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Post-Midterm Anatomy
Head & Neck
| Question | Answer |
|---|---|
| What are the 10 muscles of the posterior triangle? | 1) Trapezius, 2) SCM, 3) Anterior Scalene, 5) Middle Scalene, 6) Posterior Scalene, 7) Levator Scapulae, 8) Inferior Belly of the Omohyoid, 9) Semispinalis Capitis, 10) Splenius Capitis |
| What is the innervation of the Trapezius and the SCM? | CN XI |
| What is the innervation of the Scalene muscles? | Nerves From Cervical Plexus |
| What is the function of the Anterior Scalene muscle? | Elevate Rib 1 |
| What is the function of the Middle Scalene muscle? | Elevate Rib 1 |
| What is the function of the Posterior Scalene muscle? | Elevate Rib 2 |
| What is the function of the Omohyoid? | Depress the Omohyoid bone |
| What is the function of the Sternocleidomastoid? | Individually = will tilt head toward shoulder on the same side while rotating face to opposite side, Together = Draw head forward |
| What is the function of the Trapezius? | Rotates, Elevates, Adducts Scapula |
| What is the function of the Splenius Capitis? | Individually = Rotate head to one side, Together = Draw head backwards |
| What is the function of the Levator Scapula? | Elevate Scapula |
| What is the innervation of the Levator Scapulae? | Dorsal Scapular Nerve |
| What is the innervation of Omohyoid? | Ansa Cervicalis |
| What is the innervation of the Semispinalis Capitis? | Cervical Nerves |
| What is the innervation of the Splenius Capitis? | Dorsal Rami of Cervical Nerves |
| What are the 4 muscles of the Infrahyoid Group (Strap Muscles)? | 1) Sternohyoid, 2) Sternothyroid, 3) Thyrohyoid, 4) Omohyoid |
| What is the innervation of the Thyrohyoid? | C1 (the one exception, all other strap muscles done by Ansa Cervicalis) |
| What is the function of the Thyrohyoid? | Depress the hyoid bone, raise the larynx |
| What is the innervation of the Sternohyoid? | Ansa Cervicalis |
| What is the function of the Sternohyoid? | Depresses the hyoid bone after swallowing |
| What is the innervation of the Sternothyroid? | Ansa Cervicalis |
| What is the function of the Sternothyroid? | Draws larynx/thyroid cartilage downward |
| What are the 5 muscles of the Superhyoid Group? | 1) Anterior Belly of Digastric, 2) Posterior Belly of Digastric, 3) Stylohyoid, 4) Geniohyoid, and 5) Mylohyoid |
| What is the innervation of the Anterior Belly of Digastric? | V3 (nerve to mylohyoid) |
| What is the innervation of the Posterior Belly of the Digastric? | CN VII |
| What is the innervation of the Stylohyoid? | CN VII |
| What is the function of the Stylohyoid? | Pulls hyoid bone upward in a posterosuperior direction |
| What is the innervation of the Geniohyoid? | C1 |
| What is the function of the Geniohyoid? | Fixed mandible elevates and pulls hyoid bone forward, fixed hyoid pulls mandible down and inward |
| What is the innervation of the Mylohyoid? | V3 (nerve to lyohyoid) |
| What is the function of the Mylohyoid? | Support and elevate the floor of the mouth, elevates hyoid |
| What are the 9 muscles of Facial Expression? | 1) Platysmus, 2) Obicularis Oris, 3) Depressor Anguli Oris, 4) Buccinator, 5) Levator Anguli Oris, 6) Zygomaticus Major, 7) Zygomaticus Minor), 8) Orbicularis Oculi (Orbital and Palpebra), 9) Frontalis |
| What is the innervation of the Playsmus? | CN VII (Cervical Branch) |
| What is the function of the Platymus? | Tenses the skin of the neck and draws the lower lip and corners of the mouth downward |
| What is the innervation of the Orbicularis Oris? | CN VII (Zygomatic and Temporal Branches) |
| What is the innervation of the Depressor Anguli Oris? | CN VII (Marginal Mandibular Branch) |
| What is the function of the Depressor Anguli Oris? | Depresses corners of mouth, ‘Frown’ muscle |
| What is the innervation of the Buccinator? | CN VII (Buccal Branch) |
| What is the function of the Buccinator? | Presses the cheek against the teeth |
| What is the innervation of the Levator Anguli Oris? | CN VII (Buccal Branch) |
| What is the function of the Levator Anguli Oris? | Raises corners of mouth |
| What is the innervation of the Zygomaticus Major? | CN VII (Zygomatic and Buccal Branches) |
| What is the function of the Zygomaticus Major? | Draws the corners of the mouth upward and laterally |
| What is the innervation of the Zygomaticus Minor? | CN VII (Zygomatic and Buccal Branches) |
| What is the function of the Zygomaticus Minor? | Draws the upper lip upward |
| What is the innervation of the Orbicularis Oculi? | CN VII (Temporal and Zygomatic Branches) |
| What is the function of the Orbicularis Oculi (Orbital and Palpebra)? | Orbital = close eyelids forcefully, Palpebra = close eyelids gently |
| What is the innervation of the Frontalis? | CN VII (Temporal Branches) |
| What is the function of the Frontalis? | Elevates eyebrows, Wrinkles forehead |
| What are the Muscles of Matication? | 1) Temporalis, 2) Masseter, 3) Lateral Pterygoid, 4) Medial Pterygoid |
| What is the innervation of the Temporalis? | V3 of CN V (anterior and posterior deep temporal branches) |
| What is the function of the Temporalis? | Retracts mandible, closes jaw |
| What is the innervation of the Masseter? | V3 of CN V (masseteric branch) |
| What is the function of the Masseter? | Retracts mandible, closes jaw |
| What is the innervation of the Lateral Pterygoid? | V3 of CN V |
| What is the function of the Lateral Pterygoid? | Protrusion/Depression of the mandible (opening of the jaw) |
| What is the innervation of the Medial Pterygoid? | V3 of CN V (Medial Pterygoid Branch) |
| What is the function of the Medial Pterygoid? | Medial deviation of the jaw |
| What are the muscles of the Middle Ear? | 1) Tensor Tympani and 2) Stapedius |
| What is the innervation of the Tensor Tympani? | V3 of CN V (Mandibular Branch) |
| What is the function of the Tensor Tympani? | Contraction pulls handle of the Malleus medially |
| What is the innervation of the Stapedius? | CN VII (Nerve to Stapedius) |
| What is the function of the Stapedius? | Contraction (to control the amplitude of sound waves to the inner ear) |
| List the 7 Extraoccular Muscles. | 1) Levator Palpebra Superioris, 2) Superior Oblique, 3) Inferior Oblique, 4) Superior Rectus, 5) Inferior Rectus, 6) Medial Rectus, 7) Lateral Rectus |
| What is the innervation of the Levator Palpebra Superioris? | CN III |
| What is the function of the Levator Palpebra Superioris? | Raises upper eyelid |
| What is the innervation of the Superior Oblique? | CN IV (only muscle it innervates) |
| What is the function of the Superior Oblique? | Moves eye down and out |
| What is the innervation of the Inferior Oblique? | CN III |
| What is the function of the Inferior Oblique? | Moves eye up and out |
| What is the innervation of the Superior Rectus? | CN III |
| What is the function of the Superior Rectus? | Moves eye up and in |
| What is the innervation of the Inferior Rectus? | CN III |
| What is the function of the Inferior Rectus? | Moves eye down and in |
| What is the innervation of the Medial Rectus? | CN III |
| What is the function of the Medial Rectus? | Moves eye in |
| What is the innervation of the Lateral Rectus? | CN VI (only muscle it innervates) |
| What is the function of the Lateral Rectus? | Moves eye out |
| List the Muscles of the Tongue. | 1) Intrinsic muscles, 2) Genioglossus, 3) Styloglossus, 4) Hyoglossus, 5) Palatoglossus |
| What is the innervation of the Intrinsic muscles of the tongue? | CN XII |
| What is the function of the Intrinsic muscles of the tongue? | Fine control of tongue movements |
| What is the innervation of the Genioglossus? | CN XII |
| What is the function of the Genioglossus? | Protrudes/Depresses the tongue, prevents the tongue from sinking backwards |
| What in the innervation of the Styloglossus? | CN XII |
| What is the function of the Styloglossus? | Draws tongue up and backwards (retracts) |
| What is the innervation of the Hyoglossus? | CN XII |
| What is the function of the Hyoglossus? | Depresses tongue |
| What is the innervation of the Palatoglossus ? | CN X (the only exception of the tongue muscles) |
| What is the function of the Palatoglossus? | Depresses soft palate, elevates the tongue |
| What are the 5 muscles of the palate? | 1) Palatoglossus, 2) Levator Veli Palatini, 3) Tensor Veli Palatini, 4) Musculus Uvulae, 5) Palatopharyngeus |
| What is the innervation of the Levator Veli Palatini? | CN X |
| What is the function of the Levator Veli Palatini? | Elevates soft palate |
| What is the innervation of the Tensor Veli Palatini? | V3 (nerve to medial pterygoid branch) |
| What is the function of the Tensor Veli Palatini? | Tenses soft palate, pulls soft palate to the same side |
| What is the innervation of the Musculus Uvulae? | CN X |
| What is the function of the Musculus Uvulae? | Retracts uvula to same side |
| What is the innervation of the Palatopharyngeus? | CN X |
| What is the function of the Palatopharyngeus? | Moves pharynx up and forward during swallowing |
| What are the 6 muscles of the Pharynx? | 1) Palatopharyngeus, 2) Salpingopharyngeus, 3) Stylopharyngeus, 4) Superior Pharyngeal Constrictor, 5) Middle Pharyngeal Constrictor, 6) Inferior Pharyngeal Constrictor |
| What is the innervation of the Salpingopharyngeus? | CN X (pharyngeal plexus) |
| What is the function of the Salpingopharyngeus? | Elevates Pharynx and Larynx |
| What is the innervation of the Stylopharyngeus? | CN IX |
| What is the function of the Stylopharyngeus? | Elevates the Pharynx and Larynx |
| What is the innervation of the Superior, Middle, and Inferior Pharyngeal Constrictors? | CN X (External Laryngeal for inferior, Pharyngeal branch for superior and middle) |
| What is the function of the Super, Middle, and Inferior Pharyngeal Constrictors? | Propel food inferiorly |
| What are the 9 muscles of the Larynx? | 1) Cricothyroid, 2) Posterior Cricoarytenoid, 3) Lateral Cricoartytenoid, 4) Transverse Arytenoid, 5) Oblique Arytenoid, 6) Aryepiglottic, 7) Thyroepiglottic, 8) Thyroarytenoid, 9) Vocalis |
| What is the innervation of the Cricothyroid? | CN X (External Laryngeal branch) |
| What is the function of the Cricothyroid? | Increases tension on vocal ligament to raise the pitch of the voice |
| What is the innervation of the Posterior Cricoarytenoid? | CN X (Inferior Laryngeal branch) |
| What is the function of the Posterior Cricoarytenoid? | Abducts vocal cords, opens Rima Glottidis |
| What is the innervation of the Lateral Cricoarytenoid? | CN X (Inferior Laryngeal branch) |
| What is the function of the Lateral Cricoarytenoid? | Closes/Adducts Rima Glottidis |
| What is the innervation of the Transverse Arytenoid? | CN X (Inferior Laryngeal branch) |
| What is the function of the Transverse Arytenoid? | Closes Rima Glottidis |
| What is the innervation of the Oblique Arytenoid? | CN X (Inferior Laryngeal branch) |
| What is the function of the Oblique Arytenoid? | Helps close inlet of larynx |
| What is the innervation of the Aryepiglottic? | CN X (Inferior Laryngeal branch) |
| What is the function of the Aryepiglottic? | Helps close the inlet of the larynx |
| What is the innervation of the Thryoepiglottic? | CN X (Inferior Laryngeal branch) |
| What is the function of the Thyroepiglottic? | Draws epiglottic cartilage inferiorly |
| What is the innervation of the Thyroarytenoid? | CN X (Inferior Laryngeal branch) |
| What is the function of the Thyroarytenoid? | Shortens/Slackens vocal cords to create a lower pitch in the voice |
| What is the innervation of Vocalis? | CN X (Inferior Laryngeal branch) |
| What is the function of the Vocalis? | Close/Fine adjustment of tension in vocal cords, lowers pitch in voice. |
| The majority of the muscles of the posterior triangle of the neck are innervated by cervical nerves, which are the exceptions? | SCM and Trapezius = CN XI, Levator Scapula = Dorsal Scapular |
| The majority of the muscles of the infrahyoid are innervated by the Ansa Cervicalis, which is the exception? | Thyrohyoid = C1 |
| Are there any exceptions to the rule that the muscles of facial expression are all done by CN VII? | No, they are all done by CN VII |
| The majority of the Extraoccular muscles are innervated by CN III, which are the exceptions? | Superior Oblique = CN IV, Lateral Rectus = CN VI |
| The majority of the Glossal (Tongue) muscles are innervated by CN IX, which are the exceptions? | The Palatoglossus = CN X |
| The majority of the Palatine muscles are motor innervated by CN X, which are the exceptions? | Tensor Veli Palatini = V3 (nerve to medial pterygoid branch) |
| How does the Hard/Soft Palate receive sensory innervation? | Greater, lesser, and nasopalatine branches of V2 and CN IX to uvular region |
| The majority of the Phayngeal muscles are innervated by CN X, which are the exceptions? | Stylopharyngeus = CN IX |
| Are there any exceptions to the rule that the muscles of the Larynx are all done by CN X through the Internal Laryngeal branch? | All are done by CN X, but the Cricothyroid is done by the External Laryngeal branch |
| What type of nerves compose ALL somatic plexuses? | Ventral Rami |
| Which Cervical Nerves comprise the Ansa Cervicalis? | C1, C2, and C3 |
| What are the cutaneous branches of the cervical plexus? | 1) Transverse Cervical, 2) Supraclavicular, 3) Greater Auricular, and 4) Lesser Occipital |
| What are the motor branches of the cervical plexus? | C1 and Ansa Cervicalis |
| Which branches of the cervical plexus contribute to the Transverse Cervical nerve? | C2 and C3 |
| Which branches of the cervical plexus contribute to the Supraclavicular nerve? | C3 and C4 |
| Which branches of the cervical plexus contribute to the Great Auricular? | C2 and C3 |
| Which branches of the cervical plexus contribute to the Lesser Occipital nerve? | C2 |
| Which compartment of the neck is the visceral compartment and what are its contents? | Anterior compartment (investing layer of deep cervical fascia, the pretracheal layer of the deep cervical fascia, thyroid, trachea, SCM, infrahyoid muscles, [carotid vessels, internal jugular vein, and vagus nerve within the carotid sheath] and esophagus) |
| Which compartment of the neck is muscular compartment and what are its contents? | The Posterior compartment (cervical vertebra w/ spinal cord, prevertebral layer of the deep cervical fascia, prevertebral muscles, intrinsic back muscles, trapezius, CN XI, Phrenic nerve, the root of the brachial plexus, levator scapulae, and scalenes) |
| What are the 4 layers of the deep cervical fascia? | 1) Investing layer, 2) Pretracheal layer, 3) Preveretbral layer and 4) Costocervical layer |
| Name the 3 branches of the Jugular vein and describe their size. | 1) Internal jugular (largest), 2) External Jugular (smaller), 3) Anterior Jugular (smallest) |
| What are the 4 branches of the subclavian artery and what is the mnemonic to remember this? | Vitamin C = VITC = Vertebral artery, Internal Thoracic, Thyrocervical, and Costocervical Trunk |
| Do the internal and external carotid arteries have branches in the neck? | The internal carotid does NOT have any branches in the neck (only in the head), while the External Carotid has branches in both the head and neck (continues into head as superior temporal artery). |
| What is the blood supply of the thyroid? | 1) Super thyroid artery via ECA and 2) Inferior Thyroid via Thyrocervical Trunk via Subclavian Artery |
| What is the venoud drainage of the Thyroid? | 1) Superior and Middle Thyroid Vein via IJ and 2) Inferior Thyroid via Brachiocephalic Vein |
| What is the clinical name given to an enlarged thyroid? | Goiter |
| Describe Horner’s Syndrome. | Loss of SNS to one side of the head which can result in 1) Partial Ptosis (partial due to nonfunctioning tarsalis but active levator palpebrae superioris), 2) Miosis (Pupillary constriction), and 3) Anhydrosis and Vasodilation (No sweating, flushing) |
| Which lymph nodes become enlarged when the Palatine tonsils are infected? | Jugulodigastric |
| Name the Collar lymph nodes in the neck. | 1) Occipital (posterosuperior neck), Posterior Auricular (posterior to ear), 3) Superior Cervical (at EJV), 4) Anterior Auricular/Parotid (anterior to ear, on parotid gland), 5) Submandibular (below mandible), and 6) Submental (below chin) |
| What is CN I responsible for? | Special sense (smell) |
| What is CN II responsible for? | Special sense (sight) |
| What is CN III responsible for? | Motor control of muscles of the eye (except superior oblique and lateral rectus) and Parasympathetic innervation |
| What is CN IV responsible for? | Motor control of Superior Oblique muscle of the eye |
| What is CN V (it’s 3 branches) responsible for? | V1 (ophthalmic = sensory to upper 1/3 of the face including anterior 2/3 of scalp), V2 (maxillary = sensory to middle 1/3 of the face), and V3 (mandibular = sensory to lower 1/3 of face, motor to muscles of mastication and matt |
| What is CN VI responsible for? | Motor control of Lateral Rectus muscle of the eye |
| What is CN VII responsible for? | Motor control of muscles of facial expression (stapedius, stylohyoid, and posterior belly of the digastric), general sense of part of outer ear, special sense (taste on ant 2/3 on tongue), and PS for all glands of the head (except parotid/sweat) |
| Do CN VII and CN VIII travel together, if so where do they travel through? | Yes, together through the Internal Acoustic Meatus |
| What is CN VIII responsible for? | Special sense (balance and hearing) |
| What is CN IX responsible for? | Special sense (taste on posterior 1/3 of tongue), general sense for the pharynx, posterior 1/3 of tongue, palatine tonsil, middle ear, and part of tympanic membrane, PS innervation of parotid, and motor control of 1 muscle of the pharynx (stylopharyngeus) |
| What is CN X responsible for? | PS to pharynx/larynx/thorax/abdomen, motor to pharynx (except stylopharyngeus), palate (except tensor veli palatine), larynx, and 1 tongue muscle (Palatoglossus), sensory to larynx and part of external auditory meatus, special sense (taste/epiglottis) |
| What is CN XI responsible for? | Motor control of SCM and Trapezius |
| What is CN XII responsible for? | Motor control of muscles of the tongue (except Palatoglossus, done by CN X) |
| Where are the soma/cell bodies of the parasympathetics from CN III found? | Edinger Westphall (EW) nucleus |
| Where are the soma/cell bodies of the parasympathetics from CN VII found? | Superior Salivatory Nucleus |
| Where are the soma/cell bodies of the parasympathetics from CN IX found? | Inferior Salviatory Nucleus |
| Where are the soma/cell bodies of the parasympathetics from CN X found? | Dorsal Motor Nucleus of the Vagus |
| What type of parasympathetic fibers arise from the nuclei/soma/cell bodies? | Preganglionic |
| What cranial nerve do all the preganglionic parasympathetic nerve fibers travel with after they leave their respective nuclei/soma/cell bodies? | CN V (Though CN V itself does NOT supply parasympathetic innervation) |
| What is the somatic sensory ganglion for CN V and where is it found? | Trigeminal Ganglion (aka Gasser’s Ganglion) outside of the CNS in the dura mater near the petrous part of the temporal bone. Houses all cell bodies of V1, V2, and V3. |
| Which cranial nerves occupy the anterior cranial fossa? | CN I |
| Which cranial nerves occupy the middle cranial fossa? | CN II, CN III, CN IV, CN V, and CN VI |
| Which cranial nerves occupy the posterior cranial fossa? | CN VII, CN VIII, CN IX, CN X, CN XI, and CN XII |
| Which cranial nerves are located at the Midbrain? | CN III and CN IV |
| Which cranial nerves are located at the Pons? | CN V, CN VI, CN VII, and CN VIII |
| Which cranial nerves are located at the Medulla? | CN IX, CN X, CN XI, and CN XII |
| Where does CN I exit the cranial vault? | The Cribiform plate of the Ethmoid bone |
| Where does CN II exit the cranial vault? | The Optic Canal |
| Where does CN III exit the cranial vault? | Superior Orbital Fissure |
| Where does CN IV exit the cranial vault? | Superior Orbital Fissure |
| Where does CN V (its branches V1, V2 and V3) exit the cranial vault? | V1 = superior orbital fissure, V2 = Foramen Rotundum, V3 = Foramen Ovale |
| Where does CN VI exit the cranial vault? | Superior Orbital Fissure |
| Where does CN VII exit the cranial vault? | Internal Acoustic Meatus |
| Where does CN VII exit the skull? | Stylomastoid Foramen |
| Where does CN VIII exit the cranial vault? | Internal Acoustic Meatus |
| Where does CN IX exit the cranial vault? | Jugular Foramen |
| Where does CN X exit the cranial vault? | Jugular Foramen |
| Where does CN XI exit the cranial vault? | Jugular Foramen |
| Where does CN XI enter the skull? | Foramen Magnum |
| Where does CN XII exit the cranial vault? | Hypoglossal Canal |
| Where are somatic motor cell bodies of cranial nerves? | In nuclei within the CNS |
| Where are somatic sensory cell bodies of cranial nerves? | In ganglia outside of the CNS |
| What structure separates the anterior and middle cranial fossae? | Lesser wing of the sphenoid |
| What structure separates the middle and posterior cranial fossae? | Petrous ridge of the temporal bone |
| Where are the somatic sensory cell bodies of CN I located? | Olfactory epithelium in upper part of nasal cavity |
| Which ganglion allows for synapse of parasympathetic fibers from CN III? | Ciliary Ganglion |
| Where are the postganglionic fibers from CN III exiting the Ciliary Ganglion heading towards? | Cilaris (ciliary muscle) and the Constrictor Pupillae via Short Ciliary nerve |
| What are the afferent and efferent limbs of the Pupillary Light Reflex? | Afferent = CN II (see the light), Efferent = CN III (constrict the pupil via parasympathetics) |
| Describe Direct and Consensual reflex action in the eye. | A light shown in the right eye will cause the pupil to constrict which is a direct reflex, but this also causes the pupil of the left eye to constrict which is a consensual reflex |
| What are the afferent and efferent limbs of the Accomodation Reflex? | Afferent = CN II (see the light), Efferent = CN III (Constrict the cilaris muscle via parasympathetics) |
| What are the afferent and efferent limbs of the Gag Reflex? | Afferent = CN IX (senses something in throat), Efferent = CN X (causes gagging) |
| What are the afferent and efferent limbs of the Cough Reflex? | Afferent = CN X, Efferent = CN X |
| What are the afferent and efferent limbs of the Corneal Reflex? | Afferent = V1 (Ophthalmic branch of CN V), Efferent = CN VII (orbicularis oculi closes eyelid) |
| What are the afferent and efferent limbs of the Blink/Startle Reflex? | Afferent = CN II (see something coming at the eye), Efferent = CN VII (orbicularis oculi closes eye) |
| Describe the function of Accomodation. | When attempting to see a nearby object, the pupil constricts (via constrictor pupilla muscle) and the lens gets convex/fat/round for increased refraction (via Cilaris muscle) |
| Loss of any of the cranials nerves CN III, CN IV, or CN VI can cause what? | Diplopia (double vision) |
| What does CN V *specifically* provide sensory innervation to? | Face, Anterior 2/3 of Scalp, Oral Cavity, Nasal Cavity, Paranasal sinuses, Eyes/Conjuctiva, Part of the Tympanic Membrane, and the Dura Mater of the anterior and middle cranial fossae |
| Where does the motor branch of CN VII go after it exits the cranial vault and skull? | After exiting cranial vault (internal auditory meatus) and skull (stylomastoid foramen), the Posterior Auricular nerve branches and CN VII pierces parotid gland and branches into 5 branches (TZBMC = Temporal, Zygomatic, Buccal, Mandibular, and Cervical) |
| On which nerve do fibers from the EW nucleus travel to the Ciliary ganglion? | Nasociliary |
| On which nerve do fibers from the SS nucleus travel to the PT ganglion? | Greater Petrosal |
| On which nerve do fibers from the SS nucleus travel to the Submandibular ganglion? | Chorda Tympani |
| On which nerve do fibers from the IS nucleus travel to the Otic ganglion? | Lesser Petrosal |
| On which nerve(s) do fibers from the Ciliary ganglion travel to the Ciliary Muscle/Constrictor Pupillae? | V1 of CN V (short ciliary branch) |
| On which nerve(s) do fibers from the PT ganglion travel to the nasal/paranasal mucus glands and the lacrimal glands, respectively? | V2 of CN V (zygomaticofacial branch) and V1/V2 of CN V (lacrimal branch and communicating branch of zygomaticotemporal nerve) |
| On which nerve(s) do fibers from the Submandibular ganglion travel to the Submandibular glands, Sublingual glands, and anterior 2/3 of the tongue? | V3 of CN V(lingual branch) |
| On which nerve(s) do fibers from the Otic ganglion travel to the Parotid gland? | V3 on CN V (auriculotemporal branch) |
| Which cranial nerves possess the capacity for special sense? | CN 1 (smell), CN II (sight), CN VII (taste), CN VIII (hearing and balance), CN IX (taste), and CN X (taste) |
| What is the name of VI from CN V? | Ophthalmic nerve |
| What is the name of V2 from CN V? | Maxillary nerve |
| What is the name of V3 from CN V? | Mandibular nerve |
| What are the 5 branches of V1 and are they sensory, motor, or both? | Sensory only = NFL = Nasociliary (Post/Ant Ethmoid, Long Ciliary), Frontal (Supraorbital, Supratrochlear, Infratrochlea), and Lacrimal |
| What are the 3 branches of V2 and are they sensory, motor, or both? | Sensory only = Zygomatic (Zygomaticotemporal and Zygomaticofacial), Superior Alveolar branches, and Infraorbital |
| What are the branches of V3 and are the sensory, motor, or both? | Both sensory and motor = Auriculotemporal, Inferior alveolar (nerve to Mylohyoid and Mental), Lingual, and Motor branches (Buccal) |
| What are the branches of the external carotid artery in the head? | Superior Thyroid, Lingual, Facial, Ascending Pharyngeal, Occiptal, Posterior Auricular then bifurcates to become Maxillary (becomes Infraorbital) and Superficial Temporal (Transverse Facial) |
| What are the branches of the Internal Carotid Artery in the face/anterior head? | Ophthalmic (becomes Supraorbital, Supratrochlear and Infratrochlear) |
| What structures are found in the cavernous sinus? | CN III, CN IV, V1 of CN V, V2 of CN V, and CN VI, pituitary gland, and internal carotid artery. |
| If there is an aneurysm present in the internal carotid artery in the cavernous sinus, which nerve will be compressed? | CN VI (because of its close proximity) |
| Where is the ‘Danger Area’ of the Face and why is it so dangerous? | Danger Area of face is formed by the upper lip and corners of the mouth up to the inside corners of the eyes. Dangerous bc an infection here could spread directly to the cavernous sinus (which is in contact with the meninges and could cause meningitis) |
| What is the most direct route to the cavernous sinus from the danger area of the face? | Facial vein -> Angular vein -> *Superior Ophthalmic vein* -> Cavernous sinus |
| What are the layers of the Scalp? | SCALP: S = Skin, C = Connective Tissue (Dense), A = Aponeurosis (Gala Aponeurotica), L = Loose Connective Tissue, and P = Periosteum |
| Which component create the *TRUE* scalp? | SCA = Skin, Dense Connective Tissue, and Gala Aponeurotica |
| Where is the danger layer of the Scalp? | The Loose Connective Tissue (between Aponeurosis and the Periosteum, because the diploic veins drain into the emissary veins here, which can drain an infection into the dural sinus causing meningitis) |
| What are the contents of the Infratemporal Fossa? | 1) Deep part of Parotid gland, 2) Auriculotemporal nerve of V3, 3) Maxillary artery, 4) Pterygoid venous plexus, 5) some muscles of mastication, 6) otic ganglion, and 7) chorda tympani |
| What are the parts of the Temporal bone? | 1) Mastoid process, 2) Styloid process, 3) Squamous part, 4) Petrous part, and 5) Tympanic part |
| What are the parts of Sphenoid bone? | 1) Greater Wing, 2) Lesser Wing, 3) Pterygoid Process (with medial and lateral plates) |
| What is MAT MATT? | The mnemonic for the motor innervation by V3 = Muscles of mastication and MATT = Mylohyoid, Anterior belly of Digastric, Tensor Tympani, and Tensor Veli Palatini |
| Which arteries make up the Circle of Willis (from anterior to posterior). | 1) Anterior communicating branches, 2) Anterior Cerebral, 3) Internal Carotid, 4) Posterior communicating branches, 5) Posterior Cerebral, 6) Basilar, and 7) Vertebral |
| Which arteries are connected to, but do not technically form the Circle of Willis? | Middle Cerebral artery and Basilar Artery |
| Which muscle is locked (and would be affected by pain/inflammation) in TMJ syndrome? | Lateral Pterygoid muscle |
| What are the main contributing arteries to the Circle of Willis? | Vertebral arteries and Internal Carotid arteries |
| Where does V3 of CN V change from just sensory to both sensory and motor? | After the foramen ovale, a motor branch from the brain joins to make it a mixed nerve |
| Are there sympathetic ganglia in the head? | No! |
| What is the most superior sympathetic ganglia in the body? | Superior Cervical Ganglion (located at C2-C3 at the base of the skull) |
| What type of sympathetic fibers leave the Superior Cervical Ganglion? | Postganglionic (because the preganglionic fibers from T1-T2 have synapsed at the superior cervical ganglion) |
| Where are the cell bodies for the Sympathetic fibers that enter the head? | Lateral horn of T1-T2 (because ALL sympathetics for the entire body originate from T1-L2) |
| What allows the sympathetic fibers to ascend and descend from T1-L2 (up into the head or down into the pelvis)? | The sympathetic chain (and its ganglia) |
| Along which vessels do the postganglionic fibers travel to enter the head? | They postganglionic sympathetic fibers travel up from the superior cervical ganglion along the internal carotid arteries through the neck into the head, once in the head the fibers leave the arteries and travel with branches of cranial nerves |
| Are their parasympathetic branches of the Vagus within the brain? | While the dorsal motor nucleus IS located in the brain, there are no branches to the head (only the neck and down) |
| Do infants have frontal sinuses? | No, they have not developed yet |
| If you suspect someone has an issue with their Superior Oblique muscle, how do you check it? | Ask the patient to look inferiorly and medially |
| If you suspect someone has an issue with their Superior Rectus muscle, how do you check it? | Ask the patients to look superiorly and laterally |
| What symptoms will a patient with a damaged CN III present with? | Ptosis and Dilated Pupil (Can’t raise eyelid because Levator Palpebra Superioris isn’t functioning, nor is their Constrictor Pupillae muscle) |
| Which nerves are responsible for sensory innervation of the anterolateral auricle? | Great Auricular nerve (C2, C3) |
| Which nerves are responsible for sensory innervation of the posterosuperior auricle? | Lesser Occipital nerve (C2) |
| Which nerves are responsible for sensory innervation of the posteromedial auricle? | CN VII and CN X |
| Which nerves are responsible for sensory innervation of the anteromedial auricle? | CN VII and CN X (which is why someone may cough when cleaning their ears) |
| Where does the Eustachian tube start and end? | It begins in the nasopharynx and ends in the middle ear |
| What is another name for the Eustachian tube? | Pharyngotympanic tube |
| CN VII and CN VIII travel together through the internal acoustic meatus, which stops in the inner ear and which continues? | CN VIII stops (Cochlear branch to Cochlea, Vestibular branch to Semicircular Canals) while VII continues btwn these structures to the geniculate ganglion where it divides into the Greater Petrosal Nerve and CN VII which continues into the middle ear |
| What branch divides from CN VII in the middle ear? | Chorda Tympani (special sense and PS fibers) which runs between the malleus and incus, crosses the tympanic membrane, exits the skull into the infratemporal fossa to join with the lingual nerve (V3) which together travel to the submandibular ganglion |
| What is the most common cause of facial palsy? | Bell’s Palsy |
| What is Bell’s Palsy? | A lower motor neuron lesion of CN VII, the cause of which is unknown (but thought to be viral) |
| Can someone recover from a Bell’s Palsy? | Most people recover within 6 weeks |
| Are all palsy’s Bell’s palsy? | No, some result from skull fracture, facial nerve laceration, ear surgery, malignancy of the parotid gland, or middle ear infection. |
| How many different nerves can cause an earache? | 6 nerves are capable of causing an ear ache: V3 of CN V, CN VII, CN IX, CN X, C2, and C3 |
| How can V3 of CN V cause an earache? | Tooth abscess in the lower jaw or cancer of the anterior 2/3 of the tongue |
| How can CN VII cause an earache? | Herpes zoster oticus |
| How can CN IX cause an earache? | Cancer of the posterior 2/3 of the tongue or Tonsillitis |
| How can CN X cause an earache? | Cancer of the larynx |
| How can C2 or C3 cause an earache? | Degenerative changes in the cervical spine |
| What are the complications that can occur with middle ear infection? | 1) Perforation of the tympanic membrane, 2) Alteration of taste, 3) Facial Paralysis, 4) Mastoiditis, 5) Balance problems, 6) Meningitis, 7) Temporal lobe abscess, or 8) Hearing loss |
| What is the fibrous coat of the eye? | Sclera |
| What is the vascular coat of the eye? | Choroid |
| What is the Nervous Coat of the eye? | Retina |
| When in gestation does Rubella affect eye development? | 4-7 weeks |
| What is Colomboma and why does it happen? | Colomboma is the appearance of a ‘keyhole’ in the Iris which results due to failure of the of closure of the retinal fissure |
| What is retinal detachment and why does it occur? | The intra-retinal space provides a plane of cleavage for detachment of the retina. The detachment occurs between the neural and pigment layers of the retina and can be the result of development in utero or as the result of a blow to the eye later in life. |
| What is congenital aniridia and why does it occur? | Absence of the iris, occurs due to an arrest of development at the rim of the optic cup |
| What is congenital aphakia? | Absence of the lens, occurs due to failure of the lens placode to form. |
| What is congenital cataract? | Lens appears white and opaque at birth, occurs due to maternal rubella infection |
| How does a persistent hyaloid artery affect vision? | Remnants of the hyaloid canal or artery can be seen as ‘floaters’ which may interfere with vision |
| What is Microphthalmia and what causes it? | Small eye due to arrested development, may be cause by maternal rubella infection or taxoplasmosis infection |
| What is Anophthalmia? | Complete absence of the eye though eyelids are present, may be associated with other craniocerebral defects |
| What is Cryptophthalmos? | A hidden eye which is small/defective or lies behind the skin, occurs due to a failure of development of palpebral fissure. |
| From which pharyngeal arch does the medial aspect of the auricle/pinna of the ear develop? | 2nd arch |
| From which pharyngeal arch does the lateral aspect of the auricle/pinna of the ear develop? | 1st arch |
| From which pharyngeal arch does the tympanic membrane develop? | 1st arch |
| Where does the ear initially develop? | High up on the neck, it then migrates to its finally position |
| Describe the change in size of the auditory ossicles from infant to adult? | No change, they are the same size when born as they are in an adult |
| From which pharyngeal arch does the tensor tympani muscle develop? | 1st arch |
| From which pharyngeal arch does the stapedius develop? | 2nd arch |
| From which pharyngeal arch does the Mandibular (V3) branch of CN V develop? | 1st arch |
| From which pharyngeal arch does the Facial (CN VII) nerve develop? | 2nd arch |
| Which type of bone formation method is employed during development of the auditory ossicles? | endochondral ossification |
| What is a chalazion? | An infection of the Meibon (tarsal) glands in the eye |
| What is a stye? | An infection of the eyelash(es) |
| What is cradle cap? | Crusty lesions on the head of an infant |
| Which bones form the roof of the nasal cavity? | nasal process of the Frontal bone, cribiform plate of the Ethmoid bone, and the body of the Sphenoid |
| Which bones and cartilage form the medial wall (nasal septum) of the nasal cavity? | Perpendicular plate of the Ethmoid, Vomer, and the quadrangular cartilage (which also forms the outer features of the nose) |
| Which 2 bones form the hard palate? | Palatine process of the maxilla, and horizontal plate of the palatine bone |
| Which bones form the lateral wall of nasal sinus? | Frontal, Maxilla, Ethmoid (superior and middle concha), Lacrimal, Palatine, Sphenoid, and Inferior Concha (it is an independent bone) |
| What recess is located superior to the Superior Concha/Meatus? | Sphenopalatine recess which drains the sphenoid sinus |
| Where is the superior meatus of the nasal cavity located and what opening does it provide? | Inferior to the Superior concha, Superior to the Middle concha: it houses the posterior ethmoidal sinus opening |
| Where is the middle meatus of the nasal cavity located and what opening does it provide? | Inferior to Middle concha, Superior to Inferior concha: hiatus semilunaris just below the bulla ethmoidalis, the opening of the nasofrontal duct (drains frontal air sinus), the openings for the anterior ethmoidal sinuses and the maxillary sinus opening |
| Where is the inferior meatus of the nasal cavity located and what opening does it provide? | Inferior to the Inferior concha, Superior to the floor of the nasal cavity: it houses the opening of the nasolacrimal duct |
| What can infection of the posterior ethmoidal sinus affect? | The optic canal with optic nerve and ophthalmic artery |
| What nerve supplies the hard palate?: | Greater Palatine (aka Descending Palatine) |
| What nerve supplies the soft palate? | Lesser Palatine |
| Where is the most common origin of anterior nose bleeds? | Superficial blood vessels on the anterior part (Kiesselbach’s plexus) of the nasal septum |
| Which nose bleeds are the most dangerous? | Those originating from the posterior nasal sinus |
| Which arteries contribute to Kiesselbach’s plexus? | LEAPS = Labial (Superior), Ethmoid (Posterior), Anterior Ethmoid, Palatine (Greater), and Sphenopalatine |
| What are the 2 major arteries that contribute to Kiesselbach’s plexus? | Superior Labial and Sphenopalatine arteries |
| Which sinus is most commonly involved in sinusitis and why? | Maxillary sinus bc its opening is near the roof of the sinus, not the floor, thus, one most turn their head to the side to get it to drain. Because of its close association with the upper teeth, toothache is also associated with maxillary sinus infection. |
| What risks does an infection of the sphenoid sinus pose? | Infections here can compresses the pituitary gland in the hypophyseal fossa, the optic chiasma, and the cavernous sinous due to their close proximity |
| What nerve supplies the frontal sinus? | Supraorbital nerve |
| What nerve supplies the ethmoidal sinus? | The anterior and posterior ethmoidal branches of the nasociliary and maxillary nerves (as well as orbital branches from the PT ganglion) |
| What nerve supplies the Maxillary sinus? | Infraorbital and Alveolar branches of the Maxillary (V2) nerve |
| What nerve supplies the sphenoidal sinus? | Posterior ethmoidal branches of ophthalmic and maxillary nerve (as well as orbital branches of the PT ganglion) |
| How does the PT fossa communicate with the orbit of the eye and what blood supply is provided from the maxillary artery? | Inferior Orbital Fissure, Infraorbital artery |
| How does the PT fossa communicate with the middle cranial fossa? | Foramen Rotundum |
| How does the PT fossa communicate with the nasal cavity and what blood supply is provided from the maxillary artery? | Sphenopalatine Foramen, Posterior superior alveolar artery |
| How does the PT fossa communicate with infratemporal fossa? | Pterygomaxillary fissure |
| Which branch of the Maxillary artery in the PT fossa supplies the hard and soft palate? | Greater (descending) palatine artery |
| What are the contents of the PT fossa? | 3rd part of the Maxillary artery, maxillary nerve, and PT Ganglion with associated branches |
| What nerve branches enter and exit the PT ganglion? | Nerve of Pterygoid canal (deep petrosal and greater petrosal nerve connection), V2 of CN V, Lateral nasal nerves, greater/descending palatine, and the lesser palatine nerves |
| What is the largest parasympathetic ganglion? | PT ganglion |
| Describe ‘Crocodile tears’ syndrome, also known as ‘Bororad’s symdrome’ or ‘gustolacrimal reflex’. | If there is damage to CN VII proximal to the geniculate ganglion and they heal by rerouting through the greater petrosal nerve to the lacrimal/nasal sinuses, when one becomes hungry, instead of salivating, they cry. |
| What is the sensory innervation of the upper lip? | Superior Labial branch of V2 of CN V |
| What is the sensory innervation of the lower lip? | Mental branch of V3 of CN V |
| Where does lymph from the lips flow? | The upper lip, and angles of the mouth flow to the submandibular lymph nodes while the medial part of the lower lip flows to the submental lymph nodes |
| Where is the oral cavity? | From the oral fissure to the oropharyngeal isthmus |
| What structures make up the oropharyngeal isthmus? | The soft palate, uvula, and palatoglossal fold. |
| What is the outer border (lip liner) region of the lips referred to as and what does this area represent? | The vermilion border, it represents the mucocutaneous junction between the inner mucous membrane of the mouth and the outer cutaneous skin |
| What is the vertical groove above the upper lip called? | The philtrum |
| What are the 2 subdivisions of the mouth? | 1) The vestibule = outside the dental arches to the inside of the cheeks ( internally = outer gums and teeth, externally = inner lips and inner cheeks)) and 2) Oral cavity = inside the dental arches to the to the oropharyngeal isthmus |
| Where does the parotid duct open into? | The oral vestibule opposite the upper second molar tooth, the duct is known as Stenson’s duct (So one must be careful when dealing with the second molar, so as not to damage the parotid duct) |
| What are the boundaries of the oral cavity proper? | Anterior and Lateral = teeth and gums, Posterior = oropharyngeal isthmus, Roof = hard & soft palate, Floor = tongue, mucous membrane, geniohyoid, and mylohyoid muscles |
| Which folds and muscles border the palatine tonsil? | Palatoglossal fold/muscle anteriorly, Glossopharyngeal fold/muscle posteriorly |
| What are the 3 parts of the pharynx? | Nasopharynx (in posterior nasal cavity), Oropharynx (in posterior oral cavity), and Laryngopharynx (Super aspect of larynx, inferior aspect of pharynx) |
| At what vertebral levels is the pharynx? | From C1 – C6 |
| What are the functions of the tongue? | Taste, Deglutition, Mastication, and Speech |
| Describe the anterior aspect (apex/body) of the tongue. | “Oral part” = Anterior 2/3 has lingual papillae with taste buds, extends posteriorly to terminal sulcus. General sense from lingual branch of V3, special sense from Chorda Tympani, and motor from XII (except palatoglossus) |
| Does the anterior (apex/body) aspect of the tongue include the Circumvallate papilla? | No, though these are anterior to the terminal sulcus, they are grouped with the posterior 1/3 of the tongue |
| What structure lies at the mid-point of the terminal sulcus and what can occur here? | Foramen Cecum, a Thyroglossal cyst can develop as a remnant of the thyroglossal duct. If the duct is not completely obliterated, a ‘Lingual Thyroid’ cyst (on tongue) could also develop, or if the duct remains patent a thyroglossal fistula can develop |
| Describe the posterior (base) aspect of the tongue? | “Pharyngeal part” = Posterior 1/3, including Circumvallate papilla, palatoglossal folds, and lingual tonsil (lingual tonsil is devoid of papilla but has lymphoid nodules). General & special sense from CN IX, motor from XII (except palatoglossus) |
| What are 2 alternate names for the tongue? | Lingua or Glossa |
| How is the posterior aspect of the tongue connected to the epiglottis? | One median and two lateral glossoepiglottic folds. |
| What comprises ‘Waldeyer’s Ring’? | Tonsillar ring of lymphatics = 1 paired set of palatine tonsils (on lateral walls of posterior oral cavity), 1 single lingual tonsil (posterior 1/3 of tongue), and 1 single pharyngeal tonsil (at the posterior wall of the nasopharynx) |
| Describe the epiglottis. | Posterior to the posterior 1/3 (base) of tongue. Comprised of 2 lateral glossoepiglottic folds and a single medial glossoepiglottic fold with paired Vallecula between the tongue and the epiglottis. Pills can get stuck here when swallowing. |
| What type of medication is sublingually and where it is absorbed? | Nitroglycerin pills for angina pectoralis are given sublingually (become Nitric Oxide, vasodilators), they are absorbed by the veins |
| Describe the ventral aspect of tongue. | Covered by thin mucous membrane, the frenulum is here and attaches the ventral aspect of the tongue to the floor of the mouth. Paired sublingual folds on lateral sides cover the sublingual glands. |
| What is Ankyloglossia? | Also known as ‘Tongue tie’ = a frenulum that is too short or extends too far anteriorly, can interfere with tongue movements, breast feeding, and speech |
| What are the intrinsic muscles of the tongue and what is their main function? | Superior and Inferior Longitudinal muscles, Transverse and vertical muscles. They are found WITHIN the tongue and function to alter the shape of the tongue. |
| What are the Extrinsic muscles of the tongue? | 4 muscles = Genioglossus, Hyoglossus, Styloglossus, and Palatoglossus. Are attached to genial tubercles of mandible/hyoid/styloid process/palate and they function to move the tongue. |
| What occurs when the genioglossus becomes paralyzed? | Tongue tends to fall backward which may obstruct the respiratory passage (therefore, it is known as the safety muscle) |
| How does one stop bleeding from the tongue? | Grasping the tongue posterior to the bleeding wound |
| What is the arterial supply of the tongue? | Posterior aspect = Dorsal lingual arteries, Sublingual (deep) aspect = Sublingual artery, and Anterior aspect = Deep lingual artery |
| Which nerve must be avoided during removal of the lower third molar tooth or during operations to the submandibular gland/duct? | Lingual nerve branch of V3 |
| What occurs when there is damage to the hypoglossal nerve on one side of the tongue? | The tongue (intact side) deviates to the damaged side (“the tongue licks its own wounds”) |
| Which branch of the CN X innervates of epiglottis? | Internal laryngeal branch of Vagus |
| Which lymph nodes drain the tip of the tongue? | Submental nodes |
| Which lymph nodes drains the lateral margins of the anterior aspect of the tongue? | Submandibular nodes |
| Which lymph nodes drain the (central) medial aspect of the anterior part of the tongue? | Jugulo-omohyoid nodes |
| Which lymph nodes drain the posterior aspect of the tongue? | Jugulo-digastric nodes |
| What structure separates the nasal cavity from the oral cavity? | The hard palate |
| Which bones comprise the hard palate? | Palatine process of the maxillae and the horizontal plates of the palatine bones |
| What structure separates the posterior oral cavity from the nasopharynx? | The mobile flap sloping down and back from the hard palate: the soft palate (a fold of mucosa enclosing aponeurosis, muscles, vessels, and nerves) |
| Are there tastebuds present on the soft palate? | Yes, on its oral surface |
| What structure hangs down from the soft palate? | Uvula |
| What happens to the soft palate during deglutition (swallowing)? | It is elevated and comes in contact with the pharynx |
| What happens when the soft palate muscles are paralyzed? | Nasal regurgitation during swallowing |
| How do blood vessels reach the hard palate? | Greater Palatine Artery (branch of Maxillary) through the Greater (descending) palatine foramen |
| How do blood vessels reach the soft palate? | Lesser Palatine Artery (branch of Maxillary) through the Lesser palatine foreamen |
| What are the 5 muscles of the soft palate? | 1) Tensor Veli Palatini, 2) Levator Veli Palatini, 3) Musculus uvulae, 4) Palatoglossus, and 5) Palatopharyngeus |
| What is the venous drainage of the palate? | Pterygoid venous plexus |
| To which lymphnoids do the hard/soft palate drain? | Deep cervical nodes |
| Which cranial nerves do you test in an H test? | II, III, IV, and VI |
| How do you test the eye muscles? | Eliminate the secondary function, and test the first function |
| How do you evaluate the superior oblique? | Its function is Down (1st function) and Out (2nd function), so you eliminate the secondary function by having the patient look Down and In |
| How do you evaluate the inferior oblique? | Its function is Up (1st function) and Out (2nd function), so you eliminate the secondary function by having the patient look Up and In |
| How do you evaluate the lateral rectus? | Its only function is moving the eye Out, so you eliminate the this function by having the patient look In |
| How do you evaluate the medial rectus? | Its only function is moving the eye In, so you eliminate this function by having the patient look Out |
| How do you evaluate the superior rectus? | Its function is Up (1st function) and In (2nd function), so you eliminate the secondary function by having the patient look Up and Out |
| How do you evaluate the inferior rectus? | Its function is Down (1st function) and In (2nd function), so you eliminate the secondary function by having the patient look Down and Out |
| What nerve(s) provides sensory innervation for the middle ear? | CN IX (Glossopharyngeal) |
| What nerve(s) provides sensory innervation for the external ear? | C2 (lesser occipital), C2 & C3 (great auricular), V3 (auriculotemporal), CN VII (via Nervus Intermedius), and CN X |
| What nerve innervates the inner ear? | Vestibulocochlear (CN VIII) |
| Suppose a patient has had a middle ear infection for a few months but never feels pain in the middle ear, what test could you perform to ensure the nerve of the middle ear hasn’t been damaged? | Test taste on the posterior 1/3 of the tongue (because the Glossopharyngeal nerve is responsible for the special sense of taste here, as well as sensory innervation of the middle ear) |
| What nerve provides general sense to the anterior 2/3 of the tongue and which provides special sense? | Lingual of V3 (general), Chorda Tympani of CN VII (special) |
| What nerve provides general sense to the posterior 1/3 of the tongue and which provides special sense? | Both done by CN IX |
| What causes a Median Cleft Upper Lip (Hare Lip)? | Failure of fusion of the two medial nasal processes to form the intermaxillary segment |
| What causes a Unilateral Cleft Upper Lip? | Failure of fusion of the one (left or right) maxillary process with the intermaxillary segment |
| What causes Bilateral Cleft Upper Lip? | Failure of both maxillary processes to fuse with the intermaxillary segment |
| What causes Oblique Facial Cleft? | Failure of maxillary process to fuse with lateral nasal process on one side (left or right). The nasolacrimal duct is open on the surface on the face. |
| Describe Anterior Cleft Anomalies and their cause. | May include cleft lip and gum. Arise from a failure of fusion between the primary and secondary palate due to partial/complete lack of fusion of maxillary and medial nasal prominences |
| Describe Posterior Cleft anomalies and their cause. | The cleft extends behind the incisive fossa into the posterior part of hard & soft palate, can cause a bifid uvula. Arise from a failure of fusion between the lateral and palatine processes of maxillary prominences |
| What are Natal Teeth and what symptoms can they cause? | Teeth that are present at birth. They can cause discomfort during breast feeding and may lacerate the tongue of the newborn. If lost, they may be aspirated into the air passage. |
| What is Enamel Hypoplasia and why does it occur? | Pitted or Fissured enamel due to nutritional deficiency (ie – rickets) |
| What is Enamel Discoloration and why does it occur? | Blue/Black discoloration = Erythroblastosis Fetalis, Yellow = Administration of Tetracyclines during pregnancy |
| Where is the ‘danger space’ (retropharyngeal space) of the neck? | It is bounded superior by the base of the skull, anteriorly by the alar fascia, and posteriorly by the prevertebral fascia. It provides a route for spread of infection from the pharynx to the mediastinum in the thorax. |
| What are Choanae? | Openings from the nasal cavities to the nasopharynx |
| What nerve is synonymous with the ‘Inferior Laryngeal’ nerve branch of CN X? | Recurrent Laryngeal |
| What branch of CN X gives rise to the internal and external laryngeal nerves? | Superior Laryngeal nerve |
| What nerves make up the pharyngeal plexus? | Pharyngeal branches of CN IX and CN X |
| Which branches of the external carotid artery supply the pharynx? | 1) Tonsillar branch of the ascending Pharyngeal artery and 2) Tonsillar and Ascending Palatine branches of the Facial artery |
| Which branches of the Subclavian artery supply the pharynx? | Pharyngeal branches of the thyrocervical trunk |
| Which lymph nodes drain the pharynx? | Retropharyngeal nodes superiorly, Infrahyoid lymph nodes anteriorly, and Paratracheal nodes inferiorly |
| What is the cartilage of the 1st pharyngeal arch called? | Meckel’s Cartilage |
| What is the cartilage of the 2nd pharyngeal arch called? | Reichert’s Cartilage |
| What are the cartilages of the 1st, 2nd, and 3rd pharyngeal arches derived from? | Neural Crest Mesenchyme |
| What is the name of the 1st pharyngeal arch? | Mandibular Arch |
| What is the name of the 2nd pharyngeal arch? | Hyoid Arch |
| What happens to the 5th pharyngeal arch? | It disappears, doesn’t contribute to any structures |
| What nerve is associated with the 3rd pharyngeal arch? | Glossopharyngeal nerve (CN IX) |
| What nerve is associated with the 4th pharyngeal arch? | Superior Laryngeal of Vagus nerve (CN X) |
| What nerve is associated with the 6th pharyngeal arch? | Recurrent/Inferior Laryngeal of Vagus (CN X) |
| What are the 6 skeletal derivatives of the 1st pharyngeal arch? | 1) Spine of the sphenoid bone, 2) Sphenomandibular ligament, 3) Mandible, 4) Anterior Ligament of the Malleus, 5) Malleus, and 6) Incus |
| What are the skeletal derivatives of the 2nd pharyngeal arch? | 1) Lesser horn and upper body of the hyoid bone, 2) Stapes, 3) Styloid process, and 4) Stylohyoid ligament |
| What are the skeletal derivatives of the 3rd pharyngeal arch? | 1) Greater horn and lower body of the hyoid bone |
| What are the skeletal derivatives of the 4th and 6th pharyngeal arches? | 1) Thyroid cartilage and 2) Cricoid cartilage (basically, all the laryngeal cartilages except the epiglottis) |
| What are the muscular derivatives of the 1st pharyngeal arch? | 1) MAST MATT muscles |
| What are the muscular derivatives of the 2nd pharyngeal arch? | 1) Muscles of facial expression, 2) muscles of the scalp, 3) muscles of the ear, 4) platysma, 5) posterior belly of the digastric, 6) stylohyoid and 7) stapedius |
| What are the muscular derivatives of the 3rd pharyngeal arch? | Stylopharyngeus muscle |
| What are the muscular derivatives of the 4th pharyngeal arch? | Cricothyroid muscle |
| What are the muscular derivatives of the 6th pharyngeal arch? | Intrinsic muscles of the larynx (except cricothyroid) and striated muscles of the upper esophagus |
| Which pharyngeal arch creates the lateral side of the neck? | 2nd (which descends to cover the 3rd and 4th and fuse with the 6th). |
| What does the 1st pharyngeal cleft form? | External Auditory Meatus |
| What pharyngeal structures are found within the cervical sinus and what should happen to this sinus during normal development? | 2nd, 3rd, and 4th pharyngeal grooves and the 3rd and 4th pharyngeal arches. The cervical sinus should obliterate in the course of development. |
| What are the derivatives of the 1st pharyngeal pouch? | 1) Eustachian tube, 2) middle ear, and 3) mastoid air cells |
| What are the derivatives of the 2nd pharyngeal pouch? | 1) Palatine tonsils and 2) Tonsillar sinus |
| What are the derivatives of the 3rd pharyngeal pouch? | 1) Thymus and 2) Inferior Parathyroid glands |
| What are the derivatives of the 4th pharyngeal pouch? | 1) Superior Parathyroids and 2) C-cells of the Thyroid |
| What is a ‘Branchial Cyst’ and what is another name it? | Lateral Cervical Cyst, It is a large painless mass filled with fluid and desquamated cells that is ALWAYS anterior to the SCM, caused by failure of obliteration of the cervical sinus |
| What is the difference between a ‘Branchial Sinus’ and a ‘Branchial Fistula’? | Branchial Sinus = open externally on neck OR internally in tonsillar sinus, NOT connected, creates Branchial Cyst. Branchial Fistula = External opening on neck connects to opening into intratonsillar space |
| Describe Treacher Collin Syndrome and why does it result. | Failure of neural crest cells to migrate to the 1st Pharyngeal arch = micrognathia, 50% chance of cleft palate, Underdeveloped Zygoma with dropping lateral aspect of lower eye, and conductive hearing loss |
| What is the Robin Sequence and which disorder is it associated with? | Pierre Robin Syndrome = 1) Micrognathia (small mandible) causes normally developed tongue to be too large for the mouth which results in 2) Glossoptosis (tongue causes airway obstruction and blocks closing of palatal shelves which leads to 3) Cleft Palate |
| Describe DiGeorge Anomaly and ‘CATCH 22’. | Deletion in chromosome 22q11 due to exposure to retionoids, alcohol, or maternal diabetes which causes faulty migration of neural crest cells resulting in CATCH (Cardiac anomalies, Abnormal face, Thymic hypoplasia/aplasia, Cleft Palate, and Hypocalcemia |
| Which pharyngeal pouches are affected in DiGeorge’s Anomaly? | 3rd and 4th |
| What ligament is cut to create a temporary airway in a cricothyrotomy? | Median Cricoid ligament |
| What is the function of the extrinsic muscles of the Hyo-Laryngo-Tracheal apparatus? | To move these items together as a single process ( as a whole) to aid in swallowing and deep breathing |
| What is the function of the intrinsic muscles of the Hyo-Laryngo-Tracheal apparatus? | Phonation |
| What type of innervation is provided by the Internal Laryngeal nerve to the Larynx? | Sensory |
| What type of innervation is provided by the External Laryngeal nerve to the Larynx? | Motor to Cricothyroid |
| What type of innervation is provided by the Recurrent/Inferior Laryngeal nerve to the larynx? | Sensory and Motor to all intrinsic muscles of larynx (except cricothyroid) |
| What is significant about the Vocal Cord landmark in the larynx in terms of innervation? | Above (vestibule and ventricles), all motor/sensory innervation is done by the Superior Laryngeal Nerve (Internal = sensory, External = motor) while below this point (infraglottic space) is done by Recurrent/Inferior Laryngeal nerve (motor and sensory) |
| What is significant about the Vocal Cord landmark in the larynx in terms of lymphatic drainage? | Above vocal cords, superior laryngeal artery to the deep cervical nodes @ bifurcation of the carotid artery (superior deep cervical). Below, follow the inferior laryngeal artery to nodes of cricothyroid ligament then to inferior deep cervical lymph nodes |
| What artery accompanies the Internal Laryngeal nerve? | Superior Laryngeal Artery |
| What artery accompanies the External Laryngeal nerve? | Superior Thyroid Artery |
| What artery accompanies the Recurrent/Inferior Laryngeal Artery? | Inferior Laryngeal Artery |
| Compression or injury to which nerve results in ‘Hoarseness’ of the voice? | Recurrent Laryngeal nerve |
| Compression or injury to which nerve results in ‘Fatigued’ voice with ‘poor pitch control’? | External Laryngeal nerve |
| What is the function of the Corpus Callosum? | Connects left and right hemispheres |
| What is a Gyrus (brain)? | A fold in the cortex that serves to increase surface area |
| What is a Sulcus (brain)? | A slit like depression between the gyrus |
| What is a Fissure (brain)? | A deep sulcus |
| What is the general function of the Frontal lobe of the brain? | Voluntary Movement |
| What is the general function of the Parietal lobe of the brain? | Physical Sense Recognition |
| What is the general function of the Temporal lobe of the brain? | Language and Auditory Recognition |
| What is the general function of the Occipital lobe of the brain? | Visual Recognition |
| What is the general function of the Insular lobe of the brain? | Emotion and Self Awareness |
| Where is the Cerebellum located? | Inferior and Posterior to the Cerebrum |
| Where is the Cerebrum located? | Superior and Anterior to the Cerebellum |
| Which 3 components form the brain stem? | 1) Midbrain, 2) Pons, and 3) Medulla |
| What is the general function of the Medulla Oblongata? | Involuntary control of Cardiovascular center, respiratory center, reflex centers for coughing, swallowing, sneezing, and vomiting. |
| What is the general function of the Cerebellum? | Coordination of muscle action and somatic motor movement |
| What does the Thalamus act as? | A sensory relay station |
| Describe the components of the optic structure in the brain from anterior to posterior. | Optic Nerve, Optic Chiasm, and Optic Tracts |
| Why do neural tube defects arise? | Non-fusion of the neural folds |
| What is the only cranial nerve that arises from the dorsal aspect of the midbrain? | CN IV |
| What is Anencephaly/Meroencephaly, why does it occur, how is it detected, and how can it be prevented? | Mero = Absence of most of brain/spinal cord, An = absence of all. Due to failure of the rostral neuropore to close, detected by high levels of Alpha-Fetoprotein in maternal serum and amniotic fluid and can be prevented with Folic acid during pregnancy. |
| Describe the derivatives of the forebrain? | The forebrain (Prosencephalon) has two divisions: 1) Telencephalon and 2) Diencephalon |
| What is another name for the midbrain and what structures does it give rise too? | Mesencephalon, gives rise to colliculi, cerebral peduncles, and the cerebral aqueduct |
| What are the derivatives of the Hindbrain? | The hindbrain (Rhombencephalon) has two division: 1) Metencephalon and 2) Myelencephalon |
| What does the Telecephalon give rise to? | Cerebral hemispheres, olfactory system, cerebral cortex, medullary center, lateral ventricles, rostral part of 3rd ventricle |
| What does the Diencephalon give rise to? | Thalamus, epithalamus, hypothalamus, subthalamus, most of the 3rd ventricle |
| What does the Metecephalon give rise to? | Pons, Cerebellum, and 4th ventricle |
| What does the Myelencephalon give rise to? | Medulla Oblongata and 4th ventricle |
| What in life is cerebral growth complete? | 18 years old (though the rate of growth is maximal within the first year) |
| Why does the brain increase in size? | 1) The size of the cells, 2) Increase in volume of connective tissue, 3) Growth of blood vessels, and 4) Myelination of the fibers |
| What are the results of Agenesis of the Corpus Callosum? | While the cause is unknown, there may be partial or complete absence which can be either asymptomatic or as severe as seizures and mental deficiency |
| What is contained within the cyst formed by Cranium Bifidum with Meningocoele? | Meninges and CSF |
| What is contained within the cyst formed by Cranium Bifidum with Meningoencephalocoele? | Meninges, CSF, and part of the brain |
| What is contained within the cyst formed by Cranium Bifidum with Meningohydroencephalocoele? | Meninges, CSF, part of the brain, and ventricle. |
| What is Holoprosencephaly? | No cleavage of the forebrain into two separate hemispheres, creates a small, undivided forebrain and a large single fused ventricle (creates loss of midline structures of the face and brain) |
| What are the 4 varieties of Holoprosencephaly? | 1) Absent Intermaxillary segment, 2) Hypotelorism (close set eyes), 3) Hypotelorism and absent nose, and 4) Cyclops (no splitting of facial features so one central eye with nose above) |
| Describe Arnold-Chiari Malformation. | Most common anomaly of the cerebellum, inferior displacement of the vermis of the cerebellum and the medulla through the foramen magnum into the vertebral canal, posterior cranial cavity is small. |
| Which cranial nerves can be affected by Arnold-Chiari Malformation? | CN IX, X, and XII (associated with the medulla oblongata) may be stretched causing difficulty in speech, swallowing, and the gag reflex |
| What is a Craniopharyngioma? | Usually benign but often functional tumors that result from remnants of the hypophysial pouch (anterior pituitary) as in ascends from the oral cavity to join the posterior pituitary. |
| Describe the flow of CSF from its point of formation to its point of absorption. | Lateral ventricle -> Intraventricular foramen of Monroe -> 3rd ventricle -> Cerebral aqueduct -> 4th ventricle -> Foramen of Lushka -> subarachnoid space of spinal cord or brain through arachnoid granulations/villi into the superior sagittal sinus |
| What is the difference between communicating and non-communicating/obstructive hydrocephaly? | Obstructive/Non-communicating hydrocephaly is a collection of CSF in the ventricular system as a result of a blockage, Communicating hydrocephaly results from overproduction or mal-absorption of CSF. |
| Why does the skull swell in hydrocephaly? | Because the sutures of the undeveloped head haven’t formed completely |
| Which ventricle typically swells in obstructive hydrocephaly? | Lateral Ventricle |
| Which cranial artery supplies the lateral surface of the brain? | Middle Cerebral Artery |
| Which cranial artery supplies the medial surface of the brain? | Anterior Cerebral Artery |
| Which cranial artery supplies the inferior surface of the brain? | Posterior Cerebral Artery |
| Which cranial nerve(s) is/are associated with the Posterior Inferior Cerebellar Artery? | CN X and XI |
| Which cranial nerve(s) is/are associated with the Anterior Inferior Cerebellar Artery? | CN VI, VII, and VIII |
| Which cranial nerve(s) is/are associated with the Posterior Cerebral Artery? | CN III |
| Which cranial nerve(s) is/are associated with the Superior Cerebellar Artery? | CN III and IV |
| Describe the difference between an Ischemic CerebroVascular Accident (Stroke) and a Hemorrhagic one? | Ischemic = Embolism that blocks an artery (diabling), Hemorrhagic = Rupture of an aneurysm/artery (hypertension, severe headache, stuff neck, fatal) |
| Describe the venous drainage of the brain from the deep veins to the internal jugular vein. | Deep cerebral veins -> great vein of Galen -> straight sinus -> inferior sagittal sinus -> confluence -> transverse sinus -> sigmoid sinus -> internal jugular vein |
| Describe an extradural/epidural hematoma. | Results from blow to head at pterion (middle meningeal artery), results in loss of consciousness followed by lucid intervals the drowsiness/coma. Results in Tentorial hernation. Above the dura mater, below the skull, increases pressure in brain. |
| Describe a subdural hematoma. | Results from a contusion that affects the *superior cerebral vein*, reason may be forgotten, no lucid interval after initial loss of consciousness. Does NOT increase pressure within the brain. May be acute or chronic. |
| Describe a Subarachnoid hematoma. | Results from arterial damage (aneurysm or cerebral laceration, typically Berry aneurysm) that results in blood in the subarachnoid space, causes meningeal irritation, ‘the worst headache in life’, stiff neck, and loss of consciousness. |
| What shape does a chronic Subdural hematoma appear as on a CT scan? | Banana or Crescent shape |
| What shape does an Epidural hematoma appear as on a CT scan? | Contact lens |
| How does a Subarachnoid hematoma? | Looks like a bomb went off, blood everywhere |
| From what structure does the majority of the palate develop? | The secondary palate from the lateral palatine process |
| Which fontanelle is found at the junction of the coronal and sagittal suture? | Anterior fontanelle |
| What general structures are formed from the 1st pharyngeal arch? | Mandible, Palate, Eye, and Ear |
| What type of hydrocephalus is caused by Stenosis of the Cerebral Aqueduct of Sylvius? | Obstructive hydrocephalus |
| What is the primary driving factor that influences the development of cleft palate? | Mutant Genes |
| If a baby is born normal but shortly after develops an atretic (absent) external acoustic meatus, what process has failed to occur? | Canalization of the meatal plug |
| What is the primary result of thoracic outlet syndrome? | Pain in the upper limb |
| If the oculomotor nerve is lost, what position will the eye be in? | Down and out due to unopposed action of the lateral rectus and the superior oblique (also partial ptosis due to loss of levator palpebrae superior and dilated pupil due to loss of cilaris/constrictor pupillae) |
| Which side does the uvula deviate to when the vagus has been injured on one side? | The uvula deviates to the side OPPOSITE the damage (ie – left vagus causes uvula deviation to the right) |
| Which side does the tongue deviate to when the hypoglossal nerve has been injured on one side? | The tongue deviates to the SAME side as the damage (ie – left hypoglossal nerve causes deviation to left) |
| Infection/Inflammation of which sinus will cause tooth pain? | Maxillary Sinus Infection |
| What nerve is involved with coughing and swallowing? | Vagus |
| What structure allows the spread of an infection of the throat to the middle ear? | Eustachian tube/Pharyngotympanic tube |
| If someone has a sensitivity to loud noises/sound, what nerve(s) and muscle(s) are affected? | Stapedius muscle (CN VII) and Tensor Tympani (V3) because these muscles dampen sound |
| What sinus will structures affected by an infraorbital blowout collect in? | Maxillary sinus |
| If the corners of the mouth are drooping, eyes can’t be shut, and there is food stuck in the oral vestibule, what nerve has been lesioned? | CN VII |
| An infection in the Mastoid air cells can spread to which sinus(es)? | Transverse then Sigmoid |
| If taste is lost and drooling occurs, where has CN VII been lesioned? | At the point where it exits the internal acoustic meatus |
| To which nodes does cancer of the lower lip drain? | Submental lymph nodes |
| Through which nerve does arthritis cause pain at the TMJ? | Auriculotemporal (of V3) |
| Arachnoid villi facilitate the passage of CSF from where to where? | Subarachnoid space to superior sagittal sinus |
| Between which two muscles do the palatine tonsils lie? | Palatoglossus anteriorly, Palatopharyngeus posteriorly |
| What lies deep to the soft, thin ridge of skin that runs on top of the masseter muscle all the way into the upper lip? | Parotid (Stenson’s) Duct |
| Which nerve is responsible for cutaneous sensation over the angle of the mandible? | Great Auricular (C2, C3) |
| Which artery and vein (in 3-10% of the population) lie directly in the midline of the trachea and could cause problems when performing tracheotomy? | Inferior Thyroid Vein and Thyroidea Ima artery |
| What nerve is damaged if a patient head is tilted up to the right and up? | Right SCM |
| A middle ear infection that involves the tympanic plexus will effect which nerve/fibers? | Preganglionic Parasympathetic fibers from CN IX via Lesser Petrosal nerve (and possibly sympathetics via the Deep Petrosal nerve) |
| How do parasympathetic fibers and sympathetic fibers get to the Pterygopalatine ganglion? | The nerve of the pterygoid canal (which consists of the Greater Petrosal nerve which carries PS fibers and the Deep Petrosal from the carotid/tympanic plexus which carries S fibers) |
| Which nerve would be anesthetized to prevent pain in mandibular teeth during surgery? | Inferior Alveolar (of V2) |
| Which nerve and muscle are affected if someone is having diplopia when walking down stairs? | Trochlear Nerve (CN IV) via Superior Oblique muscle |
| If an incision must be made in the tympanic membrane, what is the safest location? | Inferoposteriorly |
| Which chamber of the eye receives newly produced aqueous humor first? | Posterior Chamber |
| If a tonsillectomy results in hear pain, what nerve is affected? | CN IX |
| What sinus must be traversed to perform surgery on the pituitary gland? | Sphenoid sinus |
| Which tonsil, if enlarged, can block the pharyngotympanic tube? | Pharyngeal tonsil |
| Loss of which muscle can cause drooling? | Buccinator (because it prevents accumulation of saliva and food in the oral vestibule) |
| Where are the neural cell bodies of sympathetics of the head found? | Superior Cervical Ganglion |
| What is Anosmia? | Loss of the sense of smell |
| What artery supplies the tonsils? | Tonsillar branch of the Facial Artery |
| What nerves supply cutaneous sensation to the inner and outer aspects of the tympanic membrane? | Inner = Glossopharyngeal (CN IX) and Outer = Auriculotemporal (V3) |
| What nerve provides cutaneous sensation between the lower eyelid and the upper lip, and which foramen does it exit to support this area? | Infraorbital nerve (branch of V2) out the Infraorbital foramen |
| What is the Carotid Sinus? | A baroreceptor (pressure receptor) which can be targeted by carotid massage to decrease blood pressure |
| What is the Carotid Body? | A chemoreceptor which is capable of sensing changes in O2/CO2 |
| Which artery is at risk in oropharynx surgery? | The tonsillar branch of the facial artery |
| A fracture of the Crista Cala causes bleeding in which space? | Superior Sagittal Sinus |
| What segment of the larynx has little to no lymphatic drainage? | Middle segment of the vocal cords |
| What structure lies just inferior to the middle ear? | Internal Jugular Bulb (drained by sigmoid/transverse sinuses) |
| Where would a laceration in the Lingual nerve occur to cause loss of general sense but not taste? | Proximal to its junction with the Chorda Tympani |
| If meningitis is suspected and lumbar puncture is necessary, how does one check to see if CSF is under pressure? | Look for Papilledema (eye swelling) |
| What are the structures of the inferior mouth, from outside to inside? | Platysma -> Anterior belly of Digastric -> Mylohyoid -> Geniohyoid -> Genioglossus |
| What nerve provides motor innervation to the upper lip? | Marginal Mandibular Branch of CN VII |
| What bone is affected by Meningohydroencephalocoele? | Squamous part of the Occipital bone |
| What disorder can cause both congenital deafness and congenital cataracts? | Maternal Rubella Infection |
| What sinus is the only sinus present at birth? | Maxillary sinus |
| On what bone is a Rinnie Tuning Fork placed to detect hearing loss? | Mastoid Process |
| Which nerve is located in the Tracheoespohageal groove? | Recurrent Laryngeal |
| A fracture of the medial aspect of the orbit can trap which extraoccular muscle(s)? | Medial Rectus (preventing lateral movement) |
| A fracture to the inferior aspect of the orbit can trap which extraoccular muscle(s)? | Inferior Rectus and Inferior Oblique (preventing superior movement) |
| If Herpes presents on the nose, what nerve did it travel down to get there? | Nasociliary |
| What nerve must be anesthetized to relieve pain from an orbital fracture? | V1, Ophthalmic branch of V |
| Which nerve pierces the dura of the tentorium cerebelli in the tentorial notch? | Trochlear (CN IV) |
| When the Optic nerve is inflamed, which other structure can also be affected? | Anular Tendon of Zinn |
| What is the most common location for damage to CN VII? | As it exits the Stylomastoid foramen |
| Pain from Meniere’s disease is caused by swelling of which structure? | Endolymphatic sac |
| After surgery on the thyroid, how could air bubbles get into the brain? | Middle/Superior Thyroid Veins |
| Which artery can be damaged in a cricothyroidostomy? | Cricothyroid artery |
| Where is a tracheostomy performed and what structure is most likely to be damaged? | At the level of the 3rd – 4th tracheal cartilages, Left Brachiocephalic Vein |
| What muscle is injured if the uvula is deviating to one side? | Levator Veli Palatini |
| A tumor of the vestibulocochlear nerve at the internal acoustic meatus can also affect which other nerve? | CN VII |
| Where do acoustic adenomas typically occur? | Cerebellopontine angle |
| Where is blood collecting in a cephalohematoma? | Under the periosteum of the skull |
| Which nerve supplies the anterior cranial fossa? | Meningeal branch of the Ethmoid nerve |
| Which nerve supplies the middle cranial fossa? | Meningeal branch of the Maxillary nerve |
| Which nerve supplies the posterior cranial fossa? | Meningeal branch of the Mandibular nerve |
| Which vein in the oral cavity is responsible for the absorption of nitroglycerin (given under the tongue)? | Deep Lingual Vein |
| Which nerve must be avoided during surgery on the sublingual or submandibular glands? | Lingual nerve |
| How can an infection of the posterior ethmoid sinus affect vision? | Compression of the Ophthalmic Artery |
| Which lymph nodes drain the tonsils, tongue, and pharynx? | Jugulodigastric lymph nodes |
| Which lymph nodes drain the eye? | Preauricular (Deep Parotid) lymph nodes |
| What branch of the circle of willis is associated with the optic chiasm? | Anterior Communicating branch |
| Where along the CN VII would a lesion occur to lose general sense and special sense from the tongue, but not lacrimation? | Distal to the geniculate ganglion but proximal to the branching of the chorda tympani |
| Which lymph node of the neck is associated with malignancy of the GI tract close and why? | Left Supraclavicular lymph nodes due to their close proximity to the thoracic duct |
| What bone would be broken in strangulation? | Hyoid bone |
| If there are no skin lesions, what is another possible source of malignant melanoma? | Retina (due to presence of melanocytes) |
| What is the sensory ganglion associated with CN VII? | Geniculate Ganglion |
| What is the sensory ganglion associated with CN IX? | Hypoglossal Ganglion |
| What is the sensory ganglion associated with CN X? | Vagal Ganglion |
| What nerve is responsible for the special sense of taste on the soft palate? | Greater Petrosal nerve of CN VII (delivered to palate via Lesser Palatine nerve) |
| Where does VII become pure motor innervation? | After it exits the stylomastoid foramen |
| Where does the lesser petrosal nerve exit the cranial cavity? | At the Foramen rotundum along with V3 (Mandibular nerve) of CN V |
| Are the pharyngeal grooves or pouches on the external aspect of the neck? | Grooves = external, Pouches = Internal |
| What is a pyramidal lobe of the thyroid? | A remnant of the thyroid duct (problem with 4th pharyngeal arch) |
| Describe the Sonic Hedgehog morphogenes. | Encode proteins that act as paracrine factors to regulate organogenesis (left-right axis in organs, AP axis in limbs, digestive tube differentiation), spermatogenesis, stem cell maintenance, oncogenesis, notochord patterning, and implantation |
| Which diseases are associated with Sonic Hedgehog? | Holoproencephaly (also associated with metranl alcohol abuse and diabetes) |
| What disorders does Thalidimide exposure lead to and what does it inhibit? | Inhibits Fibroblast Growth Factor, causes Amelia and Meromelia (Limb disorders) |
| What are Bone Morphogenic Proteins (BMP) responsible for? | Dorsal Ventral axis in limb, bone, kidney, and heart development |
| What fibroblast growth factor receptor is involved in achondroplasia? | FGBR-3 on chromosome 4p |
| Down syndrome is a trisomy of which chromosome? | 21 |
| Patau syndrome is a trisomy of which chromosome? | 13 |
| What are the results of syphilis in pregnancy? | Miscarriages, Stillbirths, or Birth Defects (deafness, hydrocephalus, mental retardation, saddle nose, notches teeth, deformed tibia) |
| How does one become infected with Toxoplasmosis and what results will it have if infected during pregnancy? | Cat feces, undercooked meat, or contaminated fruits/vegetables = chorioretinitis, hydrocephalus, intracranial calcifications, and convulsions |
| What risks do use of Accutane (Isotretinoin) during pregnancy pose? | High risk of birth defects, miscarriage, premature birth, and neonatal death |
| Describe Fetal Alcohol Disorder. | Caused by maternal alcohol abuse, results in indistinct/absent philtrum, thin upper lip, depressed nasal bridge, short nose, and mental retardation |
| What are the effects of cigarette smoking on pregnancy? | Low birth weight of baby, delayed brain development, miscarriage, and still birth |
| Should caffeine be avoided during pregnancy? | Yes, less than 2 cups of coffee a day (can enhance the effects of alcohol, nicotine, and other drugs, secreted into breast milk) |
| Can cocaine cross the placenta? | Yes, it readily crosses the placenta and disrupts fetal neuronal circuits to cause cardiac anomalies, preterm birth, and placental abruption) |
| What is a sacrococcygeal teratoma and why does it form? | Sacrococcygeal teratomas are the result of primitive streak remnants and manifest as largest tumors at the caudal end of the affected baby, and they contain *all 3 germ layers* |
| How can Spina Bifida be prevented? | 0.4mg of folic acid daily before and after pregnancy |
| Why does an external Branchial Sinus arise? | Results because 2nd pharyngeal groove and cervical sinus fail to obliterate |
| Why does an internal Branchial Sinus arise? | Persistence of the 2nd pharyngeal pouch and the cervical sinus (failure to obliterate) |
| Why does a Branchial Fistula arise? | Persistence (failure of obliteration) of the 2nd pharyngeal groove and 2nd pharyngeal pouch (goes from external neck to internal tonsillar space, between ECA and ICA) |
| Why do Auricular sinuses and pits arise? | Present on anterior aspect of the ear, they are remnants of the first pharyngeal groove |
| What is Microotia? | Rudimentary auricle (1st pharyngeal groove/arch affected) |
| What is another term for the intermaxillary segment? | Medial nasal prominence |
| What nerve mediated taste on the epiglottis? | CN X |
| Where is the piriform recess and what nerve is found superficially in its mucosa? | Piriform recess = laryngopharynx of pharynx, Internal Laryngeal branch runs in mucosa and can be easily severed during surgery due to its superficiality |
| What structures pass through the foramen ovale? | OVALE = Ovale foramen, V3, accessory meningeal artery, lesser petrosal and emissary vein |
| What nerve mediates pain in the mastoid air cells? | CN IX (because it is an extension of the middle ear) |
| How are the mastoid air cells and middle ear connected? | Epitympanic Recess |
| To get a hematoma in the scalp, what layer must the blood be under? | Gala aponeurotica |
| What nerve mediates pain in the eustachian tube? | CN IX |
| What nerve mediates pain to the internal eyelids and conjunctiva? | Ophthalmic (of V1) |
| What is the last artery to branch from the internal carotid before the circle of willis? | Ophthalmic artery |
| What are the raised structures on the floor of the mouth under the tongue? | Sublingual Papillae (they house the opening of the submandibular ducts- aka Wharton's Duct) |
| If the hypoglossal nerve has been severed, which two non-tongue muscles will be affected? | Thyrohyoid and geniohyoid (both innervated by C1 via the hypoglossal nerve) |
| If one loses cutaneous innervation on the back of the head, which nerve has been lost? | Greater Occipital nerve |
| If an abberant portion of the internal carotid is present in the middle ear, which pharyngeal arch has been affected during development? | 3rd pharyngeal arch |
| Absence of which structure is responsible for the small head to face ratio in a child? | Paranasal sinuses |
| What disorder is characterized by a rudimentary brain by absense of cranial bones? | Exencephaly |
| If someone is missing a nostril, which structure has failed to develop? | Nasal placode |
| What is a small pit in the anterior aspect of the ear called? | Auricular sinus |
| In congenital detachment of the retina, what structure has failed to develop? | Optic Cup |
Created by:
sprater16