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171 Cards in this Set

  • Front
  • Back

1. Major cranial nerve with only motor functions, found in the posterior triangle of the neck?





2. Which muscles does it innervate?

1. CN XI – the spinal accessory nerve





2. It innervates the SCM and the trapezius

Which vascular structure in the anterior neck functions as a baroreceptor?

the carotid sinus

Which structure in the anterior neck functions as a chemoreceptor?

the carotid body

Which nerve runs down the anterior border of the anterior scalene muscle?

the phrenic nerve
What are the 3 major components found within the carotid sheath?
carotid artery
internal jugular vein
vagus nerve (CN X)

What are the 2 major thyroid arteries and from where do they arise?

1. Superior thyroid artery - external carotid



2. inferior thyroid artery - thyrocervical trunk off the subclavian

The isthmus of the thyroid gland usually lies anterior to what structure?

Proximal trachea (below the cricoid cartilage, anterior to the second and third tracheal rings)
What percentage of people have a pyramidal lobe found on the thyroid gland?
~50%
Which nerve is endangered during surgical removal of the thyroid gland?
the recurrent laryngeal nerve
What are the common names for the first and second cervical vertebrae?
atlas (C1)
axis (C2)
What artery travels through the foramina of the transverse processes of the cervical vertebrae?
the vertebral artery
Damage to what structure in the neck will produce Horner’s syndrome?
Damage to the sympathetic nerves or sympathetic chain will cause Horner’s syndrome.
Name of the space between the prevertebral fascia and the buccopharyngeal fascia (behind the pharynx)?
the retropharyngeal space
Thoracic outlet syndrome refers to compression of the ________ and/or __________.
brachial plexus
subclavian artery
Where is the anterior fontanelle located?
At the junction of the sagittal , coronal, and metopic sutures



(the metopic suture is the temporary suture between the two frontal bones which remain paired for a short period after birth).

The mastoid process is a feature of which cranial bone?

temporal bone

The styloid process is a feature of which cranial bone?

temporal bone

muscles of facial expression or mastication:



Platysma

facial expression

muscles of facial expression or mastication:



Orbicularis oris

facial expression

muscles of facial expression or mastication:



Buccinator

facial expression

muscles of facial expression or mastication:



Medial pterygoid

mastication

muscles of facial expression or mastication:



masseter

mastication

muscles of facial expression or mastication:



Zygomatic major

facial expression

muscles of facial expression or mastication:



temporalis

mastication
Which cranial nerve innervates the muscles of facial expression?
CN VII- facial

which cranial nerve innervates the muscles of mastication?

CN V- trigeminal
Which cranial nerve is responsible for the sensory innervation of the face?
CN V- trigeminal
Which cranial nerve is damaged in the condition known as Bell’s palsy?
CN VII- facial

Which of the following arteries are not branches of the external carotid artery?



Facial, lingual, retromandibular, occipital, maxillary, superior thyroid, inferior thyroid

retromandibular- name of facial vein



inferior thyroid

By convention, how many layers of tissue make up the scalp?



Which of these constitute the scalp proper?

The scalp is composed of 5 layers;



1. Skin,


2. Connective Tissue,


3. Aponeurosis (Galea),


4. Loose connective tissue,


5. Periosteum


The scalp proper is 1-3

In which layer of the scalp are the nerves and vessels located?
Connective tissue
Which layer of the scalp is known as the dangerous area?
Loose connective tissue
In what anatomical region would you find the origin of the branches of the maxillary artery?
infratemporal fossa
In what anatomical region would you find the origin of the branches of the mandibular nerve (V3)?
infratemporal fossa
The parasympathetic fibers from the otic ganglion travel to which gland?
parotid gland



(nerve is responsible for salivation)

Which cranial nerve innervates the muscles that cause movement at the TemporoMandibular joint?
CN V- trigeminal
muscles that move the TMJ are the muscles of mastication
Which cranial nerve can be found dividing into several branches inside the parotid gland?
CN VII facial
Which small space inside the skull is situated between the nasal cavity and the infratemporal fossa?
pterygopalatine fossa
Where would you find the palpebral portion of the orbicularis oculi muscles?
on the eyelids
1. which muscle (of mastication) does the parotid duct cross



2. which muscle (of facial expression) does it pierce?

1. the duct crosses the masseter



2. pierces the buccinator

What is the calvaria?
The calvaria is the upper domelike portion of the bony skull (the skullcap).
Where is the coronal suture?
lies between the frontal bone and the two parietal bones.
Where is the sagittal suture?
The sagittal suture is on the top of the skull between the two parietal bones.

1. Where is the pterion?





2. Why is it a clinically important landmark?

1. The pterion is an “H”-shaped sutural junction located on the lateral aspect of the skull. (where the greater wing of the sphenoid, the squamous temporal, the frontal, and the parietal bones come together)




2. It lies over the course a branch of the middle meningeal artery branch. Fractures across the pterion can lead to epidural hematomas.

1. Where would one find the middle meningeal artery?





2. From what artery does it arise?

1. Its branches travel between the inside of the skull bones and the dura mater.




2. It arises from the maxillary artery and enters the cranial cavity through the foramen spinosum.

What type of hematoma typically results from tearing the middle meningeal artery?
Epidural hematomas
What cranial fossa contains the foramen magnum?
Posterior cranial fossa
What cranial fossa contains the superior orbital fissure?
middle cranial fossa
1. What is the sella turcica?



2. What important glandular structure is associated with it?

1. The sella turcica is a saddle-like prominence on the upper surface of the sphenoid bone (middle cranial fossa)



2. It contains the pituitary gland

1. What is a gyrus?





2. What is a sulcus?

1. one of the prominent rounded elevations that form the cerebral hemispheres.



2. The grooves on cerebrum that separate the gyri

Where is the pons located?
Ventral surface of the brainstem



(between the midbrain and the medulla oblongata, & inferior to the cerebellum.)

Where is the medulla oblongata located?
Between the pons and the spinal cord.



It is continuous with the spinal cord at the foramen magnum

What is the falx cerebri?
The sickle-shaped fold of dura mater in the longitudinal fissure (LF) between the two cerebral hemispheres.



(the LF is the groove that separates the 2 hemispheres)

What would one find within the superior sagittal sinus?
It contains venous blood & arachnoid granulations (protrude into the sinus from beneath as the CSF pressure rises)
How does cerebral blood drain from the cranial cavity?
1. first collects in larger cerebral veins

2. these drain into the dural venous sinuses.


3. Which drain into the internal jugular vein.

1. What are emissary veins?



2. Why are they clinically important?

1. Connect the venous sinuses of the dura mater and the veins of the diploë and the scalp.



2. Potential passage for the spread of infection between the scalp and the intracranial venous sinuses.

Where is cerebrospinal fluid (CSF) produced?
By the choroid plexus

(in the ventricles of the brain)

How does the CSF eventually drain into the venous system?
Through the arachnoid granulations and into the superior sagittal sinus.
What is hydrocephalus?
Excessive accumulation of CSF within the cranial cavity.



(a congenital blockage of the cerebral aqueduct, results in dilation of the cerebral ventricles, thinning of the brain tissues and separation of cranial bones)

Which two pairs of major arteries enter the cranial cavity to supply blood to the brain?
Internal carotid arteries and the vertebral arteries.
What is the major unpaired artery that is formed from the two vertebral arteries within the cranial cavity?
The basilar artery.
How do the anterior, middle, and posterior cerebral arteries arise?
Internal carotid arteries divide into the anterior and middle cerebral arteries.



The single basilar artery divides into two posterior cerebral arteries.

How many pairs of cranial nerves are there?
12
What is the name of the seventh cranial nerve?
facial
What is the name of the tenth cranial nerve?
vagus
What is the cranial nerve number of the glossopharyngeal nerve?
CN IX
Which cranial nerves travel through a foramen associated with the internal jugular vein?
CNs IX, X, and XI
Which cranial nerves travel through the cribriform plate openings?
CN I
Which cranial nerves travel through the superior orbital fissure?
CNs III, IV, V1, VI
1. In which cranial fossa is the internal auditory meatus located?



2. Which cranial nerves travel through it?

1. posterior cranial fossa

2. CNs VII and VIII

Which cranial nerve has a component that travels through the foramen magnum?
CN XI (spinal accessory nerve)
How do postganglionic sympathetic nerves get into the cranial cavity?
Enter via a plexus (travel along with the internal carotid arteries)
What glandular structure lies immediately inferior to the optic chiasm?
pituitary gland
Which cranial nerve structure lies within the Circle of Willis?
The optic chiasm of CN II lies within the Circle of Willis.
Where is the cavernous sinus located?
located on either side of the sella turcica (middle cranial fossae)

Which artery travels directly through the cavernous sinus?

The internal carotid arteries
How is the eyelid elevated and closed?
What nerves are responsible for this movement?
The levator palpebrae superioris muscle elevates the eyelid (attached to tarsal plate)

CN III




Orbicularis oculi muscle closes eyelid


CN VII



Where are tears produced

how do they travel to the nasal cavity?


What structures do they pass through?

1. By the lacrimal gland (parasympathetic fibers from facial) that



2. Flow medially to the puncta in the lacrimal papillae of the eyelids. T




3.


A. Pass through the canaliculi


B. to the lacrimal sac


C. to the nasolacrimal duct


D. into the inferior meatus of the nose.

What are the conjunctiva of the eye?
The mucous covering of the eyeball and inner surface of the eyelid.
1. What are the sclera?



2. the cornea of the eye?

1. White of eye (connective tissue layer)



2. Clear layer through which light enters the bulb.

What muscles move the eye up (elevate)?

1. superior rectus

2. inferior oblique muscles

1. What are the iris?



2. The lens of the eye?

1. The iris is the diaphragm at the front of the eyeball



2. The lens sits just behind and changes shape to focus the light on the retina.

What muscles move the eye down (depress)?
1. inferior rectus



2. superior oblique

What is the pupil of the eye?
The pupil is the opening adjusted by movement of the iris.
What muscle moves the eye medially (adduct)?



Innervation

medial rectus muscle
What muscle moves the eye laterally (abduct)?
lateral rectus muscle
What nerves innervate the Superior oblique
trochlear (CN IV)
What nerves innervate the Lateral rectus
abducens (CN VI)
What nerves innervate all the other oculomotor muscles
(CN III)
What are the layers of the eyeball?
1. outer fibrous layer (sclera & cornea)



2. middle vascular layer (choroids, ciliary body, ciliary processes, and iris).




3. inner layer (retina)

What is the ciliary body?
1. the muscles which control the shape of the iris



2. point of attachment for suspensory ligaments of the lens (also controls shape)

What is the function of the retina?
Translates light into neural impulses for transmission through the optic nerve
Where vision is the most acute?
The fovea centralis of the macula lutea
What is the blind spot?
The optic disc



(where the optic nerve and ophthalmic vessels enter the eyeball - not covered with a sensory layer)

How the blood is distributed to the orbit and eyeball?
1. Blood enters back of eye via the ophthalmic artery (branch of the internal carotid)



2. It also gives off the central artery of the retina (this travels through the center of the optic nerve to the optic disc)

Major branches of the ophthalmic division of the trigeminal nerve?
1. Frontal (divides into supraorbital and supratrochlear)



2. Lacrimal




3. Nasociliary.

What nerve is sensory to the cornea?
Nasociliary nerve
1. How does the iris open and close?

2. What muscles and nerves are responsible?

1. Opened: dilator pupillae (by radial muscles)

via sympathetic fibers from the cervical sympathetic trunk




2. Closed: sphincter pupillae (circular sphincteric fibers)


via parasympathetic fibers from the oculomotor nerve

How does the lens changes shape?



What muscle and nerve is responsible?





1. Via suspensory fibers connected to the ciliary body.



2. The ciliary muscle is innervated by CN III (parasympathetic fibers)




Stretching of lens: far vision


Contraction and rounding of lens: near vision

What structures transmit and focus light on the retina?
1. via the cornea, lens, & vitreous humor.



2. The lens is the only one that is adjustable.

1. How does blood drain from the eye?



2. What is relevance of the facial vein?

1. The ophthalmic vein (OV) drains through the superior orbital fissure and into the cavernous sinus.



2. The OV has many connections with the facial vein. This allows infections to travel from the facial vein to the cavernous sinus (may lead to meningitis).

1. What are the openings in the posterior wall of the orbit



2. What passes through them?

1. Optic foramen:

A. optic nerve


B. ophthalmic artery


2.Superior orbital fissure:


A. oculomotor


B. trochlear


C. abducens


D. trigeminal (ophthalmic division)


E. ophthalmic vein.

1. What cranial nerves are found in the eye and orbit?

2. what they do?

1. Optic nerve (CN II) – vision.

2. Oculomotor nerve (CN III) – movement of muscles of the eye & parasympathetic fibers to the muscles in iris and ciliary body.


3. Trochlear nerve (CN IV) – motor nerve to the superior oblique muscle.


4. Trigeminal nerve (CN V) – ophthalmic division V1 is sensory to the skin over the orbit, the surface of the eyeball and cornea.


5. Abducens nerve (CN VI) – motor nerve to the lateral rectus muscle.


6. Facial nerve (CN VII) – parasympathetic fibers to stimulate the lacrimal gland & motor nerves to the orbicularis oculi.

where does the auditory (Eustachian) tube open?
It opens into the lateral wall of the nasopharynx just posterior to the nasal cavity.
What structure surrounds this opening?
The torus tubarius

(helps maintain patency of the auditory tube).

where are the sinuses surrounding the nasal cavities located and where do they drain?
1. Frontal sinuses - drain through frontonasal duct to the middle meatus at the anterior hiatus semilunaris.

2.Ethmoid sinuses - drain into the middle meatus


3. Sphenoid sinuses - drain to the space above the superior conchae (sphenoethmoidal recess).


4. Maxillary sinus - drain to the middle meatus at the posterior hiatus semilunaris.

how is the maxillary sinus different?
1. mucus must be directed upward by the ciliated epithelium to the opening. It is difficult to drain when the sinus is filled and the individual is upright.



2. Roots of the teeth form conical elevations that protrude into the floor of the sinus - infections at the roots can penetrate into the sinus

what other major structures are related to the maxillary sinus?
The orbit is separated from the sinus by a thin sheet of bone. The close proximity of teeth to the floor of the sinus is also important.
what nerves innervate the walls of the nasal cavity?
1. Maxillary division of the trigeminal nerve (CN V2) - supply the mucosa



2. Nasopalatine nerve - supplies the nasal septum.


3. Olfactory nerves - supply the upper part of the nasal cavity

what nerves stimulate mucous secretion in the nasal cavity?
Facial nerve (CN VII) via Parasympathetic fibers
where does the blood supply to the nasal cavity originate?
From branches of the sphenopalatine artery, which is a continuation of the maxillary artery.
what muscles are associated with the soft palate and what do they do?
1. Levator veli palatini - elevates the soft palate



2. Tensor veli palatini - flattens soft palate


3. Palatopharyngeus - narrows the opening between the oropharynx and nasopharynx.

what are the three areas of the pharynx?
nasopharynx
oropharynx
laryngopharynx
what is the function of the 3 pharyngeal constrictors?
contract involuntarily to propel food into the opening of the esophagus
what innervates the wall of the pharynx?
the pharyngeal plexus is formed by the vagus (CN X) and spinal accessory (CN XI)
where are the major tonsilar structures located?
1. pharyngeal tonsils (adenoids if inflamed) are located adjacent Eustachian tube openings (in the nasopharynx)

2. palatine tonsils are located on the lateral walls of the oropharynx


3. lingual tonsils are back of the tongue.

1. what two bones are primarily responsible for side-to-side movement of the skull



2. and nodding of the head?

1. atlas & axis = side to side movement



2. occipital bone of skull & atlas = nodding (flexion-extension)

what does the alar ligament do?
1. Connects the dens with the occipital bone

2. limits rotation of the skull on the vertebral column.

what does the dens do and what holds it in place?
1. Found on the atlas & Forms the point of rotation of the atlas on the axis.

2. Held in place by the cruciate ligament.

1. what is the space between the cervical vertebral bodies and the posterior pharyngeal wall

2. its clinical significance?

1. The retropharyngeal space
2. route for infections in the neck to the superior mediastinum.
What is the oral vestibule?
The space between the lateral surfaces of the teeth (and gums) and the inside of the cheeks and lips.
1. How many permanent teeth are there?



2. deciduous (baby)teeth?

32

20

Which cranial nerve provides sensation to the upper and lower teeth?
Trigeminal (CN V).
V2 supplies branches to the upper teeth
V3 branches to the lower teeth
Which muscle of the palate is innervated by CN V?
Tensor veli palatini m.
Which muscle of the palate appears to emerge from the auditory tube opening in the nasopharynx?
Levator veli palatini m
Which cranial nerve provides taste sensation to the taste buds in the circumvallate papillae and posterior 1/3 of the tongue? general sensation?
Glossopharyngeal (CN IX)
Which cranial nerve innervates the muscles of the tongue?
Hypoglossal (CN XII) innervates every tongue muscle except the palatoglossus.
Which cranial nerve provides taste sensation to the anterior 2/3 of the tongue?
chorda tympani branch of Facial (CN VII)
Which cranial nerve provides general sensation to the anterior 2/3 of the tongue?
Trigeminal (mandibular branch - CN V3) via the lingual nerve
What is the major artery that supplies blood to the tongue? From what artery does it arise
The lingual artery – a branch of the external carotid.
Which salivary glands have ducts that pierce the buccinator muscles?
the duct of the parotid gland pierces the buccinator m.
Which salivary glands have ducts that open on either side of the frenulum of the tongue?
The submandibular glands
What structure lies between the palatoglossal and palatopharyngeal folds?
palatine tonsil
How can you determine if the right hypoglossal nerve is damaged?
If the right hypoglossal nerve is damaged, the protruded tongue will deviate to the right.
where are the valleculae, vestibule, and piriform recesses located?



(places where food can become trapped)

1. Valleculae - either side of the midline, posterior to the tongue and anterior to the epiglottis.

2. Piriform - is the space in the laryngopharynx just posterior to the larynx between the thyroid cartilage and the aryepiglottic fold.




3. Vestibule - the space posterior to the epiglottis between the aryepiglottic folds and above the false vocal folds (entryway to the respiratory tract)

what is the narrowest part of the airway and where is it located?
1. rima glottidis



2. found between the true vocal cords

what nerves innervate the mucosal surface of the larynx and where do they originate?
1. internal laryngeal branch of the superior laryngeal nerve - down to the vocal cords
2. inferior (recurrent) laryngeal nerve - mucosa up to the level of the vocal cords

3. Both laryngeal nerves derive from the vagus nerve.

what composes the larynx cartilage?


1. thyroid cartilage,


2. cricoid cartilage,


3. epiglottis,


4. arytenoid cartilages.

1. what are the muscles control the vocal cords, 2. what nerve innervates them?

1.


A. Posterior cricoarytenoid m. - Abduction of cords

B. Lateral cricoarytenoid m. - Adduction of cords
C. Cricothyroid m. - Stretch vocal cords
D. Thyroarytenoid m. - alters tension (changes pitch)



2. Inferior (recurrent) laryngeal n. (branch of vagus)

when are the vocal cords opened and closed?

1. opened when speaking or breathing

2. closed when attempting to increase intra-thoracic and/or intra-abdominal pressure or just prior to coughing.



how sound is produced?
1. when air is moved through the rima glottidis of the vocal cords.

2. pitch is changed due to contraction of the vocalis muscle (change in tension)


What is found between the true and false vocal cords?
The space between the true and false vocal folds is known as the ventricle.
where is the vocal cord/ligament located?
at the free medial edge of the fold (exposed to the air, and can therefore vibrate).
what is the function of the vocalis muscle?
Altering the tension of the vocal ligament, thus changing the pitch of the voice.
why is damage to the inferior laryngeal nerves important?
1. They control the muscles of the larynx.

2. Damage can cause loss of voice.

what happens if only one nerve is damaged in the vocal cords?
leads impaired movement of cord on one side, resulting in hoarseness
how does the Heimlich maneuver work?
1. Object is lodged in vestibule above the vocal folds.



2. Heimlich maneuver = thoracic cavity is squeezed, increasing pressure and forcing air up against the lodged object.

what is done during a cricothyrotomy?
cut in cricothyroid membrane to allow breathing
What are the major features of the medial and lateral ‘walls’ of the middle ear?
1. The lateral wall is made up of the tympanic membrane and the chorda tympani n.

2. The medial wall is made up of the promontory (the bulge formed by the first turn of the cochlea of the inner ear) which is covered by fibers of the tympanic plexus.




3. Promontory has two small openings, the oval window where the footplate of the stapes is inserted, and the round window

In which bone is the middle ear located?
The petrous portion of the temporal bone
What are the mastoid air cells and why they are important?
1. Found in the mastoid process of the temporal bone.

2. a middle ear infection (otitis media) may spread to these spaces (they can thus act as a reservoir of infection)

What is the roof of the tympanic cavity and what structure is close to it?
1. Tegmen tympani.

2. It is adjacent to the dural lining of the cranial cavity, Infection can erode through the tegmen and into the brain

What are the openings into the middle ear cavity?
1. auditory (pharyngotympanic) tube anteriorly

2. mastoid antrum posteriorly.

1. What are the ossicles
malleus, incus, and stapes.
1-2. What two muscles dampen movement of the ossicles?
3. Why is that important?
1. Tensor tympani (via the malleus)

trigeminal nerve (V3).


2. Stapedius (via the stapes).


facial nerve (VII).
3. a reflex function that protects from damaging noise

1. What is the function of the tympanic membrane?

2. what structures cross it?


3. Why is that important?

1. vibrates due to sound waves. It transmits that movement to the ossicles,



2. The chorda tympani n. from the facial nerve (VII) crosses the tympanic membrane.




3. Damage here can which interfere with the taste function of the anterior 2/3 of the tongue

How does the membrane change with a middle ear infection?
presence of fluid in the tympanic cavity behind the membrane results in the no longer being able to see the ‘cone of light’ present on a normal membrane.
What is the auricle?
The auricle is the external ear structure that functions to collect sound, and funnel it into the external meatus
Where is sound converted to neural impulses in the ear?
1. Sound is converted into neural impulses within the inner ear.

2. Movement of the footplate of the stapes causes movement of fluid in the cochlea.


3. This movement is sensed by neural cells within the cochlear duct that then transmit signals to the brain via the vestibulocochlear nerve (CN VIII).

What are the main functions of the inner ear?
1. hearing,

2. detection of the position of the head in space 3. balance (semicircular canals)


4. detecting body acceleration and deceleration.

What is otitis media?
inflammation and accumulation of fluid within the tympanic cavity from swelling of auditory tube.
What are the two types of hearing loss?
1. conductive - impaired movement of the ossicles or damage to the tympanic membrane



2. sensorineural - due to damage within the cochlea, the nerve cells there, the brain.

Will patients with head trauma be more likely to receive plain X-ray imaging or CT?
CT

What 2 different “windows” are used in CT imaging?

bone window
soft tissue window
What can be imaged with CT scans of the cranium?


1. Optic canal,

2. Foramen rotundum,


3. Foramen ovale,


4. Internal acoustic meatus,


5. Jugular foramen

What advantage does MRI provide when imaging the skull and CNS?
1. better resolution of the brain and spinal cord 2. better visualization of CNS pathology
In which MRI mode will the CSF be dark?
T1
What mode of MRI is most useful in visualizing CNS pathology related to hemorrhagic bleeding?
T2
Name three imaging methods used to gain information about the function or functional states of different regions of the brain.
F-MRI
PET
SPECT
which imaging methods require the use of radioactive compounds
PET
SPECT
what component of blood does F-MRI make use of to generate images?
the iron in the hemoglobin molecules