1. Bones of skull
    • Occipital
    • Parietal
    • Frontal
    • Temporal
    • Sphenoid
    • Ethmoid
  2. Facial bones
    • Maxilla
    • Mandible
  3. Joints of skull
    • Sagittal: between parietal bones
    • Frontal/coronal: parietal + frontal
    • Lambdoid: parietal + occipital
    • Squamous: parietal + temporal
  4. SCALP
    • S: Skin with hair and sebacous glands
    • C: Close subcutaneous/connective tissue
    • A: Aponeurosis flattened tendon, named galea aponeurotica/epicranium
    • L: Loose subaponeurotic tissue allowing for free movement, "danger layer"
    • P: Pericranium/periosteum
  5. Dural folds
    • Falx cerebri: seperates sides of cerebrum, attached to crista galli and tentorium cerebelli
    • Tentorium cerebelli: tent over cerebellum
    • Falx cerebelli: another sickle shaped fold seperating cerebellar hemispheres
    • Diaphragma sella: small sheet, roof over hypophyseal fossa
  6. Sinus flow
    Inferior --> straight --> confluence --> transverse --> sigmoid --> internal jugular

    superior --> confluence
  7. Circle of Willis
    Basilar artery --> posterior cerebral arteries (which then feed hemispheres --> posterior communicating arteries --> middle cerebral arteries (which then feed hemispheres and break into internal carotids to feed inside of Circle) --> anterior cerebral --> anterior communicating closes Circle
  8. Cerebrum
    • Largest part of brain
    • Gyri: longitudinal/falx cerebri, transverse fissure/sulcus, lateral fissure/sulcus, central sulcus
  9. Central sulcus
    Precentral gyrus is primary motor, lies anterior to central sulcus

    Postcentral gyrus is primary sensory lies posterior to central sulcus
  10. Basal ganglia/nuclei
    • Makes up central gray matter
    • Controls movement and posture
  11. Thalamus
    Relay station, sends impulses to ccerebral cortex
  12. Hypothalamus
    • Optic chiasma where CNII optic nerve crosses
    • Mammillary bodies -- sensory synaptic station, part of limbic station
    • Pitutary gland
  13. Brain stem parts
    • Midbrain (corporua quadrigemina made of superior & inferior collucli)
    • Pons (connects cerebellar hemispheres)
    • Medulla oblongata (pyramidal decussation)
    • Cerebellum (looks like arbor vitae, coordinates muscle activity, regulates muscle tone, maintains equilibrium)
  14. Ventricles
    • Lateral (2) -- largest, sepearted by septum pellucidum
    • Third (1) -- between thalami
    • Fourth (1) -- in pons & medulla, continuous with spinal cord
  15. CSF flow
    • Right/left ventricle
    • Interventricular foramen of Monro
    • Third ventricle
    • Cerebral aqueduct of Sylvius
    • Fourth ventricle
    • Luschka or Magendie
    • Subrachnoid space
    • Arachnoid granulations
    • Superior sagittal & venous system for drainage
  16. Platysma
    • O: skin over deltoid & pec
    • I: lower border of mandible
    • Inn: facial nerve CN VII
  17. Sternocleidomastoid
    • O: Manubrium of the sternum and clavicle
    • I: mastoid process
    • Inn: CN XI, Accessory
  18. Infrahyoid/strap muscle group
    • Thyrohyoid
    • Sternohyoid
    • Omohyoid
    • Sternothyroid
  19. Thyrohyoid
    • O: thyroid cartilage
    • I: hyoid bone
    • Inn: CN XII (hypoglossal), C1 (the exception to the rule)
  20. Sternohyoid
    • O: manubrium of the sternum
    • I: hyoid
    • Inn: ansa cervicalis
  21. Sternothyroid
    • O: manubrium of the sternum
    • I: hyoidInn: ansa cervicalis
  22. Omohyoid
    • I: scapula (omo means neck)
    • I: hyoid
    • Inn: ansa cervicalis
  23. Suprahyoid muscle group
    • Digrastric
    • Stylohyoid
    • Mylohyoid
    • Geniohyoid
  24. Scalene muscle group
    • Scalene anterior
    • Scalene medius
    • Scalene posterior

    Triangle: anterior + medius + first rib
  25. Scalene anterior
    • O: cervical vertebrae
    • I: first ribe
    • Inn: ventral rami
  26. Scalene medius
    • O: cervical vertebrae
    • I: first rib
    • Inn: ventral rami
  27. Scalene posterior
    • O: cervical vertebrae
    • I: second rib
    • Inn: ventral rami
  28. Prevertebral muscle group
    • Longus capitis
    • Longis cervicis/colli (means neck)
  29. what's in front of scalene interior?
    • Phrenic
    • Internal jugular
    • Common & internal carotid arteries
    • Subclavian vein (seperates V from A)
    • Vagus nerve

  30. what's behind scalene anterior?
    • Subclavian artery
    • Brachial plexus
  31. Bones in neck
    • 8:
    • 7 cervical vertebrae (C1/atlas, C2/axis, C3-C6 and C7/vertebral promenens) and hyoid
  32. What's in carotid sheath?
    • Internal jugular
    • Vagus nerve
    • Common carotid
  33. Cervical plexus components
    • Phrenic nerve
    • Ansa cervicalis
    • Superficial branches
  34. Phrenic nerve
    • From ventral ramus (C3, 4 and 5) diaphragm
    • Courses through neck in front of scalene anterior and through thorax in front of root of lung
    • Innervates just one muscle: diaphragm
  35. Ansa cervicalis
    • Supplies all infrahyoid (except thyrohyoid)
    • Has superior (hypoglossal nerve) and inferior roots (from C2 or C3)
  36. Superficial branches of cervical plexus
    • Lesser occipital (C2, C3)
    • Greater auricular (C2, C3)
    • Transverse cervical (C2, C3) crosses over
    • Supraclavicular (C3, C4) over clavicle
  37. Branches of aortic arch
    Arch --> brachiocephalic --> right subclavian artery and right common carotid artery --> terminates at upper border of tyroid cartilige by dividng into internal (80%) and external carotid

    Arch --> left common carotid artery (same as above)

    Arch --> left subclavian artery --> changes into axillary artery at first rib --> joins with other vertebral artery at foramen magnum --> forms basilar artery
  38. Veins
    Axillary vein --> becomes subclavian vein at lateral border of first rib --> joins with internal jugular vein --> brachiocephalic vein

    External jugular veins draining scalp & face --> sternoclidomastoid --> joins respective subclavian vein

    Internal jugular vein from dural sinuses that drain brain --> carotid sheath --> joins respective subclavian vein to form brachiocephalic
  39. External nose
    • Apex: tiop
    • Root: base
    • Dorsum: top part, upper part is bridge
    • Nares/nostrils
    • Ala: flap
  40. Piriform aperture
    pear shaped space at entrance of nose, bounded by nasal bones from above and maxilla laterally and below
  41. Roof of nasal cavity
    • Nasal bone
    • Frontal bone
    • Ethmoid bone/cribiform plate
    • Sphenoid body
  42. Inferior boundary/floor of nose
    • Maxilla (anterior)
    • Palatine (posterior)
  43. Lateral boundary of nose
    • Nasal bone
    • Lacrimal bone
    • Ethoid bone
    • Inferior nasal concha/turbinate
    • Palatine bone
    • Medial pterygoid plate of sphenoid
    • Maxilla bone
  44. Medial boundary of nose
    • Seperates right and left cavities
    • Vomer
    • Perpeindicular plate of ethmoid
    • Septal cartilage
  45. Paranasal sinuses
    • Maxillary: largest, opens into hiatus semilunaris in middle meatus
    • Frontal: single sinus on each side, opens into hiatus semilunaris in middle meatus
    • Ethmoidal/labryrinthine sinus: air cells, anterior opens into ethmoidal bulla in middle meatus; posterior opens into unnamed opening in superior meatus
    • Sphenoid: single on each side, opens into sphenoethmoidal recess in posterior to superior meatus
  46. Pharynx continuous with
    • 2 nasal cavities
    • 2 tympanic cavities
    • oral cavity
    • larynx
    • esophagus
  47. Folds of nasopharynx
    • Torus tubarius: cartilage
    • Salpingopalatine fold: from torus to soft palate
    • Salpingopharyngeal fold: from torus to lateral wall of pharynx
    • Torus levatorius: from other two folds to mouth of tube to soft palate
    • Pharyngeal recess: sometimes holds lymphoid tissue
    • Pharyngeal isthmus: opening from nasopharynx to oropharynx
  48. Pillars of fauces
    • Raised area holding palatine tonsil in place
    • Anterior pillar of fauces/palatoglossal arch: from palate to side of tongue, holds palatoglossus muscle
    • Posterior pillar of faues/palatopharyngeal arch from soft palate to lateral pharynx, holds palatopharyngeal muscle
  49. Thyroid cartilage
    • Made of two flat plates - laminae in front and diverge in back
    • Laryngeal prominence - fuse in front
    • Superior thyroid notch - can be felt
    • Superior horn - attaches via ligaments to hyoid
    • Inferior horn - articulates with cricoid
    • Oblique line - where strap muscles attach
  50. Cricoid cartilage
    • Upprt part is arch, posterior part is lamina
    • Upper border articultes with arytenoid cartilages
    • Lower part connected to trachea via cricotracheal ligament
  51. Arytenoid cartilages
    • Pyramidal shape
    • Base has two processes: vocal (attaches to vocal ligament) and muscular process (for muscles of larynx)
  52. Corniculate & cuneiform cartilages
    • Corniculate: on arytenoid cartilages
    • Cuneiform: in aryepiglottic folds
  53. Extrinsic muscles of larynx
    • Elevators (above hyoid): thyrohyoid, stylohyoid, mylohyoid, digastric (3 hyoids + 2gastric)
    • Depressors: omohyoid, sternohyoid, sternothyroid (O-hyoid-hyoid)
  54. Intrinsic muscles of larynx
    • Cricothyroid
    • Arytenoideus
    • Lateral criarytenoid
    • Posterior criarytenoid
    • Thyroarytenoid
    • Vocalis
    • (C-arytenoids-V)
  55. Muscles of larynx action & innervation
    ACTION: all adduct (except posterior cricoarytenoid that abducts)

    INNERVATION: all supplied by recurrent laryngeal nerve (except cricothyroid supplied by superior laryngeal nerve)
  56. Superior laryngeal nerve
    • From Vagus/CN X
    • External: external to larynx, innervates cricothyroid
    • Internal: pierces thyrothyoid membrane to supply sensory to mucus membrane linign larynx
  57. Recurrent laryngeal nerve
    • From Vagus/CN X
    • Right recurrent -- loops around subclavian
    • Left recurrent -- loops around aorta
    • Both ascend to larynx in groove between esophagus and trachea
  58. Laryngeal vestibule
    • Aditus/inlet: opening into larynx from laryngopharynx, closes respiratory tract from food & foreign bodies
    • Vestibular folds: ligaments are false vocal cords, space between ligaments is rima vestibule (adducting vocal cords adducts these, increases intraabdominal pressure)
  59. Laryngeal ventricle of Morgagni
    • The space on either side of larynx between vestibular fold and true vocal cords below
    • Allows free movement of vocal cords
    • True vocal cords: bound below, contain vocalis muscle and vocal ligaments
    • Rima glottidis: space between the two true vocal cords, controls airstream
  60. Valleculae
    • One median glossoepiglottic fold attaches epiglottis to posterior tongue
    • Two lateral glossoepiglottic folds attach epiglottis to pharynx
    • Epiglottic valluclae are little ditches where saliva collects
    • Important landmarks during intubation
Card Set
head and neck