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212 Cards in this Set

  • Front
  • Back
What are the anterior and posterior margins of the scalp?
superior nuchal line on the posterior aspect and supraorbital margins anteriorly.
What are the lateral margins of the scalp?
zygomatic arches
What layers of the skin make up the Scalp Proper and how is this clinically or surgically significant?
Skin, Subcutaneous tissue, and aponeurosis/occipitofrontalis muscle make up the Scalp Proper. It is considered one single layer clinically and surgically.
In which layer of the scap are there nerves and vessels?
In the 2nd layer with connective tissue
What makes up the third layer of the scalp?
The 3rd layer of the scalp is the epicranial aponeurosis (or galea aponeurotic) and the 2 bellies of the occipitofrontalis muscle.
In which layer of the scalp are emissary veins located?
emissary veins are in the 4th layer of the scalp where there is loose areolar connective tissue
What clinical significance does the 4th layer of the scalp have?
The 4th layer of the scalp contains emissary veins which may spread a superficial infection to deeper layers through communications with intercranial venous sinuses.
What is the 5th layer of the scalp?
pericranium-periosteum
What is the name of V1 and what nerves branch from it?
V1 is ophthalmic and it branches into supratochlear, infratochlear, supraorbital, external nasal, and lacrimal
What is the name of V2 and what nerves branch from it?
V2 is maxillary nerve and branches into zygomaticofacial, infraorbital, and zygomaticotemporal.
What nerve is V3 and what does it branch into?
V3 is mandibular nerve and it branches into buccal n, mental n, and auricotemporal n.
Which fissure does V1 go through?
superior orbital fissure
Which foramen doe V2 go through?
foramen rotandum
Which foramen does V3 go through?
foramen ovale
What innervates cutaneous skin in the chin?
mental nerve of V3
what provides sensory innervation to the upper eyelid?
supraorbital nerve of V1
What innervates the skin of the upper lip?
infraorbital nerve of V2
What branches of V1 innervates the scalp?
supraorbital nerve of V1 and supratrochlear nerve of V1
What provides sensory innervation to the temporal region?
Auricotemporal nerve of V3
What artery runs with the auriculotemporal branch of V3?
superficial temporal artery from external carotid artery.
Which arteries of the scalp branch from the internal carotid artery?
supraorbital and supratrochlear
which arteries of the scalp branch from the external carotid artery?
occipital artery, posterior auricular artery, superficial temporal artery.
There is a rich anastomosis in the scalp. What arteries contribute to it?
supraorbital a and supratrochlear a from internal carotid artery and occipital artery, superficial temporal artery, and posterior auricular artery from external carotid artery.
what are the borders of the face?
anterior to external ears and between hairline and chin.
what part of the mandible usually has transverse fractures that affect the TMJ and is the most commonly fractures?
Neck and condylar process
What part of the mandible is the least likely to fracture?
coronoid process
what tooth would a fracture in the angle of the mandible affect and why?
3rd molars because fractures are usually oblique
what tooth would a fracture in the body of the mandible affect?
the mandibular canine.
How are fractures of the maxilla classified?
Le Fort I- simple fracture, Le Fort II - "panda eyes", Le Fort III- complocated fracture
what branches from the cervical plexus (C2,C3) innervate that face and scalp?
the LESSER occipital nerve innervates the scalp and the great auricular nerve innervates the skin over the mandible, and the anterior and posterior auricle.
What supplies motor innervation to the face?
Facial nerve (VII)
What branches of the facial nerve pass through the parotid?
temporal, zygomatic,buccal, mandibula, cervical
What nerves innervate the muscles of the upper lip? lower lip? platysma?
buccal, mandibular, cervical
what branches of the facial nerve innervates the obicularis oculi muscles?
temporal and zygomatic
What branches of the facial nerve do not pass the parotid?
posterior auricular nerve (occipotais muscle and auricles), nerve to stapedius muscle (middle ear), nerve to posterior belly of digastric and sylohyoid muscle.
The sensory innervation to the anterior 2/3 of the tongue (taste) and the external acoustic meatus is from what nerve?
facial nerve VII
Facial nerve provides parasympathetic innervation to what regions and through which ganglions?
through the chorda tympani to the submandibular ganglion and then to the submandibular glands and sublingual. Through the greater petrosal to the pterygopalatine ganglion to lacrimal glands and nose, palate, nasopharynx
the facial nerve emerges from the skull through what foramen?
stylomastoid foramen which is between the mastoid and styloid process in the temporal bone.
What supplies sensory innervation to the face besides the branches of the trigeminal?
great auricular nerve from C2 contributes by supplying the skin over the angle of the mandible and the anterior and posterior auricle.
What innervates the posterior belly of the digastric? the anterior belly? the central tendon?
anterior belly - V3, posterior belly - branch of facial nerve, central tendon- hypoglossal
What are the three arteries of the face ?
Facial artery, superficial temporal artery, transverse facial artery
what arteries form a connection between the internal carotid and external carotid arteries?
the angular branch of the facial artery anastomoses with the dorsal nasal and palpebral branches of the ophthalmic artery of the ICA.
What are the branches of the Facial Artery and what do they supply?
Inferior labial artery supplies the lower lip, superior labial artery supplies the upper lip and gives septal and alar branches to the nose, and angular artery.
What two veins come together to form the facial vein?
the supratrochlear vein and supraorbital vein come together to form the angular vein which is where the facial vein begins.
What are the muscles of the scalp? what do they do?
occipitofrontalis - elevates the eyebrows and wrinkles the forhead.
Procerus- continuation of the frontalis muscle. pulls down the eyebrows.
What muscle compresses the naris? dilates the naris?
the transverse component of the nasalis muscle compresses the naris. the alar muscle dilates it
What is the function and innervation of the levator palpebrae superioris muscle?
opens the eyelids. innervation by CN III
Paralysis of what muscles can cause drooping of the lower eyelid and "spilling" of the tears?
Obicularis Oculi- Orbital, Palpebral, Lacrimal.
What is the origin and insertion of the temporalis muscle?
Origin is pariatal bone, Insertion is Coronoid process.
What is the only muscle of mastication that does not function in elevating the mandible?
Lateral pterygoid
What kind of joint is the TMJ? What two boned are located in the TMJ?
TMJ is a SYNOVIAL joint in between the condyle of the mandible and the glenoid fossa of the temporal bone.
What is the origin and insertion of the temporalis muscle?
Origin is pariatal bone, Insertion is Coronoid process.
What is the only muscle of mastication that does not function in elevating the mandible?
Lateral pterygoid
What kind of joint is the TMJ? What two boned are located in the TMJ?
TMJ is a SYNOVIAL joint in between the condyle of the mandible and the glenoid fossa of the temporal bone.
What are the bones of the orbit?
Frontal, Lacrimal, Ethmoind, Zygomatic, Maxilla, Sphenoid
What makes up the supraorbital margin of the eye?
supraorbital notch, frontal notch
What makes up the lateral margin of the eye?
Orbital tubercle, lateral palpebral ligament
What makes up the medial margin of the eye?
anterior lacrimal crest, fossa of the lacrimal sac
What makes up the posterior margin of the eye?
superior orbital fissure, inferior orbital fissure, optic canal.
What bones makes up the four walls of the eye? (roof, lateral, medial, floor)
Roof: lesser wing of sphenoid and frontal bone
Medial: Process of Maxilla,Lacrimal bone, and Lateral mass of ethmoid.
Lateral: Zygomatic process, greater wing of sphenoid, orbital surface of zygomatic bone
Floor: perpendicular plate of palatine, orbital surface of maxilla, zygomatic bone.
Which wall of the eye is weakest? what can damage to this wall cause?
*The FLOOR of the orbit (made up by the perpendicular plate of the palatine bone, the orbital surface of the maxilla, and the zygomatic bone) is the weakest. Injury to this area can compromise the maxillary sinus (displacement and fluids) or cause an orbital fracture.
*Medial wall is also thin ( frontal process of maxilla, lacrimal bone, lateral mass of ethmoid) and damage to this area can compromise the sphenoid and ethmoid sinuses.
What is a "blowout"? (not a hairstyle)
INDIRECT trauma that displaces the orbital walls.
If a sharp object penetrated the superior orbital wall, where would it be?
It would end up in the frontal lobe of the brain.
Orbital fractures may result in intraorbital bleeding, which may increase the pressure and push on the eyeball causing a condition known as...
exophthalmus.
Trauma to the eye could also cause fracture to nasal bones. This could cause an infection that could spread to the ________ via the __________.
cavernous sinus, ophthalmic vein
What is Periorbital Echymosis?
a BLACK EYE, caused by direct trauma to the periorbital region causing swelling and hemorrhage into eyelids and periorbital skin.
which layer of the eyelids has blood vessels?
the bulbar conjuctiva
What are the three glands of the eyelid and what is their function?
*Meibomian (Tarsal) Glands- embedded in the tarsal plate. function in preventing sticking of eyebrowns and preventing overflow of tears
*Ciliary (of Zeis) Glands- secrete sebum into eyelashes to prevent them from becoming brittle
*Glands of Moll- modified sweat glands near the lid margins with UNKOWN FUNCTION. (lid margins- canthi)
Which ligament of the eyelid serves as the insertion and orgin point for the obicularis oculi muscle?
the medial palpebral ligament
What muscles elevate the eyelid and what innervates them?
Levator palpebrae superioris elevates the eyelid and is innervated by CNIII.

Superior Tarsal muscle ASSISTS in elevation the eyelid and is innervated by sympathetic fibers
What muscles close the eyelid and what innervates them?
Obicularis Oculi muscle closes the eyelids and is innervated by CNVII.

(inferior tarsal muscle is thought to depress the inferior tarsal)
Obstruction if the tarsal glands produce an inflammation referred to as a ____

If ducts of the ciliary gland (of Zeis) become obstructed, a painful suppuritive swelling in the eyelids referred to as a ____ can develop.
Chalazion.

Sty.
Where are the lacrimal gland and sac located?
The lacrimal gland is located in the anterolateral angle of orbit. The lacrimal sac is located in the medial margin of orbit.
The lacrimal sac is connected to the nasolacrimal duct. Where does the nasolacrimal duct drain into?
the inferior nasal meatus
obstruction of the lacrimal duct may result from ...
excessive lacrimation.
What cranial nerve innervates the ciliary body and is responsible for near/far vision?
CN III, it both motor and parasympathetic. It innervates the ciliary body which attatches to the lens and changes it shape to accomodate for near and far vision.
What is the fibrous tunic of the eye?
the cornea and sclera
What are the components of the vascular tunic of the eyes?
Choroid
Ciliary Body - (secretes aqueous humor) *innervated by CNIII parasmpatheric
Iris- controls pupil diameter through suspensory ligament
What are the layers of the neural tunic?
Pigmented and Neural. The neural tunic transmits nerve impoulses to the brain.
what is the innermost tunic of the eyeball?
the retina
What covers the retina externally and internally? what artery supplies it?
The retina is externally covered by the choroid and internally covered by the vitrous body. It is supplied the the central artery of the retina, a banch of the opthalmic artery.
What is the "blind spot"?
It is the site at which the optic nerve exits. It contains no photoreceptors.
What is papilledema?
a condition in which the disc is swollen and has indistinct margins. It is caused by increased ICP from the meninges. It can also be secondary to tumor or hemorrhage.
What can be a cause of IOP? What is normal IOP range?
IOP can be secondary to glaucoma which results in "cupping" of the optic disc. normal IOP is 10-21 mmhg.
What is the macula lutea?
a small, oval, yellow area located lateral to the optic canal. the depressed part of it is the FOVEA CENTRALIS.
what is the area in the eye of most acute vision?
the fovea centralis in the macula densa.
What is the leading cause of blindness in developed countries?
Macular degeneration. It is the physical deterioration of the macula lutea. Can be due to age, diabetis, infection..
1st symptom is loss of visual acuity. other symptoms:floaters, wavy lines, blurry

NO CURE
Who is most at risk for retinal detachment?
Individuals who are nearsighted due to a more elliptocal eyeball because their retina is thinned or "stretched" more than normal eyes.
What do ciliary processes secrete?
they secrete aqueous humor into the posterior chamber (--> lens --> anterior chamber)
If the ciliary muscle is RELAXED and lens is FLAT, then the eye is unaccommodated. What type of vision is this?
FAR vision.
If the ciliary muscle is CONTRACTED and the lens THICKENED and ROUND then the eye is accommodated. What type of vision is this?
NEAR vision.
What innervates the ciliary muscle?
parasympathetic nerves from CNIII
What muscle dilates the pupil? What muscle constrict the pupil? what are their innervations?
the dilator pupillae muscle dilates the pupil thorugh SYMPATHETIC nerves.
the sphincter pupillae muscle constricts the pupils through PARASYMPATHETIC nerves.
what is Cataracts?
small opacities within the lens that over time may coalesce to completely obscure the lens.
What is the major cause of blindness worldwide?
cataracts.
What is corneal reflex? what innervates it?
corneal reflex is a bilateral response from touching eye on one side.

AFFERENT innervation - trigeminal nerve
EFFERENT innervation - facial nerve
what is glaucoma?
disease caused by increased intraocular pressure from increased aquous humor or diminished reabsorption of aqueous humor.
What are the nerves of the orbit?
*Optic nerve- accompanies ophthalmic artery, nerve of sight in the optic chiasm
*Ophthalmic nerve (V1)- sensory nerve. It divides into the lacrimal (suplies skin of the upper eyelid), frontal nerve(supra and infra orbital), nasocilliary nerve (ENTERS the orbit via the superior orbital fissure).
*Occulomotor nerve
*Trochlear
*Abducens
What are the devisions of the occulomotor nerve?
superior - superior rectus and levator palpebrae
inferior- medial and inferior rectus mucles and inferioir oblique
What would damage to the oculomotor cause?
ptosis, unopposed action of lateral rectus and superior oblique (lateral strabismus) double vision, mydriasis, inability yo accomodate ( cycloplegia)
What does the trochlear nerve innervate in the eye?
the superior oblique muscle only.

*if patient can't look down with the eye adducted, it would indicate DAMAGE to this nerve.
Abducens nerve innervates what in the eye?
lateral rectus muscle.

Damage: inability to abduct the eye, medial strabismus
what is the vein of the eye?
the orbit is drained by the superior and inferior ophthalmic veins. the superior OP joins the facial and drains into the cavernous sinus.
What is the artery that supplies the eye? what are its branches?
Ophthalmic artery

-travels with optic canal
-central artery of the retina
-lacrimal artery-which gives a branch, the recurrent meningeal artery which anastomoses with the middle meningeal artery
Where are the parasympathetic ganglia in the back on the eye located?
LATERAL to the optic nerve, MEDIAL to the lateral rectus muscle.
what are the three compartments of the nasal septum?
perpendicular plate of ethmoid, the vomer, the septal cartilage.
What innervates the respiratory area of the nasal septum?
V1 and V2:

*Anterior ethmoidal nerve (V1) (nasociliary) -anterior septum
*External nasal nerve (V1) - anterior septum
*nosapalatine nerve (V2)- muscous membranes of nasal septum
*nasal branches of V2 - lateral walls.
What arteries provide blood supply to the nasal cavity?
*Maxillary artery - through pshenopalatine artery to mucosa
*ant. and post. ethmoidal arteries
*superior labial (facial)- ascending palatine, and lateral nasal.
Which meatus do the sinuses drain into?
frontal sinus, maxillary sinus and anterior ethmoid- middle meatus

sphenoid sinus and posterior meatus - superior sinus
Which meatus does the nasolacrimal duct drain into?
inferior meatus
What innervates the external ear?
Auriculotemporal nerve (v3) and great auricular nerve (c2,3-cervical plexus)
What provides blood supply to the external ear?
posterior auricular a. and superficial temporal a.
What innervates the tympanic membrane?
auriculotemporal n (v3), and CN X, IX, VII.
what supplies blood to the tympanic membrane?
deep auricular a (maxillary) - external surface
posterior auricular and tympanic branch of the maxillary to the internal surface.
What are the anterior and posterior openings of the middle ear?
anterior - eustachian tube
posterior - mastoid antrum
What is in the middle ear? (bones, muscles..)
*auditory ossicle - malleus, stapes, incus.
*stapedius muscle - CN7 (posterior wall)
the medial wall has- *facial and oval canal.
*tensor tympani m. - CN V3
*Chorda tympani - CN7
*Tympanic plexus - CN9
What other nerve does the Vestibulochoclear nerve travel with? where does it enter? what are the fibers for?
CN8 leaves the brainstem between the pons and the medulla oblongata and travel lateraly with CNVII. In enters the internal acoustic meatus and DOES NOT EXIT THE SKULL. It has vestubular fibers for equilibrium and cochlear fibers for hearing.
What are the landmarks the form the limits of the neck?
superior limit - inf. margin of mandible, mastoid process of temporal, external occipital protuberance.

inferior limit - superior thoracic aperature ( manubrium, 1st ribs, C7) and the clavicles.
At what level is thyroid cartilage? hyoid bone? Cricoid cartilage?
*C4-C5
*C3
*C6
Where is a pressure point in the neck for the subclavian artery?
In the subclavicular Fossa - a triangular depression located posterior to the clavicular head of the SCM.
what innervates the trapezius m? platysma? sternocleomastoid?
platysma - CN7
SM - CN 11 and C2,3
trapezius - CN 11 and C3,4
What muscles make up the floor of the posterior cervical triangle?
-splenius capitus m
-levator scapulae
-scalenus post, meedius, and anterior.
The posterior cervical triangle is subdivided into two triangle by the _____________
inferior belly of the omohyoid muscle: occipital t. , supraclavicular.
What are the veins in the posterior cervical triangle?
external jugular vein - crosses the SCM, to drain into subclavian.

Subclavian vein - main vain of upper extremity, posterior to clavicle.
what two veins come together inside the parotid to form the retromandibular gland?
superior temporal and maxillary.
What are the nerves in the posterior cervical triangle?
CN 11 - devides triangle into sup. and inf. region. supplies SCM and trapezius.
Brachial plexus- between the scalene anterior and medius
cervical plexus.
Where is the cervical plexus (C1-C4) located?
deep to internal jugular vein and SCM.
What does the great auricular nerve (C2- C3) travel with ti supply the angle of mandible?
travels with external jugular.
What nerve supplies the anterior aspect of the chest and shoulder? sternoclavicular and acromioclavicular oint?
supraclavicular C3 to C4(medial, lateral, intermediate)
What are the motor branches of the cervical plexus?
-C3,C4,C5- to the phrenic.
-Ansa Cervicalis- "loop" that arises from the cervical plexus and supplies the infrahyois muscles of the neck. ITS EMBEDDED IN THE CAROTID SHEATH BUT IT"S NOT PART OF IT.
What are the suprahyoid muscles and what innervates them?
mylohyoid muscles - V
geniohyoid - XII
stylohyoid- VII
Digastric - anterior belly - (CN V), posterior belly (VII).
What are the muscles of the infrahyoid?
sternohyoid, sternothyroid, thyrohyoid, omohyoid.
All the muscles of the infrahyoid are innervated by the ansa cervicalis except one, which one?
thyrohyoid - innervated by XII via C1 fibers.
What are the structures in the carotid sheath?
Internal jugular vein, deep cervical LN, vagus, common carotid a, internal carotid a.

ANSA CERVICALIS IS EMBEDDED IN IT BUT IT IS NOT PART OF IT.
At what level does the carotid artery split into internal and external?
at C4 - thyroid cartilage level.
What are the branches of the External Carotid?
Superior Thyroid a., Ascending Pharyngeal a., Lingual a, Facial a., Occipital a., Posterior Auricular Artery, superfucial temporal artery, maxillary artery.

"Some Anatomist Like Fucking, Others Prefer S&M"
The carotid sinus a ___receptor that regulates ____. The carotid body is a ____receptor that regulates _____. What innervates them both?
-baroreceptor that regulates BP - slows heart
-chemoreceptor that regulates respiration by detecting O2,CO2, H or PH levels - CN IX, X, Symp.
What muscle does Stensen's duct run along? what muscle does it pierce? Where does it enter the oral cavity?
It runs along the masseter, it pierces the buccinator, and enters the oral cavity opposite the crown of the 2nd maxillary molar.
What are the structures within the parotid?
Facial Nerve, Retromandibular vein, ECA (BLOOD SUPPLY TO PAROTID!!!), Parotid LN
What branches are given off by the facial nerve before it enters the parotid?
-motor nerves to the posterior belly of the digastric and sylohyoid muscle and posterior Auricular nerve.
What is the Nerve supply to the parotid gland?
V3 and symp. and parasym. nerves.

- Parasympatheric from CN IX- thin, watery flow

-symphathetic from cervical ganglion produces thich muscous salivary discharge
What are the muscles of the submandibular region and what innervates them?
-digastric muscle-
*posterior belly - CN7
* Anterior belly - CN5
-geniohyoid - CN7
-mylohyoid- CN5 (nerve to myohyoid)
-hyoglossus- CN9
-genioglossus- CN9
-styloglossus- CN9
Where does Wharton's duct open in the oral cavity?
It opens in the sunlingual papillea at the sides of the frenulum of the tongue
What are the sympatheric and parasympatheric innervations of Wharton's Duct?
Symp - post-gang fibers from cervical ganglion

Parasymp - pre-gang fibers from CN 7 via the chorda tympani.
What innervates that sublingual gland?
- lingial nerve of V3
What carries general sensations from anterior 2/3 of tongue?
Lingual nerve

*NOTE: Chorda tympani from CN 7 is responsible to TASTE in anterior 2/3.
What is the pterygomandibular raphe?
It is the union of the buccinator and the lateral pterygoid muscle.

*mandibular nerve and inferior alveolar nerve in this area
What provides lymphatic drainage for the tip of tongue and lower lip? upper lip?
the submental lymph nodes for the tip of the tongue and the lower lip.

the submandibular lymph nodes for the upper lip only.
What are fordyce granules?
small painless, raised, pale red or white spots. They are ectopic sebaceous glands. NOT A DISEASE.
what is the median projection of the soft palate called? what are the lateral folds of the soft palate called? What is located between these two folds?
the median projection is calledt the Uvula. The lateral folds are called Palatoglossal arch and Palatopharyngeal arch. The palatine tonsils are located between these two folds.
What are the muscles of the soft palate? What innervates them?
Musculus Uvulae - from the posterior nasal spine into the mucous membrane of uvula - Vagus

Levator Veli Palatini - Vagus

Tensor Veli Palatine - V3 *THIS IS THE EXCEPTION

All muscles of the vagus nerve via the pharyngeal plexus except the tensor vali palatini which is supplied by the mandibul;ar division of the trigeminal nerve (CN V3)

*Damage to vagus nerve- Uvula deviates to opposite side

*Damage to glossopharyngeal- ipsilateral loss of gag reflex
What is the V shaped groove in the dorsum of the tongue?
the Sulcus terminalis which has a median foramen cecum. The sulcus terminalis devides the tongue the tongue into an oral part (anterior 2/3) and a pharyngeal part (Posterior 1/3)
What structures are in the oral portion of the dorsum of the tongue? pharyngeal portion?
Oral portion:
- median groove
-lingual papilla
-filiform
-fungiform
-vallate
-Foliate

Pharyngeal portion:
-lingual tonsils
-median and lateral epiglottic folds

*the space between the epiglottic folds is called the vallecula.
What are the muscles of the tongue? What is the nerve supply to these muscles?
Genioglossus, hyoglossus, styloglossus, palatoglossus.

*All innervated by CN XII (hypoglossal) EXCEPT PALATOGLOSSUS - innervated by CN X.

(Palatoglossal likes to PARTY so it goes to Vegas!) :)
What would damage to the hypoglossal nerve to to the tongue?
It would cause ipsilateral atrophy and if the tongue is protruded, is would DEVIATE TO THE SAME SIDE AS THE LESION!!
What provides sensory innervation to the tongue? Motor?
Anterior 2/3 -
general sensation - lingual nerve V3
Taste- chorda tympani nerve (CN7)

Posterior 2/3 -
General sensation - CN9
taste - CN9

Motor innervation is by CN 12, EXCEPT Palatoglossal which is X.

fml.
What is the lymphatic drainage of the tongue?
submental lymph nodes drains the ANTERIOR 2/3

deep cervical lymph nodes drain POSTERIOR 1/3
What are the boundaries of the temporal region?
superiorly- superior temporal line
anteriorly-frontal process of the zygomatic bone
inferiorly-zygomatic arch
What is the contents of the temporal region?
- temporalis muscle
-deep temporal artery (from maxillary a) and nerve (V3)
-Auriculotemporal nerve
-superficial temporal artery
what are the boundaries of the infratemporal region?
superior- infratemporal surface of the shpenoid bone
anterior - posterior surface of maxilla and inf. orbital fissure
medial-lateral pterygoig muscle and pterygomaxillary fissure
lateral - ramus and coronoid process of the mandible.
what is the contents of the infratemporal region?
*Lower border of the temporalis
*pterygoid m (medial and lateral)
*pterygoid venous plexus
*Max artery and branches: inf. alveolar, middle meningela, branches to external aud. and tympanic mem, branches to muscle of mastication,
*maxillary nerve, mandibular nerve, otic ganglion,
*parotid gland
Where is the pterygopalatine fossa?
area inferior to the apex of the orbit between the pterygoid process of the sphenoid bone, posteriorly, and the posterior aspect of the maxilla.
Where does the maxillary nerve become the infraorbital nerve?

What are the branches off the maxillary?
when it goes through the infraorbital fissure. the infraorbital nerve exits through the infraorbital foramen to become sensory to the face. The infraorbital nerve is an end nerve.

*Branches-

-Zygomaticofacial
-infraorbital
-zygomaticofacial
What is located in the pterygopalatine fossa?
-maxillary nerve
-maxillary artery
-pterygopalatine ganglion
The maxillary artery has branches in the infratemporal fossa and the pterygopalatine fossa. What are the branches in each?
*Infratemporal fossa:
-inferior alveolar **IMPORTANT**
-branches to muscles of mastication
-branches to external auditory meatus and tympanic membrane

*Pterygopalatine fossa:
-Posterior superior alveoral-maxillary sinus and molar and premolar teeth
-infraorbital- with infraorbital nerve
-pharngeal branch- mucous membrane of the nasopharynx
sphenopalatine-mucous membrane of the nasal cavity and septum
What branch of the maxillary artery goes to the mucous membrane of the nasal cavity and septum and is responsible for nose bleeds? which branch goes to the maxillary sinus and molar and premolar teeth?
*Sphenopalatine
*Posterior superior alveolar
Where does the retromandibular vein form?
It forms in the parotid gland from the joining of the superficial temporal vein and the maxillary vein.
What level is the start of the pharynx?
C6
Where does the nasopharynx communicate with the oropharynx?
it communicates by the pharyngeal isthmus or the nasopharyngeal hiatus which is closed during swallowing by the uvula.
From the torus tubarius, two folds contianing muscles descend into the palate and the pharynx, what are they?
Salpingopalatine fold to palate
Salpingopharyngeal fold to pharynx.
What is the name of the accumulation of lymphatic tissue in the posterior wall of the nasopharynx?
-pharyngeal tonsils, nasopharyngeal tonsils, or adenoids.
At what level is the oropharynx? laryngopharynx?
oropharynx- C2-C3
laryngopharyn-C3-C6 (epiglottis to cricoid)

*The piriform fossa is situated on each side of the larynx (food can get stuck)
What is the landmark muscle that separates the superior constrictors from the middle and inferior?
the stylopharyngeus muscle
What is the nerve supply to the pharynx?
All muscles supplied by vagus via pharyngeal plexus except stylopharyngeus which is supplies by IX
What is the blood supply to the pharynx?
ascending pharyngeal artery from the ECA and inferior thyroid artery (thyrocervical trunk)
They larynx extends from what C levels?
C3-6
What are the cartilages of the larynx?
thyroid, cricoid, arytenoid, cornicoid, cuneiform, epiglottic.
At what level is the thyroid cartilage? the cricoid?
thyroid cartilage is at C4-5. Cricoid is at C6.
What cartilage marks the end of the pharynx and the larynx and the beginning of the esophagus and trachea?
Cricoid C.
The free edge of what ligament of the larynx becomes the vocal ligament?
Cricothyroid membrane.

*the vocal ligament is the upper border of the conus elasticus and it is covered by the vocal fold.
What are the intrinsic muscles of the larynx and what is their function?
Transverse arytenoid muscle- ADducts the vocal cords

Oblique arytenoid muscle - ADducts the vocal cords

Aryepiglottic muscle- closes the inlet of the larynx

Lateral cricoartytenoid muscle- ADuctor of rima glottis

Posterior cricoarytenoid muscle- *ABDUCTOR* - ONLY ABDUCTOR!!!
What are the muscles that regulate the vocal ligaments?
thyroarytenoid muscle - shortens and relaxes vocal cord

vocalis m. - NOT attatched to vocal ligament, varies in tension of the vocal cords during singing.

cricothyroid muscle- tension and adduction of the vocal cords.
What innervates the larynx?
-All the intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve EXCEPT the cricothyroid, which is innervated by the external laryngeal nerve (which is also from the vagus but from the superior laryngeal branch)

*sensory innervation to the larynx is by the internal laryngeal nerve
What does the superficial layer of the cervical fascia ensheath?
It ensheaths the platysma and the muscles of facial expression.

*It attatches from the zygomatic process to the thorax and axilla
*it is similar to cubcutaneous tissue
What does the superficial layer or the deep cervical fascia ensheath?
It envelopes the SCM, Trapezius, Submandibular, and Parotid.

*It extends from the -nuchal line,skull bone, zygoma, mandible- to the -chest and axilla-. It splits at the mandible and coves the masseter laterally and medial surface of the medial pterygoid.
What are the borders of the visceral division of the medial layer of the deep cervical fascia?
From hyoid and thyroid cartilage anteriorly to skull base posteriory. It extends laterally to become continuous with the upped mediastunum.
What does the buccopharyngeal fascia cover? What does it envelope?
It covers the pharyngeal constrictors and the buccinator

It envelopes the thyroid, trachea, esophagous, pharynx, and larynx
What does the muscular devision of the middle layer of the deep cervical fascia envelop?
it envelopes the infrahyoid strap muscles.
What are the two layers of the deep layer of the deep cervical fascia?
-alar layer (skull to upper mediastinum)

-paravertebral layer (skull to coccyx)
What is the significance of the retropharyngeal space?
It is the space bounded by the buccopharyngeal fascia anteriorly and the alar facia posteriorly. Serious dental infections can spread down this space into the posterior mediastinum.
What are the fontanelles and when do they close?
There are 6 fontanelles:

Anterior- 18-24 months

Posterior -

Posterolateral - 1 to 2 months

Anterolateral - 3 months
What makes up the pterion?
sphenoid, temporal, frontal, and parietal
what makes up the lambda?
junction of lamboidal and sagital sutures
what is the vertex?
superior portion of the skull
what is the bregma?
forepart of the junction of the sagittal and coronal sutures
What is the Asterion?
star-shaped. parietomastoid, occipitomastoid, lambdoid
What is the glabella?
prominence on frontal bone superior to root of nose
what is the Inion?
most prominent point of external occipital protruberance
what is the nasion?
frontonasal and internasal junction.
What is the weakest part of the skull?
The weakest part of the skull is the pterion because 4 bones are coming together (sphenoid, temporal, frontal, parietal). It is associated with the middle meningeal artery because it lies in the groove on the internal aspect of the lateral wall of the skull.
What is the most frequent type of fracture to the calvaria?
linear skull fractures - usually occur at point of impact.
What are the implications of a tear in the middle meningeal artery?
blood accumulates between the dura and skull in the EPIDURAL SPACE and causes an EPIDURAL hemmorage.
What are the implications of a tear in the cerebral or dural sinus?
causes a SUBDURAL HEMMORRAGE
What is the implication of a tear in the cerebral artery?
Causes subarachnoid hemorrhage.

*May be caused by hyoertension or ruptured anurysms.
What veins drain into the dural venous sinuses?
Emissary veins from the scalp and nasal mucosa, angular veins vertebral venous plexus.
What drains into the confluence of sinus?
superior sagittal sinus and inferior sagittal sinus through straight sinus.
Where does blood go after the confluence of sinus?
into transverse sinus ---> sigmoind sinus --> which becomes IJV
What drains the cavernous sinus?
The inferior petrosal sinus and superior petrosal sinus

*inferior petrosal drains into jugular vein. superior drains into transverse sinus
What does the superior sagittal sinus drain?
blood from the nasal cavity, scalp, meningeal artery, and superior cerebral.
What does the cavernous sinus drain?
The superior and inferior opthalmic veins and the central vein of the retina.
What runs with the cavernous sinus?
ICA runs through it, and CN 3, 4, 5
What are the branches off the maxillary nerve?
Zygomaticofacial, zygomaticaltemporal, infraorbital

*becomes infraorbital at infraorbital foramen