Eustachian Tube Dysfunction

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90 Questions

Which muscle contracts longitudinally and thickens due to shortening, pushing against the wall of the Eustachian tube when swallowing?

Levator veli palatini

Which bone in the middle ear is the largest and its handle attaches to the inner tympanic membrane?

Malleus

Which muscle simultaneously pulls on the opposing wall of the Eustachian tube when swallowing?

Tensor veli palatini

Which bone in the middle ear articulates with the head of the malleus and has a small lenticular process that articulates with the stapes head?

Incus

Which bone in the middle ear has its base fitting in the oval window of the inner ear?

Stapes

Which muscle increases tension on the tympanic membrane by pulling the handle of the malleus medially, reducing the amplitude of oscillations at the tympanic membrane?

Levator veli palatini

Which muscle lessens vibrations of the stapes bone by pulling it posteriorly, tipping the bone away from the oval window?

Stapedius

Which nerve innervates the posterior surface of the auricle?

Lesser occipital nerve

Which nerve innervates the anterior, inferior surface of the auricle?

Great auricular nerve

Which nerve innervates the anterior surface of the auricle?

Auriculotemporal nerve

Which nerve innervates the posterior surface and concha of the auricle?

Vagus nerve

What is the function of the pharyngotympanic tube?

Equalizes pressure on both sides of the tympanic membrane

Which part of the ear is composed of areolar and adipose tissue?

Lobule

What is the direction of the outer part of the external acoustic meatus?

Inward, forward, and upward

Which part of the ear helps to focus and direct air pressure waves through the external auditory meatus to the middle ear?

External ear

What is the function of the middle ear?

To fine tune and amplify the vibrations of the air

Which membrane marks the boundary between the middle and inner ear?

Oval window

What is the function of the cochlea in the inner ear?

To convert vibrations of the basilar membrane into action potentials

What is the function of the vestibular system in the inner ear?

To transduce acceleration forces of the fluids into action potentials

What is the composition of the auricle (pinna)?

Elastic cartilage covered by a thin skin

What is the function of the auricle?

To pull in sound in the range of human speech

Which nerve carries preganglionic parasympathetics to the otic ganglion?

Glossopharyngeal nerve

Where is the organ of hearing located?

Inner ear

Which part of the inner ear senses change in linear motion and gravity?

Utricle

What is the function of the semicircular canals in the inner ear?

Sense change in angular acceleration or rotation of the head

What can dislodge and end up in a semicircular canal, causing vertigo?

Otoliths

What is the most common cause of dizziness and vertigo?

Benign paroxysmal positional vertigo

Which maneuver is used to cure benign paroxysmal positional vertigo?

Epley maneuver

Which nerve supplies both the vestibular and cochlear structures in the inner ear?

Vestibulocochlear nerve

Where are the bony cavities and canals of the inner ear located?

Temporal bone

Which muscle is the largest and longest among the scalene muscles?

Middle scalene

Which triangle is larger and located in the upper part of the posterior triangle?

Occipital triangle

Which muscle is responsible for elevating the first rib during forced inspiration and flexing and laterally flexing the neck?

Anterior scalene

Which muscle is responsible for elevating the second rib during forced inspiration and laterally flexing the neck?

Posterior scalene

Which muscle is responsible for elevating the first rib during forced inspiration and lateral flexion of the neck?

Middle scalene

Which muscle can be a cause of 'thoracic outlet syndrome' if it becomes tight enough?

Anterior scalene

Which triangle is smaller and located in the lower part of the posterior triangle?

Supraclavicular triangle

Which muscle is divided by the inferior belly of omohyoid into two sub-triangles in the posterior triangle?

Superior belly of omohyoid

Which muscle is responsible for elevating the first rib during forced inspiration and flexing and laterally flexing the neck?

Anterior scalene

Which nerve innervates the anterior surface of the auricle?

Great auricular nerve

Which bone in the neck is held by 4 supra-muscles and 4 infra-muscles and ligaments?

Hyoid bone

What is the midline elevation created by the thyroid cartilage called?

Laryngeal prominence

Where is the depression on the superior border of the laryngeal prominence located?

Thyroid notch

Where is the groove located upon the superior border of the manubrium between two clavicular heads?

Suprasternal notch

Where is the depression located lateral to the clavicular origin of the sternocleidomastoid muscle, posterior to the middle third of the clavicle, and anteromedial to the clavicular insertion of the trapezius muscle?

Supraclavicular fossa

Which muscle originates from the clavipectoral fascia, courses superiorly over the neck, and inserts into the skin around the chin and mouth?

Platysma muscle

Which layer of dense connective tissue binds all structures in the neck and splits to encompass the sternocleidomastoid and trapezius muscles?

Investing layer of dense connective tissue

Which layer of fascia covers the supra and infrahyoid muscles?

Infrahyoid fascia

Which layer of fascia covers the thyroid and parathyroid glands, trachea, and esophagus?

Pretracheal fascia

Which structure is encompassed by the carotid sheath, along with the carotid artery and vagus nerve?

Carotid vein

Which muscle is responsible for laterally flexing the neck to the same side and rotating the head toward the opposite side?

Sternocleidomastoid

Which muscle elevates, retracts, adducts, and rotates the scapula?

Trapezius

What is the name for an abnormal asymmetrical head or neck position?

All of the above

Which muscle is commonly associated with trigger points that can refer pain to various areas including the ear, neck, chin, and forehead?

Sternocleidomastoid

Which nerve supplies the Sternocleidomastoid and Trapezius muscles?

Accessory (CN XI)

Where is Erb's Point located?

Halfway along the posterior border of the Sternocleidomastoid muscle

Which nerve innervates the Lesser occipital, Great auricular, Transverse cervical, and Supraclavicular cutaneous nerves?

Cervical plexus

Which vein carries blood from the head to the superior vena cava?

Brachiocephalic Vein

Which vein is closest to the skin and can sometimes be seen as a rope-like bulge on the side of the neck?

External Jugular Vein

What does jugular vein distention indicate if the height is greater than 3 to 4 centimeters when measured supine with head elevated 45 degrees?

Vascular or heart disease

Which artery supplies most of the head and neck?

Common carotid artery

Which nerve provides sensory innervation to the carotid body and carotid sinus?

Glossopharyngeal nerve

Which lymphatic trunk drains the right head and neck, right upper extremity, and right thorax?

Right jugular trunk/lymphatic duct

Which vein lies deep to the sternocleidomastoid muscle and drains into the subclavian vein?

Internal jugular vein

Which nerve innervates the sternocleidomastoid and trapezius muscles?

Accessory nerve

Which structure is responsible for monitoring blood pressure at the carotid bifurcation?

Carotid sinus

Which ganglion of the cervical sympathetic trunk supplies structures of the head via the internal carotid plexus and participates in the cardiac plexus of nerves?

Superior ganglion

Which artery supplies the forehead and anastomoses with the facial and superficial temporal arteries?

Ophthalmic artery

Which vein receives drainage from the occipital nodes, retroauricular nodes, and parotid nodes?

Superficial cervical nodes

Which nerve enters the carotid triangle from behind the posterior belly of digastric and runs to the posterior aspect of the sternocleidomastoid muscle?

Vagus nerve

Which nerve innervates the strap (infrahyoid) muscles and one suprahyoid muscle (geniohyoid)?

Ansa cervicalis

Which muscle is responsible for elevating the first rib during forced inspiration and flexing and laterally flexing the neck?

Sympathetic muscle

Which nerve is motor to the diaphragm and runs on top of the anterior scalene?

Phrenic nerve

Which nerve innervates the laryngeal region, including the internal and external laryngeal nerves?

Vagus nerve

Which nerve contributes C5 to the phrenic nerve?

Brachial plexus

Which artery emerges from between the anterior and middle scalene muscles?

Subclavian artery

Which artery is responsible for supplying the thyroid and larynx?

Inferior thyroid artery

Which artery supplies the prevertebral and deep neck structures?

Deep cervical artery

Which muscles assist in depression of the mandible?

Mylohyoid, geniohyoid, and anterior belly of the digastric

Which muscle lowers the hyoid bone or raises the thyroid cartilage during vocalization?

Thyrohyoid

Which muscle stabilizes the hyoid bone during vocalization and depression of the mandible?

Sternohyoid

Which muscle divides into a superior and inferior belly, similar to the omohyoid muscle?

Digastric

Which muscles function to lower the hyoid or thyroid cartilages or to stabilize them during vocalization and jaw opening?

Infrahyoid muscles

Which muscles are innervated by the cervical plexus, except for the thyrohyoid muscle?

Both A and C

Which muscle divides into an anterior and posterior belly, with an intermediate tendon dividing the muscle?

Digastric muscle

Which muscle is responsible for raising the floor of the oral cavity and drawing the hyoid bone forward?

Mylohyoid muscle

Which muscle is closely related to the posterior belly of the digastric muscle and moves the hyoid bone posterosuperiorly?

Stylohyoid muscle

Which muscle raises the hyoid bone and is innervated by the nerve to the geniohyoid (CN XII)?

Geniohyoid muscle

Which muscle has a fibrous sling holding it to the hyoid bone and stabilizes, raises, and moves the hyoid bone?

Digastric muscle

Which muscle splits and wraps around the intermediate tendon of the digastric muscle before inserting onto the hyoid bone?

Stylohyoid muscle

Study Notes

Eustachian Tube

  • The tensor veli palatini muscle contracts longitudinally and thickens due to shortening, pushing against the wall of the Eustachian tube when swallowing.
  • The salpingopharyngeus muscle simultaneously pulls on the opposing wall of the Eustachian tube when swallowing.

Middle Ear

  • The malleus bone is the largest bone in the middle ear, and its handle attaches to the inner tympanic membrane.
  • The incus bone articulates with the head of the malleus and has a small lenticular process that articulates with the stapes head.
  • The stapes bone has its base fitting in the oval window of the inner ear.

Muscles of the Ear

  • The tensor tympani muscle increases tension on the tympanic membrane by pulling the handle of the malleus medially, reducing the amplitude of oscillations at the tympanic membrane.
  • The stapedius muscle lessens vibrations of the stapes bone by pulling it posteriorly, tipping the bone away from the oval window.

Innervation of the Auricle

  • The posterior surface of the auricle is innervated by the lesser occipital nerve.
  • The anterior, inferior surface of the auricle is innervated by the great auricular nerve.
  • The anterior surface of the auricle is innervated by the auriculotemporal nerve.
  • The posterior surface and concha of the auricle are innervated by the greater occipital nerve.

Functions of the Ear

  • The pharyngotympanic tube functions to equalize air pressure in the middle ear.
  • The outer part of the external acoustic meatus is directed downward and forward.
  • The auricle (pinna) is composed of areolar and adipose tissue and helps to focus and direct air pressure waves through the external auditory meatus to the middle ear.
  • The middle ear functions to transmit sound vibrations to the inner ear.
  • The tympanic membrane marks the boundary between the middle and inner ear.
  • The cochlea in the inner ear is responsible for hearing, and the vestibular system is responsible for balance.

Inner Ear

  • The organ of hearing is located in the inner ear.
  • The otolith organs (utricle and saccule) in the inner ear sense changes in linear motion and gravity.
  • The semicircular canals in the inner ear sense rotational movements.
  • Calcium particles in the otolith organs can dislodge and end up in a semicircular canal, causing vertigo.
  • Benign paroxysmal positional vertigo is the most common cause of dizziness and vertigo.

Triangles and Muscles of the Neck

  • The scalenus anterior muscle is the largest and longest among the scalene muscles.
  • The anterior triangle is larger and located in the upper part of the posterior triangle.
  • The posterior triangle is smaller and located in the lower part of the posterior triangle.

Miscellaneous

  • The vagus nerve (CN X) carries preganglionic parasympathetics to the otic ganglion.
  • The glossopharyngeal nerve (CN IX) supplies the carotid body and carotid sinus.
  • The facial artery supplies the forehead and anastomoses with the facial and superficial temporal arteries.
  • The superior vena cava is formed by the union of the right and left brachiocephalic veins.
  • The internal jugular vein is the largest vein in the neck and is closest to the skin.

Test your knowledge on Eustachian Tube Dysfunction and its associated maneuvers with this quiz. Learn about the causes, symptoms, and potential complications of this condition, including retracted eardrums, fluid build-up, and infections. Explore the muscles acting on the Pharyngotympanic Tube and how they open the tube during swallowing. Get ready to expand your understanding of this important anatomical feature.

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