Anatomy Head & Neck Quiz Part A

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Questions and Answers

What is the primary function of the Levator Scapulae muscle?

Elevates and retracts the scapula (correct)

Rotates the shoulder joint laterally

Adducts the humerus

Depresses the shoulder girdle

Which nerve innervates the Rhomboids?

Ventral rami of intercostal nerves

Thoracodorsal nerve

Cervical nerve

Dorsal scapular nerve (correct)

What is the origin of the Serratus Posterior Superior muscle?

Transverse processes of C1-C4

Posterior tubercles of cervical vertebrae

Nuchal ligament and spinous processes of C7-T3 (correct)

Spinous processes of T11-T12

Which muscle group is primarily involved in neck rotation and extension?

Splenius muscles Signup and view all the answers

What type of joint is the Atlanto-occipital joint?

Ellipsoid/condyloid joint Signup and view all the answers

What movement is primarily allowed at the Atlanto-occipital joint?

Flexion and extension (nodding) Signup and view all the answers

Which muscle assists in depressing ribs 9th-12th during expiration?

Serratus Posterior Inferior Signup and view all the answers

Which muscle is NOT considered an intermediate muscle of the back?

Splenius Cervicis Signup and view all the answers

What separates the Maxillary process from the Lateral Nasal process?

Nasolacrimal groove Signup and view all the answers

Which structure forms from the fusion of the medial nasal swellings?

Intermaxillary segment Signup and view all the answers

What is the main trunk of the facial nerve known as after exiting the skull?

Motor trunk Signup and view all the answers

Which branch of the facial nerve is responsible for the stapedius muscle?

Nerve to stapedius muscle Signup and view all the answers

At what week do the primitive shelves migrate upwards to form the Secondary Palatine?

8th week Signup and view all the answers

Which nerve does not supply the parotid gland despite traveling through it?

Facial nerve Signup and view all the answers

Which branch of the facial nerve is responsible for innervating the cervical region?

Cervical branch Signup and view all the answers

What connects the nasal cavity and oral cavity after the oronasal membrane disappears?

Primitive choana Signup and view all the answers

What is the length of the parotid duct?

5 cm Signup and view all the answers

Which artery primarily supplies blood to the parotid gland?

External carotid artery Signup and view all the answers

What is the main nerve responsible for the parasympathetic supply to the parotid gland?

Glossopharyngeal nerve Signup and view all the answers

Which of the following branches arises from the trigeminal ganglion?

Mandibular nerve Signup and view all the answers

Where is the main sensory nucleus of the trigeminal nerve located?

Pons Signup and view all the answers

What type of cells are primarily found in the trigeminal ganglion?

Pseudounipolar cells Signup and view all the answers

The retromandibular vein is primarily formed by which two veins?

Superficial temporal vein and maxillary vein Signup and view all the answers

Which of the following is not a branch of the trigeminal nerve?

Temporal branch Signup and view all the answers

What is the function of the Superior Oblique Muscle?

Depress, Abduct and Medially rotate the eyeball Signup and view all the answers

Which muscle of the eyeball is responsible for elevating the upper eyelid?

Levator Palpebrae Superioris Signup and view all the answers

The Lateral Rectus Muscle is primarily responsible for which action?

Abducting the eyeball Signup and view all the answers

Which artery supplies the lacrimal gland and conjunctiva?

Lacrimal Artery Signup and view all the answers

What is the innervation of the Medial Rectus Muscle?

Oculomotor Nerve Signup and view all the answers

Which artery supplies the retina excluding the cones and rods?

Central Retinal Artery Signup and view all the answers

Which muscle is innervated by the Trochlear Nerve?

Superior Oblique Muscle Signup and view all the answers

What is the primary function of the Inferior Rectus Muscle?

Depress and abduct the eyeball Signup and view all the answers

Which structure is responsible for conscious visual perception?

Calcarine cortex Signup and view all the answers

What type of cells are responsible for color vision in the fovea?

Cone cells Signup and view all the answers

Where do the axons from the nasal half of the retina send their signals?

To the opposite side of the optic chiasma Signup and view all the answers

What are the two layers of the optic cup during eye development?

Outer layer and inner layer Signup and view all the answers

What is the primary role of the association visual cortex?

Processing form and color Signup and view all the answers

What does the term 'Intraretinal Space' refer to?

Space between the layers of the optic cup Signup and view all the answers

Which part of the visual pathway helps with high-resolution object recognition?

Temporal Lobe Signup and view all the answers

What is the function of the Mantle Layer in the development of the retina?

Producing neuron and cell precursors Signup and view all the answers

Study Notes

Back Muscles

Latissmus Dorsi
- Insertion: Lateral clavicle
- Innervation: Thoracodorsal Nerve
- Function: Extends, adducts and medially rotates the humerus at shoulder joint
Levator Scapulae
- Origin: Posterior tubercles of the transverse processes of C1 - C4
- Insertion: Medial border of Scapulae
- Innervation: Dorsal scapulae nerve of C5+C3 and Cervical nerve of C4
- Function: Elevate and retracts the scapula, Tilt the glenoid cavity
Rhomboids Minor and Major
- Origin:
  - Minor: Nuchal Ligament and spinous process of C7 - T1
  - Major: Spinous process of T2 - T5
- Insertion: Scapulae
- Innervation: Dorsal scapulae nerve of C5
- Function: Retracts the scapula to vertebral column
Intermediate Muscles of the Back
- Serratus Posterior Superior
  - Origin: Nuchal ligament and spinous processes of C7 - T3
  - Innervation: Ventral Rami of intercoastal nerve of T2 - T5
  - Function: Elevate the ribs during respiration.
- Serratus Posterior Inferior
  - Origin: spinous processes of T11- T12 and L1 -L2
  - Innervation: Ventral Rami of intercoastal nerve of T9 - T12
  - Function: Depress ribs 9th- 12th during Expiration
Deep Muscles of the Back
- First Layer
  - Splenius Capitis
    - Origin: From vertebrae C7 - T3
    - Insertion: mastoid process and lateral aspect of superior nuchal line
    - Function: Helps in neck rotation and Extending
  - Splenius Cervicis
    - Origin: From vertebrae T3 - T6
    - Insertion: Spinous process of C2 - C4
    - Function: Helps in neck rotation and Extending
- Second Layer
  - Iliocostal Muscles
    - Origin:
      - Iliocostal cervicis:
      - Iliocostal Thoracis:
      - Iliocostal lumborum:
  - Longissimus Muscles
    - Origin:
      - Longissimus cervicis:
      - Longissimus Thoracis:
      - Longissimus lumborum:
  - Spinalis Muscles
    - Origin:
      - Spinalis cervicis:
      - Spinalis Thoracis:
      - Spinalis lumborum:

Atlanto-occipital and Atlanto-axial Joints

Atlanto-occipital Joint
- Type: Ellipsoid/condyloid joint
- Structure: Joint between the occipital bone [occipital condylar]and Atlas [superior articular facet]
- Features: Fibrous capsule surrounds the joint. Anterior and posterior atlanto-occipital membrane
- Movement: Flexion/extension e.g. nodding
Atlantoaxial Joint
- Structure: Joint between Atlas and the Axis vertebrae

Development of the Face

Maxillary Process and Medial Nasal Process
- The maxillary process and medial nasal process develops by week 6.
- Nasolacrimal/Naso-optic groove: Separates the maxillary process and the lateral nasal process.
- Buconasal Groove: Separates the mandibular process and the medial nasal process.
- Fusion: The maxillary process fuses with the medial nasal process to form the Upper lip by week 6.
Intermaxillary Segment
- Forms when the medial nasal swelling fuses together.
- Nasolacrimal Duct: Forms from the ectoderm.
- Lateral Nasal Process: Forms the Lateral Nasal Wall.
- Mandibular Process: Forms the Lower jaw, Lower lip and Lower teeth.
- Cheeks: Formed from the fusion of the Mandibular and Maxillary processes.
Palate Development
- Week 8: Primitive Shelves migrate upwards and take a horizontal positioning above the tongue.
- Fusion: Primitive Shelves fuse to form Secondary Palatine by week 8.
- Oronasal Membrane: Separates the nasal cavity from the oral cavity and disappears by week 8.
- Primitive Choana: Forms when the oronasal membrane disappears, connecting the nasal and oral cavities.
Paranasal Sinuses
- Develop from the lateral wall of the nasal cavity.

Facial Nerve

Cranial Nerve VII
- Function: Motor, Special sensory and Parasympathetic functions.
- Origin: From the Pons.
- Facial Colliculus: Nerve forms a loop around the Abducents Nucleus forming the Facial Colliculus.
- Internal Acoustic Meatus: The nerve travels through the Internal Acoustic Meatus.
- Facial Canal: The nerve enters the Facial Canal.
Inside the Facial Canal:
- Fusion: The two roots fuse to form one root.
- Geniculate Ganglion: Forms
- Branches:
  - Greater Petrosal Nerve:
  - Nerve to stapedius muscle:
  - Chord tympani:
Stylomastoid Foramen: The Facial nerve exits the cranium through the Stylomastoid Foramen.
Outside the Cranium:
- Posterior Auricular Nerve: The first branch of the facial nerve outside the cranium after the Stylomastoid Foramen.
- Branches:
  - Nerve to posterior belly of digastric muscle:
  - Nerve to stylohyoid muscle:
Motor Trunk: The main trunk of the facial nerve is then called the motor trunk.
Parotid Gland: Travels to the parotid gland but does not supply it.
Parotid Branches: Facial nerve divides into 5 branches in the parotid gland:
- Temporal branch:
- Zygomatic branch:
- Buccal branch:
- Marginal Mandibular:
- Cervical Branch:

Parotid Duct [Stensen’s Duct]

Function: Carries saliva from the parotid duct to the mouth.
Length: 5 cm long.
Location: Runs between the buccinator and mucosa.
Opening: Opens into the vestibule of the mouth at the Parotid pupillae.
Blood Supply:
- Supplied by branches of the External Carotid Artery:
  - Posterior auricular
  - Transverse Facial
  - Maxillary and Superficial Temporal Artery
Venous Drainage:
- Primarily drained through Retromandibular vein formed by:
  - Superficial Temporal and Maxillary vein
Nerve Supply:
- Innervation of Parotid Gland: Glossopharyngeal nerve [CN VIII] and The Auriculotemporal nerve supply the parotic gland.
  - Otic ganglion: The Auriculotemporal nerve supplies this ganglion.
Parasympathetic Supply:
- Inferior Salivatory nucleus: Located in the Dorsal aspect of the pons.
- Glossopharyngeal nerve: Signal is sent through this nerve via the tympanic branch.
- Tympanic plexus: The tympanic branch forms the tympanic plexus.
- Lesser petrosal nerve: The tympanic plexus continues as the lesser petrosal nerve.
- Otic ganglion: The signal reaches the otic ganglion where it synapses.
- Auriculotemporal nerve: Post ganglionic fibers hitch a ride with this nerve to the parotid gland stimulating saliva production.
Sympathetic Supply [ Vasomotor]:
- External Carotid Artery Plexus

Trigeminal Nerve

Cranial Nerve V
- Function: Sensory and motor fibers
Nuclei:
- Main sensory: Located posterior to the pons and lateral to the motor nucleus.
- Spinal Nucleus: Extends downward through the Medulla oblongata
- Motor nucleus: Contains unipolar cells that extend inferiorly to the pons.
- Mesencephalic Nucleus: Situated in the pons medially to the main sensory.
Course:
- Origin: Originates from the pons with two roots covered with protective layer called Pia-arachnoid.
- Sensory root: Expands to form the Trigeminal Ganglion.
- Trigeminal Ganglion: Made up of Pseudounipolar Cells. Located in the Meckel/trigeminal Cave.
- Branches: Three branches arise from the ganglion:
  - Ophthalmic
  - Maxillary
  - Mandibular
Pseudounipolar Cells: Comprised of 2 processes:
- Peripheral process:
- Central process:
Pons: Half of the fibers in the pons split into ascending and descending branches.

Eyelid

Structure:
- Bulbar Fascia: Connective tissue at the back of the eyelid.
- Bulbar conjuctiva: Connective tissue at the front of the eyelid.
- Episcleral Space: The space between the Bulbar Fascia and the eyeball. Allows Movement.

Extrinsic Muscles of Eye

Superior Oblique Muscle
- Origin: Body of sphenoid , above and medial to optic canal
- Insertion: Superior Surface of Eyeball
- Innervation: Trochlear Nerve
- Function: Depress, Abducts And Medially rotate the eyeball.
Superior Rectus Muscle
- Origin: Superior part of common tendinous ring.
- Insertion: Anterior half of eyeball, superiorly.
- Innervation: Oculomotor Nerve
- Function: Elevate, Adducts And Medially rotate the eyeball.
Lateral Rectus Muscle
- Origin: Lateral part of common tendinous ring.
- Insertion: Anterior half of eyeball, Laterally.
- Innervation: Abducent Nerve
- Function: Abducts the eyeball.
Medial Rectus Muscle
- Origin: Medial part of common tendinous ring.
- Insertion: Anterior half of eyeball, Medially.
- Innervation: Oculomotor Nerve
- Function: Adducts the eyeball.
Inferior Rectus Muscle
- Origin: Inferior part of common tendinous Ring.
- Insertion: Anterior Half of the eyeball, Inferiorly.
- Innervation: Oculomotor nerve
- Function: Depress, Abducts And Laterally rotate the eyeball.
Inferior Oblique Muscle
- Origin: Medial Floor of the orbit, posterior to the rim, Maxilla lateral to Nasolacrimal groove.
- Insertion: Inferior surface of the Eyeball.
- Innervation: Oculomotor nerve
- Function: Elevate, Adducts And Laterally rotate the eyeball.
Levator Palpebrae Superioris
- Origin: lesser wing of Sphenoid Bone, Anterior to Optic canal.
- Insertion: Anterior [Surface of Tarsal Plate.
- Innervation: Oculomotor nerve
- Function: Elevate upper eyelid.

Blood Supply to the Orbit

Ophthalmic artery: Main blood supply.
Infraorbital artery:
Ophthalmic artery branches:
- Lacrimal Artery: Supplies the lacrimal gland, conjuctiva and lateral sides of eyelid.
- Central Retinal Artery: Supply the Retina except the cones and rods.
- Short Posterior Ciliary Artery: Supplies the choroid, Rods and Cones.
- Long Posterior Ciliary Artery: Supplies the ciliary body and the iris.
- Muscular arteries: Supply Iris, Ciliary body and Superior, Inferior, Lateral and Medial Rectus Muscle.
- Supraorbital Artery: Supply forehead and Scalp.
- Posterior Ethmoidal Artery: Supply posterior Ethmoidal Cells.
- Anterior Ethmoidal Artery: Supply Anterior and Middle Ethmoidal Cells, Frontal Sinus, Nasal Cavity and skin of Nose.
- Medial Palpebral Artery: Supply eyelids.
- Exits: Through Supraorbital fissure within cone of muscles below the inferior branch of Oculomotor nerve. Enters the lateral Rectus and supply it.

Visual Pathways

Photoreceptors: Light that enters is determined by the photoreceptors in the Retina.
Retina: Has 2 halves:
- Nasal (Medial): Cells here send axons to opposite side of the optic chiasma.
- Temporal (Lateral): Cells here send axons to the same side of the optic chiasma.
Optic Nerve: Visual information exits the eye through the optic nerve.
Optic Chiasma: Some axons cross to the other side in the optic Chiasma [Nasal] forming Optic Tract.
Optic Tract: Reaches the Lateral Geniculate Ganglion in the thalamus.
Lateral Geniculate Ganglion: Fibers spread out as optic radiation to the Calcarine cortex in the Occipital Lobe.
Calcarine Cortex: Conscious visual perception occurs in the Primary visual Cortex.
- Association visual cortex: Processes Form, color and movement.
- Temporal lobe connections: Help with High-resolution object recognition.
- Parietal Cortex connection: Analyzes motion and positional relationships of objects in the visual scene.

The Visual Field

Fovea: Located in the center of the Macula Lutea of the Retina, packed with cone cells that are responsible for vision.
Right Eye:
- Temporal Retina: Left Visual field
- Nasal Retina: Right Visual field
Left Eye:
- Temporal Retina: Right visual field
- Nasal Retina: Left Visual field

Embryology of the Eye

Optic Primordium: The development of the eye begins with the Optic Primordium in the earliest stages.
- Primary Optic Vesicle: Develops from the Optic Primordium by day 18 of development.
- Optic Cup: The Primary Optic Vesicle invaginates to form the Optic Cup.
- Layers of the Optic Cup:
  - Outer Layer: Becomes the Retinal Pigment Epithelium.
  - Inner Layer: Becomes the Neural Retina which has photoreceptors, bipolar and ganglion cells.
  - Intraretinal Space: Space between the layers.

Retina Development

Retinal Pigment Epithelium: The Outer Layer of the Optic Cup becomes the Retinal pigment epithelium
Neural Retina: The Inner Layer of the Optic Cup becomes the Neural Retina.
- Photoreceptors: Contains the rods and cones
- Bipolar and ganglian cells:
Pars Optica Retinae: Found in the Neural Retina. Cells that develop into the rods and cones.
Mantle Layer: Next to the photoreceptors and produces neurons and cells. Forms 3 layers:
- Outer nucleus Layer: Contain Cell bodies for the photoreceptors axons.
- Inner Nucleus Layer: Contain Bipolar cells.
- Ganglion Cell Layer: Contains ganglion for the axons that form the Optic nerve.

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