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AHuman Struc wk3/4
| Question | Answer |
|---|---|
| What are some signs of issues with CN 9? | loss of gag reflex, and glossopharyngeal neuralgia. This would cause pain of skind istribution of that nerve which is a little tiny [piec cof skin on ear. This often occurs after an infection. |
| What innervates the carotid body and sinus? | glossopharyneal N |
| Which branchial arch does the stylopharyngeus come from? | 3rd branchial arch |
| Which CN does the lesser petrosal come from? | glossopharyngeal n |
| Which nerve innervates the parotid gland? | glossopharyngeal |
| Which N causes the gag reflex? | glossopharyngeal |
| What part of the tongue comes from ectoderm? | anterior 2/3 |
| What part of the tongue comes from endoderm? | posterior 1/3 |
| The efferent limb of the gag reflex is innervated by which nerve? | vagus |
| What is a sing of damge to CN X? | uvula and palate do not elevate |
| Damage to Cranial N 11 causes what? | loss of shoulder shrug |
| What does hypoglossal N control? | movement of tongue |
| If there is a lesion on the left hypoglossal N which side of the mouth will the tonngue point to? | left side [same side as lesion] |
| Which nerve innervates the first brancchial arch ? | CN 5 |
| Which nerve innervates the second brancchial arch? | CN 7 |
| Which nerve innervates the 3rd brancchial arch? | CN 9 |
| Which nerve innervates the 4 and 6th brancchial arch? | 10 |
| Which CN have sensory innervation in the head? | 5 [major nerve for general sensation], 7, 9, 10 [small role in innervating the ear] |
| Which N has parasympathetics to the eye? | CN 3 through the ciliary ganglion |
| Which N has parasympathetics to the nasal cavity and submandibular? | CN 7 through the pterygopalatine and submandibular gnaglion |
| Which N has parasympathetics to the parotid gland? | CN 9 through the Otic gnnglion |
| Which N has parasympathetics to the heart, lungs, and foregut? | CN 10 |
| What are the 4 parasympathetic gnaglia of the head? | ciliary, pterygopalatine, submandibular, and otic |
| What is the preganglionic branch of the Ciliary Ganglion and which CN does it branch off of? And what does it do? | Ciliary branch of Oculomotor N, smooth muscle of the eye |
| What are the postganglionic branch of the Ciliary ganglion? | short ciliary brnaches of the nasociliary N |
| What is the preganglionic branch of the Pterygopalatine ganglion and which CN does it branch off of? And what does it do? | Greater petrosal N of the Facial N. It goes to the lacrimal gland and nasal cavity |
| What are the postganglionic branch of the Pterygopalatine ganglion? | sall branches of the maxillary A and the zygomatic N to the lacrimal N and gland |
| What is the preganglionic branch of the Submandibular Ganglion and which CN does it branch off of? And what does it do? | Chorda Tympani off the Facial N joins the lingual N to go to the submandibular ganglion for submandibular and lingual areas |
| What are the postganglionic branch of the Submandibular ganglion? | Run with the lingual N of mandibular branch of trigeminal |
| What is the preganglionic branch of the Otic Ganglion and which CN does it branch off of? And what does it do? | Lesser petrosal N off the glossopharyngeal N goes to the otic ganglion for parotid gland innervation. |
| What are the postganglionic branch of the Otic ganglion? | auriculotemporal branch of the mandibular N |
| What provides the preganglionic parasympathetics to the heart, lungs and foregut? | Vagus N |
| What are the postganglionic parasympahtetic N for the heart, lungs and foregut? | short NN in the wall of organs |
| Where are the sympathetic preganglionic cell bodies? | between T1 and T2 |
| Where are all the sympathetic postganglionic cell bodies for the head? | in the superior cervical ganglion |
| How do sympathetic nerves get to where they need to go? | they wrap around arteries and travel with them |
| What kind of fibers does the deep petrosal N have? | postganglionic sympahtetic |
| What is the deep petrosal N's path? | goes through the pterygoid canal, and pterygopalatine ganglino but does not synapse there and it dangles of f the maxillary division of the trigeminal and innervates the lacimal gland |
| What is the name of the cranial nerve nucleus for CN III? | Edinger-Wesphal Nucleus |
| Describe the Oculomotor Parasympathetic path. | preganglionic parasympathetic fibers out of CN3 edinger-wesphal nucleus. synapse in ciliary ganglion. Postganglionic short ciliary NN ïƒ pupillary sphincter M [dec diameter] & ciliary M = strong lens for close vision (only need if relaxing or reading) |
| What does parasympathetic control of facial N control? | snot and secretions |
| What do you get with parasympathetic secretion of submandibular gland? | watery saliva |
| What do you get with sympathetic secretion of submandibular gland? | thick mucus saliva |
| Describe Parasympathetic Facial N route for submandibular gland and sublingual gland. | CN7 comes out of Superior Salivary Nucleus. Chorda tympani branches and synapses in submandibular ganglion. Postganglionic branches synapse in sublingual and submandibular gland. |
| Describe the parasympathetic facial n route for lacrimal gland. | CN7 ïƒ superior salivary nucleus ïƒ Greater petrosal N ïƒ petrygoid canal & joins w/ [sympathetic] deep petrosal N. Synapse in pterygopalatine ganglion & postganglionic zygomatico-temporal & lacrimal branch of maxillary fibers ïƒ lacrimal gland |
| Besides going to lacrimal lgnad the synapse of greater petrosal N in the pterygopalatine ganglion goes wehre? | pterygopalatine branches of maxillary go to nose to secrete snot. |
| Descirbe the route of parasympathetic fibers of glossopharyngeal N. | CN IX --> inferior salivary nucleus --> lesser petrosal N --> Otic Ganglion -->dangles off auriculotempral N] when going to parotid gland [just hitch hike] |
| What is hypovolemic? | too much blood loss |
| What gives the nose its shape and flexibility? | cartilage |
| What kind of tissue is on the outside of your nose and allows you to flare your nose? | fibro-areolar tissue |
| Which bones form the lateral wall of the nasal cavity? | frontal, nasal, maxilla, ethmoid, inferior concha, palatine, and sphenoid |
| Which bones form the medial wall or nasal septum of nose? | vomer, perpendicular plate of ethmoid, nasal cartilage, a little maxilla and a little palatine, and posterior is sphenoid |
| What goes through the greater palatine foramen? | descending palatine artery and anterior palatine nerve |
| What goes through the incisive foramen? | nasopalatine N and spenopalatine A |
| What is the choana? | posteiror aperture to the nose |
| Whats another name for concha bones? | turbinate bones |
| What kind of climate predisposes you to nose bleeds? | dry climate |
| What is the purpose of the nasal cavity? | warms and moistens air before enters the lung |
| What lines the vestibule of the nose? | normal skin |
| What are the two linings of the nasal cavity and what do they do? | nasal mucosa [secrete mucus, line nasal cavity] and respiratory epithelium [barrier to infection and foreign particles by actio nof mucociliary escalator, lines respiratory tract.] |
| What is olfacotry epithelium? | lines roof of nose, responsible for detecting odor, has lots of cilia, transmits chemical signal |
| What is respiratory epithelium? | has goblet cells that secrete mucus, sweep back towards choana |
| What are the 3 major AA that contribute to the nasal cavity? | Opthalmic, maxillary and facial. |
| What A anastamoses with the greater palatine A? | sphenopalatine A |
| Lesser palatine A goes to what structure? | soft palate |
| What 2 AA are given off by the opthalmic A in the nose? | anterior and posterior ethmoidal |
| What 2 arteries are given off by the maxillary A in the nose? | sphenopalatine and greater palatine |
| What 2 A branch off the facial A in the nose? | lateral nasal and septal branches |
| Where are most anterior nose bleeds from? | vestibule and fingers in the nose |
| What is kiesselbachs plexus? | region in anterioinferior part of nasal septum where 4 AA anastamose to for a pelxus: anterior ethmoidal, sphenopalatine, greater palatine, and septal branch of the superior labial A [from facial A] |
| Where is the pterygopalatine ganglionlocated? | pterygopalatine fossa |
| What nasal plexus is part of the danger triangle? | Nose is part of danger triangle which goes through pterygoidplexus [receives a bunc hof tributaries corresponding with the maxillary A] and into the cavernous sinus |
| What is epistaxis? | to bleed from the nose |
| Where are 90% of nose bleeds located? And how do you treat? | anterior nasal cavity from Kiesselbach's area. Can be controlled by pressure, cauterization and packing |
| How do you treat a posterior nose bleed and which A are they from? | from sphenopalatine A, usually treated by otolaryngologist, use nasal tampon or balloon |
| What makes up the N of the pterygoid canal? | deep petrosal N [sympathetic] and gerater petrosal N [parasympathetic] |
| What major nerve innervates the Anterior part of the nasal cavity? | Opthalmic [V1] |
| What major nerve innervates the posterior part of the nasal caavity? | V2 [Maxillary] |
| What do the autonomics in the nasal cavity do? | Autonomics in the nasal cavity secrete the moisture that assist in function of nasal cavity |
| What is the geniculate ganglion? | collection of fibers of the facial nerve located in facial canal. Fibers innervate lacirimal glands, submandibular, sublingual, tongue,… facial expression… special sensory for taste for chorda tympani.. And fibers coming up through the greater petrosal N |
| If didn't have air sinuses what would happen? | couldn't hold head up |
| What's special about ethmoid sinus? | lots of chambers |
| What is weird about maxillary sinus? | opening is on the superior side so can not drain well. Where lots of sinus infections occur. |
| What do air sinuses do? | assist in the circulatio of air to get it warm, keep head light and voice resonating |
| Who does not have air sinuses? | kids so no sinus infecitons |
| hat is located in the sphenoehtmoidal recess? | openign of the sphenoid sinus [where it drains] |
| What is located in the superior nasal meatus? | opening to posterior ehtmoidal sinus |
| What is located in the Middle meatus? | opening to anterior and middle ehtmoidal sinus, maxilalry sinus, and frontonasal duct |
| What is located in the inferior nasal meatus? | nasolacrimal duct |
| What is the forntonasal duct? | where the fontal nasal sinus communiates with the nasal cavity |
| What does the nasolacrimal duct do? | carries tears to the naal cavity |
| What bone is located at the anterior end of the hard palate? 3 incisive bone | |
| What makes up the soft palate? | mucosa, muscles and glands |
| What is the only exception to the MM innervation of MM of the palate? | tensor veli palatini is innervated by mandibular N. It wraps around hamulus of pterygoid palte |
| What is the torus tubaris? | mucus covered eustachian tube |
| What would really large tonsils do clinically? | affect ability to breath |
| What major N supplies the palate ? | maxillary N |
| What do swollen adenoids cause? | can block airway and cause snoring and sleep apnea |
| What is sleep apnea ? | abnormal pauses in breathing or instances of abnormally low breathing, during sleep |
| Whare adenoids? | mass of lymphoid tissue situated posterior to the nasal cavity, in the roof of the nasopharynx. Most people's adenoids are not even in use after a person's third year but if they cause problems they must be taken out. Enlarged adenoids can block airflow. |
| What does the auditory tube do? | Autidtory tube equalizes pressure on either sideof tympanic membrane |
| What structure is in the oropharynx? | tonsils |
| Why can occur during a tonsilectomy? | heavy bleeding and problems because huge blood suply: maxillary [descending palatine] , lingual [dorsal ingual branch] , ascending pharyngeal, facial [ascenidng palatine, tonsillar branch] |
| What does the ascending palatine A supply? | upper portions of pharynx, auditory tube, tonsils |
| Which major A supplies all the branches to the pharyx? | external carotid A |
| Where does the pharyngeal venous plexus drain? | internal jugular V |
| What is the major venus plexus of the pharynx? | pharyngeal venous plexus |
| How can you tell superior from middle constrictor? | stylopharyngeus separate smiddle from superior |
| What are the sources of the pharyngeal plexus? | vagus and glossopharyngeal NN |
| What do all the constrictors insert on? | median raphe [ridged union of continuous biological tissue] |
| What is the source of all connective tissue including skeleton? | neural crest cells |
| What is the source of all skeletal muscle? | cephalic paraxial mesoderm |
| What are most head and neck structures derived from? | neural crest cells; remember they migrate |
| What are branchial arches? | external swellings |
| What are branchial grooves? | between the branchial arches |
| How many branchial arches form? | six |
| Which arch is rudimentary [underdeveloped]? | the fifth |
| What are the 2 prominences that the 1st arch separates into? | maxillary and mandibular prominences |
| Which arch gives rise to most of the strucutres of the face? | 1st arch |
| Which groove gives rise to something? | branchial groove 1- external acoustic meatus |
| What are pharyngeal pouches? | four internal evaginations of endoderm seaparting each branchial arch; Outpouchings of pharynx and these give rise to glandular structures |
| What is branchial membrane? | meeting of ectoderm of branchial groove with endoderm of pharyngeal pouch; membrane between the pouch and groove |
| What is the foregut lined with ? | endoderm |
| What does the ectodermal outer covering for of the branchial arch? | epidermis |
| What does the endodermal inner lining of the branchial arch form? | mucosal |
| What does the mesenchymal core of the branchial arch form? | branchiomeric mesenchyme- blood vessels [endothelium of an aortic arch], cartilaginous bar [forms from neural crest ells], muscular component [forms from cephalic paraxiall mesoderm [somitomeres]], and cranial NN [one with each] |
| What do branchial grooves 2-4 form? | cervical sinus and then regerss. |
| IF the cervical sinus does not regress what forms? | cyst |
| What does the branchial arch 1 pouch form? | mddle ear |
| What does the membrane between the external acoustic canal and ear form? | tympanic membrane |
| What does the mandibular prominence form? | meckel's cartilage: dorsal part forms malleus and incus by endochondral ossification, ventral part regressesses, mandible forms by intramembranous ossification- from branchial arch 1 |
| What does the maxillary prominence form? | maxilla, zygomatic bone, and squamous portion of temporal bone by intramembranous bone formation- from branchial arch 1 ; remember fromneural crest cells |
| What is intramembranous ossification / | de novo bone formation |
| What is endochondral ossification? | from cartilage model |
| What does branchial arch 2 form? | Reichert's cartilage: stapes, styloid process, upper 1/2 of hyoid bone by endochondral bone formation |
| What does branchial arch 3 form? | lower half of hyoid bone by endochondral bone formation |
| What does branchial arch 4 and 6 form? | cartilages of larynx except epiglottis |
| Which N comes from branchial arch 1? | maxillary and mandibular divisions of trigeminal nerve |
| Which N comes from branchial arch 2? | facial nerve [7] |
| Which N comes from branchial arch 3? | glossopharyngeal N [9] |
| Which N comes from branchial arch 4 and 6? | superior [4] and recurrent [6] layrngeal branches of vagus N [10] |
| What are branchial MM from? | cephalic paraxial somitic mesoderm |
| What does the 1st branchial membrane form? | tympanic membrane |
| What does the pharyngeal puch 1 form? | tubotympanic recess: pharyngotympanic canal [eustacian tube] and cavity of middle ear |
| What does pharyngeal pouch 2 form? | epithlium of palatine tonsil and tonsilar crypts |
| What does pharyngeal pouch 3 form? | dorsal: inferior parathyroid glands, ventral: epithelium reticulum of thymus gland |
| What does pharyngeal pouch 4 form? | dorsal- superior parathyroid glands; ventral- ultimobranchial body, asoociates with nerual crest cells to form parafollicular [c-cells] of thyroid gland |
| What cell makes up most of the pharyngeal pouch structures? | neural crest cells |
| Which gland does not form from pharyngeal pouches? | thyroid gland |
| Branchial Pouch 1 forms what? | eustacian tube and tympanic cavity |
| Branchial pouch 2 forms what? | tonsils |
| Branchial pouch 3 forms what? | thymus gland |
| Branchial arch 4 forms what? | C-cells of thyroid gland [ultimpopharyngeal body] |
| Which branchial pouch gives rise to parathyroid glands? | pouch 3 and 4 |
| What is the thyroid diverticulum? | embryologica structre that the thyroid follicular cells derive; endodermal lined evagination' caudal to median tongue bud; foramen ceucm [proximal opening of thyroglossal duct] |
| What is the thyroglossal duct? | narrow tube connecting thyroid gland to tongue; it is a midline structure; most anterior structure or at least anterior to thyroid cartilage |
| What do you get if thyroglossal duct does not regress? | thyroglossal duct cyst that can become inflammed |
| What is an ectopic thryoid? | A completely ectopic thyroid gland may be located anywhere along the path of the descent of the thyroid during its embryological development, although it is most commonly located at the base of the tongue, |
| What is a thyroglossal duct sinus? | there is a connection to the base of the tongue as thyroid descends that should disappear by the time the thyroid reaches its final position. If does not, then persistent hollow tube that may accumulate of mucoid material and form a cyst at the end |
| What is the most common congenital cause of a neck mass? | branchial cleft cysts [20% of all], and 2-3% are bilateral |
| Where do the cysts generally form? | on sternocleidmosastoid M |
| Where are these branchial sinuses and cysts located? | not on the midline |
| What is 1st arch syndrome? | malformation of the ear, mandible, zygoma, and palate due to insufficinet migration of neural crest cells into the frist branchial arch. It is often associated with fetal alchol syndrome. The alchohol affects neural crest cell migration |
| What is DiGeorge Syndrome? | llack parathyroid glands [causes immune deficiency] & thymus, facial abnoramlities [low set ears, small mouth], heart & great vessel deffects- these organ malformations are dependent on migration of neural crest cells to the region of pharyngeal pouches |
| What is the stomodeum? | ectodermal lined depression, separates from foregut by oropharyngeal membrane, forms anterior 2/3 of oral cavity |
| How does the stomodeum move? | as the neural crest cells are proliferating the oropharyngeal membrane moves deeper and deeper |
| What is the remnant of the oropharyngeal membrane? | palatoglossal arch |
| What are the 5 facial primordia? | frontonasal prominence, 2 maxillary prominences, 2 mandibular prominences |
| What is the major source of conenctive tissue components like cartialge, bone and ligaments int eh face and oral regions? | neural crest cells |
| What forms the max and mandibualr prominences? | neural crest cell proliferation |
| What is a placode? | A neurogenic placode is an area of thickening in the embryonic epithelial layer where some organ or structure later develops |
| What does the nasal placode tern into? | a nasal pit |
| What does the nasal pit turn into? | medial and lateral nasal prominences |
| What forms between the lateral nasal processes and adjacent maxillary swellings? | nasolacrimal groove |
| What does the nasolacrimal groove form? | becomes incorporated into face and forms nasolacrimal duct |
| What does the fusion of the medial nasal prominences form? 3 philtrum of lip [cleft form nose to lip], fleshy nasal septum, premaxillary part of maxilla [houses teeth] and primary palate | |
| What is the fusion of paried medial nasal prominences called? | intermaxillary segment |
| What does the primary palate form from? | intermaxillary segment |
| What does the secondary palate form from? | palatal shelves and nasal septum of maxillary prominence |
| Developmentally what is the incisive foramen? | the landmark of the fusion of primary and secondary palate is the incisvie foramen |
| What does the secondary palate form from? | lateral palatine processes or paired shelves that lift from maxillary prominences and then fuse; also the nasal septum is formed fromneural crest in frontonasal and medial nasal processes |
| What does the secondary palate do? | separates oral and nasal cavities except in region of pharynx |
| How is the secondary palate initially oriented? | initially oriented downward then gorws and flips up |
| What innevates the frontonasal prominence? | opthalmic division of trigeminal |
| What innervates the maxillary prominence? | V2 |
| What innevates the mandibular prominence? | V3 |
| In which branchial arch are the facial MM located? | Second branchial arch |
| Where does the facial N exit? | stylomastoid foramen |
| What are 2 anterior cleft malformations? | cleft lip and incomplete fusion of maxillary prominence with medial nasal prominence; can be unilateral or bilateral; these occur anywhere the facial primordia fail to fuse |
| What are 2 posterior cleft malformations? | cleft palate and incomplete fusion of lateral palatine processes and nasal septum; can be unilateral or bilateral, these occur anywhere the facial primordia fail to fuse |
| What type of cleft involves the nasolacrimal duct? | oblique facial cleft |
| What causes a midline cleft lip? | missing intermaxillary segment [very rare] |
| How often does cleft lip occur and what is the frequency in sexes? Does maternal age have an affect? | 1/1000, occurs more frequently in males [80%], incidence inc with materanal age |
| How often does cleft palate occur and what is the frequency in sexes? Does maternal age have an affect? | 1/2500; 67% are female, not related to maternal age, think sex difference is due to palatal shelves fusing 1 week later in females than males so longer window of time for something to interfere |
| What could cause cleft palate and lip? | anticonculsant drugs [phenobarbital and diphenylhydantoin] during pregnancy inc risk of cleft lip and palate |
| What does most of the adult palate arise from? | secondary palate |
| What are branchial cleft cysts? | a lump that develops in the neck or just below the collarbone. It is a type of birth defect.Branchial cleft cysts form during development of the embryo. They occur when tissues in the neck and collarbone area (branchial cleft) fail to develop normally. |
| which region does the first neuron for parasympathetic control come from? | craniosacral region |
| which region does the first neuron for sympathetic control come from? | thoracolumbar region |
| which cranial nerves are involved in preganglionic parasympathetic control? | 3, 7, 9, 10 [oculomotor, facial, vagus, and glossopharyngeal] |
| Which N are postganglionic parasympathetic ganglia found associated with and what are the branches? | trigeminal N: opthalmic N, maxillary N, mandibular N, and lingual N [off the mandibular N] |
| Why doe preganglionic parasympathetic fibers associate with the trigeminal N branches? | the autonomic fibers will ride with virtually all of the terminal branches to get to where they are going. |
| After synapsing in the superior cervical ganglion what structure do nerve fibers travel through before moving on to the structure they innervate? | carotid plexus: postganglionic sympathetic fibers ascend from the superior cervical ganglion, along the internal carotid A and enter the internal carotid plexus. these distribute to deep structures and some converge to form the deep petrosal N |
| How do sensory nerve fibers travel from the trigeminal N to the eye? | They leave the trigeminal and go through the nasociiliary,through the ganglion [do not synapse] and travel to the eye via ciliary nerves |
| Which tissues does the facial N function in as secretory motor function for glandular tissue? | lacrimal gland, nasal mucosa, paranasal air sinuses, palate, submandibular gland, and sublingual gland |
| What does the rostral part of the superior salivatory nucleus preganglionic parasympathetic neurons innervate? | lacrimal glands, nasal mucosa, paranasal air sinuses, palate |
| where is the superior salivatory nucleus located? | pontocerebellar angle [margin of pons and cerebellum] |
| What 2 holes does the greater petrosal N come out of? | 1st the facial hiatus and 2nd the foramen lacerum |
| what is another name for the nerve of the pterygoid canal? | vidian N |
| What is crocodile tears syndrome? | damage to facial N proximal to geniculate ganglion. axons regrow so that N that noramlly goes through chorda tympani to the lacimal gland instead go to the greater petrosal N. So stimulus that would normally cause salivation leads to copious lacrimation. |
| What is another name for crocodile tears syndrome? | Bogorad's syndrome |
| What occurs in the nose if the parasympathetic nervous system is activated? | glandular secretions of the nose |
| What is vasomotor rhinitis? | over active parasympathetic or underactive sympathetc NS that leads to watery nasal dischara, sneezing and blood vessel congestion. Treated with videan neurectomy |
| What is videan neurectomy? | when pterygoid canal is severed. this interrupts the autonomic innervationso fthe nasal mucosa |
| What is rhinorhea? | watery nasal discharge |
| what is the genu of the facial n? | bend in the facial n |
| what is tympanic neurectomy and what do you treat with it? | severing the tympanic N which si used to treat Frey's syndrome |
| Which NN would go through the lower cervical ganglia? | preganglionic sympathetic fivers would ascend through and synapse in the superior cervical ganglia on their way to the head. |
| Which N does the postganglionic sympathetic fibers follow? | deep petrosal N to reach teh nasal cavity, orbit and paranasal air sinuses.They also might go to the carotid plexus. |
| What makes up the nuerocranium? | 8 cranial bones |
| What makes up theviscerocranium? | 14 facial bones |
| What aer bones held together by? | cranial sutures, strong elastic bands which allow for brain growth and development |
| Around what age do sutures begin to grow together andfuse? | 18-24months , now no longer able to flex or move |
| What is craniosynostosis? | sutures fusing prematurely, leads to developmental delays, seizures,and neurologic problems |
| What happens if sutures do not fuse by 24months? | increased intracranial pressure needing medical intervention |
| What is the cavernous sinus? | collectionof VV that create a cavity between the petrous portion of temporal bone and sphenoid bone. Contains VV, ophthalmic and internal carotid AA and CN 6. CN 3,4, v1, v2 areembeded in lateral wall and are susceptible to compression injury. |
| How could compression to VV, AA, and NN in the cavernous sinus occur? | ballooning of the internal carotid A, tumor invading from the nearby pituitary gland |
| What is ophthalmoplegia? | paralysis of the eye due to damage to CN 3 |
| What does the tentorium cerebella do? | separate the cerebellumfromthe inferior portion of the occipitallobe of the brain |
| What is the posterior contribution to the Circle of Willis? | basilar A |
| What is the anterior contribution to the Cicle of Willis? | internal carotid A |
| What is the pterion? And what courses through this region? | where the frontal, parietal,sphenoid and temporal bones unit.middlemeningeal artery courses through region. Thebone is very thin and susceptile to injury causingdamageto middlemeningeal A ifthere is a blow to the head. |
| If there is a blow to the pterion what could occur? | damage to middle meningeal A causing an epidural hematoma and blood to accumulate between the dura and skull. 15-20%ofpatients with epidural hematomas die. They can also cause the brain to shift |
| What should you suspect if the face is not symmetric? | Facial hemi-trophy/hypertrophy of superfacial tissue , M & bone. Mandibular. Condylar hypoplasia-intrauterine or birth trauma. TMJ Ankylosis-mandible moves to affected side. Mandibular body or ramus hyperplasia, the mandible moves to the unaffected side. |
| Describe how you can tell symmetry of face. | can divide face into 1/3s. Width on lateral aspect of nose should be the same as the distancefrom nose to pupil. Should be able to draw a straight line from pupil to angle of mouth to chin to line up the 3 foramen: supraorbital, infraorbital,and mental |
| What is primary dentition? | They develop during the embryonic stage of development and erupt—that is, they become visible in the mouth—during infancy. They are usually lost and replaced by permanent teeth,. There are about 20 of them. Also called baby teeth and milk teeth. |
| What is permanent dentition? | they begin to come in between 6 and 13 except the last 4 which are wisdom teeth and usually come in between 17 and 21 |
| What is your Oral vestibule? | anteriormost portion of the oral cavity. It is the space between the cheek/lips and the teeth.[1] |
| What is your oral cavity proper? | space within the area bounded by the teeth |
| How many primary teeth should you have or eventually exfoliate? | 20 |
| How many permanent teeth should you have? | 32 |
| Describe the types of teeth an adult should have. | six maxillary and six mandibular molars, four maxillary and four mandibular premolars, two maxillary and two mandibular canines, four maxillary and four mandibular incisors. |
| Where are supernumerary teeth typically? | around lateral incisor and premolar region |
| Which tooth do you start with when numbering teeth? | Right maxillary wisdom tooth |
| What is the clinical crown versus the anatomical crown.? | clinical crown is the part above the root versus the anatomical crown is the part covered by enamel |
| What is the clinical root versus the anatomical root? | clinical root is the part beneath the gum versus the anatomical root is the part not covered by enamel |
| What is a root canal? | When the pulp tissue is diseased or injured it dies. If you don't remove it, tooth gets infected & could lose it. After dentist removes pulp, the root canal is cleaned & sealed to protect it. Then dentist places a crown over the tooth to make it stronger. |
| What supplies the cementum? | gets same blood supply as the alveolar processes so after a root canal the tooth may be dead but the cementum is still alive |
| What is cementum? | a specialized calcified substance covering the root of a tooth. |
| What is enamel? | the hardest and most highly mineralized substance in the human bodynormally visible dental tissue of a tooth because it covers the anatomical crown and must be supported by underlying dentin |
| What is dentin? | calcified tissue, covered by enamel in the crown of the tooth and cementum in root of tooth |
| What is dental pulp? | is the part in the center of a tooth made up of living connective tissue and cells called odontoblasts. The central region of the coronal and radicular pulp contains large nerve trunks and blood vessels. |
| How many sinuses does a newborn baby have? | 1 the maxcillary, all others develop later particularly the frontal which is much much later. |
| What are you looking for with a PA Ceph: symmetry? | A Posteroanterior Cephalometric Evaluation of Craniofacial Asymmetry; making sure the crista galli,anterior nasal spine and mental line up |
| Describe development of the mandible? | when born there are 2 halves that fuse by 1 year of life |
| What does the incisive N innervate? | the teeth |
| What nerve does the incisive N branch off of? | the inferior alveolar |
| Where is the incisive canal? | branches off the mandibular canal when incisive N branches off inferioer alveolar N |
| Where is the incisive foramen and what goes through it? | in the hard palate. Receives the nasopalatine NN and the sphenopalatine AA |
| Which bone is the incisive nerve in? | the mandbile |
| Which bone is the incisive fossa in? | the maxilla |
| The sphenopalatine N comes off of what structure? And what is its terminal branch? What could happen if you damaged this terminal branch? | pterygopalatine ganglion. Sphenopalatine N. Necrosis of 4 front teeth. |
| What are the 3 phases for swallowing? | Oral phase; Pharyngeal Phase; and Esophageal Phase |
| What is the oral phase of swallowing? | Oral phase: Moistening, mastication, trough formation making the tongue slope posteriorly using the intrinsic MM of tongue, genioglossus, styloglossus, and hypoglossus. Palatoglossus and palatopharygneus MM relax to allow mvmt of food posteriorly |
| Describe the Pharyngeal Phase of swallowing. | Pharyngeal Phase: soft palate tensed & elevated by veli palatini MM to close the nasopharynx.Stylopharyngeus, salpingopharyngeus, and palatopharyngeus move pharynx up and forward. Sequential contraction of sup, mid, inf constrictors moves through pharynx. |
| What are the intrinsic MM of the tongue function? | give shape to tongue |
| What is Hairy Tongue? | hypertrophy and elongation of filiform papillae, with a lack of normal desquamation [scraping of skin off/ brushing tongue]. Often due to poor oral hygiene. If cannot scrape off then could be immuno-compromised or have HIV. |
| What is sialolithiasis? | blocked submandibular duct due to calcium deposits. The submandibular gland swells during eating. It is located close to orifice of duct and can be gently massaged out. |
| What week of development does formation of the branchial apparatus and stomodeum occur? | fourth week as neural crest cells invade head and neck lateral to rostral foregut |
| What is the source of all connective tissue including skeletal components? | neural crest cells |
| What makes up the branchial apparatus? | branchial clefts [grooves], branchial arches, and branchial pouches |
| What are branchial clefts [grooves] derived from? | ectoderm |
| What are branchial arches derived from? | cephalic paraxial mesoderm |
| What are branchial pouches derived rom? | endoderm |
| The branchial apparatus is shaped like a figure 8. what is the divet on the lateral side? What is inside the 8? What is the divet on the medial side? | branchial groove [cleft], branchial arch, branchial pouch |
| Where do branchial arches form on the embryo? | lateral side |
| What do branchial arches form? | cartilage, muscle, arteries, and nerves |
| When does the otic placodes begin to develop and what do they form? | week 22; membranous labyrinth or inner ear |
| What does the ultriculosaccular duct connect? | the ventral and dorsal divisons of the developing inner ear |
| What does the ultriculosaccular duct become? | ductus reunions |
| During which week in development does the cartilaginous shell that forms the scala vetsibuli and scala typani form? | 10th |
| What separates the scale vestibule from the cochlear duct? | vestibular membrane |
| What separates the cochlear duct from the scala tympani? | basilar membrane |
| What is the main sensory organ of the ear? | organ of corti |
| What makes up the organ of corti? | the hair cells and the tectorial membrane |
| Sound waves vibrate the organ of corti. Then what happens? | basilar membrane vibrates which bends the hair cells against the tectorial membrane. Senseory info then goes to CN 8 and to the brain |
| When does the middle ear begin to develop?and what does it form from? | 6th or 7th week; 1st branchial pouch; |
| What does the frist branchial pouch become? | the tympanic cavity |
| The ossicles remain embedded in mesenchyme until when? | 8th month of fetal life |
| When and what from does the external ear begin to develop? | 7 week embryo has 1st pharyngeal cleft. Dorsal portion of cleft becomes external auditory meatus. |
| From what and for how long does the meatal plug form? | during 3rd month of development epithelial cells at base of meatus begin to proliferate and form meatal plug. This plug persists until 7th month when it will dissolve and leave tympanic membrane unobstructed. |
| What are auricular hillocks? | the auricle is formed from 6 auricular hillocks that begin around the neck and move superiorly to level of eye |
| What are periauricular pits and appendages? | secodndary to abnormal development of the auricular hillocks or accessory hillocks respectively. Such abnormalities are present in many chromnosomal syndromes |
| What type of cartilage makes up outer ear? | elastic cartilage |
| What are ceruminous glands? | Ceruminous glands are specialized sudoriferous glands (sweat glands) located subcutaneously in the external auditory canal. They produce cerumen or earwax which lubricates and cleans the auditory canal, and serves as a barrier to trap foreign particles |
| What is cerumen? | earwax |
| The tympanic membrane is made of 3 general layers what are they and what tissue did they come from? | outermost- cutaneous-ectoderm [very thin skin]; Middle- connective tissue- mesoderm; Innermost- mucosum- endoderm |
| The middle layer of the tympanic membrane is further broken down into 2 parts what are they? | Radiate- fibroelastic connective tissue in flaccid region; Circular- fibroelastic connective tissue |
| What is another name for the ovale window? | vestibular window |
| What is another name for the round window? | cochlear window |
| What does the tensor typani M attach to? And what does it do? | manubrium of malleus; prevents excessive oscillation of tympanic membrane |
| What does the stapes insert on? | neck of stapes |
| What is the difference between children and adult Eustachian tubes and what is this signficiance? | its shorter in children which predisposes children to middle ear infections because shorter path from pharynx to ear |
| What is colesteotoma? | Hyperkeratosis [thickening of the keratin] in middle ear. Abnormal skin growth behind tympanic membrane caused by repeated infections or tearing & pulling inward of tympanic membrane. middle ear air can be turned into a partial vacuum. Can be congenital |
| What is acute otitis media [AOM] ? | most common ear infection, parts of middle ear are infected and swollen and fluid is trapped behind the eardrum. |
| What is Otitis media with effusion [OME]? | happens after ear infection has run its course and fluid stays trapped behind the eardrum. |
| What is chronic otitis media with effusion [COME]? | happens when fluid remains in the middle ear for a long time ore returns over and over even though there is no infection. Can affect hearing and makes harder for children to fight new infections. |
| What is Mastoiditis? | caused by middle ear infection [acute otitis media] that may spread to mastoid bone [honeycomb like structure may deteriorate]. Usually affects kids. Was leading cause of death in kids before antibiotics. Caused by pseudomonas, s aureus, s pneumonia |
| What is the tympanic membrane derived from? | ectoderm, mesoderm and endoderm |
| What are accessory auricular hillocks? | skin tags around the ear |
| What is cerebelopontine angle tumor? | Slow-growing tumor of vestibularcochlear nerve. It is behind the ear right under the brain. An acoustic neuroma is not cancerous (benign), it does not spread to other parts of the body. However, it can damage several important nerves as it grows. |
| What is Tonsilitis? | Tonsillitis is inflammation (swelling) of the tonsils. Symptoms: Difficulty swallowing; Ear pain; Fever, chills; Headache; Sore throat - lasts longer than 48 hours and may be severe; |
| What is pre-septal cellulitis? | common infection of the eyelid & periorbital soft tissue. Has acute eyelid erythema & edema. bacterial infection- results from local spread of adjacent upper respiratory tract infection, external ocular infection, or following trauma to the eyelids. |
| What is Conjunctivitis? | Conjunctivitis is swelling (inflammation) or infection of the membrane lining the eyelids (conjunctiva). |
| What is a blocked tear duct? | A blocked tear duct is a partial or complete blockage in the pathway that carries tears away from the surface of the eye into the nose. Symptoms: The symptom is increased tearing, which overflows onto the face or cheek |
| What is subjective tinnitus? | the perception of sound within the human ear in the absence of corresponding external sound. most commonly results from otologic disorders – the same conditions that cause hearing loss. The most common cause is noise-induced hearing loss, |
| What is Epiglottitis? | Epiglottitis is inflammation of the tissue that covers the trachea (windpipe). It is a life-threatening disease. Symptoms: Epiglottitis begins with a high fever and sore throat. Other symptoms may include: Abnormal breathing |
| What is Parotid duct stone? | (Sialolithiasis) refers to the formation of stones in the salivary glands; pain and intermittent swelling from corner of mouth to ear. Stop drinking caffeine. Remove with lemon juice. |
| What is another name for sialolithiasis? | parotid duct stone |
| What is Herpes Zoster? | commonly known as shinglesviral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. If its on ophthalmic N it is an emergency. |
| What is Allergic rhinitis? | also known as pollenosis or hay fever, is an allergic inflammation of the nasal airways. It occurs when an allergen, such as pollen, dust or animal dander (particles of shed skin and hair) is inhaled by an individual with a sensitized immune system |
| What is Medial Medullary Syndrome? | type of alternating hemiplegiaThe infarction leads to death of thehypoglossal nerveThe condition usually consists of: a deviation of the tongue to the wrong damaged side |
| What is Sixth nerve palsy? | abducens N palsy- dysfunction of cranial nerve VI which contracts the lateral rectus M to abduct (i.e., turn out) the eye. inability of eye to turn outward results in convergent strabismus or esotropia -the primary symptom is double vision or diplopia |
| What is Branchial cleft cyst? | a lump that develops in the neck or just below the collarbone. It is a type of birth defect.Branchial cleft cysts form during development of the embryo. They occur when tissues in the neck and collarbone area (branchial cleft) fail to develop normally. |
| What is Frey’s Syndrome? | redness and sweating on cheek area adjacent to ear. Appears when person eats, sees, dreams, thinks about or talks about certain kinds of food which produce strong salivation. Observing sweating in the region after eating a lemon wedge may be diagnostic. |
| What is Oculomotor Nerve Palsy? | Extraocular muscle paralysis resulting from destructive lesions in one or all of these cranial nerves results in failure of one or both eyes to rotate in concert with the other eye.The primary symptom is diplopia |
| What is CSF leak [Spontaneous cerebrospinal fluid leak syndrome]? | medical condition in which the CSF in and around the brain & spinal cord leaks out of surrounding protective sac [dura] for no reason. Most people who develop SCSFLS feel a sudden onset of a severe and acute headache. Salty drainage in back of throat. |
| What is Allergic fungal sinusitis? | disease in which fungal debris & mucus build up in sinuses. Caused by allergic reaction to fungi that are sometimes in the air. Runny, blocked nose which may make breathing difficult. Antihistamines will not relieve. May cause eye to bulge out of socket. |
| What is Invasive fungal sinus? | Symptoms are similar to a sinus infection—congestion, facial pain and swelling, and discharge |
| What is a Deviated septum [nasal septum deviation]? | physical disorder of nose, involving a displacement of the nasal septum. most frequently caused by impact trauma, such as by a blow to the face or can be congenital caused by compression of nose during childbirth. Increased snoring and trouble breathing. |
| What are Nasal Polyps? | Nasal polyps are sac-like growths of inflamed tissue lining the nose (nasal mucosa) or sinuses. Symptoms: People with nasal polyps often complain about having a cold that has lasted for months or years. |
| What is Cleidocranial dysplasia? | Cleidocranial Dysplasia - condition characterized by defective development of the cranial bones and by the complete or partial absence of the collar bones (clavicles) |
| What is Velopharyngeal inadequacy? | malfunction of a velopharyngeal mechanism [responsible for directing the transmission of sound energy & air pressure in oral & nasal cavity. When this mechanism is impaired in some way, the valve does not fully close. cleft is the most common cause of VPI |
| What is Prolactinoma? | - benign pituitary tumor, increases prolactin in blood. Pit’s close proximity to chiasma= headaches & inhibition of vision. Treat with medication or surgery. |
| oropharyngeal candidiasis | Thrush- yeast infection of mucus membrane lining the mouth & tongue. Symptoms: whitish, velvety lesions in the mouth and on the tongue. opportunistic mucosal infection caused, in most cases, by the fungus Candida albican. Common in AIDS or HIV. |
| What is Esotropia? | a form of strabismus, or "squint", in which one or both eyes turns inward |
| What is ¬¬¬Strabismus? | a disorder in which the two eyes do not line up in the same direction, |
| What is the afferent and efferent limb of the corneal blink reflex? | afferent- nasociliary N of the ophthalmic N [sensory], efferent- facial N [orbicularis oculi] |
| What would cause decreased lacrimation in bell’s palsy? | lesion of greater petrosal N off the facial n |
| What would cause loss of taste to anterior 2/3 of tongue in bell’s palsy? | lesion to chorda tympani off the facial n |
| What is ipsilateral? | same side |
| Is central 7 ipsilateral or contralateral? | contralateral |
| What might cause bell’s palsy? | herpes simplex |
| Where is the facial N’s cutaneous innervations ? | very small amount on ear |
| What is Meckel’s cave? | trigeminal cave in middle cranial fossa |
| What nerve is damaged in Frey’s syndrome? | auriculotemporal [has parasympathetic roots to parotid gland and sympthatetic to sweat glands but they get switched] |
| What does the otic ganglion send postganglionic fibers to? | Parotid Gland |
| What does the deep auricular A supply and branch from? | Deep Auricular A [external acoustic meatus;Maxillary A |
| What does the anterior tympanic A supply and branch from? | Anterior tympanic A [ tympanic cavity and tympanic membrane]; Maxillary A |
| What goes through the inferior orbital fissure? | infraorbital vessels, maxillary N and zygomatic branch |
| Which M does the pterygoid venois plexus lay on? | medial pterygoid |
| What occupies the retromandibular space? | parotid gland |
| What covers the parotid gland? | parotid sheath which comes from the investing layer of the deep cervical fascia |
| What is another name for the parotid duct? | stensen’s duct |
| What innervates the TMJ joint? | auriculotemporal and masseteric branches of the mandibular nerve |
| What is the highest part on the sagittal suture? | vertex |
| What bone encloses theinternl ad middle ear? | petrous part of the temporal bone |
| What is the asterion? | junction of parietal, occipital and mporal bones |
| What is the inion? | most prominent point of the external occipital protuberance |
| What is anosmia ? | inability to perceive odors |
| Fracture of anterior cranial fossa causes what? | anosmia [can’t perceive odors, periorbital bruising [raccoon eyes]and CSF leakage from the nose [rhinorrhea] |
| What is CSF rhinorrhea ? | CSF leakage from the nose |
| What is a tripod fracture ? | fracture involved th e3 supports of the malar [cheek or zygomatic bone] : zygomatic processes of the temporal, frontal, and maxillary bones |
| What goes through the foramen cecum? | a small emissary vein |
| What goes throught the petrotympanic fissure? | chorda tympani |
| where does the falx cerebri attach? | crista galli |
| Where does the tentorium cerebelli attach ? | anterior clinoid processes of the lesser wing of the sphenoid |
| What is hemipalgia? | paralysis of one side of the body |
| What causes cerebral hemorrhage? | rupture of the thin walled lenticulostriate artery which is a branch of themiddle cerebral a |
| What forms CSF? | vascular choroid plexuses in the ventricles of the brain |
| What is a hemangioma ? | Tumor or abnormal buildup of blood vessels in the skin or internal organs. |
| Rupturing the cicle of willis would cause what? | a subarachnoid hemorrhage |
| What causes cavernous sinus thrombosis? | formation of a thrombus [blood clot] in cavernous sinus and is caused by bacterial infection commonly by staphylococcus |
| What is papilledema? | edema of the optic disk or nerve due to increased cranial pressure |
| What is ophthalmoplegia? | paralysis of the eye movement MM |
| What is chemosis? | swellin g of the conjunctivae |
| What is a thrombus? | blood clot |
| What do emissary vein s connect together? | dura sinuses with diploic veins of the skull |
| If you fractured the ethmoid bone what might occur? | lesion of the olfactory N cauing anosmia [loss of smell] |
| What is mydriasis? | dilation of the pupil due to disease |
| What mediates the afferent and efferent limb of the sneeze reflex? | afferent-maxillary N, efferent- vagus nerve |
| What mediates the afferent and efferent limbs of the jaw jerk reflex ? what is this reflex? | MAndibular division of Trigeminal; only done when testing damage to trigeminal N not part of normal neurologic exam |
| What does the incisive branch of the inferior alveolar N innervate? | canine and incisor teeth |
| What does the inferior dental branch of the inferior alveolar N innervate? | lower teeth |
| If there is a lesion on the trigeminal nerve what will the mandible do? | deviate to side of lesion |
| What is an ampulla? | dilated end of semicircular canal and I believe it contains hair cells |
| What makes up the pharyngeal plexus? And on what M is it on? | Vagus and Glossopharyngeal N; middle constrictor M |
| Which nerve monitors carotid sinus? | glossopharyngeal n and vagus n |
| What mediates the afferent and efferent limbs of the cough reflex? | vagus N; caused by irritation of bronchial mucosa |
| If there is a lesion to the left vagus nerve what side will the uvula deviate to ? | right |
| What is dysphonia? | difficulty speaking |
| What is aphonia? | loss of voice |
| What is torticollis? | Torticollis is a twisted neck in which the head is tipped to one side. Caused by damage to accessory n |
| What are the symptoms of blunt force to the face? | displacement of eyeball, double vision [diplopia], injury to infraorbital nerve causing loss of sensation to cheek and gum, entrapment of inferior rectus muscle so no upward gaze |
| What is papilledema? | edema of the optic disk or nerve resulting from increased intracranial pressure and icnrased CSF pressure or thrombosis of the central vein of the retina [choked disk] |
| What is intorsion? | medial [inward] rotation |
| What is extorsion? | lateral [-outward] rotation |
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