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Physical Assessment: HENT Anatomy

Terms in this set (51)

Aponeurosis of the scalp
Connects the frontal belly of the occipitofrontalis and occipital belly of the occipitofrontalis muscles
Layer of the scalp
Function of connective tissue of the scalp
Contains vessels and nerves
Function of the loose connective tissue of the scalp
Allows the scalp to move
Function of the pericranium
outer layer of the periosteum
Anastomoses of the scalp
web of blood vessels without one particular feeder vessel
this is why scalp wounds bleed a lot
no single pressure point to control bleeding
What is the best way to stop a scalp wound from bleeding?
Apply direct pressure to the wound itself. Anastomoses of blood vessels, there is no pressure point to stop bleeding.
Neurocranium bones
Frontal (1), Parietal (2), Temporal (2), Occipital (1), Ethmoid (1), Sphenoid (1)
Total of 8 bones
Viscerocranium bones
...
Foramen
Holes in bone where cranial nerves tract through to innervate muscles/skin for sensation or motor innervation
Why are the fontanelles clinically important?
Can assess infant's fluid status
Dehydrated = fontanelle will look sunken in
Increase in intracranial pressure, infection = bulging fontanelle
External ear
Outer ear to the tympanic membrane
Middle ear
Tympanic membrane to the oval window
Inner ear
Everything past the oval window--organs for sensory and balance
Auricle: Helix, Concha of ear, Tragus, Lobule
Clinical importance of tragus
Press on it and it is painful --> sign of external ear infection
External acoustic meatus
Ear canal (note: area where skin stretches right over bone--this can be painful if foreign material touches this part of the ear canal
Cerumen glands
What cranial nerve innervates the ear canal?
Cranial nerve X (vagus nerve)--this is why irritating the ear canal can make you nauseous.
Pars flaccida and Pars tensa
cone of light
Should be narrow, points towards the nose
If wide, this indicates infection
Auditory ossicles
Amplifies sound about 10X (mechanical amplifier; goes from big surface area of TM to small surface area of the oval window)
Muscles of the middle ear
Tensor tympani:
Innervated by cranial nerve 5 (trigeminal nerve)
Pulls malleus medially, tensing the TM, and decreasing amplitude of oscillations.
Stapedius:
Cranial nerve VII, pulls stapes posteriorly and tilts base to decrease range of oscillation.
Eustachian tube
Connects middle ear to pharynx
Function is to equalize pressure
Can be source of infection from pharynx to ear
Cochlea
Inner ear
Responsible for hearing
Utricle and saccule
Inner ear
Responsible for sensing linear motion
Semilunar canals ear
Inner ear
Responsible for sensing rotational motion
Functions of the nose
Olfaction, respiration, filtration of dust (mucous), humidification & warming of air (highly vascular)
Nasal concha
Also known as turbinates
Inferior, middle, superior
Function to increase the surface area of the nasal cavity
Roof of nasal cavity
Formed by cribriform plate of ethmoid bone
Contains foramen for olfactory nerve (cranial nerve 1)
Paranasal sinuses
Lined with nasal mucosa (if you have a cold, can close up sinus openings which can cause sinus pressure to build up)
Facial muscles
Cranial nerve VII (facial nerve)
Occipitofrontalis (frontal belly, occipital belly): attaches to skin of eyebrows and forehead, allows raising of eyebrows and wrinkle forehead
Orbicularis oculi (palpebral, orbital): close eyes gently, tightly respectively
Orbicularis oris: closes the mouth
Buccinator: presses cheek against molars
Platysma: helps to pull down mandible (lower jaw)
Bell's palsy
paralysis of facial muscles due to injury of cranial nerve VII
Motor innervation of muscles for mastication
Cranial nerve V, branch 3 (mandibular division of the trigeminal nerve)
Muscles of mastication
Temporal: elevates mandible for closing jaw
Masseter: elevates mandible and pushes it out a little bit (small contribution)
Lateral Pterygoid: move jaw forward and side to side
Medial Pterygoid: elevates mandible
How to check temporal muscle
Ask patient to clench teeth
Cranial nerve: teeth
Cranial nerve 5 (lower teeth-mandibular branch, upper teeth-maxillary branch)
Floor of mouth
Mylohyoid muscle and tongue
Roof of mouth
Hard and soft palates
Posterior boundary of mouth
Palatopharyngeal fold and muscle
Cranial nerve of soft palate muscles
Cranial nerve 10
except tensor veli palatini cranial nerve 5
Vermillion border
boundary where lips transition from skin to red mucous membrane
Soft palate muscles
Palatoglossal- CN X
Palatopharyngeal- CN X
Tensor veli palatini- CN V
Levator palati- CN X
Uvular muscle- CN X
Mylohyoid muscle
Sheet-like muscle forms floor of mouth
Salivary glands
Parotid gland (cranial nerve IX-glossopharyngeal)
Submandibular gland (cranial nerve VII-facial)
Sublingual gland (cranial nerve VII-facial)
Parotid gland infection
Facial swelling due to infection or stones-- use warm compress
Tongue: Extrinsic and Intrinsic muscle function
Extrinsic: allow tongue to move around
Intrinsic: allow tongue to change shape
Cranial nerve: tongue--motor innervation
Hypoglossal (CN XII)--damage to cranial nerve, tongue will protrude to side of damage
Exception: palatoglossal muscle is innervated by cranial nerve X
Cranial nerve: tongue sensation
Anterior: trigeminal (CN V)
Posterior: glossopharyngeal (CN IX)
Location of different parts of pharynx
Naso-: above soft palate (where eustachian tubes drain)
Oro-: throat
Laryngo-: between epiglottis and esophagus
Tonsils
Palatine tonsils: between palatoglossal and palatopharyngeal arches
Pharyngeal tonsils: in mucosa of nasopharynx
Lingual tonsils: in the sides of the posterior tongue
Innervation of tongue: taste and somatosensory
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