anatomy quiz 2- upper respiratory system, anterior cervical region, and internal skull and CNS

Deep cervical fascia-

Encapsulates (wraps) the sternocleidomastoid posteriorly.

Carotid sheath-

Surrounds vasculature; contains common carotid artery, vagus nerve, and internal jugular vein.

Pretracheal fascia-

Contains the thyroid gland.

Danger space-

Potential space close to airway; allows communication from neck to posterior mediastinum.

Prevertebral fascia-

Wraps muscles of cervical vertebrae (scalenes); physical boundary directing infection spread.

3 principles of the fascia planes:

1. Specific layers of deep fascia in the neck invest around muscles, blood vessels, the airway, and cervical region of the vertebral column

2. act to prevent infection from 1 area of the neck to another area

3. important in swallowing, where the esophagus and trachea can move freely

5 fascial planes in order from posterior to anterior in a sagittal view:

1. prevertebral fascia

2. danger space

3. alar fascia

4. retropharyngeal space

5. buccopharyngeal fascia

where does alar fascia start and attach to?

anterior and posterior to what?

- starts at the base of the skull and ascends down to attach to the buccopharyngeal fascia

- anterior to prevertebral fascia and posterior to buccopharyngeal fascia

Buccopharyngeal fascia-

wraps the pharyngeal constrictor muscles and buccinator muscles; continuously lateral with pretracheal fascia

Danger Space located in between ?

prevertebral fascia and the alar fascia

Retropharyngeal space located in between ?

function?

- alar fascia and buccopharyngeal fascia

- communicates with the posterior mediastinum (same as the danger space)

what does superficial fascia contain? what is it supplied by?

- platysma

- facial nerve CN VII

3 structures the cervical vertebrae contain? explain.

1. atlas- C1

2. axis- C2 (helps with pivot)

3. vertebra prominens- C7 (inferior- thorax and superior- neck)

4 structures the C4 vertebral level contains?

1. epiglottis

2. bifurcation of common carotid artery

3. carotid sinus and carotid body

4. erb's point

carotid sinus and carotid body detect ?

innervated by what ?

- carotid sinus detects blood pressure

- carotid body detects chemical composition (acid and bicarb)

- glossopharyngeal nerve (CN IX) and vagus nerve (CN X)

hyoid bone-

only bone that does NOT articulate with another bone and located at the C4 vertebral level

3 structures the thoracic inlet contains?

1. 1st rib- lateral

2. manubrium- anterior

3. 1st thoracic vertebrae (T1)- posterior

Muscles of the facial expression is supplied by ?

facial nerve- CN VII

6 major muscles of the anterior cervical region?

1. sternocleidomastoid muscle

2. platysma muscle

3. trapezius muscle

4. scalene muscle

5. suprahyoid muscle

6. infrahyoid muscle

what important structures are anterior, posterior, and lateral to the sternocleidomastoid muscle?

anterior- Platysma and anterior triangle

posterior- Erb's point and posterior triangle

lateral- trapezius muscle and external jugular vein

relationship of platysma and trapezius muscle to sternocleidomastoid muscle?

- platysma: Draping over the neck, Covering the sternocleidomastoid

- trapezius: Forms posterior border of posterior triangle

what are the scalene muscles supplied by? contain?

- ventral Rami of cervical spinal nerves

- anterior scalene muscle, middle scalene muscle, and posterior scalene muscle

explain the 5 relationships around the anterior and middle scalene muscles

1. phrenic nerve passes anterior to anterior scalene muscle

2. subclavian vein passes anterior to anterior scalene muscle

3. subclavian artery passes posterior to anterior scalene muscle and anterior to middle scalene muscle

4. brachial plexus passes posterior to anterior scalene muscle but anterior to middle scalene muscle

5. thyrocervical trunk passes anterior to middle scalene muscle

3 arteries the thyrocervical trunk supplies?

1. suprascapular artery

2. transverse cervical artery

3. inferior thyroid artery

infrahyoid muscle function:

what are the 4 muscles? explain.

- depression of the laryngeal apparatus

- lateral: Omohyoid muscle and sternohyoid muscle

- medial: thyrohyoid and sternothyroid (does NOT attach to hyoid bone)

suprahyoid muscles function:

what are the 4 muscles? explain.

- elevate the laryngeal apparatus

1. mylohyoid muscle and anterior belly of digastric muscle- supplied by CN5 V3 (trigeminal nerve and mandibular nerve)

2. Stylohyoid muscle and posterior belly of digastric muscle- supplied by CN 7 (facial nerve)

3 key muscles of the facial expression? what are their functions?

innervated by?

1. buccinator muscle- control air coming into the oral cavity and moves food into oral cavity

2. Orbicularis Oris- surrounds the lips, necessary to form a seal around straw during drinking

3. Platysma- superficial muscle

- supplied by CN VII (facial nerve)

2 muscles of mastication?

innervated by?

- temporalis and masseter- contracts when clench your teeth

- supplied by CN V3 Trigeminal nerve (mandibular)

2 structures in the posterior triangle of the neck? explain

1. Erb's Point- C4 vertebral level; pressure point where all nerves are coming out

2. external jugular vein- passing lateral to the sternocleidomastoid muscle

structure in the superficial part of the posterior neck?

where does this stem from?

- erb's point

- Cutaneous nerves of the cervical plexus (C1-C4 ventral rami)

spinal accessory nerve CN XI supply? stem from?

- supplies sternocleidomastoid muscle and trapezius muscle

- cutaneous nerves of the plexus

6 structures that the deep part of the posterior neck contain?

1. scalene muscles

2. subclavian vessels

3. brachial plexus

4 cervical plexus

5. transverse cervical artery

6. suprascapular artery

4 vessels associated with anterior cervical region and the thorax?

1. phrenic nerve

2. vagus nerve

3. sympathetic trunk

4. left recurrent laryngeal nerve

what does the vagus nerve travel with?

internal jugular nerve and common carotid artery

what are the sections of the subclavian artery and their branches?

1. 1st part- vertebral artery, thyrocervical trunk, and internal thoracic artery

2. 2nd part- costocervical trunk

3. 3rd part- no branches but supplies the upper extremities and crosses the 1st rib

what does the hypoglossal nerve supply?

what cranial nerve is it?

- supplies motor to the muscles of the tongue

- CN XII

hypoglossal orientation (superior, inferior, medial, and lateral)

- superior: posterior belly of digastric muscle and stylohyoid muscle

- inferior: ansa cervicalis and superior laryngeal artery

- medial: carotid artery

- lateral: internal and external jugular vein and sternocleidomastoid muscle

ansa cervicalis supply?

- motor to the infrahyoid muscles

cervical pleura location? 2 functions? what 5 things does it prevent?

- extends above the 1st rib

- 1. lines and protects the apex of the lung (more vulnerable part) 2. anchors the lungs in thoracic cavity

- pneumothorax, hemothorax, nerve damage to brachial plexus, damage to lung, entering the subclavian artery

3 structures in the anterior triangle of the neck?

1. internal jugular vein

2. internal carotid artery- no branches in neck

3. external carotid artery- has branches

3 structures of the carotid sheath? what is each of their location in sheath and what they contain?

1. internal jugular vein- lateral; contains lymph nodes

2. vagus nerve- posterior; contains sympathetics

3. common carotid artery- left side of body; contains internal and external carotid artery

3 structures posterior to carotid sheath? explain

1. cardiac nerves- comes off superior and middle cervical ganglia and travels down into the mediastinum; supplies the heart

2. superior cervical ganglion- geared towards the head and neck region

3. inferior cervical ganglion- fused with 1st sympathetics

3 nerves associated with the common carotid birfucation?

1. Hypoglossal nerve CN XII- passing lateral to mainly external and some internal

2. Vagus nerve

3. Spinal Accessory Nerve CN XI- passing posterior to internal jugular vein

3 structures associated with the sensory to the head and neck region?

1. CN V1, V2, V3 are supplied by the Trigeminal Nerves

2. Cervical plexus

3. Dorsal Remi of spinal nerves

ONLY name the 6 branches of the external carotid artery:

1. superficial temporal artery

2. maxillary artery

3. occipital artery

4. facial artery

5. lingual artery

6. superior thyroid artery

explain the first 3 branches of the external carotid artery

1. superficial temporal artery- contains the parotid duct that connects the salivary gland and oral cavity

2. maxillary artery

3. occipital artery- supplies the back of the head; pass lateral to the internal jugular vein and sternocleidomastoid mm and crosses with the hypoglossal nerve

explain branches 4-6 of external carotid artery:

4. facial artery- supplies the face

5. lingual artery- supplies the tongue

6. superior thyroid artery- supplies thyroid gland and anastomoses with inferior thyroid

what is a branch of the superior thyroid artery? what does it run with?

- superior laryngeal artery

- internal branch of superior laryngeal nerve CN X

where does the spinal cord end at?

what are 3 major structures of the spinal cord?

- intervertebral disc between L1 and L2 vertebra

1. dorsal horn- sensory

2. ventral horn- motor

3. white matter

functions of the white matter and gray matter:

- white: axons that convey afferent signals to the higher order centers and efferent signals to the effector neurons

- gray: synapses occurs here

3 functions of the spinal cord meninges:

1. cover and protect the CNS

2. enclose and protect blood vessels that supply the CNS

3. contains the CSF

describe the 3 layers of meninges:

1. Dura Mater- outside layer; tough mater; anchors the spinal cord in vertebral canal

2. Arachnoid Mater- spider mater; contains the sub-arachnoid mater for CSF

3. Pia Mater- intimate mater; connected with nervous tissue of spinal cord

what is the difference between the neurocranium and viscerocranium?

1. neurocranium (cranial vault)- contains cranial bones, calvaria (skull cap), and cranial base (brain)

2. viscerocranium (facial skeleton)- contains 15 bones, facial expression, and associated with airway, specifically the maxilla

name the 6 major bones of the cranium (skull):

1. maxilla

2. nasal bone

3. zygomatic- cheekbone

4. mandible- jaw

5. lacrimal

6. mastoid process of temporal bone

what is the sutures of the skull's function?

what are the 5?

- structures come together to fuse into a fibrous joint until fixed

1. coronal suture 2. sagittal suture 3. squamous suture 4. lamba suture 5. pterion

what does each of the 5 sutures of the skull separate?

1. coronal suture- separates frontal bone from parietal bone

2. sagital suture- separates left and right parietal bones

3. squamous suture- separates temporal bone and parietal bone

4. lamba suture- separates parietal bone and occipital bone

5. pterion- fuses frontal, temporal, parietal, and sphenoid bone together

what artery supplies the pterion? where is ti located?

- middle meningeal artery

- Deep and inside of the skull between the bone and periosteal layer of dura mater

what are the 3 Fossas in the internal cranial cavity? what does each contain?

1. Anterior Cranial Fossa → contains the sphenoid bone, ethmoid bone, and frontal bone

2. Middle Cranial Fossa → contains sphenoid bone, and temporal bone; many nerves and blood vessels

3. Posterior Cranial Fossa → contains most of the brainstem and cranial nerves coming off the CNS

3 structures in the cranial base?

1. foramen magnum 2. carotid canal 3. jugular foramen

what is the foramen magnum contain? what is the relationship with it?

- contains the medulla and spinal cord

- the medulla connects with the spinal cord to descend to the vertebral canal

what does the carotid canal contain? location?

- contains internal carotid artery: comes off the common carotid artery (and external does as well- from the bifurcation)

- posterior to jugular foramen

what 4 vessels does jugular foramen contain? what do those supply and innervate?

1. internal jugular vein- carries venous blood from cranial cavity; connects with the jugular foramen

2. Glossopharyngeal (CN IX)- supplies sensory to pharynx and innervates carotid sinus and carotid body

3. Spinal accessory nerve (CN XI)- supplies sternocleidomastoid and trapezius

4. Vagus nerve (CN X)- innervates motor nerves to the pharynx and larynx and supplies visceral sensory and visceral motor to the thoracic organs and abdominal organs all the way to left colic flexure

what are the 7 layers of the scalp and meninges going from superficial to deep? explain

1. skin

2. CALP- has connective tissue, aponeurosis, and periosteum

3. bone

4. periosteal dura mater

5. meningeal dura mater

6. arachnoid mater

7. pia mater

what is the difference between periosteal dural mater and meningeal dura mater? how are they similar?

- Periosteal Dura Mater- closely associated with the bone and scalp

- meningeal dura mater- closely related with CNS

- can fuse together, but the separation of these maters are the dural venous sinuses

3 characteristics of the pia mater?

1. closely related to CNS tissue

2. blood vessels travel with arachnoid mater

3. in the capillaries here, both the arachnoid mater and pia mater help form the blood-brain barrier

dural folds-

meninge dura fuse together to create the dural folds and help separate different parts of the CNS

what is the difference between Falx Cerebri and Tentorium cerebelli?

1. separates the left and right hemispheres of the brain; superior- superior sagittal sinus located; connects the crysta galli, which is part of the ethmoid bone and attaches to the tentorium cerebelli

2. separates cerebellum from occipital lobe; inferior- cerebellum

what are the 4 parts of the CNS? contain? function?

1. Telencephalon- contains the cortex and basal nuclei

2. Diencephalon- contains the thalamus- relay centers and where the autonomic and hormonal regulation centers

3. Brainstem- majority of the cranial nerves and autonomic functions are coming off of. Regulates our state of consciousness

4. Cerebellum- controls motor techniques or patterns (dancing or sports)

Functional parts of the Cerebral Cortex:

1. Frontal Lobe: Planning, personality, goals, and movement

2. Parietal lobe: Awareness, sensation (general or somatic), and location of objects

3. Temporal Lobe: Memory, understanding, language, form of objects, and emotions

4. Occipital Lobe: ONLY vision

what is the difference between the brainstem functions and the cerebellum functions?

1. brainstem- Largely autonomic functions and cranial nerve functions (medulla- respiratory centers, midbrain, pons)

2. Comparator for motor coordination and training and making sure planned movements are executed correctly

2 functions of the dural venous sinuses

1. Formed from the separation of the periosteal and meningeal layers of dura mater

2. Allows flow of venous blood from the brain

describe the 4 structures of the dural venous sinus

1. Superior Sagittal Sinus- drains venous blood posteriorly (directly deep of bone)

2. Straight Sinus- meets up with superior sagittal sinus and drains into confluence of sinus

3. Confluence of sinus- where the straight sinus and superior sagittal sinus meet up and moves blood out laterally to the transverse sinus

4. Inferior sagittal sinus- drains into the straight sinus

what is the dural venous sinus drainage process?

1. Straight sinus- blood moves into confluence of sinus

2. Confluence of sinus- blood moves laterally to transverse sinus

3. Transverse sinus- blood moves to the sigmoid sinus

4. Sigmoid sinus- blood exits the jugular foramen, then drains into the internal jugular vein (basically the movement from brain to neck)

what is cerebrospinal fluid? where is it produced? where is it found?

- blood filtrate that helps cushion and nourish the CNS tissue

- produced in ventricular system of CNS

- found in sub-arachnoid space

what is the chorid plexus? where is the chorid plexus found?

- specialized capillaries that allow CSF to filtrate the blood

- found in the ventricular system spaces

describe how CSF is created and how it gets returned to the dural venous sinus

1. CSF produced in Choroid Plexus

2. CSF flows through the ventricles

3. CSF flows through the sub-arachnoid space (continuous with brain and spinal cord- not a separate space)

4. CSF reabsorbed into the venous blood via arachnoid granulations

Arachnoid granulations-

little out-pocketings of arachnoid matter that ascend into dural venous sinus to allow for CSF to drain into dural venous sinus

major blood supply to the meninges? what does it supply?

- Middle Meningeal Artery- supplies pterion, travels to lateral parts of the skull (the pterion)

- If ruptured, then brain bleed occurs

2 MAJOR arteries that supply the brain and brainstem? where do they come off of?

1. internal carotid artery- comes off bifurcation of common carotid artery

2. vertebral artery- comes off subclavian artery

2 characteristics about the vertebral artery?

1. gains access to the cranial vault

2. travel superiorly on the left and right sides until they fuse in the midline to become the basilar artery

what are the 3 branches of the internal carotid artery? what do they supply?

1. Opthamalic artery- supply nasal cavity

2. middle Cerebral artery- supplies lateral part of brain

3. Anterior Cerebral artery- supplies medial frontal lobe

anterior communicating artery branch off of? function?

- anterior cerebral artery

- connects the right and left sides of the anterior cerebral artery

what is the main branch of the vertebral artery? what is posterior and anterior? travels where?

- Basilar artery

- posterior- cerebral artery (supplies posterior parts of cerebral)

- anterior- pons

- travels upwards and terminates as the posterior cerebral artery

what are 3 branches of the Basilar artery? what do they supply?

1. posterior cerebral artery- supply parts of the cerebrum

2. posterior communicating artery- connects the vertebral system of circulation with the internal carotid circulation

3. Superior Cerebellar artery- comes off the posterior cerebral artery and travels to the cerebellum

what are Cranial Nerves 1-3? function?

CN1- olfactory nerves- detect smell and located in the nasal cavity

CN2- optic nerve

CN3- Oculomotor nerve- parasympathetics

what are Cranial Nerves 4-6? function?

CN4- Trochlear nerve

CN5- Trigeminal nerve- supply parts of the nasal cavity

CN6- abducens nerve

what are the V1, V2, and V3 nerves?

V1- opthalmic nerve

V2- maxillary nerve

V3- mandibular nerve

what are Cranial Nerves 7-9? function?

CN7- facial nerve

CN8- Vestibulocochlear nerve

CN9 - Glossopharyngeal nerve

what are Cranial Nerves 10-12? function?

CN10- Vagus nerve

CN11- Spinal accessory nerve - travels into the sternocleidomastoid muscle

CN12- Hypoglossal nerve- Lateral to internal and external carotid artery and travels to the tongue muscles

epidural hemtoma-

how is this compared to subdural hematoma? symptoms?

- forming between bone and dura mater, where the middle meningeal artery is, so if it ruptures, then you have an epidural hematoma

- More acute because the arteries have very high pressure, so they release blood very quickly

- pass out, loss of consciousness quickly

suburdal hematoma-

dural venous sinus ruptures and blood is in between the dural mater and arachnoid mater

sub-arachnoid hematoma-

blood being released in the sub-arachnoid space (where the CSF)

6 structures in the airway? explain

1. nasal cavity- posterior to nose; 1st part of airway

2. pharynx- communicate with larynx; both oral and nasal cavities open posteriorly to pharynx

3. oral cavity- separates airway and foodway; hard and soft palate

4. larynx- communicate with pharynx posteriorly

5. trachea- inferior to larynx

6. esophagus- inferior to pharynx

why are the structures involved in the airrway so important?

1. breathing- O2 in with conditioning the air

2. smelling- indicates movement towards or away from something

3. elimination- CO2 out

3 structures associated with the nose and nasal cavity:

1. ala- wing of nose

2. external naris- enter the nose

3. apex

what are the 5 cartilaginous parts of the nose?

2 lateral, 2 alar, 1 septal

nasal septum-

3 structures that make up the septum?

- separates the left and right nasal cavities

1. septal cartilage- forms septal

2. ethmoid bone- perpendicular palate

3. Vomer- bone onto itself

5 structures associated with the lateral wall of septum (aka paranasal sinus)

1. frontal bone- forms superior part of paranasal cavity

2. ethmoid bone- contributes to medial and lateral walls

3. Sphenoid bone- posterior wall

4. maxillary bone- hard palate part, lateral wall part

5. nasal cartilages

2 arteries that supply the medial wall of nasal cavity AND lateral? where do they branch from? what specifically do they supply?

1. Ophthalmic artery- branch of internal carotid artery; supplies superior and anterior parts

2. maxillary artery- branch of external carotid artery; supplies posterior and inferior parts

3 vessels associated with the venous drainage of nasal cavity?

1. Cavernous sinus

2. facial vein- can help drain nasal cavity

3. Pterygoid plexus of veins- deep to mandible