 3) Dilator pupillae (dialates pupil) |
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What innervates the intrinsic muscles of the eye?
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- Parasympathetic from occulomotor (ciliary and sphincter pupillae)
- Sympathetic trunk (dilator pupillae) |
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What provides general sensory innervation to the skin of upper face, anterior dura mater, and cornea?
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V1 - but parasympathetics from 3, 7, 9 like to piggyback on it
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What cranial nerves innervate the muscles of the eye and which one also has parasympathetic properties?
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3, 4, 6 - 3 also carries parasympathetic fibers to sphincter pupillae and ciliary muscles
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What makes up the bony part of the nasal septum?
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Vomer and perpindicular plate of ethmoid
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Which turbinates are part of the ethmoid bone?
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Superior and middle - inferior are seperate bones
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Where does the spenoid sinus empty?
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Sphenoethmoidal recess (posterior to superior turbinate)
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Where does the frontal and macillary sinus empty?
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Into the semilunar hiatus which is located in the middle meatus
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Where does the nasolacrimal duct open?
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In the inferior meatus
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Where does the ethmoid sinus empty?
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Anterior: middle meatus
Posterior: superior meatus |
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What is located just superior to the sphenoid sinus?
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Selle turcica and pituitary gland
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Which inflammed sinus can be perceived as dental pain and why?
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Maxillary - because V2 gives off superior alveolar nerve which runs through this area and supplies roots of teeth
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What provides sensation to the anterior part of the nose?
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Anterior ethmoidal nerve from V1
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What provides sensation to the dorsum and tip of nose?
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External nasal nerve (branch of V1)
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What provides sensation to the posterior part of the nose?
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Splenopalatine nerve from V2
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What are the two main arteries that supply the nose?
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1) Splenopalatine
2) Ethmoidal |
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What is the course of the olfactory nerve?
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Nerve cells in nasal mucosa connect with fibers via cribriform plate of ethmoid bone - synaps at olfactor bulb which leads to olfactory tract
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What are the sensory nerves of the palate?
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Somatic sensory from V2 - greater and lesser palatine
Special sensory (taste) from 7 |
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What provides the main blood supply to the palate?
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Greater and lesser palatine arteries (from maxillary)
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Where is the pterygopalatine fossa?
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Space between posterior border of maxilla and pterygoid plates of sphenoid (lateral entrance through pterygomaxillary fissure)
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What areas connect to the pterygopalatine fossa?
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Nasal cavity, oral cavity, pharynxx, orbit, infratemporal foss, and middle cranial fossa
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What is the nerve of the pterygoid canal called?
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Vidian's Nerve
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What two nerves make up Vidian's nerve?
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1) Deep petrosal nerve (sympathetic postganglionic from carotid plexus)
2) Greater petrosal nerve (preganglionic parasympathetic from facial nerve - synapses in pterygopalatine ganglia) |
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What are the four main structures in the pterygopalatine fossa?
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1) Branches of V2
2) Vidian's nerve 3) Pterygopalatine ganglion 4) Branches of maxillary artery |
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Where does the parasympathetic distribution of the pterygopalatine ganglion go?
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V1 - lacrimal gland
V2 - mucous/salivary glands in nasal cavity, palate, oral cavity, and pharynx |
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Where is the ostium of the auditory tube?
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Nasopharynx - beneath the torus tubarius
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What separates the oropharynx from the oral cavity?
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Palatoglossal folds
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What two folds border the palatine tonsil?
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1) Palatoglossal folds (anterior)
2) Palatopharyngeal folds (posterior) |
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What forms the borders of the valleculae?
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Glossoepiglottic folds
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What are the outpouchings lateral to the entrance of the larynx where foreign bodies or ET tubes can get stuck?
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Piriform recesses
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What are the tonsils in the nasopharynx?
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Adenoids - pharyngeal tonsils and tubal tonsils
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What nerve can be damaged during tonsillectomies?
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Glossopharyngeal nerve (lingual branch) - leads to altered sensation in posterior 1/3 of tongue
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What can result from adenoiditis?
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Choanae can be blocked leading to respiratory distress and mouth breathing (infection, dental problems, hearing loss)
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Which pharyngeal constrictor has a common attachment with the buccinator?
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Superior
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What is part of the inferior pharyngeal constrictor and serves as a sphincter to the superior espohagus?
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Cricopharyngeous
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What are the three longitudinal muscles of the pharynx?
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1) Stylopharyngeal
2) Salpingopharyngeus 3) Palatopharyngeus |
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What makes up the plexus that provides innervation to the pharynx?
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Pharyngeal plexus
- Glossopharyngeal nerve - Vagus nerve |
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What muscle of the pharynx does NOT receive its motor innervation via the vagus nerve?
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Stylopharyngeal (3rd arch muscle) - innervated by glossopharyngeal nerve
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What provides sensory innervation to the pharynx?
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Glossopharyngeal (9)
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What innervates the tensory veli palatine?
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V3 - it is a 1st arch muscle
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What innervates the levator palatini?
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Vagus nerve
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What supplies most of the muscles of the soft palate and what is the one exception?
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Vagus - except tensor veli palatini by V3
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Where are the arytenoid cartilages and what connects to them?
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Sit on the superior surface of the posterior cricoid - vocal cords run from vocal process to inner surface of thyroid
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Where is the quadrangular membrane and what do its borders form?
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- Between epiglottis and arytenoid cartilage
- Upper border forms aryepiglottic folds - Lower border forms vestibular folds (false cords) |
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What forms the true vocal cords?
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- Upper border of conus elasticus
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What is the only muscle to abduct the vocal cords?
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Posterior cricoarytenoid muscles
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What provides sensory innervation to the larynx superior to the vocal cords?
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Internal laryngeal nerve (comes from superior branch of vagus and passes through thyrohyoid membrane)
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What provides sensory innervation to the larynx inferior to the vocal cords?
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Recurrent laryngeal nerve (from vagus)
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What provides motor innervation to the muscles of the larynx and what is the exception?
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Recurrent laryngeal nerve - except cricothyroid (triangle muscle) innervated by external laryngeal nerve
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Where does the glossopharyngeal nerve exit the skull?
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Jugular foramen
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What is innervated by the somatic sensory fibers of the glossopharyngeal nerve?
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Ear canal
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What is innervated by the branchial motor fibers of the glossopharyngeal nerve?
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3rd arch muscle - stylopharyngeus
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What is innervated by the special sensory fibers of the glossopharyngeal nerve?
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Taste; posterior 1/3 of tongue
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What is innervated by the visceral sensory fibers of the glossopharyngeal nerve? (4)
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1) Pharynx
2) Middle ear 3) Carotid sinus/body 4) Posterior 1/3 of tongue |
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What is innervated by the visteral motor fibers (parasympathetic) of the glossopharyngeal nerve?
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Parotid gland
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Where does the vagus nerve exit the skull?
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Jugular foramen
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What is innervated by the somatic sensory fibers of the vagus nerve?
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Ear canal, some dura
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What is innervated by the branchial motor fibers of the vagus nerve?
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4th and 6th arch muscles - muscles of pharynx, larynx, and soft palate except stylopharyngeal (9) and tensor veli palatini (V3)
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What is innervated by the special sensory fibers of the vagus nerve?
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Taste; valleculae and epiglottis
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What is innervated by the visceral sensory fibers of the vagus nerve? (3)
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1) Larynx
2) Carotid sinus/body 3) Thoracic and abdominal viscera |
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What is innervated by the visceral motor fibers of the vagus nerve?
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Thoracic and abdominal viscera
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What is supplied by the recurrent laryngeal branch of the vagus nerve?
|
- Motor to larynx except cricothryoid muscle (external laryngeal nerve)
- Sensory from larynx below the cords |
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What is supplied by the external laryngeal branch of the superior laryngeal nerve?
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Motor: cricothyroid (travels with superior thyroid artery)
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What is supplied by the internal laryngeal branch of the superior laryngeal nerve?
|
Sensory: larynx above the cords
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What are the two branches of the superior laryngeal nerve of the vagus?
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Internal and external laryngeal nerves
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What are the muscles of mastication?
|
MTPP
- Masseter - Temporalis - Pterygoid (medial) - Pterygoid (lateral) |
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What pharygeal arch do the muscles of mastication come from and what is their innervation?
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1st arch - all innervated by motor root of V3
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What parts of the trigeminal nerve have motor and/or sensory roots?
|
Sensory: all three
Motor: only V3 |
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What muscles open mouth?
|
Suprahyoid muscles - mandible must protrude to fully open mouth
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What muscle retracts mandible?
|
Temporalis
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What muscle protrudes mandible?
|
Lateral pterygoid (when both are contracted)
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What are the main branches of the maxillary artery?
|
1) Inferior alvealar (runs inside mandibular canal)
2) Middle meningeal (splits auriculotemporal nerve) |
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Where does the middle meningeal artery enter skull?
|
Foramen spinosum
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What does the maxillary artery branch from?
|
Terminal branch of external carotid - other branch is superficial temporal artery
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What veins connect with the cavernous sinus?
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1) Facial veins
2) Pterygoid veins 3) Ophthalmic veins - All provide route for infection to spread |
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Where does V3 exit the skull?
|
Foramen ovale
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What is innervated by the branchiomotor fibers from V3? (4)
|
1st arch muscles
- Mylohyoid - Anterior digastric - Tensor tympani - Tensor veli palatini |
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What are the sensory branches of V3? (4)
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1) Auriculotemporal nerve
2) Buccal nerve 3) Lingual nerve (anterior 2/3 of tongue) 4) Inferior alveolar nerve (includes mylohyoid and mental nerve) |
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Where does the parotid papillae open?
|
In oral vestibule - in cheek lateral to 2nd maxillary molar
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What are the two salivary glands in the oral cavity and what innervates them?
|
1) Sublingual
2) Submandibular - Innervated by chorda tympani of facial nerve |
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What is carried by the chorda tympani and where does it course?
|
Parasympathetic and special sensory (taste) - hitchhikes along lingual nerve of V3
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What is the remnant of the origin of the thyroglossal duct?
|
Foramen cecum
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What are the three extrinsic muscles of the tongue and what innervates them?
|
1) Hyoglossus - lateral to hyoid
2) Styloglossus - posterior to styloid process 3) Genioglossus - big fan muscle - All innervated by hypoglossal nerve (CN 12) |
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Where does the hypoglossal nerve (CN 12) exit the skull?
|
Hypoglossal canal
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What provides general sensation to the tongue?
|
Anterior 2/3: lingual nerve of V3 (5)
Posterior 1/3: lingual branch of glossopharyngeal (9) |
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What nerves provide taste?
|
Anterior 2/3 of tongue: chorda tympani of facial nerve (7)
Posterior 1/3: lingual branch of glossopharyngeal (9) Epiglottis and Valleculae: vagus (10) |
