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Gross III final- Raj
NYCC Gross III review for Final- Raj
Question | Answer |
---|---|
Features of the skin of the face include: | Highly vascular, rich in sebaceous glands, laxity of the greater part of the skin, fixation to underlying cartilage, is elastic and thick |
Because of it's fixation to the underlying cartilage, what happens to the skin of the face when it is inflamed? | It is stretched and becomes very painful |
what happens when the sebaceous glands of the face are blocked? | acne |
what are the three components to orbicularis oculi? | Palpebral, Orbital, and Lacrimal parts |
What is the action of orbicularis oculi? | Closes the eyelid, dilates the lacrimal sac |
Where is the lacrimal part of obicularis oculi? | at the medial angle of the eye |
where is the orbital part of orbicularis oculi? | along the eyebrow |
Where is the palpebral part of orbicularis oculi? | Under the eyelid |
Where do the upper fibres of the buccinator muscle take origin from? | From the maxilla opposite to the molars |
Where do the middle fibres of the buccinator muscle take origin from? | From the pterygomandibular raphe |
Where do the lower fibres of the buccinator muscle take origin from? | From the mandible opposite to the molars |
What do the three fibres of the buccinator muscles merge with? | Orbicularis oris |
What comprises the motor nerves of the face? | Facial Nerve |
What comprises the Sensory nerves of the face? | Branches of Trigeminal, N. from cervical Plexus |
What does the opthalmic branch of the trigeminal nerve innervate? | The scalp as far as the vertex, the forehead, the upper eyelids |
What does the maxillary branch of the trigeminal nerve innervate? | The upper lip, side and ala of the nose, lower eyelid, anterior part of the temple,upper part of the cheek |
What does the mandibular branch of the trigeminal never innervate? | Lower lip, chin, lower part of the cheek, lower jaw, lateral surface of the auricle |
What is the name of the nerve from the cervical plexus that innervates a sensory component of the face? | Great Auricular N. |
What does the Great Auricular N. innervate? | Skin over the angle of the jaw |
What are the three veins of the face? | Angular, Anterior Facial, Retromandibular |
Which vein of the face has anterior and posterior divisions? | Retromandibular |
What is the common facial vein formed by? | Anterior Facial and Anterior division of retromandibular |
What is the major tributary of the subclavian vein? | External Jugular V. |
What is the external jugular vein formed by? | Posterior division of retromandibular and posterior auricular v. |
What do the supra trochlear and supra orbital communicate with? | superior opthalmic |
What does the angular vein through the deep facial communicate with? | pterygoid plexus |
what does the pterygoid plexus communicate with? | Cavernous sinus through the emissary v. |
Where can infections of the face easily be transmitted to? | Cavernous sinus |
What are the dangerous areas of the face and why? | Upper lip and lower part of the nose because they are close to the deep connections of veins |
Where is the upper territory for lymphatic drainage of the face? | preauricular |
Where is the middle territory for lymphatic drainage of the face? | Submandibular |
Where is the lower territory for lymphatic drainage of the face? | Submental |
What are the components of the lacrimal apparatus? | Gland, Duct, Conjunctival sac, Lacrimal Punctum, Lacrimal Canaliculi, Lacrimal sac, nasolacrimal duct |
where does the nasolacrimal duct drain to? | Inferior nasal meatus |
where does the parotid duct emerge from? | the anterior border |
Where does the parotid duct open into? | vestibule of the mouth opposite to the second upper molar tooth |
what is the parasympathetic innervation of the parotid duct? | Post ganglionic fibers from the otic ganglion through the auriculotemporal N. |
What is the nerver of the second brachial arch? | Facial N. |
Which branches of the facial N. are within the facial canal? | Greater petrosal N., Chorda Tympani N., Nerve to Stapedius |
Which branches of the facial N. are at the exit from the stylomastoid foramen? | Posterior Auricular, N. to posterior belly of digastric and stylohyoid |
Which branches of the facial N. are in the face? | Temporal, Zygomatic, Buccal, Marginal mandibular and cervical |
What does Chorda Tympani supply? | Anterior 2/3 of the tongue |
What nerve is lesioned with hyperacusis? | N. to Stapedius |
What are the unpaired sinuses? | superior sagittal, inferior sagittal, straight, occipital, ant and post intercavernous |
Where does the inferior sagittal sinus drain to? | Straight sinus |
what are the paired sinuses? | Cavernous, sup and inf petrosal, transverse, sigmoid |
What is the order of drainage within the sinuses? | Inferior Sagittal to straight to transverse |
Where can one find the cavernous sinus? | On the sides of the body of the sphenoid bone |
what is the anterior extension of the cavernous sinus? | superior orbital fissure |
what is the posterior extension of the cavernous sinus? | Petrous part of the temporal bone |
What can be found on the lateral wall of the cavernous sinus? | 3rd, 4th, 5th cranial nerves, particularly opthalmic and maxillary divisions |
What can be found passing through the cavernous sinus? | 6th cranial nerve and internal carotid artery |
What are the tributaries of the cavernous sinus? | from the orbit, from the meninges, from the brain |
What occurs with lesion of the optic nerve? | Blindness |
What is the action of levator palpebrae superioris? | Elevation of the upper eyelid |
What is the action of Superior Rectus? | Elevation, adduction, internal rotation |
What is the action of inferior rectus? | Depression, adduction, external rotation |
What is the action of medial rectus? | Adduction |
What is the action of lateral rectus? | Abduction |
What is the action of superior oblique? | Depression, abduction, external rotation |
What is the action of inferior oblique? | Elevation, abduction, internal rotation |
Where does the opthalmic artery enter the orbit through? | The optic canal |
What does the opthalmic artery run within? | the optic Nerve |
If there is a lesion to the central artery of the retina what happens? | Loss of eyesight |
Where does the central artery of the retina branch from | the ophthalmic artery |
what does the oculomotor N. supply? | All the muscles of the eye but LR and SO |
Symptoms of lesion of CN III Oculomotor | ptosis, lateral squint, dilatation of the pupil, loss of accomodation, diplopia, supranuclear lesion |
what occurs with supranuclear lesion? | Loss of conjugate movement of the eye |
What do postganglionic motor fibres of the ciliary ganglion supply? | Ciliaris and sphincter pupillae |
Where is the ciliary ganglion located? | between lateral rectus and optic nerve |
Lesion of the trochlear nerve presents with what? | No internal downward movement |
What does the trochlear nerve supply? | Superior Oblique |
Lesion of the superior cervical sympathetic ganglion and dilator pupillae presents with what? | meiosis |
what is meiosis? | pinpoint pupil |
what is the superior boundary of the SOF? | Lesser wing of the sphenoid |
What is the inferior boundary of the SOF? | Greater wing of the sphenoid |
What is the medial boundary of the SOF? | Body of the sphenoid |
What are the two structures NOT running through the SOF? | Optic N., Opthalmic artery |
The investing layer of fascia encloses what? | 2 muscles, 2 glands, 2 spaces |
What are the 2 muscles enclosed by investing layer of fascia? | SCM and trapezius |
What are the 2 glands enclosed by investing layer of fascia? | parotid and Submandibular |
What are the 2 spaces enclosed by investing layer of fascia? | Suprasternal and supraclavicular |
What suspends the thyroid gland? | Pretracheal Layer of fascia |
What forms the floor of the posterior triangle? | Prevertebral layer of fascia |
What encloses the neurovascular bundle in the neck? | Carotid Sheath |
Ansa cervicalis innervates what? | Strap muscles of the neck |
Superior root of ansa cervicalis is made up of which cervical branches? | C1 |
Inferior root of ansa cervicalis is made up of which cervical branches? | C2 and C3 |
Which muscles form the floor of the posterior triangle of the neck? | Semispinalis capitus, splenius capitus, levator scapulae, scalenus posterior, scalenus anterior, scalenus medius |
What are the motor nerves of the posterior triangle of the neck? | spinal accessory, trunks of brachial plexus, N. to subclavius, N. to serratus anterior, suprascapular |
What are the sensory nerves of the posterior triangle of the neck? | Lesser occipital, great auricular, transverse nerve of the neck, supraclavicular |
What do omohyoid, sternohyoid, sternothyroid and C1 fibers as branches of hypoglossal thyroid and geniohyoid make up? | strap muscles of the neck |
Innervates all the muscles of the tongue except palatoglossus | hypoglossal N. |
What two muscles lie deep to the hypoglossal N.? | Hyoglossus and genioglossus |
Where does the cranial root of the accessory nerve enter after it emerges from the medulla? | Jugular foramen |
which nerves pass through the jugular foramen? | CN IX, X, XI |
What two foramen does the spinal root of the accessory nerve travel through? | Foramen magnum, jugular foramen |
Where is the superior ganglion of the vagus nerve found? | In the jugular foramen |
Where is the inferior ganglion of the vagus nerve found? | In the base of the skull |
What does the external laryngeal nerve supply and what is it a branch of? | branch of the vagus, supplies cricothryroid and inferior pharyngeal constrictor |
what does the internal laryngeal nerve supply and what is it a branch of? | Branch of the vagus, supplies the mucosa of the larynx above the level of the vocal cord |
What nerve supplies the mucosa of the larynx below the level of the vocal cord? | Right Recurrent laryngeal N. |
Where does the right recurrent laryngeal nerve arise? | In front of the first part of the subclavian artery |
Where does the right recurrent laryngeal nerve travel? | In the groove between the trachea and tthe esophagus |
Which nerve supplies all the muscles of the neck except cricothyroid? | Right recurrent laryngeal N. |
Where is the left recurrent laryngeal nerve given off and where does it arise from? | is a branch of left vagus, given off in the thorax |
Which nerve hooks around the arch of the aorta to enter the neck? | Left recurrent laryngeal N. |
What is the tympanic N. a branch of? | glossopharyngeal N. |
What does the tympanic branch of the glossopharyngeal nerve form? | the tympanic plexus |
Where does the infra temporal fossa lie below? | The middle cranial fossa |
The infra temporal fossa is behind what? | the body of the maxilla |
The infra temporal fossa is lateral to what? | The lateral pterygoid plate |
Masseter, temporalis, medial and lateral pterygoid muscles are found where? | In the infra temporal fossa |
What are the muscles of mastication? | masseter, temporalis, lateral and medial pterygoid |
Origin of Masseter Muscle | Zygomatic arch and zygomatic process of the maxilla |
Insertion of masseter mm. | ramus of the mandible, coronoid process |
Origin of temporalis mm/ | temporal fossa, temporal fascia |
insertion of temporalis mm. | coronoid process, anterior border of mandible |
Origin of lateral pterygoid mm | upper head- infra temporal surgace and crest of greater wing of sphenoidlower head- lateral surface of the lateral pterygoid plate |
Insertion of lateral pterygoid mm | neck of teh mandible, articular disc of TMJ |
Origin of medial pterygoid mm | superficial head- from the tuberosity of the maxilladeep head- from the medial surface of the lateral pterygoid plate |
insertion of medial pterygoid mm | medial surface of the angle and ramus of the mandible |
Where does the maxillary artery arise? | behind the neck of the mandible |
What is a large, terminal branch of the external carotid artery? | maxillary artery |
The maxillary artery is divided into three parts by which muscle? | lateral pterygoid |
Where does the first part of the maxillary artery run? | horizontal along the lower border of the lateral pterygoid |
where does the second part of the maxillary artery run? | upwards behind or in front of lateral pterygoid |
Where does the third part of the maxillary artery run? | in the pterygopalatine fossa |
What are the branches of the first part of the maxillary artery? | deep auricular, anterior tympanic, middle meningeal, accessory meningeal, inferior alveolar |
what are the branches of the second part of the maxillary artery? | muscular branches |
What are the branches of the third part of the maxillary artery? | posterior superior alveolar, infraorbital, greater palatine, pharyngeal branches, artery to pterygoid canal, sphenopalatine |
The external and middle ear, auditory tube, dura mater, upper and lower jaws, muscles of infratemporal region, nose and para nasal air sinuses, palate and roof of the pharynx are supplied by which artery? | maxillary artery |
Where does the mandibular nerve arise from? | trigeminal ganglion |
What is the largest branch of the trigeminal nerve? | mandibular nerve |
Which foramen does the mandibular nerve enter the infratemporal fossa through? | foramen ovale |
What are the branches of the mandibular branch of trigeminal? | meningeal, n. to medial pterygoid and tensor palati, buccal, branches to muscles of mastication, auriculotemporal, lingual, inferior alveolar |
The auriculotemporal, lingual, and inferior alveolar nerves arise from where? | the posterior division of the mandibular n. |
the buccal nerve and branches to muscles of mastication arise from where? | the anterior division of the mandibular n. |
the meningeal branch and nerve to medial pterygoid and tensor veli palatini arise from where? | the main trunk of the mandibular n. |
Which nerve encircles the middle meningeal artery? | auriculotemporal |
which nerve is the lingual nerve joined by? | chorda tympani |
What does the lingual nerve supply? | sensory to anterior two thirds of the tongue |
which nerve gives off the mylohyoid nerve? | inferior alveolar |
what is the ONLY motor nerve that arises from the posterior division of the mandibular nerve? | mylohyoid nerve |
the lateral pterygoid, digastric, geniohyoid and mylohyoid muscles help produce which movement of the mouth? | depression |
Which muscle is the main muscle that aids in depression of the TMJ? | lateral pterygoid |
What is the main artery that supplies the upper limb? | subclavian artery |
where does the right side of the subclavian artery arise from? | brachiocephalic a. |
where does the left side of the subclavian artery arise from? | the arch of the aorta |
Where is the first part of the subclavian artery? | Medial to anterior scalene |
where is the second part of the subclavian artery? | posterior to the anterior scalene |
Where is the third part of the subclavian artery? | Lateral to the anterior scalene |
Where is the superior cervical sympathetic ganglion located? | opposite to the 2nd and 3rd CV |
Where is the middle cervical sympathetic ganglion located? | In front of the 6th cervical vertebra |
What is the middle cervical sympathetic ganglion formed from? | Fusion of the 5th and 6th cervical ganglia |
Where is the stellate ganglion located? | Lies between TP of 7th CV and the neck of the 1st rib |
Lesser occipital, great auricular, transverse cutaneous, and supraclavicular are cutaneous branches of what? | Cervical plexus |
what is the cervical plexus formed from? | upper 4 cervical nerves |
What are the 2 muscular branches of the cervical plexus? | Phrenic, some muscles of the neck |
The jugulodigastric lymph node supplies what? | Tonsil |
The jugulo omohyoid lymph node supplies what? | tongue |
Origin of scalenus anterior | anterior tubercles of the transverse processes of the C3, 4, 5, 6 |
Insertion of scalenus anterior | Scalene tubercle and upper surgacve of the first rib between the subclavian vein and artery |
It's action is to antero-laterally flex the cervical spine, rotate it to the opposite side, elevate the first rib during inspiration and stabilize | scalenus anterior |
origin of scalenus medius | Transverse process of axis, posterior tubercles of the tp's of the 3, 4, 5, 6, 7 CV |
Insertion of scalenus medius | superior surface of the first rib behind the subclavian artery |
It's action is lateral flexion of the cervical spine, elevation of the first rib and stabilization of the neck | scalenus medius |
Origin of scalenus posterior | posterior tubercle of tp's of 4, 5, 6 CV |
Insertion of scalenus posterior | outer surface of the second rib |
It's action is lateral flexion of the cervical spine, elevation of the 2nd rib and stabilization of the neck | scalenus posterior |
Origin of the upper oblique fibers of longus coli | anterior tubercle of to's of 3, 4, 5 CV |
Origin of the lower oblique fibers of longus coli | bodies of the upper 2 or 3 TV |
Origin of middle vertical fibers of longus coli | bodies of upper 2 TV and lower 3 CV |
insertion of upper fibers of longus coli | anterior tubercle of the atlas |
insertion of lower fibers of longus coli | anterior tubercle of TP of 5, 6 CV |
Insertion of middle vertical fibers of longus coli | bodies of 2, 3, 4 CV |
Origin of longus capitis | anterior tubercles of TP of 3-6 CV |
Insertion of longus capitis | inferior surface of the basilar part of the occipital bone |
Origin of rectus capitis anterior | anterior surface of the lateral mass of the atlas |
Insertion of rectus capitis anterior | basilar part of the occipital bone |
Origin of rectus capitis lateralis | upper surface of the TP of atlas |
Insertion of rectus capitis lateralis | jugular process of the occipital bone (inferior surface) |
Where is the anterior 2/3 of the hard palate formed from? | palatine process of maxilla |
Where is the posterior 1/3 of the hard palate formed from? | horizontal plate of the palatine bone |
What two structures does the soft palate separate? | nasopharynx from oropharynx |
Tensor palati, levator palati, musculus uvulae, palatoglossus and palatopharyngeus are muscles of what? | soft palate |
All the msucles of the soft palate except tensor palati are supplied by what? | pharyngeal plexes |
Where is the palatine tonsil seen? | tonsilar fossa |
where is the lingual tonsil found? | posterior part of the dorsum of teh tongue |
where is the paryngeal tonsil found? | posterior wall of the nasopharynx |
Where is the tubal tonsil found? | seen in relation to the auditory tube |
Breathing becomes difficult when which tonsil is enlarged? | pharyngeal |
what forms waldeyer's ring? | palatine, lingual, pharyngeal and tubal tonsils |
what are teh anterior communications of the pharynx? | with the nasal cavities through posterior nasal aperture |
what are the inferior communications of the pharynx? | with the oropharynx thru the nasopharyngeal isthmus |
What are the lateral communications of the pharynx? | with the middle ear cavity through the pharyngeal opening of the auditory tube |
The palatoglossal and palatopharyngeal arches are found where? | in the lateral wall of the oropharynx |
the palatoglossal arches contain what? | palatoglossus muscles |
the palatopharyngeal arches contain what? | palatopharyngeus muscles |
What is the origin of the superior pharyngeal constrictor? | pterygoid hamulus, pterygomandibular raphae, mandible, tongue |
what is the origin of the middle pharyngeal constrictor? | stylohyoid ligament, hyoid bone |
what is the origin of the inferior pharyngeal constrictor? | thyropharyngeus from the thyroid cartilage, cricopharyngeus from the cricoid cartilage |
all three pharyngeal constrictors insert where? | into the median pharyngeal raphae |
What is found between the upper border of the superior constrictor and the base of the skull? | auditory tube and levator veli palatini |
what is found between the superior and middle constrictor? | stylopharyngeus and glossopharyngeal nerve |
what is found between the inferior and middle constrictor? | internal laryngeal nerve and superior laryngeal artery |
what is found between the inferior constrictor and the esophagus? | recurrent laryngeal nerve and inferior laryngeal artery |
where is the superior meatus located? | between superior and middle conchae |
what opens into the superior meatus? | posterior ethmoidal sinus |
Where is the middle meatus located? | between middle and inferior conchae |
what two structures are seen within the middle meatus? | bulla ethmoidalis and hiatus semilunaris |
what is bulla ethmoidalis formed by? | middle ethmoidal air cells |
what is found at the end of the hiatus semilunaris? | infundibulum |
which meatus is the infundibulum found within? | middle meatus |
which sinuses open into the middle meatus? | frontal, maxillary, anterior ethmoidal, middle ethmoidal, sphenoidal |
where does the frontal air sinus open into? | anterior part of middle meatus |
where dos the maxillary air sinus open into? | posterior part of the middle meatus |
where does teh anterior ethmoidal air sinus open into? | in between the frontal and maxillary air sinus openings within the middle meatus |
Where does the middle ethmoidal sinus open into? | above the bulla ethmoidalis within the middle meatus |
where does the sphenoidal sinus open into? | sphenoethmoidal recess |
the nasolacrimal duct is found whereZ? | inferior meatus |
What is the anterior communication of the ptertygopalatine fossa? | to the orbit via the infraorbital fissure |
what is the posterior communication of the pterygopalatine fossa? | with the middle cranial fossa through foramen rotundum, through foramen lacerum with pterygoid canal, with the pharynx through the palatovaginal canal |
The posterior communication of the pterygopalatine fossa with the middle cranial fossa is through which foramen? | foramen rotundum |
The posterior communicatino of the pterygopalatine fossa with the foramen lacerum is through what? | pterygoid canal |
the posterior communication of the pterygopalatine fossa with the pharynx is through what? | palatovaginal canal |
what is the medial communication of the pterygopalatine fossa? | with the nose through the sphenopalatine foramen |
what is the lateral communication of the pterygopalatine fossa? | with the infratemporal fossa through pterygomaxillary fissure |
what is the inferior communication of the pterygopalatine fossa? | with the oral cavity through the greater and lesser palatine canal |
what is the largest parasympathetic ganglion? | pterygopalatine ganglion |
the pterygopalatine ganglion is a relay station for what? | secretomotor fibers to the lacrimal gland |
what is the vidian nerve formed by? | greater petrosal and deep petrosal nerves |
where does the greater petrosal nerve branch from? | facial n. |
where dose the deep petrosal nerve branch from? | plexus around the internal carotid artery |
what are the unpaired cartilages? | thyroid, cricoid, epiglottis |
what are the paired cartilages? | arytenoid, corniculate, cuneiform |
What are the boundaries of the cavity of the larynx? | from the inlet of the larynx to the lower border of the cricoid cartilage |
at what level is the cricoid cartilage located? | 6th CV |
What is the name for air filled spaces seen within some bones located around the nasal cavity? | paranasal air sinuses |
where is the base of the maxillary sinus located? | lateral wall of the nose |
where is the roof of the maxillary sinus located? | floor over the orbital cavity |
waht is the floor of the maxillary sinus formed by? | alveolar processes of the maxilla |
where is the apex of the maxillary sinus? | extends into the zygomatic process of the maxilla |
where does the ostium of the maxillary sinus open into? | nasal cavity |
recurrent cold, pain, and purulent discharge are signs and symptoms of what? | sinusitis |
where is pain due to inflammation felt when it affects maxillary sinusitis? | below the orbit |
where is pain felt with ethmoiditis? | felt over the nasal bridge |
where is pain felt with frontal sinusitis? | over the forehead- patient will often complain of headache |
where is pain felt in the sphenoidal sinus? | referred to vertex and occiput |
the anterior wall of the middle ear is also referred to as what? | carotid wall |
this acts as a canal for tensor tympani | anterior wall of the middle ear |
the anterior wall of the middle ear acts as an opening for what? | auditory tube |
the posterior wall of the middle ear is also referred to as what? | mastoid wall |
the pyramid of the middle ear is located within which wall? | posterior wall |
the medial wall of the inner ear is also referred to as what? | labyrinthine wall |
how might a throat infection spread to the middle ear cavity? | through the auditory tube |
Chronic otitis media | discharge of the pus from the middle ear cavity |
The mandibular division of the trigeminal nerve comes from which pharyngeal arch? | first |
muscles of mastication, tensor tympani, tensor palati, anterior belly of digastric and mylohyoid are formed by which pharyngeal arch? | first |
Meckel's cartilage is a derivative of which pharyngeal arch? | first |
the sphenomandibular ligament is the remains of which cartilage? | meckel's |
the facial nerve is derived from which pharyngeal arch? | second |
the muscles of facial expression, stapedius, stylohyoid, posterior belly of digastric are muscle derivations ffrom which pharyngeal arch? | second |
Richert's cartilage is formed by which pharyngeal arch? | second |
the upper part of the body and lesser cornu of the hyoid bone as well as the styloid process are derived form which pharyngeal arch? | second |
the internal carotid artery is the artery from which pharyngeal arch? | third |
the glossopharyngeal nerve is formed from which pharyngeal arch? | third |
stylopharyngeus is derived from which pharyngeal arch? | third |
lower part of the body and greater cornu of the hyoid bone are derived from which pharyngeal arch? | third |
the arch of the aorta on the left and right subclavian artery on teh right are derived from which pharyngeal arch? | fourth |
what is the nerve of the fourth pharyngeal arch? | superior laryngeal |
the thyroid cartilage is derived from which pharyngeal arch? | fourth |
levator palati, cricothyroid, and the pharyngeal constrictors are derived from which pharyngeal arch? | fourth |
the sixth pharyngeal arch is AKA as what? | pulmonary arch |
the ductus arteriosus is the artery of which pharyngeal nerve? | sixth |
the recurrent laryngeal nerve is derived from which pharyngeal arch? | sixth |
all the muscles of the larynx are derived from which pharyngeal arch? | sixth |
arytenoid cartilage is derived from which pharyngeal arch? | sixth |
the external auditory meatus is formed by which pharyngeal cleft? | first cleft |
the cervical sinus does what? | disappears |
the second to fifth pharyngeal clefts form what? | cervical sinus |
tympanic cavity, mastoid antrum and auditory tube are derivations of which pharyngeal pouch? | first pouch |
the palatine tonsils come from which pharyngeal pouch? | second pouch |
the thymus and inferior parathyroid gland are derived from which pharyngeal pouch? | third pouch |
the superior parathyroid glands are derived ffrom which pharyngeal pouch? | fourth pouch |
the ultimobranchial body is derived from which pharyngeal pouch? | fifth pouch |