Practical Lab 4

Most Lab 4 tags are an opening plus ______, a meningeal space plus ______, or a facial muscle plus ______

What passes through it; the vessel that bleeds into it; CN VII

Anterior cranial fossa contents: ______

Frontal lobes

Middle cranial fossa contents: ______

Temporal lobes (pituitary in sella turcica)

The pituitary sits in the ______ of the middle cranial fossa

Sella turcica

Posterior cranial fossa contents: ______

Cerebellum, pons, medulla

Cribriform plate contents: ______

CN I

Cribriform plate fracture: ______ and ______

Anosmia, CSF rhinorrhea

Optic canal contents: ______

CN II and ophthalmic artery

Superior orbital fissure contents: ______

CN III, IV, V1 (CN V), VI; superior ophthalmic vein

Foramen rotundum contents: ______

V2 (CN V)

Foramen ovale contents: ______

V3 (CN V)

Carotid canal contents: ______

Internal carotid artery

Internal acoustic meatus contents: ______

CN VII and VIII

Jugular foramen contents: ______

CN IX, X, XI; IJV (sigmoid sinus)

Hypoglossal canal contents: ______

CN XII

Foramen magnum contents: ______

End of medulla–beginning of spinal cord, vertebral arteries, spinal roots of CN XI

V1 / V2 / V3 exit through: ______ / ______ / ______

Superior orbital fissure / foramen rotundum / foramen ovale

Pterion: H-shaped junction of the ______, ______, ______, and ______ bones

Frontal, parietal, temporal, sphenoid

Pterion bone is thin and overlies the ______

Middle meningeal artery

A blow to the pterion causes a(n) ______ hematoma

Epidural

SCALP layers: S = ______

Skin

SCALP layers: C = ______

Dense connective tissue

SCALP layers: A = ______

Epicranial aponeurosis

SCALP layers: L = ______

Loose areolar tissue

SCALP layers: P = ______

Pericranium

The "danger space" of the scalp where infection spreads is the ______ layer

Loose areolar tissue

Dura mater: tough, fused to the skull's ______

Inner periosteum

Arachnoid mater: thin, lies against the ______

Dura

Pia mater: adheres to the ______ and follows its ______

Brain surface; gyri

CSF pathway (in order): ______

Choroid plexus of lateral ventricles → interventricular foramina → third ventricle → cerebral aqueduct → fourth ventricle → median and lateral apertures → subarachnoid space → arachnoid granulations → superior sagittal sinus → circulation

CSF is produced by the ______ of the lateral ventricles

Choroid plexus

Lateral ventricles → ______ → third ventricle

Interventricular foramina

Third ventricle → ______ → fourth ventricle

Cerebral aqueduct

Fourth ventricle → ______ → subarachnoid space

Median and lateral apertures

Subarachnoid space → ______ → superior sagittal sinus

Arachnoid granulations

Epidural hemorrhage space: ______

Between skull and dura

Epidural hemorrhage vessel: ______

Middle meningeal artery

Epidural hemorrhage clues: ______

Temporal fracture; lucid interval; lens-shaped

Subdural hemorrhage space: ______

Between dura and arachnoid

Subdural hemorrhage vessel: ______

Bridging cerebral veins

Subdural hemorrhage clues: ______

Older adults, alcohol use, infants; crescent-shaped

Subarachnoid hemorrhage space: ______

Subarachnoid space

Subarachnoid hemorrhage vessel: ______

Ruptured berry aneurysm

Subarachnoid hemorrhage clue: ______

"Worst headache of my life"

Lens-shaped bleed = ______; crescent-shaped bleed = ______

Epidural; subdural

Cavernous sinus lateral wall contains: ______

CN III, IV, V1, V2

Passing through the cavernous sinus itself: ______ and ______

CN VI and the internal carotid artery

In cavernous sinus pathology, ______ is usually affected first

CN VI

Danger triangle infection spreads by: ______ → ______ → cavernous sinus

Facial vein → superior ophthalmic vein

Danger triangle infection also spreads by the ______ → ______

Deep facial vein → pterygoid plexus

Orbicularis oculi action: ______

Closes the eye

Orbicularis oris action: ______

Closes and purses the lips

Buccinator action: ______

Presses the cheek against the teeth

Platysma action: ______

Tenses neck skin

Orbicularis oculi, orbicularis oris, buccinator, and platysma are all supplied by ______

CN VII

Parotid duct: crosses ______, pierces ______, opens opposite the ______

Masseter; buccinator; 2nd maxillary molar

Five branches of CN VII in the parotid: ______

Temporal, zygomatic, buccal, marginal mandibular, cervical

V1 sensory territory: ______

Forehead and upper eyelid

V1 test: ______

Forehead, corneal reflex

V2 sensory territory: ______

Cheek and upper lip

V2 test: ______

Over maxilla

V3 sensory territory: ______

Lower lip and chin

V3 test: ______; motor test: ______

Chin; clench jaw

Supraorbital foramen: ______ nerve (______)

Supraorbital nerve (V1)

Infraorbital foramen: ______ nerve (______)

Infraorbital nerve (V2)

Mental foramen: ______ nerve (______)

Mental nerve (V3)

Bell palsy is a ______ motor neuron lesion of CN VII

Lower

Bell palsy weakness: ______

Whole same-side face, forehead included

Cortical lesion (e.g., stroke) is an ______ motor neuron lesion

Upper

Cortical (UMN) lesion weakness: ______

Only the opposite lower face; forehead spared

In a cortical lesion, the forehead is spared because ______

Its motor neurons get input from both hemispheres

Extraocular nerve rule: ______

LR6 SO4, all others CN III

Lateral rectus nerve: ______

CN VI

Superior oblique nerve: ______

CN IV

Levator palpebrae superioris nerve: ______

CN III

Cardinal position out = ______

Lateral rectus

Cardinal position in = ______

Medial rectus

Cardinal position up and out = ______

Superior rectus

Cardinal position down and out = ______

Inferior rectus

Cardinal position up and in = ______

Inferior oblique

Cardinal position down and in = ______

Superior oblique

Tear flow (in order): ______

Lacrimal gland → eye surface → lacrimal puncta → canaliculi → lacrimal sac → nasolacrimal duct → inferior nasal meatus

The nasolacrimal duct drains into the ______

Inferior nasal meatus

CN III palsy: ______

Eye down and out, ptosis, dilated pupil

CN IV palsy: ______

Vertical diplopia, worse looking down (stairs, reading); head tilts away

CN VI palsy: ______

Eye turned in; cannot abduct

Anterior 2/3 tongue general sensation: ______

Lingual nerve (V3)

Anterior 2/3 tongue taste: ______

Chorda tympani (VII)

Posterior 1/3 tongue sensation and taste: ______

CN IX

Tongue motor: ______, except ______

CN XII, except palatoglossus (CN X)

Palatoglossus nerve: ______

CN X

Unilateral CN XII lesion: tongue deviates ______ the lesion

Toward

Nose: superior and middle conchae are part of the ______

Ethmoid

Nose structures: ______, superior and middle conchae, ______

Septum; inferior concha

Four paranasal sinuses: ______

Frontal, ethmoidal, sphenoidal, maxillary

Children get otitis media because the pharyngotympanic tube is ______

Shorter, wider, and more horizontal