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Anatomy Exam 3
Terms in this set (42)
Where does the blood from the face drain to?
Facial Vein, superficial temporal vein and dorsal nasal vein.
What surface landmarks (palpable ones) does one use to place a cricothyrotomy?
Thyroid cartilage has laryngeal prominence. As you palpate the thyroid cartilage, you slide your fingers inferiorly and you will feel a depression, which is the cricothyroid membrane and then the cricoid cartilage. The cricothyrotomy should be done through the cricothyroid membrane.
Where is the thyroid gland in relation to the thyroid cartilage?
It is found inferior and lateral to it.
What is the blood supply and venous drainage to the thyroid gland?
Superior and inferior thyroid arteries and in some cases the thyroid ima artery, Superior, middle and inferior thyroid veins for drainage.
Removal of the thyroid gland would jeopardize which neurovascular structures?
Removal of the thyroid gland involves the ligation of all the blood vessels mentioned in the above question. In so doing it is important not to injure the recurrent laryngeal nerve, which passes very close to the inferior thyroid artery. The external branch of the superior laryngeal nerve is also in jeopardy. Injury to it would affect the patient's ability to sing.
What symptoms on the face would patient exhibit if the sympathetic trunk were disrupted?
Face would be hot and dry because the sympathetics, which normally innervate the sweat glands would not function. Also eyelid would slightly droop on affected side.
What is the route for infection to spread from face to the meninges?
Infection can spread from face to orbit via dorsal nasal vein to ophthalmic vein to cavernous sinus and therefore to meninges.
Loss of sensation to forehead indicates damage to which nerve?
Supratrochlear, supraorbital and/or lacrimal nerves.
Loss of sensation to the upper lip indicates damage to which nerve?
Branches of maxillary nerve like infraorbital.
Loss of sensation to the chin indicates damage to which nerve?
Branch of mandibular nerve (mental nerve).
Removal of the parotid gland would jeopardize which neural structures and cause what symptoms?
Auriculotemporal nerve and Facial nerve. Loss of auriculotemporal nerve would cause loss of saliva (parotid gland is being removed so not surprising!), and loss of sensation to area anterior to ear and temporal region. Loss of facial nerve would cause the following symptoms: Inability to move ipsilateral (same side of face as injured nerve) muscles of facial expression. Therefore inability to smile = sagging corner of the mouth, inability to close eye or raise eyebrow on affected side, inability to whistle.
What is the relationship of the otic ganglion and foramen ovale?
The otic ganglion lies in the infratemporal region just inferior to the foramen ovale.
What fibers synapse in the otic ganglion and what do they innervate?
Fibers from the lesser petrosal nerve (branch of CN IX) synapse there and the postganglionic fibers travel with the auriculotemporal nerve to the parotid gland.
What is the lingual nerve capable of doing before the chorda tympani joins it?
It carries GSA fibers for touch and temperature.
What is the lingual nerve capable of doing after the chorda tympani joins it?
Now it has SVA fibers for taste to anterior 2/3 of tongue and also parasympathetic fibers destined for the submandibular and sublingual glands.
If the chorda tympani is damaged what symptoms will the patient present with?
No ability to taste on anterior 2/3 of tongue and dry mouth (submandibular and sublingual glands affected).
If CN IX is damaged, what symptoms does the patient present with?
CN IX is the "sore throat" nerve. It provides sensory innervation to the oropharynx. It also provides sensory innervation to the middle ear and external aspect of tympanic membrane, which explains why when you have a sore throat, the pain can also refer to the ear. It provides sensory innervation and taste sensation to posterior 1/3 of the tongue and is therefore responsible for the gag reflex. So if the nerve is damaged one would get loss of gag reflex and lack of taste to posterior 1/3 of tongue. Also loss of sensation to middle ear, external ear and to oropharynx (sore throat region). And parotid gland may be affected because of lesser petrosal nerve.
If CN XII is damaged, what symptoms does the patient present with?
Difficulty to protrude the tongue. Tongue will deviate to the affected side. Difficulty in speaking.
What is the sulcus terminalis?
Sulcus terminalis is the V-shaped line of circumvallate papillae positioned at the border between the anterior 2/3 of the tongue and posterior 1/3 of the tongue.
When the dentist injects anesthetic in the area around the inferior alveolar nerve, what areas will become numb?
The teeth in the lower jaw and chin (mental nerve branch) and also tongue if lingual nerve gets involved.
Why is nitroglycerin often administered under the tongue?
It transfers quickly to the blood stream because of the large superficial blood vessels at base on tongue.
How does one test CN V?
CN V -
V1 touch forehead
V2 touch cheek
V3 touch chin or ask patient to grit teeth
How does one test CN VII?
CN VII - ask patient to smile or raise eyebrows.
How does one test CN IX?
CN IX - stroke back of tongue looking for gag reflex.
How does one test CN XI?
CN XI - ask patient to shrug shoulders, flex their neck, or turn head - if right CN XI is damaged head will not turn toward to left side (rotates head to opposite side).
How does one test CN XII?
CN XII - ask patient to stick their tongue out - it will deviate to injured side.
What symptom would the patient present with if the right recurrent laryngeal nerve is damaged?
If only one side was affected then the patient would present with hoarseness.
What if both recurrent laryngeal nerves were damaged?
If both sides are affected then patient would present with inability to speak and difficulty in breathing due to the fact that the vocal folds would lie in the midline of the airway.
What function does the internal laryngeal nerve perform?
The internal laryngeal nerve is a branch of the superior laryngeal nerve of CN X and is responsible for sensory innervation of the larynx above the vocal cords. Thus it is the sensory arm for the cough reflex.
What does CN IX do? How do you test it?
CN IX is the "sore throat" nerve. It provides sensory innervation to the oropharynx. It also provides sensory innervation to the middle ear and external aspect of tympanic membrane, which explains why when you have a sore throat, the pain can also refer to the ear. It provides touch and taste sensation to posterior 1/3 of the tongue and is therefore responsible for the gag reflex. It is also responsible for motor innervation to the stylopharyngeus muscle. To test this nerve one can stroke the posterior 1/3 of the tongue.
Which cranial nerve supplies motor innervation to the pharyngeal constrictors?
CN X-XI complex, that is, both CN X and CN XI provide motor innervation to the constrictors. This is because the motor fibers responsible come from the nucleus ambiguous, which supplies both CN X and CN XI with fibers.
What is the sensory innervation to the pharynx?
Sensory innervation is provided by CN IX as mentioned above in the oropharynx, CN X in the area around the laryngopharynx, CN V2 near the opening of the eustachian tube.
Where are the tonsils located?
Pharyngeal tonsils in nasopharynx, palatine tonsils and lingual tonsils in oropharnyx.
What vessels contribute to epistaxis?
Epistaxis, or nose bleeds, receive blood from sphenopalatine artery, superior labial artery branch of facial artery, anterior ethmoidal artery, and greater palatine artery.
Why does ones nose drip when one cries?
The nasolacrimal duct, which drains the tears from the eye, empties into the inferior meatus in the nose. When one cries there is an excess of drainage into the nasal cavity.
How can congestion and infection in the nasal cavity spread into the air sinuses?
Infection can spread from the nasal cavity into the paranasal air sinuses through openings (ostia) in the nasal meatuses. The frontal sinus and maxillary sinuses open into the hiatus semilunaris of the middle meatus, the ethmoidal air sinus opens through the ethmoid bulla and the sphenoidal air sinus opens into the superior meatus.
If you swallow a fish bone or a pill and it gets stuck, where is the most likely position of the lodged object?
Objects most commonly get lodged in the piriform recess.
Which nerve (s) are responsible for the cough reflex?
CN X for sensory arm and CNX-XI complex for motor arm.
What are the muscles of the soft palate?
Levator veli palatini, tensor veli palatini and uvulae muscle.
What are the functions of the muscles of the levator veli palatini muscle?
The levator veli palatini, innervated by the X-XI complex, elevates the soft palate to close off the nasopharynx during swallowing of food and drink.
What is the function of the tensor veli palanti muscle?
The tensor veli palatini, innervated by V3, tenses the soft palate so that when the levator elevates it makes a good seal in closing off the nasopharynx.
What is the function of the uvulae muscle?
The uvulae muscle helps in phonation.
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