Head and Neck

What part of the skull encases the brain?

Neurocranium

What are the unpaired bones of the neurocranium?

Frontal, sphenoid, occipital, ethmoid

What are the paired bones of the neurocranium?

Temporal, parietal

What part of the skull encases the facial organs?

Viscerocranium

What are the unpaired bones of the viscerocranium?

Mandible, vomer, ethmoid

What are the paired bones of the viscerocranium?

Temporal, maxillae, inferior nasal conchae, zygomatic, palatine, nasal, lacrimal

What bones are involved in both the neurocranium and vsicerocranium?

Ethmoid and temporal bones

What suture closes in the first year?

Metopic

What suture closes around age 24?

Coronal

What suture closes between age 21-30?

Sagittal

What suture closes around age 26?

Lambdoid

What is the name for the fibrous, immobile joints between most skull bones?

Suture

What is a weak point in the skull?

Pterion

What is the clinical concern of the pterion?

Fractures can lead to hematoma from branches of underlying middle meningeal arteries

What are the ‘true’ sutures?

Serrate

Denticulate

Limbous

What are the ‘false’ sutures?

Squamous

Plane/harmonia

What sutures interlock?

True sutures

What sutures overlap?

False sutures

What is the embryonic origin of the anterior skull?

Neural crest cells and pharyngeal arches

What is the embryonic origin of the posterior skull?

Paraxial mesoderm

Describe the endochondral ossification of the skull.

Bones - base of skull

Joint type: synchondrosis

Describe the intramembranous ossification of the skull.

Bones - most other skull bones

Joint type: sutures

What kind of ossification is affected by achondroplasia?

Endochondral

What condition causes early fusion of epiphysis in limb bones and synchondroses of skull bones?

Achondroplasia

What condition affects bones associated with intramembranous cranial vault?

Craniosynostosis

What does premature fusion of sutures result in?

Cranial deformities

What bones make up the anterior cranial fossa?

Frontal, ethmoid, and sphenoid bones

What does the anterior cranial fossa house?

Frontal lobe (olfactory bulb, attachment for falx cerebri)

What bones make up the middle cranial fossa?

Temporal, sphenoid, parietal bones

What does the middle cranial fossa house?

Pituitary gland

Temporal lobes

Cranial nerves 2-6

What cranial fossa houses cranial nerves 2-6?

Middle cranial fossa

What bones make up the posterior cranial fossa?

Sphenoid, temporal, occipital bones

What is found in the posterior cranial fossa?

Cerebellum

Pons

Medulla

Internal acoustic meatus (CN 7 and 8)

Foramen magnum

Jugular foramen (CN 9-11)

Hypoglossal canal (CN 12)

What portion of the temporal bone houses the inner ear structures?

Petrosal portion

What is the ONLY movable joint in the adult skull?

temporomandibular joint (TMJ)

What are the articulations of the TMJ?

Mandibular fossa and articular tubercle of temporal bone

Mandibular condyles of mandible

What are the divisions of the trigeminal nerve?

Ophthalmic

Maxillary

Mandibular

What does the ophthalmic division supply?

Nose (apex), orbit, eye, forehead

What kind of innervation does the trigeminal nerve supply?

Motor

What kind of innervation do the cutaneous branches of cervical plexus provide?

Sensory

What does the maxillary division provide motor innervation to?

Upper lip, nose, anterior temporal region

What does the mandibular division provide motor innervation to?

Lower lip, anterior auricle, temporal region

What are the cutaneous branches of cervical plexus?

Great auricle (C2, C3)

Lesser occipital (C2)

What rami create the great auricular nerve?

C2 and C3

What ramus creates the lesser occipital nerve?

C2

What does the great auricular nerve provide sensory innervation to?

Skin around parotid and auricle

What does lesser occipital cutaneous branch of the cervical plexus innervate?

Skin behind auricle

What is the clinical term for compression of cranial nerve 5, usually by an artery or vein?

Trigeminal neuralgia

What symptoms accompany trigeminal neuralgia?

Sudden and severe sharp facial pain (wince, usually lasts 15+ minutes)

What division is commonly affected by trigeminal neuralgia?

Maxillary division (V1)

What are muscles of facial expression derived from?

Second pharyngeal arch

What do muscles of facial expression originate from?

Fascia and bone

What do muscles of facial expression insert in?

Skin

What is unique about muscles of facial expression?

Do not connect two bones together

What muscles do not have any bony attachment?

Procerus, risorius, orbicularis oris

What is the motor innervation to the muscles of facial expression?

Facial nerve (CN 7)

What is the ‘great motor nerve of the face’?

Facial nerve (CN 7)

What is the sensory innervation to the muscles of facial expression?

Trigeminal nerve (CN 5)

What is the great sensory nerve of the face?

Trigeminal nerve (CN 5)

Where does the facial nerve exit?

Stylomastoid foramen

Where does the facial nerve branch?

Parotid gland

What are the branches of the facial nerve?

Temporal

Zygomatic

Buccal

Mandibular

Cervical

Posterior auricular branch

What condition is associated with facial muscle paralysis?

Bell’s Palsy

What causes the paralysis of facial muscles in Bell’s Palsy?

LMN lesion

T/F: 80% of affected individuals make a full recovery from Bell’s Palsy.

True

What is the layers of the scalp?

SCALP:

Skin

Dense connective tissue

Epicranial aponeurosis

Loose connective tissue

Pericranium

In what layer of the scalp can infection and fluid fill the potential space?

Loose connective tissue

What layer of the scalp allows for movement of the scalp?

Loose connective tissue

What layers of the scalp are well-vascularized?

Skin and dense connective tissue

What layer of the scalp is well-innervated?

Dense connective tissue

What layer of the scalp is involved in the neurocranium?

Pericranium

What vessels provide arterial supply to the face?

Facial and superficial temporal arteries

What branch gives off the transverse facial artery?

Superficial temporal

What is the ophthalmic artery a branch of?

Internal carotid artery

Describe the facial vein.

Medial aspect of the eye

Descends laterally to internal jugular vein

Describe the retromandibular vein

Superficial temporal and maxillary veins unite

Both anterior and posterior divisions

What does the anterior division of the retromandibular vein drain into?

Internal jugular vein

What does the posterior division of the retromandibular vein drain into?

External jugular vein

Where is lymphatic drainage of the head directed toward?

Superficial ‘collar chain’ of lymph nodes

Where is the ‘collar chain’ of lymph nodes found?

Junction of head and neck

What are the main lymph nodes of the head?

Submental

Submandibular

Parotid

Retromandibular

Occipital

What kind of motor function does the parotid region have?

Secretomotor

What nerve provides sympathetic innervation of the parotid region?

Glossopharyngeal nerve (CN 9)

Where do the preganglionic fibers from foramen ovale (lesser petrosal nerve) synapse in?

Otic ganglion

What do postganglionic fibers from the parotid region ‘hitch a ride’ on?

Auriculotemporal nerve (V3)

What provides sensory innervation to the parotid region?

Auriculotemporal nerve

What muscles does the parotid duct pass over?

Masseter and buccinator

What does the parotid duct open into?

Oral vestibule

Where in the oral vestibule does the parotid duct open into?

2nd maxillary molar over posterior 1/3 of the tongue

What provides sensory innervation to the parotid gland?

Great auricular nerve (cervical plexus)

Auriculotemporal nerve (V3)

What cranial nerve should be associated with the auriculotemporal nerve?

CN 9

What structures are found within the parotid gland?

Lymph nodes

Facial nerve and branches

External carotid artery

Retromandibular vein

Great auricular nerve (C2 and C3)

Auriculotemporal nerve (V3)

In what condition is the parotid glands swollen?

Mumps

What bones form the floor of the temporal fossa?

Frontal, parietal, sphenoid, and temporal

What muscles are found in the temporal region?

Temporalis and masseter

What form the roof of the temporal fossa?

Temporal fascia

Investing deep fascia of the temporalis muscle

What is the insertion of the temporalis muscle?

Coronoid process

What are the contents of the infratemporal region?

Inferior portion of temporalis

Lateral/medial pterygoids

Maxillary vein and artery

Pterygoid venous plexus

Mandibular division of V3

Chorda tympani (CN VII)

Otic ganglion

What forms the lateral boundary of the infratemporal region?

Internal surface of ramus of mandible

What forms the inferior boundary of the infratemporal region?

Medial pterygoid attachment to mandible