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anatomy slides 5a

***Fontanels in the skull are the unossified remnants of the membranes in newborns. Major fontanels are: anterior (ossified within 18-36 months), posterior, mastoid and sphenoid which are ossified within 6 month or more
The sphenoid bone is called the keystone of the cranial floor because? it articulates with all other cranial bones, holding them together
Mandible the largest and strongest facial bone
Contents of Foramina in cribiform plate axons of olfactory cells in olfactory epithelium that form olfactory nerves
contents of anterior and posterior ethmoidal foramina vessels and nerves with same names
contents of foramen magnum medulla and meninges, vertebral arteries, spinal roots of CN 11, dural veins, anterior and posterior spinal arteries
contents of jugular formamen CN 9, 10, 11, superior bulb of internal jugular vein, inferior petrosal and sigmoid sinuses, and meningeal branches of ascending pharyngeal and occipital arteries
contents of hypoglossal canal hypoglossal nerve CN 13
contents of Condylar canal emissary vein that passes from sigmoid sinus to vertebral veins in neck
contents of Mastoid Foramen Mastoid emissary vein from sigmoid sinus and meningeal branch of occipital artery
mimetic muscles radiate into? the skin of the face and the head, and their contraction causes displacement of the skin.
4 groups of mimetic muscles: A- Muscles of the Scalp B- Muscles in the region of eyelid C- Muscles in the Nasal region D- Muscle of the Mouth region
Muscles of the Scalp: Epicranius Muscle: (Occipitofrontalis) produces wrinkles in forehead and gives facial expression of Astonishment. Innervation: All mimetic muscles by Facial nerve (cranial nerve CNVII)
Muscles in the region of eyelid or palpebral fissure: Orbicularis Oculi muscle: produces folds in lateral angle of the eye, expression of Worry and concern
Muscles in the region of eyelid or palpebral fissure: Corrugator supercilli Pulls the skin and eyebrow down and medially. Produces vertical folds. Protects against light. Pathetic pain muscle. Thinker’s brow expression
****All mimetic muscles innervated by? Facial (CN 7) N
Mimetic muscles in the region of the mouth: Orbicularis Oris M Function: its contraction closes the mouth. Strong contraction gives a sucking shape. Expression of reserve
Mimetic muscles in the region of the mouth: Buccinator M Function: enables air to be blown out of the mouth. Pulls angle of the mouth laterally. Keeps the mucous membrane of the cheek free of folds. Contraction gives expression of satisfaction
Muscles in the region of eyelid or palpebral fissure: Orbicularis Oculi muscle: Function: produces folds in lateral angle of the eye, expression of Worry and concern
Muscles in the region of eyelid or palpebral fissure: Corrugator supercilli Pulls the skin and eyebrow down and medially. Produces vertical folds. Protects against light. Pathetic pain muscle.
Mimetic muscles in the region of the mouth Zygomaticus Major Function: lifts the corner of the mouth upward, giving expression of laughter or pleasure
Mimetic muscles in the region of the mouth Risorius: (laughing muscle) Function: together woth zygomatic major it produces the nasolabial folds. Its contraction gives expression of Action
Mimetic muscles in the region of the mouth Lavator anguli oris: It lifts the angle of the mouth, Giving expression of self confidence
Mimetic muscles in the region of the mouth Depressor anguli oris Function: pulls the angle of the mouth downwards and produces expression of sadness
Mimetic muscles in the region of the mouth Depressor labii inferioris pulls the lower lid down, giving expression of perseverance
Mimetic muscles in the region of the mouth Mentalis Produces: chin-lip furrow, giving expression of doubt and indecision
Muscles of Mastication: Masseter (1), temporalis (2), Lateral (3) and medial pterygoid
Muscles of Mastication ***All Innervated by ? Mandibular nerve (CN 5 branch 3). ***Develop from 1st branchial arch
CN V cranial nerve 5 (trigeminal nerve). It has 3 branches: ophthalmic, maxillary and mandibular
Masseter M Function: powerfully closes the jaw by elevating the mandible. NN: Masseteric N CNV/3
Temporalis M Function: strongest elevator of lower jaw. NN: deep temporal N CNV/3
Lateral pterygoid M Function: mandibular movements (guiding muscle). NN: lateral pterygoid N CNV/3
Medial Pterygoid M Function: elevates mandible and pushes it forward. Rotational movement. NN; Medial pterygoid N. CNV/3.
Anterior Facial Regions: blood supply of the face is mostly by? by ext. carotid and partly by int. carotid. Facial artery (2) from ext. carotid passes it anastomose with dorsal nasal A. (4) coming from Ophthalmic A.
Forehead's blood is supplied by ? supratrochlear A. (8) and supraorbital (9) A., both from ophthalmic A supratrochlear A. (8) and supraorbital (9) A., both from ophthalmic A
Facial vein anastomoses via ? Angular vein (11) With dorsal nasal vein
***WHY IS THIS EXTREMELY IMPORTANT: Facial vein (10) anastomoses via Angular vein (11) With dorsal nasal vein ***This anastomoses is extremely important since this allows a direct connection to Cavernous sinus, through which, infections eg: from a furuncle on the lip, may get into skull.
Sensory innervation to the face: Is derived from branches of Trigeminal (V) nerve
Trigeminal (V) nerve Ophthalmic (V/1), Maxillary (V/2) and mandibular (V/3) nerves. Ophthalmic nerve: supplies the forehead: Supratrochlear N (17) and supraorbital
Maxillary nerve supplies lower eyelid, Cheek, lateral nasal, upper lip and anterior Temporal regions by Infraorbital N.
Mandibular N lower lip over mandible (not angle) and chin by mental N (23). Auriculotemporal N (24) supplies skin on Mandible ramus, concha of auricle and Most part of ext. layer of tympanic memb
Sensitivity of the 3 branches of trigeminal N can be tested by? pressing nerves 18, 22 and 23. This is a vertical line, 2-3 cm lateral to midline
****Trigeminal Neuralgia NERVE disorder that causes a stabbing or electric shock like pain in parts of face may be caused by MS or pressure on trigeminal nerve from a swollen blood vessel or tumor
****Trigeminal Neuralgia SLIDES INFO (Tic Douloureux) disorder of unknown etiology (cause) associated with intractable pain along the 3 branches of trigeminal nerve but especially along maxillary and mandibular nerves. A simple trigger such as touch, cold or hot can start the pain
****Trigeminal Neuralgia THERAPY Carbamazepine, radiofrequency destruction of the branches involved. Alcohol or Glycerin injection around the trigeminal ganglion. Transection of the sensory root. Vascular decompression of the trigeminal ganglion
Hyoid bone in the neck, but, may be included with the bony skeleton of the skull
Stylohyoid ligament attached to the tip of the styloid process of the temporal bone and the lesser cornu of the hyoid bone
Muscles of the neck: ****Platysma: *Action: brings down corners of the mouth, expressing sadness. *Innervation: Facial N. (VII) (cervical branch)
***Injury to this nerve leads to paralysis of platysma (skin falls away from the neck by folds Facial N. (VII) (cervical branch)
wHAT Is the only cutaneous muscle in human body (under the skin) ? Platysma:
*Careful sutures of the skin should be made in surgery of the neck region BECAUSE OF? Platysma AND FACIAL NERVE 7
Cranial muscle inserted on the Shoulder girdle: ***Trapezius M: *Function: elevation, retraction and rotation of scapula. Helps in adduction and slight elevation of arm *Innervation: spinal root of Accessory nerve (CNXI) and C3-C4 (propioception)
Sternocleidomastoid M Function: unilateral contraction turns the head to opposite side and bends it ipsilaterally. Bilateral contraction: lifts the head. Also functions in respiration. Innervation: Accessory nerve (CNXI) and C2-C3
***Accessory nerve 11 Examination Sternomastoid: ask patient to rotate head against resistance to compare power and muscle bulk on each side. Then compare each side with the patient pulling head forward against resistance. The left sternomastoid turns the head right and vice versa
***Accessory nerve 11 Examination Trapezius Ask patient to "shrug" shoulders and to hold them in this position against resistance. Compare power on each side. Patient should manage to resist any effort to depress shoulders.
***Congenital and Spasmodic Torticollis (Wry neck) Congenital Torticollis: Most common type of Torticollis. Fibromatosis (fibrous tissue tumor) of Sternocleidomastoid M. Therapy: division of the muscle below XI nerve or from its distal attachment.
**Congenital and Spasmodic Torticollis (Wry neck) symptoms Head turns to the side and face away from the affected side. Leads to stifness of the neck due to fibrosis and shortening of the sternocleidomastoid. Injury during delivery may also result in Torticollis. (muscle tear and hematoma leads to fibrosis)
***Spasmodic Torticollis (Wry neck) Cranial dystonia (abnormal tonicity) Between 20-60 years of age. Unknown cause. May involve bilateral neck muscles especially the Sternocleidomastoid M. Unilateral deviation of the head. (turning, tilting, flexion or extension of the neck)
Spasmodic Torticollis: THERAPY myotomy or also section of the spinal Accessory N. and upper cervical ant. roots
***Infrahyoid muscles: Omohyoid, Sternohyoid, Sternothyroid and Thyrohyoid
**Omohyoid muscle *Action: fascia tensor and dilates internal Jugular vein lying beneath it. (this aids to return of blood to the heart) Opens the mouth and helps in lateral flexion of the head. *Innervation: Most Infrahyoid muscles are innervated by cervical Ansa
Thyrohyoid M. Innervation: C1, before giving the branch to cervical ansa. *Action: All infrathyroid muscles work together to approximate thyroid cartilage to hyoid bone. When mouth is open, they stabilize laryngeal cartilages and the hyoid bone
Suprahyoid muscles Digastric, Stylohyoid, Myelohyoid and Geniohyoid MM
***Digastric M Function: Raising hyoid and stabilizing it in speaking and swallowing,depressing the mandible. **Innervation: Ant. Belly: V/3, trigeminal N. (from nerve to myelohyoid) and post. belly: VII, facial nerve.
Stylohyoid M Function: elevates and retracts hyoid bone, elongates floor of the mouth. Innervation: VII, facial N. (cervical branch)
**Myelohyoid M Function: Elevates hyoid and floor of the mouth and tongue in swallowing and speaking. *Innervation: V/3 (myelohyoid N. from inf. Alveolar N.)
***Geniohyoid M Function: pulls the hyoid anterosuperiorly, shortens floor of the mouth and widens pharynx. *Innervation: C1 via hypoglossal nerve
Rectus capitis Helps to flex the head. NN: Cervical Plex.(C1)
Helps to flex the head. NN: Cervical Plex.(C1) Bend the head forward and unilateral action turns the head sideways. NN: Cervical Plexus(C1-4).
Longus Colli Action: unilateral contraction bends and turns cervical column to the side. Also bend the cervical spine forwards. NN: cervical and brachial Pl. (C2-C8)
Scalene muscles: Scalene Anterior (17): Scalene Medius (20): Scalene Posterior (23 Most important muscles for quiet inspiration They lift the first 2 pairs of ribs (sup part of thorax). Unilateral contraction tilts cervical column to one side.
Scalene opening brachial plexus and subclavian artery pass through
Occipital (Omotrapezoid) triangle *Content: Cervical Plexus. Accessory Nerve comes from behind the Sternocleidomastoid M
***Scalene gap Formed between scalene Anterior and Middle and 1st rib, in which run the Brachial plexus (18) and Subclavian Artery
Anterior Triangle Borders: Posterior (lateral) : Sternocleidomastoid Superior: mandible Anterior: midline of the neck
Carotid Triangle Borders: Super: Post. belly of Digastric Med: Sup. Belly of Omohyoid (2)
Thyroid Gland Body's largest endocrine gland Is deep to sternothyroid and sternohyoid M
****Function OF THYROID Produces Thyroxin which controls the rate of metabolism of the body, and Calcitonin controlling Ca++ metabolism.
Goiter: Enlargement of Thyroid gland (nonneoplastic and noninflammatory). Usually not upward shift. Endemic in areas deficient in Iodine in food. Swelling in the neck which may disturb trachea, esophagus and/or laryngeal nerves. Exophthalmic goiter is due to excessive production of th
Thyroidectomy: Removal of thyroid due to cancer. Subtotal due to preservation of Parathyroid glands and recurrent as well as superior laryngeal nerves. Inadvertent removal of parathyroid glands lead to tetany, severe convulsion and muscle spasm due to decrease in serum Ca++ and may lead to resp f
Parathyroid glands Usually 4, one upper and one lower gland per each thyroid lobe. They are external to thyroid capsule and internal to the connective tissue sheath. Function: Produce parahormon, controlling the metabolism of P and Ca++
Created by: Mikewagner85