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193 Cards in this Set
- Front
- Back
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levels of the pharynx
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base of skull (pharyngeal tubercle) to C6 (level of the esophagus)
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what are the 4 types of tonsils?
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-palatine
-pharyngeal -lingual -tubal |
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the 3 divisions of the pharynx
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-Nasopharynx
-Oropharynx -Laryngophayrnx |
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what is the anterior opening into the nasopharynx
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posterior nasal aperture (choanae)
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What is the anterior opening of the oropharynx
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Oropharyngeal Isthmus
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Superior aperture of the larynx that opens into the laryngopharynx
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laryngeal inlet
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What connects the superior constrictor to the base of the occiput?
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Basilopharyngeal Fascia
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Where does the superior constrictor attach superiorly?
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Pharyngeal Tubercle
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What does the pharynx turn into
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the esophagus
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What does the Larynx turn into
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the trachea
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Anterior attachment for the superior constrictor
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Pterygomandibular Raphe
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What is the Pterygomandibular Raphe?
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a ligament that links the superior constrictor to the buccinator muscle
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Ant attachment for the middle constrictor
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stylohyoid ligament and hyoid bone
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Anterior attachment for the inferior constrictor
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thyroid cartilage
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what is the pharyngeal raphe?
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where the 2 sides of the pharyngeal wall join posteriorly in the midline
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Levels of the pharyngeal raphe
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pharyngeal tubercle to the connective tissue in the posterior wall of the esophagus
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All of the musclesof the larynx are innervated by what nerve?
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Recurrent Laryngeal N (branch of Superior Laryngeal, branch of Vagus N)
*exception= cricothyroid muscle (External Laryngeal N) |
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Action of the Superior Constrictor Ms
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closes and seals the oropharynx from the nasopharynx
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action of the middle and inferior consrictors
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facilitate moving the bolus of food towards the esophagus
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Posterior attachment for the constrictor muscles
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Pharyngeal Raphe
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General action of all of the constrictor muscles
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constriction of the pharynx
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All muscles of the pharynx are innervated by______?
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Vagus N
*exception= stylopharyngeus (inn by CN IX- Glossopharyngeal) |
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What are the Longitudinal Pharyngeal Muscles?
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-Stylopharyngeus
-Salpingopharyngeus -Palatopharyngeus |
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What is the origin of the salpingopharyngeus?
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Taurus Tubaris (bump over the eustachian tube)
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What is found in the 1st Gap?
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-levator veli palatini
-eustachian tube |
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what is found in the 2nd Gap?
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-stylopharyngeus
-CN IX -Lingual N -Hypoglossal N |
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What is found in the 3rd Gap?
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Internal Laryngeal N (CN X)
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What is found in the 4th Gap?
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Recurrent Laryngeal N (CN X)
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Where is the 1st Gap found?
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between the superior constrictor and the base of the occiput (behind the nasopharynx)
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What are Adenoids and where are they found?
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they are lymphoid tissue found in the 1st Gap (Nasopharynx)
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What is the sensory innervation of the Nasopharynx?
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Pharyngeal br of the maxillary n (CN V2)
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What part of the pharynx are the palatine and lingual tonsils found in?
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the oropharynx
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Innervation of the palatoglossal and palatopharyngeal folds?
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CN X
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All the muscles in the soft palate are innervated by __________?
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CN XII (Hypoglossal)
*exception= Palatoglossal is inn by CN X |
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Sensory innervation of the Oropharynx?
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Glossopharyngeal N (CN IX) via the Pharyngeal Plexus
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What are the mucosal fossae or recesses of the laryngopharynx?
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-laryngeal inlet
-piriform recess (fossa) |
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What is the innervation and location of the piriform recess/
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-internal laryngeal n (sensory)
-found in the 3rd gap |
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what nerve pierces the thyrohyoid membrane?
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the internal laryngeal n (br of the superior laryngeal n, br of Vagus N.)
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What are the 2 divisions of deep/cervical/prevertebral fascia?
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-Prevertebral Layer
-Alar Layer |
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How many spaces are created by the divisions of deep/cervical/pharyngeal fascia?
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3
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What are the 3 Longitudinal Spaces in the neck?
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-Pretracheal/ "Danger" space
-Retropharyngeal space -Prevertebral space |
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the location of the 3 longitudinal spaces?
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it involves the entire length of the neck
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levels of the Pretracheal/ "danger" space
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extends from the base of the skull to the posterior mediastinum at the level of the diaphragm
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what is limited laterally by its fusion with with the prevertebral layer and TP's
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Pretracheal/ "Danger" space
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The levels of the retropharyngeal space
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it extends from the base of the skull to the level of the 1st or 2nd thoracic vertebrae
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which neck space contains 2 lateral chains of lymph nodes separated by a mindline raphe?
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retropharyngeal space
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the Prevertebral Space is located between ________ and ___________
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lies between the vertebral bodies and the prevertebral layer of cervical fascia
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level of the Prevertebral Space
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it extends from the base of the skull to the level of the coccyx
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what are the spaces that are limited to the area above the hyoid bone?
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-Submandibular
-Sublingual -Parapharyngeal |
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What is the space that exists below the hyoid bone?
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Anterior Visceral Space
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what are the prevertebral muscles?
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-Longus Colli
-Longus Capitis -Rectus Capitis Anterior -Rectus Capitis Lateralis |
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What are the 3 parts of the longus colli muscle?
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-Superior Oblique Fibers
-Vertical Fibers -Inferior Oblique Fibers |
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What are the action of the prevertebral muscles in the neck?
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Longus Colli= flexes the neck
Longus Capitis= flexes the head Rectus Capitis Anterior= flexes the head Rectus Capitis Lateralis= flex and laterally flex the head |
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Longus Colli Origin
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Bodies C5-T3
TPs C3-C5 |
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Longus Colli Insertion
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Anterior Tubercle of C1
Bodies of C2-C4 |
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Longus Colli Innervation
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VPR of C2-C6
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Longus Capitis Origin
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C3-C6
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Longus Capitis Insertion
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basilar part of the occipital bone
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Longus Capitis Innervation
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VPR of C1-C3
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Rectus Capitis Anterior Origin
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C1
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Rectus Capitis Anterior Insertion
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Basilar part of the occipital bone
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Rectus Capitis Anterior Innervation
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VPR C1-C2
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Rectus Capitis Lateralis Origin
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C1 of TP
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Rectus Capitis Lateralis Insertion
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Jugular process of the occipital bone
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Rectus Capitis Lateralis Innervation
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VPR C1-C2
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What is it called when the inferior cervical ganglion is fused with the 1st thoracic ganglion?
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Stellate Ganglion
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What are the 3 types of cervical ganglion in the cervical sympathetic trunk?
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-superior
-middle -inferior |
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The length of the cervical sympathetic trunk?
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it extends from the base of the skull to the first rib
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What does the cervical sympathetic trunk lie posterior to?
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Internal and common carotid arteries
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What does the cervical sympathetic trunk lie between?
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between the carotid sheath and prevertebral fascia
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where is the superior cervical ganglion located
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opposite C2-C3, behind carotid artery, and anterior to the logus colli
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What are the branches of the superior cervical plexus
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-Grey Rami to C1-C4
-Internal Carotid A -Artery to ext and int carotids -Pharyngeal branches join CN IX and X pharyngeal plexus -Superior cardiac nerve, branch to cardiac plexus -Deep Petrosal N |
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Where is the Middle Cervical Ganglion located?
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Opposite C6, superior to inf Thyroid artery
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what are the branches of the middle cervical ganglion
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-gray rami to VPR of C5-C6
-arterial branches to inferior thyroid artery -middle cardiac branch to cardiac plexus |
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where is the inferior cervical ganglion located
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between the TP and of C7 and the neck of the 1st rib posterior to the vertebral artery
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What are the branches of the inferior cervical ganglion
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-gray rami to VPR of C7-C8
-arterial branches to subclavian and vertebral arteries -inferior cardiac branch to cardiac plexus |
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What is the Gray Rami?
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how nerves get out of the sympathetic trunks
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What is the White Rami?
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from T1-L2 that go into the sympathetic trunk
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what controls the parasympathetics in the neck?
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Vagus (CN X)
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what are the components of the Vagus nerve?
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GVE and SVE
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What are the 3 major branches of the Vagus N?
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-Pharyngeal branch
-Superior Laryngeal N -Internal Laryngeal N -External Laryngeal N -Recurrent Laryngeal N |
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What are some of the muscles that the Vagus nerve innervates?
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-Levator Veli Palatini
-Salpingopharyngeus -Palatoglossus -Palatopharyngeus -Superior, Middle, Inferior Pharyngeal Constrictors -Muscles of the Larynx (speech) |
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levels of the Larynx
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C3-C6
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What does the larynx communicate with?
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-laryngopharynx superiorly
-trachea inferiorly |
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what are the 3 paired cartilages of the larynx
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arytenoid, corniculate, and cuneiform
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What are the unpaired cartilages of the larynx?
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thyroid, cricoid, and epiglottis
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What attaches to the thyroid?
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-Cricothyroid ligament
-Thyroepiglottic ligament -Vocal Ligament -Thryohyoid Membrane |
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What type of cartilage is the cricoid made of?
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Hyaline cartilage (signet ring shaped-->continuous ring)
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What are the articular facets located on the cricoid cartilage?
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-lateral pair= thyroid
-superior pair= arytenoids |
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what attaches to the cricoid cartilage?
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-cricothyroid ligament
-cricotracheal ligament |
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what are the 2 cartilages that the arytenoids articulate with?
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-Corniculate
-Cuneiform |
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What attaches to the arytenoids?
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-thyroid cartilage (via the vocal ligament)
-epiglottis (via the quadrangular membrane) |
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what type of cartilage is the epiglottis?
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elastic cartilage
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How does the epiglottis attach to the Thyroid cartilage?
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via the thyroepiglottic ligament
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what attaches to the epiglottis?
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-Thyroepiglottic ligament
-Hyoepiglottic ligament -Quadrangular membrane -Glossoepiglottic folds (2 lateral and 1 median) |
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what cartilage is located superiorly to the arytenoids?
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corniculate
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what are the cartilages that float in a membrane superior to the arytenoids?
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Cuneiform
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What pierces the thyrohyoid membrane?
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the internal laryngeal nerve and superior laryngeal a and v
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Attachments of the Quadrangular mb
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-epiglolttis to arytenoid cartilages
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What does the inferior margin of the Quadrangular membrane form?
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the vestibular ligaments (false vocal chords)
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What is the median part of the cricothyroid ligament called?
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Conus Elasticus
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What is the lateral part of the cricothyroid ligament called?
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Vocal ligaments (true vocal chords)
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What part of the cricothyroid membrane forms the true vocal chords>
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the upper margin
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What forms the inlet of the larynx?
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-anterior= epiglottis
-posterior= mucous mb btwn arytenoids -lateral= aryepiglottic folds |
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what is the gap btwn the vestibular folds called?
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rima vestibuli
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what is the gap btwn the vocal chords called?
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rima glottidis
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What is another name for the vocal apparatus?
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Glottis
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What makes up the vocal apparatus?
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vocal chords and the rima glottidis
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What is the vestibule?
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superior to the venrticle
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What is the ventricle?
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gap btwn the vestibule and vocal folds
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What are the elevators of the larynx?
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-Suprahyoid Muscles
-Mylohyoid -Geniohyoid -Digastric -Longitudinal Muscles -Stylopharynheus -Salpingopharyngeus -Palatopharyngeus |
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What are direct elevators of the larynx?
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Longitudinal muscles
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What arendirect muscles of the larynx?
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Suprahyoid Muscles
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what are the depressors of the larynx?
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Infrahyoid muscles
-Sternohyoid -Omohyoid -Sternothyroid -Thyrohyoid |
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What in teh larynx does the internal laryngeal n innervate?
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the laryngeal mucous mb down to the level of the vocal chords
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What in the larynx does the recurrent laryngeal nerve innervate?
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-the laryngeal mucous mb below the vocal cords
-all laryngeal muscles of the larynx except the cricothyroid |
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What is the action of the cricothryoid?
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tenses the vocal cords
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Action of the posterior cricoarytenoids
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Abducts the vocal cords
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Action of the Lateral Cricoarytenoids
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Adducts the vocal cords
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action of the transverse arytenoids
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closes the rima glottis posteriorly
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action of the oblique arytenoids
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sphincter= closes the laryngeal inlet
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action of the thyroarytenoid
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relaxes the vocal cords
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vocalis ms action
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adjusts tension in the vocal cords (relaxes them)
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What attaches to the muscular processes of the arytenoids?
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posterior cricoarytenoids (the posterior surface of the muscular process
lateral cricoarytenoids (the anterior surface of the muscular process) |
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what attaches to the vocal process of the arytenoids?
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vocalis muscle
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What does the external laryngeal n innervate?
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cricothyroid muscle
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Similarity between cranial and spinal nerves
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they link the CNS to the PNS
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what does CN I do?
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SVA for smell and olfaction
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Where does CN I enter the skull?
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through the cribiform plate in the ethmoid bone
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where are the cell bodies and axons of the olfactory nerve?
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the cell bodies= olfactory bulb
the cell axons= olfactory tract/nerve |
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where do the fibers of the olfactory nerve terminate?
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1. cortex of the uncus and the anterior part of the hippocampal gyrus (primary olfactory cortex)
2. septal region of the medial surface of the frontal lobe (modulates emotional response to smell) |
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what is the only sensory nerve that goes directly to the cortex without going through the thalamus?
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Olfactory N
-therefore, emotion is linked to smell (smell is a primal sense) |
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What does the Optic N do?
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SSA for visual information from the retina
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How does the optic nerve enter the brain?
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through the optic canal in the sphenoid bone
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T/F half of each eye's vision goes to the other side of the brain.
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True
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Visual Pathway
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photons of light which are converted to electrical signals in the retina, these signals are carried via the optic nerves, optic chiasm, and tract to the lateral geniculate nucleus of the thalamus, and then to the brain visual centers in the occipital lobe (either side of the calcarine sulcus)
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What does the occulomotor nerve do?
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GSE to extrinsic eye muscles
GVE to instrinsic eye muscles (constrictor pupillae and ciliary muscles) |
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How does the occulomotor n enter the brain?
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the superior orbital fissure (cavernous sinus)
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Where do the preganglionics of the occulomotor nerve arise from?
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Edinger Westphal Nucleus
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Where do the postganglionics of the occulomotor nerve arise from?
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from the ciliary ganglion and the axons travel in the short ciliary nerves
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Where is the occulomotor nucleus located?
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the pretectal area of the midbrain (the nerve leaves the midbrain and travels through the cavernous sinus)
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What does the trochlear nerve do?
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GSE to the superior oblique muscle
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where does the trochlear nerve exit the brain?
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through the superior orbital fissure
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Where are the neurons for the trochlear nerve located?
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neurons arise from the trochlear nulceus in the tegmentum of the caudal midbrain (around the level of the inferior colliculus ventral to the cerebral aqueduct)
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When the trochlear nerve leaves the brain, what does it travel in?
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cavernous sinus
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What are the functions of the Trigeminal N?
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-GSA (like for temp) of the face, forehead, cheek, and jaw
-GVA, sensation from oral cavity and tongue -SVE muscles of mastication, tensor tympani, tensor veli palatini, anterior belly of digastric, and mylohyoid |
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What are the foramen for the divisions of the Trigeminal N
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V1= superior orbital fissure and supraorbital foramen/notch
V2= foramen rotundum and infraorbital foramen V3= Foramen ovale |
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What does the opthalmic n do?
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sensory to lateral nose, upper eyelid, forehead and scalp to vertex, and the dura of the anterior cranial fossa
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What does the maxillary nerve do?
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sensory to upper lip and upper oral cavity (teeth), paranasal sinuses, skin over cheeks and temporal region, and middle cranial fossa
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What does the mandibular nerve do?
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-Sensory to lower jaw and mouth, area above the ear, and the dura of the middle cranial fossa
-Motor to muscles of mastication, tensor tympani, tensor veli palatini, mylohyoid, and ant belly of digastric |
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cell bodies for pain, temp, and touch (sensory) for the trigeminal nerve are located where?
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in the trigeminal ganglion (semilunar/gasserian ganglion)
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What does the Abducent N do?
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GSE for the lateral rectus muscle
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Where does the Abducent N exit the brain?
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the superior orbital fissure
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Which CN's axons have the longest intracranial course of the CN's? and why is this clinically relevant?
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-Abducent N
-when intracranial pressure increases this is the first nerve to be affected |
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Where do the fibers from the Abducent N originate?
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the abducens nucleus in the Pons (just ventral to the 4th ventricle)
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Where do the fibers of the Abducent N exit the brain?
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at the border of the pons and medulla... it courses through the cavernous sinus
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What does the facial nerve do?
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-SVE for muscles of facial expression and stapedius
-GVE for parasympathetics to lacrimal, sublingual, and submandibular glands -SVA for taste to the ant 2/3rds of the tongue and the soft palate -GSA for skin of the external ear and tympanic membrane |
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What foramen does the facial nerve travel through?
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it enters the internal acoustic meatus, transverses the facial canal, and exits through the stylomastoid foramen
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where do the parasympathetics of the facial nerve originate?
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pterygopalatine and submandibular ganglion
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Where do the cell bodies for the sensory neurons of the facial nerve reside? and what does it enter the brainstem through?
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-the geniculate ganglion
-it enters the brainstem through the nervus intermedius |
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What does the vestibulocochlear n do?
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SSA for hearing and balance
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What foramen does the Vestibuocochlear N. travel through?
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the internal acoustic meatus in the petrous part of the temporal bone (along with CN VII)
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why is it named the vestibulocochlear nerve?
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because it is 2 nerves each carrying separate information from the inner ear
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Where are the cochlear nerve's cell bodies located? and where do the axons terminate?
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-in the spiral ganglion
-the axons terminate in the cochlear nuclei |
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Where are the vestibular nerve cell bodies located? and where do the axons terminate?
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-in the vestibular ganglion
-the axons terminate in either the vestibular nuclear complex or project to the cerebellum |
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What does the Glossopharyngeal N do?
|
-SVE for stylopharyngeus only
-GVE= parasympathetics to the parotid gland -SVA= taste to post 1/3rd of tongue and pharynx (taste buds) -GVA= carotid sinus and carotis bosy -GSA=posterior 1/3rd of tongue, skin of external ear, and meatus |
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what is the foramen for the glossopharyngeal n?
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jugular foramen
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the glossopharyngeal n supplies parasympathetics to the parotid gland via which nerve?
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lesser petrosal n
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Where do the cell bodies of the glossopharyngeal n's parasympathetic fibers lie?
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in the otic ganglion
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what lies in the carotid bodies and what nerve innervates it?
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-chemoreceptors
-glossopharyngeal n |
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what lies in the carotid sinus? and what nerve innervates it?
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-baroreceptors
-glossopharyngeal n |
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What does the Vagus N do?
|
-GVE= parasympathetics to smooth ms and glands of pharynx, larynx, and viscera of teh thorax and abdomen
-SVE= skeletal muscles of the soft palate, pharynx, and larynx, and palatoglossus -GVA= baroreceptors in the aortic arch and chemoreceptors in the aortic bodies -SVA= visceral sensation from the respiratory, cardiovascular, and gastrointestinal systems -GSA= posterior wall of the pharynx |
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What foramen does the vagus nerve pass through?
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jugular foramen
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Which nerve wanders from the brainstem to the left colic flexure?
|
the Vagus N
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What does the accessory nerve do?
|
SVE= muscles of larynx and pharynx, trapezius and SCM
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What foramen does the accessory nerve pass through?
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Jugular foramen
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What CN has a cranial and spinal root consisting of motor fibers?
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Spinal Accessory N
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What does the accessory nerve accessorize?
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the Vagus N
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What does the Hypoglossal N do?
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GSE= muscles of the tongue
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which foramen does the hypoglossal nerve pass through?
|
hypoglossal canal
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What does the hypoglossal nerve supply?
|
muscles of the tongue (except for palatoglossus)
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olfactory nerve
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CN I
smell |
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optic nerve
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CN II
vision |
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Occulomotor nerve
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CN III
eye movement |
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trochlear nerve
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CN IV
Superior Oblique (eye movement) |
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Trigeminal Nerve
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CN V
Facial Sensation |
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Abducens Nerve
|
CN VI
Abducent N (eye movement) |
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Facial Nerve
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CN VII
Facial Movement |
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Vestibulocochlear Nerve
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CN VIII
Hearing and Balance |
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Glossopharyngeal Nerve
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CN IX
Organs and taste (and stylopharyngeus) |
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Vagus Nerve
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CN X
organs and taste |
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Spinal Accessory Nerve
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CN XI
shoulder shrug and head turn |
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Hypoglossal Nerve
|
CN XII
tongue movement |
