Card Set Information
head and neck anatomy
Facial nerve emerges from what foramen?
Maxillary branch (V2) of the trigeminal nerve goes through what foramen?
Mandibular branch (V3) of the trigeminal nerve goes through what foramen?
Middle meningeal artery goes through what foramen?
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?
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?
What is the usual source of epidural bleeding?
What is th usual source of subdural bleeding?
Where do the cranial sinuses drain into?
Internal jugular vein
What glands are on the posterior apect of the thyroid gland?
Facial nerve courses through what structure?
Knife wound near the anterior surface of anterior scalene muscle would injur what nerve?
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?
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?
What is the origin of te phrenic nerve?
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
enters skull through foramen spinosum, supplies the cranial dura mater (branch from maxillary artery)
Facial Nerve (CN VII)
Enters skull through stylomastoid foramen
located in middle cranial fossa lateral to body of sphenoid recieves superior ophthalmic vein and sphenoparietal sinus
formed by the union of inferior sagittal sinus and great cerebral vein
from C3, C4
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
Bounded by the anterior cervical midline, inferior border of the mandible, and sternocleidomastoid
Bordered by the anterior and posterior bellies of the digastric and the inferior border of the mandible- hypolgossal nerve courses deep in this triangle
Bordered by the posterior belly of the digastric, superior belly of the omohyoid, and the upper part of sternocleidomastoid, contains external carotid artery
bordered by the superior belly of the omohyoid, anterior cervical midline, and the lower part of sternocleidomastoid; contains the sternohyoid, sternothyroid, and thyrohyoid muscles
bordered by the anterior bellies of the digastric and body of the hyoid
Bordered by SCM, clavicle, anterior border of trapezius; accessory nerve descends across the triangle on levator scapulae
Innervation of Sternocleidomastoid
Action of SCM
laterally flexes head and neck and rotates head and neck to opposite side
sternohyoid, omohyoid, thyrohyoid, sternothyroid
Innervation of infrahyoid muscles
ansa cervicalis (except for Thyrohyoid which is a branch of C1 via the hypoglossal)
stylohyoid, digastric, mylohyoid, geniohyoid
posterior belly of facial nerve, anterior belly of nerve to mylohyoid, branch of mandibular division of trigeminal nerve
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
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)
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?
What is the main blood supply to the larynx?
Superior thyroid artery
What symptom results from improper vbration of the vocal folds?
sit on the posterior aspect of the cricoid cartilage
ring of cartilage below throid cartilage, gets thicker posteriorly
What vessel does the superior thyroid artery branch off of?
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?
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
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
What bone is the tensor tympani muscle attached to?
What nerve does the chordae tympani come off of?
Chordae tympani runs through what before it joins the lingual nerve?
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)
What branch of V3 carries postganglionic parasympatetic secretomotor fibers from the otic ganglion to the facial nerve?
What provides general sensory innervation to the anterior 2/3 of the tongue?
What provides taste to the anterior 2/3 of the tongue?
chorda tympani (branch of facial that joins the lingual)
What nodes do the thyroid gland drain into?
deep cervical nodes
The carotid sinus recieve sensory information via what nerve?
Does the sympathetic trunk travel anterior or posterior to the carotid sheath?
What nerves make up the ansa cervicalis
superior roots= C1, inferior root= C2,3
What branch of the vagus gives sensory innnervation for auricle, exnternal acoustic meatus and tympanic membrane?
What branch of the vagus gives motor innnervation to the pharynx and palate?
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
What branch of the vagus pierces the thyrohyoid membrane?
Internal laryngeal nerve
What branch of the vagus gives motor innnervation to the cricothyroid muscle?
What muscles of the neck and posterior to the retropharyngeal space
Longus capitis and longus coli
Where does the vertebral artery originate from?
What does the inferior thyroid artery branch off of?
thyrocervical trunk (a branch of subclavian)
What nerves innervate the medial and lateral pterygoid muscles?
What branch of trigeminal contains post ganglions sympathetic and parasympathetic fibers to the lcarimal gland?
What nerve contains preganglionic parasympathetic fibers to the pteryogpalatine ganglion?
Lingual nerve (a branch of facial, CN VII)
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
How does the nasopharynx communicate with nasal cavities?
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
What are the lateral borders of the oropharynx that connect it with the oral cavity?
palatoglossal and palatopharyngeal arches (created by folds)
What is located between the palatoglossal and palatopharyngeal arches?
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?
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)
What nerve is the submandibular ganglion suspended from?
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?
What nerve provides taste and general sensation to the posterior 1/3 of tongue?
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?
What do the vocal folds contain?
What space is formed between vestibular and vocal folds?
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?
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?
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
What nerve is responsible for the afferent component of the gag reflex?
What nerve is responsible for the efferent component of the gag reflex?
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?
What muscles does the ansa cervicalis supply?
Does CN I emerge from brainstem
Does CN II emerge from brainstem
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?
Where does CN VI emerge?
Where does CN VII emerge?
Where does CN VIII emerge?
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?
What ganglion is associated with CN VII?
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?
What bone is the geniculate ganglion embedded in?
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
What thick ligament at the base of skull travels down the posterior aspect of the vertebral bodies at the posterior longitudinal ligament?
What ligament holds the dens against the anterior arch of the atlas?
Patient with hoarse voice, uvula deviates to the left, what is the damaged nerve?
What are the tonsils in the nasopharynx?
What are the tonsils inthe oropharynx?
palatine and lingual
Which part of the pharynx is the eustachian tube in?
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)