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Which nerves innervate the outer ear?
- auiculotemporal (V3)
- great auricular (cervical plexus)
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Which nerves innervate the concha?
SA (VII, X)
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Which nerve innervates the mucosa of the middle ear cavity?
VA, IX
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Where does the footplate of stapes lie?
Oval window (opposite fluid filled chambers of cochlea->hairs in organ of Corti-> CN VIII)
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What nerve crosses the lateral wall of the middle ear cavity?
- Chorda tympani (VII)
- anterior 2/3 tongue (SS)
- sub-mandibular ganglion (VE-para/pre) via lingual nerve(V3) -> SUBLINGUAL AND SUBMANDIBULAR GLANDS
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What is the tensor tympani?
- muscle attaches to malleus and auditory tube to dampen vibration
- innervatied by V3(BM)
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What is the promontory?
medial wall bony elevation, where the tympanic plexus forms from tympanic br(IX Glossopharangeal)->lesser petrosal nerve (VE-para/pre to otic ganglion -> parotid
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What structures relate to anterior wall of middle ear?
- ICA
- auditory tube opening (middle ear->nasopharynx), equilize pressure
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What are the structures of posterior wall of middle ear?
- Aditus (opening) to mastoid antrum (air cells/sinuses)
- facial canal: facial nerve as it exits stylomastoid foramen (gives off chorda tympani)
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What does the stapedius do?
- Originates from small pyrimidal eminence connects to stapes
- dampens stapes vibration
- CN VII (BM)
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What is the tegmen tympani?
- roof of middle ear
- floor of middle cranial fossa
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What is on the floor of the middle ear cavity?
Internal Jugular Vein
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What are the 5 layers of the eylids?
- 1. Skin
- 2. SubQ
- 3. Muscles: orbicularis oculi, levator palpebrae, superior tarsal muscle(symp/post fibers)
- 4. Tarsofacial layer: plate& glands (oil prevent stickiness)
- 5. Conjunctiva: palpebral
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What is the course of tears?
Lacrimal gland->duct-> sup & inf fornix->puncta->analiculi->sac->nasolacrimal duct->inferior meatus
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What is superior tarsal muscle?
VE-symp-post widens eyelids
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Which muscles elevate/depress eyball?
- elevate: superior rectus, inferior oblique
- depress: inferior rectus, superior oblique
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Which muscles adduct/abduct the eyeball?
- adduct: medial, superior & inferior rectus
- abduct: lateral rectus, inerior & superior obliques
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Which medially/laterally rotate eyball?
- medial: intorsion-superior rectus & oblique
- lateral: extorsion-inferior rectus & oblique
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What is the only branch of internal carotid artery?
- Opthalmic a (optic canal)
- branches: central, lacrimal,posterior ciliary, supraorbital, posterior ethmoid, anterior ethmoid, dorsal nasal, supratrochlear
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How is eyeball drained?
- corresponding veins to superior opthalmic->cavernous sinus
- inferior opthalmic is connected to pterygoid venous plexus
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What nerves does CN III carry?
- goes through superior orbital fissure (3-6)
- SA, SE (everything except superior oblique and lateral rectus
- VA-para/pre to ciliary ganglion via INFERIOR division
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What is the fundus?
- posterior part of eyball
- optic disc: sensory fibers & vessels of eyes conveyed-> BLIND SPOT
- macula lutea: lateral to optic disc w depression called fovea centralis area of most acute vision
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What is the cornea innervated by?
- V1 ciliary nerves
- transparane avascular sensitive
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What are the divisions of V1?
- cell bodies in trigeminal ganglion
- Lacrimal, frontal (supraorbital, supratrochlear), nasociliary (long ciliary), poterior/anterior ethmoid, infratrochlear
- anterior ethmoid gives rise to external nasal n.
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What are the 3 layers of eyeball?
- 1. Fibrous: sclera & cornea
- 2. Vascular: iris, ciliary body, choroid (vascular)
- 3. Retinal
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What is the ciliary body?
- smooth muscle & vasculature that connects the choroid and iris
- attachment for lens via zonular fibers
- controls thickness (focus & accomidation) of lens
- VE-para/post from ciliary ganglion fibers from CN III
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Which muscles control the size of the pupil?
- sphincter pupilla (parsymp)
- dilator pupillae (symp)
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How is the retina organized?
pigmented(light absorbing) & neural(rods & cones->bipolar->ganglion cells (CNII)
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What does the vitreous chamber do?
- transmits light
- holds retina in place
- suppport lense
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What does the aqueous humor do?
nourishes cornea and lens
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What is the innervation of the lacrimal gland?
VE-para/post from pterygopalatine ganglion (hitchhike along V2 and zygomatic temporal->lacrimal
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Where do all sympathetic post fibers synapse?
- Superior Cervical Ganglion (fibers from T1-L2)
- jump on ICA/ECA
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Where is the ciliary ganglion?
- between optic nerve and lateral rectus
- VE para/pre from edinger westphal nucleus -> sphincter pupillae & ciliary body
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Where do the sym post fibers to orbit go?
- originate from superior cervical ganglion
- Long ciliary V1 to dilator pupillae (doesn't go through ciliary ganglion)
- blood vessels of eye (ganglion)
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What is the pathway to ciliaris & sphincter pupallae?
- VA pathway
- Edinger Westphal->inferior CN III-> ciliary ganglion
- Short ciliary n-> muscles
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What fiber types does the short ciliary nerve contain?
- motor: VE-para/post (to ciliary body & sphincter pupillae)
- sympathetic: symp/post (to blood vessels)
- Sensory: SA (from V1)
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Which fascias make the carotid sheath?
investing, prevertebral, pretracheal
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What innervates carotid body/sinus?
- body: chemo, X
- sinus: baro, IX
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Which muscle splits to allow digastric to go through?
Stylohyoid
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Where are symp/pre cell bodies?
- lateral gray horn unless splanchnic
- symp/post: symp chain ganglion or preaortic
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What are the types of VA fibers?
- pain(sympathetic) cell bodies in DRG
- reflex (parasymp) cell bodies in vagal sensory ganglia or S2-4 DRG
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