-
Facial nerve emerges from what foramen?
Stylomastoid
-
Maxillary branch (V2) of the trigeminal nerve goes through what foramen?
Foramen rotundum
-
Mandibular branch (V3) of the trigeminal nerve goes through what foramen?
Foramen ovale
-
Middle meningeal artery goes through what foramen?
Foramen spinosum
-
What vessels form the circle of Willis?
Posterior cerebral, posterior communicating, internal carotid (turn into middle cerebral), anterior cerebral, anterior communicating
-
Where do the Posterior cerebral arteries originate?
Basilar artery
-
Where do the Anterior and Middle cerebral arteries originate?
Internal carotid artery
-
What nerves run in the cavernous sinus?
CN III, CNIV, CN V1 and V2
-
What is the main action of the masseter muscle?
close the jaw
-
What is the main action of the tmeporalis muscle?
Elevates mandible, and retracts mandible
-
Action of the lateral pterygoid muscle?
Opens jaw, depresses chin, swings jaw from side to side, produces larger lateral chewing motions
-
Action of the medial pterygoid?
Acts with masseter to eleveate mandible and protrudes jaw
-
Where does the facial vein drain?
Internal jugular vein
-
What nerves runs along the posterior aspect of the thryoid gland?
recurrent laryngeal
-
What is the usual source of epidural bleeding?
Arterial
-
What is th usual source of subdural bleeding?
venous
-
Where do the cranial sinuses drain into?
Internal jugular vein
-
What glands are on the posterior apect of the thyroid gland?
Parathyroid glands
-
Facial nerve courses through what structure?
Parotid gland
-
Knife wound near the anterior surface of anterior scalene muscle would injur what nerve?
Phrenic
-
Thyroidectomy, attempting to ligate the superior thyroid arteries, the nerve that courses close to this artery is?
External laryngeal nerve
- Which is infrahyoid muscle that is innervated by branches of the ansa cervicalis?
- Sternohyoid
- Which would normally be found in the carotid sheath
- Internal jugular vein (sympathetic trunk is closley related, not inside)
-
Accessory nerve to the right SCM injured by gunshot, most likely finding of what motor deficit?
Weakness in turning head to the left
- During surgery to thyroid gland, the surgeon should be concerned about damaging a structure that is located close to the posterior aspect of the gland, what structure?
- Recurrent laryngeal nerve
-
What are the content of the carotid sheath?
Internal jugular vein, external carotid artery, vagus nerve
-
What are the infrahyoid muscles?
Sternohyoid, Sternothyroid, Thyrohyoid, Omohyoid (superior and inferior bellies)
-
What are the suprahypid muscles?
Mylohyoid, DIgastric (anterior and posterior bellies), Stylohyoid
-
What nerves traverse the floor of the posterior triangle of the neck?
Accessory nerve to the trapezius and the brachial plexus can be seen between anterior and posterior scalene
-
Function of Suprahyoid muscles
pull the hyoid up, larynx goes with it
-
Function of Infrahyoid muscles
depress the hyoid-laryngeal apparatus
-
What is th eorigin of ansa cervicalis?
C1-C3 of cervical plexus
-
What nerve courses with the ansa cervicalis for part of its length?
Hypoglossal
-
What is the origin of te phrenic nerve?
C3,4,5
-
What gives main blood suply for the face and neck?
External carotid artery
-
What is the main blood supply to the thyroid gland?
inferior thyroid artery (from thyrocervical trunk) and superior thyroid artery (from external carotid artery)
-
What does the cervical plexus provide innervation for?
sensory to skin on neck and head, supra and infrahyoid muscles, deep neck muscles, phrenic nerve and ansa cervicalis
-
Where is the retropharyngeal space?
in front of prevertebral fascia
-
Maxillary artery
enters skull through foramen spinosum, supplies the cranial dura mater (branch from maxillary artery)
-
Facial Nerve (CN VII)
Enters skull through stylomastoid foramen
-
Cavernous sinus
located in middle cranial fossa lateral to body of sphenoid recieves superior ophthalmic vein and sphenoparietal sinus
-
Straight sinus
formed by the union of inferior sagittal sinus and great cerebral vein
-
Supraclavicular nerves
from C3, C4
-
Carotid sheath
fascial compartment contains internal jugular vein, common/internal carotid artery, vagus nerve, some deep cervical lymph nodes, and the inferior root of an ansa cervicalis
-
Anterior triangle
Bounded by the anterior cervical midline, inferior border of the mandible, and sternocleidomastoid
-
Submandibular triangle
Bordered by the anterior and posterior bellies of the digastric and the inferior border of the mandible- hypolgossal nerve courses deep in this triangle
-
Carotid triangle
Bordered by the posterior belly of the digastric, superior belly of the omohyoid, and the upper part of sternocleidomastoid, contains external carotid artery
-
Muscular triangle
bordered by the superior belly of the omohyoid, anterior cervical midline, and the lower part of sternocleidomastoid; contains the sternohyoid, sternothyroid, and thyrohyoid muscles
-
Submental triangle
bordered by the anterior bellies of the digastric and body of the hyoid
-
Posterior triangle
Bordered by SCM, clavicle, anterior border of trapezius; accessory nerve descends across the triangle on levator scapulae
-
Innervation of Sternocleidomastoid
Accessory nerve
-
Action of SCM
laterally flexes head and neck and rotates head and neck to opposite side
-
Infrahyoid muscles
sternohyoid, omohyoid, thyrohyoid, sternothyroid
-
Innervation of infrahyoid muscles
ansa cervicalis (except for Thyrohyoid which is a branch of C1 via the hypoglossal)
-
Suprahyoid muscles
stylohyoid, digastric, mylohyoid, geniohyoid
-
Stylohoid innervation
facial nerve
-
Digastric innervation
posterior belly of facial nerve, anterior belly of nerve to mylohyoid, branch of mandibular division of trigeminal nerve
-
Mylohyoid innervation
nerve to mylohyoid
-
Action of suprahyoid muscles
elevation of hyoid, larynx, phraynx, motions used for vocalization and deglutition, assist in opening mouth when hyoid is fixed by infrahyoid muscles
-
Branches of the External Carotid Artery
Superior thryoid, lingual, facial, TERMINAL BRANCHES: Maxillary and superficial temporal arteries
-
Vertebral artery
Branches off subclavian, ascends to the angle between scalenus anterior and longus colli, and then traverses the transverse foramina of the upper six cervical vertebrae
-
Branches of subclavian artery
Vertebral, internal thoracic, thyrocervical trunk
-
Inferior thyroid artery
Branch off thyrocervial trunk ascends along the medial border of scalenus anterior, posterior to the carotid sheath, and then loops inferiorly to the thyroid gland
-
Blood supply to thyroid gland
superior thyroid artery (from external carotid) and inferior thyroid artery (from thyrocervical trunk)
-
Venous drainage of thyroid gland
internal jugular vein (via superior and middle thyroidvein) and brachiocephalic vein (via inferior thyroid vein)
-
Lymphatic drainage of thyroid gland
Deep cervical lymph nodes
-
Action of Masseter Muscle
elevation of mandible
-
Innervation of Masseter muscle
masseteric nerve (branch of mandibular nerve from CNV, trigeminal)
-
Mandibular nerve
branch of trigeminal (only branch that has motor fibers)
-
Branches of the trigeminal nerve (CNV)
opthalmic, maxillary, mandibular provide cutaneous innervation of the face
-
Action and Innervation of Temporalis
elevation and retraction of the mandible innervated by the anterior an dposterior temporal nerves (branches of mandibular nerve)
-
What nerve does sensory and motor for the larynx?
VAGUS!
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What is the main blood supply to the larynx?
Superior thyroid artery
-
What symptom results from improper vbration of the vocal folds?
Hoarseness
-
Arytenoid cartilages
sit on the posterior aspect of the cricoid cartilage
-
Cricoid cartilage
ring of cartilage below throid cartilage, gets thicker posteriorly
-
What vessel does the superior thyroid artery branch off of?
external carotid
-
What vessell does the inferior thyroid artery branch off of?
thyrocervical trunk (branch from the subclavian)
-
What does the vocalis muscle do?
part of vocal fold, acts to produce sounds
-
What nerve innervates the cricothyroid muscle?
external laryngeal
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Action of posterior cricoarytenoid muscles
abduction of vocal fold
-
Action of lateral cricoarytenoid muscles
adduction of vocal ligaments
-
Muscles of the larynx
Cricothyroid, posterior cricoarytenoid, lateral cricoarytenoid, thyroarytenoid, vocalis, transverse arytenoid,oblique arytenoid, aryepiglotticus
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Motor innervation to the intrinsic muscles of the larynx?
Recurrent laryngeal nerve (except cricothyroid which is innervated by the external laryngeal nerve)
-
What nerve provides the sensory innervation below the vocal cords?
recurrent laryngeal nerve
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What bone is the tensor tympani muscle attached to?
malleus
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What nerve does the chordae tympani come off of?
Facial nerve
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Chordae tympani runs through what before it joins the lingual nerve?
middle ear
-
What provides sensory innervation to lower teeth and gums?
inferior alveolar nerve (branch of V3)
-
What provides sensory innervation of the lower lip and chin?
mental nerve (branch of V3)
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What branch of V3 carries postganglionic parasympatetic secretomotor fibers from the otic ganglion to the facial nerve?
auriculotemporal
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What provides general sensory innervation to the anterior 2/3 of the tongue?
lingual nerve
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What provides taste to the anterior 2/3 of the tongue?
chorda tympani (branch of facial that joins the lingual)
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What nodes do the thyroid gland drain into?
deep cervical nodes
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The carotid sinus recieve sensory information via what nerve?
glossopharyngeal
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Does the sympathetic trunk travel anterior or posterior to the carotid sheath?
posterior
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What nerves make up the ansa cervicalis
superior roots= C1, inferior root= C2,3
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What branch of the vagus gives sensory innnervation for auricle, exnternal acoustic meatus and tympanic membrane?
Auriculotemporal nerve
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What branch of the vagus gives motor innnervation to the pharynx and palate?
pharyngeal branch
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What branch of the vagus gives sensory innnervation to the larynx above the vocal folds and general sensory and taste for epilgottis?
Internal laryngeal nerve
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What branch of the vagus pierces the thyrohyoid membrane?
Internal laryngeal nerve
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What branch of the vagus gives motor innnervation to the cricothyroid muscle?
External laryngeal
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What muscles of the neck and posterior to the retropharyngeal space
Longus capitis and longus coli
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Where does the vertebral artery originate from?
Subclavian artery
-
What does the inferior thyroid artery branch off of?
thyrocervical trunk (a branch of subclavian)
-
What nerves innervate the medial and lateral pterygoid muscles?
mandibular (V3)
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What branch of trigeminal contains post ganglions sympathetic and parasympathetic fibers to the lcarimal gland?
maxillary
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What nerve contains preganglionic parasympathetic fibers to the pteryogpalatine ganglion?
Lingual nerve (a branch of facial, CN VII)
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What artery does the middle meningeal arty branch off of?
Maxillary artery (branch of external carotid)
-
What foramen does the inferior alveolar artery travel through (and with what nerve)?
It travels with inferior alveolar nerve (branch of V3) into the mandibular foramen
-
What forms the cruciform ligaments of the atlas?
transverse ligament of atlas and inferior and superior longitudinal band
-
What do the alar ligaments attach to
from the dens to the occipital condyles, prevent excess rotation of atlantoaxial joints
-
What muscles attach to the cartilagious part of the auditory tube that help in equalization of air pressure?
alpingopharyngeus, levator veli palatini, tensor veli palatini
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How does the nasopharynx communicate with nasal cavities?
Chooanae
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What are the upper and lower borders of the nasopharynx?
base of skull to soft palate
-
What are the upper and lower borders of the oropharynx?
Soft palate to epiglottis
-
What important structures are in the oropharynx?
pharyngela tonsils and pharyngeal opening to the auditory tube
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What are the lateral borders of the oropharynx that connect it with the oral cavity?
palatoglossal and palatopharyngeal arches (created by folds)
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What is located between the palatoglossal and palatopharyngeal arches?
palatine tonsils
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What are the uppe rand lower borders of the laryngopharynx?
epiglottis to the esophagus
-
What innervates the pharyngeal constrictors?
vagus via the pharyngeal plexus (part of the inferior pharyngeal constrictor is by the external laryngeal branch of vagus)
-
What is the function of glossopharyngeal nerve (CN IX)?
sensory to mucosa of oropharynx and only motor fibers to the stylopharyngeus
-
What nerve innervates pharyngeal muscles?
vagus (except stylopharyngeus is by glossopharyngeal)
-
What does marks the site of origin of the thyroid gland?
foramen cecum on the tongue
-
What attaches the inferior surface of the tongue to the floor of the mouth?
lingual frenulum
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What is the function of the genioglossus?
deviation of tongue to opposite side, when both act they protrude the tongue
-
What is the function of the hyoglossus?
depression of the tongue
-
What is the function of styloglossus?
elevation and retraction of the tongue
-
What is the function of palatoglossus?
elevation of the tongue
-
What are the extrinsic tongue mucles innervated by?
hypoglossus (except palatoglossus which is vagus)
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What nerve is the submandibular ganglion suspended from?
lingual nerve
-
What nerve fibers does the lingual nerve carry to the sublingual and submandibular glands?
Preganglionic parasympathetic fibers from the chorda tympani
-
What two muscles does the hypoglossal nerve course between?
mylohyoid and hyoglossus
-
What nerve courses deep to the palatine tonsil and is subject to being injusted during tonsillectomy?
glossopharyngeal
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What nerve provides taste and general sensation to the posterior 1/3 of tongue?
glossopharyngeal
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What innervates tensor veli palatini
nerve to tensor veli palatini (branch of nerve to medial pterygoid, branch of mandibular nerve)
-
What provides sensory innervation to the hard palate as far as the incisor teeth?
greater palatine nerve (branch of the maxillary nerve)
-
What nerve exits from the greater palatine foramen?
greater palatine nerve *branch of maxillary nerve)
-
What fibers from the pterygopalatine ganglion coursw with the greater palatine, lesser palatine and nasopalatine nerves to stimlate secreton from palatal glands?
postganglionic parasympathetic secretomtor fibers from pterygopalatine ganglion
-
Where to the vocal cords attach?
from the posterior surface of thryoid cartilage to the vocal process of the arytenoid cartilage
-
What recess is on each side of the epiglottis?
piriform recess
-
What do the vocal folds contain?
vocal ligaments
-
What space is formed between vestibular and vocal folds?
ventricle
-
What is the action of the cricothyroid muscle?
tilt thyroid cartilage forward, tensing and adducting the vocal ligament
-
What is the action of the posterior cricoarytenoid?
laterally rotates arytenoids, ABDUCT vocal ligaments (only abductors of vocal ligament)
-
What is the action of the cricoarytenoid?
Medially rotates the arytenoids which adducts the vocal ligament
-
Transverse and oblique arytenoids
Adduct the vocal ligaments
-
What is the action of vocalis muscle?
varies length and tension of vocal ligament to produce variations in pitch
-
What innervates laryngeal muscles?
recurrent laryngeal nerves (except cricothyroid which is by external laryngeal nerve)
-
What nerve pierces the thyrohyoid membrane?
internal laryngeal nerve (branch of superior laryngeal nerve)
-
What nerve provides sensory innervation to the laryngeal mucosa superior to the vocal folds?
internal laryngeal nerve
-
What nerve descends with the superior thyroid artery?
external laryngeal nerve
-
What provides sensory to the laryngeal mucosa inferior to the vocal folds?
recurrent laryngeal nerve
-
What nerve pierces the thyrohyoid membrane with the internal laryngeal nerve?
superior larygneal artery (branch of superior thyroid artery)
-
What recess is posterior to the epiglottis?
vallecula
-
What muscles are supplied by the motor branches of the mandibular nerve (V3)?
Masseter, Temporal, Medial and lateral pterygoids, Mylohyoid, Anterior belly of digastric, Tensor tympani, Tensor veli palatini
-
What are the symptoms of trigeminal nerve damage?
Loss of sensation in the face, loss of function of muscles of mastication, loss of taste on the anterior 2/3 of tongue
-
What is the sensory ganglion for the facial nerve?
geniculate ganglion
-
What is the sensory ganglion for the vestibulocochlear nerve?
Vestibular and cochlear ganglia
-
What muscles does the facial nerve supply?
Muscles of facial expression, posterior belly of the digastric, stylohyoid, stapedius
-
What is the motor branch of the corneal reflex?
facial (7, close your eyelid)
-
What is the sensory branch for the corneal reflex?
Maxillary nerve (V1)
-
Only muscle glossopharyngeal nerve supplies
Stylophayrngeus
-
What nerve is responsible for the afferent component of the gag reflex?
Glossopharyngeal
-
What nerve is responsible for the efferent component of the gag reflex?
Vagus
-
What is damaged if the pharynx deviates to the left when eliciting the gag reflex?
the right CN IX/X
-
What will result from a left sided CN XII injury?
tongue will deivate to the left upon protrusion
-
What nerve is the watchdog of the larynx?
internal laryngeal nerve
-
What is the deficit caused by injury of the superior laryngeal branch of the vagus nerve?
weakness of voice because of injury to the cricothyroid muscle abd anestesia to the superior part of the larynx
-
What is the deficit caused by injury of the recurrent laryngeal branch of the vagus nerve?
hoarseness and dysphonia (difficulty speaking) because of paralysis of vocal folds
-
What is the deficit caused by injury of both recurrent laryngeal nerves?
aphonia (inability to speak) and inspiratory stridor
-
What muscles are innervated by the hypoglossal nerve?
genioglossus, styloglossus, hyoglossus
-
From what nerve does the superior root of the ansa cervicalis branch?
hypoglossal
-
What muscles does the ansa cervicalis supply?
infrahyoid muscles
-
Does CN I emerge from brainstem
No
-
Does CN II emerge from brainstem
No
-
Where does CN III emerge?
Interpeduncular foramen, Just over bridge of pons
-
Where does CN IV emerge?
Dorsal surface of the midbrain, wraps around peduncles
-
Where does CN V emerge?
pons
-
Where does CN VI emerge?
Pontomedullary junction
-
Where does CN VII emerge?
Pons/Pontomedullary junction
-
Where does CN VIII emerge?
Pontomedullary junction
-
Where does CN IX emerge?
Medulla posterior to olive
-
Where does CN X emerge?
Medulla posterior to olive
-
Where does CN XI emerge?
Medulla posterior to olive
-
Where does CN XII emerge?
Medulla anterior to olive
-
What is the course of CN V2?
Passes through the maxillary bone, exits infraorbital foramen
-
What is the course of CN VI?
Through petrous part of temporal bone, Near ICA, through the cavernous sinus, exits through superior orbital fissue to supply lateral rectus
-
What ganglion is associated with CN V?
trigemnical ganglion
-
What ganglion is associated with CN VII?
geniculate
-
What are the motor, autonomic and sensory functions of the facial nerve?
Motor: muscles of facial expression, Autonomic: lacrimal gland and some salivary glands, Sensory: taste anterior 2/3 of tongue, skin of external ear
-
What foramen does CN VII come out of?
sytlomastoid foramen
-
What bone is the geniculate ganglion embedded in?
temporal bone
-
What ganglia are associated with the CN IX?
superior and inferior glossopharyngeal (sensory), otic ganglion (parasympathetic to parotid gland)
-
What motor, sensory and autonomic function does CN IX do?
Motor to stylopharyngeus, sensory to posterior 1/3 of tongue (and special taste), skin of ear, carotid sinus (BP), carotid body (gases), parasympathetic to parotid
-
What ganglia are associated with the vagus nerve?
superior and inferior vagal
-
What is the function of the hypoglossal nerve?
Motor to all the intrinsic and extrinside muscles of the tongue (except palatoglossus, which is by vagus)
-
How do sympathetic nerve fibers reach the ciliary ganglion?
Through the opthalmic artery nerve plexus or long ciliary nerves
-
What kind of fibers are in short ciliary nerves
sympathetic (post ganglionic from SCG), parasympathetic (pre andpost ganglionic from CN III), sensory (post ganglionic from V)
-
What symptoms would result from sympathetic nerve injury at the ciliary ganglion?
ptosis and pupillary constriction
-
What are the branches of the mandibular nerve (V3)?
inferior alveolar, lingual, buccal, chorda tympani, otic ganglion closely associated
-
What ligament attaches from the dens to the occipital bone
alar ligament
-
What thick ligament at the base of skull travels down the posterior aspect of the vertebral bodies at the posterior longitudinal ligament?
Tectorial membrane
-
What ligament holds the dens against the anterior arch of the atlas?
cruciate ligament
-
Patient with hoarse voice, uvula deviates to the left, what is the damaged nerve?
Right vagus
-
What are the tonsils in the nasopharynx?
Pharyngeal tonsils
-
What are the tonsils inthe oropharynx?
palatine and lingual
-
Which part of the pharynx is the eustachian tube in?
Nasopharynx
-
Where is the ethmoidal bulla located?
in the middle nasal meatus?
-
What are the openings in the middle nasal meatus?
mopening to maxillary sinus, opening of middle ethmoidal air cells, semilunar hiatus (connect to frontonasal sinus)
-
What are the opening in the superior nasal meatus?
Posterior ethmoidal cells, opening of the sphenoid sinus
-
Where are the openings of the sumandibular and sublingual ducts?
between the floor of the mouth and root of the tongue
-
The hypoglossal nerve innervates all the muscles of the tongue except which one?
palatoglossus (by vagus)
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