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VW Hisley Anatomy
IS-B1-Hisley Anatomy Questions
| Question | Answer |
|---|---|
| 1. Which one of the following bones/parts of bones are visible from the Norma Frontalis viewpoint? | Sphenoid bone (greater wing) * |
| 2. Which one of the following skull foramina visible in the external skull base viewpoint, is NOT visible in the internal skull base viewpoint? | C. Stylomastoid foramen * |
| 3. The “basion” is a landmark point of the skull that is visible in which one of the following standard viewpoint? | B. Norma Basalis * |
| 4. The facial artery normally anastomoses in the face with which one of the following external carotid artery branches? | A. Infraorbital artery * |
| 5. Which of the following muscles (not considered muscles of facial expression as described in lecture) is innervated by CN VII? | B. Buccinator muscle * |
| 6. Which one of the following cranial nerves exits the neurocranium through a foramina in the middle cranial fossa? | E. Trigeminal nerve (CN V – V3) * |
| 7. Which one of the following veins of the head is located just behind the ramus of the mandible? | B. Retromandibular vein |
| 8. Which one of the following arteries gives rise to the middle cerebral artery before joining the Circle of Willis? | E. Internal carotid artery * |
| 9. Which one of the following nerves branches off of CN VII as it ramifies WITHIN the petrous portion of the temporal bone? | A. Greater petrosal nerve * |
| 10. The deep petrosal nerve contains which of the following types of fiber? | C. Post-ganglionic sympathetic * |
| 11. Which of the following arteries is a branch of the third segment of the maxillary artery? | E. Sphenopalatine artery * |
| 12. Which of the following nerves synapses in the pterygopalatine ganglion? | D. Greater petrosal nerve * |
| 13. The parotid plexus supplies the following type of innervation? | A. Motor to the muscles of facial expression * |
| 14. The sella turcica is a sub-component of what skull bone? | C. Sphenoid bone * |
| 15. What muscle of mastication inserts in the pterygoid fossa (located between the lateral and medial pterygoid plates)? | D. Medial pterygoid muscle * |
| 16. Parasympathetic secretomotor fibers in the chorda tympani course through which one of the following nerves to arrive at the submandibular ganglion? | A. Lingual nerve * |
| 17. The sphenopalatine foramen is located where on the pterygopalatine fossa? | B. Medial side * |
| 18. Which of the following nerves provides somatic sensory (i.e.: GSA) innervation to the posterior one-third of the tongue? | D. CN IX * |
| 19. Ipsilateral Bell’s Palsy on the left side would exhibit weakness or paralysis in which one of the following muscles? | B. Buccinator muscle (left side) * |
| 20. In an eyeball/pupil in standard position (i.e.: staring straight ahead), what movement of the pupil would be observed if only the superior oblique were contracted? | E. Abduction/depression with intorsion (down and laterally with internal rotation)* |
| 21. The optic canal is an opening is what bone/sub-component? | B. Sphenoid bone (lesser wing) * |
| 22. Increasing accommodation is an intra-ocular function exhibiting which of the following effects? | D. increasing curvature of the lens * |
| 23. Transection of the Abducens Nerve (CN VI) would most likely result in the following clinical sign? | C. loss of horizontal eye movement coordination leading to diplopia * |
| 24. Which of the following statements concerning the pharyngeal apparatus is true? | C. There are 5 arches numbered 1,2,3,4,6 * |
| 25. The first pharyngeal groove develops into the: | B. External auditory meatus * |
| 26. Which skull bone and/or skull bone component develops as part of the viscerocranium but winds up as a part of the neurocranium? | C. Temporal bone (squamous portion) * |
| 27. What is the most severe form of craniosynostosis? | B. oxycecephaly * |
| 28. During palatogenesis, which of the following developmental structures is key in forming the primary palate? | E. intermaxillary segment * |
| 29. During palatogenesis, which of the following developmental structures is key in forming the median palatine raphe of the hard palate? | C. lateral palatine processes * |
| What division of what cranial nerve supports the function of mastication? | CN V3 - Mandibular division |
| Which CN provides for facial expression? | CN VII - Facial Nerve |
| Which extraocular CN exits the brainstem medially and intermediately inferior to the pons. | CN VI - Abducens Nerve |
| The CNs to the extraocular eyes are somatic nerves only (GSE - general sensory efferent) - true or false? | False - CN III is parasympathetic as well. |
| The ophthalmic division of CN V exits the cranium via the inferior orbital fissure - true or false? | False - Superior Orbital Fissure |
| The maxilla is a component of the neurocranium - true or false? | False - Viscerocranium |
| The Frankfort horizontal (aka orbitomeatal)plane runs across what two skull structures? | The two external auditory meatuses and the two orbital floors |
| Give the CN and type: Facial expression | CN VII - Motor |
| Give the CN, division (if applicable) and type: Cutaneous Sensation of head | CNV - V1, V2 and V3 (semilunar ganglion)- Sensory |
| Give the CN, division (if applicable) and type: Glandular secretion | CN VII - nerve of pterygoid canal CN IX - tympanic nerve Secretomotor |
| Give the CN, division (if applicable) and type: mastication | CN V3 - Motor |
| Give the CN, division (if applicable) and type: Taste | CN VII - (geniculate ganglion, intermediate nerve) Sensory |
| Give the CN, division (if applicable) and type: Balance | CN VIII - cochlear nerve |
| Give the CN, division (if applicable) and type: Hearing | CN VIII - vestibular nerve |
| Give the CN, division (if applicable) and type: Olfaction | CN I - olfactory bulb and tract |
| Give the CN, division (if applicable) and type: Vision | CN II - optic nerve, chiasm, radiation |
| Give the CNs, division (if applicable) and type: Extraocular muscle movement | CN III, CN IV, CN VI motor |
| Give the CNs, division (if applicable) and type: Intraocular muscles | CN III, CN V1 (ciliary ganglion) Visceromotor |
| Give the CN, division (if applicable) and type: lacrimation | CN VII - greater petrosal nerve, pterygopalatine ganglion Secretomotor |
| Sense of smell and the nasal cavity are innervated by this cranial nerve. | CN I - Olfactory Nerve |
| Vision is innervated by this cranial nerve. | CN II - Optic Nerve |
| Ciliary muscles, sphincter pupillae and all external eye muscles (except superior oblique and lateral rectus) are innervated by this cranial nerve. | CN III - Oculomotor Nerve |
| The superior oblique muscle of the eye is innervated by this cranial nerve. | CN IV - Trochlear |
| The sensory branch of this nerve receives information about the face, sinuses, teeth, orbit and oral cavities, and the dura mater. | CN V - Trigeminal |
| The motor branch of this nerve sends information to the muscles of mastication, tensor tympani, tensor veli palatini, mylohyoid and the anterior belly of the digastric muscle. | CN V - Trigeminal |
| The lateral rectus muscle of the eye is innervated by this nerve. | CN VI - Abducent |
| The muscles of the face, stapedius, posterior belly of the digastric muscle, stylohyoid, occipitalis and auriculus muscles are innervated by this cranial nerve. | CN VII - Facial |
| This mixed nerve is responsible for motor information to the submandibular, sublingual and lacrimal glands AND responsible for sensory information from the anterior 2/3 of the tongue and the sensory soft palate. | CN VII - Facial (Intermediate Nerve) |
| This purely sensory cranial nerve is responsible for balance and hearing. | CN VIII - Vestibulocochlear |
| This mixed nerve is responsible for special sensory (taste on the posterior 1/3 of the tongue), sensory (middle ear, tonsil and pharynx) and motor (stylopharyngeus, parotid gland). | CN IX - Glossopharyngeal |
| This mixed nerve is responsible for the motor and sensory of the heart, lungs, pharynx, larynx, bronchi, GI tract) and sensory of the external ear. | CN X - Vagus |
| This cranial nerve is responsible for sensory innervation of the SCM and trapezius | CN XI - Accessory |
| This cranial nerve is responsible for innervating the tongue muscles. | CN XII - Hypoglossal |
| Which 3 nerves are special sensory only? | CNs I, II and VIII |
| Which 4 nerves are motor only? | CNs III, IV, VI and XI |
| Which 5 nerves are mixed sensory and motor? | CN's V, VII, IX, X and XII |
| Where does the Olfactory nerve exit the CNS? | Cerebral hemispheres (cribriform plate) |
| Where does the Optic nerve exit the CNS? | Diencephalon (optic chiasm) |
| Where does the Oculomotor nerve exit the CNS? | Midbrain |
| Where does the Trochlear nerve exit the CNS? | Midbrain |
| Where does the Trigeminal nerve exit the CNS? | Pons |
| Where does the Abducens nerve exit the CNS? | Pontomedulla junction |
| Where does the Facial nerve exit the CNS? | Pontomedulla junction |
| Where does the Vestibulocochlear nerve exit the CNS? | Pontomedulla junction |
| Where does the Glossopharyngeal nerve exit the CNS? | Medulla |
| Where does the Vagus nerve exit the CNS? | Medulla |
| Where does the Accessory nerve exit the CNS? | Superior Spinal Cord |
| Where does the Hypoglossal nerve exit the CNS? | Medulla |
| Which CN is a derivative of the 4th pharyngeal arch? | Vagus |
| Which CN is a derivative of the 3rd pharyngeal arch? | Glossopharyngeal |
| Which CN is a derivative of the 2nd pharyngeal arch? | Facial |
| Which CN is a derivative of the 1st pharyngeal arch? | Trigeminal |
| What do the vagus, glossopharyngeal, facial and trigeminal nerves have in common? | They are all mixed nerves and they are all derivatives of a pharyngeal arch. |
| Parietal and temporal bones are _ while frontal, occipital, sphenoid and ethmoid bones are _. | Paired, unpaired |
| mandible and vomer bones are _ while lacrimal, nasal, maxilla, zygomatic, palatine and inferior nasal concha are _. | Paired, unpaired. |
| The inion skull landmark is visible in the Norma Frontalis - true or false. | False |
| Which landmark point represents the highest point in the skull when viewed in Normal lateralis? | Vertex |
| The lambdoid suture is a roughly transverse suture located anteriorly to the sagittal suture - true or false? | False - inferiorly |
| Which four bones of the neruocranium converge laterally to form the pterion? | Frontal, parietal, temporal, sphenoid |
| The pterion is an external marker for what clinically-important vessel internally? | Middle Meningeal Artery |
| Which major sutures are visible from the Norma Lateralis Viewpoint? | Coronal suture, lambdoid suture, squamosal suture, occipitomastoid. |
| Which landmark observed in the normal occipitalis marks the intersection of the sagittal and lambdoid sutures? | Lambda |
| When viewing the skull from the norma basalis viewpoint, the petrous portion of the temporal bone is located anterior to the greater wing of the sphenoid. True or False? | False |
| When viewing the skull from the Norma Basalis viewpoint, the mental foramina of the mandible are not visible - true or false? | True |
| Describe the difference between these two landmarks: glabella and nasion. | nasion is at the bridge of the nose and glabella is directly above it between the left and right supraorbital ridges |
| The greater and lesser wings of the sphenoid bone form what orbital feature? | Superior Orbital Fissure |
| Obliteration of the cranial sutures as observed in Norma Verticalis usually take place in what sequence? | Bregma -> Sagittal -> Coronal -> Lambdoid |
| What is the anterior-posterior sagittal groove on the inside of the calvarium named? | Groove for the superior sagittal sinus |
| What is the diploe? | Layer of cancellous bone between inner and outer tables of compact bone in the calvaria - containing red bone marrow and venous channels connecting emissary veins. |
| What feature of the internal surface of the calvaria are formed by the arachnoid granulations? | Groove for the superior sagittal sinus |
| In terms of dural infoldings inside the neurocranium, name the three components of the triple sickles. | superior sagittal sinus, tentorial notch (left and right anterior edges) |
| how does a drop of venous blood initially located in the superior sagittal sinus usually exit the neurocranium under normal pressure conditions? (what pathway does it take through the dural venous sinuses?) | Superior sagittal sinus -> Left Transverse sinus (usually larger) -> Left sigmoid sinus -> left internal jugular vein |
| Describe the difference between an epidural and a subdural hemorrhage. | Epi - bleeding from middle meningeal artery between skull and dura. Sub - bleeding from cerebral veins (aneurysms into sub-arachnoid space. |
| What structure comes through the foramen spinosum? | Middle meningeal artery |
| in which cranial fossa is the internal auditory meatus located? | Middle cranial fossa |
| Observed from the Norma Basalis viewpoint, the carotid canal is posterior to the jugular foramen. True or false | False - anterior |
| What structures course through the superior orbital fissure? | CN V1, CN III, CN IV and CN VI - also ophthalamic veins. |
| Which bones of the neurocranium make up the middle cranial fossa as seen from the inside. | parietal, temporal and sphenoid bones |
| Which structure exits the neurocranium just posterior to the styloid process and through what structure does it exit? | CN VII - motor root through stylomastoid foramen |
| regarding the intracranial circulation, what major vessels make up the anterior and posterior circulations which ultimately meet to form the circle of willis? | anterior (ICA -> MCA -> COW) posterior (Vertebral -> Basilar -> PCA -> COW) |
| Which CN roots exit the neurocranium through the middle cranial fossa? | CN V (all 3 branches), CN III, IV and VI |
| Name the cranial nerves that course anteriorly through the cavernous sinus. | CN V1 and 2, CN III, IV and VI |
| the angular artery is a branch of which extracranial artery? | Facial artery |
| An anastomosis between these two facial arteries provides collateral circulation between the intracranial and extracranial arterial systems. | Angular artery and orbital artery |
| Which major extracranial vein courses just behind the ramus of the mandible | Retromandibular vein |
| Which defined segment of the maxillary artery does the sphenopalatine artery branch off of and through what fossa does it course? | Segment 3, sphenopalatine fossa |
| Which intracranial artery gives rise to the anterior cerebral artery before it links with the circle of wills? | internal carotid artery |
| what is an embolus and how might it cause a cerebral infarction? | air, clot, plaque or foreign object that moves through circulation until it lodges in a vessel. If the vessel is plugged and prevents oxygen from getting to the tissues, it can create an infarction |
| name the fontanelles of the typical neonates skull. | Anterior, posterior 2 sphenoidal and 2 mastoidal |
| which Le Fort fracture classification is used to describe skull fractures occurring though the orbits? | Le Fort III Fracture |
| The nasociliary nerve contains parasympathetic secretomotor fibers destined for the lacrimal gland true or false? | False |
| What three branches do CN V - ophthalmic division divide into upon entering the orbit? | frontal, nasociliary and lacrimal |
| CN V - maxillary division gives rise to the inferior anterior alveolar nerves - true or false? | false - mandibular division |
| The ophthalmic division of CN V exits the neurocranium via the foramen rotundum true or false? | False |
| what branch of CN V-V3 splits around the middle meningeal artery? | auriculotemporal nerve |
| what foramen of the neurocranium is the middle meningeal artery pass through | foramen spinosum |
| the mental nerve is a branch of what division of CN V? | mandibular division |
| lower arch dental anesthesia is typically applied where extraorally? | Through the mandibular notch to the mandibular division root emerging from foramen ovale |
| which branch of the trigeminal nerve is both motor and sensory? | CN V3 - mandibular branch |
| which secretomotor branch of CN VII converges with the lingual nerve in the deep infratemporal fossa? | chorda tympani |
| The facial nerve gives rise to the _ nerve which merges with the chorda tympani and is involved in special sensory of taste. | Lingual nerve |
| from which division of CN V is the pterygopalatine ganglia suspended from? | CN V2 - maxillary division |
| non-parasympathetic fibers synapse in the pterygopalatine ganglion - true or false? | False (only parasympathetic) |
| which CN V division provides motor fibers to the muscles of mastication? | CN V3 - mandibular |
| what course do motor fibers of CN VII take to reach the muscles of facial expression? | internal auditory meatus -> facial canal -> stylomastoid foramen -> parotid plexus (in gland) -> terminal branches |
| What course do CN VII parasympathetic secretomotor fibers to the lacrimal gland take? | greater petrosal nerve (CN VII) -> pterygoid canal -> pterygopalatine ganglion -> maxillary nerve -> zygomatic nerve -> lacrimal nerve -> gland |
| what course do CN VII parasympathetic secretomotor fibers to the salivary glands take? | Intermediate Nerve -> Facial Canal -> Pteryotympanic Fissure (Chorda Tympani) -> Lingual Nerve -> Submandibular Ganglion -> Submandibular and Lingual Salivary Glands |
| after entering the internal acoustic meatus, name the 3 branches and their modalities that CN VII splits into inside the petrous portion of the temporal bone. | Two Nerves: Motor root and intermediate nucleus. |
| what sensory modalities do the cell bodies contained in CN VII's geniculate ganglion represent? | GSA - somatosensory and special sensory taste |
| the motor branches from the parotid plexus of CN VII contain a branch to the posterior auricle? True or False? | True |
| the roots of CN VII that exit the superolateral position of the medulla include what two nerves? | motor root and intermediate nerve |
| the root of CN V exits the brainstem at the interface between the midbrain and the pons - true or false? | False (pons) |
| There are no pre-ganglioninc secretomotor fiber contributions from CN VII to the pterygopalatine ganglion - true or false? | False - all are preganglionic in the greater petrosal nerve |
| the root of CN V crosses what component of the temporal bone to become the trigeminal ganglion? | Petrous portion of the temporal bone |
| the medial pterygoid plate is a medial boundary of the infratemporal fossa - true or false? | False - lateral pteygoid plate |
| the temporal fossa is continuous with the infratemporal fossa true or false? | True |
| The temporal fossa's inferior boundary is what? What continues beneath that landmark? | The Zygomatic process of the temporal bone. The infratemporal fossa. |
| the infratemporal fossa includes the foramina ovale and spinosum - true or false? | True |
| The masseter muscle fibers course superiorly and anteriorly to insert on the zygomatic arch of the temporal bone and zygomatic bone - true or false? | True |
| The pterygomaxillary fissure is part of the medial border of the infratemporal fossa - true or false? | True |
| the inferior orbital fissure is formed by the lesser wing of the sphenoid and the maxillary bone - true or false? | True |
| The sella turcica is a subcomponent of what part of the sphenoid bone? | The Body |
| What component of what cranial nerve exits the temporal bone via the stylomastoid foramen? | CN VII - motor root |
| the mandibular fossa is a sub-component of the petrous part of the temporal bone - true or false? | False-squamous part |
| the geniculate ganglion is located medial to the cochlea and the semicircular canals within the petrous portion of the temporal bone - true or false? | False - it's located laterally |
| the lateral pterygoid muscles (both heads) when acting unilaterally, swing the mandible to the contralateral side - true or false? | True |
| the masseter muscle and the medial pterygoid muscles acting in concert are commonly referred to as the "Mandibular sling" - true or false? | True |
| the mandibular division of CN V provides "non-masticatory" motor innervation to what other muscles? | mylohyoid, anterior digastric, tensor veli palatin and tensor tympani |
| What is the pneumonic for the non-masticatory muscles that CN V3 innervate? | MATT - name the muscles |
| what nerve courses anteriorly after passing between the superior and inferior heads of the lateral pterygoid? | Buccal nerve |
| what major artery passes transversely through the infratemporal fossa from deep to the ramus of the mandible to the pteygomaxillar fissure? | maxillary artery |
| what muscle of mastication inserts in the pterygoid fossa? | medial pterygoid muscle |
| the buccinators muscle is not considered a muscle of mastication because it does not... | act directly on the TMJ |
| what muscle of mastication inserts on the capsule of the TMJ and the coronoid process of the mandible? | Lateral pterygoid muscle |
| the structure located between the superior and inferior articular cavities of the TMJ is called what? | articular disc of TMJ |
| the temporalis muscle inserts on what feature of what bone? | coronoid process of ramus of the mandible |
| which one of the muscles of mastication is the only muscle that opens the jaw? | lateral pterygoid muscle (both heads) |
| what happens to the inferior articular cavity of the TMJ when the mouth is open wide | slides anteriorly over the articular eminence towards its crest at the articular tubule. |
| regarding the distribution of CN VII motor fibers to the muscles of facial expression, the orbicularis oculi is innervated by which two branches? | temporal and zygomatic branches |
| what basic function does any muscle of facial expression fulfill? | changes the shape of an orifice |
| the platysma is a muscle of facial expression - true or false? | True |
| the zygomaticus major is a muscle used to frown with - true or false? | False - sneer / smile |
| the depressor anguli oris is located deep to the depressor labii inferioris - true or false? | False - vice versa |
| Bells palsy demonstrates what condition related to the muscles of facial expression? | Full or partial unilateral paralysis |
| a CN VII motor LMN lesion is more likely to cause paralysis on the lower muscles of expression than the upper muscles of facial expression - true or false? | True |
| Performing a nerve block here would allow painless treatemnt of a skin wound on the side of the jaw | Mental foramina (mental nerve) |
| The angular artery anastomoses with only the external carotid artery branches around the orbit - true or false? | False - anastomoses with both infraorbital artery (maxillary / eca) and orbital and nasal branches (opthalmic artery / ica). |
| Numbness only in the temporal region anterior to the ear would most likely be caused by a lesion of what nerve of what division of what cranial nerve? | Auriculotemporal nerve - CN V3 |
| the dermatome-like skin territories of cutaneous facial sensation may be divided between the 3 CN V divisions by what two facial landmarks? | V1 tip of nose, top of eye, scalp up from lateral canthus of eye. V3 - lower lip, chin, ramus of mandible to pinna. V2 - everything in between. |
| what cutaneous nerves from CN V1, V2 and V3, the cervical plexus and sub-occipital plexus converge in the scalp region? | Supraorbital V1, zygomaticatemporal V2, auriculotemporal V3 |
| what are the four cranial parasympathetic ganglia and what are their locations? | ciliary ganglion (orbit), pteygopalatine ganglion (pterygopalatine fossa), submandibular ganglion (body of mandible), otic ganglion (behind ramus of mandible) |
| what is the source and pathway of post-ganglionic sympathetic fibers to the submandibular gland? | superior cervical ganglion -> carotid plexus on ICA -> facial and lingual arteries -> glands |
| what is the source and pathway of post-ganglionic parasympathetic fibers to the submandibular and lingual glands | submandibular ganglion -> submandibular gland submandibular ganglion -> lingual nerve -> sublingual gland |
| what is the function of the otic ganglion? | process of pre to post ganglionic CN IX secretomotor fibers innervating the parotid gland |
| anatomically, the pterygopalatine ganglion in the same named fossa is directly posterior to each orbit - true or false? | True |
| the third part of the maxillary artery arises just before and within the pterygopalatine fossa true or false? | True |
| how do parasympathetic secretomotor fibers course and combine before they enter the pterygopalatine ganglion? | CN VII -> greater petrosal nerve -> pterygoid canal in sphenoid bone -> pterygopalatine ganglion |
| what is the name of the mixed nerve in the pterygoid canal that enters the posterior portion of the pterygopalatine ganglion? | nerve of the pterygoid canal |
| the sphenopalatine foramen is located on the medial wall of the pterygopalatine fossa - true or false? | true |
| if the pterygopalatine fossa can be thought of as a funnel-shaped volume with the spout pointing downward to the palate, what two canals open inferiorly? | greater and lesser palatine canals (open into foramina in the posterior hard palate - palatine bone). |
| the infraorbital artery is a branch of the maxillary artery - true or false? | true |
| Do CN V2 sensory fibers on their way from the palate to the foramen rotundum through the pterygopalatine fossa synapse in the pterygopalatine ganglion? | No |
| What is the course taken to sublingual salivary glands by secretomotor fibers from the intermediate nerve including synapses in ganglion? | intermediate nerve -> chorda tympani -> lingual nerve -> submandibular ganglion -> lingual nerve -> sublingual glands |
| what is the function and course of CN VII secretomotor fibers going to the nasal cavity? | CNVII -> greater petrosal nerve -> pterygoid canal -> pterygopalatine ganglion -> descending palatine nerves -> greater and lesser palatine nerves (V2) -> minor palatine mucous glands in roof of palate. |
| what is the function and course of CN VII secretomotor fibers going to the lacrimal gland? | CN VII -> greater petrosal nerve -> pterygoid canal in sphenoid bone -> pterygopalatine ganglion -> V2 crossing in fossa -> zygomatic nerve -> lacrimal nerve -> lacrimal gland |
| how do tears wiped inferomedially across the face of the conjunctival sac to the lacrimal apparatus reach the inferior nasal cavity? | lacrimal canal |
| the cell bodies for the taste sensory neurons for the anterior 2/3 of the tongue are located where? | geniculate ganglion |
| the cell bodies for the taste sensory neurons for the posterior 1/3 of the tongue are located where? | inferior ganglia of CN IX |
| which nerve(s) carry (ies) GSA cutaneous information back from all "thirds" of the tongue? | Posterior 1/3 - inferior ganglion of CN IX Anterior 2/3 - geniculate ganglion of the CN V3 / lingual nerve |
| in the case of a mandibular anterior dislocation, which features of the temporal bone does the condylar process articulating across the inferior articular cavity of the TMJ pass abnormally anterior to? | Articular eminence and tubercle |
| what is the difference between the orbital axis and the visual axis? | the orbital axis is a 3D line from apex of bony orbit to middle point in orbit. Visual axis = 3D lines through the pupils looking straight ahead |
| what functions do the Edinger-Westphal midbrain nucleus perform? | Accommodation, Miosis (pupillary constriction) and convergence of eyes |
| what are the linear and rotational movements of the IO, LR, SO, SR, MR and IR? | Draw the diagram!! Slide 199 |
| what two extraocular muscles are required to elevate the pupil? | Inferior Oblique and Superior Rectus |
| do the oblique extraocular muscles insert anterior or posterior to the axial equator of the eyeball? why does this matter in terms of movement? | posteriorly. posterior attachments add elevation and depression functions to their other movements |
| what two extraocular muscles are responsible for horizontal eye movement? Are the movements synergistic? | LR and MR - yes they are synergistic |
| What is the angle between the 2 orbital axes? | 45 degrees |
| what is the angel between the lateral walls of both orbits? | 90 degrees |
| are the optical axes constantly parallel or does the angle between them vary depending on the distance to the point of focal interest? | varies |
| the floor of the orbit is mostly comprised of what bone? | maxilla |
| the optic canal is an opening which is part of what skull bone? | lesser wing of sphenoid |
| the lacrimal bone is located on which rim of the orbit - medial or lateral? | medial |
| CN V opthalmic division cutaneous nerves exit the orbit and enter the scalp region through what foramen in the frontal bone? | Supraorbital notch |
| the levator palpebrae superioris originates in the common tendon ring at the apex of the orbit? | False - it originates just above it! |
| upon entering the orbit through the optic canal, the ophthalmic artery divides directly into what branches? | opthalmic artery extension and lacrimal artery |
| what target region/organ do the long posterior ciliary arteries supply? | ciliary body and iris |
| which orbital vein does the pterygoid plexus immediately drain? | inferior ophthalmic vein |
| the trochlear nerve usually enters the orbit through the superior orbital fissure inside the common tendinous ring - true or false? | false |
| the inferior oblique muscle originates at the common tendinous ring - true or false? | False |
| what named structures do tears pass through to go from lacrimal caruncle to the nasal floor? | inferior lacrimal papilla and puntum, lacrimal canaliculi, lacrimal sac, nasolacrimal duct |
| what CN involving the extraocular muscles has a superior and inferior branch? | CN III |
| which extraocular muscles does each division of CN III serve? | Superior -> SR, LPS Inferior -> MR, IR, IO |
| the sensory root of the ciliary ganglion comes off which nerve? | CN V1 - nasociliary nerve |
| which nerve (and division) does the parasympathetic root of the ciliary ganglion come off of? | CN III inferior division |
| what are the only two extraocular muscles whos contractions do not result in some degree of intrusion or extorsion of the pupil / eyeball? | MR and LR |
| if the eyes are held adducted by a patient, which extraocular muscle contraction results in depression of the pupil/eyeball? | Superior Oblique |
| the ciliary ganglion directly gives off what structures to the posterior eyeball? | short ciliary nerves |
| which extraocular muscle has a smooth muscle, sympathetically-innervated deep component? | Levator Palpebrae Superioris |
| the dilator pupillae muscles are intraocular muscles arranged radially around the pupillary opening that cause in pupillary dilation (mydriasis) via parasympathetic innervation - true or false? | false - sympathetic innervation |
| both the dilator pupillae and the sphincter pupillae are components of what intraocular structure? | IRIS |
| The lens of the eye is normally under tonic tension to keep it flat to optimally accommodate far vision - true or false? | True |
| when lens refocusing for near vision is required, what intraocular structure contracts to decrease lens radial tension and thus cause a "balling up" of the lens? What CN is responsible for this (division). | ciliary muscle - CN III Inferior division |
| which fibers synapse in the ciliary ganglion? | parasympathetic fibers (E/W nucleus) in oculomotor CN III - inferior division |
| what section of the brainstem does CN III originate in? | Midbrain |
| what two brainstem nuclei contribute to CN III functionally? | oculomotor nucleus and Edinger-Westphal nucleus |
| does CN III have autonomic components? If so, what are they, where do they synapse and what targets affected? | yes, parasympathetic. ciliary ganglion in orbit, ciliary muscle and constrictor pupillae |
| the abducens nerve terminates on the medial or lateral surface of the lateral rectus muscle? | medial surface |
| what nasal branches does the nasociliary nerve directly give off? | posterior and anterior ethmoid nerves |
| the parasympathetic component of CN III has its origins in what brainstem nucleus | edinger-westphal nucleus |
| the CN III when entering the orbit in the superior orbital fissure passes through the common tendinous ring - true or false? | True |
| of all the CNs passing anteriorly through the cavernous sinus - which is most superior | CN III |
| CN IV exits the midbrain of the brainstem from the posterior surface and is unique in that behavior - true or false? | True |
| which cranial nerve upon exiting the brainstem, must course superiorly and over the petrous portion of the temporal bone to enter the middle cranial fossa? | CN VI |
| which autonomic nerve contributes sympathetic fibers to the greater petrosal nerve to form the nerve of the pterygoid canal | deep petrosal nerve from superior cervical ganglion |
| the course of parasymp innervation in support of lacrimation includes a shortcut using the zyogmatic nerve CN V2 - true or false? | true |
| secretomotor parasymp post-ganglionic fiber target organs from the pterygopalatine ganglion include the lacrimal gland, nasal cavity, palate and parotid gland - true or false? | false - parotid gland has post ganglionic fibers from the otic ganglion rather than pterygopalatine ganglion |
| the pterygopalatine ganglion is a thoroughfare for GSA fibers that do not synapse within it on their way to the nasal cavity and palate - true or false? | True |
| what are the 3 incoming nerve roots of the ciliary ganglion in terms of their modalities? | GSA - cornea and sclear GVE - preganglionic parasympathetic motor to ciliary body and sphincter pupillae GVE - post-ganglionic sympathetic - motor to dilator pupillae |
| the long ciliary nerve fibers pass through the ciliary ganglion - true or false? | false |
| the long ciliary nerve fibers include a sympathetic component causing contraction of the dilator pupillae - true or false? | true |
| the short ciliary nerves carry post-synaptic parasymp info from ciliary ganglia to sphincter pupillae and ciliary body - true or false? | true |
| the long ciliary nerves contain fibers to the eyeball carrying GSA from the conjunctiva - true or false? | true |
| how does contraction of the ciliary body affect the geometry of the lens? | lessens tonic radial tension on the lens - curvature increases (lens "balls up") |
| what is the difference between miosis and mydriasis? | miosis - pupillary constriction (parasymp - CN III) mydriasis - pupillary dilation (symp - carotid plexus) |
| what is accommodation? | changing the shape of the lens to change its refractive properties |
| paralysis of the SO muscle causes what main symptoms? | net extorsion of the eye - double vision (diplopia) |
| paralysis of the LR muscle causes what main symptom? | loss of horizontal eye movement coordination |
| LMN disease in CN VI can cause what symptom due to an unopposed medial rectus? | diplopia |
| what signs does Horner's syndrome cause? | ipsilateral miosis, ptosis, vasodilation and anhydrosis |
| why is pharyngeal arch development important in head and neck development? | structures of primary importance come from the arches |
| do both mesodermal mesenchyme and neural crest mesenchyme contribute to developmental components in the pharyngeal arches? | Yes |
| neural crest cells contribute in part to cranial and sensory ganglia and nerves - true or false? | true |
| the terms pharyngeal clefts and pharyngeal grooves refer to the same developmental feature - true or false? | true |
| pharyngeal arches and pouches each give rise to exclusive structure types - true or false? | true |
| what are pharyngeal membranes and which of them develop into significant adult structures? | closely juxtaposed endoderm and ectoderm at the thinnest part of a pharyngeal groove/pouch with a thin layer of mesoderm between. |
| how many pharyngeal arches, grooves and membranes are contained in the pharyngeal apparatus at it's maximal development? | arches = 5, pouches, grooves and membranes = 4 |
| the mesenchymal core of a pharyngeal arch includes contributions from both mesodermal and neural crest mesenchyme cell populations - true or false? | true |
| pharyngeal arch 1 includes what two major components? | maxillary and mandibular prominences |
| what large bone will be most markedly underdeveloped if there is insufficiency of the first pharyngeal arch? | mandible |
| what pharyngeal apparatus structure gives rise to the external auditory meatus and tympanic cavity? | first pharyngeal groove, membrane and pouch |
| cartilages derived from PA1 include the malleus, incus and stapes - true or false? | False - malleus and incus only! |
| development of the hyoid bone results from the combined development of which two arch cartilages? | 2nd and 3rd |
| the muscles of facial expression develop from what pharyngeal arch? are they derived from mesodermal or neural crest mesenchyme? | 2nd arch, mesodermal mesenchyme |
| what pharyngeal arch is CN IX associated with? | 3rd |
| what CN V division does NOT develop from the 1st arch? | Ophthalmic division (weird!) |
| embryonic blood circulation in the pharyngeal apparatus flows from the dorsal aorta, through the aortic arches and through the truncus arteriosis - true or false? | no, exactly the opposite direction. |
| what organ is derived from pharyngeal pouch two? | palatine tonsil |
| what two pharyngeal pouches give rise to the parathyroid glands? | 3 and 4 |
| what pharyngeal arches give rise to the epiglottis? | 1 |
| all skull bones are derived directly from the pharyngeal apparatus - true or false? | false |
| the temporal, maxillary and zygomatic bones develop from the first pharyngeal arch by endochondral ossification - true or false? | false - rather by intramembranous ossification |
| which bone or bone component develops as part of the viscerocranium but becomes a part of the neurocranium? | squamous portion of the temporal bone |
| which of the fontanelles is the largest? relative to the sutures, where is it? | anterior fontanelle - around bregma |
| what are the two types of ossification that occur in the neurocranium and viscerocranium during skull development? | endochondral - cartilaginous intramembranous - membranous |
| what are the basic sequence of steps in endochondral ossification as occurs in skull development? | mesenchyme -> cartilage elements fuse -> cartilaginous base endochondral ossification -> thick bone |
| what are the basic sequence of steps in intramembranous ossification as occurs in skull development? | mesenchyme in membranous neurocranium -> fibrous membrane forms -> intramembranous ossification -> thinner bony plates |
| the thick bones at the base of the skull are formed primarily by what type of ossificaiton? | endochondral |
| the membranous viscercranium includes the mandible, maxilla and temporal bone (squamous portion) - true or false? | true |
| the cartilaginous viscerocranium includes the thyroid cartilage and the parietal bone - true or false? | false - parietal bone is part of developing membranous neurocranium |
| the frontal bone forms as a part of the cartilaginous neurocranium - true or false? | false - membranous neurocranium |
| the occipital bone forms as a part of the cartilaginous neurocranium - true or false? | true |
| scaphocephaly is a form of cransynostosis caused by the pre-mature fusion of the sagittal suture - true or false? | true |
| what is the most severe form of craniosynostosis | oxycephaly |
| what two primordial configurations collaborate on palate formation? | primary and secondary palate |
| relative to the incisive foramen, where is the part of the hard palate that develops from the premaxillary segment? | primary palate |
| what superficial part of the mouth is derived from the superficial part of the premaxillary segment? | incisor teeth |
| relative to the incisive foramen, where is the part of the hard palate that develops from the right and left lateral palatine processes? What bones contribute to this part of the palate? | this is the secondary palate (posterior to the incisive fossa) formed from bone from the developing maxillary and palatine bones |
| what is the intermaxillary segment and what does it form? | wedge-shaped mass of mesenchyme between developing maxillae. The intermaxillary segment is formed by the merger of the median nasal prominences (PA1) |
| what role do the lateral palatine processes play in the formation of the secondary palate? | they grow towards the median plane of the hard palate forming the median palatine raphe |
| in a unilateral cleft lip as presented in lecture, what development failures occurred? | 1) failure of the mesenchymal mass in the maxillary prominences on the affected side to meet and unite with the merged medial nasal prominences. 2) epithelium in affected labial groove breaks down and forms the complete discontinuity. |
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