Anatomy HN3 HN.txt

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Anatomy HN3 HN.txt
2012-05-25 01:25:54
Anatomy HN3 HN

Anatomy HN3 HN
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  1. 1. What are the general contents of the pterygopalatine fossa?
    PPG, V2, 3rd part of maxillary a
  2. 2. What is the relationship of the pterygopalatine fossa to the infratemporal fossa and nasal cavity?
    • medial to infratemporal fossa
    • lateral to nasal cavity
  3. 3. What bone forms the roof of the pterygopalatine fossa?
    greater wing sphenoid
  4. 4. What bone forms the anterior wall of the pterygopalatine fossa?
    posterior maxilla
  5. 5. What bone forms the posterior wall of the pterygopalatine fossa?
    pterygoid process (medial & lateral pterygoid plates)
  6. 6. What bone forms the medial wall of the pterygopalatine fossa?
    palatine bone
  7. What is the doorway (lateral wall) of pterygopalatine fossa?
    pterygomaxillary fissure (communication to infratemporal fossa)
  8. 7. The pterygopalatine fossa communicates with the orbit via what bony passage?
    inferior orbital fissure
  9. 8. The pterygopalatine fossa communicates with the nasal cavity via what bony passage?
    sphenopalatine foramen
  10. 9. The pterygopalatine fossa communicates with the middle cranial fossa via which foramina?
    • foramen rotundum
    • pterygoid canal
  11. 10. The pterygopalatine fossa communicates with the oral cavity via which canal?
    palatine canal
  12. 11. The pterygopalatine fossa communicates with the infratemporal fossa via which fissure?
    pterygomaxillary fissure
  13. 12. Which main artery courses through the pterygopalatine fossa? How does it terminate? Which branches does it give rise to in the fossa?
    • maxillary
    • PSA, infraorbital, descending palatine, a of pterygoid canal, pharyngeal
    • terminates by passing through sphenopalatine foramen-> sphenopalatine a
  14. 13. Which artery supplies the maxillary molars and premolars?
    • posterior superior alveolar (PSA)
    • travels with PSA n (V2)
  15. 14. Which artery supplies the lower eyelid and side of the nose?
    • infraorbital through inferior orbital fissure, infraorbital groove/canal and foramen
    • supply eyelid, lacrimal sac, infraorbital region of face, side of nose and upper lip
  16. 15. Which artery will divide and supply arteries to the hard and soft palate?
    • descending palatine (palatine canal w greater & lesser palatine nerves and through greater and lesser palatine foramina)
    • supply mucous membrane and glands of hard palate, palatine gingiva, soft palate & palatine tonsils
  17. 16. Which artery will supply branches to the nasal cavity and paranasal sinuses?
    • sphenopalatine (maxillary terminal after sphenopalatine foramen)
    • supply: lateral nasal wall, septum, paranasal sinuses
  18. The Pterygopalatine Ganglion & Its Branches
  19. 17. Summarize the targets that are innervated by the VE-para/post fibers of the pterygopalatine ganglion.
    lacrimal gland, mucosal glands of nasal cavity, nasopharynx and palate
  20. 18. By which nerves does the pterygopalatine ganglion “hang” by V2? What type of fibers do these nerves contain?
    • Maxillary (between foramen rotundum and infraorbital canal)
    • SA-> sensory root via pterygopalatine nerves
  21. 19. Including the fibers to the lacrimal gland, how many branches does the pterygopalatine ganglion have?
    • 6
    • 1. orbital
    • 2. posterior superior nasal
    • 3. nasopalatine
    • 4. greater palatine
    • 5. lesser palatine
    • 6. pharyngeal
  22. 20. What kind of fibers does Vidian’s nerve bring into the pterygopalatine ganglion?
    from the posterior brings VE-para/pre and symp/post
  23. 21. Where are the cell bodies for the sensory (SA) fibers that course in the branches of the pterygopalatine ganglion?
    trigeminal ganglion
  24. 22. How do VE-symp/post fibers get from the internal carotid plexus to Vidian’s nerve?
    deep petrosal nerve joins greater petrosal to form vidian's nerve
  25. 23. What is the only kind of synapse that occurs in the pterygopalatine ganglion?
    VE-para/pre (superior salivatory->VII->greater petrosal) to VE-para/post
  26. 23. Where are the Ve-para/pre cell bodies for the fibers in Vidian’s nerve?
    (superior salivatory nucleus)
  27. 24. What nerve is considered to be the “sympathetic root” of the pterygopalatine ganglion?
    deep petrosal nerve
  28. 25. What nerve is considered to be the “motor root” of the pterygopalatine ganglion?
    greater petrosal nerve
  29. 26. What nerves are considered to be the “sensory root” of the pterygopalatine ganglion?
  30. 27. What fiber types course in the branches of the pterygopalatine ganglion?
    • SA
    • VE-symp/post
    • VE-para/post
  31. 28. Describe the pathway by which VE-para/post fibers from the pterygopalatine ganglion get to the lacrimal gland.
    pterygo-palatine ganglion → pterygopalatine ns → V2 → zygomatic n. → zygomaticotemporal n. → communicating branch → lacrimal n. → lacrimal gland.
  32. 29. Which nerves (branches of the PPG) supply the lateral nasal wall?
    • lateral group of posterior superior nasal nerves
    • posterior inferoir nasal n
  33. 30. Which branch of the PPG supplies the nasopharynx?
  34. 31. Which branch of the PPG supplies the hard palate?
    • nasopalatine (also septum innervation)
    • thru incisive canal
  35. 32. Which branch of the PPG supplies the soft palate?
    lesser palatine n (thru palatine canal) may contain some SS taste for soft palate with cell bodies in geniculate ganglion)
  36. What branch of the PPG supplies the posterior ethmoid air cells and shenoidal sinus?
    Orbital brs
  37. 33. What are the other branches of V2 that arise in the pterygopalatine fossa but are not connected to the ganglion?
    • 1. zygomatic
    • 2. posterior superior alveolar
    • 3. infraorbital -> middle superior alveolar and anterior alveolar
  38. 34. Which nerve innervates the 3 molar teeth of the maxilla?
    posterior superior alveolar (V2)
  39. 35. Which nerve innervates the 2 premolar teeth of the maxilla?
    middle superior alveorlar (V2) br from infraorbital
  40. 36. Which nerves supply the 2 incisor and canine of the maxilla (on one side)?
    anterior superior alveolar (V2) br from infraorbital
  41. 37. Which nerves form the superior dental plexus?
    anterior, middle, posterior superior alveorlar nerves
  42. 38. Why does it take one injection to anesthetize the mandibular teeth (on one side), but multiple injections to anesthetize the maxillary teeth (on one side)?
    only one nerve IA supplies mandibular while 3 supply maxillary PSA, MSA, ASA
  43. The Facial Nerve
  44. 39. What is the nervus intermedius?
    part of CN VII consists of VE-para/pre fibers, SS (taste), and SA fibers.
  45. 40. What kind of fibers are carried in the motor root of CN VII?
    • muscles of facial expression
    • stapedius m. (in the middle ear cavity)
    • posterior belly of the diagstric
    • stylohyoid m.
  46. 41. What muscles are innervated by the fibers of the motor root of CN VII? (be complete)
    muscles of facial expression, stapedius (in the middle ear cavity), posterior belly of the digastric, & stylohyoid
  47. 42. Which two ganglia receive VE-para/pre fibers that outflow in CN VII?
    • Nervus intermedius part of CN VII supplies VE-para/pre fibers
    • pterygopalatine ganglion (via the greater petrosal n.)
    • submandibular ganglion (via the chorda tympani)
  48. 43. Which glands are being innervated by these pterygopalatine ganglion & submandibular?
    lacrimal, submandibular, sublingual
  49. 44. What kind of cell bodies are found in the geniculate ganglion?
    • sensory ganglion of CN VII
    • lies within petrosal
    • supplies SS (taste) fibers to the anterior 2/3rd of the tongue (via chorda tympani which joins the lingual n.).
    • The SS (taste) cell bodies are in the geniculate ganglion
  50. 45. Describe all the functions you can think of that CN VII is involved in.
    • BM: facial expression, stapedius, posterior belly digastric & stylohyoid
    • SS: ansterior 2/3rds teeth
    • VE-para/pre: lacrimal, sublingual, submandibular (superior salivatory nucleus)
    • SA: cutaneous external auditory meatus
  51. 1. Between which bony landmarks does the pharynx extend?
    base of skull to crcoid cartilage (C6)
  52. 2. What is the relationship of the pharynx to the nasal cavity, oral cavity, and larynx?
  53. 3. The muscles of the larynx develop from which branchial arches?
    • 3, 4, 6
    • 3: stylopharyngeus
  54. 4. Describe the two layers of the muscular layer of the pharynx.
    • outer circular
    • inner longitudnal
  55. 5. What space is immediately posterior to the pharynx?
    retropharyngeal space
  56. 6. From the internal pharynx, name the 5 layers of the pharyngeal wall.
    • mucosa, submucosa, pharyngobasilar fascia, muscularis, buccopharyngeal
    • (retropharyngeal space, prevertebral fascia)
  57. 7. The muscularis layer of the pharynx lies between which two fascias?
    pharyngobasilar & buccopharyngeal
  58. 8. Name the 3 muscles of the outer circular layer.
    • superior, middle, inferior constrictors
    • swallowing
    • pharyngeal plexus (CN XI via X, BM)
    • median raphe common attachment
  59. 9. Name the 3 muscles of the inner longitudinal layer.
    • salpingo-pharyngeus
    • palatopharyngeus
    • stylo-pharyngeus
    • pharyngeal plexus (CN XI via X, BM) except stylopharyngous (CN IX, BM)
    • elevate pharynx & larynx during speaking & swallowing
  60. 10. Which constrictor muscle attaches to the occipital bone?
  61. 11. Which constrictor muscle attaches to the hyoid bone?
  62. 12. Which constrictor muscle attaches to the thyroid and cricoid cartilages?
  63. 13. What is the median raphe?
    midline tendinous attachment for the constrictor muscles.
  64. 14. The muscles of the inner longitudinal layer, in general, are innervated by which nerve structure?
    pharyngeal plexus (CN XI via X, BM) except stylopharyngeus(IX BM)
  65. 15. What is the general function of the muscles of the inner longitudinal layer?
    elevate pharynx and larynx when speaking & swallowing
  66. 16. Where is the pharyngeal plexus?
    • buccopharyngeal fascia
    • VA: nasopharynx & oropharynx (IX), laryngopharynx (X)
    • VE-para/pre: mucosal glands (X)
    • VE-symp/post: superior cervical ganglion to blood vessels
    • BM: XI via X, except stylopharyngeus (BM IX not part of pharyngeal plexus)
  67. 17. The pharyngeal plexus contains what nerve fiber types (functional components)?
    • VA: nasopharynx & oropharynx (IX), laryngopharynx (X)
    • VE-para/pre: mucosal glands (X)
    • VE-symp/post: superior cervical ganglion to blood vessels
    • BM: XI via X, except stylopharyngeus (BM IX not part of pharyngeal plexus)
  68. 18. Which muscle of the inner longitudinal layer is innervated by CN IX?
  69. 19. Name the 3 regions of the internal pharynx.
    nasopharynx, oropharynx, laryngopharynx
  70. 20. What are the 2 landmarks that divide the internal pharynx into 3 regions?
    soft palate, epiglottis
  71. 21. What bone forms the roof of the nasopharynx? And which tonsils are found there?
    • sphenoid
    • pharyngeal tonsils
  72. 22. The auditory tube opening in the nasopharynx is a tunnel that leads to what cavity?
    middle ear cavity
  73. 23. The tonsillar bed is located in which region of the internal pharynx?
    oropharynx, palatine tonsils, anterior wall contains lingual tonsils
  74. 24. Which two arches help to form the tonsillar bed?
    palatoglossal, palatopharyngeal
  75. 25. What large structure forms the anterior wall of the oropharynx?
    posterior 3rd of tongue
  76. 26. Which cranial nerve travels deep in the base of the tonsillar bed and where is it going?
    IX on way to posterior 3rd of tongue
  77. 27. Where is the laryngopharynx?
    inferior to epglottis
  78. 28. Small bones or dental instruments/materials may become caught in which part of the laryngopharynx?
    piriform recess: lateral to inlet
  79. 29. Which region of the internal pharynx is supplied by both VA and SA fibers?
    • nasopharynx
    • superior:V2 SA
    • inferior IX VA
  80. 30. Which cranial nerve supplies the majority of VA fibers to the laryngopharynx?
  81. 31. Which cranial nerve supplies VA fibers to both the laryngo- and oropharynx?
  82. 32. Which cranial nerve supplies SA fibers to the superior ½ of the nasopharynx?
  83. 33. Name the nerve that supplies the VE para/post fibers to the superior ½ of the nasopharynx? Where are the cell bodies located for these para/post fibers?
    pharyngeal br of pterygopalatine ganglion, VE-para/post to mucosal, SA: submucosa (V2), VE-symp-post (superior cervical)
  84. 34. Which cranial nerve supplies VE para/pre fibers to the inferior ½ of the nasopharynx, oropharynx, and laryngopharynx? Where are the VE para/post cell bodies that these fibers synapse on?
  85. 35. Explain the terms “nasal cavity” and “nasal cavities.”
    opening, divided by septum
  86. 36. What part of the pharynx is immediately posterior to the nasal cavity?
  87. 37. Name the 3 bony/cartilaginous elements of the nasal septum.
    • septal cartilage
    • perpendicular plate of ethmoid
    • vomer
  88. 38. Name the 4 nerves that innervate the nasal septum.
    • CN I olfactory
    • V1: anterior ethmoid
    • V2: infraorbital
    • PPG: nasopalatine
  89. 39. Name the 4 major arteries that supply the nasal septum.
    • posterior & anterior ethmoid (opthalmic, internal carotid)
    • sphenopalatine (maxillary, external carotid)
    • lateral nasal branch of facial a
  90. 40. What is and Where is Kiesselbach’s Area?
    • anstomosis of the 4 arteries
    • posterior & anterior ethmoid, sphenopalatine, lateral nasal
  91. 41. Which two conchae are part of the ethmoid bone?
    superior & middle
  92. 42. Are the conchae a feature of the lateral nasal wall or nasal septum?
  93. 43. What is a meatus?
    • sinus drainages
    • superior
    • middle
    • inferior
  94. 44. Name the 4 major arteries that supply the lateral nasal wall.
    • anterior & posterior ethmoid (opthalmic, internal carotid), sphenopalatine and lateral nasal
  95. 45. Which of the nasal wall arteries is a continuation of the maxillary a.?
  96. 46. Which of the nasal wall arteries originate from the ophthalmic a.?
    posterior & anterior ethmoidal
  97. 47. Which of these arteries is a branch of the facial a.?
    lateral nasal
  98. 48. Name the 5 nerves that innervate the lateral nasal wall.
    • CN I: olfactory
    • V1: anterior ethmoidal
    • PPG: posterior superior nasal & posterior inferior nsal
    • V2: infraorbital
  99. 49. What is a paranasal sinus?
    air-filled, mucosa-lined chambers around and connected to nasal cavity
  100. 50. Do all of the paranasal sinuses drain into the nasal cavity?
  101. 51. Name the condition that describes inflammation of a sinus.
  102. 52. What is the relationship between the maxillary sinus and the teeth?
    maxillary sinus is just above the roots of the maxillary teeth
  103. 53. Which 4 bones contain the paranasal sinuses?
    • - frontal sinus (frontal bone)
    • - sphenoidal sinus (sphenoid)
    • - ethmoidal air cells (ethmoid)
    • - maxillary sinus (maxilla
  104. 54. The sphenoidal sinus drains into which space?
    sphenoethmoidal recess
  105. 55. Which sinuses drain through the infundibulum and into the middle meatus?
    frontal & anterior ethmoidal air cells
  106. 56. Which sinus drains through the hiatus semilunaris and into the middle meatus?
    maxillary sinus
  107. 57. Which sinus drains onto the ethmoidal bulla and into the middle meatus?
    middle ethmoidal air cells
  108. 58. Which sinus drains into the superior meatus?
    posterior ethmoidal air cells
  109. 59. The nasolacrimal duct drains into which meatus?
    inferior meatus
  110. 1. The position of the larynx corresponds to which vertebral levels?
    C3-C6, connects inferior pharynx to trachea
  111. 2. What is the relationship of the larynx to the trachea?
    superior and continuous
  112. 3. What is the relationship of the larynx to the laryngopharynx?
    anterior to
  113. 4. What position are the true vocal cords in during respiration?
  114. 5. What position are the true vocal cords in during phonation?
  115. 6. What are the two major functions of the larynx?
    • phonating
    • protect & maintain open airway
  116. 7. How would you describe the laryngeal skeleton?
    • 9 interconnected cartilages and hyoid bone
    • thyroid, cricoid, epiglottic, artenoid & corniculate (paired also cuneiform)
  117. 8. What are the main cartilages of the laryngeal skeleton?
    • epiglottic
    • corniculate (paired)
    • thyroid
    • arytenoid(paired)
    • cricoid
  118. 9. What are the main membranes of the laryngeal skeleton?
    • thyrohyoid, cricothyroid, quadrangular and triangular
    • triangular: cricoid to vocal ligament
  119. 10. What is the vocal ligament? What are its attachments?
    • submucosal "skeleton of true vocal fold
    • stretched between arytenoid and thyroid cartilages
    • movements alters position, tension and length
  120. 11. What is the conus elasticus?
    • 2 triangular membranes and vocal ligaments
    • guard tracheal inlet
  121. 12. Which muscles are the adductors of the true vocal cords?
    • lateral cricoarytenoid
    • transeverse arytenoid
    • oblique arytenoids
    • transverse & oblique: interartenoid muscle
    • adduct(towards midline closed)
  122. 13. Which muscle is the only abductor of the true vocal cords?
    • posterior cricoarytenoid
    • abduct (away from midline)
  123. 14. Which muscle is the tensor of the true vocal cords?
    • cricothyroid (visible from anterior triangle)
    • (stretch vocal cord)
  124. 15. Which muscles are the relaxors of the true vocal cords?
    thryroarytenoid & vocalis(medial thyroarytenoid)
  125. 16. What are the attachments of the posterior cricoarytenoid muscle?
  126. 17. Which laryngeal muscle can be seen in the anterior triangle of the neck?
  127. 18. What is the laryngeal aditus?
  128. 19. What is the laryngeal vestibule?
    between inlet and false vocal cord
  129. 20. What is the laryngeal ventricle?
    • between false and true vocal folds
    • lateral space in larynegeal wall
  130. 21. What is the glottis?
    horizontal area at level of true vocal folds and space between (rima glottis)
  131. 22. Where is the supraglottic cavity?
    • superior to vocal folds
    • internal laryngeal (VA, VE-para/pre)
  132. 23. Where is the infraglottic cavity?
    • below
    • recurrent laryngeal (VA, VE-para/pre)
  133. 24. Do the false vocal folds play a role in sound production? What do they do?
    no, only protection
  134. 25. Which cranial nerve is responsible for the sensory innervation of the larynx? What kind of sensory fibers are involved?
    CN XI via X Branchial Motor
  135. 26. Which cranial nerve is responsible for supplying the VE-para/pre fibers to the mucosa of the larynx (to para/post cells that send fibers to mucus glands)?
    • CN X vagus
    • VA, VE-para/pre
    • branches: superior laryngeal, recurrent laryngeal
  136. 27. What specific nerve innervates the mucosa of the glottis and supraglottic cavity?
    internal laryngeal (VA, VE-para/pre) to submucosa
  137. 28. What specific nerve innervates the mucosa of the infraglottic cavity?
    recurrent laryngeal (VA, VE-para/pre) to submucosa
  138. 29. What kind or type of nerve fibers (functional component) innervate all the laryngeal muscles?
  139. 30. Which specific nerve supplies all the laryngeal muscles except one?
    recurrent laryngeal CN XI via X BM
  140. 31. Which specific nerve supplies the cricothyroid muscle?
    external laryngeal n. CN XI via X BM
  141. 32. Describe the blood supply to the larynx (which two arteries are involved and what are their origins?).
    • superior laryngeal a: branch of superior thyroid, accompanies internal laryngeal nerve through thyrohyoid membrane)
    • inferior laryneal a: branch of inferior thyroid (subclavian), accompanies recurrent laryngeal nerve slipping under inferior constrictor
    • Both cross piriform recess of pharynx deep to the mucosa to reach larynx.