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236 terms

gross anatomy II - test 1

STUDY
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damage to C.N. VII can lead to what
Bell's palsy
sensory innervation to the face is via branches of which nerve
C.N. V
the trigeminal (C.N. V) nerve divides into three major branches emerging onto the face. what are they
- opthalmic
- maxillary
- mandibular
the ophthalmic nerve divides into even more branches, which include
- supraorbital
- supratrochlear
- infratrochlear
- external nasal
- lacrimal
the maxillary nerve divides into even more branches, which include
- zygomaticotemporal
- zygomaticofacial
- infraorbital
the mandibular nerve divides into even more branches, which include
- auriculotemporal
- buccal
- mental
the most frequently injured nerve with blow to the face
infraorbital nerve
trigeminal neuralgia (synonym)
Tic Doloureaux
sudden attacks of severe pain occurring in an area of sensory distribution of the trigeminal nerve would indicate what condition
trigeminal neuraglia
list the areas affected by trigeminal neuraglia from most common to least common
maxillary > mandibular > opthalmic
sensory innervation of the posterior aspect of the neck and scalp is from the
dorsal primary rami of C2-C4 spinal nerves
which area does the greater occipital nerve (dorsal primary ramus of C2) innervate
occipital region
sternocleidomastoid
OINF
O: sternal head from the front of the manubrium, clavicular head form the medial third of the clavicle
I: lateral surface of mastoid process, lateral half of the superior nuchal line
N: accessory nerve (C.N. XI)
F: chief flexor of the head
torticollis (synonym)
wryneck
muscle affected from torticollis
sternocleidomastoid
what disorder can be described as a fibrous tissue tumor which develops at or shortly before birth
congenital torticollis
muscular torticollis is caused by
birth injury
what disorder occurs in adults and is due to abnormal tonicity and responds well to chiropractic care
spasmodic torticollis
trapezius
OINF
O: external occipital protuberance, ligamentum nuchae, spinous processes of the seventh cervical and all thoracic vertebrae
I: the lateral third of the clavicle, spine of the scapula, acromion process
N: accessory never (C.N. XI) and C3,C4
F: the upper portion elevates, the middle portion retracts, the lower portion depresses the scapula
which vein drains the face and scalp along with containing a large amount of cerebral blood
external jugular vein
formed immediately below the parotid gland by the union of which veins
external jugular vein;
- retromandibular vein
- posterior auricular vein
which vein runs downward and backward along the lateral surface of the sternocleidomastoid
external jugular vein
which vein empties into the subclavian vein
external jugular vein
what are the tributaries of the external jugular vein
- retromandibular vein
- posterior auricular vein
- posterior external jugular vein
- anterior jugular vein
- transverse cervical vein
- suprascapular vein
when does the external jugular vein become prominent
- congestive heart faliure (obstruction of the superior vena cava)
- opera singers and bagpipe players develop this due to intrathoracic pressure
where are superficial cervical lymph nodes found
along the external jugular vein, superficial to the sternocleidomastoid
what separates the posterior and anterior triangles of the neck
sternocleidomastoid
the boundaries of the posterior triangle of the neck are
anteriorly: posterior border of the SCM
posteriorly: anterior border of the trapezius
inferiorly: superior border of the middle third of the clavicle
the boundaries of the anterior triangle of the neck are
superiorly: inferior border of the mandible
anteriorly: anterior midline of the neck
posteriorly: anterior border of the SCM
the roof of the anterior triangle is formed by
- deep cervical fascia
- superficial cervical fascia
- platysma
subdivisions of the anterior triangle are
- submental triangle
- submandibular triangle
- carotid triangle
- muscular triangle
what is the important vascular triangle where the common carotid artery usually bifurcates
carotid triangle
the only one of the anterior triangle subdivisions to be unpaired
submental triangle
the boundaries of the submental triangle are
- left and right bellies of the digastric
- body of the hyoid bone
floor of the submental triangle
mylohyoid muscle
the boundaries of the submandibular triangle
- mandible
- anterior belly of digastric
- posterior belly of digastric
floor of the submandibular triangle
mylohyoid and hyoglossus muscles
contents of the submandibular triangle
- submandibular gland
- internal carotid artery
- facial artery
- internal jugular vein
- glossopharyngeal (C.N. IX) and vagus (C.N. X) nerves
the boundaries of the carotid triangle are
- posterior belly of digastric
- superior belly of omohyoid
- anterior border of SCM
the floor of the carotid triangle
- portions of the thyrohyoid
- hyoglossus
- inferior and middle constrictor muscles
contents of the carotid triangle
- internal carotid arteries
- external carotid artery
- superior thyroid artery
- lingual artery
- facial artery
- tributaries to the internal jugular vein
the boundaries of the muscular triangle are
- superior belly of omohyoid
- anterior midline of the neck
- anterior border of SCM
floor of the muscular triangle
posterior layer of pretracheal fascia
contents of the muscular triangle
- sternohyoid
- sternothyroid
- thyroid gland
- trachea
- esophagus
list the four infrahyoid muscles
- omohyoid
- sternohyoid
- thyrohyoid
- sternothyroid
the superficial layer of the infrahyoid muscles is made up of
- omohyoid
- sternorhyoid
the deep layer of the infrahyoid muscles is made up of
- sternothyroid
- thyrohyoid
omohyoid
OINF
O: inferior belly, upper border of the scapula. superior belly, intermediate tendon
I: the body of the hyoid bone
N: ansa cervicalis (C1-C3)
F: depresses the hyoid bone and larynx
sternohyoid
OINF
O: posterior surface of manubrium and medial end of clavicle
I: body of hyoid bone
N ansa cervicalis (C1-C3)
F: depresses the hyoid bone and larynx
sternothryroid
OINF
O: posterior surface of manubrium, inferior to origin of the sternohyoid
I: oblique line on lamina of thyroid cartilage
N: ansa cervicalis (C1-C3)
F: depresses the larynx
thyrohyoid
OINF
O: the oblique line on lamina of thyroid cartilage
I: body of hyoid bone
N: C1 via hypoglossal nerve
F: depresses hyoid bone
what occurs when the hyoid and larynx are depressed
- swallowing
- speech
- breathing
- when hyoid is fixed, digastric can depress mandible
what are the two layers of cervical fascia
- superficial
- deep
what are the four layers of the deep cervical fascia
- investing layer of the deep cervical fascia
- pretracheal fascia
- prevertebral fascia
- carotid sheath
this layer of fascia lies deep to the superficial cervical fascia and splits to enclose the SCM and trapezius
investing layer of the deep cervical fascia
this layer of fascia encloses the thyroid gland, trachea, and esophagus
pretracheal fascia
this layer of fascia encloses the vertebral column and the deep muscles of the back
prevertebral fascia
this layer of fascia is a cylinder of fascia which extends from the base of the skull to the root of the neck
carotid sheath
what structures are contained within the carotid sheath
- common carotid artery
- internal carotid artery
- internal jugular vein
- vagus nerve
- deep cervical lymph nodes
clinical significance of the fascial layers of the neck
- lubrication for gross movements of neck and swallowing
- adhesion can cause neck pain
- channel for infections to spread
- cancer involving deep cervical lymph nodes can compress the internal jugular vein
the opening through which structures of the neck pass into the thorax
thoracic inlet (superior thoracic aperture)
the boundaries of the thoracic inlet include
- first thoracic vertebra
- first ribs and their cartilages
- manubrium sterni
what is the shape of the thoracic inlet
kidney shaped
the arteries which pass through the thoracic inlet include
- brachiocephalic trunk
- left common carotid artery
- left subclavian artery
- internal thoracic artery
the veins which pass through the thoracic inlet include
brachiocephalic vein
the nerves which pass through the thoracic inlet include
- phrenic nerve
- vagus nerve
- recurrent laryngeal nerve
- sympathetic trunk
viscera which pass through the thoracic inlet include
- trachea
- esophagus
- cervical pleura
- apex of lung
- thymus
the thymus is part of which major system in the body
immune system
location of the thymus
behind (posterior to) the manubrium and the body of the sternum
which structure(s) are superior to the thymus
thyroid gland
which structure(s) are anterior to the thymus
- sternohyoid
- sternothyroid
blood supply to the thymus
internal thoracic artery
innervation of the thymus
from the stellate ganglion of the sympathetic trunk an vagus
which hormones does the thyroid gland produce
thyroxine and calcitonin
at which vertebral level does the thyroid gland reside
C5-T1
about 50% of thyroid glands have an extra lobe called
pyramidal lobe
a muscle that connects the isthmus of the thyroid gland with the hyoid bone
levator glandulae thyroideae muscle
arterial blood supply to the thyroid gland includes
- superior thyroid artery
- inferior thyroid artery
on the right side of the thyroid gland there is a third possible artery that supplies the thyroid gland that branches off of the brachiocephalic trunk
arteria thyroidea ima
venous blood supply to the thyroid gland includes
- superior thyroid vein
- middle thyroid vein
- inferior thyroid vein
innervation of the thyroid gland
superior, middle, and inferior cervical sympathetic ganglia
abnormal enlargement of the thyroid gland
goiter
goiter due to dietary deficiency of iodine
endemic goiter
symptoms are those of hypothyroidism
endemic goiter
goiter due to autoimmune disease
exothalmic goiter
symptoms are those of hyperthyroidism
exothalmic goiter
grave's disease (synonym)
exothalmic goiter
endocrine glands involved in calcium homeostasis
parathyroid glands
blood supply to the parathyroid glands
inferior and superior thyroid artery
nerve supply to the parathyroid glands
inferior or middle cervical sympathetic ganglia
factors contributing to the difficulty of thyroid surgery
- vascularity
- presence of recurrent laryngeal nerve
- damage to parathyroid
the posterior gap in the trachea is spanned by which muscle
trachealis muscle
bloody supply to the trachea
inferior thyroid artery
nerve supply to the trachea
recurrent laryngeal nerve
connects the pharynx to the stomach
esophagus
at which vertebral level does the esophagus begin
C6
the main arteries to the head and neck
left and right common carotid arteries
main source of blood to structures of the neck, face, and scalp
external carotid artery
enters through the carotid canal in the temporal bone to supply blood to the brain
internal carotid artery
the branches of the external carotid artery include
- superior thyroid artery
- ascending pharyngeal artery
- lingual artery
- facial artery
- occipital artery
- posterior auricular artery
- superficial temporal artery
- maxillary artery
the two branches of the external carotid artery that represent the terminal branches
superficial temporal and maxillary arteries
a baroreceptor that is innervated by the glossopharyngeal nerve (C.N. IX)
carotid sinus; innervated by the carotid sinus nerve
a reddish-brown chemoreceptory located within the bifurcation of the common carotid artery and is innervated by the carotid sinus branch of the glossopharyngeal nerve (C.N. IX)
carotid body
usually the largest of the jugular veins and begins at the jugular foramen as the direct continuation of the sigmoid sinus
internal jugular vein
drains into the brachiocephalic vein
internal jugular vein
the dilation of the internal jugular vein at its origin below the jugular foramen
superior jugular bulb
tributaries of the internal jugular vein
- inferior petrosal sinus
- pharyngeal veins
- facial vein
- lingual vein
- superior thyroid vein
- middle thyroid vein
the dilation of the internal jugular vein near its termination into the brachiocephallic vein
inferior jugular bulb
misalignment of joint involving the articular eminence of the skull and the condylar process of the mandible
temporomandibular joint syndrome
the three large paired salivary glands
- submandibular
- parotid
- sublingual
part of a which gland is large and located within the submandibular triangle and in the submandibular fossa
superficial part of the submandibular gland
part of which gland is small and located superior to the mylohyoid
deep part of the submandibular gland
blood vessels found within the submandibular region
- lingual artery and vein
- facial artery and vein
lymphnodes found within the submandibular region
- submandibular lymph nodes
- submental lymph nodes
functions of the nasal cavity
- provide an airway
- olfaction
- warming and moistening inspired air
- cleansing inspired air
what divides the nasal cavity into right and left chambers
nasal septum
posterior apertures of the nasal cavity which open into the nasopharynx
choanae
the floor of the nasal cavity is formed by which bones. they also form the hard palate
- palatine part of maxilla
- horizontal plate of palatine bone
the roof of the nasal cavity is formed by which bones
- nasal
- frontal
- cribriform plate of ethmoid
- body of sphenoid
medial wall of nasal cavity
nasal septum
when the nasal septum does not lie in the median plane
deviated septum
causes of deviated septum
- congenital malformation
- birth injury
- trauma
when the septum is severely deviated it can cause
- breathing difficulties
- exacerbate snoring
lateral wall of the nasal cavity is formed by which bones
- nasal
- maxilla
- lacrimal
- ethmoid
- inferior nasal concha
- perpendicular part of palatine
- medial pterygoid plate of sphenoid
superior nasal choncha is part of which bone
ethmoid
middle nasal choncha is part of which bone
ethmoid
inferior nasal choncha is part of which bone
separate
functions of nasal chonchae
- increase surface area to help heat, moisten, and clean inspired air
- increase turbulence
a rounded projection into the middle meatus
ethmoidal bulla
connects the lacrimal sac of the orbit to the nasal cavity
nasolacrimal duct
a curved slit lying below the ethmoid bulla within the middle meatus
hiatus semilunaris
receives the openings of the frontal sinus, maxillary sinus, and middle & anterior ethmoidal air cells
middle meatus
receives the opening of the posterior ethmoidal air cells
superior meatus
a small space located above and behind the superior nasal concha that receives the opening of the sphenoid sinus
sphenoethmoidal recess
the lower 2/3 of the nasal cavity
respiratory region
loss of olfaction
anosmia
the superior nasal concha and the upper 1/3 of the nasal septum make up
olfaction region
the primary blood supply to the nasal cavity
- sphenopalatine branch of the maxillary artery
- anterior ethmoidal branch of the ophthalmic artery
nose bleed, common due to rich blood supply
epistaxis
involves small branches in or near the vestibule, caused by minor trauma, low humidity
mild epistaxis
results from rupture of the sphenopalatine artery at one of its major anastomoses. caused by major trauma
severe epistaxis
where does lymph from the nasal cavity drain
deep cervical nodes
drains into the middle meatus via the frontonasal duct
frontal sinus
most prone to infection in this sinus because opening lies on medial wall about half way up, which leaves it poorly drained
maxillary sinus
the largest of the paranasal sinuses
maxillary sinus
only paranasal sinus that may be present during birth
maxillary sinus
consists of several groups of ethmoidal air cells
ethmoidal sinus
lies within th ebody of the sphenoid bone and poens into the phenoethmoidal recess
sphenoidal sinus
air cells that open into the superior meatus
posterior ethmoidal air cells
air cells that open into the ethmoidal bulla with the middle meatus
middle ethmoidal air cells
air cells that open into the hiatus semilunaris with the middle meatus
anterior ethmoidal air cells
places where an infection of the nasal cavity can spread
- lacrimal apparatus and conjunctiva via nasolacrimal duct
- nasopharynx
- paranasal sinuses
- middle ear via pharyngotympanic tube
- anterior cranial fossa via cribiform plate
- mastoid air cells via aditus from middle ear
infection of the lacrimal apparatus via nasolacrimal duct leads to
conjunctivitis (pink eye)
the most common infection of the nasal cavity
infection of the nasopharynx leading to acute pharingitis (sore throat)
infection of the paranasal sinuses can lead to
sinusitis
infection of the middle ear can lead to
otitis media
infection of the anterior cranial fossa can lead to
- meningitis
- brain abscess
- naegleria floweri (brain eating amoeba)
infection of the mastoid air cells can lead to
mastoiditis
what indicates damage to the cribriform plate
cerebrospinal fluid dripping through the nose
cerebrospinal fluid dripping through the nose indicates
damage to the cribriform plate
roof of the oral cavity
palate
anterior 2/3 of palate
hard palate
posterior 1/3 of palate
soft palate
which foramina are contained in the hard palate
- incisive
- greater palatine
- lesser palatine
the soft palate is continuous with two lateral arches
- palatoglossal arch
- palatopharyngeal arch
the palatoglossal arch is made up of
- palatoglossal fold (superficial)
- palatoglossus muscle (deep to the fold)
the palatopharyngeal arch is made up of
- palatopharyngeal fold (superficial)
- palatopharyngeus muscle (deep to the fold)
median projection of the soft palate
uvula
blood supply to the hard palate
greater palatine artery
blood supply to the soft palate
lesser palatine and facial arteries
damage to the left vagus nerve causes the uvula to deviate to the right, this is due to the lack of innervation to which muscle
musculus uvulae
functions of tongue
- taste
- mastication
- swallowing
- speech
structure that divieds the tongue into the oral part(anterior 2/3) and the oropharyngeal part(posterior 1/3)
sulcus terminalis
a foramen located at the apex of the sulcus terminalis
foramen cecum
the foramen cecum is a remnant of an embryological structure known as
the embrynoic throglossal duct
when the embryonic thyroglossal duct does not go away at birth
a thyroglossal cyst can form near the midline of the neck
conical projections on the tongue with sharply pointed tips
filiform papillae
do filiform papillae have taste buds
no
mushroom shaped projections on tongue
fungiform papillae
do fungiform papillae have taste buds
yes
the larges of the lingual papillae arranged in a V shaped row in front of the sulcus terminalis
vallate papillae
do vallate papillae have taste buds
yes, bitter. they trigger the gag reflex
grooves and ridges along the margin of the tongue, poorly developed in humans
foliate papillae
to foliate papillae have taste buds
yes, sour
a mass of lymphoid tissue found on the oropharyngeal surface of the tongue
lingual tonsil
two folds that connect the tongue to the epiglottis
- median glossoepiglottic fold
- lateral glossoepiglottic fold
the space on either side of the median glossoepiglottic fold
vallecula
connects the tongue to the floor of the mouth
lingual frenulum
when the lingual frenulum is short superior to inferior and long anterior to posterior, the tongue is strapped to the floor of the mouth, impeding speech. what is this called
ankyloglossia (tongue tie)
the only extrinsic muscle of the tongue that is not innervated by the hypoglossal nerve
palatoglossus
functions of clinical importance of the genioflossus muscle
- pulls tongue forward
- prevents tongue from going backwards and blocking the airway
- importing during general anesthesia and in seizure disorder
blood supply to the tongue
lingual artery
blood supply to the dorsum of the tongue
dorsal lingual artery
blood supply to the intrinsic muscles of the tongue
deep lingual artery
blood supply to the extrinsic muscles of the tongue
sublingual artery
venous supply to the tongue
lingual vein
drain lymph from the tip of the tongue, central part of lower lip, and the floor of the mouth
submental lymph node
drain lymph from the cheek, side of the nose, upper lip, lateral part of lower lip, gums, and margin of the tongue
submandibular lymph node
drain lymph from medial portion of the oral part and all of the oropharyngeal part of the tongue
deep cervical lymph node
submental lymph node drains what
drain lymph from the tip of the tongue, central part of lower lip, and the floor of the mouth
submandibular lymph node drains what
drain lymph from the cheek, side of the nose, upper lip, lateral part of lower lip, gums, and margin of the tongue
deep cervical lymph node drains what
drain lymph from medial portion of the oral part and all of the oropharyngeal part of the tongue
two sets of teeth during a life time
- deciduous
- permanent
types of teeth in a single quadrant in a deciduous set
- 2 incisors
- 1 canine
- 2 molars
total number of teeth in a deciduous set
20
types of teeth in a single quadrant in a permanent set
- 2 incisors
- 1 canine
- 2 premolars
- 3 molars
total number of teeth in a permanent set
32
border between the nasopharynx and the nasal cavity
chonae
border between nasopharynx and oropharynx
pharyngeal isthmus
superior boundary of the nasopharynx
roof of the pharynx
inferior boundary of the nasopharynx
the soft palate
the anterior boundary of the nasopharynx
posterior border of the inferior nasal concha
posterior boundary of the nasopharynx
posterior wall of the pharynx
location of the pharyngeal tonsil
posterior wall of the nasopharynx
clinical significance to the pharyngeal tonsil
- may become enlarged causing difficulty breathing through the nose
- second most removed tonsil
opens into the lateral wall of the nasopharynx
pharyngotympanic tube
connects the nasopharynx with the middle ear
pharyngotympanic tube
a small tonsil with lies immediately behind the opening of the pharyngotympanic tube
tubal tonsil
superior boundary of the oropharynx
soft palate
inferior boundary of the oropharynx
superior border of epiglottis
anterior boundary of the oropharynx
palatoglossal fold
posterior boundary of the oropharynx
posterior wall of the pharynx
the oropharynx lies at which vertebral levels
C2, C3
the oropharynx communicates with the oral cavity through
the oropharyngeal isthmus
most frequently removed tonsils
palatine tonsils
superior boundary of the laryngopharynx
superior border of the epiglottis
inferior boundary of the laryngopharynx
lower border of the cricoid cartilage where it joins the esophagus
anterior boundary of the laryngopharynx
posterior surface of the larynx
posterior boundary of the laryngopharynx
posterior wall of the pharynx
opening into larynx within the laryngopharynx
laryngeal inlet
foreign objects can get caught in a space in the anterior wall of the laryngopharynx located on eihter side of the laryngeal inlet called
piriform recess
arterial supply to the pharynx
- ascending pharyngeal artery
- maxillary artery
a layer of fascia that surrounds the pharynx external to the muscles of the pharynx. continuous with the pretracheal fascia below
buccopharyngeal fascia
a layer of fascia which lies internal to the muscles and external to the mucosa of the parynx
pharyngobasilar fascia
a potential space between the buccopharyngeal fascia and the prevertebral fascia
retropharyngeal space
review act of swallowing on page 49 at the bottom
;)