Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/558

Click to flip

558 Cards in this Set

  • Front
  • Back
Is the dura totally free of attachments w/in the spinal canal?
Dura is completely covered in the cerebral cavity
What are spinal cul de sacs?
Blind pouches that wrap around the spinal nerve and dorsal root ganglion.CSF sits in these and makes them stagnet. Area that bacteria will accomilate and grow.
(Blind alley)
What is the clinical importance of cul de sacs in the head and neck?
Flow of CSF-stagnent, already where bacteria accumulates & grows--> infection can occur due to fluid stagnet in it..... ( in certain places can cause meningitous)
What is the largest dural vessels?
Middle meningeal artery
Where does the largest dural artery, the middle meningeal artery pass through?
Foramen spinosum (right next to the spine of the sphenoid bone)
IF you fracture the pteryon part of the skull , what can happen?
The middle meningreal atery can rupture,producing an epidural hematoma.
Why is the middle meningeal artery the most important dural vessel clinically?
Like other meingeal arties it is between the skull & the 2 layers of dura... The middle meningeal is the largest artery and it lies against the extremely thin part of the skull, pteryon. If the Pteryon is fractured, the middle meningeal artery can rupture causing an epidurl hematoma.
What drains the cerebral hemispheres of the brain?
The midline of the superior sagittal sinus (draains the cerebral hemispheres)..... not associated with blood supply of the dura.
W/in cranial cavity, the dura matter is fused w/ __________ linking the inner aspect of the cranial bones.
ENDOSTEUM
What is endosteum?
The tissue lining the medullary cavity of bone.
Endosteum is fused with dura mater w/in the cranial cavity, which links the inner aspect of cranial bones.
W/in cranial cavity, the dura matter is fused w/ Endosteum linking the inner aspect of the cranial bones. It becomes a 2 layered structure consisiting of:
1. Inner Meningeal Layer
2. Outer Endosteal Layer
The inner menigeal and outer endosteal layers of the dura are firmly attached- where?
Exception?
Firmly attachted- Througout most of the cranial cavity.
EXCEP- venous sinusses
What SPACE is formed/produced bu the endosteal layer of the dura being fimly attached to the skull bones, but can be pulled away from the bones in most places?
POTENIAL EPIDURAL SPACE
The endosteal layer can NOT beeasily pulled away from the bone at -
INTERNAL SUTURE LINES- clinical importance????
Describe an epidrual hemotoma -6
1. blood from a ______ artery
2. between _____ & ____
3.Limited by _____ _____
4. Shape??
5.Pushes on ______
6. Cause Intracrainal pressure to?
1. blood from a dural artery
2. between dura & skull
3.Limited by Suture lines
4.Lens shaped (biconvex)
5.Pushes on brain (where does it go?)
6.Increased Intracrainal pressure
When does the meningeal and endosteal layers of the dura separate?
At the level of the FORAMEN MAGNUM
When the meningeal layer of dura separates from the endosteal layer (at foramen magnum), it continues down the spinal cnal sparated from the vertbrae by what?
Epidural fat
When dura passes through the foramen magnum it connects to the inside of the skull. The dura and endosteum of the skull fuse together and form a single membrane. If antery is broken, then blood will pool in the skull, makes epideral hemmorage. Brain is made of water & lipids and is ______________. Puts pressure on Brain stem. Brain stem controls _____ & _____.
INCOMPRESSIBLE
HEART & LUNGS
What are the 2 subdivisions of the Cranial Dura?
1.
a. b. c.
2. a. b.
1. Falx cerebi- falciform extension
a. sup. sagittal sinus, b. inf. sagittal sinus, c. Straight sinus
2.Tentorium Cerebelli
a. supratentorial, b.infratentorial
Subdivisions o f the Cranial Dura-
1. Falx cerebri - falciform extension does what?
It is in the saggital plane that sepetates the left and right cerebral hemispheres.
--> Midline front to back fallisofrom (sickle shape) membrane.
The tntorium dural extension does what?
It spreads latterally in the horizontal plane at the level of the STRAIGHT SINUS.
- IT separates the cerebral hemisphere above from the cerebellum below leaving an opening through which the brainstem passes
What separates the cerebral hemispheres above from the cerebellum beloow leaving an opening through which the brain stem passes?
TENTORIUM CEREBELLI
What separates the the left and right cerebral hemisphres?
Falx cerebi
Dura splits in certian places. This separates the__ & __ _______.
Dura splits in certian places. This separates the RIGHT & LEFT HEMISPHERES
What does the supratentorial compartment of the tentoium contain?
cerebral hemispheres
What does the infratentorial compartment of the tentorium contain?
Cerebellum & most of the brainstem.
The ______ _____ (or ______ ____ ) is the opening through which the brainstem passes i.
The TENTORIAL NOTCH (or TENTORIAL INCISURE ) is the opening through which the brainstem passes
Where does the free edge of the tentorium arise from?
The postieror clinoid process of the sphenoid bone.
The tentorial incisure presents what kind of passages for the brainstem?
ridged, rather sharp edge passage
In a fracture in the pteryon of the temporal region of the skull may cause an epidural hematoma bc even though the dura is firmly attached to the inner surface of the skull, the >>>>
The pressure of arterial blood is capable of diseecting between- this causes epidural hematoma
Why is an epidermal hematoma dangerous?
bc blood is confined & forms a mass that presses on the brain ( a space occupying lesion).
What problems can epidermal hematomas cause when they become large space occupying lessions?
2-
1.move into supratntorial compartment (brain incompressible, but something must give)- causes parts of inf. cerebral hemispheres to be forced through the tentorial incisure (EX. Brian Hernatiaon) into the infratentorial compartment= further compressing brainstem.
BASICALLY- space occupied by blood, so brain gets pushed to opposite side or downward. IF pushed downward, then pushed through tentorium notch.- which gets pushed further= CEREBRAL HERNIA!!
2. Increased Intracranial pressure & problems associated with it.
Where does the MMA pass through?
Foramen spinosum
What are the 2 key structures that pass through the TENTORIAL INCISURE.?? and what problems does an epidermal hematoma create for this structure?.
1. Oculomotor N.-
-consequence of epidermal hematoma--> Can produce the early sign of disturbed eye movements, bc compresses this nerve.
2.Cerebral peduncle (part of brain stem)
-Consequences of epidermal hematoma--> Can produce early eigns of contralateral hemiparesis.
A consequence of epidermal hematoma is contralateral hemiparesis.. what is that?
Muscle weakness on the opposite side of the face that was affected. --> Pressure on right side of brain gets paraylisis on front side of body due to these structures (cerebral peduncle)???
What happens when theree is further compression of the brainstem below the tentorial incisure --- it effects lower parts of the brainstem, which are home to what? and causes what?
Home to cardioregulatory centers.--> A very real consequence is rapid death.
Great superior vein of Galen drains what??? and is connected to what:?
_ Drain most of the brain and connects with the Straight Sinus
What drains the brain????
VENOUS SINUS drain brain... not the dura
Great cerebral vein of Galen drans moe of what ?
Drains most of deep vein into straight sinus
A.What sinus is confluent w/ ant. & post. venous plexus of the spinal canal??
B.What are the venous plexus?
C.What happens here? importance?
A. OCCIPITAL SINUS
B. are VALVELESS
C. Cancer can spread from the body to the brain this way.
WHat is the falx?
Dural extension between cerebral hemispheres
What makes up/ drains into the straight sinus?
1. Inf. Sagittal sinus
2. Vein of Galen
Once the inf. sagittal sinus and vein of galen drain into the straight sinus... THe straight sinus joins what where?
The Straight sinus joins the Sup. Sagittal Sinus at the Confluence of the Sinuses.
Where is the Occipital sinus found? and where does it drain?
Occipital sinus is found in the FALX CEREBELLI & Drains into the Conflence of Sinuses.
What is clinically important about the occipital sinus?
It communicates inferiorly with the internal verterbral venous plexus. --> Venous plexous- backflow-down or back- metases is poissible to travel up & enter sinuses of brain from other places of body, like testicular canceer... or a bacterial infection.
Venous drainage in the brain goes from ???
Back to front & from top to bottom
What forms the left Transverse sinus?
Straight sinus
What drains the brain????
VENOUS SINUS drain brain... not the dura
Great cerebral vein of Galen drans moe of what ?
Drains most of deep vein into straight sinus
A.What sinus is confluent w/ ant. & post. venous plexus of the spinal canal??
B.What are the venous plexus?
C.What happens here? importance?
A. OCCIPITAL SINUS
B. are VALVELESS
C. Cancer can spread from the body to the brain this way.
WHat is the falx?
Dural extension between cerebral hemispheres
What makes up/ drains into the straight sinus?
1. Inf. Sagittal sinus
2. Vein of Galen
Once the inf. sagittal sinus and vein of galen drain into the straight sinus... THe straight sinus joins what where?
The Straight sinus joins the Sup. Sagittal Sinus at the Confluence of the Sinuses.
Where is the Occipital sinus found? and where does it drain?
Occipital sinus is found in the FALX CEREBELLI & Drains into the Conflence of Sinuses.
What is clinically important about the occipital sinus?
It communicates inferiorly with the internal verterbral venous plexus. --> Venous plexous- backflow-down or back- metases is poissible to travel up & enter sinuses of brain from other places of body, like testicular canceer... or a bacterial infection.
Venous drainage in the brain goes from ???
Back to front & from top to bottom
What forms the left Transverse sinus?
Straight sinus
Where is the cavernous sinus located? and how does it receive blood ?
Cavernous sinus on both sides of theSELLA TURICA & receives blood from the ORBIT (eye) & pituitary!
How does blood flow from the brain tothe heart?
any anastomosis?
Blood flow: Brain=>Sinuses=>internal jugular v.=>heart.
-Brain Capillaries= DON'T anastomsis.- they are END CAPILLARIES!!! - so, clod a vein or sinus then get a stroke!- get same affect if you cut supply off or block its return.
What drains the brain????
VENOUS SINUS drain brain... not the dura
Great cerebral vein of Galen drans moe of what ?
Drains most of deep vein into straight sinus
A.What sinus is confluent w/ ant. & post. venous plexus of the spinal canal??
B.What are the venous plexus?
C.What happens here? importance?
A. OCCIPITAL SINUS
B. are VALVELESS
C. Cancer can spread from the body to the brain this way.
WHat is the falx?
Dural extension between cerebral hemispheres
What makes up/ drains into the straight sinus?
1. Inf. Sagittal sinus
2. Vein of Galen
Once the inf. sagittal sinus and vein of galen drain into the straight sinus... THe straight sinus joins what where?
The Straight sinus joins the Sup. Sagittal Sinus at the Confluence of the Sinuses.
Where is the Occipital sinus found? and where does it drain?
Occipital sinus is found in the FALX CEREBELLI & Drains into the Conflence of Sinuses.
What is clinically important about the occipital sinus?
It communicates inferiorly with the internal verterbral venous plexus. --> Venous plexous- backflow-down or back- metases is poissible to travel up & enter sinuses of brain from other places of body, like testicular canceer... or a bacterial infection.
Venous drainage in the brain goes from ???
Back to front & from top to bottom
What forms the left Transverse sinus?
Straight sinus
What are the protrusions of the arachnoid membrane through the dura into the dural sinuses??
ARACHNOID GRANULATIONS
What do archnoid granulations serve to activery (&passively) do?
Transport excess CSF into the venous return
What are SF Cerebral veins often reffered to as?? Why?
Bridging Veins
- BC they bridge the gap among the subarachnoid space.
As one ages what happens to hte SF cerebral veins? problems?
Veins stretch and Brain shrinks (encephalic recession)
problem- if fall and hit head, can cause a vein to snap & creat low presssure bleeding between the dura & arachnoid layers = SUBDURAL HEMATOMA- not as dangerous as an epidural hematoma, but still dangerous
What drains the jugular vein and what does it do with the blood?
The DURAL SINUSES drain the jugular vein & put the blood back into SYSTEMIC Circulation.
What does the SF Scalp veins anastomoses with?
Diploic veins which anastomose with dural sinuses.
What do the SF Scap veins & emissary veuns w/diplotic branches pass through and what do they join>?
Pass through the skull to join the Sup. Sagittal Sinus.
What connects systemic and cerebral blood flow? ANd these veins have no valves- blood take the path of least resistance.
Emissary veins
Emissary veins are found in what 3 places?
1.Parietal Foramen
2. Mastoid Roamen
3. Occiptal Foramen
-Only spots the veins can travel to the SF part of the skull
What is the reason scalp wounds are dangerous?? think inside
Infections can transverse from the outside directly to the brain ( eg- encephalitis). Route is often used & infections of cranial cavity will occur.
What are diploic veins??
run in the spongy bone between the inner & outer dense bony layers of the skull bones.
What is the clinical importance of Diploic veins?
Bc of their connections w/ the SF Scalp veins externally & the the DURAL sinuses withIN the Cranial Cavity.
What are the 3 sinuses and 1 vein associated with the Falx cerebri (falciform extension of dura in sagittal plane- seps. left& right hemi)? & most importnat sinus?
Sinuses:
1. Superior Sagittal Sinus= most important.
2. Inferior Sagittal Sinus
3.Straight SInus
Vein: Great Cerebral Vein of Galen.
The great cerebral vein of Galen joins the Inf. Sagittal sinus to form ______?
The Straight Sinus
what forms the straight sinus?
Joining of great cerebral vein of galen and inf. sagittal sinus
What do the straight and sup. sagittal sinuses come together to form?
Confluence of sinuses.
Confluence of sinuses is formed by what 2 sinuses coming together?
1. Straight sinus
2. Sup. Sagittal sinus
In the confluence of sinuses the sup. sagittal sinus turns to ______ and the straight sinus turns to the ______ w/ NO _____!
In the confluence of sinuses the sup. sagittal sinus turns to RIGHT and the straight sinus turns to the LEFT w/ NO __ MIXING__!
What is a space occupying lesion (ex- blood clot) growing half size of baseball & pushing on the skull into the foramen magnum. Cerebral hemispheres have herniated through the notch & into the foramen magnum, they compress the brain stem, with cardiopulmonary regulation systems; that will shut down heart & respiration.
BRAIN ( OR CEREBREAL) HERNIAS
What is created from the 2 layers of meningeal dura that have separated from the endosteal dura forming the tentorium cerebelli?
The Transverse SInus
What is the opening called that is created when the sharp free medial border of the tentorium arches posteriorly from the posterior clinoid processes on each side.
Tentorial notch or Tentorial incisures
What does the opening of the tentorial notch create?
A passage of the brain stem.
There are several dural sinuses w/in the cranial cavity. In general, the blood flow is from ( sup to inf. OR inf. to sup) and from (post. to ant. OR ant. to post.), *& ultimately ofrom where through what to form what?
Blood flow is from- SUP to INF & ANT. to POST.
- & ultimately out of the CRANIAL CAVITY Through the INTERNAL JUGULAR VEIN that Forms at the JUGULAR FORAMEN.
The Venous Sinuses include: 10 sinuses & 3 veins
1.Superior ophthalamic vein
2.Sphenoparietal sinus
3.Cavernous sinus
4.Basilar venous plexus
5.Superior petrosal sinus
6.Inferior petrosal sinus
7.Transverse sinus
8.Great cerebral vein of Galen
9.Inferior sagittal sinus
10. Straight sinus
11. Superior sagittal sinus
12. Sigmoid sinus
13. Anterior intercavernous sinus
In the Venous sinuses... What flows together to form the CAVERNOUS SINUS? (3 or 4??)
1.Sup. Ophthalmic veins (not a sinus)
2. Sphenoparietal sinuses
3. Ant. Intercavernous sinuses
( + 4. vesalian veins???))
In the Venous Sinuses... WHat flows together to form the STRAIGHT SINUS? (2)
1.Great Cerebral Vein of Galen
2.Inf. Sagitttal Sinus
In the Venous Sinuses... What flows together to form the TRANSVERSE SINUS? (3)
1. Straight SInus
2.Sup. Sagittal sinus
3. Sigmoid SInus
In the Venous Sinuses... What flows together to form the SIGMOID SINUS? (3)
(1. Basilar Venous Plexus???)
2. Sup. Petrosal SInus
3. Transverse Sinus
In the Venous Sinuses... What SINUSES flow together to form the JUGULAR VEIN? (2)
1. Inferior petrosal sinus
2. Sigmoid sinus
In the Venous Sinuses...
If you tie off blood to the brain .. what happens?
ISCHEMIC STROKE- brain capilariies don't asnastomoeses - if tied off it rots.
In the Venous Sinuses... What is overall effect if stop flow to the brain?
What is the overall effect if cut off return of blood from brain to heart?
If you do either of these = SAME EFFECT= STROKE!!
How is the Internal Vertebral Venous Plexus formed?? (IVVP)
1. Occipital Sinus
2. Basilar Venous Plexus
Is the Brain, Scalp & Meninges perfused by the same system/set of arteries? if not, do they overlap?
What about venous drainage?
Brain- Perfused by 1 system of arteries
Scalp&Meninges- perfused by a 2nd set of arteries
(THEY DO NOT OVERLAP)
-Venous Drainage of scalp & meninges is, for the most part, also separate from the brain; however, there is a potentially dangerous interconnection between these venous drainage patterns that passes through the skull.
What is the pattern of blood flow in cartoid arteries
Hint: ECA suppplies what
ICA supplies what?
Venous supply to scalp is interconnected to the sinuses, esp. dura sinus.
ECA-*( external Carotid artery)-Supplies the Dura...
ALSO-**ECA- Supplies the SCALP- ECA doesn't necessarily go to dura sinus
ICA(Internal Carotid Artery)- Supplies the Brain
What are the potentially dangerous interconnections between the brain and the scalp&meninges venous dranage patterns that pass throug the skull?
ECA-->DURA & SCALP -->SF Veins of Head & neck
ICA - Veterbral A.-->Brain-->Dural Sinuses-->Internal Jugular V.
* Alternative route of both ECA-->Scalp & ICA-vertebral A.--> Brain-->Dural Sinuses:
ECA-->SCALP <==SKULL==>DURAL SINUSES <--Brain<-Vert.A. ICA
When SF Cerebral Veins leave the brain's surface to enter 1 of dural sinuses they must cross what 3 layers to do so?
1. Subarachboid Space
2.Arachnoid Membrane

3. Subdural Space= name Bridgining veins
Subdural space is what kind of space between what?
-A potential space
-Between Arachnoid membrane and Dura
- Arachnoid membrane is closely associated w/inner surface of dura, but not fused to it= potenital space
What reveives sinus the most bridging veins? why are they clinically refrerred to by this name?
_Sup. Sagittal Sinus reveives most of the Bridging veins.
-Cerebral veins must ALSO cross subdural space to reach dural sinuses
Veins that run through diploe of the skull connects to scalp vein into the ??
Brain sinuses
VEINS (&a.??) of scalp are interconnnected w/______ veins--->which drain into skull & brain= ______ Veins!
Veins(&a.??) of scalp are interconnnected w/_DIPLOTIC_ veins--->which drain into skull & brain= _EMISSARY_ Veins!
SF Cerebral Veins course deep to the ________ membrane , crossing the ________ _____, passing through the ______ & crossing the ______ _____ to enter the ____ ____ Sinus!!
SF Cerebral Veins course deep to the _ARACHNOID_ membrane , crossing the _SUBARACHNOID_ _SPACE_, passing through the _ARACHNOID_ & crossing the _SUBDURAL_ _SPACE_ to enter the _SUP._SAGITTAL_ Sinus!!
What veins do the SF Scalp veins receive blood from? These veins drainthe bones of the skull.
DIPLOIC VEINS
What do diploic veins drain?
the bones of the skull
Some SF Scalp veins/Diplioc v. are relatively large & pass through the skull to join the Sup. Sagittal Sinus. These Veins are know as _____
Emissary Veins
Emissary Veins provide a connection between what?
Cerebral venous draninge & that of the Scalp
How can a scalp infection come directly into the sup. sagital sinus?
Infection=>Emissary Vein=>Sup. Sagittal SInus=>Cerebral Hemisphere
Bridging vein is from what to what?
From surface of brain to sinus
What causes a subdural hemota as one gets older?
Brain shinks as you get older, but tension on bridging veins since dura doesnt move. IF fall, venous blood leaks and get a hematoma.
What is the split dura (2) forming the sup. sagittal sinus?
1. Arachnoid granulations-weep CSF into the dural venous sinuses thus dumping it into the systemic venous return.
2. Bridging Veins- cross subarachnoid& subdural spaces
What is the clinical signigicance of bridging veins?
???? they get bigger as the brain gets smaller as one ages... can cause subdeural hematoma if fall..
Why is it a nonemergency for a subdural hematoma and an emergency for epidural hematoma??
Bc it is NOT restricted by suture lines, so there are NOT pressure problems like epidural hematomas... but can still cause death
What is the clinical significance of emissary veins?
Connect the dural venous sinuses w/ veins outside the cranium
Cerebral arteries are located in the subarachnoid space.. What is the clinical significance of this?
BC scalp infections can come directly into the sup. sagitall sinus-->(jugular vein & systemic supply)--> happens - infections via emissary vein -can cause sup. sagittal sinus into cerebral hemisphere.
(Infection=>emissary veins=>sup. sagittalsinus=>cerebral hemisphere)
What is included/ found in the Cavernous sinus on each side?
1. Abducens Nerve (CN6)
2.Occulomotor Nerve (CN3)
3.Trochlear Nerve (CN4)
4. Carotid Artery
5.Trigeminal Nerve (CN5)- only 2 of 3 branches
a. Opthalmic Nerve (opthalmic division of CN 5- V1)
b.Maxillary Nerve (mazillary division of CN5 V2)
How does the cavernous sinus blood flow?
Normally up to down- & front to back, but can reverse if clogged or tided off of the opthalimic vein
What if there is a clog in the sup. petrosal?? what happens to blood in the cavernous sinus?
Blood flows back tothe cavernous sinus
How many nerves run through the cavernous sinus? how many of those nerves are CN? Branches of CN?
5 individual nerves
3 CN
2 branches off of 1 CN
Where can meningitis start?/// What is the most common route of meningitis infections?
Meningitis can start in the DURA around the CAVERNOUS SINUS.
-Most common route of MENINGITIS= Sinus infections
Sinus infections are the most common route of what?
MENINIGITIS
Why don't you want statis or clot formation in the cavernous sinus?
bc it would affect the nerve... Symptoms would be from the nerve effected.
Ex: optic chiasm- push there= blindness
Where do the optic nerves cross?
Optic chiasm
What is the relationship of the pituitary glad to the optic chiasm 9what about pituitaty tumrs)? Suggest a surgical approach to pituitary gland.
-Pituitary is inf. to the optic chiasm.
-Pituitatry tumors can expand the Diaphragm Sellae, putting pressure onthe optic chiasm and may cause visual symptoms... (ex blindness)
Describe the relationships of CN 3,4,6, V1&V2 to the confines of the cavernous sinus?
These nerves lie in or close to the lateral wall of the cavernous sinus, so they can also be affected when this sinuses is injured due to fractured in the cranial base causing internal carotid startes to be torn & filling the sinus.
What is the relationhip of the cavernous sinus to the sphenoidal sinus?
The cavernous sinus is located on each side of the sella turcia on the upper surface of the body of the sphenoid, which contain the sphenoid sinus.
What is the relationship of CN6 tothe carotid artery?
They both pass throu the Cavernous sinus.. The abducens nerve passes posterolaterally to the carotid artery.
Infections, tumors, aneurisms may all involve these structures. HOw might a facial infection affect these nerves? (pushing zits)?
By pushing zits may spread infection tothe facial veins which are connected to the cavernous sinus which will in turn spread to the dural venous sinuses
What are the MAJOR tributaries that drain the face and scalp that are interconnected w/ veins &sinuses of cranial cavity by way of EMISSARY VEINS.- Veins- lateral to nose, above lips &below eyes= clinical interest and know as- DANGER TRIANGLE!
(5)
1. Patietal Emissary Vein
2. Supraorbital A. & V.
3.Angular A. & V.
4.Infraorbital A. & V.
5.Masoid Emissary V. & meningeal branch of Occipital A. (post. meningeal A.)
Why are the veins of the DANGER TRIANGLE of clinical interest? What about valves?
The facial veins can spread to the dural sinuses since they are in connection w/ the cavernous sinus & they do not have valves, so back flow CAN occur.
Medial to the jaw is a network of veins- they drain superiorly by _____ vein of ____ which Connects/communicates with the ______ sinus.
Medial to the jaw is a network of veins- they drain superiorly by _EMISSARY_ vein of _VESALIUS_ which Connects/communicates with the _CAVERNOUS_ sinus.
2 Examples of the direct valveless communication with the cavernous sinus inside and cranial cavity?
1. deeper veinous structures of the face include: pterygoid plexus (may be 2 -internal &external)
2.Sup. & Inf. Ophthalmic veins
Inf. alveolar n. is where ____ goes. If infection is in needle can spread to ______ sinus.- results in what in the patient?
Inf. alveolar n. is where _ANTHESTIC_ goes. If infection is in needle can spread to _CAVERNOUS_ sinus.
Results in what in the pt.?- Jaw hurts & fever. Eye closed on that side and eyeball turned outward & dilated. Affects SEVERAL CN!
Iatrogenic-caused be dr.
If blood from eye veins are flowing towards the cavenbous sinus & you push zits, the infection can
Go to the cavernous sinus.. Foramen of Versalius.
How is the pterygoid plexus interconnected with cavernous sinuses?
via the vein of Vesalius
How is the pterygoid plexus interconnected with the inf ophthalimic vein?
unnamed connections
The opthalmic veins have a direct connection with the
vacernous sinus
Infraorbital vein leaving Facial vein passing through the infraoribital foramen to join what?
Inf. Ophthalmic vein.. Dental anesthesia implications???
What are spinal nerves?
Nerves that arise from the spinal cord & exit the spinal canal. They are formed by the joining of dorsal & ventral roots. They are very short & brancg quickly. Generally, they are located w/in the intervertebral foramena & do not extend much beyond them before branching.
What is a cranial nerve?
- IT exits a foramen in the skull & not between successive vertebrae.
part of peripheral nervous system just like spinal nerves
Which axon type has the modalitity of sensory axons from skin, muscles, joints, etc. (touch, proprioception, pain, temp.)?
GSA- General somatic Afferent
What type of axon has the modality of motor axons to smooth muscle, cardiac muscle, gut & glands of the body where ever they may be.
GVE- General Visceral Efferent
What type of axon has the modality has motor axons tothe general skeletal muscles of the body (biceps, triceps, etc.)
GSE- General Somatic Efferent
What type of axon has the modality of sensory axons from the general visceral of the body ( visceral pain, gut distension, BP, pCO2 etc.
GVA- general visceral afferent
Cranial nerves can have which of the modalities of spinal nerves?
Some or all
All autonomic axons (ANS) are what axon type?
GENERAL VISCERAL ONLY- GVE & GVA- no exceptions!
Para & symp- GVE &GVA ONLY
Sensations and muscles of the nasal vacity, oral cavity, pharynx & larynx--> NOT innervated by ANS ...Taste & Smell are what type of axon is this?
SVA- SPecial visceral afferent
What type of axon isn;t like GS sensoryu structures found in the rest of the body, include Eye, cochlea, vestibular organs, & semicircular ducts.- sensation hearing balance
SSA- Special Somatic Afferent
What is the neurocranium?
The part of the skull encloses the brain.
What is the portion of the skull derived from the primative skeleton of the gill apparatus called???
- Portion of the vertebrate skull dervided from the embyonic pharyngeal arches that give rise to mandible,auditory ossicles, hyoid bone & distinict processes of the skull.
SPLANCHNOCRANIUM
The axon modality that innervates visera but, not part of ANS.
SVE- Special visceral Efferent- 4 incranial nervers.
CN that operate visceral arches? 4
1st arch- trigeminal
2- facial
3-Glospharyngeal
4- Vagus nerve
Brachial means??
Relating to, or resembling gils of a fish, their homologous embryonic structure or derivatives of their homologous parts in higher animals.
Most of the visceral skeleton is?
Cartilaginous,
EXCEPTIONS:
1.1st viseral arch (mand. arch)
2. Most of 2nd viseral Arch (hyoid bone)
NO CN is described as having _____ GVE axons- but might hitch hike up
SYMPATHETIC
What are the 4 CN that have parasympathertic GVE axons?
CN 3, 7,9, 10
All Spinal nerves carry 4 modalities...
GVE, GVA, GSA,GSE
1 exception
CNs have how many modalities? and how many can an individual CN have?
7- GSE, GSA, GVE,GVA, SVE, SVA, SSA
each one can have 1-5 modalities
Axon/modality of CN: 1- Olfactory N.
SVA of smell
-series of small nerves from upper nasal cavity.
Axon/modality of CN: 2- Optic Nerve
SSA for persception of light & the sense of Vision.- perception of light & dark more important than just vision.
Axon/modality of CN: 3- Occulamotor nerve - 2
1. Majority of axons- GSE to 4 of 6 extraocular mm. ( sup, med., inf. rectus. & inf. oblique)& levator palpebrae superioris
2.Parasympathetic axons GVE- cillary m - postganglionic near orbit of eye
Axon/modality of CN:
4 -Trochlear Nerve
GSE- innervation of a single extracocular m - sup oblique.= eye movements.
Axon/modality of CN: 5
Trigeminal nerve
3 branches
More sensory than motor
-mostly GSA- face & scalp
-small SVE to the muscles of mastification.
1.ophthalmic- v1
2. maxillary- v2
3. mandibular- v3
Axon/modality of CN:
6- Abducens N.
GSE- takes eye away from head/ switches gaze & eye laterally.
-innervates single extraoccular m.- Lateral rectus
Axon/modality of CN:
7-Facial Nerve- 4 modalities
1.SVE
2.GVE
3.SVA
4. GSA-tiny-
Parasympathetitc component of nerve- 2 ganglia- pterygopalatine & sublingual.
Axon/modality of CN:
8- vestibulocochlear
-purely SSA for the senses of hearing & balance from the inner ear
Axon/modality of CN:
9-glossopharyngeal Nerve-5
5 modlaites for small nerve
1.SVE
2. GVE-Salivary glands
3.GVA-caratoid body & sinus (BP)
4.SVA-taste
5.GSA-bit- from ear
1 ganglion-otic
Axon/modality of CN:
10- Vagus
Same as 9-
5 modlaites for large paraympathetic nerve1.SVE
2. GVE-Salivary glands
3.GVA-caratoid body & sinus (BP)
Axon/modality of CN:
11- Accessory nerve-2
1. SVE
2. GSE
-Innervates sternocleiodmastoid & trapezius mm
Axon/modality of CN:
12- hypoglossal Nerve
GSE- to tongue in viseral space. Muscles of tongue are derived from somites.. moves tongue
-Innervates intrinsic & extrinisc lingual m.
Sensory ganglia that are associated with CN that carry sensory axons are?
GSA, GVA, SSA, & SVA
-dorsal root specigic
Sensory ganglia of CN:
Trigeminal N. CN5-
Trigeminal ganglion ( semilunar or gassarian) -GSA
Sensory ganglia of CN:
Facial Nerve-7
gENICULATE GANGLION- GSA, SVA
Sensory ganglia of CN:
Vestibulocochalear nerve-8
Spiral & vestibular ganglia-SSA
Sensory ganglia of CN:
glossopharyngeal N.-9
Superior gangnlion (GSA & SVA) inferior ganglion (GVA)
Sensory ganglia of CN:
Vagus n. 10
Superior ganglion (GSA &SVA)... inf. gva
Olfactory and optic nerves are indeed sensory, but have no definitive ganglia associated withthem- their primary sensory cell bodies are located
Olfactory n- olfactory bulb
optic nerve- retina
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN- 1- Olfactory
Cribriform plate (multiple foramina)
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-2-Optic Berve
-Optic Canal (foramen)
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-3 Oculomotor Nerve
Superior Oribital Fissure
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-4-Trochlear Nerve
Superior Oribital Fissure
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-5 Trigeminal Nerve-3 divisions
Opthalmic- Sup. orbital fissure
maxillary- Foramen Rotundum
Mandibular- Foramen ovale
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-6 Abducens Nerve
Sup. Orbital Fissure
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-7 Facial Nerve
Internal Acoustic meatus
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-8 Vestibulocochlear Nerve
Internal acoustic meatus
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-9-Glossopharyngeal nerve
Jugular foramen
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-10- Vagus Nerve
Jugular Foramen
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-11- Accessory Nerve
Jugular Foramen
Foramina of Entrance or EXIT!!!- how CN gets out of skull:
CN-12 Hypoglossal nerve
Hypoglossal Canal
Foramina of Entrance or EXIT!!!- What CN Exits from the Foramen rotundum?
CN5-Trigeminal N- maxiallary division
Foramina of Entrance or EXIT!!!- Which CN exits from the Cribiform plate ( multiple foramina)?
CN1- Olfactory
Foramina of Entrance or EXIT!!!- What CN exits from the Foramen Ovale?
CN5-Trigeminal N- Mandibular
Foramina of Entrance or EXIT!!!- Which CNs exit from the Superior Orbital fissure?4
1.CN3 Occulomotor
2.CN4 Trochlear
3. CN 5- Trigeminal- opthalmic division
4. CN6- Abducens
Foramina of Entrance or EXIT!!!- Which CN exits from the optic canal (foramen)?
CN2-Optic Nerve
Foramina of Entrance or EXIT!!!- Which CNs exit from the Jugular foramen? 3
1.CN9-Glossopharyngeal
2. CN10-Vagus
3. CN11- Accessory
Foramina of Entrance or EXIT!!!- Which CN exits from the hypoglossal canal?
hypoglossal nerve
Foramina of Entrance or EXIT!!!- Which CNs exit from the Internal Acoustic Meatus? 2
1. CN7 facial
2. CN 8 Vestibulocochlear
CN of 3,5,7,9, &10 are all carriers of what kind of axons?
PARASYMPATHETIC
Does CN12 have parasympathetic component?
NO!!
What CN does everything like to hitchhike on?
CN5 trigeminal
What CN innervate VISCERAL ARCH: 1
CN5-Trigeminal nerve- m. of Mastication
What CN innervate VISCERAL ARCH: 2
CN7-Facial N. - m. of facial expression
What CN innervate VISCERAL ARCH:3
CN9- Glossopharengeal
What CN innervate VISCERAL ARCH: 4
CN 10- Vagus
What CN innervate VISCERAL ARCH:5
Doesn't appear in HUMANS!!!**
What CN innervate VISCERAL ARCH: 6
CN12-Hypoglossal
The viseral arches 1-6 are innervated by what axon?
SVE
Axial and Visceral Skeleton of the human- during further development- muscles associtated with some arches migrate to areas that have little in common with their arch. Thus much of the hyoid arch musculature migrates to become the muscles of facial expression, HOWEVER, no matter where these muscles migrate, they
KEEP THEIR ORGIN ARCH SPECIFIC INNERVATION
What is an anteriorly incomplete vertically oriented muscular tube that is continuous w/the nasal & oral Cavities superiorly?
The PHARYNX
The Pharynx is an anteriorly incomplete vertically oriented muscular tube that is continuous w/the nasal & oral Cavities superiorly. At the level of the lower larynx, it narrows to form a complete tube known as the _______
ESPHOGUS- IT occupies the space between the visceral arches & the vertebral column of the neck. It serves both respiratory & digestive system fxs.
Thyroid cartilage is part of the somatic or visceral skeleton?
VISCERAL
nasopharynx is located?
Behind the nasal cavity
Where the pharynx splits.. Ant-? post.?
Ant= Trachea- air to lungs
post- esphogus= food to stomach
The pharyngeal apparatus encloses the posterior aspect of the ____ ____ & terminates as the _______.
The pharyngeal apparatus encloses the posterior aspect of the VISCERAL ARCHES& terminates as the ESOPHAGUS.
What is the constricting muscle that sets up a peristalsis wave that pushes a bolus of food or water or air down?
Pharyngel muscle
Cervicle Spine:
1. Vertebral Body (centrum)
-describes vertebral body
Cervicle Spine:
2. Vertebral pedicle-
Hold lamina up off the verterbal body
Cervicle Spine:
3. Vertebral lamina
- roof of verterbal canal
Cervicle Spine:
4. Transverse process-
-Wing of vertebra. What ribs attach to in thoraci regin
Cervicle Spine:
5.Spinous Process
Posterior spine of verterbra- at junction of LAMINA
Cervical Spine:
6. Articular processes (sup & inf.)
Zygopopheses - joint between 2 vertebra.- connection/bridge
Cervical Spine:
7. Vertebral notches (sup/inf)
upper & lower border of pedicle. 2 makes interverbral canal - where spinal nerves go through here
Cervical Spine:
8. Intravertebral Canal
Where spinal cord likes= verterbral canal
In Cervical vertebra- The posterior tubercle of the transverse process attaches to what?
Tendons of muscle
Cervical vertebra have spine that is
bifid
What make up the lateral mass of a cervical spine?
Transverse process & costal process
Foramen transversarium piercing the lateral mass of the cervical vertebra.. what goes through this?>
VERTERBRAL A> only enters and goes up from c6- so C7 doesnt have a vertbral artery through it eventhough it has a foramen transversum
In the cervical vertebra the posteior tubericle is equivalent to a
true transverese proces
What is the anterior tubercle of the cervical vertebra equivalent to?
costal process (forms ribs in thoracic region)
What is special about the anterior tubercle of the c-6 vertebra?
It is called the carotid tubercle bc the common carotid a. maybe compressed here to control bleeding from these vessels. Landmark. Cassiagnacs tubercle.
What passes through the transverse foramina?
Exception?
Vertebral A.
- only exception is the C7 .. doesn't have averterbral aterry running through it.
Which vertebrae doesn't have a body... "it gave it's body to another vertebrae to form adens)
C1- Atlas
What vertebrae has a dens/odontoid process that flides on a notch that creates a synovial joint?
C2- Axis
What passes along the groove just posterior to the Superior Articular Process of C-1 vertebra?
The vertebral artery
(name= groove for vertebral Artery)
What movement predominates at the atlanto -occipital articulation?
Flexion and extension- Nodding head YES!
What movement predominates at the alanto-axial articulation?
Shaskes head NO!
What articulation does nodding head yes?
Atlanto-occipital Articualtion
What articulation does shaking head no! from side to side?
Atlanto-axial articulation
The atlas vertebra lacks a centrum "body". Where did it go?
The body fused to the Axis (C2)
The atlas vertebra has ant. & post. arches. What do they replace?
LAMINA
What snack food, candy or china place setting would you use to describe the atlas vertebra?
Donut - hard.. any pressure???
Can you describe what might happen if the occipital condyles were to compress the atlas vertebra from above?
Spread the bone in all directions crushing it. = Jefferson fracture.!!!
What is the largest ligament of the neck? It is thick fibroelastic ligament..
Ligamentum nuchae
What is a sygapophyseal joint?
z joint/ facet join- synovial joint between the sup & articular process of 1 vertebra & the inf articular process of the vertebra directly above it. There are 2 facet joints in each spinal motion segment.
Anesthesiologist often refer to "face joints" & "facet joint pain", what does this mean?
The facet joints are synovial joints which help support the weight & control movement between individual vertebrae of the spine. AKA- zygopopphyseal joints
Where is Chassagnac's tubercle? What is it's clinical significance?
Ant. tubercle of transverse process of (6th) cervical vertebra, which lies lateral to & at a slightly higher level than the post. tubercle, & against which the carotid artery may be compressed by the finger.- Carotid may be compressed to keep bleeding from these vesels
Where is the ligmenta flava end?
At the posterior C-2, C-1 interspace
fx ???????`
Ligaments do what?
strengthen the spinal canal- sacrifice stability joint to provide mobility & vice versa
The vertebral a. passing medially across the dorsal primary ramus of the c-1 spinal nerve, & piercing the post. alanto-occipital membrane, to which it is firmly tethered. Are there any Clinical implications resulting from the vertebral a. being so attached to the post. alantoocciptal membrane??
Yes, HYPER-rotation (flexion??) of skull at atlantoaxial joint will rupture the vertebral a. & will spread to brain & hemorrhage will occur. = you die.
fx of the ligmenta flava?
passive for extension of head
What is the fx of the cruciate ligament?
Provides the support for rotation
With hyper roatatoin of the head at the alanto-axial joint= can cause what to happen to the odontoid process?
may become fracturesd
The median alantoaxial articulation is that of a typical synovial joint.. Is there any clinical sig. to this??
- Like any other synovial joint- can be injured by arthritis...
-If have osteoporosis can hurt dens if pressure put on it!!
The skull is?
The entire head skeleton
The cranium is?
The skull w/out the mandible (lower jaw)
The entire head skeleton is the ______, where as the skull w/out the mandible (lower jaw) is the______!
The entire head skeleton is the SKULL, where as the skull w/out the mandible (lower jaw) is the CRANIUM!!
Divide the head in 2 parts and the 2nd part has 2 parts which are?
1.
2.
a.
b.
1.Facial Skeleton= Vicerocranium or splanchnocranium or face
2. Calvaria - remainder of the cranium
a. Neurocranium
b. Basicranium
What do the neurocranium and basocranium do collectively?
They enclose the brain.
Neocranium- covers brain from above , in front & back, & on both sides, & a small portion supports the brain from beneath (from front &back)
Basicranium- supports the brain from beneath.
What is the most important difference between neurocranium & basicranium?
DEVELOPMENTAL
The most important difference between the neurocranium & the basicranium is developmental.
What does Neurocranium forms through? & What components are in it?
Intramembranous ossification.

- Components that are a mixture of mesoderm (back) & neural crest cells (front).

(-from upper halves of orbit to occiptal bone to temporal bone)
The most important difference between the neurocranium & the basicranium is developmental.
What does Basicranium forms through? & What components are in it?
-Forms mostly through ENDOCHONDRAL Ossification.

-Components: made mostly of Mesoderm

(derived from cartilage)
What is the facial skeleton?
How is it ossified?
What is made of?
Facial skeleton- from frontal bone to mandible
-Ossifies intramembranously
-Made Entirely of Neural Crest cells
How does intramembranous ossification work? 2
1. Developing brain is covered by a (fibrous thin flexible capsule) made of both neural crest &mesoderm. The space btw is only a potential space
2. The capsule differentiates into 2 layes: -->Endomenix (internal) & -->Ectomenix (external)... Separated by a potential space. In doing so, The mesoderm & neural crest are LARGELY separated. The endomeninx consists entireely of neural crest cells. The extomenix is a mixture of mesoderm & some neural crest.
How does intramembranous ossification work after steps 1 &2? 34
3.The extomeninx & endomeninz both differentiate into 2 layers.
Endomeninx internal division- contacts developing brain= pia mater.
Endomenix outer layer= archnoid mater.
BOTH of these leayers are composed of NEURAL CREST
4. Ectomeninx inner layer= becomes dura mater- which is made of mesoderm w/perhaps a little neural crest.
Ectomeninx outer layer-becomes osteogenic layer that will give rise to the Bones of the membranous neurocranium - it contains BOTH Neural crest & mesoderm!
Endomeninx- cell type and location'
Ectomeninx cell type and location
The capsule differentiates into 2 layes: -->Endomenix (internal) consists entireely of neural crest cells.
-->Ectomenix (external) is a mixture of mesoderm & some neural crest.
Menix?
singular of meningies - which is what it gives rise to
What are the 6 steps (condensed) jof how intramembranous ossification works?
1. Loose mesenchyme- ireg. shapped
2. Condensed mesenchyme-flattend down - less extracellular space.
3.Membrane formation -->differentated to fibroblast to collagen fibers(percurosr of bone)
4. Formation of osteoblasts & osteoid
5. Progress from middle from island of messenchyme cells to outward in sheets.
6. Center of Intramembranous ossification in parietal bone.(center outward expansion of bone in membrane- Traces still visible in dry bone)
What is described as strips of soft tissue. Specialize articulation that doesn't move. & allows bones to almost touch?
NEUROCRANIAL SUTURES
What is defined as "a craniofacial articulation in which contiguous margins of bone approximate each other & are united by a thin layer of fibrous tissue"?
SUTURE
Define a suture:
a craniofacial articulation in which contiguous margins of bone approximate each other & are united by a thin layer of fibrous tissue
On sutures what do osteoblasts do?
They add new bone to margin in neurological growth.
What are the 2 fxs of sutures during growth...(Why have sutures, why not have bones grow together?)
1. Sutures allow "molding" of skull, which facilitates birth. ( if have a rigid plate bones could easily break- (cone head))=Calvarial molding during birth (occiptal bone displaces forward- flexible)
2.Sutures allow both prenatal & postnatal brain growth.
How are suture widths maintained while the brain ins expanding?
The rate of new bone formation at the margins keeps pace with the expanding brain, so that the suture widths are maintained.
Growth of neurocranial bones at the sutures is ____ ____. If bone is simply added at the sutures, the bones' curvature is maintained, and the bone does not ___ the growing brain ______.
Growth of neurocranial bones at the sutures is NOT ENOUGH. If bone is simply added at the sutures, the bones' curvature is maintained, and the bone does not COVER the growing brain CLOSELY.
As the bone grows in area (adding bone at margins) it must change it's ________ to conform to the brain's surface.
As the bone grows in area (adding bone at margins) it must change it's CURVATURE to conform to the brain's surface.
As the bone grows in area (adding bone at margins) it must change it's CURVATURE to conform to the brain's surface. This is done by:
REMODELING- a combinatyion of deposition on the bones' outer surfaces (+) & resorption of the bones' inner surfaces (-). ( OSTEOCLAST- take it away faster at the edges & slower at the center & OSTEOBLAST add it to the outside- eventually- this process makes the bone flat)
-Local variations in the rate of remoedling flatten the bone, so it continues to conform to the brain's contour.
Local variations in the rate of remoedling ______ the bone, so it continues to ______ to the _____ contour.
Local variations in the rate of remoedling FLATTEN the bone, so it continues to CONFORM to the BRAIN'S contour.
In the Basal Cranium- The only parts that don't ossify/ disappear are the ?
NASAL SEPTUMS & OUTER PART
What are the regions of chondrocraniuym that do not ossify, at least not initially... iNstead, they persist as cartilagenous zones between bones called?
SYNCHONDROSES
Synchondroses --> what results primarily in anteroposterior growth of the cranial base?
Sites of further appositional bone growth at the bone-cartilage interfaces
How do synchondroses ossify & growth cease?
From front-to-back sequence.
Where is the primary site of postnatal growth in the cranial base?
Sphenobasilar (basioocipital) synchondrosis.
What other animal genes play important roles in the formation & function of synchondroses??
Hedgehog genes (sonic, indian & desert)
How does growth at synchondrosis work? 5- brief.
1.Resting zone (typical hyaline cartilage)
2.Proliferative zone(division of chondrocytes)-
3.Hypertrophic zone (chondrocytes swell & extracellular matrix is reduced.)
4. Chondrocytes die & remaining matrix begins to calcify
5. Ossification zone
How does growth at synchondrosis work? 5
-1. Resting zone- whats in it? what happens here?
- Typical hyaline cartilage -round
-a lot of extracellular matrix= NOT much growth here
How does growth at synchondrosis work? 5
2. Proliferative zone- what is going on here and how
- Division of chondrocytes
-chondrocytes divide & line up in rows
How does growth at synchondrosis work? 5
3.Hypertrophic Zone- What happens here and how?
- Chondrocytes swell & extracllular matrix is reduced
-grow chondrocytes & elminate space btw chondrocytes- ground cells are cleared out
How does growth at synchondrosis work? 5
4.Chondrocytes die & remaining matrix begins to calcify- where do they go when they die??
-Leave tunnels & bound by tubes where collumn of cells were/ ground substances
How does growth at synchondrosis work? 5
5. Ossification zone
- What moves into spaces made by chondryocytes dying & remaining matrix calcifying? -2
- Osteoprogenitor cells & Capillaries move into the spaces left by dead chondrocytes.
-Osteoprogenitor cells differentiate into osteoblasts which begin forming bone)
(push bones apart & new bone forms on margin)
How does growth at synchondrosis work? 5- all details
1.Resting zone (typical hyaline cartilage)-->round; a lot of extracellular matrix & not much growth here.
2.Proliferative zone(division of chondrocytes)- chodrocytes divide & line up in rows
3.Hypertrophic zone (chondrocytes swell & extracellular matrix is reduced)-->grow chondrocytes & eliminate space btw them- ground cells cleared out.
4. Chondrocytes die & remaining matrix begins to calcify.--> leave tunnels & bound by tubes where collumn of cells level ground substance.??
5. Ossification zone (Osteoprogenitor cells & capillaries move into (migrate in) the spaces left by the dead chondrocytes; osteoprogenitor cells differentiate into osteoblasts, which begin forming bone). --> push bones apart & new bone forms on margins.
What are the 3 important SF muscles of the Neck?
1. Platysma
2. Trapezius
3.Sternocleidomastoid
SF Muscles of the Neck:
1. Platysma
o:
i:
Fx/act:
Innervation:
Platysma- Most SF- Vail like
o: Lower portion of skin in face along Mandible verticallay down
i:Subcutanous tissue thoracic region
Fx/act: CORRUGATOR OF THE SKIN OF THE NECK
Innervation:cn-7 FACIAL NERVE- Muscle facial expression- arch 2
SF Muscles of the Neck:
2.Trapezius
o:
i:
Fx/act:
Innervation:
2. Trapezius
o:upper fibers- base of skull (ligamentum nuchi)
i: lateral 3rd of clavicle
Fx/act:1.CERVICAL PORTION- ELEVATES
SHOULDER**
2.FLEXES HEAD IPISILATERALLY
In: CN 11 ACCESSORY N.
SF Muscles of the Neck:
3.Sternocleidomastoid (SCM)
o:
i:
Fx/act:
Innervation:
SCM
o:Mastoid process
i:Medial 1/3 of clavical & Manubrium of Sternum
Fx/act:(3)
1.EXTENDS HEAD
2. FLEXES HEAD
3.ROTATES HEAD CONTRALATERALLY(Look to left use right SCM.
In: CN11- Accessory Nerve
What happens if you injure your SCM?
Can increase CT & muscles get small so the head or w/e is shrugged
What is torticollis?
-- A twisted neck in which the head is tipped to 1 side, while the chin is turned to the other.
-Symptoms: limited range of motion of the head, heachace, head tremor, neck pain, shoulder is higher on 1 side than the other, stiff neck, swelling of neck muscles
(Fork neck to looking side??? -SCM)
Spinal nerves exits ____ _____ and divides into ventral & dorsal primary rami
INTERVERTEBRAL FORAMEN
Preaxial muscles of theneck are supplied by?
Ventral primary rami
Postaxial muscles of the neck are supplied by?
Dorsal primary rami
Post axial muscles of neck
What are the 4 muscles that are innervated by the Subocciptal nerve of the dorsal Rami of C1 Spinal Nerve?
1. Rectus Capitis Post. Minor muscle
2. Obliquus Capitis Sup. muscle
3.Rectus Capitis Posterior Major muscle
4. Obliquus Capitis Inf. muscle
What is unique about the Serratus Posterior Superior Muscle in the neck?
It is a preaxial m. that migrated. It is innervated by the Dorsal Scapular N. from brachial plexus=>ventral primary ramus (c4-c5.. c5-c6)
All of the postaxial muscles are innervated by:
Dorsal primary Rami
What is the deepest postaxial muscle that is very small, but has some mechanical fx in the neck, although it doesnt have any fx elsewhere in the body.
ROTATORES CERVICIS (part of longus brevis)
Rotator muscles of the thoracic & lumbar regions have little or no mechanical fx, what valuable fx does the Rotatores Cervicis have?
-have many neuromuscular spindles. - Do minute rotation, but get stretched which is very important in proprioception... So stretched ,and moved and measure minute rotations - do this with proprioception receptors.
- connected to semicicular canals of the ear. These canals measure balance & proprioception. - Where you are in space- angular acceleration. Stabilize the head & allow to put objects in space fobiation.
Preaxial vervical muscles of importance: 6
-innervated by ventral primary rami
1. rectus capitis ant.
2. rectus capitis lateralis
3. Longus capitis
4.Lonus colli
5.Scalene Muscles -(ant., mid,. post)
6. Levator scapulae
Where is the brachial sulcus PLEXUS located? and what does it contain?
Btween the ant. & middle scalene muscles ... brachial plexus is behind the bracial sulcus
What are the 3 triangles of the neck?
1.
2.
3. --- with 4 subdivisions
a.
b.
c.
d.
Triangles of the neck- used for landmarks
1.Subocciptal Triangle
2.Post. Cervical Triangle
3. Ant. Cervical Triangle--- with 4 subdivisions
a.Submandibular Triangle
b.Submental Triangle
c.Carotid Triangle
d.Muscular Triangle
3 Triangles of the Neck:
1. Subocciptal Triangle- Lies deep to ______ ______
Semispinalis capitis (&rectus??)
3 Triangles of the Neck:
1. Subocciptal Triangle
-Boundaries? sup, lat, inf.
Sup./med- Rectus Capitus post. Major
Sup/lateral-Obliquus Capitis Sup.
Inf.-Obliquus Capitus inferior
3 Triangles of the Neck:
1. Subocciptal Triangle
Important contents:3
importance of these contents?
Important contents:
1. Vertebral A. (3rd part)
2.Subocciptal Nerve (dorsal ramus-nerve C1)
3.Post. Arch of atlas/Suboccipital venous plexus
Important bc- Fracture of the ATLAS= aneurism of vertebral atery. When taking CSF would want to know where these vessles were( alsothe purpose of these m. is to provide Fine Motor FC in movements of the head. The actions of Trap, SCM & other larger mm that move the head are refined by the relatively small SUBOCCIPTAL TRIANGLE.)
3 Triangles of the Neck:
2. Posterior Cervical Triangle
-Boundaries? ( ant.- , Post.-, Inf.-)
Boundaries:
Ant.- SCM
Post.-Trapezius
Inf.- middle 1/3 of Clavicle
3 Triangles of the Neck:
2. Posterior Cervical Triangle
- What are the contents? 4:
Contents:
1. Nerves & Plexuses:4
2. Vessels-4
3.Lymph Nodes-2
4.Muscles-6
3 Triangles of the Neck:
2. Posterior Cervical Triangle
- What are the contents? 4:
1. Nerves & plexuses-4
Contents:
1. Nerves & Plexuses:4
a.Spinal Acessory N. (CN11)
b.Branches of Cervical plexus
c. Roots & Trunks of Brachial Plexus
d.Phrenic Nerve (C3,C4,C5)
3 Triangles of the Neck:
2. Posterior Cervical Triangle
- What are the contents? 4:
2. Vessels-4
contents? 4:
2.Vessels-4
a.Subclavian A. (3rd part)
b.Transverse Cervical A.
c.Suprascapular A.
d.Terminal part of External Jugular V.
3 Triangles of the Neck:
2. Posterior Cervical Triangle
- What are the contents? 4:
3.Lymphnodes 2
Contents:4
3. Lymphnodes:2
a. Occipital
b. Supraclavicular
3 Triangles of the Neck:
2. Posterior Cervical Triangle
- What are the contents? 4:
4. Muscles-6
contents 4:
4. Muscles- 6
a.Inf. belly of Omohyoid
b. Ant. Scalene
c. Mid. Scalene
d. Post. Scalene
e. Levator Scapulae
f. Splenius
3 Triangles of the Neck:
2. Posterior Cervical Triangle
- Are there special relationships between the Accessory N. & Brachial Plexus? What is the clinical importance?
Relationships:
- Accessory Nerve (CN11) is particularly vulnerable to damage at lymph node biopsy, where damage results in an inability to shrug the shoulder or raise the arm above the head (ex. brushing hair). The external jugular vein's SF location also makes it vulnerable to injury.
(CN11- latera lsurface to levator scapulae)
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- Boundariess: -Lateral, Ant., Sup., Floor, Roof.
Boundaries:
-Lateral: Ant. border of SCM
-Ant: Midline of the neck??
-Sup:Inf. Border of the body of the mandible
-Floor: Cervical Viscera
-Roof: Platysma
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- What are the contents? 4
This is a LARGE triangle and is subdivided into 4 more triangles:
A. Submabdibular (Digastric)
B. Submental
C. Carotid
D. Muscular
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
A. Submandibular Triangle- Boundaries
A. Submandibular (Digastiric) Triangle-boundaries:
-Sup: Inf. Border of mandible
-Inf.- Post& Ant. Bellies of Digastric
(-Floor-Mylohyiod, Hypoglossus & Roof- SF platysma- smae for all ant. triangle)
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
A. Submandibular (digastric) Triangle- Contents:-5ish
A. Submandibular (Digastric) Triangle- Contents:
1. submandibular gland
2. submandibular LYMPH nodes
3. Hypoglossal N.
4. Mylohyoid N.
5. Lingual & Facial A.&V.
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
A. Submandibular (digastric) Triangle- Clinical issues:
A. Submandibular (digastric) tirangle- Clinical issues:
1. Abcesses of mandible
in submandibular salivary glands
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
B. Submental Triangle- Boundaries-
B.Submental Triangle- Boundaries:
Lateral:Right & left anterior bellies of digastric
Medial: midline of neck
Inf: Hyoid bone
Inf:
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
B. Submental Triangle- Contents:
B. Submental Triangle- Contents:
1.Few Submental lymph nodes--> Incisor Teeth
2.Mylohyoid muscle (midleine raphe)
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
C.Carotid Triangle-Boundaries:
C.Carotid Triangle-Boundaries:
Medial: Omohyoid Sup Belly
Lateral: Upper 1/3 of SCM
Sup- Digastric post.
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
C.Carotid Triangle- Contents:
C.Carotid Triangle- Contents:
**1.Carotid Sheath- It is a protective mech.- protects itself from friction on other structures) as the cartoid a. is a developmental structure--->which contains:
a. (External) Carotid Artery
b. Vagus Nerve CN 10
c. Internal Jugular Vein
( maybe also contains CN11, 12 & cervical plexus??)
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
D. Muscular Triangle- boundaries:
D. Muscular Triangle- boundaries:
Sup. - lowerborder of omohyid sup.
Lateral- Ant. part of SCM & hyoid bone
Medial- Mid line of neck ( jugular notch)
3 Triangles of the Neck:
3. Anterior Cervical Triangle
- 4 Contents= 4 sub triangles:
D. Muscular Triangle- contents:
D. Muscular Triangle- contents:
1. Infrahyoid strap muscles
Infrahyoid muscles are AKA:
STRAP MUSCLES
Infrahyoid Muscles: includes which muscles? all hyoids but which one? 4
_ all hyoiods except (mylohyoid- which is suprahyoid)
Infrahyoid/strap muscles include:
1. Sternothyroid-deep
2.Sternohyoid-deep
3.Thyrohyoid-SF
4.Omohyoid-SF
What connects the digastric muscle to hyoid?
Sling/fibrous Loop (root-sheaths) for intermediate digastric tendon.
What action does the infrahyoid muscles do?
Depresses hyoid
What action does the suprahyoid muscles do?
Elevates the hyoid bone
What are the 3 Suprahyoid muscles?
1. Digastric muscle (ant. & post.)
2. Mylohyoid M.
3. Stylohyoid>???????? idk
???? Antagonist of infrahyoid m.?
1. stylohyoid
2. mylohyoid
3. digastric
bc they do elevation
What is raphe'?
Midline to the mylohyoid???
Hyoglossus muscle is what kind of muscle and where does it arise from?
Hyoglossus muscle- EXTRINSIC LINGUAL m.
- arising from hyoid just post. to the mylohyoid muscle... NOT a suprahyoid m.
All Hyiods are STRAP M. except ____ intervated by:
except mylohyoid
all intervated by C1
Genio= ____
Omo= ______
Genio= Chin
Omo= Shoulder
geniohyoid muscle is deep to ________ & to the Ant. belly of the ______ =
Geniohyoid m. is deep to MYLOHYOID & ant. belly of DIAGASTRIC m.= "SANDWICH" the mylohyoid
The Mylohyoid, Digastric, & Genioglossus are NOT _____
Strap muscles
All Infrahyoid muscles & geniohyoid of suprahyoid muscles are-
STRAP muscles
What rides on the hyoid?
Floor of mouth and tongue
Digastric action = elevates hyoid, but if infrahyoid mm are holding hyoid down, what is the action of the digastric muscle?
It OPENS the mouth.- uses pulley to do this.
When taken together, why are infrahyoid muscles & suprahypid muscles decribed as antagonistic?
Bc they do opposite jobs in how they opperate the hyoid & how they work in articulation (talking).
Extrinsic Lingual muscles:
O:
I:
O- arises w/out the tongues somwhere outside the tongue
I- inserts into tongue
Intrinsic Lingual Muscles:
o:
i:
Rise & Insert in tongue- no bone o or i.
All of the tongue is innervated by:
CN 12 Hypoglossal Nerve.
What muscle depresses the tongue?
Hypoglossus muscle
Styloglossus Muscle
O:
I:
A:
O:Styloid Process
I:Hypoglossus & intrinsic M. of tongue
A:Elevates tongue posteriorly & pulls posteriorly
The Mylohyoid, Digastric, & Genioglossus are NOT _____
Strap muscles
All Infrahyoid muscles & geniohyoid of suprahyoid muscles are-
STRAP muscles
What rides on the hyoid?
Floor of mouth and tongue
Digastric action = elevates hyoid, but if infrahyoid mm are holding hyoid down, what is the action of the digastric muscle?
It OPENS the mouth.- uses pulley to do this.
When taken together, why are infrahyoid muscles & suprahypid muscles decribed as antagonistic?
Bc they do opposite jobs in how they opperate the hyoid & how they work in articulation (talking).
Extrinsic Lingual muscles:
O:
I:
O- arises w/out the tongues somwhere outside the tongue
I- inserts into tongue
Intrinsic Lingual Muscles:
o:
i:
Rise & Insert in tongue- no bone o or i.
All of the tongue is innervated by:
CN 12 Hypoglossal Nerve.
What muscle depresses the tongue?
Hypoglossus muscle
Styloglossus Muscle
O:
I:
A:
O:Styloid Process
I:Hypoglossus & intrinsic M. of tongue
A:Elevates tongue posteriorly & pulls posteriorly
Genioglossus:
O:
I:
O- sup. geniotubercle on chin
I- tongue
Palaloglossus muscle is what kind of muscle innervated by what?
Palatal glossus m. is NOT a tongue muscle, it is a Palatal m.
it is innervated by CN10- not 5
What innervates the stylohyoid?
Facial N. CN7
What innervates the Digastric m.
ant belly-
post belly-
What innervates the Digastric m.
ant belly- CN 5- TRIGEMINAL
post belly-CN 7 FACIAL
What innervates all the intrinsic and extrinsic lingual m.?
CN12 hypoglossus
What are the 3 intrinsic muscles?
1. Sup. Longitudinal m.
2. Inf. Longitudinal m.
3. Transverse & vertical m.
(directional m)
What are the 3 extrinsic m.? all the ___ muscles except for:
1. Stylogolossus m.
2. Hypoglossus m.
3. Genioglossus m.
-all the _-GLOSSUS_ muscles except for PALATOGLOSSUS
What defines an intrinsic lingual muscle?
It is responsible for all the "gymnastics" or tricks of the tongue- rolling the tongue, etc.
Right hypoglossal n. region tongue will point to side off if lesion is on what side?
Right.
Tongue protrusion is an important sign in ??
CN testing
The Genioglossus muscle does what?
protrudes tongue directly forward.. Fan out and diverge latterally into tongue
If acting in concert, genioglossus muscles thrust tongue??
forward in the midline
If acting independently, each genioglossus muscle thrust the tongue...
Forward and to the CONTRALATERAL Side
What are the parts of the thyroid gland?4
1. Pyramidal lobe- often absent or small
2. Right lobe
3. Left lobe
4. Isthmus
What arteries supply it (thyroid) and what weins drain it? What are its relationships?
The thyrocervrical trunk branch of the subclavian has a Thyroid artery branchs off & supplies theyroid.
3 Veins drain :
1. Sup.internal Jugular
2.Med. Internal Jugular
3. Inf. Branchial cephalic trunk.
What is the thyroid imma artery *& why is it important?
less blood if cut??
parathyroid location?
Post. of thyroid gland.
Superficial Cervical Fascia contains-3 things:
1. SF Veins
2. SF Nerves
3. platysma muscle
Deep Cervical Fascia:
Investing layer= what layer
- where is it
-what does it enclose?
Investing layer= SF layer of deep layer
- It completely encircles neck.- -Each side of neck is split to enclose: 1. trapezium & 2. SCM before meeting at midline
Deep Cervical Fascia:
"deep layer"- - 2 fascias
1. Prevertebral Fascia
a. Preaxial layer b.nuchal layer
2. Pretracheal Fascia-
a.viseral portion b. muscular portions
Deep Cervical Fascia:
"deep layer"- - 2 fascias
1.Prevertebral Fascia-
-encloses what?
a. preaxial layer- location
b. nuchal layer-location
- Encloses the deep muscles of the neck- both preaxial & postaxial muscles.
a. preaxial layer- ant. to the cervical vertbrae
b.nuchal layer- post. to vervical vertebrae
-->Both layers of fascia enclose deep muscles of neck associated with the vertebral column
Deep Cervical Fascia:
"deep layer"- - 2 fascias
2.Pretracheal Fascia- suronds what?
a. Visceral portion
b. Muscular portion
-Surronds the visera & muscles of the ant. part of neck.
a. Visceral portion- of the pretracheal fascia- invests the thyrois glad, trachea & esphogus
B. Muscular portion - invests the "strap muscles of the ant. part of the neck.
Deep Cervical Fascia:
"deep layer"- - 2 fascias
- Ther are several derivatives of the deep fascia that are composed of combination of layers or produced by chronic movements. These include-3
1. Carotid Sheaths
2.Buccopharyngeal fascia
3.Alar Fascia
-important in dentistry
What does the muscular portion of pretracheal layer of the deep cervical fascia (or infrahyoid m.) do?
enclosess the strap muscles of the ant. part of the neck
What is the open space sup. to buccalpharyngeal fascia?
what if cut?
Retropharyngeal SPace- area where 3rd moalrs. dont want to cut/break into it. if cut can spread infection to mediastinum.
There are how many brachial arches and how do u # them?
indentions are located?
5 Brachial arches- 1,2,3,4,6 from top to bottom.
-Indentations on outside and inside- get a partial squeexing in to get indentation.
Brachial arches: Indentations
On outside=
on Inside=
On outside= Clefts 1
On Inside = Pouches
Each brachial arch has what in it?
IN addition to that: 2 other things in it? that give rise to what
Have: Artery, CN, & Cartilage
- IN addition Have:
1.Mesoderm- igives rise to muscles
2. Neural crest cells- gives rise to bone
Important characteristics of Neural crest:
1.Pluerapotient= can give rise to all types of tissue
2.NCC migrates as they differentiate into what 2tissue types:
1. melanocytes
2. dorsal root ganglia
Neural Crest Cells give rise to what in the head - which happens no where else in body?
Gives rise to BONE in head!
(frontal bone) - rest of the body mesenchyme gives rise to bone
Brachial Arch Derivatives: 3
Bones, catilage, and CT
Brachial Arch Derivatives: Bones, catilage, and CT:
Arch 1- gives rise to? 3-4 and done by?
Facial bones, incus & Malles (NCC), including the squamous temporal
- NCC
Brachial Arch Derivatives: Bones, catilage, and CT:
Arch 2- gives rise to?5
and done by?
1. Stapes
2. Styloid Process
3. Stylohyoid Lig.
4. Lesser Horns of Hyoid
5. 1/2 hyoid body
- NCC
Brachial Arch Derivatives: Bones, catilage, and CT:
Arch 3- gives rise to? 2 and done by?
1. Greater Horns of hyoid
2. 1/2 hyoid body
-NCC
Brachial Arch Derivatives: Bones, catilage, and CT:
Arch4& 6- gives rise to? 1 and done by?
NO NCC giving rise to bone here- all lateral Plate mesoderm
1. Larngeal catilages
Brachial arch derivatives- bone, cart, ct... From the top of the head down the neck the NCC derivitieves to bones -----
DECREASES
What is the frontal bone derived from?
Neural crest Cells- in the 1st arch derivatives
- EVEN THOUGH it is neural cranium, it is still NCC derived
Multiple swellings- like maxillary and mandibular ... all come out of what arch?
multiple swellings, BUT All come out of 1st cranial arch- migrate out to form bone
In embryo development the upper lip has 3 parts:
1. Intermaxillary process
2. &3. - 2 maxillary parts
the coronal and sagittal sutures are derived from what?
how do they compare to lambdoid suture?
- They are NCC derived.
- Sagittal and coronal sutures are frequently prematurely synostosed, where as lambdoid sutre almost never is.
Does the fact that the sag.& coronal sutures fequently are prematurely synostosed, & the lambdoid suture almost never is.. sugges that mutations of genes involved in neural crest development could be linked to craiosynotosis>??
This is defective sutures forming in ncc disorder.. so yes
Isolated ( = ___ ________)Cleft lip & Palate
Isolated ( = NON- SYNDROMIC)Cleft lip & Palate
Isolated (nonsyndromic) cleft lip & palate:
Lip and palate clefts that can occur in otherwise healthy pt?
ISOLTATED clefts
Isolated (nonsyndromic) cleft lip & palate
-Isolated clefts can involve?
and can occur
Can involve just the lip, just the palate, or both
- can occur unilaterallyu or Bilaterally
Intemaxillary process- gives rise to what?
Gives rise to 1' palate = holds incisors .. fusion here
Palatine shelves work / fuse together by
growing towards each other til make contack and zips in both directions- complete palate
The genetic cause(s) of isolated cleft lip & palate are still unclear- what is apossible mutation?
MSX1
Isolated Cleft lip occurs in _____ live births. 80% of Isolated cleft lip occur in _____.
-risk factor? increased maternal age???
Once in1000
males
IS a risk factor
Isolated cleft palate is more or less common tan cleft lip? occurs in ____ live births and in is more common in males or females (67%))
-risk factor? increased maternal age???
-Less common
ONCE in 2500
-females
-NOT A RISK FACTOR
Child with isolated cleft lip/palate- what % chance of having another child with the condition?
4%
Child with isolated cleft lip/palate- if one of parents has cleft probability of child
17%
IS maternal smoking a risk factor for isolated cleft lip or palate?
YESSS
Syndromic Cleft Lip & Palate- common or not?
Clefts are frequently components of syndromic disorders.
Cleft lip (w/or w/out cleft palate) occurs frequently in how many syndroms and occassionaly in how many syndromes?
Freq.- 21 syndromes
occassionally- 45
Cleft palate (w/or w/out cleft lip) occurs frequently in how many syndroms and occassionaly in how many syndromes?
Freq- 27 syndromes
occasionally- 74
Is cleft palate or cleft lip more commonly associated as a component of syndomic disorders?
CLEFT PALATE
Brachial Arch Derivatives: Muscles
Skeltal m. in head comes from?
Mesoderm - gets broken up into somiotomeres in head... instead of somites like rest of body.
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it
Somitomeres 1&2-
Oculomotor N.
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it::
Somitomere 3-
Trochlear N.
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it:
Somitomere 4- N.
Trigeminal N. &&& further assocaiated w/bracial arch muscle
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it:
Somitomere 5- n.
Abducens N.
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it
Somitomere 6- n
Facial n. &&& further assocaiated w/bracial arch muscle
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it
Somitomere 7- n
Glossopharyngeal &&& further assocaiated w/bracial arch muscle
Brachial Arch Derivatives: Muscles:Somitomers# & nerve associated with it
Occipital somite 1:
Vagus Nerve &&& further assocaiated w/bracial arch muscle
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it:
Occipital Somite 2:
Vagus N. &&& further assocaiated w/bracial arch muscle
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it:
Occipital Somite 3:
Hypoglossal n.
Brachial Arch Derivatives: Muscles:-Somitomers# & nerve associated with it:
Occipital Somite 4:
Hypoglossal n.
Brachial Arch Derivatives: Muscles:- Muscle in what in tissue?
Muscle in collumns w/mixed in
= muscles in columns of tissue
Brachial Arch Derivatives: Muscles- What is the nerve and what does it do?
Arch 1:
Cranial Nerve- 5- Trigemnal
- muscles of mastication, anterior digastirc, mylohyoid, tensor veli, palatii, tensor tymapani
-NO CN5 that doesn't come out of the 1st arch
Brachial Arch Derivatives: Muscles- What is the nerve and what does it do?
Arch 2:
Cranial Nerve- 7- Facial
-Muscles of facial expression, stylohyiod, stapedius, posterior diagastric
Brachial Arch Derivatives: Muscles- What is the nerve and what does it do?
Arch 3:
Cranial Nerve- 9- Glossopharyngeal
-stylopharyngeus
Brachial Arch Derivatives: Muscles- What is the nerve and what does it do?
Arch 4:
Cranial Nerve-10 Vagus
-Pharynegeal constrictors= cricothyroid, levator palati (innervated by pharyngeal plexus & superior laryngeal n.)
Brachial Arch Derivatives: Muscles- What is the nerve and what does it do?
Arch 6:
Cranial Nerve-Vagus
-intrinsic laryngeal m ( innervated by reccurent laryngeal n.)
Brachial Arch Derivatives: Arteries/ vessels- not as important as bone, nerve muscle)
Artery for Arch 1:
Terminal branches of Maxillary Artery.
- bc muscles that supply 1st arch supply this.. ex. mm of mastification
Brachial Arch Derivatives: Arteries/ vessels
Artery for Arch 2:
Stapedial artery (inembroys) & corticotympatnic in adult mice.. DISSOLVES in primates
Brachial Arch Derivatives: Arteries/ vessels
Artery for Arch 3:
Common Carotid artery & 1st part of internal carotid artery
Brachial Arch Derivatives: Arteries/ vessels
Artery for Arch 4
Arch of aorta
right subclavian artery
parts of pulmonary arteries
Brachial Arch Derivatives: Arteries/ vessels
Artery for Arch 6:
Ductus arteriosus
parts of pulmonary arteries
External ear is given rise from what and what arches? what if there is somethign wrong?
1st & 2nd arch give rise to external ear.
-if something wrong w/1 or2 arch then could see malformation in external ear
What clefts turn into adult structures?
only 1st cleft- external auditory meatus- the rest disappear
2nd Pouches endoderm will differentiate into:
lymphoid tissue
3 pouch endoderm will differentiate into:
parathyroid & thymus
4th pouch endoderm will differentiate into:
2 branches- parahthyroid & ultimabrachial body (parfolicular cells in thyroid- produce calcitonin)
What is rami/ cervical does the Cervical plexus composed of?
C1, C2, C3,C4- Ventral Primary rami
The cervical plexus at C1 is special bc???
C1 doesn't have sensory fibers
The cervical plexus forms 2 sensory loops which are?
HOw many sensory nerves does each produce?
C2 &C3 AND C3&C4
- Each produce 3 sensory nerves
The cervical plexus supplies what muscles??
the Anterior (Preaxial) muscles of the Neck!
What does the cervical plexus form tothe majority of the strap muscles?
the ANSA CERVICALIS
What does C1 do?
supplies motor to subocciptal triangle
Sensory distribution of cercvical plexus. Why does it come off at C2 instead of C1?
Bc C1 has no sensory fibers so occipital n comes off of C2.
Sensory distribution of cercvical plexus.
C2-C3 Loop gives rise to what 3 nerves?
1. Lesser Occiptial N.
2. Great Auricular N.- goes over mandible-->
3. Transverese Cervical N.
Sensory distribution of cercvical plexus.
C3-C4 Loop gives rise to what 3 nerves?
1. Lateral Supraclavicular N.
2.Intermediate Supraclavicular N.
3. Medial Supraclavicular N.
If 3rd molar was infected can affect What nerve & reffered back to cervical region and cause neck ache>?
Great Auricular N.
The Ansa Cervicalis:
Ansa=
Loop- innervateds c1 with hypoglossus nerve/?
The Ansa Cervicalis:
C1 joins what nerve to then drop off most C1 axons off it to form the ramus descendens ________ of the ansa cervicals
C1 joins what HYPOGLOSSAL nerve to then drop off most C1 axons off it to form the ramus descendens HYPOGLOSSI of the ansa cervicals
The Ansa Cervicalis:
Most C1 axons drop off hypoglossal nerve to form the ramus descendens hypoglossi of the ansa cervicals, but what do the rest do?
Some c1 Axons continue w/in hypoglossal nerve to drop off & innervate the:
1. Thyrohyoid m.
2.Geniohyoid M.
The Ansa Cervicalis:
C2 & C3 jointo form the Ramus Descendens ______ of the ansa cervicalis
C2 & C3 jointo form the Ramus Descendens _CERVICALIS_ of the ansa cervicalis
The Ansa Cervicalis:
C2 &C3 jointo form the ramus descends cervicalis of the ansa cervicalos. Then joins with the ramus descends ____ to complete the ansas at a variable distance located:
C2 &C3 jointo form the ramus descends cervicalis of the ansa cervicalos. Then joins with the ramus descends _HYPOGLOSSI_ to complete the ansas at a variable distance located: BELOW THE GREATER HORN OF THE HYOID BONE.
The Ansa Cervicalis:
innervates what??
STRAP MUSCLES- all infra*& suprahyoid m.
What happend If you cute the hypoglossal nerve at orgin ?
Dead Tongue on side of region that was lesioned.
What if you cut C1 root at spinal cord ??
Then drop out strap m. on same side- so have a hard time swallowing.
Other than the 3 sensory nevrves given off at C3-C4 loop, what else is here?
Loop make phrenic nerve which is anterior to the anterior sclane muscle.
How does hypoglossal nerve come out and what is its relation to C1 nerve?
Hypoglossal n comes out and C1 nerve is right there. C1 send s out ventral primary ramus to join hypoglossal n., but not part of hypoglossal n.- IT HITCHHIKES
What happens if you cut the hypoglossal. before rami descendens???
THen have a hard time swallowing and doesn't work on that side.
In cervical plexus:
Hypoglossal n. innervates/ goes to?
Lingual Muscles
In cervical plexus:
Subocipital nerve at C1 innervates/ branches off to what? and how?
Ventralprimary ramus and joins hypoglossal nerve as a hitchhiker..
-Suboccibpital branches off to 3:
1.Ramus descendents hypoglossi
2.thyrohyoid
3.Geniohyoid
Brachial plexus is ______ to ant. Scalene muscle.
Brachial plexus is _POSTERIOR_ to ant. Scalene muscle.
Brachial plexus is ______ to mid. scalene muscle.
Brachial plexus is _ANT_ to mid. scalene muscle.
??
Phrenic Nerve is ______ to ant. scalene m.
Phrenic Nerve is _ANT._ to ant. scalene m.
After the subclavian a. arches over apex of lung & makes a groove on lung, it arches over 1st rib between?
Ant. and middle scalene
Vagus nerve and Phrenic nerve are what relation to the subclavian artery and vein?
Vagus & Phrenic Nn are ANT. to subclavian artery, BUT POST. to subclavian v.
Where is the right reccurent laryngeal nerve located?
Around the Rt. subclavian aterty
Where is the left reccurent laryngeal nerve located?
((On base of pulmonary trunk & ))
a**Around aortic arch
Subclavian a. arches over apex of lungs & tothe 1st rib (between the ant. & mid scalene m.) THis is where the vessels leave and enter the ??
THORAX
The subclavian vein is _____ to anterior and middle scalene muscles?
????
The subclavian vein is _ANT. & MEDIAL????_ to anterior and middle scalene muscles
The carotid sheath is a condensation of 3 parts of the deep cervical fascia:
1. Prevertebral layer
2. Pretrachial layer
3. Investing Layer
The carotid sheath contains 3 things? and location of those things
1. Carotid artery - medially
2. Internal Jugular Vein- Laterally
3. Vagus Nerve- posteriorly & between the vessels
Carotid sheeth is said to be continuous with __________ - ________- extends superiorly, & begins to break up near the __________ of the ________ _____ artery although some contend that it remains more-or-less intact to the_____ of the _____.
Carotid sheeth is said to be continuous with _ANT. MEDIASTINUM_ - _INFERIORLY_- extends superiorly, & begins to break up near the _BIFURCATION_ of the _COMMON_ _CAROTID_ artery although some contend that it remains more-or-less intact to the_BASE_ of the _SKULL_.
Subclavian has 3 Parts: how many branches are in each part?
1st Part- 3 branches: last have 4 subbranches
2ndPart-1 branch- with 2 subbranches
3rd Branch- 1 but dont need to know it
Subclavian has 3 Parts
1st part- 3 branches and 4 subbranches on last one
1.Vertebral A. (va)
2.Internal thoracic. A. (ita)
3.Thyrocervical Trunk (tct)
a. Suprascapular a. (ssa)
b. Transverse cervical a. (tca)
c. & d.- bifrucation
c. Ascending cervical a. (aca)
d. Inferior thyriod a. (Ita)
Subclavian has 3 Parts
2 part- 1 branch- 2 subbranches
1.Costococervical Trunk (cct)
a. Hiusinntercostal/ supreme intercostal a. (hi)-descending b. Deep cervical a. (dca) - Ascending
Subclavian has 3 Parts
3rd part- 1 branch - what is it and when is it there?
Dorsal Scapular Artery (dsa)- only when deep branch of 2nd part is missing
The Vertebral a., Deep Cervical a., & Ascending Cervical a.- are interanastomosed bc??
This area of VC is moveable. If move one way & compress one A. then you will still get blood flow from 1 of the other 2 arteries.
-these multiple anastomoses between them could possible be collateral circultion.
where is the carotid (Cassiagnac's) tubercle ?
C6 - anterior tubercle
The common carotid artery bifurcates to form the external and internal carotid arteries.
Are there signifcant branches in either?
Internal carotid- no significant branches before entering the cranial cavity.
External carotid a.- has def. branches-9- some up so out behind mandible
What are the major branches of the external carotid artery? in order
- going up?- 5
-stick out behind mandible- 3
Going up:
1. Ascending pharyngea a.
2.superior thyroid a.
3. Lingual a.
4. Facial a.
5.Maxillary a.
6. Transverse facial
Sticking out beind mandible
7. occipital a.
8. Post. Auricular a.
9. SF Temporal a.
Relationship between the carotid a. to the omohyoid m?
Omohyoid m. is almost competely ant. to common carotid.
What is the relationship of the commmon carotid a. and inf. thyroid a.
??? Inf. thyroid a. is perpenditcular/ lateral and post. to common carotid.
Post. belly of diagastric corsses ______ to External carotid and facial nerve.
LATERAL
Maxiallary a . runs _____ to mandible, but mandible hides it.
MEDIAL
Ascending pharyngeal a. is what to the external carotid a.?
it is tucked up behing the external carotid
Digastric is ____ to internal carotid?
???? MEDIAL
What is the relationship between the hypoglossal n. to the occipital a.?
Hypoglossal n. wraps around the occipital nerve and loops around. ...
What is the 1st branch of the external carotid?
>> Occiptal a.
The stylohyoid is ____ to internal and external Facial ateries.
The stylohyoid is _SF_ to internal and external Facial ateries.
What is the relationship of the maxiallary artery and the ramus of the mandible??
???
Maxillary artery is Medial to the ramus of the mandible and it runs transversly/ horizontal/ perpendicular to the way the ramus lies when jaw open>
What is the relationship netween the lingual artery and the hypoglossal n?
Lingual a. is forward, medial/deep to the hypoglossal n.
It is between the hyoglossus and the genioglossus
There are how many sources/supplies of arterial perfusion of the brain? name them
2
1. Internal carotid arteries
2. Vertebral arteries
There are 2 sources of arterial perfusion of the brain
1. Internal carotid arteries- by pathway of? supply brain from-2
1.The internal carotid a. by way of carotid canal through the base of skull.
-supply brain from:
1. behind 2. infront
There are 2 sources of arterial perfusion of the brain
2. Vertebral arteries by way of? supply brain from-2
2. The vertebral a. by way of the Transverse foramina of cervical vertebrae, posterior atlanto-occipital membrane & foramen magnum.
Supplies brain from:
1. Below 2. Behind
2sources of arterial perfusion of the brain.
2. Vertebral arteries
-W/in cranial vacity the 2 vertebral arties join to form what is known as the _________. Thus, this _______ (directional) arterial perfusion of the brain is often reffered to as the ______-_______ System.
-W/in cranial vacity the 2 vertebral arties join to form what is known as the_BASILAR ARTERY_.Thus, this _POST._ arterial perfusion of the brain is often reffered to as the _VERTEBRO_-_BASILAR_ System.
What are 3 important ex of collateral circulation betweeen the carotid & verto-basilar systems?
1. Connections between the verterbral a. & deep cervical (from the costocervical trunk of subclavian a.) & ascending cervical (branches of thyrocervical trunk of subclavian a). by way of intervertebral foramina.
2.Connections between the vertebral a. & the occipital a.(from external carotid a.) by way of the suboccipital triangle.
3.Direct connections- w/in the cranial cavity around the brainstem. By way of Ant. & Post. communicating arteries that form what is known as the circle of Willis.
3 collateral circulation betweeen the carotid & verto-basilar systems
1. Connections between the verterbral a. & deep cervical (from the costocervical trunk of subclavian a.) & ascending cervical (branches of thyrocervical trunk of subclavian a). By way of what?
By way of intervertebral foramina.
3 collateral circulation betweeen the carotid & verto-basilar systems
2.Connections between the vertebral a. & the occipital a.(from external carotid a.) by way of?
By way of the suboccipital triangle.
3 collateral circulation betweeen the carotid & verto-basilar systems
3.Direct connections- w/in the cranial cavity around the brainstem. By way of ___ && ____ ________ _____ that form what is known as the ___ of ______.
triangle.
3.Direct connections- w/in the cranial cavity around the brainstem. By way of _ANT. & POST. COMMUNICATING ARTERIES that form what is known as the CIRCLE of WILLIS.
Facial a. is _____ to angle of mandible then sweeps ________ to come __ ______ of mandible.
Facial a. is _DEEP_ to angle of mandible then sweeps _DOWNWARD_ to come _IN_ _FRONT_ of mandible.- Lazy shape tract>??
Internal carotid artery enters _____ ____ into _____ _____ to _____ _____ to make the branch for the 1st time= _____ ___
Internal carotid artery enters _CAROTID CANAL_ into _CAROTID SINUS_ to _CLENOID PROCESS_ to make the branch for the 1st time= _OPTHALMIC ARTERY.
What is the 1st branch of the internal carotid artery?
opthalmic arthery
Problems involving heart(including atrial fib) pools blood and forms blood clots- if a blood clot breaks off it becomes emboli to common carotid what could result in the head?
could break to internal carotid to the 1st branch= Opthalmic artery- blindness of the eye bc of a stroke of the eye.
Pattern of Venous Drainage of the Head & Neck:
All end by going to _____ => __ __ ____ ( _ _ _)=> ___ ___
All end by going to:
Brachiocephalic => Sup. Vena Cava (SVC) => Das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 1: Posterior Auricular=> ____ ______=> _____=>_____=>____ =>__ ___
Route 1: Posterior Auricular=> _External Jugular_=> _Subclavian_ => Brachiocephalic->SVC->Das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 2: Inferior thyroid => ___ =>__ =>
Route 2: Inferior Thyroid-(just goes to the last 3)
Inf. Thyroid=> Brachiocephalic=> SVC=> Das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 3: Occipital => ___ =>___ => ___=>____
Route 3: Occipital=> _Internal Jugular-> brachiochephalic-> SVC->das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 4:Sup. Thyroid => ____ ___ => ___ =>___ =>
Route 4: Sup. Thyroid=> _Internal Jugular-> brachiochephalic-> SVC->das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 5: Middle Thyroid
Route 5: Middle Thyroid=> _Internal Jugular-> brachiochephalic-> SVC->das Herz
Pattern of Venous Drainage of the Head & Neck:
- know the rest on slide 22- neck 3
know the rest!!!!
Where/ how is ant. facial drainage drained?
- Facial V.
Where/how is posterior head/neck drainage drained?
1. RETROMANDIBULAR v
2. Occipital v
Facial vein joins the retromandibular vein and drains into???
The Internal Jugular Vein
Large venous plexus= ____ _____ is inbetween. Drainage from plexus can go to what 3 places and how>?
Pteryogoid Plexus
- 3 places:
1. facial- facial vein
2. (Posterior head)retromandibular v.
3. Cavernous sinus through versalius vein
The vagus nerve descends in the neck supplying ______ branches to the pharynx, layrnx, trachea, as well as the esophogus & other vasculat & glandular structures.
The vagus nerve descends in the neck supplying _PARASYMPATHETIC_ branches to the pharynx, layrnx, trachea, as well as the esophogus & other vasculat & glandular structures
The vagus nerve descends in the neck supplying Parasympathetic branches to what?? 5ish
1. Pharynx
2. Larynx
3. Trachea
4. Esophogus
5. Other vascular & glandular structures
What nerve supplies 2 or 3 cardiac structures in the neck that terminate cardiac plexuses?
VAGUS NERVE
Where does the left reccurrent laryngeal nerve descend/innervated and ternminate? and what nerve does it become at the point of termination?
Left reccurent laryngeal nerve goes around aortic arch and supplies the heart, trachea, & esphogus
-Terminates in Larynx= Inf. Laryngeal n.
What is the physiological significance of the carotid body?
Chemoreceptor- this place contains more blood than any other tissue in body. Glomus- areterail to venuel
What is the physiological significance of the carotid sinus?
Barroreceptor- to measure BP
What modality of axons come from these structures?
GVA- both show barroceptor & chemoreceptor fx.(CN9 & 10_)
Carotid sinus streches= inc.bp, cn9 detects this & is connected to CN10- which signals to slow BP down.
Glossopharyngeal nerve gives branches to the post. 1/3 of the tongue & pharynx along with the vagus nerve - forming what is known as the?
PHARYNGEAL PLEXUS
What is the cervico thoracic or stellate gangilion the result of?
The inferior cervical fusing to the 1st thoracic ganglion
How do you get sympathetics into places in head?
1. uses one of the RARE named consisten routes of:
a.Internal Carotid N.
b. Deep petrosal N.
c.Greater Pertosal n.
2. ANy which way they can- jump on artery or nerve..
Pattern of Venous Drainage of the Head & Neck:
All end by going to _____ => __ __ ____ ( _ _ _)=> ___ ___
All end by going to:
Brachiocephalic => Sup. Vena Cava (SVC) => Das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 1: Posterior Auricular=> ____ ______=> _____=>_____=>____ =>__ ___
Route 1: Posterior Auricular=> _External Jugular_=> _Subclavian_ => Brachiocephalic->SVC->Das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 2: Inferior thyroid => ___ =>__ =>
Route 2: Inferior Thyroid-(just goes to the last 3)
Inf. Thyroid=> Brachiocephalic=> SVC=> Das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 3: Occipital => ___ =>___ => ___=>____
Route 3: Occipital=> _Internal Jugular-> brachiochephalic-> SVC->das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 4:Sup. Thyroid => ____ ___ => ___ =>___ =>
Route 4: Sup. Thyroid=> _Internal Jugular-> brachiochephalic-> SVC->das Herz
Pattern of Venous Drainage of the Head & Neck:
Route 5: Middle Thyroid
Route 5: Middle Thyroid=> _Internal Jugular-> brachiochephalic-> SVC->das Herz
Pattern of Venous Drainage of the Head & Neck:
- know the rest on slide 22- neck 3
know the rest!!!!
Where/ how is ant. facial drainage drained?
- Facial V.
Where/how is posterior head/neck drainage drained?
1. RETROMANDIBULAR v
2. Occipital v
Facial vein joins the retromandibular vein and drains into???
The Internal Jugular Vein
CN - that does GSE
3,4,6,12
CN- that do GSA-
5,7,9,10
cn- that do GVE-
3,7,9,10
CN that do GVA-
9, 10
CN that do SVE
5,7,9,10,11
CN that do SVA-
1,7,9,10
CN that do SSA-
2,8
The dura mater in the skull- 2 layers- inner=
outer=
inner= meningeal layer
outer= endosteal layer
At specific locations within the skull, the 2 layers of the dura split to form blood filled channels know as ______ ______
dural sinuses
Cavernous sinus- 1 artery
5- nerves
artery- carotid
1.CN 3
2. CN4
3. CN6
4. V1
5.V2
Scalp infection may gain access to the venous drainage of the brain by way of special veins known as ____
Emissary veins