Regional Final 2

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266 Questions

Which muscle is embedded in the superficial fascia of the neck?

Platysma

Which muscle group is not a part of the anterior neck musculature?

Lateral vertebral muscles

Which triangle extends from the anterior midline to the anterior border of the sternocleidomastoid muscle?

Anterior triangle

Which vein drains the scalp posterior and superior to the auricle?

External jugular vein

What forms the anterior boundary of the carotid triangle?

Superior belly of omohyoid

Which muscle divides the posterior triangle of the neck into occipital and supraclavicular triangles?

Inferior belly of omohyoid

Which vein descends obliquely, superficial to the sternocleidomastoid, toward the middle of the clavicle?

External jugular vein

Which artery is a content of the carotid triangle?

Common carotid artery

What forms the lateral boundary of the submental triangle?

Anterior bellies of digastric muscles

Which vein is a tributary of the external jugular vein?

Transverse cervical vein

Which nerve is a content of the carotid triangle?

Vagus nerve

Which muscle is a content of the muscular triangle?

Sternohyoid

What forms the apex of the posterior triangle of the neck?

Union of the sternocleidomastoid and the trapezius muscles

Which vein is a tributary of the internal jugular vein?

Superior thyroid vein

Which artery is a content of the posterior triangle of the neck?

Subclavian artery

Which muscle is responsible for drawing down the lower lip and angle of the mouth?

Sternocleidomastoid

Which nerve innervates the sternocleidomastoid muscle?

Accessory nerve

Which muscle elevates the hyoid and depresses the mandible?

Digastric

Which muscle originates from the styloid process and elevates the hyoid bone?

Stylohyoid

Which muscle is involved in lateral flexion of the neck and elevation of the 1st and 2nd ribs?

Scalenus anterior

Which triangle contains the submandibular gland, facial vessels, submandibular lymph nodes, hypoglossal nerve, and mylohyoid nerve and vessels?

Submandibular triangle

What divides the anterolateral part of the neck into anterior and posterior triangles?

Sternocleidomastoid

Which muscle is responsible for stabilizing the larynx?

Sternohyoid

Which muscle consists of posterior and anterior bellies connected by an intermediate tendon?

Digastric

Which muscle depresses the hyoid and stabilizes the larynx?

Sternothyroid

Which triangle is bounded by the midline of the neck, anterior border of the sternocleidomastoid, and inferior border of the body of the mandible?

Anterior triangle

Which muscle originates from the sternum and clavicle and inserts onto the mastoid process and superior nuchal line?

Sternocleidomastoid

Which symptom is commonly associated with subclavian steal syndrome?

Ataxia

What is the Latin meaning of the term 'vagus' in the context of the vagus nerve?

Wandering

What is the primary function of the vagus nerve?

Supplying parasympathetic innervation to organs

What is the clinical manifestation of vasovagal syncope?

Momentary loss of consciousness

How is subclavian steal syndrome commonly diagnosed?

Doppler ultrasound of the neck arteries

What characterizes Grade 3 subclavian steal syndrome?

Permanent retrograde blood flow

Which of the following is innervated by the vagus nerve?

Heart rate

What is the primary nerve of the parasympathetic nervous system?

Vagus nerve

Where does the common carotid artery bifurcate into the internal and external carotid arteries?

Between the hyoid bone and thyroid cartilage

Which nerve is embedded in the body of the carotid sheath?

Vagus nerve

At which level does the right subclavian artery begin?

Posterior to right sternoclavicular joint

Which artery may originate from the 1st part of the subclavian artery?

Costocervical trunk

Where does the vertebral artery originate from?

1st part of the subclavian artery

Where does the 4th (intracranial) part of the vertebral artery ascend into?

Cranial cavity via foramen magnum

What syndrome is characterized by subclavian artery stenosis?

Subclavian steal syndrome

Where is the ansa cervicalis embedded?

In the body of the carotid sheath

What is the content of the suboccipital triangle?

3rd part of the vertebral artery

Which artery is a branch of the external carotid artery?

Maxillary artery

Where does the left subclavian artery begin?

In the superior mediastinum

Which artery runs superiorly and posteriorly from the subclavian artery to the transverse foramen of C6?

1st (prevertebral) part of the vertebral artery

Which cartilage is shaped like a signet ring with a narrow anterior arch and wider posterior lamina?

Cricoid cartilage

What is the attachment point for the sternothyroid, thyrohyoid, and inferior pharyngeal constrictor muscles on the thyroid cartilage?

Oblique line

Which cartilage forms a leaf-shaped plate of elastic cartilage that stands almost vertically posterior to the root of the tongue and hyoid bone?

Epiglottis

Which paired cartilage is located superior to the cricoid cartilage and has a small articular facet for the base of the arytenoid cartilage?

Arytenoid

Which nerve supplies the cricothyroid muscle?

Superior laryngeal nerve

Which artery accompanies the internal laryngeal nerve?

Superior thyroid artery

Where does the thyroid gland originate from?

Endoderm of the floor of the pharynx

Which type of thyroid cancer develops from C cells?

Medullary

Where are the parathyroid glands located?

Posterior to the thyroid gland

What is the primary function of the hormone calcitonin secreted by the thyroid gland?

Lowers blood calcium levels

Which artery may be present in approximately 10% of people as a branch of the subclavian artery?

Thyroid ima artery

Which vein drains into the internal jugular vein?

Superior thyroid vein

What is the primary function of the vagus nerve in the neck region?

Innervates the laryngeal muscles

Which type of thyroid cancer is characterized by rapid growth and poor differentiation?

Anaplastic

Where do the inferior thyroid veins drain into?

Brachiocephalic vein

What is the primary function of the hormone secreted by the parathyroid glands?

Increases blood calcium levels

Which nerve innervates the intrinsic laryngeal muscles responsible for specific movements related to phonation and respiration?

Vagus nerve

What is the primary function of the cricothyroid muscle?

Controls pitch and adjusts the tension of the vocal ligament

Which cartilage forms the inferior border of the laryngeal inlet?

Cricoid cartilage

What is the function of the thyrohyoid membrane in the larynx?

Supports and connects the larynx

Which muscle is responsible for adducting the vocal folds during phonation?

Transverse arytenoid muscle

Which region of the larynx is associated with clinical conditions like vocal cord polyps and laryngitis?

Infraglottic region

Which muscle group supports the position of the larynx in the neck?

Suprahyoid and infrahyoid muscles

What is the primary function of the cricoarytenoid joint in the larynx?

Adducts and abducts the vocal folds

Which ligament plays an important role in supporting and connecting the larynx?

Vocal ligament

What is the primary function of the posterior cricoarytenoid muscle?

Abducts the vocal folds during respiration

Which muscle is responsible for specific movements related to phonation and respiration?

Thyroarytenoid muscle

What is the primary function of the vocalis muscle in the larynx?

Controls pitch and adjusts the tension of the vocal ligament

Which structure marks the opening of the parotid duct into the oral vestibule?

Parotid papilla

What forms the lateral boundary of the submental triangle?

Mylohyoid muscles

What muscle divides the posterior triangle of the neck into occipital and supraclavicular triangles?

Sternocleidomastoid muscle

What forms the anterior boundary of the carotid triangle?

Sternocleidomastoid muscle

What characterizes Grade 3 subclavian steal syndrome?

Constant vertebrobasilar insufficiency

Which triangle contains the submandibular gland, facial vessels, submandibular lymph nodes, hypoglossal nerve, and mylohyoid nerve and vessels?

Submandibular triangle

Where does the common carotid artery bifurcate into the internal and external carotid arteries?

At the level of the thyroid cartilage

Which muscle is embedded in the superficial fascia of the neck?

Platysma muscle

Which nerve supplies sensory innervation to the pharynx?

Maxillary nerve

Which muscle receives motor innervation from a nerve other than the vagus nerve?

Stylopharyngeus

Which artery is responsible for supplying arterial blood to the pharynx?

External carotid artery

Which vein forms a plexus on the outer surface of the pharynx?

Pterygoid venous plexus

Which nerve contributes to the formation of the pharyngeal plexus?

Glossopharyngeal nerve

Which muscle forms the external muscle layer of the pharynx?

Superior constrictor

Which structure communicates with the laryngeal cavity via the piriform fossa?

Laryngopharynx

What is the primary content of the piriform fossa?

Internal laryngeal nerve

Which nerve supplies motor innervation to almost all pharyngeal muscles?

Vagus nerve

Which muscle is responsible for swallowing foreign objects like coins or fish bones?

Inferior constrictor

Which nerve contributes to the sensory innervation of the pharynx?

Glossopharyngeal nerve

Which muscle has specific origins and insertions in the pharynx?

Superior constrictor

Which nerve contains sensory, motor, and autonomic fibers and arises from the medulla of the brainstem?

Glossopharyngeal nerve

Which artery is an anterior branch of the external carotid artery and supplies various structures in the oral cavity?

Lingual artery

Which gland has multiple small ducts that drain into the floor of the mouth?

Sublingual gland

Which part of the pharynx extends from the soft palate to the superior border of the epiglottis?

Oropharynx

Which part of the pharynx is respiratory in function and contains the pharyngeal tonsil and pharyngeal opening of the auditory tube?

Nasopharynx

Which artery supplies various structures in the oral cavity and is a branch of the external carotid artery?

Lingual artery

Which nerve is involved in the special sensory nerve supply for taste?

Facial nerve

Which nerve has branches including the tympanic nerve, carotid branch, muscular branch, pharyngeal branches, tonsillar branches, and lingual branches?

Glossopharyngeal nerve

Which nerve contains sensory, motor, and autonomic fibers?

Glossopharyngeal nerve

Which gland is one of the major salivary glands and has superficial and deep parts, as well as a duct that opens into the oral cavity?

Submandibular gland

Which part of the pharynx extends from the base of the skull to the inferior border of the cricoid cartilage?

Laryngopharynx

Which nerve is part of the general sensory nerve supply to the oral cavity?

Lingual nerve

Which nerve supplies the motor innervation for the tensor veli palatini muscle?

Maxillary nerve

Which artery supplies the palate?

Greater palatine artery

Which muscle is responsible for elevating the root of the tongue?

Palatoglossus

Which nerve supplies the sensory innervation of the palate?

Glossopharyngeal nerve

Which part of the tongue lacks papillae and is characterized by rounded elevations caused by lymphoid nodules?

Pharyngeal part

Which nerve supplies the motor innervation for the intrinsic muscles of the tongue?

Hypoglossal nerve

Which muscle is located within the palatoglossal arch and extends from the soft palate to the side of the tongue?

Palatoglossus

Which artery supplies the tongue?

Lingual artery

Which nerve supplies the motor innervation for the extrinsic muscles of the tongue?

Vagus nerve

Which muscle is responsible for approximating the palatoglossal arch to its contralateral mate?

Levator veli palatini

Which nerve supplies the sensory innervation of the tongue?

Glossopharyngeal nerve

Which part of the tongue contains papillae with taste buds?

Dorsum

Which structure overlies the anterior branch of the middle meningeal artery?

Superior temporal line

What is the communication between the temporal fossa and infratemporal fossa?

Space between zygomatic arch and cranial wall

Which nerve is a content of the pterygopalatine fossa?

Trigeminal nerve (V3)

What forms the floor of the temporal fossa?

Greater wing of sphenoid and squamous part of temporal bone

Which artery overlies the pterion?

Middle meningeal artery

What is the boundary between the temporal fossa and infratemporal fossa?

Zygomatic arch

Which nerve is a content of the infratemporal fossa?

Maxillary nerve (V2)

What is the posterior boundary of the infratemporal fossa?

Tympanic part of styloid process

Which artery supplies the mucosa of the posterior part of the nasal septum?

Maxillary Artery

Which artery supplies the walls and contents of the pterygoid canal?

Maxillary Artery

Which artery is the terminal branch of the maxillary artery, entering the nasal cavity via the sphenopalatine foramen?

Sphenopalatine Artery

Which artery supplies the lower eyelid, side of the nose, and upper lip on the face?

Infraorbital Artery

Which artery accompanies the infraorbital nerve to enter the orbit through the inferior orbital fissure?

Infraorbital Artery

Which artery supplies the mucosa of nasopharynx and sphenoidal sinus?

Descending Palatine Artery

Which artery supplies the mucosa of the maxillary sinus and sometimes has a middle superior alveolar artery as well?

Infraorbital Artery

Which artery accompanies the posterior superior alveolar nerve and descends on the posterior surface of the maxilla?

Posterior Superior Alveolar Artery

Which nerve contains postganglionic sympathetic fibers from the deep petrosal nerve?

Deep petrosal nerve

Which nerve supplies preganglionic parasympathetic fibers to the lacrimal gland?

Greater petrosal nerve

Which nerve provides general sensory fibers from the maxillary nerve?

Maxillary nerve

Which nerve is a branch of the facial nerve and contains preganglionic parasympathetic fibers for the lacrimal gland?

Greater petrosal nerve

Which structure contains the pterygopalatine ganglion?

Pterygopalatine fossa

Which nerve gives rise to branches including the infraorbital, zygomatic, and alveolar nerves?

Maxillary nerve

Which nerve forms the nerve of the pterygoid canal by joining with the deep petrosal nerve?

Greater petrosal nerve

Which nerve provides sensory innervation to the palate, nasal cavity, and nasopharynx?

Maxillary nerve

Which nerve contains postganglionic sympathetic fibers?

Deep petrosal nerve

Which nerve is responsible for innervating the lacrimal gland, nasal cavity, and palate?

Facial nerve

Which nerve contains preganglionic parasympathetic fibers from the greater petrosal nerve?

Facial nerve

Which ganglion plays a role in innervating the lacrimal gland, nasal cavity, palate, and nasopharynx?

Pterygopalatine ganglion

Which nerve joins the lingual nerve in the infratemporal fossa?

Facial nerve

Which artery terminates in the pterygopalatine fossa?

Maxillary artery

Which artery provides circulation to the muscles of mastication?

Pterygoid part of the maxillary artery

Which vein drains the pterygoid venous plexus in the infratemporal fossa?

Maxillary vein

Which nerve accompanies the posterior superior alveolar nerve and descends on the posterior surface of the maxilla?

Inferior alveolar nerve

Which artery supplies the mucosa of nasopharynx and sphenoidal sinus?

Maxillary artery

Which nerve contains postganglionic sympathetic fibers from the deep petrosal nerve?

Trigeminal nerve

Which artery supplies the walls and contents of the pterygoid canal?

Maxillary artery

Which nerve provides sensory innervation to the palate, nasal cavity, and nasopharynx?

Lingual nerve

Which vein drains the scalp posterior and superior to the auricle?

Maxillary vein

Which nerve supplies the sensory innervation of the palate?

Lingual nerve

Which nerve contains sensory, motor, and autonomic fibers and arises from the medulla of the brainstem?

Trigeminal nerve

The tip of the nose is also known as the:

Apex

The nostrils are bordered laterally by the:

Alar cartilages

The nasal cavity communicates posteriorly with the nasopharynx via the:

Posterior nasal apertures

The olfactory mucosa lines the highest part of the roof and contains:

Olfactory receptor cells

The nasal mucosa is continuous with the mucosal lining of:

Paranasal air sinuses

The supporting framework of the nose is composed of:

Hyaline cartilage

The nasal cavity consists of a floor, a roof, two lateral walls, and a:

Nasal septum

The respiratory mucosa of the nasal cavity is covered by:

Ciliated epithelium

Which bone contains the frontal sinuses?

Frontal bone

Which artery forms a common site of epistaxis (nosebleed)?

Sphenopalatine artery

Which sinus is related superiorly to the pituitary gland and optic chiasm?

Sphenoid sinuses

Which part of the nasal cavity drains into the nasopharynx?

Inferior nasal meatus

Which artery supplies the maxillary sinus and its contents?

Sphenopalatine artery

Which structure forms the floor of the nasal cavity?

Hard palate

Which bone contains the ethmoidal air cells?

Ethmoid bone

Which artery forms a plexus in the submucosa of the nasal cavity?

Sphenopalatine artery

Which bone contains the maxillary sinus?

Maxilla

Which part of the nasal cavity receives secretions from the paranasal air sinuses and nasolacrimal duct?

Middle nasal meatus

Which artery provides circulation to the nasal cavity?

Sphenopalatine artery

Which structure separates the nasal cavity from the anterior cranial fossa?

Cribriform plate

Which opening transmits the optic nerve and ophthalmic artery?

Optic canal

Where is the infraorbital foramen located?

7-8mm below inferior orbital margin

What is the primary communication function of the supraorbital notch (or foramen)?

Transmits supraorbital nerve and vessels

What is the function of the nasolacrimal canal?

Transmits nasolacrimal duct

Which artery usually accompanies the lacrimal nerve and gives off branches that accompany the zygomaticofacial and zygomaticotemporal nerves?

Lacrimal artery

Which vein communicates anteriorly with the facial vein and usually joins the superior ophthalmic vein, but may drain directly into the cavernous sinus?

Inferior ophthalmic vein

Which muscle divides the posterior triangle of the neck into occipital and supraclavicular triangles?

Trapezius

Which muscle is responsible for drawing down the lower lip and angle of the mouth?

Depressor anguli oris

Which artery supplies the walls and contents of the pterygoid canal?

Pterygoid artery

Which nerve innervates the intrinsic laryngeal muscles responsible for specific movements related to phonation and respiration?

Vagus nerve

Which vein is a tributary of the internal jugular vein?

Facial vein

Which muscle group supports the position of the larynx in the neck?

Suprahyoid muscles

Which artery accompanies the infraorbital nerve to enter the orbit through the inferior orbital fissure?

Maxillary artery

Which structure contains the pterygopalatine ganglion?

Pterygopalatine fossa

Which bone contains the ethmoidal air cells?

Ethmoid bone

Which nerve supplies the motor innervation for the intrinsic muscles of the tongue?

Hypoglossal nerve

Which layer of the eyeball contains the macula lutea and fovea centralis for visual acuity?

Inner layer (retina)

What is the function of the ciliary muscle in the eyeball?

Assisting in accommodation

Which part of the eye contains the blind spot with no photoreceptors?

Optic disc

Through which space does the cerebrospinal fluid (CSF) extend from the middle cranial fossa around the optic nerve to the eyeball?

Subarachnoid space

Which artery is a branch of the internal carotid artery and supplies the orbit via the optic canal?

Ophthalmic artery

What forms the posterior part of the fibrous layer of the eyeball and is continuous with the cornea?

Sclera

Which layer of the eyeball contains the iris with smooth muscles controlling pupillary size?

Vascular layer

What is the function of the ciliary processes in the eyeball?

Secreting aqueous humor

Which part of the eyeball contains the transparent segment that bulges from the sclera and has no blood vessels?

Cornea

Where does the optic nerve begin in the eyeball?

Optic disc

What surrounds the optic nerve as it extends from the eyeball to the brain?

Meninges

Through which foramen does the ophthalmic artery enter the orbit to supply the eyeball?

Superior orbital fissure

What is the primary function of the auricle (pinna)?

Assists in localizing the source of sound

What is the composition of the tympanic membrane?

Thin membrane located at the medial end of the external acoustic meatus

What are the walls of the lateral part of the external acoustic/auditory meatus composed of?

Elastic cartilage covered with skin

What characterizes the lobule of the auricle?

Non-cartilaginous part consisting of loose connective tissue and fat covered with skin

Which part of the internal ear is sensitive to horizontal acceleration?

Utricle

What is the main function of the maculae within the utricle and saccule?

Sensitivity to the position of the head with respect to gravity and linear acceleration

Which part of the internal ear contains the spiral organ/organ of Corti, responsible for hearing?

Cochlear duct

Which nerve innervates the maculae and cristae ampullares within the internal ear?

Vestibulocochlear nerve (CNVIII)

Which muscle is responsible for dampening the vibrations of the auditory ossicles in the middle ear?

Stapedius

What is the primary function of the Eustachian tube?

Equalization of pressure on both sides of the tympanic membrane

Which structure separates the middle ear from the internal ear?

Tympanic membrane

What characterizes glue ear, or otitis media with effusion?

Filling of the middle ear with fluid

What can cause tinnitus, a ringing in the ears?

Hearing loss

Where does the tensor tympani muscle insert?

Handle of the malleus

What is the primary function of the auditory ossicles in the middle ear?

Transmit vibrations from the tympanic membrane to the internal ear

What is the common prevalence of tinnitus in the population?

10-15%

What is the characteristic shape of the cochlea?

Resembling a snail shell

What is the primary cause of ear infections such as otitis media?

Viral or bacterial infections

What is the primary content of the tympanic cavity in the middle ear?

Air

What is the characteristic feature of chronic otitis media?

Long-lasting inflammation of the middle ear

Which ligament strengthens the lateral aspect of the temporomandibular joint capsule?

Lateral temporomandibular ligament

What separates the temporomandibular joint into superior and inferior compartments?

Articular disc

Which ligament lies medial to the temporomandibular joint capsule and extends from the spine of the sphenoid to the lingula of the mandibular foramen?

Sphenomandibular ligament

Which ligament lies posterior/inferior to and separate from the temporomandibular joint capsule?

Stylomandibular ligament

Which muscle draws eyebrows medially and produces vertical wrinkles in the supranasal part of the forehead?

Corrugator supercilii

Which muscle of the mouth acts as a sphincter muscle of the lips to compress them together and protrude them?

Orbicularis oris

Which muscle originates from the outer surfaces of alveolar processes of maxilla and mandible, and compresses the cheek against molar teeth?

Buccinator

Which nerve innervates the mimetic muscles of the face?

Facial nerve

Where does the facial nerve exit the temporal bone?

Stylomastoid foramen

Which muscle of the nose is located over the root of the nose and produces transverse wrinkles across the root of the nose?

Procerus

Which muscle of the mouth draws the angle of the mouth upward and backward (smiling)?

Zygomaticus major

Which muscle of the mouth retracts the angle of the mouth (grinning)?

Risorius

Which muscle is not a part of the muscles of mastication?

Orbicularis oculi

What is the primary movement of the temporomandibular joint (TMJ)?

Flexion/extension

What is the most prevalent gender ratio affected by TMJ disorders?

4:1

Which condition is often associated with jaw clenching and teeth grinding?

Myofascial Pain Dysfunction Syndrome (MPD)

What is a common symptom of Myofascial Pain Dysfunction Syndrome (MPD)?

Clicking/popping/locking of the jaw

Which event can cause temporomandibular joint (TMJ) disorders?

Dental work

Which muscle is responsible for jaw clenching?

Masseter

What can temporomandibular joint (TMJ) dislocation lead to?

Facial nerve injury

Which muscle is embedded in the superficial fascia of the face?

Orbicularis oculi

What are the common physical findings of Myofascial Pain Dysfunction Syndrome (MPD)?

Limited mouth opening

Which nerve innervates the muscles of mastication?

Trigeminal nerve (V)

What is a potential cause of Myofascial Pain Dysfunction Syndrome (MPD)?

Poor positioning of the articulating disc within the TMJ

Where does the vertebral artery enter the cranial cavity?

Foramen magnum

Where does the basilar artery terminate?

Upper end of pons

Where does the internal carotid artery begin?

Bifurcation of common carotid artery

Where does the internal carotid artery terminate?

Where it divides into anterior and middle cerebral arteries

Which artery enters the orbit via the optic canal together with the optic nerve?

Ophthalmic artery

Which artery forms a potential vascular shunt, aiding in the development of collateral circulation if one of the proximal vessels is occluded?

Anterior communicating artery

Which sinus is located in the middle cranial fossa and drains contents of the orbit, parts of the cerebral hemisphere, pituitary gland, and sphenoparietal sinus?

Cavernous sinus

Which structure roofs over the posterior cranial fossa, separating the cerebellum from the occipital lobes of the cerebral hemispheres?

Cerebellar tentorium

Which sinus runs along the upper border of the falx cerebri and terminates posteriorly in the confluence of the sinuses?

Superior sagittal sinus

Which sinus is a direct continuation of the transverse sinus and terminates in the jugular foramen, where it becomes continuous with the internal jugular vein?

Sigmoid sinus

Which structure forms a small circular fold that roofs over the sella turcica and has a small opening for the pituitary stalk?

Sellar diaphragm

Which sinus communicates superiorly with the confluence of the sinuses and inferiorly with the internal vertebral venous plexus within the vertebral canal?

Occipital sinus

Which artery runs along the posterior border of the tentorium cerebelli and, when it reaches the petrous part of the temporal bone, turns down to become continuous with the sigmoid sinus?

Transverse sinus

Which structure is located in the midline, along the junction of the falx cerebri and tentorium cerebelli, and terminates posteriorly in the confluence of the sinuses?

Straight sinus

Which structure is a small sickle-shaped fold in the posterior cranial fossa that projects between the two cerebellar hemispheres?

Cerebellar falx

Study Notes

Anatomy of Neck Muscles and Nerve Supply

  • Sternocleidomastoid muscle has multiple actions including tenses skin of neck and draws down lower lip and angle of mouth
  • It originates from the sternum and clavicle and inserts onto the mastoid process and superior nuchal line
  • Innervated by the accessory nerve and branches from C2 and C3 spinal nerves
  • Sternocleidomastoid divides the anterolateral part of the neck into anterior and posterior triangles
  • Infrahyoid muscles including sternohyoid, omohyoid, thyrohyoid, and sternothyroid depress the hyoid and stabilize the larynx
  • Suprahyoid muscles including digastric, stylohyoid, and mylohyoid elevate the hyoid and depress the mandible
  • Digastric muscle consists of posterior and anterior bellies connected by an intermediate tendon
  • Stylohyoid muscle originates from the styloid process and elevates the hyoid bone
  • Lateral vertebral muscles including scalenus anterior, scalenus medius, and scalenus posterior are involved in lateral flexion of the neck and elevation of the 1st and 2nd ribs
  • Anterolateral neck is divided into anterior and posterior triangles, with the anterior triangle further divided into submandibular, carotid, muscular, and submental triangles
  • Submandibular triangle contains submandibular gland, facial vessels, submandibular lymph nodes, hypoglossal nerve, and mylohyoid nerve and vessels
  • Anterior triangle of the neck is bounded by the midline of the neck, anterior border of the sternocleidomastoid, and inferior border of the body of the mandible, and is further divided into several subdivisions

Larynx Anatomy and Function Overview

  • The larynx is responsible for sound production, breathing, and protecting the trachea from aspiration.
  • It is located at C3 - C6 in adults and has a skeleton made up of 3 paired and unpaired cartilages.
  • The cricothyroid and cricoarytenoid joints allow for specific movements of the larynx.
  • Membranes and ligaments like the thyrohyoid membrane and vocal ligament play important roles in supporting and connecting the larynx.
  • The larynx has intrinsic and extrinsic muscles that control its movement and function, innervated by branches of the vagus nerve.
  • It is internally divided into three parts: laryngeal inlet, glottis, and infraglottal region.
  • The laryngeal inlet communicates between the laryngopharynx and larynx and is covered by respiratory epithelium.
  • The glottis, consisting of vocal folds and space between them, is crucial for sound production and is innervated by the vagus nerve.
  • The infraglottic region extends from vocal folds to the inferior border of the cricoid cartilage and is associated with clinical conditions like vocal cord polyps and laryngitis.
  • Extrinsic laryngeal muscles, including suprahyoid and infrahyoid muscles, support the position of the larynx.
  • Intrinsic laryngeal muscles like cricothyroid, posterior cricoarytenoid, and thyroarytenoid are responsible for specific movements related to phonation and respiration.
  • The functions of specific muscles, such as the transverse arytenoid and vocalis muscles, are crucial for controlling pitch and adjusting the tension of the vocal ligament.

Anatomy of the Palate and Tongue

  • The palate contains muscles such as levator veli palatini, tensor veli palatini, palatopharyngeus, palatoglossus, and the uvular muscle, each with specific actions related to tongue and palate movement.
  • The motor innervation of these muscles involves the medial pterygoid nerve for the tensor veli palatini and the pharyngeal branch of the vagus nerve for the other muscles, while sensory innervation is through various branches of nerves like the glossopharyngeal nerve.
  • The palate is supplied by arteries such as the greater and lesser palatine arteries and veins drain into the pterygoid venous plexus and pharyngeal venous plexus.
  • The tongue is a highly muscular organ with functions including speech, food manipulation, tasting, swallowing, and oral cavity cleansing and is comprised of different parts including the root, body, dorsum, and inferior surface.
  • Surface features of the tongue include the terminal sulcus, foramen cecum, and median sulcus, with additional features on the sublingual surface such as the lingual frenulum, deep lingual vein, sublingual caruncle, and sublingual fold.
  • The oral part of the tongue is characterized by papillae including filiform, fungiform, vallate, and foliate papillae, with the latter three containing taste buds, while the pharyngeal part lacks papillae and is characterized by rounded elevations caused by lymphoid nodules.
  • The tongue contains both extrinsic and intrinsic muscles, including the genioglossus, hyoglossus, styloglossus, and palatoglossus as extrinsic muscles, and superior and inferior longitudinal, transverse, and vertical muscles as intrinsic muscles.
  • The motor nerve supply of the tongue involves the vagus nerve for the palatoglossus and the hypoglossal nerve for all other extrinsic and intrinsic muscles.
  • The levator veli palatini muscle is located within the palatoglossal arch and extends from the soft palate to the side of the tongue, with the action of elevating the root of the tongue and approximating the palatoglossal arch to its contralateral mate.
  • The tongue plays a crucial role in various functions such as speech, food manipulation, tasting, swallowing, and oral cavity cleansing.
  • The palate contains muscles with specific actions related to tongue and palate movement, with distinct motor and sensory innervation from various nerves and a complex network of arteries and veins.
  • The tongue is a highly muscular organ with various surface features and muscles, each with specific functions and nerve supply.

Pterygopalatine Fossa and Pterygopalatine Ganglion Overview

  • The pterygopalatine fossa is a small pyramidal space located near the infratemporal fossa, with specific boundaries and various communications with nearby structures.
  • It communicates with the cavernous sinus, inferior ophthalmic vein, and facial vein, and has connections to the orbit, nasal cavity, and middle cranial fossa.
  • The fossa contains the maxillary nerve, pterygopalatine part of the maxillary artery, and the pterygopalatine ganglion.
  • The maxillary nerve, a sensory nerve, passes through the pterygopalatine fossa and gives rise to various branches, including the infraorbital, zygomatic, and alveolar nerves.
  • The pterygopalatine ganglion is a parasympathetic ganglion located in the fossa, receiving sensory, preganglionic parasympathetic, and postganglionic sympathetic fibers.
  • It is the source of general sensory fibers from the maxillary nerve, preganglionic parasympathetic fibers from the greater petrosal nerve, and postganglionic sympathetic fibers from the deep petrosal nerve.
  • The ganglion plays a role in innervating the lacrimal gland, nasal cavity, palate, and nasopharynx, as well as the mucosal glands of the nasal cavity and palate.
  • The greater petrosal nerve, a branch of the facial nerve, contains preganglionic parasympathetic fibers for the lacrimal gland and the glands of the nasal cavity, palate, and nasopharynx.
  • It joins the deep petrosal nerve, which contains postganglionic sympathetic fibers, to form the nerve of the pterygoid canal.
  • The nerve of the pterygoid canal passes through the pterygoid canal and terminates in the pterygopalatine ganglion, where preganglionic parasympathetic fibers synapse.
  • Branches of the pterygopalatine ganglion include the greater and lesser palatine nerves, nasopalatine nerve, posterolateral nasal branches, and the pharyngeal nerve, which supply various areas in the palate, nasal cavity, and nasopharynx.
  • The pterygopalatine ganglion also plays a role in the innervation of the mucosa of the sphenoidal sinus and nasopharynx.

Mandibular Nerve and Maxillary Artery in Infratemporal Fossa

  • Mandibular nerve contains sensory, motor, and autonomic fibers
  • It leaves the middle cranial fossa and enters the infratemporal fossa via foramen ovale
  • The nerve lies deep to lateral pterygoid and branches into anterior and posterior divisions
  • Branches from the main trunk include medial pterygoid, meningeal, masseteric, lateral pterygoid, deep temporal, buccal, auriculotemporal, inferior alveolar, and lingual nerves
  • Chorda tympani, a branch of the facial nerve, joins the lingual nerve in the infratemporal fossa
  • Otic ganglion is a small parasympathetic ganglion located in the infratemporal fossa
  • Maxillary artery, a branch of the external carotid artery, passes through the infratemporal fossa and terminates in the pterygopalatine fossa
  • The artery has three parts: mandibular, pterygoid, and pterygopalatine, each with specific branches
  • Branches of the mandibular part include deep auricular, anterior tympanic, middle meningeal, accessory meningeal, and inferior alveolar arteries
  • The pterygoid part of the maxillary artery provides circulation to the muscles of mastication
  • The maxillary artery distributes to the tympanic region, muscles of mastication, meninges, lower teeth, and pterygoid venous plexus in the infratemporal fossa
  • The pterygoid venous plexus is a complex network of veins in the infratemporal fossa, drained by the maxillary vein and connecting with the parotid gland

Structure and Innervation of the Eyeball

  • Anterior and posterior ethmoidal foramina located along frontoethmoidal suture
  • Eyeball consists of 3 concentric layers: fibrous layer, vascular layer, and inner layer (retina)
  • Sclera forms the posterior part of the fibrous layer and is continuous with the cornea at the corneoscleral junction
  • Cornea, a transparent segment of the fibrous layer, bulges from the sclera and has no blood vessels
  • Vascular layer consists of choroid, ciliary body, and iris
  • Ciliary body contains ciliary muscle for accommodation and ciliary processes that secrete aqueous humor
  • Iris contains smooth muscles controlling pupillary size and receives parasympathetic and sympathetic innervation
  • Inner layer (retina) has optic and nonvisual parts and contains the macula lutea and fovea centralis for visual acuity
  • Optic disc, located medial to the macula lutea, is the blind spot with no photoreceptors
  • Optic nerve begins at the optic disc and is surrounded by sheaths of pia mater, arachnoid, and dura mater
  • Subarachnoid space with its CSF extends from the middle cranial fossa around the optic nerve to the eyeball
  • Ophthalmic artery, a branch of the internal carotid artery, enters the orbit via the optic canal and gives off the central artery of the retina

Middle Ear Anatomy and Clinical Considerations

  • The tympanic membrane is concave laterally at the umbo, with the handle and lateral process of the malleus firmly attached to its inner surface.
  • Ear infections, such as otitis media, can be caused by viral or bacterial infections, and chronic or acute in nature. It is common in children and can lead to symptoms like pain, pressure, and hearing loss.
  • Glue ear, or otitis media with effusion, is characterized by the filling of the middle ear with fluid, leading to temporary hearing loss, and is more prevalent in children.
  • Tinnitus, a ringing in the ears, affects 10-15% of the population and can be caused by various factors such as hearing loss, ototoxic drugs, or head injury.
  • The middle ear, or tympanic cavity, is a small, air-containing cavity in the petrous part of the temporal bone, housing the auditory ossicles (malleus, incus, and stapes) that transmit vibrations from the tympanic membrane to the internal ear.
  • The walls of the tympanic cavity include a thin bony roof, a floor separating it from the internal jugular vein, an anterior wall separating it from the internal carotid artery, and a posterior wall communicating with the mastoid air cells.
  • The middle ear also contains the pyramidal eminence housing the stapedius muscle and is formed mostly by the tympanic membrane, which separates it from the internal ear.
  • The three auditory ossicles in the middle ear are the malleus, incus, and stapes, which transmit and dampen vibrations. They are also modified and dampened by the protective action of the tensor tympani and stapedius muscles.
  • The tensor tympani muscle inserts into the handle of the malleus, while the stapedius muscle is located within the pyramidal eminence of the posterior tympanic cavity and inserts into the stapes.
  • The Eustachian tube, also known as the pharyngotympanic tube, allows for equalization of pressure on both sides of the tympanic membrane and begins in the anterior wall of the tympanic cavity, ending in the lateral wall of the nasopharynx.
  • The bony labyrinth of the internal ear contains clear fluid (perilymph) and three semicircular canals, while the membranous labyrinth consists of membranous sacs and ducts contained within the bony labyrinth.
  • The cochlea, resembling a snail shell, consists of a central pillar (modiolus) around which a bony tube makes approximately two turns, containing circulating endolymph connected to the subarachnoid space through the perilymphatic duct.

Temporomandibular Joint and Related Disorders

  • Temporomandibular joint (TMJ) is a thickening of parotid fascia extending from the styloid process to the posterior border of the mandible ramus
  • TMJ movement occurs in three planes: elevation/depression, protraction/retraction, and right/left lateral excursion
  • Muscles of mastication include the masseter, temporalis, medial pterygoid, and lateral pterygoid, all innervated by branches of V3
  • TMJ disorders affect around 25% of the population and are more prevalent in females (4:1 ratio)
  • TMJ dislocation can lead to various injuries, such as facial nerve injury, intracranial hematomas, and damage to cranial nerves, resulting in deafness
  • Myofascial Pain Dysfunction Syndrome (MPD) is a chronic muscle tension disorder often associated with jaw clenching and teeth grinding
  • MPD may result from poor positioning of the articulating disc or degenerative joint disease within the TMJ
  • Common symptoms of MPD include pain in mastication muscles, radiating pain to the ear/jaw, clicking/popping/locking of the jaw, and headache/neck pain
  • Physical findings of MPD include limited mouth opening, muscle spasm, facial swelling, audible clicking/popping, and TMJ tenderness
  • Mimetic muscles of the face are embedded in the superficial fascia, originating from the skull bones and serving as sphincters or dilators of facial openings
  • Muscles of the orbit, such as the orbicularis oculi, are part of the mimetic muscles group
  • TMJ disorders can be caused by traumatic events like sports injuries, vehicular accidents, dental work, and falls

Test your knowledge of the anatomy of neck muscles and nerve supply with this quiz. Explore the functions, origins, insertions, and innervation of key muscles like the sternocleidomastoid and infrahyoid muscles. Identify the divisions and contents of the anterior and posterior triangles of the neck.

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