Cadaver - Head & Neck

Front 1

Platysma

Back 1

Hint 1

o Origin: superficial fascia over pectoralis major and deltoid
o Insertion: mandible; muscles around mouth
o Innervation: CN VII
o Action: depresses mandible, draws lower lip downward, tenses skin of neck

Front 2

Orbicularis Oculi

Back 2

Hint 2

• O: medial orbital margin, medial palpebral ligament, lacrimal bone
• I: skin around margin of orbit, tarsal plate
• A: close eyelid

Front 3

Temporalis

Back 3

Hint 3

o Origin: inferior temporal line, temporal fossa, temporalis fascia
o Insertion: coronoid process; anterior border of mandibular ramus
o Innervation: deep temporal branches of V3
o Action: anterior fibers-elevate mandible; posterior fibers-retrude mandible

Front 4

Masseter

Back 4

Hint 4

o Origin: zygomatic arch/maxilla
o Insertion: coronoid process/ramus mandible
o Innervation: CN V
o Action: elevates and retracts the mandible (closes jaw)

Front 5

Masseter

Back 5

Hint 5

o Origin: zygomatic arch/maxilla
o Insertion: coronoid process/ramus mandible
o Innervation: CN V
o Action: elevates and retracts the mandible (closes jaw)

Front 6

Buccinator

Back 6

Hint 6

• O: mandible, pterygomandibular raphe, alveolar process of maxilla and mandible
• I: angle of mouth
• A: press cheek against molar teeth to keep food between teeth, expel air from oral cavity

Front 7

Parotid (Stenson's) Duct

Back 7

Hint 7

found along the edge of the parotid gland; exits from the anterior border of the gland and passing about a finger’s breadth below the zygomatic arch over the superficial fibers of masseter, the duct makes a sharp turn over anterior border of masseter to perforate buccinator and enter the oral cavity (around the max 2nd molar)

Front 8

Facial Artery and Vein

Back 8

Hint 8

• Facial artery: arises in carotid triangle from ECA, ascends deep to submandibular gland, winds around inferior border of mandible and enters the face (torturous which allows for distention and opening of the jaw); distributes to the muscles of facial expression/face
Facial vein: direct continuation of angular vein past inferior margin of orbit; descends along lateral border of the nose, receiving external nasal and inferior palpebral veins, then obliquely across face to mandible. It receives anterior division of retromandbiular vein, after which it is sometimes called the common facial vein.

Front 9

Facial Nerve - Cervical Branch

Back 9

Hint 9

• Cervical:
• Runs forward beneath platysma; one branch descends to join cervical cutaneous nerve from the cervical plexus, which innervates Platysma

Front 10

Facial Nerve - Mandibular Branch

Back 10

Hint 10

• Marginal mandibular:
• Innervates muscles of lower lip & chin; [communicates with mental branch of inferior alveolar branch]

Front 11

Facial Nerve - Buccal Branch

Back 11

Hint 11

Runs laterally over the Masseter muscle;• Superficial branches innervate procerus; [join with infratrochlear and nasociliary branches of V1]
• Deep branches innervate zygomaticus and levator labii superioris & nasalis; [form infraorbital plexus with infraorbital branch of V1]
• Lower deep branches innervate buccinators & orbicularis oris; [join with fibers of buccinator branch of V3]

Front 12

Facial Nerve - Zygomatic Branch

Back 12

Hint 12

• Innervates orbicularis oculi
• [Joins with fibers of lacrimal n. and zygomaticofacial branch of V2]

Front 13

Facial Nerve - Temporal Branch

Back 13

Hint 13

• Innervates auriculares anterior & superior, [and join with zygomaticotemporal branch of V2 & auriculotemporal branch of V3]
• Anterior branches innervate frontalis, orbicularis oculi, corrugator supercilii, [and join the supraorbital & lacrimal branches of V1]

Front 14

Opthalmic Nerve (V1) -> Frontal Nerve -> Supraorbital Nerve (through Supraorbital Foramen)

Back 14

Front 15

Maxillary Nerve (V2) - Infraorbital Nerve (through Infraorbital Foramen) NVB

Back 15

Hint 15

infraorbital NVB exits here (anterior superior and middle superior alveolar nerve/artery branch off before exit)

Front 16

Mandibular Nerve (V3) -> Inferior Alveolar Nerve -> Mental Nerve (through Mental Foramen)

Back 16

Front 17

Long Buccal Nerve (CN V3 - BAIL)

Back 17

Hint 17

Innervates skin and oral mucosa of the cheek; sensory innervation to the vestibule of the oral cavity

Front 18

Facial Artery

Back 18

Hint 18

arises in carotid triangle from ECA, ascends deep to submandibular gland, winds around inferior border of mandible and enters the face (torturous which allows for distention and opening of the jaw); distributes to the muscles of facial expression/face

Front 19

Facial Vein

Back 19

Hint 19

direct continuation of angular vein past inferior margin of orbit; descends along lateral border of the nose, receiving external nasal and inferior palpebral veins, then obliquely across face to mandible. It receives anterior division of retromandbiular vein, after which it is sometimes called the common facial vein.
It terminates at the internal jugular vein, and drains the anterior scalp and forehead, eyelids, external nose, anterior cheek, lips, chin, and submandibular gland.
and receives drainage from external palatine vein; joins either the anterior branch of retromandibular vein OR drains directly into internal jugular vein

Front 20

Angular Artery

Back 20

Hint 20

Branch of facial artery (ECA)

Front 21

Platysma

Back 21

Hint 21

o Origin: superficial fascia over pectoralis major and deltoid
o Insertion: mandible; muscles around mouth
o Innervation: CN VII
o Action: depresses mandible, draws lower lip downward, tenses skin of neck

Front 22

Sternocleidomastoid

Back 22

Hint 22

o Origin: sternal head: anterior manubrium; clavicular head: medial surface of clavicle
o Insertion: lateral surface of mastoid process and lateral portion of superior nuchal line
o Action: bilaterally – flexion of cervical vertebral column anteriorly, or when supine, raises head; unilaterally – tilt s head toward ipsilateral shoulder and rotates head so that chin faces the opposite side
o Innervation: Spinal XI [and C3, C4 ventral rami (sensory)]

Front 23

Trapezius

Back 23

Front 24

Puncta Nervosum (Erb's Point)

Back 24

Hint 24

Cutaneous branches of the cervical plexus radiate from a single area deep to the posterior border of the SCM at its center; a site at the lateral root of the brachial plexus located 2-3cm above the clavicle. It is formed by the union of the C5 and C6 nerve roots, which later converge. At the nerve trunk, branches of suprascapular nerves and the nerve to the subclavius also merge. Afterwords, the merged nerve divides into the anterior and posterior division of C5 and C6.

Front 25

Great Auricular Nerve (C2-C3) - Cutaneous branch of Cervical Plexus

Back 25

Hint 25

(C2, C3) - provides sensory innervation for the skin over parotid gland and mastoid process, and both surfaces of the outer ear.
o [Anterior branch: distributed to skin overlying parotid gland and meeting with CN VII within gland
o Posterior branch: supplies skin over mastoid process and on the back of the ear (except at its upper part); communicates with lesser occipital n, auricular branch of CN X and posterior auricular branch of CN VII]

Front 26

Transverse Cervical Nerve (C2 & C3) - Cutaneous branch of cervical plexus

Back 26

Hint 26

(C2, C3) - innervates skin overlying anterior triangle of neck

Front 27

Anterior/medial Supraclavicular Nerve (C3-C4) - cutaneous branch of cervical plexus

Back 27

Hint 27

C3, C4 - innervate the skin all the way to the midline

Front 28

Middle Supraclavicular Nerve (C3-C4) - cutaneous branch of cervical plexus

Back 28

Hint 28

C3, C4 - innervate skin over pectoralis major & deltoids; communicate with cutaneous branches of upper intercostal nn.

Front 29

Posterior Supraclavicular Nerve (C3-C4) - cutaneous branch of cervical plexus

Back 29

Hint 29

C3, C4 - innervate skin of upper & posterior portions of shoulder

Front 30

Spinal Accessory Nerve

Back 30

Hint 30

nerve emerges from the jugular foramen, crosses the internal jugular vein within the posterior triangle and innervates SCM and trapezius

Front 31

Omohyoid (Inferior Belly)

Back 31

Hint 31

O: upper border of scapula and suprascapular lig.
I: lower border body of hyoid
A: depresses hyoid bone
I: ansa cervicalis (C1-C3)

Front 32

Omohyoid (Superior Belly)

Back 32

Hint 32

superior belly: central tendon located deep to SCM; here, superior belly unites with inferior belly
I: lower border body of hyoid
A: depresses hyoid bone
I: ansa cervicalis (C1-C3)

Front 33

External Jugular Vein

Back 33

Hint 33

o Formed by the union of the posterior auricular vein and the posterior branch of the retromandibular vein; passes obliquely downward over SCM to enter the posterior triangle, where it receives three tributaries: transverse cervical vein, suprascapular vein, and anterior jugular vein
o Drains into the subclavian vein.

Front 34

Subclavian Vein

Back 34

Hint 34

courses over the anterior border of the anterior scalene and it become the axillary vein once it passes the 1st rib

Front 35

Scalenus Anterior Muscle (Anterior Scalene)

Back 35

Hint 35

(separates subcalvian artery and branchial plexus)
o O: transverse processes of cervical vertebrae 3 thru 6
o I: superior aspect of 1st rib at scalene tubercle
o A: bends cervical portion of vertebral column antero-laterally and rotates it towards the opposite side/elevates 1st rib
o I: ventral rami of C4 thru C6

Front 36

Scalenus Medius Muscle (Middle Scalene)

Back 36

Hint 36

o O: transverse processes of cervical vertebrae 2 thru 7
o I: superior aspect of 1st rib
o A: bends the vertebral column to the same side; elevates 1st rib
o I: ventral rami of C3 thru C6

Front 37

Brachial Plexus Trunks

Back 37

Hint 37

roots and trunks of brachial plexus pass through scalene interval anterior to middle scalene

Front 38

Phrenic Nerve (C3, C4, C5)

Back 38

Hint 38

ventral rami of C3-C5 which innervate the diaphragm

Front 39

Subclavian Vein

Back 39

Hint 39

o Internal jugular vein and subclavian vein join to form the brachiocephalic vein; courses over the anterior border of the anterior scalene and it become the axillary vein once it passes the 1st rib
External Jugular vein drains into it

Front 40

Transverse Cervical Artery (Superior) and Suprascapular Artery (Inferior)

Back 40

Hint 40

branches off of thyrocervical trunk
• Transverse Cervical
• supplies trapezius, serratus anterior, muscles of rotator cuff (teres major, supraspinatus, infraspinatus, subscapular muscles)
• Suprascapular
• supplies SCM and Supraspinitus

Front 41

Thyrocervical Trunk

Back 41

Hint 41

• Inferior thyroid: crosses deep to carotid sheath to reach the thyroid gland
• Dorsal scapular: supplies latissimus dorsi, levator scapulae, trapezius, and rhomboids
• Suprascapular: supplies SCM and supraspinitus (travels w/same n.)
• Transverse Cervical
• supplies trapezius, serratus anterior, muscles of rotator cuff (teres major, supraspinatus, infraspinatus, subscapular muscles)

Front 42

Branches of Facial Nerve

Back 42

Hint 42

Two Zebras Bit My Cookies
Temporal, Zygomatic, Buccal, Marginal Mandibular, Cervical (& Posterior Auricular)

Front 43

Zygomatic Arch

Back 43

Hint 43

masseter muscle originates here

Front 44

Masseteric Artery and Nerve

Back 44

Hint 44

o Masseteric n. and a. enter the deep surface of the masseter m. by passing through the mandiblular notch (branches of the V3 and maxillary artery respectively)

Front 45

Angle of Mandible

Back 45

Hint 45

attachment of stylomandibular ligament, m pterygoid, masseter

Front 46

Coronoid Process

Back 46

Hint 46

masseter and temporalis insert here

Front 47

Deep Temporal Nerves (of CN V3)

Back 47

Hint 47

motor innervation of the temporalis

Front 48

Medial Pterygoid Muscle

Back 48

Hint 48

• Origin – deep head (medial side of the lateral pterygoid plate); superficial head (pyramidal process of palatine bone and maxillary tuberosity)
• Insertion – medial surface of the ramus and angle of the mandible
• Innervation – nerve to medial pterygoid of V3
• Action – elevates mandible; helps lateral pterygoids in lateral movement

Front 49

Medial Pterygoid Muscle

Back 49

Hint 49

• Origin – deep head (medial side of the lateral pterygoid plate); superficial head (pyramidal process of palatine bone and maxillary tuberosity)
• Insertion – medial surface of the ramus and angle of the mandible
• Innervation – nerve to medial pterygoid of V3
• Action – elevates mandible; helps lateral pterygoids in lateral movement

Front 50

Lateral Pterygoid Muscle

Back 50

Hint 50

o Origin: greater wing of sphenoid; lateral pterygoid plate
o Insertion: pterygoid fovea; articular disk/meniscus of TMJ (neck of condyle)
o Innervation: lateral pterygoid n of V3
o Action: depress mandible; protrude mandible; lateral excursion

Front 51

Lateral Pterygoid Muscle

Back 51

Hint 51

o Origin: greater wing of sphenoid; lateral pterygoid plate
o Insertion: pterygoid fovea; articular disk/meniscus of TMJ (neck of condyle)
o Innervation: lateral pterygoid n of V3
o Action: depress mandible; protrude mandible; lateral excursion

Front 52

Mandibular Nerve (V3) - Buccal Nerve and Buccal Artery

Back 52

Hint 52

Use medial and lateral pterygoids as references. Pass b/w two heads of lateral pterygoid

Front 53

Lingual Nerve

Back 53

Hint 53

Between medial and lateral pterygoids. Courses inferiorly on the superficial aspect of medial pterygoid. Adjacent to inferior alveolar nerve (Superior). Innervates anterior 2/3 of tongue; parasympathetic fibers to submandibular ganglion

Front 54

Lingual Nerve

Back 54

Hint 54

Between medial and lateral pterygoids. Courses inferiorly on the superficial aspect of medial pterygoid. Adjacent to inferior alveolar nerve (Superior). Innervates anterior 2/3 of tongue; parasympathetic fibers to submandibular ganglion

Front 55

Inferior Alveolar Nerve

Back 55

Hint 55

Between medial and lateral pterygoids. Adjacent to lingual nerve (Inferior). Enters mandibular foramen.

Front 56

Inferior Alveolar Nerve

Back 56

Hint 56

Between medial and lateral pterygoids. Adjacent to lingual nerve (Inferior). Enters mandibular foramen. Accompanied by inferior alveolar artery and vein

Front 57

Mandibular Nerve (CN V3)

Back 57

Hint 57

Branches of Trigeminal nerve; Branches: BAIL (Long Buccal, Auriculotemporal, Inferior Alveolar, Lingual)

Front 58

Chorda Tympani

Back 58

Hint 58

Emerges from petrotympanic fissure, passes anteriorly and joins the Lingual nerve

Front 59

Nerve to Mylohyoid

Back 59

Hint 59

Arises from Inferior Alveolar Nerve. Innervates mylohyoid and anterior belly of digastric

Front 60

Nerve to Mylohyoid

Back 60

Hint 60

Arises from Inferior Alveolar Nerve. Innervates mylohyoid and anterior belly of digastric

Front 61

Inferior Alveolar NVB (vein, artery, nerve)

Back 61

Hint 61

Passes through mandibular foramen. Course inferiorly on the superficial aspect of medial pterygoid

Front 62

Condylar Process of Mandible

Back 62

Front 63

Articular Disc of TMJ

Back 63

Hint 63

lateral pterygoid inserts here

Front 64

Auriculotemporal Nerve (CN V3 - BAIL)

Back 64

Hint 64

two divisions encircling the middle meningeal artery→f. spinosum; conveys sensory fibers from the skin of the temporal region and postganglionic parasympathetic fibers from the otic ganglion to the parotid gland. The otic ganglion is located near the main trunk of the mandibular nerve

Front 65

Auriculotemporal Nerve and Middle Meningeal Artery

Back 65

Hint 65

two divisions encircling the middle meningeal artery→f. spinosum; conveys sensory fibers from the skin of the temporal region and postganglionic parasympathetic fibers from the otic ganglion to the parotid gland. The otic ganglion is located near the main trunk of the mandibular nerve

Front 66

Maxillary Artery

Back 66

Hint 66

One of two terminal branches of External Carotid Artery; runs deep to condylar neck; 3 parts: mandibular, pterygoid, pterygopalatine

Front 67

Maxillary Artery

Back 67

Hint 67

One of two terminal branches of External Carotid Artery; runs deep to condylar neck; 3 parts: mandibular, pterygoid, pterygopalatine

Front 68

Inferior Alveolar Artery (of Maxillary Artery)

Back 68

Hint 68

Travels with inferior alveolar nerve and vein to mandibular foramen

Front 69

Middle Meningeal Artery (of Maxillary Artery)

Back 69

Hint 69

1st branch off of maxillary artery (1 of two terminal branches off ECA); passes through foramen spinosum to enter middle cranial fossa; ascends lateral walls of skull and branches to anterior and posterior
branches

Front 70

Middle Meningeal Artery (of Maxillary Artery)

Back 70

Hint 70

1st branch off of maxillary artery (1 of two terminal branches off ECA); passes through foramen spinosum to enter middle cranial fossa; ascends lateral walls of skull and branches to anterior and posterior
branches

Front 71

1st part of Maxillary Artery

Back 71

Hint 71

Mandibular portion of Maxillary Artery

Front 72

2nd part of Maxillary Artery

Back 72

Hint 72

Pterygoid part of the Maxillary Artery

Front 73

Posterior Superior Alveolar Artery

Back 73

Hint 73

Branch of pterygopalatine segment of Maxillary artery

Front 74

Pterygoid Venous Plexus

Back 74

Hint 74

Drains into the cavernous sinus by emissary veins via the sphenoid foramen and maxillary vein; Interconnecting vascular venous structures; o Between the temporalis and lateral pterygoid
o Drains from
• infraorbital (maxillary teeth)
• sphenopalatine
• buccal
• greater and lesser palatine
• inferior alveolar (mandibular teeth)
• mental
• deep facial
o Drains to maxillary vein and some to the cavernous sinus

Route of infection (bc it has emissary connections so can have backflow to cavernous sinus); Connections to maxillary vein to retromandibular OR deep facial vein to facial. Plexus communicates with angular, facial veins and cavernous sinuses

Front 75

Retromandibular Vein

Back 75

Hint 75

• Connects to the pterygoid plexus via maxillary vein
• Formed by the union of the maxillary + temporal veins
• Posterior branch joins with the posterior auricular vein to form the external jugular vein→ subclavian v.--> SVC
• Anterior branch joins the facial vein to form the common facial vein→ drains to IJV
• Drains parotid, TMJ; located within parotid, external to ECA, deep to facial n

Front 76

Left Middle Meningeal Artery

Back 76

Hint 76

Supply blood to dura mater and cranial bones

Front 77

Clavicular Head of Pectoralis Major

Back 77

Front 78

Sternocostal Head of Pectoralis Major

Back 78

Front 79

Deltopectoral Triangle

Back 79

Front 80

Cephalic Vein

Back 80

Front 81

External Intercostal Muscle

Back 81

Front 82

Internal Intercostal Muscle

Back 82

Front 83

Costal Cartilage

Back 83

Front 84

Intercostal NVB (Nerve (shown) + Artery + Vein)

Back 84

Hint 84

Located in costal grooves of all ribs; VAN - Vein, Artery, Nerve from superior to inferior

Front 85

Innermost Intercostal Muscle (deep and lateral to probe)

Back 85

Hint 85

Deep to Internal Intercostal Muscle.

Front 86

Manubrium

Back 86

Front 87

Body of Sternum

Back 87

Front 88

Sternal Angle

Back 88

Front 89

Jugular Notch

Back 89

Front 90

Anterior Cervical Triangle: 1) Inferior Border of Mandible (superior), 2) Medial Border of SCM (posterior), 3) Midline of Neck (anterior)

Back 90

Front 91

Carotid Triangle: 1) Posterior Belly of Digastric (superior), 2) Medial Border of SCM (lateral), 3)

Back 91

Hint 91

Front 92

Submental Triangle: 1) Hyoid Bone (inferior), 2) Midline of Neck (medial), 3) Anterior Belly of Digastric (lateral)

Back 92

Front 93

Submandibular Triangle: 1) Body of Mandible (superior), 2) Anterior Belly of Digastric (anterior), 3) Posterior Belly of Digastric (posterior)

Back 93

Front 94

Anterior Belly of Digastric

Back 94

Hint 94

• O: anterior belly: digastric fossa of mandible; posterior belly: mastoid notch of temporal bone
• I: tendinous connection of both bellies through a fascial loop on the hyoid bone
• A: depresses mandible/elevates hyoid
• I: anterior belly: branch of mylohyoid of V3; posterior belly: branch of CN VII

Front 95

Posterior Belly of Digastric

Back 95

Hint 95

• O: anterior belly: digastric fossa of mandible; posterior belly: mastoid notch of temporal bone
• I: tendinous connection of both bellies through a fascial loop on the hyoid bone
• A: depresses mandible/elevates hyoid
• I: anterior belly: branch of mylohyoid of V3; posterior belly: branch of CN VII

Front 96

Neck Region: 1) Internal Jugular Vein, 2) Common Carotid Artery, 3) Thyroid Cartilage, 4) Thyroid Gland, 5) Thyroglossal Duct, 6) Hyoid Bone

Back 96

Front 97

Sternohyoid

Back 97

Hint 97

O: posterior manubrium, sternoclavicular lig., and medial end of clavicle
I: medial lower body of hyoid
A: depresses hyoid bone
I: ansa cervicalis (C1-C3)

Front 98

Sternocleidomastoid

Back 98

Hint 98

o Origin: sternal head: anterior manubrium; clavicular head: medial surface of clavicle
o Insertion: lateral surface of mastoid process and lateral portion of superior nuchal line
o Action: bilaterally – flexion of cervical vertebral column anteriorly, or when supine, raises head; unilaterally – tilt s head toward ipsilateral shoulder and rotates head so that chin faces the opposite side
o Innervation: Spinal XI [and C3, C4 ventral rami (sensory)]

Front 99

Orbicularis Oris

Back 99

Hint 99

• O: some fibers near medial plane of maxilla superiorly and mandible inferiorly, deep surface of skin
• I: mucous membrane of lips
• A: compresses and protrudes lips

Front 100

Frontal Bone

Back 100

Front 101

Parietal Bone

Back 101

Front 102

Occipital Bone

Back 102

Front 103

Temporal Bone

Back 103

Front 104

Sphenoid Bone

Back 104

Front 105

Ethmoid Bone

Back 105

Front 106

Zygomatic Bone

Back 106

Front 107

Maxilla Bone

Back 107

Front 108

Nasal Bone

Back 108

Front 109

Lacrimal Bone

Back 109

Front 110

Vomer Bone

Back 110

Front 111

Palatine Bone

Back 111

Front 112

Inferior Nasal Concha

Back 112

Front 113

Mandible Bone

Back 113

Front 114

Mental Foramen

Back 114

Front 115

Infraorbital Foramen

Back 115

Front 116

Supraorbital Foramen

Back 116

Front 117

Orbital Plate of Frontal Bone

Back 117

Front 118

Coronal Suture

Back 118

Front 119

Superior Orbital Fissure

Back 119

Front 120

Inferior Orbital Fissure

Back 120

Front 121

Hypoglossal Canal

Back 121

Front 122

Middle Concha

Back 122

Front 123

Mental Symphysis

Back 123

Front 124

Anterior Cranial Fossa

Back 124

Front 125

Middle Cranial Fossa

Back 125

Front 126

Posterior Cranial Fossa

Back 126

Front 127

Crista Galli

Back 127

Front 128

Cribriform Plate

Back 128

Hint 128

part of ethmoid bone; olfactory bulbs sit here - rootlets pass through perforations in plate to reach nasal epithelium in nasal cavity

Front 129

Pituitary/Hypophyseal Fossa (Sella Turcica)

Back 129

Front 130

Groove for Transverse Sinus

Back 130

Hint 130

lateral from IOP, Occipital: in tentorium cerebelli; Right: larger, drains superior sagittal; Left: drains straight; drains to internal jugular vein

Front 131

Groove for Sigmoid Sinus

Back 131

Hint 131

continue from transverse sinuses and end at the jugular f.

Front 132

Jugular Foramen

Back 132

Hint 132

CN IX, X and XI pass through it

Front 133

Foramen Magnum

Back 133

Front 134

Internal Acoustic Meatus

Back 134

Hint 134

CN VII and VIII pass through it

Front 135

Petrous Part of Temporal Bone

Back 135

Front 136

Squamous Part of Temporal Bone

Back 136

Front 137

Clivus

Back 137

Front 138

Orbital Plate of Frontal Bone

Back 138

Front 139

Middle Cranial Fossa Structures
A. Optic nerve
B. Tentorium cerebelli
C. Diaphragma sellae
D. Cerebral peduncles
E. Tectum
F. Tegmentum

Back 139

Hint 139

Tentorium cerebelli – horizontal fold across posterior third of skull to separate cerebral hemispheres (occipital lobes) from cerebellum, attaches along transverse sulcus on each side of skull, and attaches along superior petrosal sulcus and ends medially at posterior clinoid process

Diaphragma sellae – dura mater membrane covering sella turcica; stretches from anterior clinoid processes to posterior clinoid processes; pierced by the infundibulum (stalk of pituitary gland)

Front 140

Foramen Lacerum

Back 140

Hint 140

Inferior to carotid canal
Greater petrosal nerve-heads to foramen lacerum, enters the pterygoid canal and joins the nerve of the deep petrosal to form the nerve of the pterygoid canal.

Front 141

Foramen Spinosum

Back 141

Hint 141

• Middle meningeal artery: passes through foramen spinosum

Front 142

Groove for Middle Meningeal Artery

Back 142

Hint 142

supplies dura of anterior and middle cranial fossae; 1st branch off of maxillary artery (1 of two terminal branches off ECA); passes through foramen spinosum to enter middle cranial fossa; ascends lateral walls of skull and branches to anterior and posterior
branches

Front 143

Foramen Ovale

Back 143

Hint 143

V3 passes through

Front 144

Posterior Clinoid Process

Back 144

Hint 144

posterior are lateral ends of dorsum sellae

Front 145

Foramen Rotundum

Back 145

Hint 145

V2 passes through

Front 146

Anterior Clinoid Process

Back 146

Hint 146

anterior are medial ends of lesser
wings of sphenoid bone

Front 147

Lesser Wing of Sphenoid

Back 147

Front 148

Optic Canal

Back 148

Front 149

Lamboidal Suture

Back 149

Front 150

Pterion

Back 150

Front 151

Greater Wing of Sphenoid

Back 151

Front 152

Zygomaticofacial Foramen

Back 152

Front 153

Pterygomaxillary Fissure

Back 153

Front 154

Pterygopalatine Fossa

Back 154

Hint 154

small triangular fossa at the angle of the junction between the pterygomaxillary and inferior orbital fissures. It contains the pterygopalatine ganglion, maxillary nerve (V2), and terminal parts of the internal maxillary artery. Six foramina open into it: foramen rotundum, pterygoid canal, pharyngeal canal, sphenopalatine foramen (which transmits the sphenopalatine artery into the nasal cavity), pterygopalatine foramen, and the inferior orbital fissure

Front 155

Sagittal Suture

Back 155

Front 156

Superior Nuchal Line

Back 156

Front 157

External Occipital Protuberance

Back 157

Front 158

Greater Palatine Foramen

Back 158

Front 159

Lesser Palatine Foramen

Back 159

Front 160

Infratemporal Fossa

Back 160

Front 161

Foramen Ovale

Back 161

Hint 161

anterior and medial to foramen spinosum

Front 162

Foramen Spinosum

Back 162

Hint 162

inferior and lateral to foramen ovale

Front 163

Carotid Canal

Back 163

Hint 163

posterior to foramen spinosum; superior to foramen lacerum

Front 164

Stylomastoid Foramen

Back 164

Hint 164

facial neve (CN VII) exits here

Front 165

Jugular Foramen

Back 165

Front 166

Occipital Condyle

Back 166

Front 167

Incisive Foramen

Back 167

Hint 167

Nasopalatine nerve enters roof of the mouth through the Incisive foramen

Front 168

Palatine Plate of Maxilla

Back 168

Front 169

Maxillary Tuberosity

Back 169

Front 170

Vomer

Back 170

Front 171

Medial Pterygoid Plate and Hamulus

Back 171

Front 172

Lateral Pterygoid Plate

Back 172

Front 173

Mandibular/Glenoid Fossa

Back 173

Front 174

Pterygoid/Vidian Canal

Back 174

Front 175

Pharyngeal Tubercle

Back 175

Hint 175

median pharyngeal raphe attaches superiorly to the pharyngeal tubercles

Front 176

Spine of Sphenoid Bone

Back 176

Front 177

Petrous Part of Temporal Bone

Back 177

Front 178

Hypoglossal Canal

Back 178

Front 179

Stylomastoid Foramen

Back 179

Front 180

Condylar Process

Back 180

Front 181

Neck of Mandible

Back 181

Front 182

Angle of Mandible

Back 182

Front 183

Body of Mandible

Back 183

Front 184

Ramus of Mandible

Back 184

Front 185

Coronoid Process of Mandible

Back 185

Front 186

Mental Foramen

Back 186

Front 187

Lingula

Back 187

Front 188

Mylohyoid Line

Back 188

Front 189

Mental Spines/Genial Tubercles

Back 189

Front 190

Mandibular Foramen

Back 190

Front 191

Submandibular Fossa

Back 191

Front 192

Pterygoid Fovea

Back 192

Front 193

Vomer

Back 193

Front 194

Perpendicular Plate of Ethmoid Bone

Back 194

Front 195

Crista Galli

Back 195

Front 196

Nasal Septum

Back 196

Front 197

Inferior Concha

Back 197

Front 198

Middle Concha

Back 198

Front 199

Superior Concha

Back 199

Front 200

Sphenopalatine Foramen

Back 200

Hint 200

- Near the posterior aspect of the superior conchae and anterior to the sphenoid sinus; sphenopalatine artery passes through (pterygopalatine portion of maxillary artery)

Front 201

Pterygoid Hamulus

Back 201

Hint 201

tensor veli palatini attaches here

Front 202

Ostium of Maxillary Sinus

Back 202

Hint 202

Below the bulla ethmoidalis, and partly hidden by the inferior end of the uncinate process

Front 203

Uncinate Process of Ethmoid Bone

Back 203

Hint 203

projects downward and backward from this part of the labyrinth; it forms a small part of the medial wall of the maxillary sinus, and articulates with the ethmoidal process of the inferior nasal concha.

Front 204

Ethmoid Bulla

Back 204

Front 205

Ostium of Middle Ethmoid Air Cells

Back 205

Front 206

Infundibulum (Ethmoidal)

Back 206

Front 207

Pterygoid/Vidian Canal

Back 207

Front 208

Pterygoid Process of Sphenoid Bone

Back 208

Front 209

Semilunar Hiatus

Back 209

Front 210

External Auditory Meatus

Back 210

Front 211

Tympanic Part of Temporal Bone

Back 211

Front 212

Zygomatic Process of Temporal Bone

Back 212

Front 213

Suprameatal Triangle

Back 213

Front 214

Mandibular/Glenoid Fossa

Back 214

Front 215

Parotid Gland

Back 215

Front 216

SCALP - Skin

Back 216

Hint 216

contains hair follicles, sweat glands, sebaceous glands

Front 217

SCALP - Connective Tissue (dense)

Back 217

Hint 217

anchored firmly to skin above and to aponeurosis below; carotid arteries (ICA and ECA) anastomose and supply blood here

Front 218

SCALP - Aponeuroses

Back 218

Hint 218

broad, flat tendon for occipitalis and frontalis muscles

Front 219

SCALP - Loose Connective Tissue

Back 219

Hint 219

loose areolar tissue that allows freedom of movement of the superficial three layers

Front 220

SCALP - Pericranium

Back 220

Hint 220

firmly attached to underlying bone

Front 221

Calvaria

Back 221

Front 222

Arachnoid Granulations

Back 222

Hint 222

protrusions in dura that allow filtering of CSF back to circulation

Front 223

Sagittal Section of Brain:
Falx Cerebri
Falx Cerebelli
Tentorium Cerebelli

Back 223

Hint 223

Falx cerebri – separates cerebral hemispheres, attached anteriorly to crista galli, superiorly to lips of superior sagittal sulcus, posteriorly ends at internal occipital protuberance, posterior third of inferior border is attached to tentorium cerebelli, anterior two-thirds of inferior border is free edged
b) Falx cerebelli – smaller fold that also separates cerebral hemispheres but inferior to tentorium cerebelli (from internal occipital crest to foramen magnum) note: impt anastomoses occur btw venous dural sinuses and the internal vertebral venous plexus @f. magnum
c) Tentorium cerebelli – horizontal fold across posterior third of skull to separate cerebral hemispheres (occipital lobes) from cerebellum, attaches along transverse sulcus on each side of skull, and attaches along superior petrosal sulcus and ends medially at posterior clinoid process

Front 224

Tentorial Notch

Back 224

Hint 224

opening the in the tentorium cerebelli for the brainstem and thru which herniation of the forebrain may cause impt neurological symptoms

Front 225

CN I - Olfactory Nerve

Back 225

Hint 225

not a true nerve actually a tract; tract emerges from brain and ends as the olfactory bulbs

Front 226

CN II - Optic Nerve

Back 226

Hint 226

not a true nerve, outgrowth of the brain; Nerves go through optic foramina (of the sphenoid bone) to enter each orbit, go to posterior aspect of eyeballs; some fibers cross at optic chiasm

Front 227

Internal Carotid Artery (next to Optic Nerve)

Back 227

Hint 227

enters skull through carotid canal, transverses the petrous portion of the temporal bone, and passes through the cavernous sinus. The two internal carotid arteries join to send communicating branches anteriorly and posteriorly (communicating branches) to join with basilar to form Circle of Willis

Front 228

Ophthalmic Artery

Back 228

Hint 228

First branch from ICA, through optic canal; distal to cavernous sinus; supply all the structures in the orbit as well as some structures in the nose, face and meninges

Front 229

Infundibulum/Pituitary Stalk

Back 229

Hint 229

stalk of the pituitary and the hypophysis: pituitary gland that sits in the sella turcica

Front 230

CN III - Oculomotor Nerve

Back 230

Hint 230

pierces dura and enters cavernous sinus, travels along lateral wall; enters orbit by passing through superior orbital fissure
-Controls eye movement and pupil constriction (superior: levator palpebrae superioris, superior rectus; inferior: medial rectus, inferior rectus, inferior oblique; ciliary muscle

Front 231

CN IV - Trochlear Nerve

Back 231

Hint 231

passes through cavernous sinus; exits cranial cavity through superior orbital fissure; innervates superior oblique

Front 232

CN VI - Abducens Nerve

Back 232

Hint 232

pierces dura overlying the clivus and travels a bit (longest intracranial course) and enters cavernous sinus, travels through it most medially of the nerves (inferior to internal carotid artery); exits cranial cavity via superior orbital fissure to enter orbit; innervates lateral rectus

Front 233

CN V - Trigeminal Nerve

Back 233

Hint 233

pierces dura just antero-inferior to the trochlear nerve

Front 234

Olfactory Bulb

Back 234

Hint 234

olfactory bulbs sit on cribriform plates of ethmoid bone; rootlets pass through perforation in the cribriform plates to reach the nasal epithelium in the nasal cavity

Front 235

CN VII - Facial Nerve

Back 235

Hint 235

pierces dura and exits through internal auditory meatus, entering the petrous temporal bone; goes through the facial canal; exits base of skull through stylomastoid foramen; innervates muscles of facial expression (motor trunk divides in parotid gland to temporal, zygomatic, buccal, marginal mandibular, cervical branches); chorda tympani branch of VII eventually joins lingual branch of V3 to hitchhike along it (innervates anterior 2/3 of tongue: taste); Greater petrosal nerve – branches from VII at geniculate ganglion and exits via hiatus of facial nerve, crosses foramen lacerum, and joins deep petrosal nerve to form nerve of the pterygoid canal (Vidian nerve); nerve to the stapedius; PS innervation of submandibular, sublingual, and lacrimal glands

Front 236

Diaphgrama Sellae

Back 236

Hint 236

dura mater membrane covering sella turcica; stretches from anterior clinoid processes to posterior clinoid processes; pierced by the infundibulum (stalk of pituitary gland)

Front 237

Trigeminal Ganglion

Back 237

Hint 237

found in Meckel’s cave – dural projection as the nerve dilates to form the ganglion

Front 238

CN VIII - Vestibulocochlear Nerve

Back 238

Hint 238

arises from brainstem lateral to facial nerve; exits cranial cavity via the internal auditory meatus to supply the inner ear

Front 239

CN V1 - Ophthalmic Division of Trigeminal

Back 239

Hint 239

enters cavernous sinus and travels along lateral wall and enters orbit via superior orbital fissure; supplies forehead, eyes, nose, temples, meninges, paranasal sinuses, part of nasal mucosa; NFL: Nasociliary, Frontal -supraorbital, supratrochlear, Lacrimal

Front 240

CN V2 - Maxillary Division of Trigeminal

Back 240

Hint 240

also enters cavernous sinus and exits cranial cavity via foramen rotundum and enters pterygopalatine fossa; supplies max and mand dentition, lower eyelid, part of nose, upper lip, cheeks, hard palate, maxillary sinuses; ZIP: Zygomatic-zygomaticotemporal, zygomaticoorbital, zygomaticofacial, Infraorbital- superior labial, nasal, inferior palpebral, Palatine-greater and lesser palatine nerves, nasopalatine- incisive canal

Front 241

CN V3 - Mandibular Division of Trigeminal

Back 241

Hint 241

does not go through cavernous sinus; instead, drops straight down through foramen ovale to infratemporal region; contains motor portion of the nerve; supplies muscles of mastication, tensor tympani, tensor
veli palatini, anterior digastric, mylohyoid; BAIL: Long Buccal, Auriculotemporal, Inferior alveolar and Lingual

Front 242

CN IX - Glossopharyngeal

Back 242

Hint 242

exits cranial cavity via jugular foramen; motor innervation to stylopharyngeus muscle, taste and sensation for posterior 1/3 of tongue, soft palate, pharynx, tonsils, auditory tube, tympanic cavity; afferent limb of gag reflex; PS innervation to parotid gland (via otic ganglion)

Front 243

CN X - Vagus Nerve

Back 243

Hint 243

nerve exits at jugular foramen; supplies muscles of larynx, pharynx, palate, and upper esophagus; taste from epiglottis and valleculae

Front 244

CN XI - Spinal Accessory Nerve

Back 244

Hint 244

cranial portion arises from converging rootlets below X; spinal portion arises from motor spinal contributions of C1-C6 that entered the cranium through foramen magnum to travel with the cranial portion; nerve exits through jugular foramen; innervates the SCM and trap

Front 245

CN XII - Hypoglossal Nerve

Back 245

Hint 245

nerve rootlets combine and exit via hypoglossal canal; innervates the intrinsic and extrinsic muscles of the tongue (expt palatoglossus)

Front 246

Vertebral Arteries

Back 246

Hint 246

first branches from subclavian arteries; ascends in neck to enter transverse foramen of C6; enters skull via foramen magnum; right and left vertebral arteries join to form basilar artery (which goes on to supply the circle of Willis)

Front 247

Basilar Artery

Back 247

Hint 247

right and left vertebral arteries join to form basilar artery (which goes on to supply the circle of Willis)

Front 248

Straight Sinus

Back 248

Hint 248

base of falx tentorium cerebelli; drainage: inferior sagittal and great cerebral vein to confluence of sinuses

Front 249

Cavernous Sinus

Back 249

Hint 249

paired, 1cm wide, R and L of sphenoid bone; transversed by network of fibrous filaments (unusual): serve to slow flow of venous blood through these structures; allows pathogens to colonize within these regions
- extends 2cm from superior orbital fissure anteriorly to apex of petrous temporal bone posteriorly; anterior and posterior intercavernous sinuses (forms circular sinus) connects both L and R cavernous sinus; receives blood from: Pterygoid plexus via inferior ophthalmic vein, emissary veins, and deep facial vein drain into cavernous thru sphenoid foramen

Front 250

Confluence of Sinuses

Back 250

Hint 250

sinus junction at internal occipital protuberance; drainage from: Superior Sagittal, Straight, and Occipital Sinuses; drainage to: transverse sinuses

Front 251

Inferior Sagittal Sinus

Back 251

Hint 251

inferior to falx cerebri; anterior: crista galli; posterior: joins Great Cerebral Vein; drainage: small cerebral veins

Front 252

Superior Sagittal Sinus

Back 252

Hint 252

largest dural sinus; cranial falx cerebri; anterior: foramen cecum; posterior: internal occipital protuberance; drains: cerebral veins, emissary veins, diploic veins

Front 253

Nasociliary Nerve (CN V1)

Back 253

Hint 253

ciliary ganglion, long ciliary nerves, anterior and posterior ethmoidal nerves, infratrochlear nerve; runs obliquely toward medial wall of the orbit, passes b/w superior oblique and medial rectus; travels w/ the ophthalmic artery

Front 254

Frontal Nerve (CN V1)

Back 254

Hint 254

supraorbital nerve, supratrochlear nerve; provides sensory info for forehead skin, frontal sinus mucosa, and upper eyelid; above levator palpebrae superioris

Front 255

Lacrimal Nerve (CN V1)

Back 255

Hint 255

innervates lacrimal gland (smallest of three branches)

Front 256

Ciliary Ganglion

Back 256

Hint 256

sensory root from nasociliary nerve of CN V1; parasympathetic root from inferior branch of CN 3 (pupillary constriction, ciliary muscle→ accommodation- narrows pupil and increases lens convexity); sympathetic root from internal carotid plexus (pupillary dilator, ophthalmic artery, tarsal muscle and levator palpebrae superioris); gives off short ciliary nerves

Front 257

Supraorbital Nerve

Back 257

Hint 257

branch of Frontal Nerve (CN V1)

Front 258

Supratrochlear Nerve

Back 258

Hint 258

branch of Frontal Nerve (CN V1)

Front 259

Lateral Rectus

Back 259

Hint 259

abducts; innervated by CN VI

Front 260

Medial Rectus

Back 260

Hint 260

adducts; inferior division of CN III

Front 261

Superior Rectus

Back 261

Hint 261

elevates, adducts, intorts; innervated by CN III

Front 262

Inferior Rectus

Back 262

Hint 262

depresses, adducts, extorts; innervated by CN III

Front 263

Levator Palpebrae Superioris

Back 263

Hint 263

elevates upper eyelid; innervated by CN III

Front 264

Superior Oblique

Back 264

Hint 264

depresses, abducts, extorts; arises from superomedial margin of the optic foramen, runs forward forming a tendon passing though the trochlea; innervated by CN IV

Front 265

Inferior Oblique

Back 265

Hint 265

o action: depresses, adducts, extorts (3 axes movement)
o course: arise from annular tendon to attach to anterior sclera
o innervation: inferior division of CN 3

Front 266

Trochlea

Back 266

Front 267

Lacrimal Gland

Back 267

Hint 267

• located in the lacrimal fossa of the frontal bone
• sensory innervation from lacrimal nerve (V1)
• secretomotor nerves piggyback on zygomatic nerve (V2)
o parasympathetic innervation from greater petrosal nerve of CN 7
o sympathetic innervation from deep petrosal nerve from internal carotid plexus
o greater petrosal and deep petrosal → Vidian nerve → pterygopalatine ganglion → infraorbital nerve (V2) → zygomatic branch of infraorbital → lacrimal gland
• arterial supply from lacrimal artery (branch of ophthalmic artery)

Front 268

Lacrimal Sac & Nasolacrimal Duct

Back 268

Hint 268

• tears are secreted by the lacrimal gland (at superolateral part of eye) to lubricate the eyes
• tears pool in the lacrimal caruncle/lake (at medial part of eye)
• tears drain into the puncta lacrimalis and then through the lacrimal canaliculi to the lacrimal sac
• lacrimal sac (above medial palpebral ligament) drains into the nasolacrimal duct which opens at the inferior nasal meatus (of the same side)
• remember tears are disseminated by actions of the orbicularis oculi and related papebral musculature

Front 269

Zygomaticus Major

Back 269

Hint 269

Innervated by buccal and zygomatic branches of facial nerve; extends from zygomatic arch to corner of the mouth; supplied by facial artery

Front 270

Lesser Occipital Nerve (C2) - cutaneous branch of cervical plexus

Back 270

Hint 270

(C2) - innervates lateral scalp behind ear
o [Auricular branch: innervates skin along the side of the head behind the ear; joins with greater occipital n, great auricular n. & posterior auricular branch of CN VII]
Superficial Nerve of Cervical Plexus

Front 271

Ansa Cervicalis (Superior and Inferior Roots): C1-C3 - muscular branch of cervical plexus

Back 271

Hint 271

innervates all infrahyoid muscles except thyrohyoid; Superior Root: ventral ramus of C1 spinal root (descendans hypoglossi)
• These nerve fibers travel w/ hypoglossal n. before branching to form the superior root; hypoglossal n. will always be found looping around (90 degree turn) the occipital branch of the external carotid A en route to the floor of the mouth (XII also courses btw the mylohyoid and hyoglossus)
• Inferior Root: ventral rami of C2 and C3
Deep Nerve of Cervical Plexus

Front 272

Phrenic Nerve (C3-C5) - muscular branch of cervical plexus

Back 272

Hint 272

important nerve that lies on the anterior surface of the anterior scalene; descends from its origins in the cervical plexus along the anterior surface of the anterior scalene; deep nerve of cervical plexus

Front 273

Hypoglossal Nerve

Back 273

Hint 273

courses between the mylohyoid and hyoglossus muscles

Front 274

Superior Thyroid Artery (ECA)

Back 274

Hint 274

• Infrahyoid: GT
• Sternocleidomastoid: GT
• Superior Laryngeal: GT (upper larynx)
• Cricothyroid: cricothyroid ligament

Front 275

Ascending Pharyngeal Artery (ECA)

Back 275

Hint 275

• Pharyngeal: middle constrictors
• Palatine: soft palate & tonsil
• Prevertebral: longus capitis & colli
• Inferior tympanic: tympanic cavity
• Posterior meningeal: dura mater

Front 276

Lingual Artery (ECA)

Back 276

Hint 276

• Suprahyoid: GT
• Dorsal lingual: post. part of dorsum of tongue, tonsil, soft palate & epiglottis
• Sublingual: sublingual gland & mylohyoid m.
• Deep lingual: underside of tongue, genioglossus

Front 277

Facial Artery (ECA)

Back 277

Hint 277

• Cervical branches: ATGS
• Ascending palatine: soft palate, palatine glands
• Tonsilar: tonsil & tongue
• Glandular: submandibular gland
• Submental: chin & lip
• Facial branches: ISLAM
• Inferior labial: GT
• Superior labial: GT
• Lateral nasal: GT
• Angular (terminal branch): lacrimal sac; anastomoses with V1
• Muscular: neck, face

Front 278

Occipital Artery (ECA)

Back 278

Hint 278

supplies scalp, mastoid process, SCM & Trapezius
• Muscular: digastric, stylohyoid
• SCM: GT
• Auricular: mastoid air cells
• Meningeal: dura of PC fossa
• Terminal: occipital bone
Hypoglossal Nerve passes over it

Front 279

Transverse Facial Artery
Labial Arteries
Angular Arteries
Superficial Temporal Arteries

Back 279

Front 280

Levator Labii Superioris

Back 280

Hint 280

• O: frontal process of maxilla and infraorbital region
• I: skin of upper lip and alar cartilage of nose
• A: elevates lip, dilate nostril, raise angle of mouth

Front 281

Deep Facial Vein
Angular Vein
Posterior Auricular Vein

Back 281

Front 282

Mylohyoid

Back 282

Hint 282

• O: mylohyoid line of mandible
• I: median raphe from chin to hyoid bone and onto hyoid (mylohyoid raphe)
• A: elevates floor of mouth & hyoid bone/depresses mandible (raises tongue in early stage of swallowing)
• I: mylohyoid branch of inferior alveolar branch of V3

Front 283

Geniohyoid

Back 283

Hint 283

• O: inferior genial tubercle
• I: anterior border of hyoid
• A: elevates the hyoid and draws it forward/depresses mandible
• I: C1 through the hypoglossal n.

Front 284

Genioglossus

Back 284

Hint 284

Origin – superior genial tubercle/superior part of mental spine of mandible
Insertion – dorsum of tongue and body of hyoid
Innervation – CN XII
Action – depresses tongue, posterior part pulls tongue anteriorly for protrusion

Front 285

Stylohyoid

Back 285

Hint 285

• O: posterior border of styloid process of temporal bone
• I: hyoid bone, at junction of the body and greater cornu
• A: elevates hyoid & draws it posteriorly
• I: stylohyoid branch of VII

Front 286

Stylopharyngeus

Back 286

Hint 286

o Only muscle derived from pharyngeal arch 3
o Origin: styloid process
o Insertion: thyroid cartilage (pharynx)
o Innervation: only muscle innervated by CN 9; CN 9 accompanies stylopharyngeus thru the gap between the superior and middle constrictors
o Action: elevates the pharynx and larynx

Front 287

Hyoglossus

Back 287

Hint 287

Origin – body and greater horn of hyoid
- Insertion – side and inferior aspect of tongue
- Innervation – CN XII
- Action – depresses and retracts tongue

Front 288

Sternothyroid

Back 288

Hint 288

deep to sternohyoid; is raised and stretched by the mass of the underlying thyroid gland;
O: posterior manubrium, deep to sternohyoid; 1st costal cartilage
I: oblique line on lamina of thyroid cartilage
A: depresses larynx
I: ansa cervicalis (C1-C3)

Front 289

Thyrohyoid

Back 289

Hint 289

(deep to the sternohyoid)
O: oblique line on thyroid cartilage
I: lower border of body and greater cornu of hyoid
A: depresses hyoid bone/elevates larynx
I: thyrohyoid branch of C1 through the hypoglossal

Front 290

Ansa Cervicalis (Superior Root)

Back 290

Hint 290

Superior Root: ventral ramus of C1 spinal root (descendans hypoglossi)
• These nerve fibers travel w/ hypoglossal n. before branching to form the superior root; hypoglossal n. will always be found looping around (90 degree turn) the occipital branch of the external carotid A en route to the floor of the mouth (XII also courses btw the mylohyoid and hyoglossus)

Front 291

Levator Anguli Oris

Back 291

Hint 291

immediately below the infraorbital foramen; innervated by buccal branches of the facial nerve

Front 292

Vagus Nerve (in neck)

Back 292

Hint 292

internal jugular vein courses with the nerve laterally, common carotid medially

Front 293

Carotid Sinus

Back 293

Hint 293

dilation of the ICA near the bifurcation of the common carotid a. containing baroreceptors
• Convey info abt changes in BP; innervated by IX to medulla

Front 294

Common Carotid Artery

Back 294

Hint 294

Part of the carotid sheath (with internal jugular vein and vagus nerve); bifurcates into internal and external branches

Front 295

External Carotid Artery

Back 295

Hint 295

More superficial branch of the common carotid artery; branches into SALFOPSM

Front 296

Internal Carotid Artery

Back 296

Hint 296

More deep branch of the common carotid artery; supplies the brain

Front 297

Brachiocephalic Artery

Back 297

Hint 297

supplies blood to the R arm, head and neck; divides into the R subclavian and right common carotid artery, only on the right side of body

Front 298

Left Common Carotid Artery

Back 298

Hint 298

Part of the carotid sheath (with internal jugular vein and vagus nerve); bifurcates into internal and external branches; adjacent to left subclavian artery

Front 299

Right Vagus Nerve

Back 299

Hint 299

clearly visible b/w IJV and carotid artery throughout the neck in the carotid sheath; passes through jugular foramen and carotid sheath, and then courses posterior to the root of the lungs and branches to form the esophageal plexus (along w/ direct visceral branches arising from the sympathetic turns bilaterally) on the anterior surface of the of esophagus

Front 300

Left Brachiocephalic Vein

Back 300

Hint 300

Drains left and right inferior thyroid veins; Internal jugular vein and Subclavian vein join to form brachiocephalic; union of the two brachiocephalics forms SVC; conduct the venous outflow of the head (IJV) and upper extremities (subclavian vein) to the SVC (the left one is particularly long, crossing the midline almost horizontally and receiving the drainage of the inferior thyroid vein from the neck en route to the SVC)

Front 301

Superior Vena Cava

Back 301

Hint 301

Carries deoxy blood from the upper half of the body into the RA and is formed by the union of the L+R brachiocephalic veins; the azygos vein joins it just before it enters the RA

Front 302

Depressor Labii Inferioris

Back 302

Hint 302

helps lower bottom lip; innervated by mandibular division of facial nerve

Front 303

Left Vagus Nerve

Back 303

Hint 303

internal jugular vein courses with the nerve laterally, common carotid medially; L vagus nerve descends from the neck toward the posterior mediastinum (posterior to root of the lung) along the L side of the aortic arch and it ramifies extensively here, providing visceral efferent (PS) fibers to both the pulmonary and cardiac plexuses.

Front 304

Internal Branch of Superior Laryngeal Nerve

Back 304

Hint 304

Superior Laryngeal: branch of the vagus nerve. It arises from the middle of the ganglion nodosum and in its course receives a branch from the superior cervical ganglion of the sympathetic.

It descends, by the side of the pharynx, behind the internal carotid artery, and divides into two branches
Internal Branch: goes through the thyrohyoid membrane (accompanied by superior laryngeal a. and v.); innervates mucous membrane superior to vocal folds

Front 305

External Branch of Superior Laryngeal Nerve

Back 305

Hint 305

Superior Laryngeal: branch of the vagus nerve. It arises from the middle of the ganglion nodosum and in its course receives a branch from the superior cervical ganglion of the sympathetic.

It descends, by the side of the pharynx, behind the internal carotid artery, and divides into two branches;
External Branch: goes to cricothyroid muscle (only laryngeal muscle not innervated by recurrent laryngeal nerve)

Front 306

Thyroid Gland (Isthmus)

Back 306

Hint 306

covered by a pretracheal layer of deep cervical fascia; two lobes and an isthmus); look for pyramidal lobe or partially obliterated thyroglossal duct; supplied by superior and inferior thyroid arteries; drains to superior, middle and inferior thyroid veins

Front 307

Cricothyroid Muscle

Back 307

Hint 307

• O: lateral surface of cricoid cartilage
• I: (lower fibers) anterior margin of inferior horn of thyroid C; (upper fibers) lower border of lamina of thyroid C
• I: external laryngeal nerve (from superior laryngeal branch of X)
• A: tenses vocal folds (raise pitch of speech)
Cricothyroid joint: Movement at this joint changes length and tension of the vocal ligaments, determining pitch of speech

Front 308

Thyroid Cartilage

Back 308

Hint 308

contains the larynx; laryngeal prominence in front is palpable, superior and inferior thyroid notches; posteriorly, superior horns of the thyroid come close to greater horns of hyoid; many muscles originate and insert here; sternothyroid inserts, thyrohyoid originates, inferior pharyngeal constrictor inserts, stylopharyngeus inserts, palatopharyngeus inserts

Front 309

Cricoid Cartilage (Signet Ring)

Back 309

Hint 309

only complete ring around the trachea; disparity in anterior arch thickness (band) and posterior lamina thickness (slightly broader)… like a signet ring; opposite the sixth cervical vertebra

Front 310

Hyoid Bone

Back 310

Hint 310

floating bone just below the mandible with lesser and greater horns

Front 311

Right Brachiocephalic Vein

Back 311

Hint 311

Internal jugular vein and Subclavian vein join to form brachiocephalic; union of the two brachiocephalics forms SVC; conduct the venous outflow of the head (IJV) and upper extremities (subclavian vein) to the SVC

Front 312

Greater Petrosal Nerve

Back 312

Hint 312

branches from VII at geniculate ganglion and exits via hiatus of facial nerve, crosses foramen lacerum, and joins deep petrosal nerve to form nerve of the pterygoid canal

Front 313

Depressor Anguli Oris

Back 313

Hint 313

frowning; from mandible to angle of the mouth; innervated by mandibular branch of facial nerve

Front 314

Thoracic Duct (& Right Lymphatic Duct)

Back 314

Hint 314

On the left side of the body;
Arises from: cysterna chyli in abdomen (small sac)
o Enters thorax through aortic opening in diaphragm
o Ascends within thorax in between the azygos vein & aorta
o Drains: lower extremities, pelvis, abdomen, upper left quadrant of body
o Picks up bronchomediastinal trunk in thorax
• Contains visceral lymphatic drainage
o As duct approaches root of neck, swings to left, arches around L IJV
o Empties: confluence of the left IJV and subclavian veins

Right lymphatic duct: receives drainage from the right upper quadrant and drains into the right subclavian v.; only segment of the body not drained by thoracic duct

Front 315

Deep Temporal Arteries (Pterygoid Portion of Maxillary Artery)

Back 315

#18

Hint 315

Front 316

Inferior Alveolar Artery (Mandibular Portion of Maxillary Artery)

Back 316

#29

Hint 316

Runs with inferior alveolar nerve

Front 317

Middle Meningeal Artery (Mandibular Portion of Maxillary Artery) w/ Auriculotemporal Nerve

Back 317

#41

Hint 317

Mandibular portion of Maxillary Artery; passes through foramen spinosum; surrounded by two branches of auriculotemporal nerve

Front 318

Buccal Artery (Pterygoid Portion of Maxillary Artery) (& Nerve)

Back 318

#23

Hint 318

Runs with buccal nerve

Front 319

Sphenopalatine Artery (Pterygopalatine Portion of Maxillary Artery)

Back 319

#20

Hint 319

Near the posterior aspect of the superior conchae and anterior to the sphenoid sinus is the sphenopalatine foramen thru which courses the sphenopalatine artery

Front 320

Submandibular Ganglion

Back 320

#10

Hint 320

lingual nerve and chorda tympani carry taste sensations (anterior 2/3 of tongue) and PS fibers to submandibular ganglion;
Attached to the inferior loop of the lingual nerve
o Responsible for the innervation of the submandibular and sublingual glands
o Hangs via two filaments from the lingual nerve (branch of V3)
o Preganglionic parasympathetic fibers synapse from the medulla’s superior salivatory nucleus

Front 321

Pterygopalatine Ganglion

Back 321

#12

Hint 321

Part of CN V2; Vidian nerve passes through foramen lacerum and synapses here; contained in the pterygopalatine fossa

Front 322

23: Inferior Thyroid Artery
21: Ascending Cervical Artery
19: Superior Thyroid Artery

Back 322

#23 + #21 + #19

Hint 322

inferior thyroid artery (supplies trachea, esophagus, larynx, thyroid gland) is a branch off the thyrocervical trunk, ascending cervical artery (supplies vertebrae and neck muscles) branches off inferior thyroid; superior thyroid is a branch off ECA; both thyroid arteries supply the thyroid gland

Front 323

Vertebral Artery

Back 323

#47

Hint 323

branch off Subclavian artery; ascends and courses posteriorly toward the cervical spine where it normally ascends thru the transverse foramina of the upper six vertebrae
• Supplies blood to the posterior part of circle of Willis and anastomoses with blood supplied to the anterior part of the circle of Willis from the carotid

Front 324

Submandibular Gland

Back 324

Hint 324

mixed gland found below the mandible and superior to the digastric muscles; located inferior to mylohyoid muscle and close to medial surface of the body of the mandible

Front 325

Right Internal Thoracic Artery

Back 325

#24

Hint 325

Branch off subclavian artery; supplies the anterior chest wall and the breasts
• Anterior intercostal arteries (supplies ribs)
• Superior epigastric A
• Descends inferiorly to anastomose with inferior epigastric (from external iliac)

Front 326

Costocervical Trunk

Back 326

Hint 326

Branch off subclavian artery; Arteries that supply back of neck
• Posterior Intercostal arteries
• supplies first two intercostals spaces]]
branches into deep cervical artery and superior intercostal artery

Front 327

Inferior Thyroid Veins (& Left Brachiocephalic)

Back 327

#21

Hint 327

left brachiocephalic vein drains both inferior thyroid veins

Front 328

Superior Thyroid Veins (& Middle)

Back 328

#15

Hint 328

Both drain to IJV
• Superior thyroid vein; begins in substance of and on top of the thyroid gland and also drains in IJV
• Middle thyroid vein: drains blood from the lower part of the thyroid gland to the IJV

Front 329

Retropharyngeal Space

Back 329

Hint 329

bound by the buccopharyngeal fascia anteriorly and the anterior lamina (alar fascia) of the prevertebral fascia posteriorly (btw the pharynx and prevertebral fascia); b/c serious infections of teeth can spread down this space into the posterior mediastinum, it is can be designated as the danger space

Front 330

Nasopharynx

Back 330

#13

Hint 330

o Communicates anteriorly with nasal cavity
o Nasal cavity is split into left and right by the nasal septum
o Continuous with nasal cavity at the choanae or posterior nasal aperture
o Nasopharynx and oropharynx separated by soft palate musculature

Front 331

Oropharynx

Back 331

#15

Hint 331

o Communicates anteriorly with oral cavity
o Separated from oral cavity by the fauces or pillars
o Nasopharynx and oropharynx separated by soft palate musculature

Front 332

Laryngopharynx

Back 332

#17

Hint 332

Below the oropharynx to the esophagus

Front 333

Cervical Sympathetic Trunk & Superior Cervical Ganglion

Back 333

#22

Hint 333

• Cervical sympathetic trunk located behind the carotid sheath as it rises from the thorax towards the base of the skull embedded in prevertebral fascia
• Superior cervical ganglion: superior extent of trunk

Front 334

Inferior Cervical Ganglion

Back 334

Hint 334

• Inferior cervical ganglion: opposite the transverse process of the 7th cervical vertebrae where it is often continuous with the first thoracic ganglion to form the stellate ganglion

Front 335

Anterior Jugular Vein

Back 335

Hint 335

drains anterior aspect of neck and descends on either side of the midline to point above the jugular notch of the manubrium and empties into external jugular; connects with internal jugular vein

Front 336

Superior and Middle Cervical Ganglia

Back 336

Hint 336

• Superior cervical ganglion: superior extent of trunk
• Middle cervical ganglion: foten diminutive

Front 337

Internal Jugular Vein

Back 337

Hint 337

formed by joining of the inferior petrosal sinus and the sigmoid sinus; runs down side of the neck vertically (lateral to ICA and then to common carotid) joins with subclavian vein to form brachiocephalic vein

Front 338

Common Facial Vein

Back 338

Hint 338

o Union of facial vein and anterior retromandibular; anterior branch of retromandibular vein and facial vein join to form the common facial vein --> IJV

Front 339

Submandibular/Wharton's Duct

Back 339

Hint 339

runs with the lingual nerve in the floor of the mouth; crosses superior to the lingual nerve as the duct courses toward its opening on the sublingual caruncle

Front 340

Hard Palate

Back 340

#2

Hint 340

Oral and nasal cavity separated by hard palate

Front 341

Soft Palate & Uvula

Back 341

#14

Hint 341

soft palate divides nasopharynx from oropharynx; o Soft palate muscles attach to a fibrous aponeurosis
o Soft palate is elevated and tensed to limit reflux of fluid into nasopharynx during swallowing and to enable certain plosive speech sounds
o Musculus uvulae, levator veli palatini, tensor veli palatini

Front 342

Superior Pharyngeal Constrictor

Back 342

Hint 342

o Attaches to lower 1/3 of posterior of medial pterygoid, pterygomandibular raphe, and alveolar process of mandible
o Passavant’s ridge: a prominence seen during swallowing on the nasopharyngeal wall by contraction of the superior constrictors; when the palate is not functioning during swallowing, the deficiency is compensated by a greater convergence of Passavant’s ridge

Front 343

Middle Pharyngeal Constrictor

Back 343

Hint 343

o Attaches to both horns of hyoid bone and stylohyoid ligament

Front 344

Inferior Pharyngeal Constrictor

Back 344

Hint 344

Front 345

Median Pharyngeal Raphe

Back 345

Hint 345

fibrous median septum to which the pharyngeal constrictor muscles attach posteriorly; located in the midline on the posterior wall of the pharynx and attaches superiorly to the pharyngeal tubercle of the occipital bone

Front 346

Thryopharyngeal portion of Inferior Pharyngeal Constrictor

Back 346

#16

Hint 346

o Upper part: thyropharyngeal part (from oblique thyroid line)

Front 347

Cricopharyngeal portion of Inferior Pharyngeal Constrictor

Back 347

#18

Hint 347

cricopharyngeal part (from cricoid cartilage btw the cricothyroid and the inferior part of the thyroid cartilage)

Front 348

Pterygomandibular raphe

Back 348

#2

Hint 348

o Tendinous band of buccalpharyngeal fascia
o Attached to pterygoid hamulus of the medial pteryogid and the posterior end of the mylohyoid line of the mandible
o Attached to the superior middle constrictor and buccinators

Front 349

Styloid Process

Back 349

Hint 349

Its proximal part (tympanohyal) is ensheathed by the vaginal process of the tympanic portion.
Its distal part (stylohyal) gives attachment to the following:
stylohyoid ligament
stylomandibular ligament
styloglossus muscle (innervated by the hypoglossal nerve)
stylohyoid muscle (innervated by the facial nerve)
stylopharyngeus muscle (innervated by the glossopharyngeal nerve)

Front 350

Salpingopharyngeus/Salpingopharyngeal Fold

Back 350

#24

Hint 350

• Salpingopharyngeus (covered by mucosal fold)
o Origin: inferior part of the cartilage of the pharyngotympanic tube (Eustachian tube) in the nasal cavity
o Insertion: palatopharyngeus muscle
o Innervation: pharyngeal plexus of CN 10
o Action: raises the nasopharynx during swallowing and laterally draws the pharyngeal walls up

Front 351

Palatopharyngeus/Palatopharyngeal Fold

Back 351

#19

Hint 351

o Origin: palatine aponeurosis and hard palate
o Insertion: thyroid cartilage
o Innervation: vagus and cranial accessory nerve
o Action: pulls pharynx and larynx upward

Front 352

Choana

Back 352

#16

Hint 352

opening of the nasal cavity into the nasopharynx; aka posterior nares/nasal aperture

Front 353

Torus Tubarius

Back 353

Hint 353

broad cartilaginous end of the auditory/eustachian/pharyngotympanic tube; tubal elevation of the base of the cartilaginous portion of the Eustachian tube above the orifice of the tube

Front 354

Auditory/Eustachian/Pharyngotympanic Tube

Back 354

#27

Hint 354

extends from middle ear to lateral wall of nasopharynx at inferior nasal concha level; opening of the auditory tube is found below the broad cartilaginous end of the tube know as the torus tubarius

Front 355

Pharyngeal Recess

Back 355

#8

Hint 355

fossa of Rosenmuller; posterior to the opening of the auditory tube and the torus tubarius; at the superior end, the pharyngeal tonsils/adenoids will occupy this area

Front 356

Pharyngeal Tonsil/Adenoids

Back 356

#5

Hint 356

occupy superior end of pharyngeal recess; when enlarged, called adenoid hypertrophy or adenoid facies

Front 357

Maxillary Vein

Back 357

Hint 357

o Short trunk joining pterygoid plexus to retromandibular

Front 358

Levator Veli Palatini

Back 358

Hint 358

soft palate muscle;
o Origin: petrous temporal + cartilaginous auditory tube (torus tubarius)
o Insertion: contralateral muscle in the velum palatinum (soft palate)
• Review: torus tubarius is ridge in the nasopharyngeal wall posterior to the opening of the auditory tube, caused by the projection of the cartilaginous portion of this tube. The salpingopharyngeal fold also descends from this torus tubarius.
o Action: elevates the soft palate, pulling posteriorly and narrowing the walls of the nasopharynx (drawing medially)
o Innervation: pharyngeal plexus of CNX.

Front 359

Tensor Veli Palatini

Back 359

Hint 359

soft palate muscle;
o Origin: scaphoid fossa, spina angularis, and cartilaginous part of the auditory tube
o Insertion: velum palatinum after being redirected by the tendinous portion of the pterygoid hamulus.
o Action: tenses the soft palate and opens the cartilaginous auditory tube. In other words, it elevates the lateral edges, providing a good seal of the soft palate from the nasopharynx.
o Innervation: tensor veli palatini branch of CNV3

Front 360

Lingual Tonsil (& Root of Tongue)

Back 360

#16

Hint 360

lymph tissue covering the base of the tongue

Front 361

Palatoglossus

Back 361

Hint 361

Origin – palatine aponeurosis of soft palate
- Insertion – side of tongue
- Inneration – cranial root of CN XI vial pharyngeal branch of CN X and
pharyngeal plexus
- Action – elevates posterior part of tongue

Front 362

Palatopharyngeus

Back 362

Hint 362

(covered by a mucosal fold)
o Origin: palatine aponeurosis and hard palate
o Insertion: thyroid cartilage
o Innervation: vagus and cranial accessory nerve
o Action: pulls pharynx and larynx upward

Front 363

Oropharyngeal Isthmus/Oropharynx

Back 363

#5

Hint 363

• Boundaries of oropharynx: laryngopharynx inferior, oral cavity anterior (by the oropharyngeal isthmus or the isthmus of the fauces= bounded superiorly by soft palate, inferiorly by root of tongue (where lingual tonsils lie), laterally by palatoglossal and paaltopharyngeal arches/folds), nasopharynx superior (by the soft palate muscles), pharyngeal wall posteriorly (sup constrictor)

Front 364

Palatine Tonsils/Tonsilar Fossa

Back 364

Hint 364

palatoglossal fold and palatopharyngeal fold (aka anterior and posterior pillars of the fauces); palatine tonsils lie btw the pillars of the fauces on the loose connective tissue covering the superior pharyngeal constrictor

Front 365

Waldeyer's Tonsillar Ring

Back 365

Hint 365

annular arrangement of lymphoid tissue in the pharynx. Waldeyer's ring circumscribes the naso- and oropharynx, with some of its tonsillar tissue located above and some below the soft palate (and to the back of the oral cavity)
Pharyngeal tonsils, tubal tonsils, palatine tonsils, lingual tonsils

Front 366

Tonsillar & Ascending Palartine Branches of Facial Artery

Back 366

Hint 366

The palatine tonsil receives its BS from a tonsillar branch of the facial artery and the ascending palatine arteries

Front 367

Epiglottis

Back 367

Hint 367

o Lid-like flap of cartilage guarding the entrance of the laryngeal inlet
o During swallowing, elevation of the hyoid draws the epiglottis down to direct food to esophagus
o Upper epiglottis: CN 9 fibers contribute to afferent gag reflex
o Lower epiglottis: CN 10 fibers contribute to afferent cough reflex

Front 368

Epiglottis

Back 368

Hint 368

o Lid-like flap of cartilage guarding the entrance of the laryngeal inlet
o During swallowing, elevation of the hyoid draws the epiglottis down to direct food to esophagus
o Upper epiglottis: CN 9 fibers contribute to afferent gag reflex
o Lower epiglottis: CN 10 fibers contribute to afferent cough reflex

Front 369

Glossoepiglottic Folds

Back 369

Walls of this depression/opening

Hint 369

o Median glossoepiglottic fold: middle fold on epiglottis
o Lateral glossoepiglottic folds: lateral folds on epiglottis attached to pharyngeal wall

Front 370

Piriform Recess

Back 370

#11

Hint 370

on either side of the laryngeal orifice; bounded medially by the aryepiglottic folds and bounded laterally by the thyroid cartilage and thyrohyoid membrane
o Often pills or capsules can get stuck here

Front 371

Valleculae

Back 371

Hint 371

depression between the median and lateral glossoepiglottic folds; two small depressions created by the three glossoepiglottic folds
(run anteriorly from epiglottis to base of posterior 1/3 of tongue – one median glossoepiglottic fold and two lateral glossoepiglottic folds); the depressions lie on either side of the median fold

Front 372

Ary-epiglottic fold

Back 372

#9

Hint 372

stretched between the sides of the epiglottis and the apex of the arytenoid cartilages→contain the aryepiglottic muscles

Front 373

Vestibule of Larynx/Laryngeal Inlet

Back 373

#50

Hint 373

opening connecting pharynx and larynx, formed by epiglottis edges, aryepiglottic folds, arytenoids, and interarytenoid notch

Front 374

Vestibular/False Vocal Fold

Back 374

Hint 374

• Contain no muscle and are found superior to the true vocal folds; Vestibule: portion of the larynx above the vocal folds

Front 375

True Vocal Fold

Back 375

Hint 375

contain: vocal ligament, vocalis muscle, thyroarytenoid muscle; Ventricle: fossa between the vocal folds; inferior to false vocal folds

Front 376

Vocal Ligament

Back 376

#19

Hint 376

core of each vocal cord, run from vocal process of arytenoids to inner surface of thyroid lamina; position of these ligaments determines quantity of air flow
o Vocal process of arytenoid cartilage: attaches vocalis muscle and vocal ligament
o Movement at the cricothyroid joint changes length and tension of the vocal ligaments, determining pitch of speech

Front 377

Ventricle of larynx

Back 377

#24

Hint 377

fossa between the vocal folds

Front 378

Rima Glottidis

Back 378

Hint 378

opening between the left and right true vocal cords, closed by the arytenoid muscles, opened only by posterior cricoarytenoid muscles; Valsalva manaveur: straining maneuver to raise abdominal pressure, maximum adduction of rima glottidis

Front 379

Vocalis Muscle (part of Thyro-arytenoid muscle)

Back 379

#20

Hint 379

Vocal process of arytenoid cartilage: attaches vocalis muscle and vocal ligament; fine adjustments of vocal cords

Front 380

Vocal Processes of Arytenoid Cartilage

Back 380

Hint 380

anterior angle of the base of the arytenoid cartilage projects horizontally forward; it gives attachment to the vocal ligament

Front 381

Arytenoid Cartilage

Back 381

#14

Hint 381

triangular cartilages articulating inferiorly with cricoid lamina
o Vocal process: attaches vocalis muscle and vocal ligament
o Muscular process: attached thyroarytenoid muscles

Front 382

Corniculate Cartilage

Back 382

#13

Hint 382

articulate with the summits of the arytenoid cartilages and serve to prolong them posteriorly and medially

Front 383

Cuneiform Cartilage

Back 383

#24

Hint 383

paired cartilages that sit on top of and move with the arytenoids; located above and in front of the corniculate cartilages, and the presence of these two pairs of cartilages result in small bulges on the surface of the mucous membrane; covered by ary-epiglottic folds

Front 384

Inferior Laryngeal (Branch of Recurrent Laryngeal)

Back 384

#16

Hint 384

Recurrent laryngeal of CNX: all the intrinsic muscles of the larynx except cricothyroid

Front 385

Posterior Cricoarytenoid

Back 385

#8

Hint 385

only muscle to abduct the vocal cords/open rima glottidis

Front 386

Transverse Arytenoid

Back 386

#7

Hint 386

adducts vocal cords

Front 387

Oblique Arytenoid

Back 387

Hint 387

adduct vocal cords; continuation of aryepiglottic muscles

Front 388

Superior Nasal Concha

Back 388

#13

Hint 388

protect olfactory bulb, part of ethmoid bone

Front 389

Middle Nasal Concha

Back 389

#14

Hint 389

protect sinuses from coming into direct contact with nasal airflow, part of ethmoid bone

Front 390

Inferior Nasal Concha

Back 390

#15

Hint 390

responsible for airflow, humidification, filtering; are separate bones (superior and middle conchae are parts of other bones)

Front 391

Superior Nasal Meatus

Back 391

#2

Hint 391

sphenopalatine foramen opens into it posteriorly, posterior ethmoidal cells anteriorly (drain here)

Front 392

Middle Nasal Meatus

Back 392

#3

Hint 392

bulla ethmoidalis(=elevation containing the middle ethmoidal cells (drain here)), hiatus semilunaris (anterior ethmoidal cells (drain here), frontonasal duct, ostium of maxillary sinus…. Sooooo frontal, middle ethmoid, and maxillary drain here!!!), uncinate process

Front 393

Inferior Nasal Meatus

Back 393

#17

Hint 393

ostium of nasolacrimal duct anteriorly (draining tears form the lacrimal sac into the inferior meatus

Front 394

Spheno-ethmoidal recess

Back 394

#12

Hint 394

sphenoethmoidal recess behind the superior concha

Front 395

Nasolacrimal Duct Opening

Back 395

#19

Hint 395

ostium of nasolacrimal duct anteriorly (draining tears form the lacrimal sac into the inferior meatus

Front 396

Semilunar Hiatus

Back 396

#16

Hint 396

hiatus semilunaris (anterior ethmoidal cells (drain here); on lateral wall of middle nasal meatus

Front 397

Bulla ethmoidalis (& Superior Nasal Meatus)

Back 397

#15

Hint 397

bulla ethmoidalis(=elevation containing the middle ethmoidal cells (drain here) in the middle nasal meatus

Front 398

Greater Palatine (Pterygopalatine) Canal

Back 398

Hint 398

passage in the skull that transmits the descending palatine artery, vein, and greater and lesser palatine nerves between the pterygopalatine fossa and the oral cavity

Front 399

Greater Palatine Artery and Nerve

Back 399

#14

Hint 399

Maxillary lingual gingivae of posterior teeth supplied by gingival branches of greater palatine nerve
Nerve travels through the pterygopalatine canal and greater palatine foramina and supplies the mucosa and glands of the hard palate, as well as the anterior soft palate; Artery is branch of pterygopalatine part of Maxillary artery

Front 400

Lesser Palatine Artery and Nerves

Back 400

#15

Hint 400

usually two lesser palatine nerves which emerge from the lesser palatine foramina and supply the mucosa and glands of the soft palate and uvula. The posterior superior lateral nasal branches reach this aspect of the nasal cavity and also supply the superior and middle nasal concha/meatuses and posterior ethmoidal sinuses

Front 401

Posterior Superior Nasal/Alveolar Nerve (of Pterygopalatine Ganglion, CN V2 - ZIPS)

Back 401

#13

Hint 401

Travel as NVB; reach this aspect of the nasal cavity and also supply the superior and middle nasal concha/meatuses and posterior ethmoidal sinuses. (The posterior superior medial nasal branches supply the posterior superior nasal septum

Front 402

Anterior Superior Alveolar (of Infraorbital Branch of CN V2 - ZIPS)

Back 402

#53

Hint 402

Travels with NVB; Maxillary vestibular gingivae of anterior teeth supplied by anterior and
middle superior alveolar and infraorbital; run along the lateral walls of the sinus btw the mucosa and bone from the infraorbital nerve

Front 403

Middle Superior Alveolar (of Infraorbital Branch of CN V2 - ZIPS)

Back 403

Hint 403

Maxillary vestibular gingivae of anterior teeth supplied by anterior and middle superior alveolar and infraorbital; run along the lateral walls of the sinus btw the mucosa and bone from the infraorbital nerve

Front 404

Infraorbital Canal

Back 404

Hint 404

opens just below the margin of the orbit; transmits the infraorbital nerve as well as infraorbital artery, both of which enter this canal at the infraorbital groove and after coursing through the maxillary sinus exit via the infraorbital foramen

Front 405

Zygomaticofacial Nerve (Zygomatic of CN V2 - ZIPS)

Back 405

B

Hint 405

lateral to infraorbital canal

Front 406

Nasopalatine Nerve

Back 406

#22

Hint 406

nerve lies in the pterygopalatine fossa as a branch of CNV2. It enters the nasal cavity through the sphenopalatine foramen to reach the septum, then descends to the roof of the mouth through the incisive foramen, giving rise to the incisal branch and communicating with the corresponding nerve of the opposite side along with the greater palatine nerve. It supplies palatal structure around the maxillary central and lateral incisors and the nasal septum

Front 407

Lingual Branch of Glossopharyngeal Nerve

Back 407

Hint 407

posterior to palatoglossal fold, runs medially and on posterior border of stylopharyngeus muscle for a short distance before it passes deep to hyoglossus muscle to enter the deep portion of the tongue

Front 408

Lingual Frenulum

Back 408

Hint 408

midline fold of mucous membrane running from lingual gingiva
behind mandibular central incisors posteriorly to undersurface of tongue

Front 409

Sublingual folds

Back 409

Hint 409

produced by underlying sublingual salivary glands running
posteriorly and laterally from the lingual frenulum – horse-shoe shaped

Front 410

Sublingual gland

Back 410

Hint 410

primarily mucous-secreting salivary gland
- Located in floor of mouth, nestles laterally in sublingual fossa of mandible and
medially against base of tongue
- It is elongated – L and R meet anteriorly →horseshoe shape of sublingual folds
- Covered by a thin lining of mucosa to separate from oral cavity

Front 411

Sublingual caruncle

Back 411

Hint 411

eminence on either side of the frenulum of the tongue, on which the major sublingual and the submandibular duct open

Front 412

Median Lingual Sulcus

Back 412

Hint 412

runs posteriorly along the dorsum from the apex of the
tongue – divides the tongue into two lateral halves

Front 413

Sulcus terminalis

Back 413

No Number

Hint 413

v-shaped groove whose apex points posteriorly in midline –
divides tongue into anterior 2/3 and posterior 1/3

Front 414

Foramen cecum

Back 414

Hint 414

small pit at apex of sulcus terminalis – vestige of proximal
end of thyroglossal duct

Front 415

Fungiform papillae

Back 415

#2

Hint 415

found on anterior 2/3 tongue, globular, bright red, mainly
at tip and lateral margins of tongue, contain few taste buds

Front 416

Filiform papillae

Back 416

#4

Hint 416

most numerous papillae on anterior 2/3 tongue, arranged in
-shaped rows parallel to sulcus terminalis, give tongue rough texture (helps in handling food), contain sensory nerve endings (very sensitive touch corpuscles)

Front 417

Circumvallate Papillae

Back 417

#1

Hint 417

large and circular, about 12 are located in a v-shaped
row anterior to sulcus terminalis, each surrounded by circular trough (contain many taste buds)

Front 418

Parotid Papilla

Back 418

Hint 418

where orifice/opening of parotid duct into oral cavity is located – at
occlusal level of maxillary 2nd molar