Term
-In this anterior & oblique view of the right side of the neck, we can see the different anatomical regions. Each distinct region is given its own color in order to highlight their boundaries.
-The primary boundary between triangles of the neck is the __, which divides the neck into two separate triangles. Named according to their location, these long paired muscles act as a dividing line that creates one __ and 2 __. which are found on either side of the body’s midline. |
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Definition
-
- sternocleidomastoid muscles; anterior triangle; posterior triangle |
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Term
-The boundaries of the posterior triangles of the neck are made up of the following three aspects of muscles found in the neck region:
-The __ forms the anterior border of the posterior triangle.
-The posterior border of this triangle is the __
-Inferiorly, the posterior triangle is bounded by the portion of the __ that spans between sternocleidomastoid and trapezius |
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Definition
-
- posterior border of the sternocleidomastoid muscle
- anterior border of the trapezius muscle
- superior border of the clavicle bone |
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Term
-The boundaries of the anterior triangle of the neck are made up of the following three aspects of muscles found in the neck region:
-The __ forms the lateral borders of the anterior triangle.
-The superficial border of this triangle is the __
-Running vertically downward from the mandible to the nape of the neck is the __. This imaginary boundary separates the area into two equivalent anterior triangles, one on either side of the median plane of the neck. |
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Definition
-
- anterior border of the sternocleidomastoid muscle
- inferior border of the mandible bone
- midline of the neck |
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Term
-As we begin our study of the muscles in this region, we will begin by identifying the superficial muscles, then moving progressively inward until we reach the deep muscles in the neck. The first The first muscle we encounter is the __.
-The __ is a superficial muscle that overlaps the __. Its fibers arise from the superficial aspect of __ (muscle of the anterior chest), and cross over the clavicle before ascending obliquely upward/medially along the sides of the neck.
-The platysma has a unique action. Contraction of this muscle increases the __. Often used by men during shaving, the comical stretching of the platysma earned it the nickname of the “shaving muscle.” |
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Definition
- platysma
- platysma; sternocleidomastoid; pectoralis major
- diameter of the neck |
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Term
-One of the more unique bones in the body, the __ is different in that it doesn’t directly articulate with any other bones. Instead, it is attached only by surrounding muscles and ligaments.
-Found in the anterior midline of the neck between the __ and __, the __ bone is typically level with the base of the __ when at rest. There are two groupings of muscles that have an attachment on the hyoid bone. These muscles are often categorized by the location of their muscle bellies relative to hyoid.
-Those muscles found superior to the hyoid bone are referred to as __ muscles, while those below it are known as the __ muscles |
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Definition
- hyoid bone
- chin; thyroid cartilage; hyoid; mandible
- suprahyoid muscles; infrahyoid muscles |
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Term
-the suprahyoid muscles consist of:
1.
2.
3.
4.
- the _ is found just deep to the mylohyoid muscle, and is located along the floor of the oral cavity |
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Definition
1. diagastric: anterior and posterior belly
2. stylohyoid
3. mylohyoid
4. geniohyoid
- geniohyoid muscle |
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Term
-When the suprahyoid muscles simultaneously contract, their collective effect causes the hyoid bone to be __.
-As a result, the __ is pulled up by the connection to the hyoid, the __. This occurs during __, while the __ simultaneously covers the opening into the __. |
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Definition
- raised upward
- larynx; thyrohyoid membrane; swallowing; epiglottis; larynx |
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Term
- there are four infrahyoid muscles
- the two superficial infrahyoid muscles include:
- the two deep infrahyoid muscles include: |
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Definition
-
- sternohyoid; omohyoid (superior and inferior belly)
- sternothyroid; thyrohyoid |
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Term
| When the infrahyoid muscles contract as a group they collectively act to both __ and __ the hyoid bone so that the contraction of the suprahyoids allows the infrahyoids to function as __ of the __ |
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Definition
| - depress; stabilize; accessory depressors; mandible |
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Term
-While so far we know the basic outline of the large anterior triangle of the neck, this area is in fact further subdivided into 4 smaller triangles. Listed below, each of this is highlighted in the image to the right:
1.
2.
3.
4. |
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Definition
-Digastric triangle (2)
-Submental triangle (1)
-Carotid triangle (2)
-Muscular triangle (2) |
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Term
-In this image we can see the sets of triangles that make up the larger anterior triangle. To begin with, the __ are found on the underside of the chin and are identical in size, mirroring each other across the midline. In the image below, we see the 3 major structures that make up the boundaries of this subdivision of the anterior triangle.
- the 3 structures forming the boundary of each diagastric triangle are as follows: |
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Definition
- diagastric (submandibular) triangle
-1. Lower border of the mandible
2. Posterior belly of the digastric muscle
3. Anterior belly of the digastric muscle |
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Term
-Now that we have identified the location of the digastric triangles, we will take a quick look at important components within it (this process will continue for each of the 4 anterior triangle subdivisions).
-Some of the key structures found in this area below the body of the mandible include the __. This is a branch off of the __, and as its name implies it is primarily responsible for supplying oxygenated blood to the superficial structures of the face.
-Also present are a pair of salivary glands, which are conveniently called the __. Found beneath the floor of the mouth, these are major producers of saliva (accounting for ~70% of our total salivary output while we are eating). |
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Definition
-
- facial artery; external carotid artery
- submandibular glands |
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Term
-While the other 3 subdivisions of the anterior triangle are pairs of equivalent triangles, mirroring each other horizontally across the midline, the __ exists as a single region of the anterior triangle. As its name suggests, it lies just inferior to the two __, which are openings in the mandible that allow neurovascular structures to pass through.
-The structures forming the boundaries of this triangle are labeled in this image, and listed below according to their locations:
--Lateral: bounded by the __
--Superior: __
--Inferior: __
-To the left we can also see that the floor of the submental division is formed by the __. This muscle contributes to the floor of the oral cavity. |
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Definition
- submental triangle; mental foramina
-
-- anterior bellies of diagastric muscle
-- inferior border of the mandible
-- body of the hyoid bone
- mylohyoid muscle |
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Term
-The carotid triangle is that portion of the anterior triangle bounded laterally by the __, medially by the __, and superiorly by the __.
-Some of the most notable neurovascular structures located inside the carotid triangle include (but are not limited to) those listed below:
1.
2.
3.
4. |
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Definition
- anterior sternocleidomastoid; superior belly of omohyoid; stylohyoid/posterior digastric muscle
-
1. common carotid artery
2. internal jugular vein
3. vagus nerve (CN X)
4. hypoglossal nerve (CN XII) |
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Term
-The common carotid artery terminates by bifurcating into the __ and __
--The external carotid has branches in the region of the __ and __, while the internal carotid artery has no branches until it emerges in the __ |
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Definition
- internal; external carotid aa.
-- head; neck; cranial cavity |
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Term
-The internal carotid exhibits an initial swelling called the __
--It is a baroreceptor that helps to regulate __
-The __ is a small mass of vascular tissue located at the bifurcation of the common carotid into the external/internal carotid arteries (carotid body location indicated, actual structure not visible)
--Lies close to the __
--It is a __, responding to CO2 levels in the blood to increase respiration if levels get too high
--The carotid body and sinus are innervated by the __ |
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Definition
- carotid sinus
-- blood pressure
- carotid body
-- carotid sinus
-- chemoreceptor
-- glossopharyngeal nerve (CN IX) |
|
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Term
- the boundaries of the muscular triangle include the __, __, and __
-The contents of the muscular triangle include the __ highlighted and the __. |
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Definition
- median line of the neck; anterior border of the sternocleidomastoid; superior belly of the omohyoid
- infrahyoid muscles; thyroid/parathyroid glands |
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Term
Anterior Triangle: Structures of the Muscular Triangle
-Having explored the anterior triangle in general, we should remember that within its boundaries lies such structures as the __ and the __.
-Another briefly mentioned gland found lying immediately anterior and inferior to the larynx is the __. this gland is located in the __.
-The __ is one of the largest endocrine glands, and is involved in regulation of the body’s __ by increasing metabolic activity. This increase in metabolism produces heat that help in regulating the body’s temperature. |
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Definition
- hyoid bone; larynx
- thyroid gland; muscular triangle
- thyroid gland; metabolism |
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Term
- the following arteries are branches of the external carotid a.:
--__:Terminates on the temporal region of the skull (region above the ear)
--__:Considered a terminating branch of the external carotid and gives off branches deep in the face
--__:Supplies the superior aspect of each lobe of the thyroid gland
--__: supplies the muscles of the tongue
--__: supplies the face |
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Definition
-
-- superficial temporal a.
-- maxillary a.
-- superior thyroid a.
-- lingual a.
-- facial a. |
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Term
Venous drainage of the neck
- superficial veins include:
- Deep veins include:
-Note that most of the superficial veins drain back to the deeper __ vein while the external jugular vein drains to the __ vein |
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Definition
- facial v, superficial temporal v, maxillary v, retromandibular v, external jugular v, anterior jugular v.
- internal jugular v.
- internal jugualar; subclavian |
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Term
-The __ supplies both motor and sensory innervation to the structures of the neck.
-As are all nerve plexi, the __ is itself a network of nerves formed when the __ from nearby spinal nerve levels join each other. This occurs shortly after the rami branch off the true spinal nerve at each level.
-For schematic purposes only, these images of sensory nerves will be drawn on one side of the cervical spine, while nerves supplying motor innervation are on the opposite.
***However, its important to realize that the actual cervical plexus is __, meaning it exhibits both motor and sensory nerve fibers on __ sides of the spinal column. |
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Definition
- cervical plexus
- central plexus; ventral rami
-
*** bilateral; both |
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Term
| The cervical plexus and its sensory branches exit behind the __ in an area called __. |
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Definition
| sternocleidomastoid; erb's point |
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Term
innervation of the neck - sensory
- the important nerves in the neck are as follows: |
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Definition
| - supraclavicular nerve; transverse cervical nerve; greater auricular nerve; lesser occipital nerve |
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Term
-The __ is part of the cervical plexus, and is a unique distribution of motor neurons that supply three of the infrahyoid muscles
-- these three are as follows:
-It has a __, which is __, and an __, which is __
-A single __ branch travels with the __ nerve to innervate the the __ and the __ muscles. The relationship of C1 to the hypoglossal nerve is not shown here, only the C1 branch |
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Definition
- ansa cervicalis
-- sternohyoid; superior belly of the omohyoid; sternothyroid
-- superior loop (C2); medial; inferior loop; lateral
- C1; hypoglossal nerve; geniohyoid; thyrohyoid |
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Term
-In this left lateral view of the neck, we can see only the skeletal structures and the infrahyoid muscles. The __ is a loop of nerves found just superior to the internal jugular vein (in the cervical plexus), which itself is made up of both a __ & an __.
- Branches off ansa cervicalis supply motor innervation to 3 of the 4 infrahyoid muscles: the __, __, and __
-The __ muscle is instead supplied by fibers from the ventral root of the spinal nerve exiting from C1 spinal cord level. After exiting the spine, the C1 branch travels anteriorly from the spine by passing parallel to the hypoglossal nerve (CN XI). |
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Definition
- ansa cervicalis; superior; inferior root
- omohyoid; sternohyoid; sternothyroid muscles
- thyrohyoid |
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Term
-The larynx is located in the __ of the __ of the neck. It connects the inferior part of the __ to the __, and is commonly called the “voice box”. It separates the __ and __ tracts.
-One of its cartilages (__, discussed later) acts as a protective covering over the opening to the airway. It also prevents foreign bodies from entering the airway.
-__ is an adapted secondary feature, wherein the larynx manipulates pitch and volume. |
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Definition
- muscular triangle; anterior triangle; pharynx; trachea; respiratory; digestive
- (epiglottis)
- phonation |
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Term
| The larynx opens into the __, the region below the __. |
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Definition
| - laryngopharynx; oropharynx |
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Term
-The larynx hangs from the __ by the __
--Connects the __ to the __ |
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Definition
- hyoid bone; thyrohyoid membrane
-- thyroid cartilage; hyoid bone |
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Term
| The larynx is composed of cartilages held together by fibrous membranes. The thyroid cartilage, for example, is the largest, shield shaped cartilage, with a prominence that we know as the “Adam’s Apple”. There 9 cartilages, 3 of which are paired and 3 are not (those listed in red are not paired): |
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Definition
Thyroid(not paired)
Cricoid (not paired)
Arytenoid (2) cartilage
Corniculate (2)
Cuneiform (2)
Epiglottis(not paired) |
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Term
-The __ is the Adam’s apple
-Emergency tracheotomies are performed between the __ and the __ in the __ |
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Definition
- laryngeal prominence
- trachea; thyroid cartilage; cricothyroid membrane |
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Term
-The respiratory pathway is protected from food and other substances traveling down the pharynx by the __.
--Cartilage flap that covers over the larynx during __
-The epiglottis directs food into the __ |
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Definition
- epiglottis
-- swallowing
- esophagus |
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Term
-The laryngeal cartilages are linked by fibrous membranes to one another, to the __ above, and the first __ below
-A thickening within a membrane is a __
-The __ links the hyoid bone to the thyroid cartilage |
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Definition
- hyoid bone; tracheal cartilage
- ligament
- thyrohyoid membrane |
|
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Term
| -The cricothyroid membrane joins the __, __, and __ cartilages (at their vocal processes). The free edge of the cricothyroid membrane is thickened to form the __. A midline thickening in the cricothyroid membrane is the __, which has lateral and median aspects. |
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Definition
| - cricoid; thyroid; arytenoid; vocal ligament; cricothyroid ligament |
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Term
-The two __ have two processes, the __ (attaches the vocal ligament), and the __.
-Movement of the laryngeal muscles can close or open the __ to produce sound. The __(previous) is the opening between the __ and the __. |
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Definition
- arytenoid cartilages; vocal process; muscular process
- rima glottidis; rima glottidis; true vocal cords; arytenoid cartilages |
|
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Term
- cricothyroid muscle
--When it contracts, the __ tilts forward, putting tension on the __ and thereby raising the pitch of the voice |
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Definition
| -- thyroid cartilage; vocal folds |
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Term
-__ and __
Run from one arytenoid cartilage to the other, bringing together these two pieces of cartilage __ |
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Definition
| - oblique; transverse arytenoid muscles; closes or adducts vocal folds |
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Term
| posterior cricoarytenoid muscle attaches from the back of the __ to the __, it is the only __ of the __ which causes the __ to open |
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Definition
| - cricoid cartilage; arytenoid cartilage; abductor; true vocal volds; rima glottidis |
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Term
Lateral cricoarytenoid
Attaches to the __ and primarily __ |
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Definition
| - lateral portion of the cricoid cartilage; closes (adducts) the vocal folds |
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Term
- __ provides motor and sensory innervation to the larynx
- the superior laryngeal nerve splits into the __ and __ |
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Definition
- vagus nerve
- internal laryngeal nerve; external laryngeal nerve |
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Term
- __: sensory above vocal folds
- __: motor to cricothyroid m. |
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Definition
- internal laryngeal nerve
- external laryngeal nerve |
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Term
-All the intrinsic muscles of the larynx except the __ are innervated by the recurrent laryngeal nerves. __ innervation below the __ is also supplied via the recurrent laryngeal nerves.
- __:Travels from the vagus n., under the subclavian a., and along the trachea to the larynx
-__:Travels from the vagus n., under the aorta, and along the trachea to the larynx |
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Definition
- cricothyroid mm.; sensory; vocal folds
- right recurrent laryngeal nerve
- left recurrent laryngeal nerve |
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Term
-The region above the vocal folds receives blood supply from the __. This is a branch from __, which itself branches off from the __
-The region below the vocal folds receives blood supply from the __, which branches from the __ |
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Definition
- superior laryngeal artery; superior thyroid artery; external carotid artery
- inferior laryngeal artery; inferior thyroid artery |
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Term
-In this left lateral view of the skull, note that the region around the large temporal bone is known as the __ (area outlined by the box), found where the temporalis muscle attaches. Below this is what’s known as the __ (area outlined by the smaller box). Note that the infratemporal fossa is deep to the zygomatic arch (indicated by the arrow).
-The bones that make up the boundaries of the infratemporal fossa are shown here. Many of these bones have muscle attachment sites that play a vital role in supporting the muscles of mastication. The bones important to associate with mastication and the infratemporal fossa include: |
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Definition
- temporal fossa; infratemporal fossa
- mandible, sphenoid, maxilla, temporal, zygomatic |
|
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Term
Boundaries of the Infratemporal fossa
Lateral:
Medial:
Anterior:
Posterior:
Superior: |
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Definition
Boundaries of the Infratemporal fossa:
Lateral: ramus of mandible and zygomatic arch
Medial: lateral pterygoid plate
Anterior: posterior portion of maxilla
Posterior: temporomandibular (TMJ) joint
Superior: greater wing of sphenoid |
|
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Term
| Give 5 contents of the infratemporal fossa: |
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Definition
Medial Pterygoid
Lateral Pterygoid
Maxillary Artery
Pterygoid plexus of veins
Mandibular Division (V3) |
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Term
-The __ is the main bone used in mastication. The muscles that attach to its many attachment sites provide it great power to start the first line of mechanical digestion. Below, the table will outline what muscles distally attach to the areas of the mandible. -The only area outlined here that is not a muscle attachment site is the __. This opening is where the __ of the __ travels inside the mandible to provide sensory innervation to the teeth.
- the four muscles of mastication include: |
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Definition
- mandible
- mandibular foramen; mandibular branch (v3); trigeminal nerve
- masseter; temporalis; lateral pterygoid; medial pterygoid |
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Term
Masseter
- PA:
- DA:
- action: |
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Definition
- zygomatic arch
- superficial side of angle of mandible
- elevate mandible |
|
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Term
temporalis
- PA:
- DA:
- action: |
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Definition
- temporal fossa
- coronoid process
- elevate mandible |
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Term
medial pterygoid
- pa:
- DA:
- action: |
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Definition
- lateral pterygoid plate
- deep side of mandibular angle
- elevate mandible |
|
|
Term
lateral pterygoid
- pa:
- da:
- action: |
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Definition
- lateral pterygoid plate/greater wing of sphenoid
- condyloid process at temporomandibular joint
- protract and depress chin |
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Term
-As we can see in this anterior view of the isolated __, this is one of the more complex skeletal structures in the body. As it sits within the center, anterior portion of the skull, the sphenoid exhibits several key structures to which important muscles of mastication attach.
-We can see the wing-like projections on either side connecting to the central body of the sphenoid. We can also see two projections that descend perpendicularly from where the wings and body meet. These are the __ & __, one on either side.
-Note that the __ serves as the point of attachment to both the medial AND lateral pterygoid muscle |
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Definition
- sphenoid bone
- medial; lateral pterygoid plate
- lateral pterygoid plate |
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Term
arterial supply - infratemporal fossa
-The external carotid has two terminal branches that are depicted in orange. These branches are the __ and __. The __ branches lower than the __ and supplies the maxilla, mandible and teeth.
-The __ artery itself has multiple specific branches that are key contributors of arterial blood to the region of the infratemporal fossa. We will discuss the maxillary artery & its branches in more detail on the next slide.
-The __ branch supplies the scalp near the temporalis muscle. The __ branch of the external carotid is the most important artery for blood supply to the muscles of the infratemporal fossa, however it is important to note that the external carotid has two terminal branches |
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Definition
- maxillary artery; superficial temporal artery; maxillary; superficial temporal
- maxillary
- superficial temporal branch; maxillary |
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Term
division of the maxillary artery
-As we just mentioned, there are 3 divisions of the maxillary artery that relate to the infratemporal fossa. The yellow branch shows the __.
-In green, the __ is shown. These arteries supply the superior layer of teeth and other structures that lie in the cheek area.
- The blue outline shows the __ that supplies the lower structures of the face. This artery runs deep to the facial artery that is discussed in the superficial facial lecture.
- Also, take note of the __. This artery will be discussed in more depth in the cranium lecture, however it is important to understand where it originates. |
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Definition
- posterior superior alveolar artery
- buccal branch
- inferior alveolar artery
- middle meningeal artery |
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Term
-Venous drainage of the infratemporal fossa is accomplished using primarily the __. This is a vast network of veins that lies directly behind the mouth as shown here. This network will drain into the __. This vein will then drain into the __ (junction of the maxillary and superficial temporal vv.) and continue towards the neck until it reaches the base and drains into the __ and eventually back to the heart.
-Also, the __ will drain some deoxygenated blood from the masseter and medial pterygoid muscles. The external palatine will drain into the __ and back to the __.
-Note that this venous drainage is much deeper than the network that was used with the superficial face, however the facial vein also drains these deeper venous structures. |
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Definition
- pterygoid plexus of veins; maxillary vein; retro-mandibular vein; internal jugular vein
- external palatine vein; facial vein; internal jugular |
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|
Term
-There are two basic routes for venous drainage that removes blood from the infratemporal fossa. The first pathway follows the route below:
-The second pathway (not pictured on this slide) follows the course below: |
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Definition
- pterygoid plexus > maxillary vein > retromandibular vein > internal jugular vein
- pterygoid plexus > external palatine vein > facial vein > internal jugular v. |
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Term
-Sensory innervation to the infratemporal fossa is accomplished via the __ of __, the __. This nerve enters into the infratemporal fossa through the __.
-There are several branches of the mandibular division of CN V. The __ travels superiorly to provide sensory innervation the area above and in front of the ear (although it looks like it innervates the temporalis, it only provides sensory innervation to the skin in this region). |
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Definition
- mandibular division (V3); CN V; trigeminal nerve; foramen ovale
- auriculotemporal nerve |
|
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Term
sensory branches of v3 that travel in the infratemporal fossa
-The __ provides sensory innervation for the lower teeth and jaw. Note that the portion of this nerve shown by a dashed line indicates that portion which dives deep into the mandible to access the lower teeth. It travels through the __ (inset to the right) to travel inside the mandible.
-The __ is medial to the inferior alveolar nerve. It does NOT enter the mandible. However, the dashed line indicates that it is deep to the mandible and travels to the underside of the tongue, where it where branches to provide sensation to the tongue.
-Lastly, the __ provides sensory innervation for the inside of the cheek (i.e. if you bite your cheek when chewing, this nerve conveys the pain!) |
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Definition
- inferior alveolar nerve; mandibular foramen
- lingual nerve
- buccal nerve |
|
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Term
| Remember that the V3 division of the __ also carries __ fibers to innervate the four muscles of mastication: the medial pterygoid, lateral pterygoid, temporalis, and masseter. |
|
Definition
|
|
Term
-The main bones that make up the superficial face are as follows:
-This picture highlights the __, or cheek bone and the vomer. There are two __, separated by the nasal bones and maxilla. The zygomatic bone has a prominence that is characteristic of the cheek. The top of the zygomatic forms the floor of the __ while the lower portion connects to the __. This bone is a muscle attachment site for the muscles zygomaticus major and zygomaticus minor. These muscles allow us to form a common smile.
-The __ is a thin, long midline (unpaired) bone that runs down the middle of the nose. The vomer separates the nasal cavity as it composes part of the nasal septum, and in reality serves little use in facial expression. The mandible and maxilla are clearly defined in this slide. It is important to note that the __ makes up the lower jaw, while the __ composes the upper jaw. |
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Definition
- maxilla; zygomatic; vomer; mandible; frontal
-zygomatic; zygomatic; orbit of the eye; maxilla
- vomer; mandible; maxilla |
|
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Term
-The superficial muscles of the face work together to allow for facial expression. Here you can see the general outline of the muscles and begin to determine their function. Highlighted individually to the right are the following superficial muscles of the face:
--It is important to note that the __ covers the entire surface of the skull. This tendinous covering connects the __ and __. This membrane works with the frontalis muscle to accomplish forehead expression and raising the eyebrow. |
|
Definition
-Frontalis
-Orbicularis Oculi
-Nasalis
-Zygomaticus Minor
-Orbicularis Oris
-Platysma
-Depressor Anguli Oris
-Zygomaticus Major
-- epicranial aponeurosis; occipitalis; frontalis |
|
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Term
-__ acts as the main sphincter that aids in opening and closing the mouth. This muscle is also used to pucker the lips. this muscle extends from the base of nose and encircles the lips to the upper chin region. Innervation of this muscle comes from the __ of cranial nerve __, the __.
-__ is the sphincter muscle that opens and closes the eyelids causing the blinking effect. This muscle is also used to aid in __. As the muscle contracts the __ compresses and causes tears to flow onto the eye. The nerve supply to this muscle comes from the __ and __ branches of cranial nerve __, the __. |
|
Definition
- orbicularis oris; buccal branch; VII; facial nerve
- orbicularis oculi; tear production; lacrimal gland; temporal; zygomatic; VII; facial nerve |
|
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Term
| -__ and __ work together to accomplish an ordinary __. These muscles both attach at the top of the corner of the mouth, therefore when contracted they pull the mouth upward creating a smile. It is important to note that __ is located above __. The name of these muscles is due to their size and function rather than position. -__ is the counterpart to zygomaticus major and minor. This muscle aids in frowning by contracting and pulling the corner of the mouth downward. |
|
Definition
- zygomaticus major; minor; smile; zygomaticus minor; major
- depressor anguli oris |
|
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Term
-__ and __ act together to rise and lower the lips (labia=lips). These muscles come in pairs and work together to accomplish facial expression of the lips.
-__ elevates the upper lip while __ lowers the bottom lip. Both of these muscles are innervated by the __ and are supplied with blood through the __. |
|
Definition
- levator labii superioris; depressor labii inferioris
- levator labii superioris; depressor labii inferioris; facial nerve; facial artery |
|
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Term
-The motor innervation of the superficial face is primarily supplied via the __. This nerve passes through an opening between the styloid and mastoid processes called the __ (not pictured).
-The facial nerve contains five branches pictured here. This nerves innervates muscles of facial expression. You will notice that each branch is named according to the general area of the face it supplies. The __ branch covers the temporal bone, __ refers to the cheek which is exactly where the branch is located, the __ and __ branches lie on the zygomatic and mandible bones respectively, and the __ branch continues down the neck to the cervical region of the body.
-The names of these branches can be remembered using the acronym:
this will allow you to not only remember the names of the branches of the facial nerve but also keep the order from superior to inferior correct. |
|
Definition
- facial nerve (CN VII); stylomastoid foramen
- temporal; buccal; zygomatic; mandibular; cervical
- ten zebras bit my cupcake |
|
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Term
-With the bones of the skull being slightly transparent, this right lateral view of the head/neck’s skeletal structures allows us to visualize the location of the __
-In order to supply both sensory innervation to the face as well as some motor functions (for mastication –V3 only) the trigeminal nerve gives off 3 branches, or divisions, named with a V and numbered subscript. These divisions are seen here, with their common names that imply the region they innervate
-- V1 division: __
-- V2 division: __
-- V3 division: __ |
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Definition
- trigeminal nerve (CN V)
-
-- opthalmic
-- maxillary
-- mandibular (only division to contain motor fibers) |
|
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Term
-Cranial nerve V is commonly referred to as the t__. The name gives way to the three (“tri”) main branches from the main __. This nerve supplies sensory innervation to the face and structures in the oral/nasal cavities (i.e. teeth, nasal mucosa).
-The three branches of the trigeminal nerve are referred to as V1-V3. In order from superior to inferior, V1 is __, V2 is __ and V3 is the __ division.
-The __ division also contains motor innervation to the muscles of mastication. It is the only division that carries motor innervation in addition to the sensory fibers. |
|
Definition
- trigeminal nerve; trigeminal ganglion
- opthalmic; maxillary; mandibular
- mandibular |
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Term
-The face is supplied by one main artery, the ___. This artery has many branches that supply the facial muscles however in this course you will not be responsible for their specific names.
-It is important to note that the __ extends up the neck and branches to the __ and __. The branches of the external carotid are named for the region they supply in the face and neck. For the superficial face, the facial artery is most important. Deeper facial structures are supplied by the maxillary and lingual arteries, for example, and will be examined more in their respective modules.
-Although the __ is cut in this picture it does extend to supply the scalp with blood as well via the superficial temporal artery.
-The __ is responsible for blood supply to the brain and will not branch until it enters the cranial cavity. |
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Definition
- facial artery
- common carotid artery; external; internal carotid arteries
- external carotid
- internal carotid |
|
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Term
-This schematic is a simplified version of the path of blood flowing out of the facial skeleton and back to the heart. As blood drains out of the __ it follows the path shown here to the __ and finally into the __ and back to the __
-Note that the brachiocephalic trunk is formed from the union of the __ with the __. |
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Definition
- facial vein; internal jugular vein; left brachiocephalic vein; right atrium of the heart
- internal jugular vein; subclavian vein |
|
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Term
| the two muscles of the face that do not receive blood supply from the facial artery, are __ and __, which receive blood supply from the __ |
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Definition
| orbicularis oculi; frontalis; ophthalmic artery |
|
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Term
| __ nerve deals with sensory to the face while the __ nerve deals with motor |
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Definition
|
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Term
-As we can see in the left lateral view of the brain and brainstem, there are three basic anatomical divisions.
-The largest of the three divisions is the __, which is made up of both a left and right hemisphere separated by the __.
-The __ is active in coordinating motor control and balance.
-The __ s a vital link between the brain and cerbellum/spinal and is the origin of 10 of the 12 cranial nerves. |
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Definition
-
- cerebrum; faix cerebi
- cerebellum
- brainstem |
|
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Term
-The brain is divided into two hemispheres (left and right), which are connected through a network of __ matter, or axon fibers called the __. This allows for communication between the two hemispheres.
-In this midsagittal view of the right hemisphere, we can also see the __. One of the functions of the previous is to regulate the hormones released by the __ located just anterior and inferior to it.
-Also note the components of the brainstem; the __, __, & the __. The __ is continuous with the spinal cord. The brainstem connects the spinal cord and brain and contains ascending and descending fiber tracts. |
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Definition
- white; corpus callosum
- hypothalamus; pituitary gland
- midbrain, pons, medulla; medulla |
|
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Term
- give the 5 anatomical divisions of the brain and their associated function:
-The __ is a groove that spans from the left to right side of the brain and separates the frontal and parietal lobes. The __ is another prominent groove that separates the temporal lobe from the frontal and parietal lobes. |
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Definition
1. frontal = motor
2. parietal = sensory
3. occipital = vision
4. temporal = hearing
5. insular = integrating emotions
- central sulcus; lateral sulcus |
|
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Term
-The bones of the skull are large flat bones that encase the brain to serve as the first layer of protection. The frontal, parietal, temporal, and occipital lobes of the brain lie under these bones respectively.
-The paired __ bones compose the majority of the top of the cranium. The previous ones are bordered anteriorly by the __ bone which continues down to form the forehead. The __ connects the two parietal bones. The __ serves to connect the parietal and frontal bones. |
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Definition
-
- parietal; frontal; sagittal suture; coronal suture |
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Term
-This posterior view of the skull shows a clear image of the __ bone.
-Although difficult to see in this image, at the base of this bone is the __, which is a large opening through which the __ passes.
-The occipital bone is separated from the parietal bones by the __. All sutures of the skull are considered __ joints because they are immovable. |
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Definition
- occipital
- foramen magnum; brainstem
- lambdoid suture; synarthrotic |
|
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Term
-The lateral view of the skull allows for a clear view of the __ bone. It is important to note the symmetry in the bones of the skull. Therefore, there are two __ and __ bones but only one __ and __ bones. These bones articulate together to form the cranium.
-The fused joint between the temporal and parietal bones is marked by a visible line known as the __. This meandering line continues laterally towards the anterior skull. The portion found where the sphenoid and parietal bones meet is appropriately named the __. Once past the horizontal boundary between the parietal and frontal bones, the remaining section of the suture is renamed as the __.
-Also note that the point where all these cranial sutures meet is known as the __ and is the weakest portion of the entire skull. |
|
Definition
- temporal; parietal; temporal; occipital frontal
-squamous suture; sphenoparietal suture; sphenofrontal suture
- pterion |
|
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Term
- __ are large depressions of the floor of the cranial cavity and are divided into three main regions: __, __, and __
- anterior cranial fossa
--Encompasses the structures in the front of the head and ends at the __
- middle cranial fossa
--Begins after the __ and ends with the __ of the __. Also note in the center of the middle cranial fossa is the __, which literally means “Turk’s saddle” and is so named due to its saddle like appearance. This structure lies at the base of the brain and houses the __.
- posterior cranial fossa
--Contains one of the most important structures in the head. In the middle of the occipital bone is the __, a large opening that allows passage of the beginning of the __ (which is continuous with the __). The MRI image to the right shows how the spinal cord enters through the foramen magnum. |
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Definition
- cranial fossae; anterior cranial fossa; middle cranial fossa; posterior cranial fossa
-
-- lesser wing of the sphenoid bone
-
-- lesser wing of the sphenoid; petrous ridge; temporal bone; sella turcica; pituitary gland
-
-- foramen magnum; spinal cord; (medulla of the brainstem) |
|
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Term
-The sphenoid bone is one of the most structurally complex bones in the human body. It is important to note that the bone has a __ and a __ of which only the __ is seen from the external cranium. This can be seen in the lower image on the right.
-The __ and __ will be muscle attachment sites for the medial and lateral pterygoid muscles respectively.
-The sphenoid bone also contains two __, conveniently named the __, are located just adjacent to one another. |
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Definition
- greater; lesser wing; greater wing
- medial; lateral plates
- sinuses; sphenoidal sinuses |
|
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Term
-The ethmoid bone is also a very structurally complex bone. It lies in front of and medial to the sphenoid bone, and makes up part of the orbit and nasal cavity. It houses cranial nerves involved in __ or __. The __ lies between the two halves of this bone. The holes seen in this area are where the __ arise and relay olfactory input to the brain. Additionally, the __ projects from this area. this is an attachment site for the protective meninge, the __, that separates the right and left hemispheres of the brain.
-In the anterior view, the portions of the ethmoid bone that contribute to the nasal cavity and orbit can be seen. The __ and __ and __ contribute to the structure of the nasal cavity. The __ is part of the nasal septum, while the __ make up the lateral nasal wall. These areas contain __ that help to moisten air as it enters in the respiratory system for the first time. |
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Definition
- smell; olfaction; cribriform plate; olfactory nerves; crista galli; falx cerebri
- superior; middle nasal concha; perpendicular plate; perpendicular plate; concha; mucous membranes |
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Term
-Now that we’ve covered the protective cranium, we’re moving deeper to the protective layers of the brain.
-There are 3 protective layers of the brain superficial to deep:
1.
2.
3. |
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Definition
1. dura (tough mother)
2. arachnoid membrane (spider-like)
3. pia mater (delicate mother) |
|
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Term
-In this right lateral view, the right hemisphere of the brain is revealed by removing the right side of the cranium.
-The vascular, opaque layer of tissue covering the brain’s right hemisphere is known as __.
-Of the three layers of meninges that cover the brain, __ is the outermost layer, and is also the toughest. It is often nicknamed “__”. We will examine this protective layer in more detail on the following slide. |
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Definition
-
- dura mater
- dura mater; tough mother |
|
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Term
| -Dura mater is the thickest layer of the protective coverings of the brain, hence the nickname, “tough mother.” It is the outermost layer of meninges that covers both the brain and spinal cord. In the brain, the dura mater is supplied blood via the __. The dura mater consists of two layers, a __ and __ layer. These layers separate in some regions to form spaces and protective layers. This will be examined further on the next few slides. |
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Definition
| - middle meningeal artery; periosteal; meningeal layer |
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Term
-The dura mater consists of a __ layer just beneath the bone and a __ layer that separates from the periosteal layer to invaginate into the brain tissue.
-The separation of the periosteal and meningeal dura creates a __ through which blood is drained from the brain. The dural sinous outlined in orange on the image to the right represents the largest of the dural sinuses, the __.
-Once the meningeal layers rejoin, a __ is formed. This is a protective layer that serves as a protective barrier between the lobes of the brain.
-This is the basic way in which a dural sinus and dural fold are formed. There are many different named dural folds/sinues that will be emphasized on the next few slides. |
|
Definition
- periosteal layer; meningeal layer
- venous/dural sinus; superior sagittal sinus
- dural fold
- |
|
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Term
-The arachnoid mater is a meningeal layer between the __ and the __. It contains spider web-like extensions that cross the __. This space contains __ that acts as a buffer or cushion for the brain.
-The arachnoid mater contains __, which are evaginations of arachnoid mater into a __. They extend into the venous sinuses of the brain and allow the __ to exit the sub-arachnoid space. __ provide a one-way flow (escape) of CSF from the subarachnoid space into venous blood in the dural sinus, specifically the __.
- csf flows in the __ |
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Definition
- dural; pia mater; subarachnoid space; cerebrospinal fluid
- arachnoid granulations; dural (venous) sinus; csf; arachnoid granulations; superior sagittal sinus
- subarachnoid space |
|
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Term
-A delicate, highly vascularized layer that is intimately applied to the surface of the brain and spinal cord. The latin meaning of the name is “__”, which hints at just how delicate __ is as a meninge. This thin fibrous tissue in relatively impermeable, and therefore the CSF is maintained in the __ between the arachnoid and pia mater.
-__ permeate through the pia mater as this layer anchors the vessels to the brain tissue. In the lower image on the right, the pia mater would follow the grooves of the brain as the delicate third layer of protection. The pia mater is just __ thick therefore it is not able to be lifted by a probe. It is said to be “intimately associated” with the brain itself. |
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Definition
- tender mother; pia mater; subarachnoid space
- blood vessels; one cell layer |
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Term
-The brain has three layers of coverings collectively referred to as meninges. The most outer meninge is the __, or in latin, “__”. This layer is the thickest and contains the __ that supplies the dura. This artery is a branch from the __.
-The other two meninges of the brain are the __ and __. Working from superficial to deep, the __ is the next layer. This meninge houses the __ that aid in the drainage of __.
-The __ is consistent with the brain and cannot be surgically separated. This meninge anchors __ to brain. The pia mater and arachnoid mater are separated via the __.
-It is also important to note that the __ and __ are protected by the same three meningeal layers. |
|
Definition
- dura mater; tough mother; middle meningeal artery; maxillary artery
- arachnoid mater; pia mater; arachnoid mater; arachnoid granulations; csf
- pia mater; blood vessels; subarachnoid space
- spinal cord; brainstem |
|
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Term
-Dura mater itself is comprised of two layers: a __ (the outermost) and a __ (the innermost) layer.
-While these two layers are mostly in contact with each other, they can separate, creating an open channel between them. These open channels or spaces are called __. They collect __ from the brain as well as __ (in the case of the superior sagittal sinus), and this fluid eventually drains into the __.
On the next slide, we will examine the names of the dural folds created when meningeal layers of dura rejoin. Then we will learn the names of the different dural sinous formed from the separation of __ and __ |
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Definition
- periosteal; meningeal
- dural (venous) sinuses; blood; csf; internal jugular vein
- periosteal; meningeal dura |
|
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Term
-The dural fold formed between the two hemispheres of the cerebrum is referred to as __. This fold forms the __ along the superior portion of the fold and the __ inferiorly in the free edge of the fold.
-The __ separates the cerebellum and there are no sinuses directly formed by this fold that you need to learn.
-The __ is a horizontal fold that forms the __. Anterior to the tentorium cerebelli is the ___ (which is in the region of the cavernous sinus). This is a fold that encompasses the __
-The __ is actually an opening through which the brainstem passes. |
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Definition
- falx cerebri; superior sagittal sinus; inferior sagittal sinus
- falx cerebelli
- tentorium cerebelli; transverse sinus; diaphragma sellae; pituitary gland
- tentorium incisure |
|
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Term
1. __: located in the superior border of the falx cerebri between the periosteal and meningeal dura
2. __: located on the inferior edge of the falx cerebri in the __ only
3. __: located at the junction of the falx cerebri and tentorium cerebelli
4. __: located on the internal occipital protuberance
5. __: lead from the confluens of the sinuses toward the sigmoid sinuses between the periosteal and meningeal dura
6. __: lead inferiorly from the transverse sinuses down to the internal jugular veins at the jugular foramen between the periosteal and meningeal dura
7. __: receives the blood from the sigmoid sinus and drains venous blood back to the __ vein and into the __ |
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Definition
1. superior sagittal sinus
2. inferior sagittal sinus; meningeal dura
3. straight sinus
4. confluens of the sinuses
5. transverse sinus
6. sigmoid sinus
7. internal jugular vein; brachiocephalic vein; superior vena cava |
|
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Term
-The __ border the temporal bone and the sphenoid bone, lateral to the __. It is a large collection of thin walled veins that create this cavity. It will be discussed in further detail on the next slide.
-Blood drains from the cavernous sinuses back to either the end of the…__ via the __ or to the end of the __ by the __. |
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Definition
- cavernous sinuses; sella turcica
- sigmoid sinus; inferior petrosal sinus; transverse sinus; superior petrosal sinus |
|
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Term
-The blue circle represents where the cavernous sinus is found.
-Within this area there are many vital structures. The ___ follows up through the cavernous sinus to supply the brain with blood.
-Also running along the cavernous sinus are cranial nerves __, __, __, and __. Therefore when this area becomes inflamed or infected it should be clear that multiple functions are affected (we will discuss cranial nerves in more detail in the next module). |
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Definition
-
- internal carotid artery
- III, IV, V1, VI |
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Term
-As stated before, the venous sinuses are used to drain __ and __ from the brain. Although we followed the pathways of the sinuses, we are now going to look at the production and drainage of CSF in greater detail to better understand this system.
--The brain has interconnected __ located deep within it that are continuous with the subarachnoid space and the central canal of the spinal cord, all these areas produce __.
--The __ secretes csf and is located within the ventricular system. Primarily within the __, however __ is located in all four ventricles.
--__ is constantly secreted within the ventricles, escapes into the surrounding subarachnoid space and central canal of the spinal cord via the __ and __, and then leaks into the __ via the __. |
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Definition
- csf; blood
-- cavities (ventricles); csf
-- choroid plexus; lateral ventricles; choroid plexus
-- csf; lateral; median apertures; dural venous sinuses; arachnoid granulations |
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Term
-We’ve already examined the protective cranium and meninges layers of the brain. Now we will move deeper and examine the structures that produce the CSF fluid that eventually ends up in the subarachnoid space.
-The ventricular system is made up of four ventricles that are filled with __. The __ empty through the __ and into the __.
-The __ then empties via the __ into the __.
-Note the __ are paired while the __ and __ ventricles are unpaired. Also, from this diagram you can see that the 4th ventricle is continuous with the __. |
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Definition
-
- csf; lateral ventricles; interventricular foramen; 3rd ventricle
- 3rd ventricle; cerebral aqueduct; 4th ventricle
- lateral ventricles; 3rd; 4th; spinal cord |
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Term
-__ is housed in the four ventricles previously discussed however it must have a way out of the ventricles and into the subarachnoid space. This is accomplished through apertures.
-The apertures come from the __ and allow the CSF to travel to the __. Here, you can clearly see the left and right lateral apertures and the median aperture. |
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Definition
- csf
- 4th ventricle; subarachnoid space |
|
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Term
-We have now covered the protective cranium, the protective layers of the brain, and the CSF. We will now move on to blood supply which we know how blood gets out, now we will look at how gets in.
-Blood supply to the brain is accomplished through two primary sets of arteries, the __ arteries and the __ arteries.
--Recall, the __ arteries branch from the __ artery while the __ arteries branch from the __ artery.
-The __ arteries converge to form the __ (shown on next slide) artery. The __ arteries branch to form the __ and __ arteries. |
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Definition
-
- vertebral arteries; internal carotid arteries
-- vertebral; subclavian; internal carotid; common carotid
- vertebral; basilar; internal carotid; anterior; middle cerebral |
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Term
-The __ is the main arterial supply for the brain. An inferior view of the brain shows where the circle is located. The circle is a __ connection between six different arteries. Note that all arteries are paired except for the __ artery.
-Blood first enters via the __ arteries and the __ artery (formed by the union of the __ arteries). These primary arteries are connected via “__”, hence forming the Circle of Willis. |
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Definition
- circle of willis; anastomosic; basilar
- internal carotid; basilar; (vertebral); communicating arteries |
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Term
There is a difference between spinal and cranial nerves. In this section we will focus on cranial nerves which have more specific functions for each nerve when compared to spinal nerves. These 12 paired nerves are directly connected to the brain and/or brainstem.
Cranial nerves are named in the order in which they arise from the brain or brainstem. They are commonly referred to using roman numerals as seen to the right. The following is a list that needs to be committed to memory. Refer to the picture that each nerve leads to on the right to get a general idea of its function. |
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Definition
CN I- Olfactory Nerve
CN II- Optic Nerve
CN III- Oculomotor Nerve
CN IV- Trochlear Nerve
CN V- Trigeminal Nerve
CN VI- Abducens Nerve
CN VII- Facial Nerve
CN VIII- Vestibulocochlear Nerve
CN IX- Glossopharyngeal Nerve
CN X- Vagus Nerve
CN XI- Accessory Nerve
CN XII- Hypoglossal Nerve |
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Term
-From this picture understand that CN __- CN __ begin at various stages of the __. The cranial nerves go in order from superior to inferior beginning with CN III, except for CN __, which emerges from the posterior side between the __ and __, which together with the __ make up the brain stem.
-Also note the fact that each cranial nerve is paired to innervate both sides of the body. Also, consider the size of CN X, the __. This is referred to as the “__” because it begins on the brainstem and innervates structures all the way down to the colon.
-When studying this slide consider which level of the brainstem each nerve originates from rather than studying the specific diagram. You will not be asked to label this diagram. |
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Definition
- 3-12; brainstem; 4; pons; midbrain; medulla
- vagus nerve; wandering nerve |
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Term
- functionally the cranial nerves can be:
-- __ only: exclusively __
-- __ only: exculsively __
-- __: contains both motor and sensory
-The cranial nerves can also be viewed as having __ (CNS to skin & skeletal muscle; conscious) or __ (CNS to viscera; unconscious) components.
-Some cranial nerves (__, __, __, and __) contain parasympathetic efferent (__) fibers for taste, vision, audition, equilibrium, and olfaction
-The nerves containing parasympathetic components have __ associated with them.
-Cranial nerves do NOT contain __ fibers
-The parasympathetic cranial nerve fibers and sympathetic fibers do run together and work __. |
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Definition
-
-- motor; efferent
-- sensory; afferent
-- mixed
- somatic; autonomic
- (3, 7, 9, 10); (secretomotor)
- parasympathetic ganglia
- sympathetic fibers
- anatagonistically |
|
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Term
- CN I is the __
-CN I is purely __. The olfactory nerve is routed to numerous parts of the brain that function in interpreting smell, as well as in linking smell to emotions and specific memories. It is the only nerve that is not rerouted through the __.
- cranial exit: __
- does not originate from the __ |
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Definition
- olfactory nerve
- sensory; thalamus
- cribiform plate
- brainstem |
|
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Term
-This diagram shows the pathway for CN II, the __. Damage to CN II results in functional blindness. It contains bipolar neurons that begin with photoreceptors in the retina of the eye, and axons which pass posteriorly into the skull via the __ (seen below in anterior view of the skull),
-The optic nerve aids in vision and is once again purely __. The nerve stimuli passing through this nerve are ultimately interpreted in the posterior portion of the brain, known as the __ (highlighted in red to the bottom right).
-Cranial exit: __
- does not originate from __ |
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Definition
- optic nerve; optic canal
- sensory; visual cortex
- optic canal
- brainstem |
|
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Term
- cranial nerve III: ___
- cranial nerve three is __ to the __ muscles of the eye, and therefore begins on the brainstem and enters through the __ to innervate the following muscles that aid in eye movement
-- __, __, __, __
-The oculomotor nerve contain BOTH __ & __ nerve fibers on its way to supply the eye and extraocular muscles. PYM innervation causes __ and adjusts __ of the lens, which allows us to see both far away and close-up.
-Cranial exit: __ |
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Definition
- oculomotor nerve
- motor; extraocular; superior orbital fissure
-- superior rectus, inferior rectus, medial rectus, inferior oblique
- motor; parasympathetic; pupil constriction; thickness
- superior orbital fissure |
|
|
Term
-CN IV: __
- CN IV originates on the posterior side of the midbrain and is purely __. This nerve innervates the __, the extraocular muscle responsible for depressing AND abducting the eye.
-Trochlear nerve will pass through the __ and end in the __ of the eye. Once again, because this nerve serves __ function, it will run to the eye rather than from the eye.
-Cranial exit: __ |
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Definition
- trochlear nerve
- motor; superior oblique muscle
- superior orbital fissure; superior oblique muscle; motor
- superior orbital fissure |
|
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Term
- CN V = __
-Cranial nerve V originates on the __ of the brainstem and is mostly __ to the face. The __ division contains both motor and sensory. Recall that the trigeminal nerve has three main branches, referred to as V1, V2 and V3.
-The first and second branch of CN V, V1 and V2 are purely __ to the face, however V3 serves __ and __ innervation. V3 innervates the muscles used in __.
- V1 cranial exit: __
- V2 cranial exit: __
- V3 cranial exit: __ |
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Definition
- trigeminal nerve
- pons; sensory; third
- sensory; sensory; motor; mastication
- superior orbital fissure
- foramen rotundum
- foramen ovale |
|
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Term
- cranial nerve VI: __
- Cranial nerve VI orginates on the junction of the __ and __ of the brainstem.
-This nerve innervates the __ muscle of the eye, and is purely __.
-In the image to the right, the lateral orbit has been removed and a portion of the lateral rectus muscle, so the full extent of the CN VI is not shown.
-Cranial exit: __ |
|
Definition
- abducens nerve
- pons; medulla
- lateral rectus; motor
-
- superior orbital fissure |
|
|
Term
| -An easy way to remember innervation to the extraocular eye muscles: |
|
Definition
- [LR6SO4]3
-- lateral rectus innervated by CN VI
-- superior oblique innervated by CN IV
-- remaining four extraocular muscles are innervated by CN III |
|
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Term
- cranial nerve: __
-Cranial nerve VII is located on the pons of the brain stem, and supplies the face with __, __ and __ innervation.
-The __ innervation will cause the increased secretions of the __ and __ glands.
-The __ innervation runs to the muscles of facial expression and the branches of this component are labeled to the right. Recall the acronym __ to help to remember these branches.
The __ innervation provides taste to the anterior 2/3 of the tongue (not shown).
Cranial exit: __ and __ |
|
Definition
- facial nerve
- motor; sensory; parasympathetic
- parasympathetic; submandibular/sublingual; lacrimal
- motor; ten zebras bit my cupcake
- sensory
- internal acoustic meatus to exit the skull; stylomastoid foramen (for the motor branches) |
|
|
Term
- cranial nerve VIII: ___
- CN VIII lies on the __ of the brainstem and supplies __ innervation to the inner ear. This nerve travels with CN VII and will exit the skull via the __ located on the temporal bone shown below.
-Damage to this nerve will result in loss of hearing and balance due to the equilibrium kept in the inner ear.
-Cranial exit: __ |
|
Definition
- vestibulocochlear nerve
- medulla; sensory; internal acoustic meatus
-
- internal acoustic meatus |
|
|
Term
- cranial nerve IX: __
-cranial nerve IX originates on the __ of the brain stem and supplies __, __ and __ innervation.
-The motor innervation supplies the muscle, the __, which aids in raising the pharynx during swallowing (discussed more in later modules) It attaches to the styloid process and the back of the throat to help lift the throat.
-The sensory innervation provides taste to the __ (indicated by the area posterior to dashed line) and sensation to the back of the __.
-The PM innervation will __ secretions at rest of the __ gland, the largest salivary gland. As seen previously, CN __ runs through it, but CN __ innervates the gland.
-Cranial exit location: __ |
|
Definition
- glossopharyngeal nerve
- medulla; motor; sensory; parasympathetic
- stylopharyngeus
- posterior 1/3 of tongue; throat
- increase; parotid; 7; 9
- jugular foramen |
|
|
Term
- cranial nerve X: __
-CN X originates off of the __ of the brainstem. It then passes through the __ and into the __ on its descent to innervate __ of the neck, chest and abodmen.
-This large, meandering nerve contains __, __, and __ nerve fibers. It is a major supplier of innervation to viscera of the neck, thorax, and abdomen.
-Cranial exit: __ |
|
Definition
- vagus nerve
- medulla; jugular foramen; carotid sheath; viscera
- motor; sensory; parasympathetic
- jugular foramen |
|
|
Term
-Motor innervation to the muscles of the __ and __ is supplied by the vagus nerve. The __ muscles help move the vocal cords, while the __ muscles supplied by CN X aid in moving the throat up and down while eating.
-As seen in the image on the right, as the vagus nerve travels down, two branches loop back up. These branches are referred to as the __ and __.
-Recall that these branches were emphasized in the mediastinum modules, as the right __ loops around the right subclavian artery and the __ loops around the arch of the aorta |
|
Definition
- larynx; pharynx; larynx; pharynx
- left; right recurrent laryngeal nerves
- right recurrent laryngeal nerve; left recurrent laryngeal nerve |
|
|
Term
-The vagus nerve is vital to carry out processes essential to life, such as breathing, getting blood to the heart and digestion. Its long course from the medulla down through the thorax and into the abdomen earned it the nickname “__.” To the right you can see how this nerve runs along the __ and ensures blood reaches the heart.
-the vagus nerve supplies the skin of the ear, taste buds on the epiglottis, mucosa of the lower pharynx, mucosal lining of larynx and thoracic and abdomen viscera with __ innervation.
-__ innervation of the viscera causes digestion to speed up and cardiac function to slow down during resting state. The __ fibers in a fight or flight response would greatly increase cardiac function and slow digestion because your body recognizes this is not as important to digest your food as it is to run away from what has frightened you. |
|
Definition
- the wandering nerve; aorta
- sensory
- parasympathetic; sympathetic |
|
|
Term
- cranial nerve XI: __
-CN XI has two divisions, the __ division that originates on the medulla of the brainstem and the __ division that originates on the spinal cord.
-CN XI supplies __ innervation to the muscles of the neck and shoulder. Specifically, CN XI innervates the __ and __ (runs down the posterior of the neck).
-Cranial exit: __ |
|
Definition
- accessory nerve
- cranial division; spinal division
- motor; trapezius; sternocleidomastoid
- jugular foramen |
|
|
Term
- cranial nerve XII: __
-CN XII originates on __ of the brainstem and supplies the intrinsic muscles of the __ with __ innervation. CN XII exits via the __ shown to the right.
-Damage to this nerve will result in loss of coordination of the tongue which will impair speech and eating abilities.
-Cranial exit: __ |
|
Definition
- hypoglossal nerve
- medulla; tongue; motor; hypoglossal canal
-
- hypoglossal canal |
|
|
Term
-The nasal cavity is the area between the __ and the __. The nasal cavity is lined with a special __ for heating the air passing through the cavity to later enter the lungs. The cells in the upper 1/3 of the nasal cavity also serve as __ that trigger sense of smell.
-There are __ air sinuses that function to lighten the mass of the skull, increase surface area of nasal mucosa and serve as resonating chambers. The general location of the sinuses can be seen in red on the diagram to the right. These spaces will be emphasized later in the reading. |
|
Definition
- external nares (the nostrils); internal nares (before the nasopharynx); respiratory epithelium; sensory receptors
- six |
|
|
Term
-The nasal cavity is divided into a right and left cavity by the __. The lateral wall of the left nasal cavity has been removed so that the nasal septum is in view. On the opposite side of the septum is the right side of the nasal cavity
-__ mark the opening of the nasal cavity. It is guarded by coarse hairs that keep out debris from the environment. It is also a site for drainage
-The __ are located just before the naso- pharynx, the portion of the pharynx closest to the nasal cavity. |
|
Definition
- nasal septum
- external nares
- internal nares (choanae) |
|
|
Term
- the nasal septum has three main components
1.
2.
3. |
|
Definition
1. the perpendicular plate of the ethmoid bone
2. the vomer
3. the septal cartilage |
|
|
Term
Paranasal sinuses
-__ lighten the mass of the skull, increase surface area of nasal mucosa and serve as resonating chambers. The sinuses are named for the facial bones in which they are located behind (note: the text color of the sinuses is color-coded to the next slide).
-__- largest of the sinuses located under the eyes in the maxillary bones
-__- superior to the eyes in frontal bone
-__- between the nose and eyes in the ethmoid bone
-__- at the center of the skull base under the pituitary gland in the sphenoid bone |
|
Definition
- sinuses
- maxillary sinuses
- frontal sinuses
- ethmoid sinuses
- sphenoid sinuses |
|
|
Term
-The lateral wall has three shell shaped bony ridges that protrude out into the cavity and curve toward the front of the __. Theses bony ridges are called the __. These include __, __, and __
-Inferior to each conchae is a space known as the __. these are drainage sites from the __ or the __. Pictured to the right are the paranasal sinuses that drain into the nasal cavity which include __, __, __, and __.
- Note: the __ is not a sinus and the __ also drains in the nasal cavity, but is not considered a duct |
|
Definition
- external nares; nasal conchae; superior conchae; middle conchae; inferior conchae
- meatus; paranasal air sinuses; nasolacrimal duct; frontal; sphenoid; maxillary; ethmoidal air cells
- orbit; nasolacrimal duct |
|
|
Term
| -The __ is defined as a natural body passage or canal. They compose drainage sites for __. the three are __, __, and __ |
|
Definition
| - meatus; paranasal sinuses; superior meatus; middle meatus; inferior meatus |
|
|
Term
-This illustration shows the lateral wall including the conchae and meatuses.
-The arrows indicate the flow of air through the __, while the cream color indicates the conchae. Here the __ increases creating a spiral effect, which __ the air passing through the cavity to prepare to enter the lungs. |
|
Definition
-
- meatus; surface area; heats |
|
|
Term
| - state the sinuses/duct drained and the nasal passage receiving the drainage |
|
Definition
1. sphenoethmoid recess: sphenoid sinus
2. superior meatus: posterior ethmoid sinus
3. middle meatus: anterior ethmoid sinus, middle ethmoid sinus, frontal sinus, maxillary sinus
4. inferior meatus: nasolacrimal duct |
|
|
Term
| -Also called the tear duct, the __ collects tears from the eye and drains into the __ in the nasal cavity (note-it is not considered a __, but still drains to the nasal cavity). This drainage pathway is the source of a runny nose when crying or suffering from allergies |
|
Definition
| - nasolacrimal duct; inferior meatus; (paranasal sinus) |
|
|
Term
-The __ is located in the upper 1/3 of the nasal cavity. it has __ specialized for transmission of __ molecules.
-The __ covers the remaining portion of the nasal septum and lateral walls (concahe) of the nasal cavity. This epithelium __ and __ the air you breath.
-From left lateral view, below, just behind the frontal nasal sinus lies the __ in yellow, which is innervated by __. The bone beneath it is the __ of the __. Notice how the holes in the bone allow the sensory neurons of CN1 to move up through the bone to synapse with neurons in the olfactory bulb. |
|
Definition
- olfactory epithelium; bipolar neurons; odor
- respiratory epithelium; warms; humidifies
- olfactory bulb; CN1; cribiform plate; ethmoid bone |
|
|
Term
-Olfactory receptor cells: The axons leave the region of the olfactory epithelium in groups that pass upward through the __ of the __ as the __, where they synapse in
the overlying __. |
|
Definition
| - cribiform plate; ethmoid bone; filia olfactoria; olfactory bulb |
|
|
Term
-The anterior and upper regions of the lateral and medial walls of the nasal cavity receive general
sensation from branches of the __, a branch of the __. Below the olfactory bulb is the __, where the __ are located.
-The lower and posterior regions are
innervated by the __
via branches from the __ that is suspended deep in the facial skeleton. |
|
Definition
- anterior ethmoidal nerve (CN V1); olfactory nerve; olfactory region; filia olfactory
- maxillary nerve (V2); pterygopalatine ganglion |
|
|
Term
For the level of detail in this course, we do not need to know the specific names of the numerous arteries in the nasal cavity. However, the point we want to take away when examining the arterial blood supply to this cavity is that the vessels supplying this region arise from two distinct sources.
The two arterial blood sources that give rise to the multitude of arteries seen in this image are roughly outlined by the colored arrows, and include the __ and the __ (a branch from the __ artery supplies the nasal cavity). |
|
Definition
-
- internal carotid; external carotid arteries; (maxillary artery) |
|
|
Term
| The mouth, or the oral cavity, is a mucosa-lined cavity whose boundaries are the __ anteriorly, the __ laterally, the __ superiorly, and the __ inferiorly. |
|
Definition
| - lips; cheeks; palate; tongue |
|
|
Term
-The oral cavity consists of two parts, the __ and the __.
-The __ is the slit-like space between the teeth and the cheeks. When you brush the outer surface of your teeth, your toothbrush is in the __.
-__ is the whole cavity space between the teeth.
-The __ forms the roof of oral cavity and has two parts, the __ and the __ |
|
Definition
- vestibule; oral cavity proper
- vestibule; vestibule
- oral cavity proper
- palate; hard; soft palate |
|
|
Term
-The boundaries of the oral cavity proper are the roof containing the __, the floor containing the __, and the __ laterally.
-The tip of the soft palate is called the _, which is a muscular flap that elevates to close off the __ during swallowing. |
|
Definition
- hard & soft palate; anterior 2/3 of the tongue; cheeks
- uvula; nasopharynx |
|
|
Term
-With the tongue elevated, the following are visible: the __ a midline fold of mucous membrane attached to the inferior surface of the tongue and the floor of the oral cavity, the __, and the __ on either side of the frenulum.
-The opening of the __ is the __ that opens on both sides of the frenulum shown by the red arrows. |
|
Definition
- frenulum; submandibular duct; submandibular papillae
- submandibular duct; submandibular papillae |
|
|
Term
-The tongue is a mass of skeletal muscle that functions in __, __, __, and __
- the tongue is anchored to the __, __, __, and __ |
|
Definition
- taste, mastication, swallowing, speech
- styloid process; hyoid bone; mandible; pharynx |
|
|
Term
-__ are located beneath the floor of the mouth and contribute to 70% of the salivary volume .
-__ lie anterior to the __ under the tongue, beneath the __ of the floor of the mouth. These glands secrete a mucous substance that helps to lubricate food.
-NOTE: both of these glands are innervated by __ |
|
Definition
- submandibular glands
- sublingual glands; submandibular glands; mucous membrane
- CN VII |
|
|
Term
-The __ are the largest of the salivary glands. They are each found wrapped around the __, and secrete saliva into the __ close to the upper molars. They contribute to digestion with a serous or watery fluid that contains __, an enzyme that breaks down carbohydrates.
-The __ is the route that saliva takes from the parotid gland and opens into the mouth lateral to the __
-NOTE: the parotid gland is innervated by __ |
|
Definition
- parotid glands; mandibular ramus; oral cavity; amaylase
- parotid duct; second upper molar
- CN IX |
|
|
Term
-In the oral cavity, there are groups of lymphatic tissue called __. This tissue consists of __ that are strategically placed to fight against pathogens in food that is ingested.
-The blue circle indicates the __.
-The orange circle indicates the __. They can be seen near the posterior portion of the __.
-The white circle indicates the __ which are located on the __. |
|
Definition
- tonsils; immune cells
- pharyngeal tonsils
- palantine tonsils; tongue
- lingual tonsils; posterior 1/3 of the tongue |
|
|
Term
-The tongue can be divided into a
__ part and a __ part.
-THE ORAL PART EXHIBITS:
--The tip of the tongue rests against
the __ aspect of the __.
--The margins of the tongue touch the __ and the __.
The dorsum is divided into __ and __ by a V-shaped groove called the __ shown in black. |
|
Definition
- oral; pharyngeal
-
-- posterior; teeth
-- gums; teeth
-- posterior 1/3; anterior 2/3; sulcus terminalis |
|
|
Term
-The __, described on this slide, cover the tongue and are also known as taste buds.
-The __, (not shown on the large tongue diagram) meaning thread shaped, are the __ and most numerous and have __. They also roughen the __ to allow to manipulate food better during chewing.
-The __, mushroom shaped, are less abundant than filiform and are scattered widely over the tongue. Taste buds occur in the __ on the __ of these papillae.
-__ indicated by the white box, are directly anterior to the __. They line up in a __ shaped row and have taste buds on the __ aspects. |
|
Definition
- papillae
- filiform papillae; smallest; keratinized tips; tongue
- fungiform papillae; epithelium; tops
- vallate (circumvallate) papillae; sulcus terminalis; V; lateral |
|
|
Term
- pharyngeal part of the tongue
--The __, which is a cartilaginous piece of the larynx, is where the tongue attaches posteriorly. The previous has spaces between the folds that are pocket-like and are referred to as the __. This is where food can sometimes get stuck.
--The mucous membrane from the surface
of the epiglottis forms three folds that attach to the tongue, two __ and a single __. |
|
Definition
-
-- epiglottis; epiglottic valleculae
-- lateral glossoepiglottic folds; median glossoepiglottic fold |
|
|
Term
-The tongue is made of __
arranged into thick bundles of
fiber.
-There are two types of muscle in the tongue; __ and __
- |
|
Definition
- skeletal muscle
- intrinsic; extrinsic musculature |
|
|
Term
-The __ musculature of the
tongue is responsible for its __
and __, meaning they do change the position of the tongue. These muscles do not attach to __
-The __ muscles extend to the tongue from the bones of the skull or the __. These muscles protrude the tongue, retract it, and move it laterally.
-Regarding the intrinsic muscles of the tongue, this is the only place in the body where skeletal muscle bundles are
oriented at __ to one
another
- the extrinsic muscles of the tongue include __, __, __, and __ |
|
Definition
- intrinsic; form; shape; bones
- extrinsic; soft palate
- 90 degree angles
- palatoglossus; hyoglossus; genioglossus; styloglossus |
|
|
Term
The extrinsic muscles are named by the bones they are attached to and include:
-Palatoglossus
--Attaches to the __ and __
-Hyoglossus
--Attaches to the __ and __
-Genioglossus
--Attaches to the __ and the __
-Styloglossus
--Attaches to the __ and the __ |
|
Definition
-- soft palate; tongue
-- hyoid bone; tongue
-- genu of the mandible; tongue
-- styloid process; tongue |
|
|
Term
-The __ is the palatoglossus muscle covered in mucosa. It runs from portions of the __ down to the anterior pillar, or fold, into the side of the __. This muscle brings the two __ together
-The __ is the palatopharyngeal muscle covered in mucosa. It runs from portions of the __ down to the __, or fold, into the wall of the __. It will pull the wall upward, forward and medial to shorten the pharynx and well as constrict the __ by adducting the __.
-NOTE: the __ are located in between the anterior and posterior pillars or arches described here |
|
Definition
- palatoglossus arch; soft palate; anterior pillar; tongue; anterior pillars
- palatopharyngeal arch; soft palate; posterior pillar; pharynx; oropharyngeal isthmus; posterior pharyngeal pillars
- palantine tonsils |
|
|
Term
-The blood supply to the tongue is via the __ shown by the green arrow.
-The __ artery branches from the __ between the __ and __ |
|
Definition
- lingual artery
- lingual artery; external carotid; superior thyroid; facial artery |
|
|
Term
motor innervation
-The styloglossus, genioglossus, and hyoglossus are innervated by the __.
-Palatoglossus is the exception. It is innervated by __. |
|
Definition
- hypoglossal nerve cn xii
- cnx |
|
|
Term
sensory innervation taste
-Epiglottis is innervated by the __ shown by the orange polka dots.
-The __ innervates the posterior 1/3 of the tongue, shown by the green polka dots.
-The __ innervates the anterior 2/3 of the tongue for only taste sensations, shown by the yellow polka dots |
|
Definition
- vagus (x)
- glossopharyngeal nerve (IX)
- facial nerve (VII) |
|
|
Term
sensory innervation - general sensory
-Epiglottis is innervated by the __
-The __ innervates the posterior 1/3 of the tongue.
-The __ innervates the anterior 2/3 of the tongue for only general sensation. |
|
Definition
- vagus (x)
- glossopharyngeal nerve (IX)
- lingual nerve (CN V) |
|
|
Term
-The circles highlight the deep lymph nodes in the neck located along the sternocleidomastoid muscle that eventually drain into the __, then into the __ or right lymphatic duct at the junction of the __ and __.
- __>__>__>__ |
|
Definition
- jugular trunk; thoracic duct; subclavian; internal jugular veins
-Submental nodes (under the chin) submandibular nodes (along the jaw line and below) deep cervical lymphs (in the neck) right lymphatic duct and thoracic duct |
|
|
Term
-The __, also known as the throat, is a common passageway for the digestive and respiratory systems (except the __). It is a __ tube that is located posterior to the oral cavity, nasal cavity, and larynx, and anterior to the vertebral column.
-It extends from the base of the skull to the lower border of the __ of the __ where it becomes continuous with the __ (vertebral level __). |
|
Definition
- pharynx; (laryngopharynx); fibro-muscular
- cricoid cartilage; larynx; esophagus (c6) |
|
|
Term
The pharynx has three divisions that are continuous with one another:
-1. __ is posterior to the nasal cavity and superior to the __ of the __. Because it is superior to where food enters, the nasopharynx serves only as an __. The nasopharynx also communicatess with the nasal cavity by two posterior nasal openings called __.
-The opening for the __ is located on the lateral wall of the nasopharynx; the auditory tube links the nasopharynx to the __. The nasopharynx contains 2 groups of lymphatic tissue, including the __ and the __. |
|
Definition
- nasopharynx; uvula; soft palate; air passage; choanae (internal nares)
- auditory (eustachian) tube; middle ear cavity; pharyngeal tonsils; tubal tonsils |
|
|
Term
| The __, or the __, are located on the high, posterior nasopharyngeal wall where they destroy pathogens that enter the nasopharynx in the air. |
|
Definition
| pharyngeal tonsils; adenoids |
|
|
Term
-__ is posterior to the oral cavity and is bounded by the __ inferiorly and the __ superiorly. Both swallowed food and air pass through the oropharynx.
--It contains __ which lie between palatoglossal and palatopharyngeal arches.
-__ is essentially the portion of the pharynx that is found behind the larynx. It extends from the __ to the inferior border of the __
--The __ or the voice box extends from the fourth to the sixth cervical vertebra. It attaches superiorly to the __ and opens into the laryngopharynx; inferiorly, it is continuous with the __ or windpipe. |
|
Definition
- oropharynx; epiglottis; soft palate's uvula
-- palantine tonsils
- laryngopharynx; epiglottis; cricoid cartilage
-- larynx; hyoid bone; trachea |
|
|
Term
-The __ are skeletal muscles that compose the back of the throat. They constrict to receive the bolus of food and push it inferiorly into the esophagus, and to raise the larynx as a whole so the epiglottis will seal off the opening to the larynx.
-The __ is attached to an inferior bony projection on the __.
-The superior pharyngeal constrictor muscle is a __. A major lateral deficiency in these superior attachments is closed by the __
which allows for the spread of infection from the oral cavity to the thorax.
-The __ serves as the origin and insertion for several of the pharyngeal constrictors |
|
Definition
-pharyngeal constrictors
- superior constrictor; occipital bone
- quadrilateral muscle; pharyngobasilar fascia
- pharyngeal raphe |
|
|
Term
-The middle constrictor arises anteriorly from __ and fans posteriorly to enclose the lower aspects of the __ and attach to the __.
--The lower fibers arch posteriorly to the level of the __. The __ of the __ are useful anatomical landmarks for the transition between the middle and inferior constrictor muscle.
-The inferior constrictor arises from the __ of the __ and the __ of the __ and sweeps posteriorly to overlap the middle constrictor and attach to median __ |
|
Definition
- hyoid bone; superior constrictor; pharyngeal raphe
-- larynx; greater horns; hyoid bone
- oblique line; thyroid cartilage; cricoid cartilage; larynx; pharyngeal raphe |
|
|
Term
internal muscles of the pharynx
-The __ and __ pass through the gap between the superior and middle constrictors
-While there are other intrinsic muscles of the throat that elevate the pharynx, for our purposes we will only focus on the __. It attaches to the __ on the skull, and to the __ between the superior and middle constrictors.
-Note that cranial nerve __ travels on top of this muscle (seen in yellow). |
|
Definition
- stylopharyngeus muscle; glossopharyngeal nerve
- stylopharyngeus; styloid process; throat
- 9 |
|
|
Term
-Simply put, swallowing is the process of consuming something and passing it from the mouth, to the __ and into the __, while shutting the ___
-Swallowing is a progression through multiple stages, beginning with a voluntary action during which a __ is formed in the oral cavity.
-Once the __ is elevated, sealing the __ from the __, the __ widens and shortens, taking in the bolus of food.
-This second aspect is involuntary, followed by the involuntary contraction of __ which force the bolus inferiorly into the __. |
|
Definition
- pharynx; esophagus; epiglottis
- bolus
- soft palate; nasopharynx; oropharynx; pharynx
- pharyngeal constrictors; esophagus |
|
|
Term
-The pharynx is innervated by the __, formed by __, __, and __
-CN __ is motor to the stylopharyngeus and sensory to the mucosa of the pharynx.
-CN __ is motor to all muscles of the pharynx except the stylopharyngeus.
-The gag reflex is due to the sensory innervation of CN __ and the motor innervation of CN __. |
|
Definition
- pharyngeal plexus; cn 9; cn 10; postganglionic sympathetic fibers
- 9
- 10
- 9; 10 |
|
|
Term
| -The Human __ refers to each of the two bony cavities, or __, found on either lateral side of the nose. The term “orbit” can be used to signify just the bony sockets, or it can be used more broadly to refer to all the anatomical contents found within each socket |
|
Definition
|
|
Term
- the bones of the orbit include:
-The lateral wall of the orbit is comprised of the __ Bone and part of the __ Bone. The __ bone also forms the apex of the orbit.
-The posterior wall is formed by the __ Bone, although gaps known as the __ and __ mean the posterior wall of the orbit is not completely sealed by the __ bone.
-The medial wall of the orbit is formed by two small bones, the __ and the __ Bones.
-Finally, the __ makes up the inferior boundary of the orbit’s bony cavity. At the posterior edge of the __, a small contribution from the __ bone fuses between the ethmoid and maxilla. |
|
Definition
- maxilla; Frontal; Zygomatic; Sphenoid; Lacrimal; ethmoid
- zygomatic bone; frontal bone; frontal bone
- sphenoid bone; superior; inferior orbital fissures; sphenoid
- ethmoid; lacrimal
- maxilla; maxilla; palatine |
|
|
Term
-Before beginning our discussion of the eyeball and cornea, it is important to understand the structures that cover the inner contents of the orbit.
-The __ are a set of moveable folds that protect the eye from injury and keep the cornea moistened when closed. The external surface of the eyelids is covered by thin __, and internally they are lined by a transparent __. Within both lids are elongated plates of dense connective tissue known as the __.
-A specialized layer of cells lines the inside of both the upper and lower eyelids. This membranous lining, called the __, not only lines the inner lids but covers the __ as well. As it travels along the inner surface of the eyelids, the conjunctiva reach a point where it reflects back on itself, curving either back up or back down (lower and upper lid, respectively) the anterior sclera. By producing mucus and some tears, the conjunctiva helps to keep the eye lubricated, and plays a role in keeping microbes from invading the body through the space between the eyeball and the eyelids. |
|
Definition
-
- eyelids; cutaneous tissue; mucous membrane; tarsal plates
- conjunctiva; anterior sclera |
|
|
Term
-While the conjunctiva does produce mucous, the job of keeping the eye moistened belongs primarily to what’s known as the __. This refers to a set of structures that lubricate the anterior eye through tear production. The __ is a roughly almond-shaped structure that lies in the __ region of each orbit. The gland is divided into two sections by the tendon of the upper eyelid’s __ muscle. The lacrimal gland produces lacrimal fluid (tears).
-Once produced, tears are secreted through a series of ejaculatory ducts. These ducts carry the fluid down towards the __ of the eye. From here, the eye is moistened with lacrimal fluid by blinking the eyelids. When blinking, the inner edge of each lid joins together first along their lateral edge, then sweep together medially. This motion pushes lacrimal fluid medially across the cornea, and helps remove particles from the anterior surface of the eye.
-After collecting at the medial angle of the eye, the fluid passes through the superior and inferior __ before collecting in the __, which is the dilated upper region of the __. The duct carries this fluid to the __ and eventually drains posteriorly into the __, where it is swallowed. |
|
Definition
- lacrimal apparatus; lacrimal gland; superio-lateral; levator palpebrae superior muscle
- lateral angle
- lacrimal canaliculi; lacrimal sac; nasolacrimal duct; inferior nasal meatus; nasopharynx |
|
|
Term
-In this image of the right eye, the skin is transparent around certain components of the lacrimal apparatus. As we can see, the __ sits roughly above and lateral to the eye, while the __, __, and the __ are found on the medial side of the eye.
-The location of the lacrimal gland means that the tears produced by the gland must travel down and then across the anterior surface of the eye in order to reach the nasolacrimal duct to be drained. This is accomplished by __, which spreads tears from the lateral to the medial side across the surface of the cornea and conjunctiva.
-As we blink, the lacrimal fluid that has been secreted by the gland and has collected at the lateral angle of the eye is quickly swept medially across the cornea surface and bathes the conjunctiva, keeping the eye moist and removing potential irritants. The pathway taken by tears during blinking, beginning with their production by the __ to their eventual drainage via the __, is shown by the blue dashed lines. |
|
Definition
- lacrimal gland; lacrimal canaliculi; lacrimal sac; nasolacrimal duct
- blinking
- lacrimal gland; nasolacrimal duct |
|
|
Term
-Before examining the various components of the eyeballs, it is important to know the surrounding tissues that envelope them. Spreading from the optic nerve to the corneal limbus is a thin membrane known as the __, which forms a membranous socket that encases the eyeball.
-In order to attach to the sclera, the __ must first penetrate the bulbar fascia. Protrusions of the bulbar fascia around the __ and __ muscles anchor to the walls of the orbit that secures the eye and limits its abduction and adduction. Inferiorly, it forms a type of sling that supports the eyeball within the orbital socket.
-Filling much of the remaining spaces within the orbit are deposits of adipose tissue, or __. These pockets of fatty tissue cushion and support the eye within the socket. |
|
Definition
- bulbar fascia
- extraocular muscles; medial; lateral rectus muscles
- orbital fat |
|
|
Term
-The human eyeball is a conscious sense organ that occupies most of the volume of the anterior orbit. Commonly mistaken for being spherical, the eye is in fact __, and results from the fusion of an anterior and posterior portion.
-The structure of the eyeball is organized into three layers, or “coats”; the __ outer layer, middle __ layer, and inner __ layer. While these layers are in fact quite close to each other, they differ in their contents and purpose. We will discuss each of these layers and their contributions to the structure and function of the eye.
-The fibrous layer is made up of two components; a smaller, anterior component known as the __ and a larger posterior portion known as the __. The tough, tunic-like __ (also known as the “__”) is an opaque, external coat that comprises some five-sixths of the eye. The __ not only gives shape to the eyeball, but also serves as an attachment for the __ and __ muscles of the eye. |
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Definition
- oblong
- fibrous; vascular; neural
- cornea; sclera; sclera; (white of the eye); sclera; extrinsic; intrinsic |
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Term
-The middle layer found just deep to the fibrous outer coat is the __ layer of the eye. The various components that make up this layer contribute to both arterial and nutritional supply to the eyeball, as well as the clarification of the images we see by direct manipulation of the __.
-Moving backward from the anterior eye, the vascular layer includes 3 main structures; the __, the __, and the __. We will discuss the last two components on the next slide.
-The vascular layer is important in providing nutrients and oxygen directly to the __ and __, and it supplies these indirectly to the __, __, and __ (since these structures lack intrinsic blood vessels they must be supplied by diffusion).
-Lining the inner wall of the sclera is a layer of pigmented tissue known as the __, which lies immediately deep to __. Covering a majority of the posterior eye, the choroid’s pigments help to reduce the scattering of incident light rays that enter the eye through the pupil. |
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Definition
- vascular; lens
- choroid; ciliary body; iris
- ciliary body; iris; retina; cornea; lens
- choroid; sclera |
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Term
-The other components of the vascular layer are more visible at along the anterior chamber of the eye, as seen here.
-The __ is a circumferential ring (seen in cross-section, with its continuous ring running around the outer edge of the iris) that is made up of both the __ and __. The muscle controls __ (a process that maintains image clarity) by changing the shape of the lens within the eye.
-The ciliary processes are inward folds of the __ that are arranged in a circle behind the __. They produce a clear, gel-like fluid known as __ that fills the posterior and anterior chambers of the eye. Aqueous humor is produced by the __ and flows from the posterior chamber of the eye (the region between the lens and the iris) and the anterior chamber of the eye (the region between the iris and the cornea). This fluid must be regularly drained in order to prevent a buildup of fluid in the eye, leading to glaucoma.
-The final component of the vascular layer of the eye is the __. The __, which is the colored portion of the eye, is a thin and circular structure that controls the diameter of the __. The __ is in fact a hole in the center of the iris through which light enters the eye and travels to the posterior wall, the __. |
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Definition
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- ciliary body; ciliary muscle; ciliary processes; accommodation
- choroid; iris; aqueous humor; ciliary body
- iris; iris; pupil; pupil; retina |
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Term
-The innermost layer of the eye is referred to as the __ layer. The primary structural component of this inner coat is the __, which is a light-sensitive tissue layer that covers the majority of the posterior surface of the inner eye.
-The function of the __ can be compared to that of film in a non-digital camera. As incident light rays enter the eye (via the pupil), they travel posteriorly to impact on the tissue of the retina. The resulting chemical and electrical events then that occur here trigger neural impulses that relay posteriorly to the brain via the sensory fibers of the __. The optic nerve transmits information from the retina to be interpreted by the __ found in the occipital lobe of the posterior brain |
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Definition
- neural; retina
- retina; optic nerve (CN II); primary visual cortex |
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Term
-Now that we have discussed the three layers, or coats that make up the structure of the eye, we can take a closer look at the eye’s interior structure.
-The __ of the eye is a transparent, crystalline and biconvex structure found at the boundary between the anterior and posterior portions of the eye. The lens works in tandem with the __ to focus incident light onto the __.
-There is a large space within the eye found between the posterior side of the __ and the posterior wall of the __. Filling this space is a clear, gel-like substance known as the __, which functions in maintaining the eye’s structure and keeping the retina in place. The fluids of vitreous body should not be confused with aqueous humor, which is the gelatinous fluid that fills the anterior chamber of the eye (the space between the lens and the cornea).
-While aqueous humor continuously replaces itself, the __ is stagnant. It is therefore important that this fluid remains transparent and free of contaminants, so that nothing can interfere with light traveling through the lens and hitting the retina. |
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Definition
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- lens; cornea; retina
- lens; sclera (the retina); vitreous body
- vitreous body |
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Term
-Voluntary movement of the eyes is a complex and orchestrated process that involves either one or multiple extrinsic muscles working to point the eye in various directions. There are 6 extrinsic muscles involved in eye movement, and these are collectively referred to as the __, since they are found attaching to the external surface of the eye directly onto the sclera.
-From this anterior view of the right eye we can just see the anterior edges of these muscles. There are four rectus muscles: the __ and __, as well as the __ and __ muscles.
-The remaining two extraocular muscles are the __ and the __. Unlike the more straightforward action of the four rectus muscles, contraction of the oblique muscles result in __ of the eye. We will examine the actions and the effect on eye movement of each of these muscles on the next several slides. |
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Definition
- extraocular muscles
- lateral; medial rectus; superior; inferior rectus
- superior oblique; inferior oblique; diagonal rotation |
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Term
-From this superior view of the right eye we can see the extraocular muscles as they travel from their common origin anteriorly to attach to the eye. The four rectus muscles are each named after their location relative to the eye. These muscles form a cone as they run anteriorly towards the eyeball, with the point of the cone being a fibrous cuff known as the __. This structure surrounds the __ and part of the __ at the orbit’s apex.
-The primary action of each of the four rectus muscles is to pull the eye in the direction to which they are named. Contraction of the lateral rectus pulls the eye laterally, requiring simultaneous relaxation of the medial rectus. The medial rectus pulls the eye medially when lateral rectus is relaxed. These two muscles are said to be __; their actions oppose each other and therefore one must be inhibited in order for the other to move the eye in it’s corresponding direction.
-Like the lateral and medial rectus, the inferior and superior rectus muscles are also antagonists; they move the eye downward and upward respectively. However, they are also responsible for __ the eye. |
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Definition
- common tendinous ring; optic canal; superior orbital fissure
- antagonists
- adducting |
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Term
-From this superior view, we can see the __ muscle and its unique connection to the superior surface of the eye. The superior oblique travels from the common tendinous ring at the back of the orbit and follows the medial wall to a cartilage structure known as the __.
-The __ serves as a pulley-like structure to which the superior oblique attaches, and from which the __ passes through on its way to attach to the eye. Upon contraction, the tendon of the superior oblique is tensed and causes the pupil to be pointed both downward and laterally by the superior oblique. The __ pulls the eye upward and laterally.
-The following slide has a table summarizing these muscles, their actions, and innervations, as well as an illustration that helps memorize eye movement |
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Definition
- superior oblique; trochlea
- trochlea; tendon of the superior oblique; inferior oblique |
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Term
| - name the extraocular muscle, primary action, secondary action (if applicable), and innervation |
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Definition
- superior rectus: elevation, adduction, cn III
- medial rectus: adduction, cnIII
- inferior rectus: depression, adduction, cn III
- lateral rectus: abduction, cnVI
- superior oblique: pa is depression and abduction, cn IV
- inferior oblique: pa is elevation and abduction, cn III |
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Term
-The arterial supply of the orbit originates with a branch of the __ Artery, known as the __ Artery. From the __, the __ artery travels through the __ along with the optic nerve.
-Several key branches of the __ supply the various structures of the orbit and the eye. The __ actually pierces into the optic nerve eye via the __ to supply the retina.
-Another branch off the ophthalmic is the __, which as its name implies it supplies the lacrimal gland. In addition, there are two vessels that travel anteriorly from the ophthalmic artery and pierce through the posterior sclera. These are the __ and __; two long and two short supply each eye. These arteries supply the __ of the eye after piercing through the sclera, as well as the __ and the __.
-Also important in the vasculature of the orbit are the __ (not pictured) of the ophthalmic artery. These branches both supply the extraocular muscles and continue on to the choroid layer of the eye. |
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Definition
-internal carotid artery; ophthalmic artery; internal carotid; ophthalmic; optic canal
- ophthalmic artery; central artery of the retina; optic disc
- lacrimal artery; long; short posterior ciliary arteries; choroid layer; iris; ciliary body
- muscular branches |
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Term
-The venous drainage of the structures of the orbit is primarily provided by the __ and __. Each of these veins drains their respective region of the orbit and exit via the superior orbital fissure. The two ophthalmic branches drain posteriorly where they meet to form a joint __. This short vein empties into a large cavity called the __, which is bordered by the temporal and sphenoid bones.
-Two notable veins are found in the anterior orbit. The __ runs obliquely downward on the side of the root of the nose. Near the superior edge of the nose, it communicates with the __ before continuing downward.
-Near the lower margin of the orbit, the angular vein goes on to become what’s known as the __. This vein continues on to travel backward beneath the mandible and eventually drains into the __. The circular connection between the angular vein and both branches of the ophthalmic veins form a venous anastamosis between the facial vein and the cavernous sinus. |
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Definition
- superior; inferior ophthalmic veins; ophthalmic vein; cavernous sinus
- angular vein; superior ophthalmic vein
- facial vein; internal jugular vein |
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Term
-The sensory fibers that communicate optical stimuli from the retina posteriorly to the visual cortex of the brain are found within the __. The purely sensory fibers of this nerve are sheathed in extensions of the cranial meninges and subarachnoid space, which is filled with a thin layer of CSF. These extensions make up what’s called the __, which fuses anteriorly with the fascial sheath of the eyeball and sclera.
-The optic nerve exits the orbit via the __, from which it travels posteriorly and medially to reach a structure within the brain known as the ___. Located just below the hypothalamus, this is where the fibers of each of the two optic nerves partially crossover one another. The resulting two groups of fibers become known as optic tracts, which travel posteriorly towards the primary visual cortex.
-Also visible in this illustration is the ophthalmic nerve (V1) as it enters the orbit via the superior orbital fissure. We will discuss this nerve and its branches on the following slide. |
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Definition
- optic nerve (CN II); optic sheath
- optic canal; optic chiasm |
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Term
-By discussing the function of each nerve (either sensory or motor), the innervation of the orbit can be made more clear. Keep in mind that all the nerves we will discuss are in fact paired nerves, one for each orbit.
-The __ has multiple branches that each supply sensory and/or motor innervation to separate regions of the face. One of these branches, the __, provides sensory innervation to the orbit. Along with supplying the cornea, ciliary body, and iris, the ophthalmic nerve also sends branches to the lacrimal gland and conjunctiva. Branches from the ophthalmic also supply the cutaneous tissue of the eyelids, eyebrow, nose and forehead.
-The ophthalmic nerve branches off the trigeminal nerve at the __, found in the dura matter deep to a part of the temporal bone. From here it travels just below the oculomotor and trochlear nerves (which we will soon discuss) and enters the orbit via the superior orbital fissure. |
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Definition
-
- trigeminal nerve (CN V); opthalmic nerve
- trigeminal ganglion |
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Term
-Up until now we have discussed nerves that provide sensory innervation (both exiting and entering the orbit). Motor innervation is supplied several additional cranial nerves that supply one or more of the extraocular muscles. In this illustration, small segments of these muscles remain visible so we can see the pathway of the nerves.
-The __ emerges from the brain and travels against the lateral wall of the cavernous sinus along with the other orbital nerves. Just prior to entering the orbit through the superior orbital fissure, this nerve splits a __ and __.
-The __ travels medially, passing over the optic nerve on its way to supply the superior rectus and levator palpebrae superioris muscles. The __ itself gives off 3 branches, each of which supplies a different extraocular muscle. One branch of the inferior rami of the oculomotor nerve innervates the medial rectus, inferior rectus, and inferior oblique muscle respectively. |
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Definition
-
- oculomotor nerve (CN III); superior; inferior branch
- superior branch of the oculomotor nerve; inferior branch |
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Term
-Motor innervation of the extraocular muscles is provided by several cranial nerves that all enter the orbit via the __. The contributions from the multiple nerves that make up the innervation of the extraocular muscles are summarized in this slide.
-As we just discussed on the previous slide, the inferior rectus, medial rectus, and the inferior oblique muscles are all supplied by the __ of the oculomotor nerve, while the superior oblique is innervated by its __ branch.
-Also entering the orbit via the superior orbital fissure, the __ travels laterally to supply the lateral rectus muscle. the __ enters the orbit to innervate its only target structure, the superior oblique muscle.
-The use of a mnemonic device similar to a molecular equation helps to memorize the innervation just discussed. It abbreviates the muscles along with a subscript for the number of the cranial nerve that innervates them. LR and SO stand for lateral rectus and superior oblique, while R refers to the “Rest” of the muscles. They are supplied by cranial nerves 6, 4, and 3 respectively. |
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Definition
- superior orbital fissure
- inferior branch; superior branch
- abducens nerve (CN VI); Trochlear Nerve (CN IV) |
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Term
-Dilation and constriction of the pupil occurs by the action of two circular groups of smooth muscle, the __ and __ muscles. As an involuntary process, pupil dilation/constriction is under autonomic nervous control, with the dilator pupillae innervated by __ and __ supplying the sphincter pupillae.
-Sympathetic Innervation of the Dilator Pupillae:
--Postganglionic sympathetic fibers originate in the __, from which they travel along the __ to the carotid plexus and hitch a ride along branches of __ to reach the Dilator Pupillae muscle in the eye. This is a smooth muscle that dilates the pupil.
-Parasympathetic Innervation of the Sphincter Pupillae:
--On their path to innervate the Sphincter Pupillae muscles, preganglionic parasympathetic fibers originating in the __ travel with the __ until they reach the __, at which point they synapse. Postganglionic parasympathetic fibers leave the ciliary ganglion to follow along the short ciliary nerves in order to penetrate the __. Once through, these fibers innervate the sphincter pupillae muscles. These muscle constrict the pupil. |
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Definition
- dilator pupillae; sphincter pupillae; sympathetics; parasympathetics
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-- superior cervical ganglion; internal carotid artery; V1
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-- brain; oculomotor nerve; ciliary ganglion; posterior sclera |
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