Head And Neck Anatomy Weeks 5 - 8

Front 1

Describe the External Acoustic Meatus.

Back 1

Over all 24mm long, runs medially and slightly anteriorly

Outer 1/3 is cartilagenous, has hairs

Inner 2/3's bony

Ceruminus glands secrete wax

Front 2

Describe the typanic membrane

Back 2

Ellipticle in shape, lateral surface concave, seperates outer and middle ear.

Skin externally, mucosa internally.

Thickened edge is tympanic ring which fits tympanic groove in temporal bone

Translucent, can see handle of Malleous and Chorda tympani.

Handle of Malleus attached to inner surface at maximum concavity = umbo

Above umbo = pars flacida
Below umbo = pars tensa

Front 3

Describe the middle ear/tympanic cavity

Back 3

Air filled
Lined with respiratory mucosa
Runs anteromedial to posterolateral = 15mm, 4-6mm wide

Front 4

Describe the ossicles

Back 4

All covered in mucosa and linked by synovial joints

Malleus:
Head in superior tympanic recess and attached Incus
Handle attached to tympanic membrane and Tensor typani and is crossed by CT
Lateral and anterior processes attached to ligaments

Incus
Body attached to head of malleus
Long crus to head of stapes
Posterior short crus to ligament

Stapes
Head of stapes to long crus of incus
Base to oval window
Neck to Stapedius

Front 5

Describe the course of Stapedius and it's innervation.

Back 5

Muscle orginiates in canal of posterior wall, tendon emerges from pyramid then to Neck of Stapes

Facial nerve innervation

Front 6

Describe the course of Tensor Tympani and it's innervation.

Back 6

Originates in Bony canal above auditory tube, tendon turns 90 degrees as it emerges, then attaches Handle of Malleus

Trigeminal nerve innervation (Medial Pterygoid branch)

Front 7

What do Stapedius and Tensor Tympani do?

Back 7

Contract in response to high intensity sound therefore decrease vibrations and decrease intensity.

Tensor tympani also pulls on tympanic membrane to decrease sound intensity.

Front 8

Describe the Auditory tube?

Back 8

Cartilage anteromedially, Bony posterolaterally (1/3)

Respiratory epithelium

Middle ear to nasopharynx

Opened by tensor veli palatini to equalise pressure between middle ear and nasopharynx

Front 9

Describe the Bony/Osseous Labyrinth and it's 3 structures:

Back 9

In Petrous Temporal bone and contains Perilymph

Cochlea:
2.5 turns around modiolis
Modiolis contains Spiral Ganglion (Cochlear nerve)

Vestibule:
Has oval (sup) and round (inf) window

Semicircular canals:
Anterior canal causes arcuate eminance on middle cranial fossa
Lateral canal causes buldge on medial wall of middle ear

Front 10

Describe the Membranouse Labyrinth and it's 3 structures

Back 10

Fills 1/4 of the Osseous Labyrinth, and contains Endolymph

Cochleal Duct:
Blindly ending duct
Contains sensory Organ of Corti
Scala tympani and Scala vestibuli on either side

Saccule and Uticle:
Contain macula for Head Position (Vestibular nerve)

Semicircular Ducts
Dilated region = Ampulla at vestibule end. Contains Crista for Head Movement (Vestibular nerve)
Anterior and Posterior ducts have shared trunk

Front 11

Describe the innervation of Parotid:

Back 11

PS from Glossopharyngeal hitch hiking on auriculotemporal

S from external cartoid plexus

Sensory from Cervical plexus

Front 12

What is the Parotid's vascular supply?

Back 12

Posterior auricular artery

Retromandibular vein

Front 13

Which structures are within the Parotid?

Back 13

Deepest - External Carotid
Middle - Retromandibular Vein
Superficial - Facial nerve

Front 14

What lies mesial to the Parotid?

Back 14

Internal Jugular, Internal Carotid and Vagus, with styloid muscles in between

Front 15

Describe the course, diameter, structure and epithelium of the parotid duct:

Back 15

Leaves the anterior border of parotid, crosses superficial surface of Masseter, pierces Buccinator, enter vestibule of Oral Cavity opposite second upper molar.

3mm

Fibromuscular

Columnar epithelium

Front 16

List cutaneous sensory branches of the Opthalmic nerve to the face:

Back 16

Supratrochlear
Infratrochlear
Supraorbital
External Nasal
Lacrimal

Front 17

List cutaneous sensory branches of the Maxillary nerve to the face:

Back 17

Infraobrital
Zygomaticotemporal
Zygomaticofacial

Front 18

List cutaneous sensory branches of the Mandibular nerve to the face:

Back 18

Mental
Long Buccal
Auriculotemporal

Front 19

List the Rectus Muscles and where they insert into the Sclera.

Back 19

6mm behind Cornea into Sclera

Superior recti - tendinous ring around optic nerve

Medial recti - tendinous ring around optic nerve

Inferior recti - tendinous ring around optic nerve

Lateral recti - 2 heads from from lateral portion of tendinous ring and adjoining margin of superior orbital fissure (nasocilary runs between)

Front 20

What is the innervation of the rectus muscles?

Back 20

Oculomotor except lateral rectus which is Abducent

Front 21

Name the oblique muscles, their inserstions, attachments and innervation.

Back 21

Enter sclera behind the equator.

Superior Oblique: from Body of Sphenoid superolateral to optic canal to trochlea (tendinous band at trochlea fossa), bends posterolateraly to insert between superior & lateral rectus.
Innervated by Trochlea nerve

Inferior Oblique: From Orbital portion of Maxilla, lateral to nasolacrimal groove, between inferior rectus and orbital floor, between lateral rectus and orbit to sclera between inferior and lateral rectus. Innervated by Oculomotor

Front 22

What is the order of muscles and nerves above the eyeball?

Back 22

Eyeball
Superior oblique
Superior rectus
Levator palpebrae superioris
Supraorbital/trochlea nerves

Front 23

How does the lens of the eye become rounder to accomadate near vision?

Back 23

PS stimulation of Cilary body causes it contract, therefore releasing tension on the Zonule fibres, and allowing a rounder lens.

Front 24

How are pupillary sphincters manipulated?

Back 24

PS from Oculomotor constricts

S from Carotid Plexus dilates

Front 25

What are tears made of?

Back 25

3 types of secretions:

Mixed serous from Lacrimal
Mucus from Goblet cells of the conjunctiva
Sebaceous from Sebaceous Tarsal Glands deep to Orbicularis Oculi (also on eyelashes)

Front 26

Describe the position and distribution of the Lacrimal Gland.

Back 26

Lies superolateral to orbit, with some in the eyelid lateral to the tarsal plate.

Front 27

What are the eyelids lined with? What are they continuous with?

Back 27

Lined with conjunctiva containing Goblet cells. Continuous with Cornea.

Front 28

Describe the pathway of tears?

Back 28

From eye to medial corner, into lacrimal puncta (one per eyelid) which are the entrances to the lacrimal canaliculi, into the lacrimal sac, down the Nasolacrimal duct and out into the inferior meatus

Front 29

What is the function of the Sclera?

Back 29

Fibrous outer coat

Front 30

What is the function of the Cornea?

Back 30

Refractive apparatus of eye

Front 31

What is the funciton of the Uvea and what does it include?

Back 31

Vascular internal coat, includes Choroid and Cilary Body

Front 32

What is the Iris?

Back 32

Stroma with Sphincter pupillae and Dilator pupillae muscles

Front 33

What are the 3 parts of the retina?

Back 33

Sensory: a thick inner sensory layer of rods and cones. Depressed Macula/forvea lateral to Optic disc (blind spot) only has cones and high visual acuity.

Pigment epithelium: underneath sensory retina which phagocytoses worn photoreceptors.

Non-sensory: makes up the posterior portion of the cilary body and iris

Front 34

Where is aqueous humour made and where does it travel?

Back 34

Made in the folds of the cilary body. Travels from posterior chamber through pupil to anterior chamber then down Canal of Schlem to venous system

Front 35

What is the lens?

Back 35

Transparent and biconcave strucutre that focuses.

Front 36

What is Vitrous humour?

Back 36

Highly fluid CT posterior to lens in the Vitrous Chamber

Front 37

What is the pupillary reflex?

Back 37

Constriction of pupils on exposure to light mediated by Oculomotor

Front 38

What is the Corneal Reflex?

Back 38

Blinking.
Afferent via Opthalmic
Efferent via Facial to Orbicularis Oculi

Front 39

What is the Arterial supply to the Eye?

Back 39

Opthalmic artery with branches:
Supraorbital
Supratrochleal
Orbital (to lacrimal and muscles)
Central artery of Retina (goes below optic nerve to optic disc, branches, no anastomoses)

Front 40

What is the Venous supply to the Eye and their drainage pathways?

Back 40

Inferior Opthalmic Vein to Cavernous Sinus

Retinal Veins to Superior Opthlamic Vein to Cavernous Sinus

Front 41

How is the IAN located?

Back 41

Halfway between the anterior and posterior border of the Ramus about 1cm above the occlusal surface of the lower molars.

Front 42

What are the articulating structure of the TMJ?

Back 42

Articular/Glenoid/Mandibular fossa

Head of Condyle (perichondrium covered Fibrocartilage)

Anterior Articular Tubercle

Articular disc (fibrocartilage, thicker medially and posteriorly)

Front 43

What are the Supporting Structures of the TMJ?

Back 43

Joint Capsule: from edges or temporal articular surfaces to neck of condyle

Lateral Ligament: lateral thickening of Joint Capsule. Collagen (+ elastin superoposterior)

Sphenomandibular ligament: From Spine of Sphenoid to Lingual, made from investing layer of deep cervical fascia.

Stylomandibular ligament: Styloid process to Angle of Mandible

Front 44

What is the Joint capsule lined with?

Back 44

Synovial membrane that produces protective and lubricative synovial fluid.

Front 45

What is the Vascular supply to the TMJ?

Back 45

Arteries:
Deep auricular, Ascending pharyngeal and Superficial Temporal arteries

Veins:
Pterygoid plexus

Front 46

What kind of joint is the TMJ based on its movement?

Back 46

Ginglymoarthrosis / Sliding hinge joint

Front 47

How does the TMJ allow jaw opening?

Back 47

First rotation
Slides forward
Second rotation

Front 48

What is the innervation of the TMJ?

Back 48

Sensory form Auriculotemporal, Deep temporal and Masseteric nerves with imput from Oral Mucosa and PDL.

Front 49

Which tissues of the TMJ have Mechanoreceptors for Proprioception?

Back 49

Joint capsule, lateral ligament, retroarticular tissue.

Front 50

Where is the Pterygomandibular Raphe located and what is attached to it?

Back 50

Vertical ridge from upper to lower 2nd/3rd molars, attached to Hamulus.

Buccinator anteriorly
Superior Constrictor posterioly

Front 51

Muscles involved in ELEVATION of Mandible?

Back 51

Masseter, Temporalis, Medial Pterygoid

Front 52

Muscles involved in DEPRESSION of Mandible?

Back 52

Infrahyoids, Suprahyoids and Lateral Pterygoids

Front 53

Muscles involved in PROTRUSSION of Mandible?

Back 53

Masseter, Lateral Pterygoids

Front 54

Muscles involved in RETRUSION of Mandible?

Back 54

Masseter, Horizontal fibres of Temporalis

Front 55

Muscles involved in LEFT LATERAL movement of Mandible?

Back 55

Right Pterygoids

Left Masseter and Temporalis

Front 56

Muscles involved in RIGHT LATERAL movement of Mandible?

Back 56

Left Pterygoids

Right Masseter and Temporalis

Front 57

What is the insertion/attachments of Masseter?

Back 57

Medial of zygomatic arch to lateral ramus.
Deep part also to coronoid process

Front 58

What is the insertion/attachments of Buccintor?

Back 58

Pterygomandibular raphe and outer posterior of Maxilla/Mandibular to Orbicularis Oris

Front 59

What is the insertion/attachments of Medial Pterygoid?

Back 59

Deep head from Medial of Lateral Pterygoid plate and Superficial head to Pyramidal process of palatine bone.

Both to Medial ramus

Front 60

What is the insertion/attachments of Lateral Pterygoid?

Back 60

Upper small head from Infratemporal fossa of Sphenoid, Lower bigger head from lateral of Lateral Pterygoid.

Both to neck of condyle and TMJ capsule

Front 61

What is the insertion/attachments of Temporalis?

Back 61

Temporal fascia via Superficial fibres and Temporal fossa, forms a thick white tendon behind Zygomatic arch to medial of coronoid process and upper ramus.