click below
click below
Normal Size Small Size show me how
Raj Gross III ex 2
NYCC head and neck exam 2, Dr. Raj Philomen WI10
Question | Answer |
---|---|
Boundaries of face (3) | Superior-hairline. Inferior-chin. Lateral-auricles. |
Skin is highly ___________, therefore it will bleed __________ but recover quickly. | vascular, profusely |
Skin contains a large number of ________glands. (2) | sebaceous (keep face oily), sweat |
Infection of the sebaceous glands | acne |
sweat function | control body temperature |
skin is __________attached to underlying structures | loosely |
Because skin is loosely attached to underlying structures but fixed to underlying __________, boils under the skin are painful. | cartilage |
skin is _______ & thick because the muscles of facial expression are attached | elastic! |
Because of skin thickness, wounds tend to _____, then heal by forming a ________tissue and then a scar. | gap, fibrous |
the ___________fascia of the skin of the face is loosely arranged. | superficial |
Is there deep fascia of skin of face? | NO (exception: capsule for parotid and submandibular gland) |
What will cause edema to first appear in the face? What is this called? | Kidney failure, nephrotic syndrome |
What will cause edema to first appear in the lower extremities? What is this called? | Heart failure, pitting edema |
Any inflammation of the ______ or ______ of the face will be painful because these structures are tightly stretched. | nose, ear |
Which syndrome displays distended belly and puffy face? | Kwashikor's |
Which muscle is seen around the orbital margin? | Orbicularis oculi (O. oculi) |
Which cranial nerve supplies the muscles of facial expression, anterior 2/3 of tongue taste, superior salivatory nucleus supplies it: | Facial CN VII |
what are the 5 divisions of the facial nerve? | Two Zebras Bit My Cat: Temporal, Zygomatic, Buccal, Marginal mandibular, Cervical |
Two Zebras Bit My Cat, Tell Ziggy Bob Marley Called, Tight Zippers Bruise My Crotch - use any of these, but tell me what they are... | 5 branches of C.N.VII-Facial (Temporal, Zygomatic, Buccal, Medial Mandibular, Cervical) |
3 parts of Orbicularis oculi: | 1-orbital, 2-palpebral, 3-lacrimal (LOP) |
L.O.P. | Lacrimal, Orbital, Palpebral - the three parts of Orbicularis oculi muscle |
The ORBITAL part of O.oculi arises from | medial part of medial Palpebral Ligament |
Where is the medial palpebral ligament? What arises from it? | medial corner of eye, the orbital part of the O. oculi muscle |
the ORBITAL part of the O.oculi muscle forms a ________around the orbit, and returns to its point of origin. | circle |
Contraction of the ORBITAL part of O.oculi produces: (2) | closes eye tightly, vertical wrinkling (If you do not know what that is, wait 15 years). |
Another description for action of ORBITAL part of O.oculi muscle instead of "closes eye tightly" is | snaps shut in defense! |
The __________part of O.oculi arises from the lateral part of the medial palpebral ligament. | PALPEBRAL |
What arises from the lateral part of medial palpebral ligament? | PALPEBRAL part of O.oculi |
Orbital part of Orbicularis oculi arises from _________ part of medial palpebral muscle. | Orbital part of O.oculi is from medial part of medial palpebral ligament. |
The PALPEBRAL part of O.oculi arises from lateral part of medial palpebral ligament and attaches onto | Lateral Palpebral RAPHE |
What is the difference in insertions between the ORBITAL part and PALPEBRAL part of O.oculi? | Orbital part is a circle (orbit=circle) - it ends where it began at the medial part of the medial palpebral ligament. Palpebral part -starts at lateral part of medial palpebral ligament, goes right along lid to lateral palpebral Raphe. |
Function of PALPEBRAL part of O.oculi that runs along lid from lateral part of medial palpebral ligament to lateral palpebral raphe? | closes the eye gently, causes BLINKING |
palpo means to | touch softly; caress, flatter (origin of PALPEBRAE) |
palpebrae means | eyelid |
Why would 'palpo' (to touch softly; caress, flatter) be the word origin of PALPEBRAE? | Palpebrae part of O. oculi closes eye gently, blinks - things we associate with reactions to flattery and bedroom eyes) |
The _________ part of Orbicularis oculi arises from the lacrimal bone and lacrimal fascia. | LACRIMAL |
the LACRIMAL part of O.oculi arises from (2) | lacrimal bone and lacrimal fascia |
the LACRIMAL part of O.oculi attaches to (2) | superior tarsus & inferior tarsus |
tarsus (of eye area) | thickening of the palpebral fascia, deep to the superficial fascia in the eyelids, that gives contour to the eyelids |
What is the origin of the LACRIMAL part of O.oculi? Insertion? | Lacrimal bone & fascia (origin), Superior & Inferior tarsus (insertion) of LACRIMAL part of Orbicularis oculi |
Action of LACRIMAL part of O.oculi? | dialates the lacrimal sac |
thickening of palpebral fascia that gives shape/contour to eyelid | tarsus (also insertion of Lacrimal part of O.oculi) |
Muscle that completely surrounds the upper & lower lips | Orbicularis ORIS |
will you i.d. Orbicularis oris muscle in our cadaver for lab test? | No |
Action of Orbicularis oris? | closes mouth (sphincter, just like all the others) |
The Orbicularis ORIS has 3 | strata (pl.) singular is 'stratum' |
One of several parallel horizontal layers of material arranged one on top of another | stratum (stratification, stratify, stratosphere) - Orbicularis ORIS has 3! |
3 stratum of Orbicularis ORIS | deep, middle, superficial |
the deep stratum of O.oris is called the ________part | intrinsic |
The Intrinsic layer of O.oris forms the _______stratum. | deep |
The Intrinsic layer of O.oris deep stratum has 2 slips of muscles: | 1-superior incisivus taking origin from maxilla, 2-inferior incisivus taking origin from mandible |
the intrinsic layer of deep stratum of O.oris has 2 slips of muscles, both with the word 'incisivus', each orginating from the bone of upper and lower jaw. What are they? | 1-superior incisivus taking origin from maxilla and 2-inferior incisivus taking origin from mandible |
Which part of O.oris forms the middle and superficial stratum? | Extrinsic |
the __________stratum of the extrinsic part of O.oris is derived from the Buccinator muscle. | middle (remember-buccinator is what balances your food on your molars, so it's between the masseter and the wall of the mouth. It is in the MIDDLE/MOLAR/BUCCINATOR stratum. |
Triangles of the Neck (2 great triangles) | Anterior triangle(s) and Posterior triangle(s) |
Boundaries of side of neck for all triangles | anterior=anterior midline, posterior=anterior border of trapezius, superior=base of mandible & a line from the angle of mandible to mastoid process, inferior=clavicle |
what divides the side of neck into anterior and posterior triangles? | SCM (sternocleidomastoid muscle) |
the _______ of the triangles is formed by skin, superficial & deep cervical fascia. | roof |
the roof of the triangles is formed by | skin, superficial & deep cervical fascia |
deep cervical fascia has 4 parts: | 1-investing layer, 2-pretrachial layer, 3-prevertebral layer, 3-carotid sheath |
the _________layer of the deep cervical fascia encloses 2 muscles, 2 glands, and 2 spaces. | Investing layer |
the __________layer forms the roof of the posterior triangle and splits to enclose 2 muscles, 2 glands, 2 spaces. | Investing layer |
The investing layer of the deep cervical fascia forms the roof of ___________________ and splits to enclose ______________________. | posterior cervical triangle/ 2 muscles, 2 glands, 2 spaces |
The investing layer (roof)of deep cervical fascia forms the posterior triangle of neck and encloses 2 muscles, 2 glands, 2 spaces. Name the 2 of each category: | 2 muscles: SCM and trapezius, 2 glands: parotid and submandibular, 2 spaces: suprasternal (notch) and supraclavicular (notch) |
name the two muscles of the investing layer (roof) of deep cervical fasica forming the posterior triangle | SCM & trapezius |
name the 2 glands covered by the investing layer (roof)of deep cervical fascia of posterior triangle | submandibular and parotid |
name the 2 spaces covered by the investing layer of deep cervical fascia | suprasternal and supraclavicular (the two apparent external landmark triangles attached to inferior bone and formed by SCM and traps) |
the _________layer of the deep cervical fascia suspends the thyroid via the Berry suspensory ligament, a product of the deep cervical fascia condensed into a strong band. | Pretracheal layer |
the deep cervical fascia 4 layers: | investing, pretracheal, prevertebral, carotid sheath |
the _________layer of deep cervical fascia suspends the thyroid gland via ligament of Berry (suspensory ligament) formed by the codensation of the d.c.f. | pretracheal layer |
pretracheal layer (roof)of deep cervical fascia= | suspends thyroid gland via Berry ligament |
investing layer (roof)of deep cervical fascia (roof)= | 2 muscles, 2 glands, 2 spaces |
the __________layer of deep cervical fascia forms the floor of the posterior triangle | prevertebral layer |
the prevertebral layer of deep cervical fascia forms the ________of the posterior triangle of the neck. | floor |
the prevertebral (floor) of the d.c.f. contributes to the formation of the __________ ________. | axillary sheath |
why would we need a sheath around the axillary contents? | because it contains the brachial plexus |
the __________ layer of deep cervical fascia fascia forms the floor of the posterior triangle and helps ensheath the axillary contents. | prevertebral |
the _______sheath covers the common carotid artery, internal carotid artery, internal jugular vein, ansa cervicalis nerve (+ sup. and inf. root branches), and vagus nerve. | CAROTID sheath |
see slide for carotid sheath | did you look at the slide? |
contents of carotid sheath: (5) | 1. common carotid artery, 2. internal carotid artery, 3. internal jugular vein, 4. ansa cervicalis, 5. vagus nerve |
how many routes of Ansa Cervicalis do we see in the in the anterior wall of the carotid sheath? | 2 (inferior & superior roots) |
on the posterior wall of carotid sheath, what do we see closely related to the carotid sheath but not inside it? | sympathetic chain (see slide of Ansa cervicalis) |
boundaries of the Posterior triangle (6) | Anterior= posterior border of SCM, Posterior= anterior border of trapezius, Inferior= middle 1/3 of clavicle, Apex= meeting point of SCM & trapezius, Roof= deep cervical fascia, Floor= several muscles covered by prevertebral layer, nerves, vessels |
anterior boundary of posterior triangle of neck | posterior border of SCM |
posterior boundary of posterior triangle of neck | anterior border of trapezius |
inferior boundary of posterior triangle of neck | middle 1/3 of clavicle |
apex of posterior triangle of neck | meeting point of SCM and trap |
roof of posterior triangle of neck | deep cervical fascia |
floor of posterior triangle of neck | prevertebral layer of deep cervical fascia covering several muscles (think scalenes and posteriorly), brachial plexus, subclavian artery, subclavian vein |
what muscles, for example, does the prevertebral layer of deep cervical fascia forming the floor of posterior triangle cover? | scalenes (ant,post,med), levator scap, splenius capitis, semispinalis capitis |
see slide of floor of posterior triangle | slide |
what nerve plexus helps form the floor of the posterior triangle? | Brachial plexus |
What vessels help form the floor of the posterior triangle of the neck? | Subclavian artery, Subclavian vein |
what divides the posterior triangle into and upper occipital and lower subclavian triangle? | INFERIOR BELLY of OMOHYOID |
'omo' means having to do with the | 1. (anatomy) shoulderFrom Proto-Indo-European *omso-. Cognates include Ancient Greek ὦμος (ōmos), Sanskrit अंस (áṃsa), Latin umerus and Gothic |
the inferior belly of the omohyoid divides the | posterior triangle |
the inferior belly of the omohyoid divides the posterior triangle into | upper occipital triangle, lower subclavian triangle |
what are the boundaries of the carotid triangle? | short side upper: digastric muscle, short side lower: posterior side of inferior belly of omohyoid, long side lateral: anterior side of SCM - if you choked someone, it is exactly where your thumb would pinch the hyoid towards the fingers |
what are the boundaries of the upper occipital triangle of greater Posterior triangle? | this looks like a sail...inferior border: inferior belly of omohyoid, long side medial: posterior border of SCM, long side lateral: anterior border of trapezius (remember the point of the sail is where the SCM and trap meet on the mastoid process) |
what are the boundaries of the lower subclavian triangle of the greater Posterior triangle? | looks like a pup tent...inferior border: middle clavicle, medial border is post SCM, lateral border is inferior border of inferior belly of omohyoid |
Into what 2 triangles is the greater Posterior triangle divided and by what structure? | upper occipital triangle & lower subclavian triangle, divided by the inferior belly of OMOHYOID muscle |
the greater Posterior triangle contains cutaneous nerves, motor nerves, and vessels. What are the cutaneous nerves? (4) | 1-supraclavicular n., 2-transverse cervical n. of the neck, 3- great auricular nerve, 4-lesser occipital nerve |
where is the transverse cervical nerve exactly? | from cervical plexus, emerges from behind post SCM (ergo, it is IN the posterior triangle initially) and whips forward and upward towards 'Adam's apple'. Superior branch to cricoid area; inferior branch 1/3 down platysma. Both emerge cutaneous platysma. |
describe the location of supraclavicular nerve | Emerges under transverse cervical n. Divides into anterior/medial branch @ base of platysma, intermediate branch to mid-clavicle, posterior/lateral branch toward acromioclavicular joint. |
where is the great auricular nerve visually? | emerges above transverse cervical n. Runs along posterior border of SCM up to ear lobe and a little behind. |
where is lesser occipital nerve? | Emerges with greater auricular then splits, running posteromedially, right over mastoid process then along head approx 1" or so behind greater auricular nerve. |
name the cutaneous nerves of the posterior triangle | 1-Transverse Cervical, 2-Supraclavicular, 3-Great Auricular, 4-Lesser Occipital |
function of Transverse Cervical nerve of posterior triangle of neck | from cervical plexus, receives motor fibers from CN VII Facial to supply Platysma |
function of Supraclavicular nerve of posterior triangle of neck | cutaneous supply to shoulder and clavicular regions (anterior, intermediate, posterior) |
function of Great Auricular nerve of posterior triangle of neck | posterior and anterior branches that supply skin behind ear |
function of Lesser Occipital nerve of posterior triangle of neck | uppermost cutaneous branch of cervical plexus, acts as a lateral communicating branch of greater occipital nerve at occiput |
name the Motor nerves of the posterior triangle of the neck (5 major) | 1-spinal accessory, 2-Brachial plexus (upper, middle, lower trunks), 3-suprascapular, 4-subclavian, 5-long thoracic nerve |
Where does the spinal root of the CN XI Accessory come from and where does it go? | emerges from anterior horns C1-6, travels through subarachnoid space, and unites with cranial root. These united fibers travel to trapezius and SCM to turn head and lift shoulder. Lives in posterior triangle of neck. MOTOR |
The upper, middle, and lower trunks of the ________________ are found in the posterior triangle. It passes between the anterior and middle scalenes to supply the arm and part of shoulder. | Brachial plexus lives in posterior triangle of neck (for this class). MOTOR |
The ____________nerve is MOTOR to the supra- and infraspinatus muscles on post scapula. It is found in the posterior triangle of the neck, since it is formed by C5-6. Runs to suprascapular notch! | Suprascapular nerve MOTOR |
the suprascapular nerve of the posterior triangle of neck is motor to | supraspinatus and infraspinatus |
the suprascapular nerve runs along brachial plexus then heads posteriorly to the (bony structure/landmark) | suprascapular notch |
the ___________nerve innervates the subclavius and often distributes a branch to Vagus X. | subclavian nerve MOTOR |
where is the subclavian nerve found, on its way to innervating subclavius? | posterior triangle of neck |
the _________________nerve pierces the middle scalenus muscle and runs on serratus anterior, which it innervates. | Long thoracic nerve MOTOR |
Where is the long thoracic nerve (for this class)? | in the posterior triangle of the neck |
name the 5 MOTOR nerves found in the posterior triangle of the neck: | 1-spinal accessory nerve, 2-Brachial plexus (anterior, middle, posterior), 3-subclavius nerve, 4-suprascapular nerve, 5-long thoracic nerve |
vessels of the posterior triangle (6 but can't see 1)) | SUPERFICIAL CERVICAL artery and vein, SUPRASCAPULAR artery and vein, SUBCLAVIAN vein, SUBCLAVIAN artery (cannot see) |
Where is the lesser auricular nerve? | There is NONE so use GREAT auricular nerve (not "greater") or it will be marked wrong on test. |
Great Auricular Nerve | supplies skin around parotid gland and angle of mouth |
Supraclavicular nerve | anterior, intermediate, posterior branches to clav and shoulder |
Transverse Cutaneous Nerve of the neck | branch of cervical plexus |
Lesser Occipital Nerve | supplies skin behind the ear |
Origin of SCM | clavicular and sternal heads |
What is difference between origins of SCM heads? | clavicular head is muscular, fleshy while sternal head is tendinous |
Insertion of SCM | united sternal and clavicular heads ascend to mastoid process of temporal bone |
Nerve to SCM | ACCESSORY CN IX - Spinal branch for MOTOR and propriorecption impulses from SCM to C2-3 (w/ vagus) |
Actions of SCM (3) | opposite side turn for unilateral contraction, together flexes forward against resistance, FORCED INSPIRATION muscle |
cystic hygroma is a | swelling of lymph nodes in the neck |
enlarged groups of swollen lymph nodes are called _________lymph nodes | matted |
matted lymph nodes may indicate 3 pathologies: | 1-TB, 2-Cancer, 3-Hodgkin's disease |
if tuberculosis, lymph nodes feel | rubbery |
if cancerous, lymph nodes feel | stoney hard |
if left supraclavicular lymph nodes are stoney hard, this usually indicates ___________ disease | Virchow's |
if generalized enlargement of lymph throughout body, ___________ disease | Hodgkin's disease |
stoney hard lymph nodes indicate cancer, especially if found in (2) | testes or stomach |
a "signal lymph node" is usually the first to | swell |
where are signal lymph nodes found in the neck? | Anterior triangle of neck: cervical lymph nodes, Posterior triangle of neck: supraclavicular lymph nodes |
a cystic swelling with fluid inside the lymph node is called a | cystic hygroma |
a swelling produced by accumulation of fat & lipids | lipoma (benign) |
a swelling of the costal element of C7 that develops into a rib and causes multiple problems is a | cervical rib (an extra rib above the typical thoracics - this can't be good!) |
A Cervical rib, (swelling of costal element of _____), may be either complete or incomplete. | C7 |
A complete costal rib is | attached to the sternum or 1st rib - asymptomatic |
An incomplete costal rib may either end as (2): | 1-enlarged bony mass projecting into the posterior triangle (bad), 2-tapered end attached to 1st rib by fibrous structure |
An incomplete costal rib may be exacerbated by exercise. How? (2) | exercise, due to the angulation of the subclavian artery over the rib or the pressure irritation of the lower trunk of the brachial plexus. |
nerve symptoms of incomplete rib "syndrome" pressing on brachial plexus LOWER TRUNK | MOTOR: loss of power to the hand, wasting of thenar & hypothenars (claw hand) SENSORY: tingling, numbness, pain on medial side of hand and forearm |
vasomotor symptoms due to incomplete rib "syndrome" as due to angulation of subclavian artery over the rib: (2) | sweating of hand because subclavian a. carries parasympathetic fibers along its walls, loss of blood supply to the affected limb causes circulatory impairment leading to gangrene |
short version of subclavian angulation problem with incomplete rib syndrome: | hyperhydrosis of hand, gangrene due to blood supply off |
Final problem of posterior triangle muscles is when head bent to one side and chin points opposite. ___________? | Torticollis (Wry neck) |
why does torticollis occur | due to irritation of Accessory Nerve-SPINAL branch to SCM and traps |
how many triangles make up the Anterior Triangle of the neck? | 4 |
midline of anterior triangle of neck is formed by | symphysis menti to the sternum (middle of chin to sternum) |
posterior of anterior triangle of neck is formed by | anterior aspect of SCM |
base of anterior triangle of neck is formed by | mandible and a line extending the angle of the mandible to the mastoid process and superior nuchal line |
apex of the anterior triangle of neck is formed by | meeting point of the SCM with the midline |
the anterior triangle is an _________ triangle, with it's base at the top and its apex at the bottom (like the heart and sacrum). | upside down |
4 divisions of the anterior triangle: | 1-digastric, 2-carotid, 3-submental, 4-muscular |
Describe the boundaries of the digastric triangle (of the anterior triangle of the neck): | medial-anterior belly of digastric, base-base of mandible to mastoid process, lateral-posterior belly of digastric muscle with stylohyoid, roof-deeper structures like mylohyoid, hypoglossus, small part of middle constrictor |
the digastric muscle forms 2 boundaries of the | digastric triangle of the anterior triangle of the neck |
what is the name of the tendon on the hyoid bone through which the bellies of the digastric muscle (anterior and lateral) emerge? | INTERMEDIATE tendon |
origin of anterior belly of digastric | digastric fossa of mandible |
origin of posterior belly of digastric | mastoid notch of temporal bone |
innervation of anterior belly of digastric | MYLOHYOID nerve |
innervation of posterior belly of digastric &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& | CN VII Facial (& is the sign on the 7 key) |
the anterior and posterior bellies of digastric are united by | the intermediate tendon |
innervation of posterior belly of digastric | facial nerve 7 |
innervation of anterior belly of digastric | mylohyoid nerve -the mylecyrus nerve (singers breath from their anterior belly of di) |
action of both anterior and posterior bellies of digastric muscle | depress mandible, elevate hyoid (the two possibilites of the insertion and orgin if one or the other is fixed) |
what two muscles form the posterior wall of the digastric triangle of AT ("AT" means Anterior Triangle) | posterior belly of digastric (inserting at intermediate tendon) and the stylohyoid (inserting on the hyoid bone) |
in many people, the _____________muscle bifurcates and wraps around the posterior belly of the digastric, on its way to insert at the hyoid. | stylohyoid (like a 2-pronged pitchfork around the insertion of post belly of digastric) |
origin of stylohyoid | styloid process |
innervation of stylohyoid muscle | Facial 7 |
why does it make sense for Facial CN VII to provide innervation for posterior belly of digastric and stylohyoid, but not mylohyoid and anterior belly of digastric? | the MARGINO-MANDIBULAR branch of Facial N. VII is appropriately located for these laterally placed muscles, while the mylohyoid nerve is more anterior. |
origin of mylohyoid | mylohyoid line of mandible |
origin of posterior belly of digastric | mastoid notch of temporal bone |
insertion of mylohyoid | lower part to the hyoid bone & medial part to Median Raphe |
innervation of mylohyoid | mylohyoid nerve |
action of mylohyoid muscle | elevates floor of mouth, elevates hyoid bone, depresses the mandible |
what diaphragm do the mylohyoids form | oral diaphragm |
the ________ ____________ is formed by the myloid hyoid muscles | oral diaphragm |
what three muscles of the digastric triangle of AT depress the mandible | anterior belly of digastric, posterior belly of diagastric, mylohyoid |
what muscles of the digastric triangle elevate the hyoid bone? | all of them! (post & ant bellies of diagastric, stylohyoid, mylohyoid) |
what is the only muscle of the digastric triangle of AT that elevates the floor of the mouth and why can it do this? | mylohyoid - elevates floor of mouth because it forms the oral diaphragm |
what 2 internally placed muscles are also in the digastric triangle of AT, along with the digastrics, mylo- and stylohyoids? | STYLOglossus, HYOglossus |
Ganglion of digastric triangle of AT | submandibular ganglion |
contents of digastric triangle of AT (7) | 1-submandibular salivary duct & gland, 2-hypoglossal nerve, 3-submental branch of facial artery, 4-mylohyoid nerve, 5-facial artery, 6-glossopharyngeal nerve, 7-lingual nerve (deep to hyoglossus muscle) |
Some Have Submental Methods For Getting Laid | CONTENTS OF DIGASTRIC TRIANGLE OF ANTERIOR TRIANGLE: Submandibular salivary gland & duct, Hypoglossa n., Submental branch of facial artery, Mylohyoid n., Facial N., Glossopharyngeal N., lingual n. (deep to hyoglossus muscle) |
In the upside down "Y" shape of the anterior triangle, the lower left is the muscular, the same compartment above the hyoid is the submental, then posterior to the anterior belly of digastric is digastric triangle. What is last and where? | posterior to post belly of digastric, and posterior to superior belly of omohyoid, anterior to SCM: CAROTID TRIANGLE |
anterosuperior boundary of carotid triangle of AT | stylohyoid & posterior belly of digastric m. |
anteroinferior bouncary of carotid triangle of AT | superior belly of omohyoid |
medial boundary of carotid triangle of AT | medial & inferior pharyngeal constrictors, hyoglossus, throhyoid membrane |
which spinal innervation for esophagus | C6 |
what structure do we call the "Adam's apple"? | thyroid cartilage |
arteries of the carotid triangle of AT | Common Carotid, Internal Carotid (no branches), External Carotid (5 branches) |
The carotid triangle is aptly called so because it contains | all three carotid divisions |
branches of external carotid artery | superior thyroid artery, lingual artery, ascending pharyngeal artery, facial artery, occipital artery, posterior auricular, maxillary, superficial temporal |
which carotid has 5 branches inside carotid triangle of AT and what are they? | external carotid: superior thyroid, lingual, ascending pharyngeal, facial, occipital |
where does the internal and external carotid split (structure landmark) | upper border of thyroid cartilage, C3-C4 interspinous |
3 veins of carotid triangle of AT | internal jugular, common facial vein, lingual vein |
what runs alongside the facial artery branch of internal carotid artery | common facial vein |
there are 5 arteries and 3 veins inside the carotid triangle. Name the 3 veins: | internal jugular, common facial vein, lingual vein |
Regarding the internal jugular vein, what nerve runs alongside it within the carotid triangle of AT? | VAGUS |
what nerve branches from the Vagus inside the carotid triangle | superior laryngeal nerve |
the superior laryngeal nerve divides into: | external laryngeal nerve (runs with superior thyroid artery) & internal laryngeal nerve (runs with superior laryngeal artery) |
the ______________________is a branch of the vagus nerve, found inside the carotid triangle | superior laryngeal nerve |
the ______________________is a branch of the internal carotid artery that feeds the upper thyroid. | superior thyroid artery |
the ______________________is a branch of the superior laryngeal nerve that runs with the superior thyroid artery to the thyroid. | external laryngeal nerve + superior thyroid artery (thyroid is on the outside so it gets the external laryngeal nerve, not the internal one) |
cranial nerve that gives off the superior laryngeal nerve and its external and internal components within the carotid triangle. | VAGUS to superior laryngeal to external laryngeal with superior thyroid artery & internal laryngeal with superior laryngeal artery |
6 primary nerves of the carotid triangle: | 1-VAGUS, 2-Superior Laryngeal (w/ internal & external branches), 3-HYPOGLOSSAL, 4-decendens hypoglossi/superior root of a. cervicalis, 5- ANSA Cervicalis, 6-Cervical sympathetic chain |
boundaries of the SubMENTAL triangle of the AT | lateral: anterior belly of digastric muscle, apex: chin, base: hyoid bone |
contents fo the SubMENTAL triangle of the AT | submental Lymph nodes |
Boundaries of the muscular triangle of the AT | anterior- midline of neck (imaginary), posterosuperior - superior belly of omohyoid, posterorinferior- anterior border of SCM |
contents of the muscular triangle of the AT | STRAP muscles of neck (Infrahyoid muscles) |
Strap muscles of the muscular triangle of the AT are also called | infrahyoid muscles |
How many strap/infrahyoid muscles of the muscular triangle of AT? | 4 |
Name the strap muscles of muscular triangle: | Sternohyoid, Sternothyroid, Thyrohyoid, Omohyoid (SOTS) |
SOTS | strap muscles of muscular triangle: Sternohyoid, Stylohyoid, Omohyoid, Thyrohyoid |
innervation of sternohyoid muscle | ansa cervicalis (C1,2,3) |
action of sternohyoid muscle | depresses hyoid bone |
innervation of omohyoid muscle | Inferior belly of Omohyoid - ansa cervicalis, Superior belly of Omohyoid - descendens hypoglossi of ansa cervicalis (the superior root of A.cervicalis is descendens hypoglossi) |
action of omohyoid | depresses hyoid bone |
Omo | shoulder |
Thyrohyoid muscles innervation | Twig of hypoglossal for C1 |
action of THyrohyoid | depress hyoid, ELEVATE LARYNX |
does the Hypoglossal nerve innervate any of the strap/infrahyoid muscles? | no (the branch of hypoglossal innervating thyrohyoid is not technically CNXII) |
what anchors the 2 bellies of Omohyoid to the clavicle? | a central tendon |
how many common carotid arteries are there? | 2 (a right and left) |
origin of Right common carotid artery | brachiocephalic trunk (innominate artery behind the R sternoclavicular joint) |
origin of Left common carotic artery | directly from the arch of the aorta behind the middle of manubrium sternae (opposite and left of manubrium) |
Left common carotid is most medial branch off aortic arch. Lateral to it is the | left subclavian artery |
the _________________ is also called the innominate artery and is the origin of the ______common carotid artery | brachiocephalic, right |
Both right and left common carotid arteries terminate: | at the upper border of the thyroid cartilage or the disc between C3-C4, and then the commons divide into internal and external carotid arteries |
C3-C4 or the thyroid cartilage is the termination point of | the common carotid arteries on both side - where they bifurcate into external and internal |
which carotid artery has all the branches we see in the muscular and carotid triangles? | External (internal is for the brain) |
remember skull model: the internal carotid artery has a _____________ part and a _________part as it ascends | cavernous, cerebral |
where is the carotid sinus located? | at the bifurcation of internal and external carotid arteries |
the carotid sinus has a thick tunica ___________ and thin tunica ____________. Why is this significant? | thick adventitia, thin media. Most arteries have thin adventitia, thick media. |
the carotid sinus acts as a | baroreceptor |
the carotid sinus is stimulated whenever there are changes in | blood pressure, because it is a baroreceptor |
the carotid sinus modifies _______ _________ in response to pressure changes (baroreception). | blood pressure |
The carotid ________is a small dilation at the bifurcation of the common carotid artery. | sinus |
The carotid ________is an oval shape, yellowish brown structure that is also seen in the arch of the aorta and subclavian artery. | body |
the Carotid BODY is innervated by | GLossopharyngeal and cervical sympathetic chain fibers. (CN IX is mixed and it monitors the carotid body and sinus) |
The carotid sinus acts as a baroreceptor, but the carotid body acts as a | chemoreceptor |
The carotid body (chemoreceptor) responds to | changes in O2 and CO2 tension in blood, so it regulates respiration |
function of carotid body | regulates respiration because it monitors oxygen to carbon dioxide ratio in blood |
tumors of the carotid body (respiration/blood gasses) are hard, oval shaped. They will move laterally but not vertically. Enlarged - will press on carotid artery to make | Carotid body SYNCOPE |
External Carotid ARtery origin | common carotid artery at the level of upper border of thyroid cartilage or disc between C3-C4 |
segmental levels associated with common carotid bifurcation | C3-C4 |
the __________ carotid artery runs upwards and backwards and has 8 branches. | External |
2 uppermost terminal branches of external carotid artery | Superficial Temporal ARtery, Maxillary ARtery |
8 branches of external carotid artery, from lowest to highest: | Superior Thyroid, Lingual, Facial, Occipital, |
Sister Lucy's Powdered Face Often Attracts Medical Students | Superior Thyroid, Lingual, Posterior auricular, FAcial, Occipital, Ascending pharyngeal, Maxillary, Superficial TEmporal |
s.t.a.g.l.i.s. | branches of Facial artery: Submandibular, Tonsilar, Ascending palatine, Glandular, Lateral nasal, Inferior labial, Superior labial |
the _______________vein begins as a continuation of the sigmoid sinus | Internal jugular vein |
the internal jugular vein thas 2 dialations at its commencement and termination, called: | 1-superior bulb lodged in internal jugular foramen, 2-inferior bulb seen in the lesser supraclavicular fossa |
the jugular foramen has ___compartments | 3 |
3 compartments of jugular foramen | POSTERIOR (biggest) transmits sigmoid sinus, MIDDLE transmits cn's 9,10,11, and ANTERIOR transmits emissary veins |
what surface landmarks for Internal jugular vein | jugular notch between sternal and clavicular heads of the SCM |
the Internal Jugular vein ends as it unites with the ______________to become the brachiocephalic vein | subclavian |
the internal jugular vein ends as it unites with the subclavian vein to become the | brachiocephalic vein |
5 tributaries flowing towards the internal jugular vein: | inferior petrosal sinus, common facial vein, lingual vein, superior thyroid vein, middle thyroid vein |
I Juggle In Places Commonly Found Lacking Superior Toilets and Merry Thespians | Inferior Jugular, Inferior Petrosal, Common Facial, Lingual, Superior Thyroid, Middle Thyroid (well, YOU make one up then!) |
What is between the left internal jugular vein and left subclavian vein | Thoracic duct |
What is on the right, between the right internal jugular vein an dthe right subclavian vein | R lymphatic duct |
What is the last veinous tributary, not listed in sentence after I Juggle In Places Commonly Found Lacking Superior Toilets and Merry Thespians? | Vein of KOCHER |
which is shorter, the left or right brachiocephalic vein | Right (right over superior vena cava) |
what is the Ansa Cervicalis? | A nerve loop formed by the first, second, and third cervical spinal nerves. It distributes branches to the Infrahyoid (strap) muscles. |
ansa | from Latin: "handle", from Italian: "curve or bend in river" "loop" |
see slide for cervical plexus with ansa cervicalis | see slide for ansa cervicalis with cervical plexus origins so the inferior and superior roots of A. cervicalis make sense |
Ansa cervicalis distributes branches to the __________ muscles. | Infrahyoid/strap muscles |
the Superior root of A. cervicalis is also called | Descendens Hypoglossus |
why would it make sense for the superior root of ansa cervicalis to also be called descendens hypoglossus? | because it emerges from C1 and runs along underneath the Hypoglossal n. XII |
what does descendens hypoglossus/superior root of ansa cervicalis from C1 do? | innervates superior belly of omohyoid (p 181 in Color Atlas of Anatomy- Rohen) |
the inferior root of ansa cervicalis emerges from C2, (and C3) with the lesser occipital n. What is another name for the inferior root of ansa cervicalis? | decendens cervicalis |
job of descendens cervicalis/inferior root of ansa cervicalis emerging with lesser occipital n. at C2,3? | innvervates lesser belly of omohyoid muscle |
muscles supplied by C2,C3 | sternohyoid, sternothyroid |
Muscles supplied by C1 | sternohyoid, sternothyroid, thryohyoid, geniohyoid |
what two muscles are under the tongue, which is supplied by Hypoglossal? | geniohyoid and thyrohyoid |
under the superior belly of omohyoid, which is supplied by C1/superior root of ansa cervicalis/descendens hypoglossus, what two muscles are further supplied by this superior root of ansa cervicalis? | sternohyoid, sternothyroid |
the Hypoglossal n. XII is seen in what two triangles of the neck | Carotid and Digastric |
What nerve supplies all the muscles (extrinsic and intrinsic) of the tongue, except the palatoglossus muscle? | Hypoglossal n. XII |
what supplies the palatoglossus muscle | pharyngeal plexus of nerves |
the Hypo-glossus n. XII innervates every muscle ending in -glossus except | palatoglossus |
after the CN XII Hypoglossus emerges from pre-olivary sulcus of medulla, it exits the cranium through | the Hypoglossal canal!! |
I Juggle In PlaceS Commonly Lacking Superior Toilets and Merry Thespians | Internal Jugular: Inferior Petrosal Sinus, Common facial vein, Lingual vein, Superior Thyroid vein, Middle Thyroid vein |
What 3 nerves make up the Pharyngeal Plexus of nerves? | Sympathetic chain, Glossopharyngeal, Vagus (motor) |
The Hypoglossal Nerve CN XII supplies all of the extrinsic and intrinsic muscles of the tongue except | palatoglossus (supplied by pharyngeal plexus of sympathetic chain, glossopharyngeal, vagus) |
The ____________ nerve is between the internal jugular vein and the internal carotid artery. | Hypoglossal |
the Hypoglossal nerve is between the _______________________ vein and the ____________________ artery. | internal jugular, internal carotid |
The Hypoglossal nerve is contained in both the _________ & the ___________triangles. | carotid and digastric |
the Carotid and Digastric triangles share what cranial nerve? | Hypoglossal CN XII |
In the ____________ triangle, the Hypoglossus nerve lies on the surface of the hyoglossus muscle. | Digastric (hypoglossal on hyoglossus) |
In the digastric triangle, the Hypoglossus nerve is lying directly on the surface of the _________ muscle. | Hyoglossus |
The Hypoglossus nerve divides into a number of branches in the ____________ triangle, one to the tongue, one to the geniohyoid, one to the thryohyoid. | digastric |
digastric implies | GASTROintestinal tract so digastric triangle has the Hypoglossal n. and Anterior belly of digastric (mylohyoid n.), Posterior belly of digastric (VII), Stylohyoid (VII), Mylohyoid (mylohyoid n.), Styloglossus (XII) and Hyoglossus (XII) |
the Hypoglossus n. has 3 branches and merges with ? in the digastric triangle | 1-tongue, 2-thyrohyoid, 3-geniohyoid, merges with descendens HYPOGLOSSAL/superior root of ansa cervicalis |
Innervation of all extrinsic and intrinsic tongue muscles, except palatoglossus muscle. | Hypoglossal N. |
How to test Hypglossal nerve fcn? | patient protrudes tongue, should stick out forward but if deviates to paralyzed side then could be a lower motor lesion causing hemi-atrophy of the tongue on affected side. |
key words for lesion to Hypoglossal nerve: | protrude, deviation to lesion, hemi-atrophy, LMN |
Accessory N. XI function (spinal and cranial) | spinal - supplies trapezius and SCM, cranial - distributes branches of vagus to pharynx muscles and palate |
The Accessory cn XII is an accessory to __________ for muscles of pharynx and palate. | VAGUS X |
Roots of Accessory n | spinal and cranial |
the _______root of Accessory emerges from post-olivary sulcus of medulla and enters the | jugular foramen |
contents of jugular foramen | sigmoid sinus, CN's 9.10.11, emissary veins |
which branch of Accessory travels with Vagus? | Cranial, going to pharynx and palate |
Only the ________part of the Accessory nerve enters the cranial cavity via foramen magnum but both cranial and spinal accessories leave the cranial cavity via the __________ _____________. | spinal, jugular foramen |
lesion to cranial accessory n | dysphonia, dysphagia |
lesion to spinal accessory n. | wry neck/torticollis - leads to paralysis of trapezius and SCM |
the ________ accessory root arises from 3 or 4 segments of the spinal cord (pre-olivary sulcus) | spinal |
the spinal accessory forms a single nerve from all of its roots and enters the cranial cavity by entering the | foramen magnum |
how does the spinal accessory n. leave the cranium? | through the jugular foramen (sigmoid sinus, cranials 9.10.11, emissary veins) |
in the jugular foramen, the spinal accessory nerve joins the _____________, exits then pierces the SCM, also traverses along post triangle and enters the trapezius. | cranial accessory |
testing the spinal accessory n. | patient shrugs shoulders against resistance, compare bilaterally, torticollis could be due to an inflammation of spinal accessory in SCM |
3 nerves passing down from brain through jugular foramen | 9.10.11 |
why does paralyzing genioglossus muscle pull tongue to weak side instead of strong side? | no longer have balance between the two genioglossus muscles so pull is to paralyzed side |
the ________ nerve emerges through jugular foramen and runs through neck, thorax, and abdomen | Vagus |
Vagus emerges from pontomedullary junction and enters the jugular foramen between what two nerves? | 9.11 |
the Vagus is seen in the neck LATERALLY between what two vessels? | common carotid artery and internal jugular vein |
the Vagus has _______ganglion. What are they? | 2: superior and inferior ganglia of Vagus |
word closely associated with ganglion of Vagus | laryngeal |
Laryngeal = | Vagus |
2 branches of Superior Ganglion of VAGUS | 1- meningeal branch supplying dura mater of post cranial fossa, 2 - auricular branch (Arnold's nerve) for auricle, tympanic membrane, and external acoustic meatus |
how will you remember the 2 superior ganglion of VAGUS? | Arnold tapped his ear (Vagal maneuver) and scratched his head. |
only an Inferior Gang would Care if Super Lary was a wandering Phary! | Inferior Ganglion of Vagus: Carotid, Superior Laryngeal, Pharyngeal |
only an Inferior Gang would Care | Inferior Ganglion of Vagus 1-CAROTID branch supplies carotid body |
if Super Lary was a... | Inferior Ganglion of Vagus 2-SUPERIOR LARYNGEAL has two branches: external and internal |
External Laryngeal nerve is a branch of | superior laryngeal nerve (Super Lary) from Inferior Ganglion of Vagus |
External Laryngeal nerve supplies | cricothyroid and inferior constrictor |
During swallowing or yawning, several muscles in the pharynx elevate the soft palate and open the throat. One of these muscles, the tensor veli palatini, also acts to ? | open the eustachian tube. This is why swallowing or yawning is successful in equalizing middle ear pressure. |
we said Superior Ganglion of Vagus AURICULAR branch supplied auricle, tympanum, and external acoustic meatus. Did we say anything about the pharyngo-tympanic tube (Eustachian) with Vagus? | No, because the pharyngo-tympanic tube is opened by Tensor veli palatini (tensor palati), supplied by V3 of Trigeminal N. |
Levator palatini and Salpinopharyngeus muscles are both innervated by | Vagus |
Tensor muscles of pharyngo-tympanic area (Tensor veli palatini, Tensor tympani) are both innervated by | Mandibular branch V3 of Trigeminal CN V |
what does tensor palati do and which nerve supplies it? | opens the pharyno-tympanic tube (eustachian), innervated by V3 Mandibular of Trigeminal |
the external laryngeal nerve is a branch of the ______________; it supplies | Superior Laryngeal (Super Lary), supplies cricothyroid and inferior constrictor - it is out loud and proud! All external! |
Internal Laryngeal nerve is a branch of | Superior Laryngeal (Super Lary) |
the internal laryngeal nerve travels with the | Superior Laryngeal ARTERY |
the internal laryngeal nervee nters the larynx (where did you think it was going with a name like that?) through the ______________ membrane. | thyrohyoid |
What travels with the Superior Laryngeal Artery? | the Internal Laryngeal nerve, a branch of Superior Laryngeal N., a branch of Inferior Ganglion of VAGUS |
Job of Internal Laryngeal nerve, traveling with Superior Laryngeal Artery? | supplies Mucous Membrane of Larynx above level of vocal cord |
external laryngeal nerve is out loud and proud (only an Inferior Gang would Care if Super Lary was a wandering Phary) innervating what? | External Lary = cricothyroid and inferior constrictor cause Lary likes imitation boas (btw, I am for gay rights so if you have a problem with any of my cards, make your own) |
Internal Lary is more introspective. What does the Internal Laryngeal Branch of Superior Laryngeal Nerve of Inferior Ganglion of Vagus do? | supplies the mucous membrane of the larynx |
Carotid branch of inferior ganglion of vagus supplies | carotid body |
Pharyngeal branch of the Inferior Branch of Vagus contains fibers of | cranial accessory nerve (remember: cranial root of Accessory n. distributes branches of the Vagus to muscles of pharynx and palate) |
THE MOST IMPORTANT THING ABOUT THE PHARYNGEAL BRANCH OF THE INFERIOR GANGLION OF VAGUS: | forms the PHARYNGEAL PLEXUS (the sympathetic, Vagus, and Glossopharyngeal n. form it together) |
what is the only muscle of the palate and pharynx NOT supplied by the pharyngeal branch/plexus of the Inferior Ganglion of Vagus? | Tensor palati - opens th pharyngotympanic tube (Eustachian) so is neither a palate nor pharynx muscle or job of vagus. Innervated by V3 Mandibular branch of Trigeminal - yawning pulls mandible down, opens tube! |
Before the Vagus enters the thorax on the right, it gives off one branch located in the neck: | Right Recurrent Laryngeal Nerve |
Remember why the Right Recurrent Laryngeal nerve was not on the mediastinum gross I test? | because it hooks around the subclavian artery, passes inbetween the trachea and esophagus and enters the larynx - it is not ever in the thorax! |
the __________________________nerve hooks around the Subclavian artery and passes between the trachea & esophagus to enter the larynx. | Right Recurrent Laryngeal n. |
the Right Recurrent Laryngeal Nerve (RRLN)that hooks around the R subclavian, etc., supplies? | all the muscles of the larynx EXCEPT cricothyroid (supplied by external laryngeal/out and proud Lary) |
Right Recurrent Laryngeal Nerve | supplies all laryngeal muscles except cricothyroid muscle |
External Laryngeal nerve, branch of inferior ganglion of vagus, supplies | cricothyroid and inferior constrictor |
Left recurrent Laryngeal nerve is in the | thorax, lateral to ligamentum venosum of liverq |
which recurrent laryngeal nerve hooks around the subclavian artery and passes inbetween the trachea and esophagus to innervate the larynx? | RIGHT RECURRENT Laryngeal Nerve |
how to test Vagus function? | compare palatal arches - flattened arch on affected side |
is uvula pulled to normal or pathological side in Vagus lesion? | normal side |
a lesion of the _________will produce nasal regurgitation if liquid swallowed | Vagus |
a lesion of the ________will produce a nasal twang | Vagus |
Hoarseness of the voice is not only the result of a lesion to the Vagus but could also indicated ______________ | Hyperthyroidism |
If there is a lesion to the Vagus, what position are the laryngeal folds (vocal cords) in? | cadaveric (neither abducted or adducted) |
dysphagia | difficulty swallowing |
When the _________ branch of the Vagus is stimulated, it will produce a persistent cough | auricular branch |
when a doc cleans the ear wax out of patient's ear, stimulation of the ___________of the _________ may cause vasovagal collapse (fainting due to parasympathetic stimulation) | Auricular branch of Vagus |
2 branches of superior ganglion of Vagus | Meningeal, Auricular |
4 branches of Inferior ganglion of Vagus | Carotid, Pharyngeal, Recurrent Laryngeal, Superior Laryngeal (divides to External and Internal Laryngeal) |
Cranial Nerve IX | Glossopharyngeal |
The Glossopharyngeal nerve is primarily sensory, but it has 1 motor innervation: | stylopharyngeus muscle |
Only muscle innervated by Glossopharyngeal (IX) | stylopharyngeus muscle |
Glossopharyngeal is sensory to | post 1/3 of tongue (normal and special sensation) |
Contents of Jugular foramen? | Sigmoid sinus, cranial nerves 9.10.11, emissary veins |
Foramen of exit for Glossopharyngeal CNIX | jugular foramen (9.10.11) |
the Glossopharyngeal nerve lies in front of | Vagus nerve X |
Glossopharyngeal lies between what two enormous vessels? | Carotid artery and Internal Jugular vein |
Between the carotid artery and the internal jugular vein lies the | Glossopharyngeal nerve |
Is the Glossopharyngeal deep or external to styloid process and attached styloid muscles? | Deep (behind). Think: Hypoglossal is most exterior and it comes out most posteriorly (post-olivary sulcus) vs. glossopharyngeal which is deeper, comes out in pre-olivary sulcus, and runs with internal jugular and carotid artery |
2 terminal branches of Glossopharyngeal (IX) | TONSILAR & LINGUAL |
Solitary Tract and Nucleus receives fibers from: | (I was alone when I 8 it) - Facial, Glossopharyngeal, Vagus (7,9,10) |
Also involved in the afferent autonomic limb of visceral reflexes of the cardiovascular and gastrointestinal systems | Solitary Tract and Nucleus |
Two terminal branches of Glossopharyngeal | tonsilar and lingual |
4 lesser branches of Glossopharyngeal: from the inferior ganglia of Gloss, enters the middle ear and forms plexus called tympanic plexus | Tympanic branch of Glossopharyngeal |
Supplies the carotid sinus and carotid body | Carotid branch of Glossopharyngeal |
Supplies the stylopharyngeus muscle | Muscular branch of Glossopharyngeal |
Is Glossopharyngeal sensory or motor to pharyngeal plexus? | sensory |
Along with the pharyngeal branch of Vagus (motor), it forms the PHARYNGEAL PLEXUS | pharyngeal branch of Glossopharyngeal |
why would it make sense that Vagus and Glossopharyngeal form the pharyngeal plexus? | Because both give fibers to the solitary nucleus and tract |
The Hyoglossus muscle can be used as a divider mark between: | Hypoglossal Nerve (XII) and Glossopharyngeal Nerve (IX). Hypo superficial, Glosso deep |
Structures deep to Hyoglossus muscle | glossopharyngeal nerve, lingual artery |
Does Lingual nerve run inside the mandibular foramen or within submental triangle? | submental triangle |
Some Anatomists Like Freaking Out Poor Medical Students | Superficial temporal, Ascending pharyngeal, Lingual, Facial, Occipital, Post auricular, Maxillary, Superior thyroid ----external carotid branches: Some Anatomists Like Freaking Out Poor Medical Students |
superficial to hyoglossus | hypoglossus n., submandibular salivary gland, lingual nerve |
Glossopharyngeal is the nerve of the ____pharyngeal arch. | III (3rd) |
Glossopharyngeal is motor to the ________________muscle. | stylopharyngeus |
Glossopharyngeal is secrotomotor to the __________ gland. | parotid |
Glossopharyngeal is ________ & Sensory to the post 1/3 of tongue. | Gutatory (taste) |
Glossopharyngeal is sensory to the _________ & palatine _________. | pharynx, palatine |
to test lesion of Glossopharyngeal, place something with taste on _______________part of tongue -taste correctly, then ok | posterior 1/3 |
check ________reflex (afferent limb is formed by Glosspharyngeal n.) | gag |
surgical division of the Glossopharyngeal results in _____________because the carotid _________ is affected (baroreceptor). | hypertension, sinus |
the ______fossa lies on the side of skull and the importance is that the pterion is inside it. | temporal (pterion) |
superior and inferior boundaries of temporal fossa | above: superior temporal line, below: zygomatic arch |
what lies inside the Temporal fossa? | pterion |
The ______________fossa lies below the middle cranial fossa, lies behind the body of the maxilla, and lies lateral to the pterygoid plate. | INFRAtemporal |
muscles of mastication, maxillary artery, mandibular nerve | contents of the INFRAtemporal fossa |
Contents of INFRAtemporal fossa: (3) | muscles of mastication, maxillary artery (and all its branches!), Mandibular nerve (V3 of Trigeminal) |
name the muscles of mastication, lying inside the INFRAtemporal fossa: (4) | Masseter, Temporalis, Lateral pterygoid, MEdial pterygoid (MMTL - mental) |
____________muscle of INFRAtemporal fossa elevates the depressed mandible (closes mouth), clenches teeth (Maria Shriver jawline) | Masseter |
innervation of Masseter of INFRAtemporal fossa | Mandibular nerve |
What innervates all muscles of Mastication? | Trigeminal branch V3 - MANDIBULAR NERVE |
the ___________ muscle of the INFRAtemporal fossa inserts on the coronoid process of mandible. | Temporalis |
The Temporalis muscle helps __________the mandible and _________the mandible. | elevate, retract |
the _______________pterygoid muscle is most superficial and must be removed to see the contents of INFRAtemporal fossa | Lateral pterygoid is superficial |
a small portion of the __________ pterygoid muscle inserts into the articular disc of TMJ. | Lateral pterygoid inserts TMJ disc. |
The primary depressor of mandible (opens mouth) | Lateral pterygoid opens mouth |
Two muscles that act together to protrude the mandible | Lateral and medial pterygoid |
If the Lateral pterygoid originates on the lateral surface of the lateral pterygoid plate, then the Medial pterygoid originates on the ___________surface of the lateral pterygoid plate. | medial |
the ____________pterygoid elevates the mandible (closes mouth, along with masseter and temporalis) | medial |
only muscle in INFRAtemporal fossa that depresses mandible? | Lateral Pterygoid, the primary depressor of mandible |
two muscles that protrude the mandible | Lateral and Medial pterygoid |
The Lateral and Medial Pterygoids act alternately to produce | side to side (horse chewing oats) |
The largest terminal branch of the external carotid artery | MAXillary |
MAXillary, the largest terminal br. of external carotid, arises at neck of mandible level and divides into: (3) | 1st, 2nd, 3rd parts |
1st part of MAXillary artery | runs horizontally along lower border of lateral pterygoid muscle. |
2nd part of MAXillary artery | runs vertically upwards, either superfically or deep to lateral pterygoid muscle |
3rd part of MAXillary artery | passes b/w upper and lower heads of Lateral pterygoid, then enters the pterygomaxillary fissure to the pterygopalatine fossa |
Branches of 1st part of MAXillary artery, running horizontally along the lower border of lateral pterygoid muscle: (5) | middle meningeal artery (with auriculotemporal nerve encircling it), accessory middle meningeal, inferior alveolar, deep auricular, anterior tympani |
what two branches of 1st part of MAXillary artery must you id? | Middle Meningeal with ariculotemporal encircling it, Inferior alveolar to lower teeth |
arterial branches of 2nd part of MAXillary artery of Infratemporal fossa | muscular branches to muscles of mastication |
what nerve innervates All of the muscles of mastication? What artery feeds muscles of mastication? | Mandibular branch of Trigeminal V3, muscular branch of MAXillary artery of external carotid |
Branches off the 3rd part of MAXillary artery entering pterygopalatine fissure: (2) | infraorbital artery, posterior superior alveolar artery |
What branches MAXillary artery do you need to identify on pin test in lab>? | Middle Meningeal artery with auriculotemporal n. around it, Infraorbital artery, POsterior Superior Alveolar artery, Inferior Alveolar Artery |
Branches of MAXillary artery within the pterygopalatine fossa (NOT fissure, past that!) | greater Palatine artery, pharyngeal branches, spenopalatine artery, artery to pterygoid canal |
3 nerves forming the pharyngeal plexus of nerves | Vagus, Sympathetic, Glossopharyngeal |
What veins for INFRAtemporal fossa? | Pterygoid plexus of veins, MAXillary veins |
the ______________ plexus of veins is between the temporalis and medial and lateral pterygoid muscles, mainly around the lateral pterygoid. It has many tributaries. | Pterygoid plexus of veins |
veins joining the pterygoid plexus with the beginning of the retromandibular vein | MAXillary veins |
veins of INFRAtemporal fossa? | Pterygoid plexus of veins, MAXillary veins |
spongy structure of expeanded veins on both sides of the sella turcica into which the ophthalmic veins and other veins empty. The carotid artery and abducent nerve lie within it and cranial nerves III, IV, V-1, V-2 travel its lateral wall. | Cavernous Sinus (p 281 in pocket guide to human anatomy) |
The Pterygoid plexus of veins in the INFRAtemporal fossa communicates with (3): | Cavernous sinus, Anterior Facial Vein, Inferior Ophthalmic vein |
The Anterior Facial vein communicates with the pterygoid plexus and Inferior Ophthalmic vein. So the Inferior Ophthalmic vein communicates with | Pterygoid plexus of veins, Anterior facial vein |
Because the ___________________ communicates with the Cavernous sinus, an infection of the face can spread through these veins to the Cavernous sinus, in which case you are screwed. | Pterygoid plexus of veins |
The ___________vein arises from the posterior part of the pterygoid plexus of veins. | MAXillary |
The MAXillary vein of the INFRAtemporal fossa joins the _______________vein to form the Retromandibular vein. | Superficial temporal |
2 veins that form the Retromandibular vein | MAXillary vein and Superficial Temporal vein |
Extends from the union of several branches in front of the ear to the facial vein, and is formed by the union of the Superficial Temporal vein and the MAXillary vein | Retromandibular vein |
The Mandibular nerve is a branch of the | Trigeminal (V3) |
The Mandibular nerve arises from the | Trigeminal ganglion |
The Mandibular nerve passes through the | foramen ovale on the way to the infratemporal fossa |
The Mandibular nerve originates at the Trigeminal ganglion, passes through the foramen ovale, and enters the | infratemporal fossa. |
What does the Mandibular nerve branch of Trigeminal do after it enters the infratemporal fossa? | Gives off Nerve to MEDIAL PTERYGOID, then a MENINGEAL branch, and divides into ANTERIOR and POSTERIOR divisions |
the Maxillary branch of the Nerve to the Medial Pterygoid is at ____o'clock, and Meningeal branch passing through foramen spinosum is at ___o'clock. | 5, 10 |
what ganglion is right through the pterygopalatine fissure? | pterygopalatine ganglion |
Muscle that draws the soft palate backward and upward and is innervated by Vagus. | Levator veli palatini |
Muscle that stiffens the lateral wall of the membranous lamina of pharyngotympanic tube (Eustachean) and tenses soft palate, innervated by Mandibular (V-3) branch of Trigeminal nere | Tensor veli palatini |
All of the following are characteristics of the face except the following:a. highly vascular b. fixation to underlying fasica c. rich in sebaceous glands d. is elastic and thin e. laxity of the greater part of the skin | d. is elastic and thin |
Orbicularis oculi is innervated by: | Facial nerve |
The orbital part of orbicularis oculi serves what function? a.Helps fill the lacrimal sac b.Closes the eye tightly | closes the eye tightly |
The buccinator originates from the _____________________ and is responsible for what action: | pterygomandibular raphe; blowing |
Zygomaticus major is responsible for: | laughing |
The ophthalmic branch of trigeminal nerve supplies: | lower eyelids |
The maxillary branch of trigeminal nerve supplies: | posterior part of the temple |
The mandibular branch of trigeminal nerve supplies: | chin |
If there is a lesion of the trigeminal nerve the great auricular nerve will still supply what sensory area: | the skin over the angle of the jaw |
The common facial vein is formed by | the anterior facial vein and the anterior division of the retromandibular vein |
the external jugular vein is formed by | posterior auricular vein and posterior division of retromandibular vein |
Put the following veins in the proper order of drainage:i.Angular veinii.Cavernous sinusiii.Pterygoid plexusiv.Deep facial veinv.Emissary vein | i, iv, iii, v, ii (Angular, Deep Facial Vein, Pterygoid Plexus, Emissary vein, Cavernous Sinus) |
The supra trochlear and supra orbital veins communicate with the cavernous sinus through the: | superior ophthalmic vein |
Because of the venous connections on the face infection will spread to the cavernous sinus causing cavernous sinus thrombosis. For this reason the dangerous areas of the face are: | Upper lip and lower part of the nose |
All of the following are proper lymphatic drainage patterns of the face except:a. Upper territory to preauricularb. Middle territory to submandibularc. Middle territory to suborbitald. Lower territory to submental | c. Middle territory to suborbital |
Put the following in order showing the fluid pathway through the lacrimal apparatus:i. Lacrimal canaliculiii. Lacrimal saciii. Nasolacrimal ductiv. Conjunctival sacv. Lacrimal glandvi. Lacrimal punctumvii. Lacrimal duct | v, vii, iv, vi, i, ii, iii |
The nasolacrimal duct sends tears into the | inferior nasal meatus |
The sensory supply to the parotid duct is a branch of | ophthalmic division of trigeminal nerve (V) |
The lacrimal nerve carries ___________ fibers from the pterygopalatine ganglion to the lacrimal gland | parasympathetic |
The parotid duct opens to the vestibule of the mouth opposite the | 2nd upper molar |
The lacrimal nerve carries ___________ fibers from the pterygopalatine ganglion to the lacrimal gland | parasympathetic |
The parasympathetic nerve supply of the parotid duct is from the | Otic ganglion through the auriculotemporal nerve |
Frey’s syndrome, also called auriculotemporal syndrome includes all of the following except: | dry mouth |
The facial nerve gives of all the following branches while in the facial canal except: | lesser petrosal nerve |
Frey's syndrome (auriculotemporal syndrome) includes what symptoms | Cutanteous hyperasthesia, injury to the auriculotemporal nerve, cheeks becoming red/hot/painful, sweating over the affected area (Thom's mom) |
Branches of the facial nerve while in the facial canal | Chorda tympani, greater petrosal, nerve to stapedeus |
The facial nerve gives off the posterior auricular nerve, nerve to stylohyoid, and nerve to posterior belly of digastric when it exits the: | stylomastoid foramen |
Hyperacousis occurs with: | lesion of nerve to stapedius |
Bell's Palsy: _______________lesion and what part of face is paralyzed? | infranuclear lesion, whole half |
What fold of dura mater forms the roof of the hypophyseal fossa? | diaphragm sellae |
What fold of dura mater forms the roof of the posterior cranial fossa? | tentorium cerebelli |
Which sinus drains blood to the RIGHT transverse sinus? | superior sagittal sinus (is right handed) |
Which sinus is continuous with the LEFT transverse sinus? | Straight sinus |
Which sinus is joined by the great cerebral vein to BECOME the straight sinus? | Inferior sagittal sinus |
the straight sinus is two sinuses becoming one. What two? | great cerebral and inferior sagittal sinus = straight |
The right and left sinuses become the | sigmoid sinuses |
what two sinuses become the sigmoid sinuses? | right and left sinuses |
lucid intervals are present during an _____________ hemorrhage | extradural = lucid intervals |
middle meningeal arteries are involved in ____________ hemorrhages | extradural = middle meningeal |
blood in the CSF is found with ___________ hemorrhages | subarachnoid = CSF blood |
paralysis appears first in the face with an ________________ hemorrhage | extradural = face paralysis |
The superior sagittal sinus involvement means ________________ | subarachnoid = superior sagittal |
occluding which branch of the ophthalmic artery renders the entire retina bloddless? | the central artery of retina |
eye muscle: elevate, abduct, extorsion | inferior oblique |
eye muscle: depress, adduct, extorsion | inferior rectus |
eye muscle: depress, abduct, intorsion | superior oblique |
eye muscle: elevate, adduct, intorsion | superior rectus |
Fibers from the Edinger-Westphal nucleus are relayed in the ciliary ganglion. The _____________ fibers supply ciliaris and sphincter papillae. | postganglionic parasympathetic |
Lesion of Oculomotor III causes (4) symptoms: | ptosis, dilation of the pupil, diplopia, loss of accomodation (cycloplegia) |
does lesion of cn III cause medial strabismus? | no, it causes ptosis, dilation of the pupil (mydriasis), diplopia, loss of accomodation (cycloplegia) |
What structures pass through the superior orbital fissure? | SOF: Oculomotor, Trochlear, Frontal |
why doesn't the optic nerve pass through the superior orbital foramen? | because it has its own canal - the optic canal! |
The SCM, trapezius, partodid and submandibular glands are contained in what fascial layer? | Investing layer (STPS) |
Take STPS to invest in your future! | SCM, Traps, Parotid, Submandibular are all in the investing fascia |
What IS in the carotid sheath? | It goes Artery (carotid), Vagus, Vein (Internal Jugular) with Ansa attached to front. Sympathetics are OUTside in back. See diagram |
see Little Devil - Ansa Cervicalis within Carotid Sheath slide. Contents of carotid sheath? | Carotid artery, Vagus, Internal Jugular, ansa in sheath but most anterior with its two roots. |
Is the sympathetic chain inside the carotid sheath? | NO |
Nerve for posterior belly of Digastric | Facial |
Nerve for Thyrohyoid muscle | C1 through Hypoglossal n. |
Nerve for Omohyoid | Ansa Cervicalis |
Nerve for Sternohyoid | Ansa Cervicalis |
Nerve for SternoTHYroid | Ansa Cervicalis |
Nerve for anterior belly of Digastric muscle | Mylohyoid nerve running with Inferior Alveolar inside mandibular foramen |
Nerve for Stylohyoid | Facial |
Stylohyoid and posterior belly of digastric nerve? | Facial |
Omohyoid, Sternohyoid, SternoTHYroid innervation | Ansa cervicalis |
nerve for anterior belly of digastric? | mylohyoid nerve |
Anterioinferior border of carotid triangle | superior belly of omohyoid |
Border where common carotid bifurcates? | upper border of thyroid cartilage and/or disc between C3-C4 |
the carotid body is a _______________ | chemoreceptor (B.O.D.: Body, Oxygen, Dioxide) |
Continuation of the sigmoid sinus that continues downward, joins subclavian, and forms the brachiocephalic vein | Internal jugular vein |
Tributaries of the Internal Jugular - "I Juggle In PlaceS Commonly Found Lacking Superior Toilets and Merry Thespians" | I Juggle (internal jugular) In PlaceS (inferior petrosal sinus) Commonly Found (common facial) Lacking (lingual) Superior Toilets (superior thyroid) and Merry Thespians (middle thyroid) |
I Juggle In PlaceS Commonly Found Lacking Superior Toilets and Merry Thespians | Internal Jugular Inferior Petrosal Sinus Common Facial Lingual Superior Thyroid and Middle Thyroid = branches of inferior jugular vein |
The hypoglossal nerve supplies all tongue muscles except one: ___________, nerve supply: _________ | palatoglossus, Vagus |
Vagus does not innervate: | stylopharyngeus, Tensor palati |
How to test lesion of Hypoglossal nerve? What to look for? | Patient sticks out tongue; if lesion, will deviate to lesioned/bad side |
The cranial root of the Accessory nerve gives branch through the Vagus nerve to: | soft palate, pharynx, larynx except - stylopharyngeus, Tensor palati, and cricothyroid |
Glossopharyngeal is mostly sensory and for carotid sinus and body and tympanic/ear, but it has one motor branch to | Stylopharyngeus |
The Glossopharyngeal nerve enters the _________foramen. | Jugular |
Afferent involved in gag reflex: ___________ | Glossopharyngeal |
Efferent involved in gag reflex: _____________ | Vagus |
Afferent and Efferent involved in gag reflex | afferent is glossopharyngeal (sensory), efferent is vagus (throw up! save self!) |
Posterior superior alveolar branch of Maxillary artery is on the first, second, or third part of the M.a.? | third |
Muscular branches - first, second or third part of Maxillary artery? | second |
Deep auricular branch - first, second or third part of Maxillary artery? | first |
Anterior tympanic branch - first, second or third part of Maxillary artery? | first |
Greater palatine branch - first, second or third part of Maxillary artery? | third |
Inferior alveolar branch -first, second or third part of Maxillary artery? | first |
Sphenopalatine branch - first, second or third part of Maxillary artery? | third |
Mandibular nerve enters _________________through foramen ovale. | infratemporal fossa |
I Love S&M | Inferior oblique=Lateral eye rotationSuperior oblique=Medial eye rotation |
Lazy French Tarts Lie Naked In Anticipation Of Sex | Order of structures through superior orbital fissure: Lacrimal, Frontal, Trochlear, Lateral, Nasociliary, Internal, Abducens, Ophthalmic veins, Sympathetic veins |
O.V.A.L.E. foramen | structures of foramen ovale: Otic ganglion (just below), V3 branch of trigeminal (mandibular), Accessory meningeal artery, Lesser Petrosal N., Emissary veins |
Paris St. Germain's Hour | Extrinsic (foreign) muscles of tongue: Palatoglssus, Styloglossus, Genioglossus, Hyoglossus |
Hypoglossus n. supplies all muscles of tongue except? What supplies this tongue muscle? | Palatoglossus - pharyngeal plexus of n. (vagus, glossopharyngeal, sympathetic all together) |
Some Angry Lady Figured Out PMS | External carotid artery branches: Superior thyroid, Ascending pharyngeal, Lingual, Facial, Occipital, Posterior auricular, Maxillary, Superficial Temporal |
O TOM CAt | contents of cavernous sinus from medial to lateral: Oculomotor, Trochlear, Ophthalamic, Maxillary, Carotid, Abducens |
May I Softly Squeeze Charlie's Girl? | superior thryoid artery branches: Muscular, Infrahyoid, Superior laryngeal, Sternomastoid, Cricothyroid, Glandular |
Medical Schools Let Common People In | Internal jugular branches: Middle thyroid, Superior thyroid, Lingual, Common facial, Pharyngeal, Inferior Petrosal Sinus |
Standing Room Only | Trigeminal exits: Superior orbital fissure (V1), Rotundum (V2), Ovale (V3) |
GHost THought SOmeone STupid SHot IOn | Muscles innervated by Ansa Cervicalis: GenioHyoid, ThyroHyoid, Superior Omohyoid, StyloThyroid, StyloHyoid, Inferior Omohyoid |
PPL (people) have tonsils | Pharyngeal, Palatine, Lingual |
There are 3 V's in your Voicebox | Vestibular fold, Ventricle, Verticle fold |
My Ass Meets The Toilet | V3 (Mandibular branch of Trigeminal) Muscles: Mylohyoid, Anterior digastric, Masticatory muscles, Tensor veli palatini, Tensor tympani |
G.L.A.S.T. | Cervical nerve arrangement: Great auricular, Lesser occipital, Accessory n. pops out between L and S, Supraclavicular, Transverse cervical |
Lingual nerve course of travel: The Lingual nerve took a curve around the Hyoglossus. 'Well, I'll be f**ked,' said Wharton's Duct, 'The bastard's gone and crossed us!' | lingual nerve pathway to tongue (remember it does NOT travel in mandibular foramen but with Chorda Tympani of VII on medial side of mandible) |
Medial pterygoid and Tensor Palati are innervated by | a branch of Mandibular (V3) |
The ___________(anterior or posterior) division of mandibular is motor except for one sensory branch. What is sensory branch? | anterior all motor except Buccal nerve supplying skin on buccinator muscle. |
the __________division of Mandibular n. is sensory except for one muscular branch - what muscle? | Posterior division of Mandibular (V3) all sensory except one muscular branch - the mylohyoid |
Does the mandibular branch of trigeminal supply the medial pterygoid before or after it divides into anterior and posterior branches? | before, also gives off meningeal branch before dividing, then divides into anterior and posterior |
The ____________________duct opens into the floor of the mouth on the summit of the sublingual papillae. | submandibular salivary |
The isthmus of the thyroid gland is located at the __________ tracheal cartilage rings. | 2nd & 3rd |
The thyroid veins all drain into the internal jugular vein except ______________ which drains into brachiocephalic. | inferior thyroid vein goes to brachiocephalic vein |
Middle Thyroid artery is a branch of the | Internal carotid |
B.p. significantly different in both arms, a bruit heard in supraclavicular fossa on affected side, and ataxia and diplopia due to loss of blood to brain are all symptoms of: | subclavian steel syndrome |
ganglion in front of 6th cervical vertebrae | middle (like Middlesex)cervical ganglion |
ganglion opposite to the 2nd and 3rd cervical vertebrae | superior cervical ganglion |
ganglion located at upper cricoid cartilage | Crikey, it's Middlesex! (middle cervical ganglion at the 6th vertebrae) |
ganglion located behind the vertebral artery | stellate cervical ganglion (hemisection of vertebral artery will make you see stars in 7th heaven) |
ganglion located by 7th cervical vertebrae and neck of 1st rib | stellate cervical ganglion (hemisection of vertebral artery will make you see the stars in 7th heaven) |
Lesser occipital, Great auricular and supraclavicular are all ___________ branches of the ______________ of nerves. | cutaneous, cervical plexus |
Which lymph node drains the tonsil | jugulodigastric |
All the muscles of the soft palate are supplied by the ____________________ Nerve(s) except the Tensor Palati. | PHARYNGEAL PLEXUS of nerves |
muscle that flattens the tongue | vertical |
muscle that makes the dorsum of the tongue concave | superior longitudinal |
muscle that makes the dorsum of the tongue convex (rounded) | inferior longitudinal |
Narrows and elongates the tongue | transverse |
the Pterygoid hamulus is an origin of the | superior pharyngeal constrictor |
The styloid ligament is an origin of the | middle pharyngeal constrictor |
muscle and nerve separating superior from middle pharyngeal constrictor | stylopharyngeus with glossopharyngeal n. |
Thyropharyngeus from the thyroid cartilage is an origin of the | inferior constrictor muscle |
medial wall of nasal cavity | nasal septum |
posterior ethmoidal sinus opens into the | superior meatus |
the bulla ethmoidalis is produced by the _____________ ethmoidal cells. | middle ethmoidal cells |
Little's area is a common site of | epistaxis |
largest sympathetic ganglion | pteryopalatine ganglion |
The pterygopalatine ganglion acts as a relay station for secretomotor fibers to the | lacrimal gland |
the unpaired cartilage of the laryngopharynx | epiglottis (arytenoid, carniculate, and cuneform are all paired) |
muscle that opens the glottis | posterior crico-arytenoid muscle |
mucous is swept into nasal cavity by | cilia |
the osteum of the _____________sinus opens to the nasal cavity | maxillary |
what nerve is sensory to pharynx and palatine tonsils? | hypoglossal |
what nerve is secretomotor to parotid gland | hypoglossal |
what nerve is motor to stylopharyngeus | hypoglossal |
what nerve is gustatory and sensory to post 1/3 of tongue | hypoglossal |
largest terminal branch of external carotid artery | maxillary artery |
largest ganglion | pterygopalatine ganglion |
maxillary artery is divided into 3 parts | 1st is lowest in infratemporal fossa, 2nd is along lateral pterygoid, 3rd enters pterygomaxillary fissure and into pterygopalatine fossa |
middle meningeal artery, accessory middle meningeal artery, inferior alveolar artery, deep auricular artery, anterior tympani artery - all branches of? | 1st part of Maxillary artery, the largest terminal branch of external carotid artery |
muscular branches to the muscles of mastication come off the ______________ part of Maxillary artery | 2nd |
the infraorbital artery and posterior superior alveolar artery come off the ___________part of maxillary artery | 3rd |
greater palatine artery, pharyngeal branches, spenopalatine artery, and artery to the pterygoid canal are all branches of the ______________artery within the _______________. | maxillary artery within pterygopalatine fossa |
how many branches come off the 1st part of maxillary artery (lowest) | 5; mm, amm, ia,da, at (meninges x2, low teeth, ear, inner ear) |
the 2nd part of maxillary artery only supplies the | muscular branches of mastication |
the 3rd part of maxillary artery supply the lower eye and upper teeth - name these 2 arteries: | infraorbital and posterior superior alveolar arteries |
Veins of the INfratemporal fossa (2) | pterygoid plexus of veins, maxillary vein |
the pterygoid plexus of veins lies on ______________ muscle of the _________________. | lateral pterygoid, infratemporal |
the pterygoid plexus of veins of the infratemporal fossa communicates with the interior facial vein, the inferior ophthalmic vein and most importantly, the | cavernous sinus |
the maxillary vein of the infratemporal fossa arises from the | pterygoid plexus of veins - posterior part |
the Maxillary vein + Superficial Temporal Vein = | Retromandibular vein |
the retromandibular vein is formed by (2) | maxillary vein and superficial temporal vein |
the superficial temporal vein + ____________ vein form the retromandibular vein that drains the _______________- | maxillary vein, infratemporal fossa |
infection can spread from the face to the cavernous sinus (brain) because | the pterygoid plexus of veins sits directly over the lateral pterygoid and drains the inferior facial vein and the inferior ophthalmic vein |
the face can spread infection to the _________________via the pterygoid plexus of veins | Cavernous Sinus |
what two veins form the retromandibular vein | maxillary and superficial temporal vein |
division of Trigeminal ganglion supplying infratemporal fossa | V3 - Mandibular division |
Standing Room Only | Supraorbital fissure V1, Rotundum V2, Ovale V3(branches of trigeminal ganglion and foramen) |
what is the mother of all trigeminal branches, V1, V2, or V3? | V3 - Mandibular with anterior and posterior divisions, as well as nerve to medial pterygoid and meningeal nerve before bifurcation |
what nerve supplies the medial pterygoid and where is it from? | nerve to medial pterygoid, a branch of V3 before the A-P division |
besides nerve to medial pterygoid, what is the other nerve given off before V3 A-P division | meningeal branch Nervous Spinosus (recurrent) |
the maxillary V3 divides anteriorly and posteriorly. Anterior division is __________ with one exception, and Posterior is _________ with one exception. | Anterior V3 = MOTOR, Posterior V3 = sensory each has one exception/opposite |
anterior V3 MOTOR except | buccal nerve supplying skin over buccinator |
all branches of anterior V3 are MOTOR to muscles of __________ except the one sensory branch to Buccal nerve. | muscles of mastication |
How to remember Anterior branch of Mandibular V3 is motor? vs. posterior branch as sensory? | the brain and spinal cord are arranged the same way: sensory in the posterior, motor in the anterior |
Masseteric, Deep Temporal, Buccal, Lateral Pterygoid (remember medial pterygoid is before the A-P division) are nerves of | Anterior MOTOR division of Mandibular V3, except Buccal nerve is sensory exception to rule |
Posterior division of mandibular V3 is all _________ except mylohyoid | sensory (in the posterior, like the brain) |
The ______________ nerve of the posterior division of V3 surrounds the middle meingeal artery coming off maxillary artery | Auriculotemporal (2 roots that surround the middle meningeal artery of infratemporal fossa) |
the Auriculotemporal nerve provides secretomotor, postganglionic fibers which arise from the otic ganglia to the | submandibular gland |
The Lingual nerve has a branch running with it - the | chorda tympani, supplying Special Sensations to the anterior 2/3 of the tongue. |
Since the posterior division of V3 is sensory, what do you figure the chorda tympani and lingual nerves do for the tongue? | supply Special Sensations (chorda tympani) and sensory to anterior 2/3 of tongue |
what V3 branch runs through the mandibular canal and what twig does it give off? | Inferior Alveolar branch, nerve to mylohyoid (the only purely motor of posterior V3) |
The Mylohyoid nerve from Inferior Alveolar from V3 supplies the mylohyoid muscle and | the ANTERIOR BELLY OF DIGASTRIC |
the Anterior belly of Digastric is innervated by | nerve to mylohyoid (V3 mandibular) |
The __________________nerve enters the mandibular canal/foramen and supplies the entire mandible, plus gives off twig Mylohyoid nerve that supplies mylohyoid muscle and ___________ belly of digastric. | Inferior Alveolar nerve, anterior belly of digastric |
A peripheral parasympathetic ganglion supplying secretomotor fibers to the parotid gland | otic ganglion |
what nerve provides secretomotor, post-ganglionic fibers which arise from the otic ganglia to the parotid gland | Auriculotemporal nerve of V3 |
Auriculotemporal provides _____-ganglionic fibers from otic ganglion to parotid, while ___-ganglionic fibers are carried ia the inferior ganglion of the glossopharyngeal nerve. | auriculotemporal is post, glossopharyngeal is pre |
origin of Lesser Petrosal Nerve | TYmpanic Plexus of V3 posterior sensory |
the Tympanic Plexus gives rise to | Lesser Petrosal nerve that joins the otic gang where the pregang parasympathetics are relayed |
Otic Ganglion/Preganglionic/Parasympathetic/Parotid/tympanic/lesser petrosal | all V3 posterior mandibular sensory secretomotor |
why will cancer of tongue refer as ear pain? | because lingual and auriculotemporal arise from same trunk |
4 branches of posterior V3 mandibular sensory, plus one motor exception | Auriculotemporal, Lingual, Inferior Alveolar (with nerve to mylohyoid and ant. belly of digastric), Otic Ganglion, exception is motor to mylohyoid/anterior belly of digastric |
what is next largest salivary gland after parotid? | submandibular |
the submandibular gland is J-shaped and occupies most of digastric triangle. has two parts | superficial and deep |
superficial submandibular is superficial to | mylohyoid muscle |
deep submandibular is deep to | mylohyoid |
the ____________gland opens to floor of mouth and opens at the summit of the sublingual papilla on either side of the frenulum linguae | submandibular DUCT |
the _____________ gland is drained by ~ 15 ducts into the floor of the mouth | sublingual salivary gland |
blood supply of sublingual salivary gland | facial artery |
venous drain of sublingual salivary gland | facial and lingual vein |
the sublingual salivary gland drains lymph to | submandibular lymph nodes |
nerve supply to sublingual salivary gland | SUBMANDIBULAR GANGLION |
the submandibular GANGLION lies on the surface of the ___________muscle and innervates the sublingual salivary gland | Hyoglossus |
2 tongue muscles | hyoglossus and genioglossus |
3 structures on surface of hyoglossus muscle of tongue | lingual nerve, submandibular gland/duct, facial nerve |
the submandibular GANGLION is suspended by 2 roots of the | lingual nerve |
the submandibular GANGLION receives pregangs from __________ (special senses) and post gangs from submandibular gland and sublingual gland | chorda tympani (pregang) |
is the TMJ a synovial joint? | yes |
the upper compartment of TMJ allows only _______movements | gliding |
the sphenomandibular ligament is a part of __________ cartilage | Meckel's |
the _____________ligament is formed by condensation of deep cervical fascia | stylomandibular |
artery of TMJ | superficial temporal and maxillary |
vein of TMJ | retromandibular |
nerve of TMJ | auriculotemporal |
4 movements of TMJ | depresses, elevates, retracts, protracts |
#1 cause of TMJ dislocation | yawns! |
lock jaw is also called | trismus |
trismus/lock jaw can be caused by irritation to the __________ nerve or _____________nerve | inferior alveolar or auriculotemporal |