Skull and Cranial Structures Overview

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Questions and Answers

What unique feature does the fetal skull have that is not present in the adult skull?

  • Larger cranial capacity
  • A larger face relative to the cranium
  • Fontanelles (correct)
  • Fused sutures

Which of the following structures is found superior to the middle ear?

  • Tegmen tympani (correct)
  • Tympanic membrane
  • Jugular bulb
  • Mastoid air cells

What forms the medial wall of the orbit?

  • Greater wing of sphenoid
  • Frontal bone
  • Maxilla
  • Ethmoid bone (correct)

Which muscle is responsible for tensing the vocal cords?

<p>Cricothyroid (C)</p> Signup and view all the answers

Which nerve provides sensory innervation to the anterior 2/3 of the tongue?

<p>Lingual nerve (CN Vc) (A), Chorda tympani (CN VII) (D)</p> Signup and view all the answers

What can cause a subdural hematoma?

<p>Age-related brain atrophy (B), Physical trauma (C), Excessive anticoagulation (D)</p> Signup and view all the answers

Which artery is located superficial to the sternocleidomastoid muscle?

<p>External jugular vein (A)</p> Signup and view all the answers

What is the primary function of cortical interneurons?

<p>Modulate excitatory and inhibitory signals (D)</p> Signup and view all the answers

Which structure is part of the boundaries of the orbit?

<p>Greater wing of sphenoid (D)</p> Signup and view all the answers

Which nerve is associated with the afferent component of the pupillary reflex?

<p>Optic nerve (CN II) (B)</p> Signup and view all the answers

What is the location of Little's area?

<p>Anterior part of the nasal septum (A)</p> Signup and view all the answers

Which nerve is responsible for the sensation of the posterior one-third of the tongue?

<p>Glossopharyngeal nerve (CN IX) (D)</p> Signup and view all the answers

Which muscles are primarily responsible for closing the mouth?

<p>Masseter, medial pterygoid, temporalis (A)</p> Signup and view all the answers

What is the role of the chorda tympani?

<p>Taste sensation from the anterior two-thirds of the tongue (A)</p> Signup and view all the answers

Which artery contributes to the anastomosis between the internal carotid artery (ICA) and external carotid artery (ECA)?

<p>Dorsal nasal artery (C)</p> Signup and view all the answers

What structures are covered by the pretracheal fascia?

<p>Thyroid and parathyroid glands (C)</p> Signup and view all the answers

In which part of the auditory pathway does sound first gain synaptic relay?

<p>Cochlear nuclei (B)</p> Signup and view all the answers

Which of the following is a characteristic of Jacksonian seizures?

<p>Focal seizures originating in the frontal lobe (D)</p> Signup and view all the answers

What is the function of the ciliary muscle in relation to lens shape?

<p>Contracts to thicken the lens for near vision (B)</p> Signup and view all the answers

Which of the following best describes the drainage of the maxillary sinus?

<p>Drains into the middle meatus (A)</p> Signup and view all the answers

What is the primary function of the chorda tympani nerve?

<p>Taste from the anterior 2/3 of the tongue (D)</p> Signup and view all the answers

Which structure is primarily responsible for closing the mouth?

<p>Masseter (D)</p> Signup and view all the answers

Which nerve is responsible for sensation in the lower eyelid?

<p>Infraorbital nerve (CN Vb) (A)</p> Signup and view all the answers

Which structure anatomy primarily contributes to the drainage of the parotid salivary gland?

<p>Stensen’s duct (D)</p> Signup and view all the answers

What does the recurrent laryngeal nerve innervate?

<p>All intrinsic laryngeal muscles except cricothyroid (C)</p> Signup and view all the answers

Which artery is involved in the anastomosis between the internal carotid artery and external carotid artery?

<p>Dorsal nasal artery (D)</p> Signup and view all the answers

Where does the cerebrospinal fluid (CSF) flow after leaving the third ventricle?

<p>Into the subarachnoid space through the fourth ventricle (A)</p> Signup and view all the answers

Which cranial nerve is responsible for the complete vision loss in the affected eye due to optic nerve damage?

<p>CN II (C)</p> Signup and view all the answers

What is the main role of the ciliary muscle in the eye?

<p>To thicken the lens for near vision (B)</p> Signup and view all the answers

Which fascia surrounds the thyroid gland?

<p>Pretracheal fascia (D)</p> Signup and view all the answers

What is the primary difference between the adult and fetal skull regarding facial structure?

<p>The fetal skull has a smaller face relative to the cranium. (C)</p> Signup and view all the answers

Which of the following structures is located posterior to the middle ear?

<p>Mastoid air cells (C)</p> Signup and view all the answers

Which bones form the lateral wall of the orbit?

<p>Greater wing of sphenoid and zygomatic bone (C)</p> Signup and view all the answers

Which muscle is NOT innervated by the vagus nerve?

<p>Cricothyroid (D)</p> Signup and view all the answers

What structure is known for modulating excitatory and inhibitory signals within the cortex?

<p>Cortical interneuron (A)</p> Signup and view all the answers

Which of the following correctly describes the location of the quadrangular ligament?

<p>Connects the epiglottis to the arytenoid cartilage (B)</p> Signup and view all the answers

What is the main function of the external jugular vein?

<p>Draining blood from the face and scalp (D)</p> Signup and view all the answers

Which of these causes is associated with thoracic outlet syndrome?

<p>Pressure on vascular structures (A)</p> Signup and view all the answers

What imaging finding is typical for a subarachnoid hemorrhage?

<p>Hyperdensity in basal cisterns (C)</p> Signup and view all the answers

Which artery contributes to the blood supply of the scalp?

<p>Posterior auricular artery (C)</p> Signup and view all the answers

Flashcards

What are fontanelles?

In a fetal skull, the fibrous membranes connecting cranial bones, allowing for growth and molding during birth.

Describe the relations of the middle ear.

The middle cranial fossa is superior to the middle ear, the jugular bulb is inferior, the internal carotid artery and Eustachian tube are anterior, the mastoid air cells are posterior, the tympanic membrane is lateral, and the oval and round windows are medial.

What are the boundaries of the orbit?

The roof is formed by the frontal bone, the floor by the maxilla and zygomatic bone, the medial wall by the ethmoid and lacrimal bone, and the lateral wall by the zygomatic bone and greater wing of the sphenoid.

Which muscles are innervated by the vagus nerve?

The vagus nerve innervates the palatoglossus, levator veli palatini, pharyngeal constrictors, intrinsic laryngeal muscles (except cricothyroid), and palatopharyngeus.

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Which muscle tenses the vocal cords?

The cricothyroid muscle tenses the vocal cords, increasing their pitch.

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What is the function of cortical interneurons?

Cortical interneurons modulate the excitatory and inhibitory signals within the cerebral cortex, influencing the strength and timing of neuronal activity.

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Describe the attachments and location of the quadrangular ligament.

It is a ligament located between the epiglottis and arytenoid cartilage. Its upper boundary forms the aryepiglottic fold, which acts like a valve for the larynx, and its lower boundary forms the vestibular fold.

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Which blood vessel lies superficial to the sternocleidomastoid muscle?

The external jugular vein is superficial (outer layer) to the sternocleidomastoid muscle.

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What is the structure of the alar space?

The alar space is a potential space located between the prevertebral fascia and alar fascia. It extends cranially from the skull base to the T2 vertebrae.

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Which nerve is near the superior thyroid artery?

The external branch of the superior laryngeal nerve lies near the superior thyroid artery.

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Location of Little’s area

The anterior part of the nasal septum where the Kiesselbach's plexus is located.

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Salivary gland drainage

The parotid gland drains via Stensen's duct, which opens near the upper second molar. The submandibular gland drains through Wharton's duct into the sublingual papilla, and the sublingual gland drains through the ducts of Rivinus in the floor of the mouth.

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Muscles closing the mouth

The masseter, medial pterygoid, and temporalis muscles are all involved in closing the mouth.

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Innervation of posterior digastric

The posterior belly of the digastric muscle is innervated by the facial nerve (CN VII).

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Lens shape change mechanism

The ciliary muscle contracts, relaxing the zonular fibers, causing the lens to thicken for near vision.

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Blindness from optic nerve damage

Damage to the optic nerve results in complete blindness in the affected eye. This is due to the optic nerve being the sole pathway for visual information from the eye to the brain.

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Temporal bone relations

The temporal bone has four parts: squamous, tympanic, mastoid, and petrous. It houses important structures of the middle and inner ear.

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Foramina location

Foramina are openings in the skull that allow for passage of nerves, blood vessels, and other structures. For example, the foramen ovale in the sphenoid bone allows the trigeminal nerve (CN V) to pass through.

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Fascial coverings of thyroid

The thyroid gland is covered by pretracheal fascia, which is a layer of connective tissue in the neck.

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Nerve for lower eyelid sensation

The infraorbital nerve (CN Vb) provides sensation to the lower eyelid.

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Function of chorda tympani

The chorda tympani nerve carries taste from the anterior 2/3 of the tongue and parasympathetic fibers to the submandibular and sublingual salivary glands.

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Fetal skull differences

The fetal skull has soft spots called fontanelles, its sutures are not yet fused, and its face is smaller compared to the cranium.

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Middle ear relations

The middle ear is surrounded by key structures: superiorly by the middle cranial fossa, inferiorly by the jugular bulb, anteriorly by the internal carotid artery and Eustachian tube, posteriorly by the mastoid air cells, laterally by the tympanic membrane, and medially by the oval and round windows.

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Orbital boundaries

The orbit's roof is formed by the frontal bone, its floor by the maxilla and zygomatic bone, its medial wall by the ethmoid and lacrimal bone, and its lateral wall by the zygomatic bone and the greater wing of the sphenoid bone.

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Vagus nerve innervation

The vagus nerve controls several important muscles: the palatoglossus, levator veli palatini, pharyngeal constrictors, intrinsic laryngeal muscles (except the cricothyroid), and the palatopharyngeus.

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Vocal cord tension

The cricothyroid muscle tenses the vocal cords, increasing their pitch.

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Cortical interneuron function

Cortical interneurons act like mediators, balancing the excitatory and inhibitory signals within the cerebral cortex.

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Quadrangular ligament

The quadrangular ligament connects the epiglottis and arytenoid cartilage. Its upper boundary forms the aryepiglottic fold, acting like a valve for the larynx, and its lower boundary forms the vestibular fold.

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External jugular vein location

The external jugular vein runs superficially to the sternocleidomastoid muscle, making it visible on the surface of the neck.

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Alar space structure

The alar space is a potential space between the prevertebral fascia and alar fascia, extending from the skull base to the T2 vertebrae. It's a potential space, meaning it's not always a space that is filled.

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Nerve near superior thyroid artery

The external branch of the superior laryngeal nerve runs close to the superior thyroid artery within the neck.

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What is Kiesselbach's plexus?

Located in the anterior portion of the nasal septum, it is a convergence point for several blood vessels and a common site for nosebleeds.

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How do the major salivary glands drain?

The parotid gland's duct opens near the upper second molar, while the submandibular gland's duct opens near the tongue's base. The sublingual gland has multiple smaller ducts opening onto the floor of the mouth.

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Which muscles close your mouth?

The masseter, medial pterygoid, and temporalis muscles work together to close the jaw, creating the chewing force.

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What nerve innervates the posterior digastric muscle?

The facial nerve controls the movement of the posterior belly of the digastric muscle, which helps depress the mandible.

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How does the lens change shape for focusing?

Contraction of the ciliary muscle relaxes the zonular fibers, allowing the lens to thicken for near vision. This process helps focus objects close to the eye.

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What happens when the optic nerve is damaged?

Damage to the optic nerve completely disrupts the flow of visual information from the eye to the brain, causing complete blindness in that eye.

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Where is the temporal bone located and what are its parts?

The temporal bone has four parts: squamous, tympanic, mastoid, and petrous. It houses structures like the middle and inner ear, which are essential for hearing and balance.

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What are foramina and what are their functions?

Foramina are openings in the skull, like windows for nerves and blood vessels. For example, the foramen ovale allows the trigeminal nerve, important for facial sensation, to pass through.

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What fascial layer covers the thyroid gland?

The thyroid gland is enclosed by pretracheal fascia, a layer of connective tissue that helps support and organize the neck's structures.

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Which nerve provides sensation to the lower eyelid?

The infraorbital nerve, a branch of the trigeminal nerve, carries sensory information from the lower eyelid, cheek, and upper lip.

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Study Notes

Skull and Cranial Structures

  • Fetal Skull Differences: Fontanelles present, sutures unfused, smaller face relative to cranium.
  • Middle Ear Relations: Superior: Tegmen tympani (middle cranial fossa); Inferior: Jugular bulb; Anterior: Internal carotid artery, Eustachian tube; Posterior: Mastoid air cells; Lateral: Tympanic membrane; Medial: Oval & round windows.
  • Orbit Boundaries: Roof: Frontal bone; Floor: Maxilla, zygomatic bone; Medial wall: Ethmoid, lacrimal bone; Lateral wall: Zygomatic bone, greater wing of sphenoid.
  • Vagus Nerve Innervation: Palatoglossus, levator veli palatini, pharyngeal constrictors, intrinsic laryngeal muscles (except cricothyroid), palatopharyngeus.
  • Vocal Cord Tension: Cricothyroid muscle.
  • Cortical Interneuron Function: Modulate excitatory & inhibitory signals within the cortex.
  • Quadrangular Ligament: Attaches epiglottis to arytenoid cartilage; upper boundary aryepiglottic fold, lower boundary vestibular fold.
  • Sternocleidomastoid Surface Vessel: External jugular vein.
  • Alar Space: Between prevertebral & alar fascia from skull base to T2.
  • Superior Thyroid Artery Neighbor: External branch of superior laryngeal nerve.
  • Tongue Innervation: Posterior 1/3: Glossopharyngeal (CN IX); Anterior 2/3: Lingual nerve (general sensation, CN V3), chorda tympani (taste, CN VII).
  • Pupillary Constriction Reflex Afferent: Optic nerve (CN II).
  • Thoracic Outlet Syndrome Symptoms: Pain, numbness, weakness in upper limb; potential swelling/discoloration with vascular compression.
  • Subdural Hematoma Causes: Trauma (bridging vein tears), anticoagulation, age-related brain atrophy.
  • Subarachnoid Hemorrhage Imaging: CT: Hyperdensity in basal cisterns/sulci; Angiography: Aneurysm detection.
  • Scalp Structure & Blood Supply: Layers: Skin, connective tissue, aponeurosis, loose areolar tissue, periosteum; Blood Supply: Superficial temporal, occipital, posterior auricular, supraorbital arteries.
  • Little's Area Location: Anterior nasal septum (Kiesselbach's plexus).
  • Salivary Gland Drainage: Parotid (Stensen's duct to upper 2nd molar); Submandibular (Wharton's duct to sublingual papilla); Sublingual (Rivinus ducts to oral floor).
  • Mouth Closure Muscles: Masseter, medial pterygoid, temporalis.
  • Posterior Digastric Belly Innervation: Facial nerve (CN VII).
  • Temporal Bone Relations: Squamous, tympanic, mastoid, & petrous parts relating to middle & inner ear structures.
  • Foramina Location: Examples: Foramen ovale (CN V3), foramen rotundum (CN V2), foramen spinosum (MMA), jugular foramen.

Eye and Brain

  • Lens Shape Change: Ciliary muscle contraction relaxes zonular fibers, thickening lens for near vision.
  • Optic Nerve Damage & Blindness: Complete vision loss in affected eye.
  • Foramina Location (Examples): Foramen ovale (CN V3), foramen rotundum (CN V2), jugular foramen, foramen spinosum (MMA).
  • Thyroid Fascial Coverings: Pretracheal fascia.
  • Lower Eyelid Sensation: Infraorbital nerve (CN V2).
  • Chorda Tympani Function: Taste anterior 2/3 of tongue, parasympathetic to submandibular/sublingual glands.
  • Neck Triangles & Fascia: Anterior (submental, submandibular, carotid, muscular); Posterior (occipital, supraclavicular); Layers: Investing, pretracheal, prevertebral, carotid sheath.
  • Medial Pterygoid & Superior Pharyngeal Constrictor Attachments: Medial pterygoid: Medial surface lateral pterygoid plate to mandible; Superior constrictor: Pterygoid hamulus, buccinator to pharyngeal raphe.
  • Laryngeal Muscles Innervation/Action: Recurrent laryngeal: All intrinsic except cricothyroid (external branch superior laryngeal); Actions: Phonation, vocal cord tension/relaxation.
  • Central Visual Pathway/Field Defects: Retinotopy (retina to LGN to primary visual cortex); Lesions result in homonymous hemianopia, quadrantanopia.
  • Auditory Pathway Order: Cochlea → cochlear nuclei → superior olive → lateral lemniscus → inferior colliculus → MGN → auditory cortex.
  • Posterior Tongue Sensation: Glossopharyngeal (CN IX).
  • Waldeyer's Ring Components: Palatine, pharyngeal, lingual, tubal tonsils.
  • Infratemporal Fossa Boundaries: Superior: Greater wing sphenoid; Lateral: Mandible ramus; Medial: Lateral pterygoid plate.
  • Orbit Upper Lateral Margin Muscles: Lacrimal branch CN V2.

Neck and Other Structures

  • Anterior Neck Innervation: Cervical plexus, ansa cervicalis.
  • Scalp Innervation: Anterior: Supraorbital (CN V1); Lateral: Auriculotemporal (CN V3); Posterior: Lesser/greater occipital nerves.
  • Pterygopalatine Fossa Nerve: Maxillary nerve (CN V2).
  • Ocular Muscle Integrity Test: H-test for extraocular muscle function.
  • Cortical Cell Structure/Function: Pyramidal (output, excitatory); Stellate (input, inhibitory).
  • Skull Foramina (Examples): Foramen rotundum (CN V2), foramen spinosum (MMA).
  • Innervation Exceptions: Tensor veli palatini (CN V3), Palatoglossus (CN X).
  • Facial Nerve Integrity Test: Buccinator (puff cheeks).
  • Uvula Deviation & Lesion: Vagus nerve (CN X).
  • Expressive Aphasia Location: Broca's area (frontal lobe).
  • Jacksonian Seizures Origin: Focal seizures originating from frontal lobe.
  • Nasal Septum Bones: Perpendicular plate ethmoid, vomer.
  • Sinuses Drainage: Maxillary sinus: Middle meatus.
  • Cranial Nerve Eye Lesions: CN III: Ptosis, mydriasis; CN IV: Vertical diplopia; CN VI: Lateral gaze palsy.
  • Cerebral Artery Meninges Location: Subarachnoid space.
  • Neck Fascia Surrounding Thyroid: Pretracheal fascia.
  • Alar Fascia Extent: Skull base to T2.
  • Cerebrospinal Fluid (CSF) Flow: Lateral ventricles → foramen of Monro → third ventricle → cerebral aqueduct → fourth ventricle → subarachnoid space.
  • Eustachian Tube in Children: Shorter, more horizontal.
  • Blind Spot: Optic disc.
  • Carotid Anastomosis: Dorsal nasal (ophthalmic) and angular (facial).

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