RCA: Head and Neck

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  1. Name the muscle, origin, insertion and action
    • Orbicularis oculi
    • Attachments:
    • - origin; medial palpebral ligament & medial orbital margin,
    • - insertion; lateral palpebral raphe, skin around the margin of orbit
    • Action: closes eyelids
  2. Name the muscle, origin, insertion and action
    • Orbicularis oris
    • Origin: Fibres arise from midline of maxilla, mandible and deep surface of skin
    • Insertion: mucous membrane of lips
    • Action: compresses and protrudes lips
    • #
    • Buccinator; Muscle of the cheek
    • Origin: posteriorly from pterygomandibular raphe
    • - Superiorly & inferiorly from alveolar processes of maxilla and mandible
    • Insertion: angle of mouth
    • Action: presses cheek against molar teeth - aiding chewing,
    • - compresses distended cheeks - air expulsion from oral cavity
  3. Name the muscle, origin, insertion and action
    • Frontalis : muscle of scalp
    • Arise from epicranial aponeurosis
    • Insertion - skin of forehead
    • Action: elevates eyebrows and wrinkles forehead
    • #
    • Orbicularis Oculi
  4. Name the muscle, origin, insertion and action
    • Platysma: Superficial muscle of neck
    • Arise - superficial fascia of deltoid and pectoral regions
    • Insertion - mandible, orbicularis oris
    • Action: depresses mandible, tenses the skin
  5. Describe the path of the facial nerve, and give the branches;
    • Emerges from stylomastoid foramen and enters parotid gland
    • Runs superficially within gland and gives rise to five terminal branches;
    • - Temporal
    • - zygomatic
    • - maxillary → buccal
    • - mandibular
    • - cervical
    • These emerge from the 3 margins of the gland; superior, anterior and inferior
    • Function: Supply muscles of facial expression
  6. Generally, describe the vasculature supply and drainage of the face
    Identify the Orange, purple and yellow vessels
    • Most arteries of the face are branches of external carotid artery
    • Venous return is to internal jugular vein.
    • #
    • External jugular vein
  7. Name the CYAN vessel, its tributaries, and its path
    • Facial Artery
    • Arises from external carotid artery
    • Ascends deep to submandibular gland
    • Winds around inferior border of mandible just anterior to masseter muscle
    • Tortuous (i.e. windy and indirect) course upwards and medially over the face
    • - To medial angle (canthus = where eyelids meet) of the eye
    • Sends branches to upper and lower lips and side of the nose
  8. Name the RED vessels, its tributaries, and its path
    • Superficial temporal artery (and vein)
    • Smaller of the two terminal branches of external carotid artery
    • Emerges on the face anterior to the ear
    • Ascends and supplies the temporal region (think temporal lobe)
  9. Name this vessels, its tributaries, and its path
    • Ophthalmic artery
    • Arises from the internal carotid artery
    • Passes through the optic foramen together with the optic nerve
    • Gives off branches to the structures in the orbit; i.e. area around eye and socket
  10. Name the GREEN vessels, its tributaries, and its path
    • Supraorbital artery (and vein)
    • Terminal branch of ophthalmic artery
    • Passes superiorly from supraorbital foramen
    • Distributes to the muscles and skin on the forehead and scalp
  11. Name the BLUE vessels, its tributaries, and its path
    • Facial vein
    • Major vein draining the face
    • Begins at the medial canthus of the eye, and runs posterior to the artery
    • At inferior margin of mandible drains into internal jugular vein (along with the retromandibular vein)
  12. Name the CYAN vein, its tributaries, and its path
    • Superior ophthalmic vein (+ inferior ophthalmic):
    • Both branches of ophthalmic veins pass through the superior orbital fissure and
    • - enter the Cavernous sinus
  13. Name the NON-CYAN veins, its tributaries, and its path
    • Pterygoid plexus of veins
    • Network of small veins around lateral pterygoid muscle
    • Communicates with Cavernous sinus by emissary veins passing through foramen ovale
    • #
    • Deep facial vein
    • Facial vein
  14. Describe how all the veins in the face communicate
    • Facial vein communicates with;
    • - the superior ophthalmic vein at the medial cathus
    • - the pterygoid plexus via the deep facial vein (which drains into the facial vein)
  15. Which nerve is responsible for the sensory supply of the face?
    • Largely through the three branches of trigeminal nerve;
    • - Ophthalmic (V1)
    • - Maxillary (V2)
    • - Mandibular (V3)
    • * But some skin over the angle of mandible and year is supplied by great auricular nerve from the cervical plexus
  16. Describe the Ophthalmic division, including its path, branches and functions
    • Ophthalmic division (V1): Wholly sensory, divides into three branches, which all enter through superior orbital fissure;
    • Frontal: Gives rise to supraorbital nerve
    • - Supply upper eyelid, forehead & scalp
    • Lacrimal: Passes laterally (lacrimal gland)
    • - Supplies lateral skin & conjunctiva of upper eyelid
    • Nasociliary: Sensory nerve to the eye
    • - Also gives rise to the external nasal nerve which supplies skin of dorsum of the nose
  17. Describe the Maxillary division (V2), including its path, branches and functions
    • Purely sensory
    • Maxillary Nerve leaves middle cranial fossa through foramen rotundum, and enters pterygopalatine fossa
    • Gives off number of branches including the infraorbital nerve and the zygomatic nerve
    • Infraorbital nerve: the main nerve which enters the orbit through inferior orbital fissure *unsure if labelled properly*
    • - Runs on the floor of the orbit, and emerges onto the face through infraorbital foramen
    • - Function: Gives nervous supply to lower eyelid, cheek & upper lip
    • #
    • Zygomatic nerve
    • - Also enters the orbit through the inferior orbital fissure
    • - Runs on the lateral wall of orbit, where it divides into two branches (i.e. the zygomaticotemporal and zygomaticofacial)
    • - They emerge onto face through foramina in zygomatic bone.
    • - Function: Supply skin over the zygomatic bone
  18. Describe the Mandibular division (V3), including its path, branches and functions
    • The mandibular nerve is a mixed nerve (sensory & motor), and descends through the foramen ovale
    • Mental nerve: Terminal branch of inferior alveolar nerve. Emerges from mental foramen
    • - Function: Supply skin of the chin and lower lip
    • Buccal nerve: Runs anteriorly to supply the cheek
    • Auriculotemporal nerve: Runs superiorly together with superficial temporal vessels
    • - Sensory supply to skin in temporal region
  19. What is the role of the cervical plexus in the innervation of facial sensation?
    • Cervical Plexus: *Found in the posterior triangle and formed by union of first four cervical spinal nerves
    • - formed by the anterior rami of C2-4
    • - 2 nerve groups; deep for muscles and superficial for the skin of the anterior and lateral neck, plus lateral aspect of the head
    • Cutaneous branches from the plexus emerge around the middle of the posterior border of sternomastoid muscle
    • #
    • Great auricular nerve (C2 &C3): *One of the four* cutaneous branches of cervical plexus. It ascends across sternomastoid muscle
    • - Function: Supplies skin over the auricle and angle of the mandible.
  20. Why do facial lacerations tend to gape?
    • Because the face has no distinct deep fascia and the superficial fascia between the cutaneous attachments of the facial muscles is loose, facial lacerations tend to gape.
    • Consequently, the skin has to be sutured with great care to prevent scarring.
  21. Name the muscle, origin, insertion, innervation and action
    • Temporalis
    • - Origin: floor of the temporal fossa
    • - Insertion: coronoid process and anterior border of ramus of mandible
    • Innervation: deep temporal branches of mandibular nerve (V3)
    • Actions: elevates mandible; posterior fibres retrude mandible
  22. Name the muscle, origin, insertion, innervation and action
    • Masseter
    • - Origin - zygomatic arch
    • - Insertion - lateral surface of ramus of mandible
    • Innervation: masseteric nerve from mandibular nerve (V3)
    • Action: elevates mandible
  23. Name the muscle, origin, insertion, innervation and action
    • Medial pterygoid
    • - Origin- medial surface of lateral pterygoid plate
    • - Insertion- medial surface of ramus of mandible
    • Innervation: mandibular nerve (V3) via nerve to medial pterygoid
    • Action: elevates and protrudes mandible
    • #
    • Lateral pterygoid
    • Origin: two heads;
    • - upper; infratemporal surface of greater wing of sphenoid
    • - lower: lateral surface of lateral pterygoid plate
    • Insertion; neck of mandible, capsule & disc of Temporomandibular joint (TMJ)
    • - Innervation: lateral pterygoid nerve from mandibular nerve (V3)
    • - Action: protrudes and depresses chin
    • #
    • *Buccinator + parotid duct
  24. Name the muscle, origin, insertion, innervation and action
    • Digastric muscle
    • Origin - two bellies;
    • - Anterior; antero-medial surface of mandible
    • - Posterior: medial side of mastoid process
    • Insertion; intermediate tendon to hyoid bone
    • Innervation: anterior belly by mylohyoid nerve, branch of inferior alveolar n. (V3)
    • - Posterior belly by a branch of facial nerve (VII)
    • Action: elevates the hyoid
    • - With the hyoid bone fixed, depresses the mandible
  25. Temporomandibular joint (TMJ); What contributes to the articulation?

    What other feature is in the joint space?
    • Modified hinge synovial joint
    • Articular surfaces include;
    • - condyle of the mandible,
    • - the articular tubercule (temporal bone)
    • - the mandibular fossa of the temporal bone
    • #
    • An articular disc divides the joint cavity into superior and inferior compartments
  26. What ligaments exist at the TMJ (3)?
    • Lateral ligament: Laterally capsule is thickened as the lateral ligament
    • #
    • There are two other ligaments that connect mandible to the cranium
    • - Stylomandibular ligament: Runs from styloid process to angle of the mandible
    • - Sphenomandibular ligament: Runs from the spine of the sphenoid to the lingula on the medial side of the mandible
  27. What movements of the mandible are allowed at the TMJ (5)? What happens with the disk and tubercle on depression of the mandible?
    • Depression
    • Elevation
    • Protrusion
    • Retraction
    • Lateral movement
    • #
    • When mandible is depressed during mouth opening, the condyle rotates on inferior surface of the disc (hinge movement)
    • Both structures move anteriorly on articular surface (gliding movement)
    • Until condyle lies inferior to tubercle
  28. Name the muscle, origin, insertion, innervation and action
    And the vessel
    • Sternomastoid muscle
    • #
    • Origin - mastoid process and superior nuchal line
    • Insertion; 2 heads
    • - Sternal head; manubrium of sternum
    • - Clavicular head; medial third of clavicle
    • Innervation: accessory nerve (XI), and C2 and 3 nerves
    • Actions: flexes neck and rotates it so face is turned superiorly towards the opposite side
    • - both muscles acting together - draw head forwards
    • #
    • External jugular vein
    • Begins near the angle of the mandible by the union of;
    • - posterior division of retromandibular
    • - posterior auricular veins
    • It crosses sternomastoid and pierces the investing layer of cervical fascia and terminates in the subclavian vein
  29. Describe the muscles which anchor the hyoid bone and their innervation and functions
    • Infrahyoid (Strap) muscles: Following four strap muscles anchor the hyoid bone (they fix and steady it)
    • Why?: so that the suprahyoid muscles can act to depress the hyoid and larynx during swallowing and speaking
    • Innervation: They are supplied by branches arising from the cervical plexus
  30. What are the four Infrahyoid (strap) muscles?
    • Sternohyoid: positioned superficially
    • - origin; manubrium & medial end of clavicle
    • - insertion; body of hyoid bone
    • Sternothyroid: lies deep to sternohyoid
    • - origin; posterior surface of manubrium
    • - insertion;: oblique line of thyroid cartilage
    • Thyrohyoid:
    • - origin; oblique line of thyroid cartilage
    • - insertion; lower border of body and greater horn of hyoid
    • #
    • Omohyoid: consists of two bellies
    • - Inferior; arises from upper border of scapula and passes forward deep to the sternomastoid
    • - - it attaches to the intermediate tendon which is held in place by a fibrous loop attached to the clavicle
    • - Superior belly is inserted into the hyoid
  31. Name the muscle, origin, insertion, innervation and action
    • Scalenus anterior muscle (or anterior scalene muscle )
    • - Origin; transverse processes of cervical vertebrae
    • - Insertion; anterior part of first rib
    • - Innervation: lower cervical spinal nerves
    • - Function: flexes the neck forwards and laterally, elevates 1st rib during forced inspiration
    • Scalenus medius: everything is the same as the anterior muscle except;
    • - Insertion; posterior aspect of first rib
    • - Function: flexes neck laterally only
    • #
    • Other practise anatomy labels;
    • - Sternomastoid muscle
    • - Levator scapulae muscle
    • - Omohyoid muscle (inferior belly)
    • - Sternothyroid muscle
    • - Sternohyoid muscle
    • - Thyrohyoid muscle
  32. Describe the three layers of the Deep Fascia of the Neck
    • Investing layer of cervical fascia: Surrounds all structures in the neck and lies between the superficial fascia and muscles
    • - it splits to enclose SCM & trapezius muscles
    • Pretracheal fascia: limited to anterior part of the neck
    • - Lies deep to the infrahyoid muscles, and splits to enclose thyroid, trachea, and oesophagus
    • Prevertebral fascia: forms a tubular sheath for the vertebral column and the muscles associated with it
    • Carotid sheath(es): Tube of fascia that extends from base of the skull to root of the neck. It contains 4 things;
    • - Common and internal carotid arteries
    • - Internal jugular vein
    • - Vagus nerve (X)
  33. Describe the Lymphatic drainage of the face
    • Lymphatic vessels in forehead and anterior part of face accompany other facial vessels
    • - and drain into the submandibular lymph nodes, located along the inferior border of the mandible
    • From lateral part of the face drains into parotid nodes
    • Central part of lower lip and chin drain into submental nodes
    • #
    • All the lymph from the head and neck eventually drains into the deep cervical lymph nodes
    • - which forms a chain along the internal jugular vein
  34. With exception of the atypical C1 and C2, how can we tell the cervical vertibrae from the rest?
    • Body: Small & square shaped
    • - concave superior surface & convex inferior surface
    • Vertebral foramen (canal): large and triangular
    • Transverse processes: transverse foramina (small or absent in C7)
    • - vertebral arteries pass through, except C7
    • Spinous process: short and bifid
    • - process of C7 is long
  35. Describe the differences in C1 and C2
    Describe the joints these vertebrae are involved in
    • The atlas (C1)
    • - has no spinous process or body
    • - consists of two lateral masses connected by anterior and posterior arches
    • - Atlanto-occipital Joints: superior articular facets receive occipital condyles of the skull, permit nodding of the head
    • #
    • The axis (C2)
    • The distinguishing feature is the dens which projects superiorly from the body
    • - Transverse ligament of the atlas: a strong band extending between medial surfaces the lateral masses. It holds the dens of C2 against the anterior arch of C1
    • - Alar ligaments: extend from sides of the dens to lateral margins of foramen magnum. They check excessive rotation of the head and atlas relative to the axis.
    • Atlantoaxial Joints: permit head to be moved from side to side.
    • - Dens acts as a pivot that allows 'skull and C1' as a unit to rotate on C2
  36. What is this nerve? Give its function
    • Phrenic nerve: Takes origin from C4 but receives contributions from C3 to C5
    • - Function: sole motor supply to diaphragm and also sensory to its central part
    • Location: forms at the superior lateral border of the scalenus anterior (anterior scalene muscle)
    • - descends across the muscle and passes between subclavian vein and subclavian artery to enter the thorax
  37. Name the artery labeled CYAN and its tributaries;
    • Inferior thyroid artery
    • The thyrocervical trunk arises from the subclavian artery, medial to the scalenus anterior muscle
    • It has 3 branches; largest and most important is the Inferior thyroid artery
    • - passes to the inferior pole of the thyroid gland (pulled back in the picture)
  38. Name the branches of the external carotid artery (6)

    • Superior thyroid artery: most inferior of
    • the three anterior branches in the neck
    • - Runs deep to the infrahyoid muscles to reach superior pole of thyroid gland
    • Lingual artery: arches
    • superoanteriorly and passes deep to the hypoglossal nerve
    • - disappears deep to the hyoglossus muscle of the tongue.
    • Facial artery: arises either in common with the lingual artery or immediately superior to it
    • Ascending pharyngeal artery: first or second branch and arises from medial side
    • - ascends on the pharynx
    • Occipital artery: arise from posterior surface
    • - passes posteriorly along the posterior belly of digastric to posterior part of the scalp
    • Posterior auricular artery: small posterior branch which ascends posterior to the external auditory meatus
  39. Name this vein, give its path and give its tributaries
    • Internal jugular vein: Drains blood from the brain and superficial parts of the face and neck
    • - Path: commences at the jugular foramen, runs inferiorly through the neck in the carotid sheath, and unites with the subclavian vein
    • Tributaries are;
    • - facial
    • - lingual: deep lingual veins are where sublingually taken drugs are rapidly absorbed
    • - pharyngeal
    • - superior and middle thyroid veins
  40. Describe the nerve supply of the pharynx
    • The pharynx receives nerves from three sources;
    • - pharyngeal branch of the vagus: motor supply to muscles of pharynx & soft palate, and also carries sensory information from laryngopharyx
    • - glossopharyngeal nerve: sensory supply to pharynx except nasopharynx (by pharyngeal branch of V2)
    • - branches from the superior cervical ganglion (sympathetic)
    • These nerves form a plexus in the submucosa termed "pharyngeal plexus"
  41. Muscles of the Soft Palate (4)
    Name the muscles, origin, insertion, innervation and actions


    • The soft palate is the muscle part of the roof of the oral cavity
    • Tensor palati muscle:
    • - Origin; scaphoid fossa of medial pterygoid plate and cartilage of auditory tube.
    • - Path; the muscle passes inferiorly; its tendon hooks around the hamulus of medial pterygoid plate
    • - Insertion; expands & joins opposite tendon to form palatine aponeurosis
    • - Innervation; branch of mandibular nerve (V3)
    • - Actions; tenses soft palate, opens the auditory tube
    • Levator palati:
    • - Origin; cartilage of auditory tube and petrous part of temporal bone
    • - Insertion; palatine aponeurosis
    • - Innervation; pharyngeal plexus (pharyngeal branch of vagus)
    • - Action; elevates soft palate
    • Palatoglossus muscle:
    • - Origin; arise from the of the palatine aponeurosis
    • - Path; runs downwards forming the palatoglossal arch
    • - Insertion; inserted to the side of the tongue
    • - Innervation; pharyngeal plexus (pharyngeal branch of vagus)
    • - Action; pulls the tongue up & constrict the oropharyngeal isthmus
    • Palatopharyngeus muscle:
    • - arise from the palatine aponeurosis & runs down into the oropharynx forming the palatopharyngeal arch
    • - action - elevate the larynx & pharynx or depress the soft palate
  42. Describe five regions into which infections of nasal cavities may spread.
    • 1. The anterior cranial fossa through the cribriform plate of the ethmoid bone
    • 2. The nasopharynx and retropharyngeal soft tissues
    • 3. The middle ear through the auditory tube
    • 4. The paranasal sinuses
    • 5. The lacrimal apparatus and conjunctiva through the nasolacrimal duct
  43. Label the compartments;
    • Nasal cavities
    • Oral cavity
    • Larynx
    • - Trachea
    • Pharynx
    • - Oesophagus
  44. Describe the features of the oropharynx
    • The Oropharynx connects with the oral cavity through the oropharyngeal isthmus (isthmus = a narrowing). It extends from the soft palate to the upper border of epiglottic cartilage of the larynx
    • Soft palate
    • Palatopharyngeal arch
    • Uvula
    • Palatoglossal arch
    • Palatine tonsil: when infected known as "tonsilitis"
    • *Arch interchangeable with folds
  45. Describe the histology and features of the pharynx
    • Histology;
    • - the upper part is lined by respiratory-type epithelium
    • - the lower two parts are lined by stratified squamous epithelium (i.e. specialized for wear and tear – they are part of the digestive tract)
    • #
    • The nasopharynx connects with the nasal cavities by two large posterior nasal apertures (choanae)
    • Auditory tube (eustachian tube): opens on to its lateral wall (pharyngeal opening of eustachian tube)
    • – posterior to the opening of AT is a hood-like tubal elevation (produced by the cartilaginous part of eustachian tube)
    • (Naso)pharyngeal tonsil ("adenoids" in children): a collection of lymphoid tissue in the mucosa of the roof and posterior wall
    • - adenoiditis if inflammed
    • Tubal elevation: associated with the eustachian tube, behind which/in the posterior aspect is a mass of lymphoid tissue called;
    • - the tubal tonsil
    • Extrinsic muscles: mainly move the tongue but can also alter its shape. There are 4 pairs;
    • - Palatoglossus muscle : elevates the posterior tongue, constricts the pharynx
    • *Palatoglossus is the only tongue muscle supplied by the pharyngeal branch of vagus through the pharyngeal plexus, the rest are supplied by hypoglossus*
    • - Hyoglossus muscle : depresses the tongue
    • - Styloglossus muscle : draws the sides of the tongue upwards and the whole tongue back
    • - Genioglossus muscle : depresses and extends the tongue
    • Two muscle make up the floor of the oral cavity (+ connective tissue);
    • - Geniohyoid muscle
    • - Mylohyoid muscle (cut)
  46. Describe the features of the laryngopharynx
    • Epiglottis
    • Aryepiglottic fold
    • Piriform fossa (recess)
    • Laryngeal inlet (aditus)
    • Function: Altering length and tension in vocal cords determines the pitch and quality of the voice
  47. Name these features of the Larynx. Where does the larynx lay relative to vertebrae?
    • Hyoid bone: at the level of C3
    • Thyrohyoid membrane: superior attachment of the larynx to the hyoid bone
    • Thyroid cartilage : large and forms the adam's apple at the level of C4
    • - synovial joints where separate cartilage meet
    • Arytenoid cartilages
    • Cricothyroid membrane; (a.k.a. vocal membrane)
    • - upper free edge that extends from thyroid cartilage (close to the midline) backwards to vocal process of arytenoid cartilage forms the vocal ligament
    • - Covered by mucous membrane to form the vocal fold
    • Cricoid cartilage: at the level of C6
    • Cricotracheal ligament: inferior attachment of the larynx to the first cartilage of the trachea
    • * The larynx is related posteriorly to C3-6 vertebrae. Cricoid cartilage palpatable at C6
  48. Name the Cartilages and associated structures of Larynx
    • Epiglottic cartilage: Nerves and blood vessels pass through foramina in epiglottic cartilage
    • Hyoid bone
    • Thyrohyoid membrane
    • Thyroid cartilage
    • Arytenoid cartilages: with vocal ligament at inferior end
    • - vocal cord: upper border of Cricothyroid membrane forms the vocal fold
    • Cricothyroid membrane: forms vocal fold when covered by mucous membrane
    • Cricoid cartilage
    • Trachea
    • * Epiglottic cartilage not seen, but attached to the laryngeal prominence
  49. Label the parts of the thyroid, cricoid and arytenoid cartilages


    • Right and left lamina of the thyroid cartilage
    • Superior horn of the thyroid cartilage
    • Inferior horn of the thyroid cartilage
    • Laryngeal prominence of the thyroid cartilage
    • Lamina of the cricoid cartilage
    • Arch of the cricoid cartilage
    • Vocal process of the arytenoid cartilage
  50. Name the membranes and associated structures of Larynx
    • Quadrangular membrane: a thin submucosal sheet of connective tissue
    • - attached to the arytenoid cartilage and to the lateral border of the epiglottic cartilage and laryngeal prominence
    • - Upper border is at aryepiglottic fold
    • Vestibular ligament: lower border of quadrangular membrane
    • - covered by mucous membrane to form the vestibular fold
    • Arytenoid cartilage
    • Cricothyroid membrane: attached inferiorly to the arch of the cricoid cartilage, anteriorly to the laryngeal prominence (posterior aspect) and posteriorly to the arytenoid cartilage (vocal process)
    • Vocal ligament: upper border of cricothyroid ligament
  51. Name the membranes and associated structures of Larynx
    • Quadrangular membrane
    • Epiglottis
    • Vocal ligament: = true vocal cords
    • Cricothyroid membrane
    • Vestibular ligament: = false vocal cords
    • - covered by mucous membrane to form the vestibular fold
    • Upper border of quadrangular membrane: helps form aryepiglottic fold
  52. Name these structures of the normal larynx on inspiration
    • Epiglottis
    • Vocal fold (true cords): positions and tensions in the vocal folds can be varied by intrinsic muscles of the larynx
    • - acting at cricoarytenoid joints (synovial) to bring about rotation/ separation of arytenoid cartilages,
    • - or acting at cricothyroid joints (synovial) to permit tilting of Thyroid C relative to Cricoid C
    • Ventricular folds (false cords)
    • - Adduction of the vocal and vestibular folds traps the air below and makes possible an increase of intrathoracic pressure (as in coughing) or of intraabdominal pressure (as in urination and defecation)
    • Ary-epiglottic fold
    • Trachea
    • Piriform fossa
    • Esophagus
    • Rima glottidis: the size of the interval between the vocal folds
    • - Sound is produced by expired air rushing past the vocal folds. The length and tension of the vocal folds controls the pitch (frequency) and quality (timbre) of voice
  53. Label the features of a coronal section through the larynx
    • Epiglottis
    • - anterior to the laryngeal inlet (a.k.a. the aditus)
    • Three cavity regions;
    • - Vestibule: between aditus and vestibular cords
    • - Ventricle: between vestibular cords and vocal cords
    • - Infraglottic region: below the vocal cords
    • Vestibular folds
    • Vocal folds; gap between the vocal cords is called the rima glottidis
    • Thyroid cartilage and Cricoid cartilage
    • Thyroid gland
  54. Muscles of the larynx;
    Name the muscle, origin, insertion, innervation and action
    • Cricothyroid
    • - Origin; anterolateral part of cricoid cartilage
    • - Insertion; inferior margin of thyroid cartilage
    • - Innervation; external laryngeal nerve - (all the other intrinsic muscles are innervated by recurrent laryngeal nerve)
    • - Actions; stretches and tenses vocal fold
    • Thyro-arytenoid muscle
    • - Origin; posterior surface of thyroid cartilage
    • - Insertion; muscular process of arytenoid cartilage
    • - Actions; relaxes vocal fold
    • Lateral crico-arytenoid muscle
    • - Origin; arch of cricoid cartilage
    • - Insertion; muscular process of arytenoid cartilage
    • - Actions; adducts vocal fold
    • Transverse and oblique arytenoid muscle
    • - Path; Transverse runs between arytenoids. Oblique is superficial to above, running from muscular process of one arytenoid to the apex of the other
    • - Actions; these muscles aid in adduction by drawing the arytenoids together
    • Ary-epiglottic muscle
    • - Path; oblique arytenoids are continues as this larger sheet of muscle to the side of the epiglottis
    • - Actions; this muscle together with the interarytenoids and the epiglottis itself, acts as a sphincter, narrowing the opening into the larynx (laryngeal aditus), and preventing swallowed material from entering it
    • Posterior crico-arytenoid muscle
    • - Origin; posterior surface of cricoid cartilage
    • - Insertion; muscular process of arytenoid cartilage
    • - Actions; abducts vocal fold
  55. Name the muscle, origin, insertion, innervation and action
    • Cricothyroid
    • - Origin; anterolateral part of cricoid cartilage
    • - Insertion; inferior margin of thyroid cartilage
    • - Innervation; external laryngeal nerve - (all the other intrinsic muscles are innervated by recurrent laryngeal nerve)
    • - Actions; stretches and tenses vocal fold
    • Thyro-arytenoid muscle
    • - Origin; posterior surface of thyroid cartilage
    • - Insertion; muscular process of arytenoid cartilage
    • - Actions; relaxes vocal fold
    • Lateral crico-arytenoid muscle
    • - Origin; arch of cricoid cartilage
    • - Insertion; muscular process of arytenoid cartilage
    • - Actions; adducts vocal fold
    • Transverse and oblique arytenoid muscle
    • - Path; Transverse runs between arytenoids. Oblique is superficial to above, running from muscular process of one arytenoid to the apex of the other
    • - Actions; these muscles aid in adduction by drawing the arytenoids together
    • Posterior crico-arytenoid muscle
    • - Origin; posterior surface of cricoid cartilage
    • - Insertion; muscular process of arytenoid cartilage
    • - Actions; abducts vocal fold
  56. Name the muscle, origin, insertion, innervation and action
    • Cricothyroid
    • - Origin; anterolateral part of cricoid cartilage
    • - Insertion; inferior margin of thyroid cartilage
    • - Innervation; external laryngeal nerve - (all the other intrinsic muscles are innervated by recurrent laryngeal nerve)
    • - Actions; stretches and tenses vocal fold
    • Transverse and oblique arytenoid muscle
    • - Path; Transverse runs between arytenoids. Oblique is superficial to above, running from muscular process of one arytenoid to the apex of the other
    • - Actions; these muscles aid in adduction by drawing the arytenoids together
    • Posterior crico-arytenoid muscle
    • - Origin; posterior surface of cricoid cartilage
    • - Insertion; muscular process of arytenoid cartilage
    • - Actions; abducts vocal fold
  57. Name the muscle, origin, insertion, innervation and action
    • Transverse and oblique arytenoid muscle
    • - Path; Transverse runs between arytenoids. Oblique is superficial to above, running from muscular process of one arytenoid to the apex of the other
    • - Actions; these muscles aid in adduction by drawing the arytenoids together
    • Ary-epiglottic muscle
    • - Path; oblique arytenoids are continues as this larger sheet of muscle to the side of the epiglottis
    • - Actions; this muscle together with the interarytenoids and the epiglottis itself, acts as a sphincter, narrowing the opening into the larynx (laryngeal aditus), and preventing swallowed material from entering it
    • Posterior crico-arytenoid muscle
    • - Origin; posterior surface of cricoid cartilage
    • - Insertion; muscular process of arytenoid cartilage
    • - Actions; abducts vocal fold
  58. Describe and list the laryngeal nerves

    • Laryngeal nerves: Derived from the vagus nerve (X)
    • - Through the internal and external branches of the superior laryngeal and recurrent laryngeal nerves.
    • Superior laryngeal nerve: Arise high in the neck and divides into two branches;
    • Internal laryngeal nerve: Pierces the thyrohyoid membrane
    • - supplies sensory to the laryngeal mucosa superior to vocal folds
    • External laryngeal nerve
    • - Descends with the superior thyroid artery and supplies the cricothyroid muscle
    • Recurrent laryngeal nerve: Left originates in thorax & Right in root of the neck
    • - Ascends in the groove between trachea and esophagus
    • - Intimately related to the medial surface of thyroid gland
    • Function: supplies all intrinsic muscles of the larynx except cricothyroid
    • - Also supplies sensory to the laryngeal mucous membrane inferior to vocal folds
  59. Name the ORANGE and PINK muscles, and give their origin, insertion, innervation and action
    • Muscles which make up the floor of the oral cavity include;
    • #
    • Geniohyoid muscle: Located superior to mylohyoid muscles
    • - Origin; inferior mental spine of mandible to body of hyoid bone
    • - Innervation; C1 via the hypoglossal nerve (XII)
    • - Action; elevates hyoid bone, depresses mandible
    • Mylohyoid muscle
    • - Origin: mylohyoid line of mandible
    • - Insertion; raphe and body of hyoid
    • - Innervation; mylohyoid nerve, branch of the inferior alveolar n. (V3)
    • - Actions; elevates hyoid bone, floor of the mouth, and tongue OR with hyoid fixed depresses the mandible
  60. Name these nerves + functions
    • Lingual nerve: Arises from the mandibular nerve (V3)
    • - Runs inferiorly between the medial pterygoid and the ramus of mandible, anterior to inferior alveolar nerve
    • - Runs on the hyoglossus muscle, and supplies general sensation to mucosa of anterior two-thirds of the tongue & floor of the oral cavity
    • Chorda tympani nerve: Branch of the facial nerve (VII)
    • - Joins the lingual nerve and runs anteriorly in its sheath
    • - Function: Supplies (a) special sensation (taste) to the anterior two-thirds of the tongue and (b) parasympathetic fibres to submandibular ganglion
    • Inferior alveolar nerve: Arises from the mandibular nerve (V3)
    • - Runs inferiorly between the medial pterygoid muscle and the ramus of mandible
    • - Enter the mandible through the mandibular foramen
    • - Runs forward in the mandibular canal supplying sensory to the lower teeth
  61. Describe ongings in the pterygopalatine fossa with Maxillary nerve (V2) branches
    • Within the pterygopalatine fossa gives off two branches which suspend the parasympathetic pterygopalatine ganglion
    • - Sensory fibres of the maxillary nerve pass through the ganglion without synapsing, to supply nose, palate, nasopharynx
  62. Label the nerves and give functions
    • Greater palatine nerve and Lesser palatine nerve: Pass inferiorly from the pterygopalatine ganglion
    • - Descends through the palatine canal
    • - Enter palate through greater & lesser palatine foramina
    • - Function: supply sensory to hard & soft palate
    • Nasopalatine nerve: Runs medially and enters the nasal cavity
    • - runs on the nasal septum & through a foramen to anterior part of the hard palate
    • Nasal nerve: Enter the nasal cavity to supply parts of the lateral wall and septum
    • Pharyngeal nerves: Passes posteriorly
    • - Supply the mucous membrane of the nasopharynx
    • Posterior superior alveolar nerves: Arise from the maxillary nerve within the pterygopalatine fossa
    • - Descend to supply upper posterior teeth.
    • Anterior superior alveolar nerves: Arises from the infraorbital nerve and supplies the upper anterior teeth
    • #
    • Pterygopalatine ganglion
  63. Maxillary nerve (V2) branches; name the nerves indicated
    • Greater palatine nerve and Lesser palatine nerve: Pass inferiorly from the pterygopalatine ganglion
    • - Descends through the palatine canal
    • - Enter palate through greater & lesser palatine foramina
    • - Function: supply sensory to hard & soft palate
    • Nasopalatine nerve: Runs medially and enters the nasal cavity
    • - runs on the nasal septum & through a foramen to anterior part of the hard palate
    • Nasal nerve: Enter the nasal cavity to supply parts of the lateral wall and septum
    • Pharyngeal nerves: Passes posteriorly
    • - Supply the mucous membrane of the nasopharynx
    • Pterygopalatine ganglion
  64. Maxillary nerve (V2) branches; name the nerves indicated
    • Posterior superior alveolar nerves: Arise from the maxillary nerve within the pterygopalatine fossa
    • - Descend to supply upper posterior teeth.
    • Anterior superior alveolar nerves: Arises from the infraorbital nerve and supplies the upper anterior teeth
    • #
    • Pterygopalatine ganglion
  65. This is an image with the medial nasal septum turned up.
    Maxillary nerve (V2) branches; name the nerves indicated
    • Greater palatine nerve and Lesser palatine nerve: Pass inferiorly from the pterygopalatine ganglion
    • - Descends through the palatine canal
    • - Enter palate through greater & lesser palatine foramina
    • - Function: supply sensory to hard & soft palate
    • Nasopalatine nerve: Runs medially and enters the nasal cavity
    • - runs on the nasal septum & through a foramen to anterior part of the hard palate
    • Nasal nerve: Enter the nasal cavity to supply parts of the lateral wall and septum
    • Pterygopalatine ganglion
  66. Label:
    • Nasal bone
    • Lacrimal bone
    • Mandible
    • Zygomatic bone
    • Vomer
    • Maxilla
    • Parietal Bone
    • Occipital Bone
    • Sphenoid
    • Ethmoid
    • Temporal Bone
    • Frontal Bone
    • Sagittal suture
    • Occipital Bone
    • Temporal bone
    • Right + left parietal bone
    • Squamous suture
    • Mandible
    • Occipital bone
    • Lambdoid suture
    • Sagittal suture
    • Right + left parietal bone
    • Coronal suture
    • Frontal bone
    • Nasal bones
    • Sphenoid
    • Frontal sinus
    • Sphenoidal sinus
    • Nasal bone
    • Ethmoid
    • Vomer
    • Palatine bone
    • Maxilla
    • Mandible
  67. Describe the functions and gross anatomical features of the medial wall of the nasal cavities
    • The two nasal cavities are separated by a median partition, the *nasal septum* that forms the medial wall of each nasal cavity. The nasal septum comprises a skeleton of;
    • – bone: vomer, perpendicular plate of ethmoid
    • Vomer
    • perpendicular plate of ethmoid
    • – and cartilage together with a covering of mucosa
    • Septal cartilage
    • #
    • Nasal crests of the;
    • - maxilla and
    • - palatine bones
  68. Describe the functions and gross anatomical features of the lateral wall of the nasal cavities
    • The lateral wall of each nasal cavity similarly comprises a skeleton of hard tissue with (2) components
    • – bone : nasal conchae or turbinate (= scroll-like) bones, frontal process of maxilla, perpendicular plate of palatine bone, nasal bone, lacrimal bone
    • Frontal process
    • Lacrimal bone
    • Nasal bone
    • (Perpendicular plate of) Palatine bone
    • Ethmoid bone; with superior and middle concha and
    • - inferior concha; is a separate bone
    • Nasal meatuses: air passages below the respective conchae; i.e. superior, middle and inferior
    • – and cartilage together with a covering of mucosa
    • Cartilage
  69. Describe the functions and gross anatomical features of the roof (3) and floor (2) of the nasal cavities
    • Frontal bone
    • Cribiform plate of the ethmoid bone
    • Sphenoid
    • Horizontal plate of the palatine bone
    • Palatine process of the maxillae bone
  70. Describe the functions and gross anatomical features of the floor (only) of the nasal cavities
    • Palatine process of the maxillae bone
    • Hard palate
    • Horizontal plate of the palatine bone
    • Soft palate
  71. What is the orbit? What are the 5 anatomical parts of the orbit? What bones form them?
    • The orbit: is the cavity or socket of the skull in which the eye and its appendages are situated. It has 4 walls and an apex;
    • Roof: mainly orbital plate of frontal bone, near the apex lesser wing of sphenoid
    • Medial wall: mainly ethmoid with contributions from frontal bone, lacrimal, and sphenoid.
    • Floor: mainly by maxilla, partly by zygomatic bone. Floor is partly separated from lateral wall by the inferior orbital fissure.
    • Lateral wall: zygomatic bone and greater wing of sphenoid.
    • - Partly separated from roof by superior orbital fissure (communicates with middle cranial fossa)
    • Apex: is at optic canal, medial to superior orbital fissure
  72. Give the technical name for eyelids
    Describe the surrounding/lacrimal apparatus

    • Eye lids (palpebrae) are covered externally by thin skin, and internally by conjunctiva, which is reflected onto the eyeball.
    • #
    • Tarsal plates: are dense fibrous tissue bands which strengthens the eyelids.
    • - Tarsal glands are embedded in the plates, secretion lubricates and prevents eyelids sticking together.
    • Medial and lateral palpebral ligaments: connect the eyelids to their respective margins of the orbit.
    • Lacrimal gland: lies in a fossa in lateral part of the roof of orbit.
    • - It drains by about dozen small ducts on to the conjunctiva
    • Lacrimal sac: is lodged within the lacrimal groove.
    • - It receives lacrimal canaliculi and is continuous below with the nasolacrimal duct, which drains into the inferior meatus of the nose.
  73. Contents of the orbit: Muscles
    Name the muscles, their origin, insertion, innervation and actions
    • Levator palpebrae superioris muscle:
    • - Origin - roof of orbit close to apex
    • - Insertion - tarsal plate and skin of upper eyelid
    • - Innervation - oculomotor nerve (III)
    • - Action - elevates upper eyelid
    • #RECTUS MUSCLES (4) ; (attachments)
    • Superior rectus: common tendinous ring at the apex of the orbit to superior surface of eyeball
    • - Action: elevates the eyeball
    • Inferior rectus: common tendinous ring to inferior surface of eyeball
    • - Action; depresses the eye ball
    • Medial rectus: common tendinous ring to medial surface of eyeball
    • - action - adducts the eyeball
    • - Innervation: above 3 by oculomotor nerve (III)
    • Lateral rectus: common tendinous ring to lateral surface of eyeball
    • - Action - abducts the eyeball
    • - Innervation: abducent nerve (VI)
    • Superior oblique muscle:
    • - Origin - body of sphenoid
    • - Insertion - tendon passes through a fibrous ring (trochlea) at superomedial angle of orbital wall, changes direction and inserts into sclera deep to superior rectus muscle
    • - Innervation - trochlear nerve (IV)
    • - Action - abducts and depresses
    • Inferior oblique muscle:
    • - Origin - anterior part of floor of orbit
    • - Insertion - sclera deep to lateral rectus muscle
    • - Innervation - oculomotor nerve (III)
    • - Action - abducts and elevates
  74. Contents of the orbit: Nerves
    • Nasocilliary nerve: passes forwards within the cone of muscles, and gives off the following branches;
    • Long ciliary nerves: carry sensory fibers to cornea
    • - postganglionic sympathetic fibres from superior cervical ganglion to the dilator pupillae muscles
    • Posterior and anterior ethmoidal nerves: enter the respective foramina in the medial wall of the orbit
    • - Anterior ethmodal n. enters the face via the nose as the external nasal nerve
    • Ciliary ganglion: situated behind the eyeball
    • - is a relay station for parasympathetic fibres brought along the oculomotor nerve
    • Short ciliary nerves: carries postganglionic parasympathetic fibres to the sphincter pupillae and ciliary muscles.
  75. Contents of the orbit: Arteries
    • Ophthalmic artery: branches off the internal carotid artery as it emerges from the cavernous sinus
    • - accompanies the optic nerve into the orbit through the optic canal
    • - Branches are similar to those of the nasociliary nerve
    • Central artery of the retina: runs to the retina within the optic nerve
  76. Contents of the orbit: Veins
    Name the CYAN vein, its tributaries, and its path
    • Ophthalmic veins: Both branches of ophthalmic veins pass through the superior orbital fissure and
    • - enter the Cavernous sinus
    • #
    • Facial vein communicates with;
    • - the superior ophthalmic vein at the medial cathus
  77. What are the 3 parts of the external ear?
    • Auricle: Sensory supply - V3 (auriculotemporal nerve)
    • External auditory meatus: S-shaped passage which extends to the tympanic membrane
    • - Lateral third cartilaginous, medial two-thirds bony (petrous temporal).
    • - Cereuminous and sebaceous glands produce cerumen (ear wax).
    • Tympanic membrane: slopes away at lower edge, covered with skin externally and mucous membrane internally.
  78. What are the parts of the middle ear?
    Give the bones and muscles + functions

    • The tympanic cavity is directly internal to membrane.
    • Contains auditory ossicles linking tympanic membrane to oval window of inner ear.
    • - Malleus, incus, stapes (move at synovial joints)
    • Two small muscles, tensor tympani (handle of mallius - V3) stapedius (stapes - VII) - dampen excessive movement on loud noises.
    • Auditory Tube: opens into anterior wall of tympanic cavity at lateral end
    • - into the nasopharynx at medial end.
  79. What are the parts of the inner ear?
    - Give the innervation
    • Bony labyrinth: is in very dense petrous temporal bone. It contains;
    • - Vestibule: Oval window opens to tympanic cavity (filled by foot plate of stapes).
    • - Cochlea: lies anterior to vestibule. Round window into tympanic cavity
    • - Semicircular canals lie posterior to vestibule, one in each plane.
    • #
    • Supplied by VIII: at the lateral end of the internal auditory meatus, it divides into a cochlear and vestibular portions.

Card Set Information

Author:
vickrum
ID:
302361
Filename:
RCA: Head and Neck
Updated:
2017-05-15 04:17:49
Tags:
MICN301
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Description:
RCA
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