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HEAD & NECK SPOTTERS Final with
answers
G. PannEER SELVI
Department ofAnatomy
Spotter -1
1. A)Identify the pinned structure (Scalp)
B)Mention its layers.
– S.... Skin
– C.... Connective tissue(Superficial fascia)
– A ... Aponeurosis (Epicranial aponeurosis or
galea aponeurotica)
– L.... Loose areolar tissue
– P.... Pericranium
C) Which is the dangerous area in it?
Loose areolar tissue is the dangerous
layer of scalp because the emissary veins
transmit the infection from the scalp to
intracranial venous sinuses.
Spotter -1 cont…
D) Mention its blood supply.
ARTERIAL SUPPLY:
IN FRONT OF AURICLE:
Supratrochlear. A - Branch of ophthalmic artery
Supra orbital. A - in turn from internal carotid Artery
Superficial temporal. A ... branch of ECA
BEHIND AURICLE:
Posterior auricular .A - Branch of External carotid artery
Occipital artery
VENOUS DRAINAGE:
Emissary vein:
– Parietal emissary vein... Superior Sagittal sinus
– Mastoid emissary vein... Sigmoid sinus
Diploic vein:
– Frontal diploic vein into supraorbital vein
– Anterior temporal diploic vein into Anterior deep
temporal vein
– Posterior temporal vein into transverse sinus
– Occipital diploic vein into Occipital vein or
transverse sinus
VENOUS DRAINAGE cont..
Supra trochlear Vein + Superficial temporal Vein
+
Supra orbital Vein Maxillay .V
Angular vein
Facial vein Retromandibular Vein
Anterior division Posterior division
+
Posterior auricular vein
Common facial vein
External Jugular Vein
Internal jugular vein Subclavian vein
Spotter -1 Cont
E) Mention its nerve supply.
In front of auricle Behind auricle
Sensory supply
1 Supra orbital of ophthalmic
division of trigeminal nerve
Great auricular nerve(C2, C3 from cervical
plexus)
2. Supra trochlear nerve of
ophthalmic division of trigeminal
nerve
Lesser occipital nerve(C2, from cervical
plexus)
3. Zygomaticotemporal nerve-
branch of maxillary nerve
Greater occipital nerve(C2, dorsal ramus)
4. Auriculotemporal nerve- branch of
mandibular nerve
Third occipital nerve(C3, dorsal ramus )
Motor nerve
5. Temporal branch of facial nerve-
frontalis
Posterior auricular branch of facial nerve-
occipitalis
Spotter -2
2. A) Identify the pinned structure (Orbicularis oculi)
B) Mention its parts.
Parts:
– Orbital
– Palpebral
– Lacrimal
C) Mention its nerve supply and action.
– Tight closure of eye lids
– Gentle closure of eyelid as in blinking and
sleeping
– Dilates lacrimal sac for suction of lacrimal fluid
Nerve suppy: Temporal and zygomatic branch of
facial nerve
D) Mention its clinical importance.
– Eyes cannot be closed in Bell’s palsy of infra
nuclear lesion of facial nerve
Spotter -3
3. A) Identify the pinned
structure (Upper Eye lid)
B) Mention its nerve
supply (motor & sensory).
Motor supply:
Oculomotor nerve to LPS
Sensory nerve:
Ophthalmic nerve
branches
Spotter -4
4. A) Identify the pinned structure (Buccinator)
B) Mention its parts and attachment.
– ORIGIN:
– Upper fibres: Maxilla opposite to molar
teeth
– Lower fibres: Mandible opposite to molar
teeth
– Middle fibres: Pterygomandibular raphe
– INSERTION:
– Upper fibres: Straight to upper lip
– Lower fibres: Straight to lower lip
– Middle fibres: Decussate
C
Spotter- 4 Cont…
C) Mention its nerve supply and action.
– NERVE SUPPLY:
– Buccal branch of facial nerve
– ACTION:
– Flattens the cheek against gums and teeth
– Prevents accumulation of food in vestibule
– Whistling muscle
D )Mention the structures piercing it.
– Parotid duct
– Buccal branch of mandibular nerve
E) Mention its clinical importance.
– Food accumulates between cheek and teeth in Bell’s palsy
(infranuclear lesion of facial nerve)
Spotter -5
5. A) Identify the pinned
structure (Frontalis)
B) Mention its nerve
supply and action.
– N.S: Temporal branch of
facial nerve
– Action: Horizontal
wrinkles over the
forehead
Spotter - 6
6. A)Identify the pinned structure
(Orbicularis oris)
B) Mention its parts.
– Intrinsic part (deep stratum)
– Extrinsic part
C) Mention its nerve supply and action.
Action:
– Closure of lips
– Protrudes the lips
Nerve supply:
– Buccal branch of facial nerve
D) APPLIED ANATOMY
– Unable to protrude the lips as in whistling
– Mouth deviated to normal side when
attempted to smile in infra nuclear lesion of
facial nerve
Spotter -7
7. A) Identify the tied structure
(Facial artery)
B)Mention its branches in
the face.(SIL mnemonics)
 Superior labial
 Inferior labial
 Lateral nasal
C) What is it a branch of?
External carotid artery
Spotter - 8
8. A) Identify the pinned
area (Dangerous area of
face)
B) Mention its clinical
importance.
Infection from this area
taken retrograde to
cavernous sinus through
deep facial--- pterygoid
venous plexuses–
emissary vein---
Cavernous sinus
Spotter -9
9. A)Identify the pinned
structure (Auricle)
B)Mention the muscles
attached to it.
 Auricuris superior
 Auricuris Anterior
 Auricuris Posterior
C)Mention its nerve supply
(motor & sensory).
 Motor: Facial nerve
 Sensory: Auriculotemporal
nerve
Spotter -10
10. A) Identify the pinned structure
(Anterior Belly of digastric
muscle)
B) Mention its attachments.
 Origin: Digastric fossa of mandible
 Insertion: Common tendon to hyoid
bone
C) Mention its development.
 First pharyngeal arch
D) Mention its nerve supply.
 Nerve to mylohyoid(Mandibular
nerve branch)
Spotter -11
11. A)Identify the pinned
structure (Posterior Belly of
digastric muscle)
B) Mention its attachments
 Origin: Mastoid notch
 Insertion: Common tendon to
hyoid bone
C) Mention its development.
 Second pharyngeal arch
D) Mention its nerve supply.
 Facial nerve
Spotter -12
. A) Identify the pinned structure
(Mylohyoid)
B) Mention its attachments.
 Origin: Mylohyoid line of
mandible
 Insertion: Hyoid bone
C) Mention its development.
 First pharyngeal arch
D) Mention its nerve supply.
 Nerve to mylohyoid
(Mandibular nerve branch)
Spotter -13
13. A)Identify the tied
structure (Hypoglossal
nerve)
B) Mention the muscles
supplied by it.
Muscles of tongue
– Genioglossus, Hyoglossus,
Styloglossus
– Intrinsic muscles: Superior
and inferior longitudinal,
vertical and transverse
Spotter -14
14. A)Identify the pinned structure
(Sternocleidomastoid )
B) Mention its attachments.
Origin:
– Sternal head : Anterior surface of manubrium
sternum
– Clavicular head: Superior surface of medial
2/3rd of clavicle
Insertion: Lateral surface of Mastoid process
C)Mention its nerve supply and action.
N.S:
– Spinal Accessary nerve(Motor)
– Ventral rami C2, C3(Proprioception)
D)Mention its clinical importance.
– Wry neck or Torticollis
Spotter -15
15. A) Identify the pinned
structure (Trapezius)
B) Mention its
attachments.
C) Mention its nerve
supply and action.
– Spinal accessory nerve and
C3 and C4 fibres
– Action: Over head
abduction of shoulder
along with serratus
anterior
Spotter -16
16. A) Identify the tied structure
(Common carotid artery)
B) What is it a branch of?
– Right side : Brachiocephalic trunk
– Left side: Arch of Aorta
C) Mention its level of bifurcation or
termination.
– Disc between C3 and C4
D) Where are its pulsations felt?
– Carotid tubercle on C6 vertebra
E) Mention its branches.
– External and internal carotid artery
Spotter -17
17. A) Identify the tied structure (External carotid
artery)
B) What is it a branch of?
– Common carotid artery
C)Mention its branches
– Superior thyroid artery
– Lingual artery
– Facial artery
– Posterior auricular artery
– Occipital artery
– Ascending pharyngeal artery
– Maxillary artery
terminating branches
– Superficial temporal artery
Spotter -18
18. A)Identify the tied
structure (Internal
carotid artery)
B)What is it a branch of?
– Common carotid artery
C) Mention its branches.
– Ophthalmic artery
– Middle cerebral artery
– Anterior cerebral artery
– Superior and inferior
hypophyseal artery
Spotter -19
19. A)Identify the tied structure
(Internal jugular vein)
B)Mention its origin and
termination.
– Origin: Sigmoid sinus
– Termination: Subclavian vein
–
C)Mention its tributaries.
– Inferior petrosal sinus
– Lingual vein
– Common facial vein
– Pharyngeal vein
– Superior thyroid vein
– Middle thyroid vein
– 4th vein of Kocher
– Occipital vein
Spotter -20
20. A)Identify the tied
structure (Vagus nerve)
B) Mention its branches
in the neck.
– Pharyngeal branch
– Superior laryngeal nerve
– Recurrent laryngeal nerve
on right side
Spotter -21
21. A) Identify the pinned space
(Suboccipital triangle)
B) Mention its boundaries.
– Superomedially: Rectus capitis
posterior minor and major
– Superolaterally: Superior
oblique
– Inferior: Inferior oblique
– Floor: Posterior arch of atlas,
Posterior atlantoccipital
membrane
C) Mention its contents.
– Third part vertebral artery
– Suboccipital venous plexuses
– Suboccipital nerve
Spotter -22
22. A)Identify the tied structure
(External jugular vein)
B)Mention its tributaries.
– Posterior external jugular vein
– Suprascapular vein
– Transverse cervical vein
C)Mention its formation and
termination.
– Formation: Posterior Auricular
vein joins with posterior
division of retromandibular ven
– Termination: Subclavian vein
Spotter - 23
23. Identify the pinned structure
(Falx cerebri)
a) Mention its attachments.
• Anterior end : Crita galli
• Posterior end: upper Surface of
tentorium cerebelli
• Upper margin: Sagittal sulcus
• Lower margin: Free
b) Mention the sinuses related to it.
• Superior sagittal sinus along
upper margin
• Inferior sagittal sinus along lower
margin
• Straight sinus along attachment
to tentorium cerebelli
• Falx cerebri
Spotter -24
24. Identify the pinned structure
(Falx cerebelli)
a) Mention its attachments.
• Base: Attached to inferior
surface of tentorium cerebelli
• Apex: Attached to foramen
magnum
• Posterior margin: To internal
occipital crest
• Anterior margin: Free and
concave
b) Mention the sinus related to it
• Occipital sinus
Spotter -25
25. A) Identify the pinned structure (Tentorium cerebelli)
B) Mention its attachment
FREE MARGIN:
– U- shaped and free
– Ends of ‘U’ attached to anterior clinoid process
– Tentorial Notch: Occupied by midbrain and
superior vermis of cerebellum
ATTACHED MARGIN:
– Posterolaterally: Attached to transverse sulcus and
posteroinferior angle of parietal bone
– Antero laterally: Superior border of Petrous part of
temporal bone and posterior clinoid process
– At the point of meeting of both margin: Pierced by
3rd and 4th cranial nerve
– Meckel’s cave formed by evagination of inferior
layer of tentorium over trigeminal ganglion lies
along attached margin
TWO SURFACES:
– Upper surface: Posterior end of falx cerebri
attached
– Lower surface: Upper end of falx cerebelli attached
C). Mention the sinuses related to it.
– Transverse sinus
– Superior Petrosal sinus
– Straight sinus
Tentorium cerebelli
Spotter - 26
26. A) Identify the probed
space (Internal acoustic
meatus)
B) Mention the structures
passing through it.
– Facial nerve
– Glossopharyngeal nerve
– Labyrinthine vessels
Spotter - 27
27. A) Identify the probed
space (Jugular
foramen)
B) Mention the
structures passing
through it.
– 9th, 10th, 11th cranial
nerve,
– Internal jugular vein
– Inferior petrosal sinus
Spotter - 28
28. A) Identify the pinned structure (Parotid gland)
B) Mention its secretomotor pathway.
Inferior salivary nucleus in the medulla oblongata
Glossopharyngeal nerve (9th cranial)
Tympanic branch
Tympanic plexus
Lesser Petrosal nerve
Otic ganglion
Auriculotemporal nerve (postganglionic fibres)
Parotid gland
c) Mention the structures present within it.
– External carotid artery
– Retromandibular vein
– Facial vein
– PAROTID LYMPH NODE
Spotter - 29
29. A) Identify the tied
structure (Parotid duct)
B) Where does it open?
Opposite to the crown of
upper second molar tooth
C) Mention the structures
pierced by it.
– Buccal pad of fat
– Buccopharyngeal fascia
– Buccinator muscle &
– Buccal mucosa
Spotter - 30
30. A) Identify the pinned structure
(Submandibular gland)
B)Mention its secretomotor pathway.
Superior salivary nucleus
Nervous intermedius
Facial nerve
Chorda tympani
Joins lingual nerve
Submandibular ganglion (Relay)
(Postganglionic fibres)
Submandibular salivary gland
Spotter 30 cont…
C) Where does its duct open?
Opens on the summit of sublingual papillae at
the side of frenulum of tongue
D) Mention the artery which grooves it.
Facial artery
E) Name the muscle which divides it into two
parts.
Mylohyoid muscle
Spotter - 31
31. A) Identify the pinned structure
(Temporalis)
B)Mention its nerve supply and
action.
Temporal branch of mandibular
nerve
Action: Elevation and Retraction
of TMJ
C)Mention its attachments.
Origin: Temporal surface and
fascia
Insertion: Coronoid process
D) Mention its development
First pharyngeal arch
31
Spotter -32
32. A) Identify the pinned structure
(Masseter)
B) Mention its nerve supply and action.
– Massetric nerve of mandibular nerve
C) Mention its attachments.
Origin:
– Superficial fibres: Ant. 2/3rd of zygomatic
arch
– Middle fibres: Deep surface of zygomatic
arch
– Deep fibres: Posterior 1/3rd of Zygomatic
arch
Insertion: Lateral surface of ramus of Mandible
D) Mention its development
First pharyngeal arch
Spotter - 33
33. A) Identify the pinned structure (Medial
pterygoid)
B)Mention its nerve supply and action.
–Nerve to medial pterygoid of mandibular
nerve
C) Mention its attachments.
Origin:
– Superficial fibres-:Maxillary tuberosity
– Deep fibres: Medial surface of medial
pterygoid plate
Insertion: Pterygoid fovea
D) Mention its development
–First pharyngeal arch
Spotter - 34
34. A) Identify the pinned structure
(Lateral pterygoid)
B) Mention its nerve supply and action.
– Posterior division of mandibular nerve
C)Mention its attachments.
– Upper fibre: infratemporal surface and
crest of sphenoid bone
– Lower fibres: Lateral surface of Lateral
pterygoid plate
D)Mention its development
– First pharyngeal arch
Spotter - 35
35. A) Identify the tied
structure (Lingual nerve)
B) Mention its distribution.
– Anterior 2/3rd of Tongue
– Submandibular and
Sublingual salivary gland
C) Mention its clinical
importance.
– During extraction of 3rd
molar teeth , care should be
take not to injure lingual
nerve
Spotter - 36
36. A) Identify the tied structure
(Inferior alveolar nerve)
B) Mention its distribution.
– Mylohyoid branch: To mylohyoid
and anterior belly of digastrics
– Branches in the mandibular canal to
lower teeth and gum
– Mental nerve: Supplies skin over
chin, mucous membrane of lower
lips and incisive branch to gums of
canine and incisor teeth
C)Mention its clinical importance.
– In extraction of mandibular teeth,
inferior alveolar nerve is
anaesthetised
Spotter - 37
37. A)Identify the tied structure
(Maxillary artery)
B) Mention its parts
– Mandibular
– Pterygoid
– Sphenopalatine
C) Which structure divides it into
three parts?
– Lateral pterygoid
D) Mention the branches of first part.
– Deep auricular
– Anterior tympanic
– Middle meningeal
– Accessory Meningeal
– Inferior Alveolar
Spotter -38
38. A)Identify the tied
structure (Frontal nerve)
B)What is it a branch of?
– Ophthalmic division of
Trigeminal nerve
C) Mention its branches
– Supra trochlear
– Supraorbital
Spotter - 39
39. A) Identify the pinned
structure (Superior rectus
muscle)
B)Mention its
attachments
C)Mention its nerve
supply & actions
– Nerve supply: Oculomotor
nerve
– Actions: Elevation ,
adduction and intorsion
Spotter - 40
40. A) Identify the pinned
structure (Superior oblique
muscle)
B) Mention its attachments
C)Mention its nerve supply
& actions
– Nerve supply: Troclear nerve
– Actions: Depression ,
abduction and intorsion
Spotter - 41
41. A) Identify the pinned
structure (Lateral rectus
muscle)
B) Mention its
attachments
C) Mention its nerve
supply & actions
– Nerve supply: Abducent
nerve
– Actions: Abduction
Spotter - 42
42. A) Identify the pinned structure
(Levator palpebrae superioris
muscle)
B)Mention its attachments
C)Mention its nerve supply &
actions
Nerve supply:
– Voluntary part: Oculomotor nerve
– Involuntary part: sympathetic fibre
from superior cervical ganglion
Action: Elevation of upper eyelid
D) Mention its clinical importance
– Drooping of eyelid- Ptosis
Spotter - 43
43. A)Identify the tied
structure (Optic nerve)
B)Mention its function
– Vision
C)Mention its blood
supply
– Branches of ophthalmic
artery
D)Mention its clinical
importance
– Blindness
Spotter - 44
40. A) Identify the pinned structure
(Thyroid gland - lobe)
B) Mention its anterior/
posterolateral/medial relations
C) Mention its development
– Median endodermal thyroid diverticulum
D) Mention its blood supply.
E) Mention its clinical importance
– Goitre
– Thyroidectomy
F) Why do its swellings move up with
deglutition?
– Suspensory ligament of Berry attached to
cricoid cartilage
44 Thyroid gland
Spotter - 45
43. A)Identify the pinned
structure (Thyroid
cartilage)
B) Mention its histological
structure
– Hyaline cartilage
C) Name any two muscles
attached to it.
– Thyrohyoid, Sternothyroid
45 Thyroid cartilage
Spotter - 46
46. A)Identify the pinned
structure (Cricoid cartilage)
B)Mention its histological
structure
– Hyaline cartilage
C)Name any two muscles
attached to it.
– Cricothyroid and Posterior
cricoarytenoid
Cricoid cartilage
Spotter - 47
47. A) Identify the pinned
structure (Epiglottis)
B)Mention its
histological structure
– Elastic cartilage
C)Name any two
muscles attached to it.
– Aryepiglotticus
Spotter - 48
48. A) Identify the pinned
structure (Vestibular fold)
B)Mention the structure
present deep to it.
– Conus elasticus
C)Mention its nerve supply
– Internal laryngeal nerve
D)Mention the space below
it.
– Sinus of larynx
48
Spotter - 49
49. A)Identify the pinned structure
(Vocal fold)
B) Mention the structure present
deep to it.
– Vocalis
C) Mention its nerve supply
– Recurrent laryngeal nerve
D)Mention the space above it.
– Sinus of larynx
E) Mention its clinical importance
– Teacher’s nodule
49
Spotter - 50
50. A)Identify the probed
space (Sinus of larynx)
B) Mention its
boundaries.
 Above: Vestibular fold
 Below : Vocal fold
Spotter - 51
50. A)Identify the probed area
(Pyriform fossa)
B) Mention its boundaries
 Medially: Aryepiglottic fold
 Laterally: Thyroid cartilage
C) Mention the nerve related to it
 Internal laryngeal nerve
D) Mention its clinical importance
 Removal foreign antibodies
injure the internal laryngeal nerve
resulting in supra epiglottic part
anesthetised .
Spotter - 52
52. A)Identify the probed area
(Tonsillar fossa)
B) Mention its boundaries
 Anterior: Palatoglossal arch
 Posterior: Palatopharyngeal arch
 Above : Soft palate
 Below: Posterior 1/3rd of Tongue
C) Mention the structure located
in it
 Palatine tonsil
D)Mention its clinical importance.
 Tonsilitis
Spotter - 53
53. A)Identify the pinned
structure (Palatine tonsil)
B)Mention the structures
forming its bed
Pharyngobasilar fascia
Superior Constrictor
Palatopharyngeus
Superior Constrictor
Buccopharyngeal Fascia
Stlopharyngeus
Glossopharyngeal nerve
C)Mention its clinical
importance
 Tonsillitis
Spotter - 54
54. A)Identify the pinned
space (Vallecula)
B) Mention its boundaries
 Medial: Median
Glossoepiglottic fold
 Lateral: Lateral
glossoepiglottic fold
C) Mention its nerve
supply
 Internal laryngeal nerve
Spotter - 55
55. A) Identify the pinned
structure (Dorsum of
tongue)
B) Mention its development
C) Mention its sensory nerve
supply
D) Mention the muscles
present in the organ
E) Mention the motor nerve
supply of the organ
F) Mention the lymphatic
drainage of the organ
G) Mention the blood supply
of the organ
H) Mention its clinical
importance
Spotter - 56
56. A)Identify the pinned structure
(Genioglossus).
B) Mention its attachments
Origin:
 Upper genial tubercle of mandible
Insertion:
 Upper fibres to tip of tongue
 Middle fibres to dorsum of tongue
 Lower fibres to hyoid
C)Mention its development
 Occipital myotomes
D)Mention its nerve supply.
 Hypoglossal nerve
E)Mention its action & clinical
importance
 Retracts the tongue
 Depresses the tongue
 Protrudes the tongue
Spotter - 57
57. A)Identify the probed
space (Vestibule of
mouth)
B) Name the structure
which opens into it.
 Parotid ducts
 Buccal glands
Spotter - 58
59. A)Identify the pinned structure (Soft
palate)
B) Mention the muscles present in it
 Tensor veli palatini
 Levator veli palatini
 Musculus uvula
 Palatoglossus
 Palatopharyngeus
C) Mention its development (muscles)
 Tensor veli palatini- from First
pharyngeal arch
 All others: 6th pharyngealarch
D) Mention its motor nerve supply.
 Pharyngeal plexus except tensor
veli palatini by mandibular nerve
Spotter - 59
59. A) Identify the probed space
(Auditory tube)
B)Name the cavities
connected by it.
 Nasopharynx to middle ear
cavity
C)Mention its development.
 First and second pharyngeal
pouch
Spotter - 60
60. A)Identify the pinned
structure
(Salpingopharyngeal
fold)
B)Mention the muscle
present in it & its nerve
supply.
Salphingopharyngeus
muscle
Nerve Supply: Pharyngeal
plexus
Spotter - 61
61. A)Identify the pinned
space. (Inferior meatus)
B) Mention the structures
opening into it.
 Nasolacrimal duct
Spotter - 62
62. A) Identify the pinned
space ( middle meatus)
B) Mention the structures
opening into it
 Frontal air sinus
 Anterior Ethmoidal air
sinus
 Middle Ethmoidal air
sinus
 Maxillary air sinus
Spotter - 63
63.A)Identify the pinned
space ( superior meatus)
B) Mention the structures
opening into it.
 Posterior ethmoidal air
sinus
Spotter - 65
65. A)Identify the pinned structure (Nasal
septum)
B) Mention the components forming it.
Bony part:
 Vomer
 Perpendicular plate of ethmoid... margins
contributed by
 Rostrum of sphenoid
 Nasal spine of frontal bone
 Nasal crest of nasal bone, maxilla and palatine
bone
Cartilagenous part:
 Septal cartilage
 Septal process of inferior nasal cartilage
Cuticular part: Fibro fatty tissue covered by skin.
Its lower margin known as Columella
Spotter 65 cont..
C)Mention its blood supply.
 Anterosuperior: Anterior
ethmoidal artery
 Posterosuperior: Posterior
ethmoidal artery
 Anteroinferior: Superior labial
branch of facial artery
 Posteroinferior:
Sphenopalatine artery
D)Mention its nerve supply.
 Special sensory: Olfactory
nerves
 General sensory:
 Anterosuperior: Anterior
ethmoidal nerve
 Posterosuperior: Posterior
superior medial nasal branch
of pterygopalatine ganglion
 Anteroinferior: Anterior
superior alveolar nerve of
maxillary nerve
 Posteroinferior: Nasopalatine
nerve of pterygopalatine
ganglion
Spotter - 66
66. A)Identify the pinned space
(Frontal air sinus)
B)Where does it open?
Middle meatus of nose
C)Mention its blood supply.
D)Mention its nerve supply.
E)Mention its clinical
significance.
Spotter - 67
67. A)Identify the pinned space
(Sphenoidal air sinus)
B) Where does it open?
Sphenoethmoidal recess
C)Mention its blood supply.
D)Mention its nerve supply.
E)Mention its clinical
significance.
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420559379-Head-Neck-Spotters-Final-With-Answers-1 (1).pptx

  • 1. HEAD & NECK SPOTTERS Final with answers G. PannEER SELVI Department ofAnatomy
  • 2. Spotter -1 1. A)Identify the pinned structure (Scalp) B)Mention its layers. – S.... Skin – C.... Connective tissue(Superficial fascia) – A ... Aponeurosis (Epicranial aponeurosis or galea aponeurotica) – L.... Loose areolar tissue – P.... Pericranium C) Which is the dangerous area in it? Loose areolar tissue is the dangerous layer of scalp because the emissary veins transmit the infection from the scalp to intracranial venous sinuses.
  • 3. Spotter -1 cont… D) Mention its blood supply. ARTERIAL SUPPLY: IN FRONT OF AURICLE: Supratrochlear. A - Branch of ophthalmic artery Supra orbital. A - in turn from internal carotid Artery Superficial temporal. A ... branch of ECA BEHIND AURICLE: Posterior auricular .A - Branch of External carotid artery Occipital artery VENOUS DRAINAGE: Emissary vein: – Parietal emissary vein... Superior Sagittal sinus – Mastoid emissary vein... Sigmoid sinus Diploic vein: – Frontal diploic vein into supraorbital vein – Anterior temporal diploic vein into Anterior deep temporal vein – Posterior temporal vein into transverse sinus – Occipital diploic vein into Occipital vein or transverse sinus VENOUS DRAINAGE cont.. Supra trochlear Vein + Superficial temporal Vein + Supra orbital Vein Maxillay .V Angular vein Facial vein Retromandibular Vein Anterior division Posterior division + Posterior auricular vein Common facial vein External Jugular Vein Internal jugular vein Subclavian vein
  • 4. Spotter -1 Cont E) Mention its nerve supply. In front of auricle Behind auricle Sensory supply 1 Supra orbital of ophthalmic division of trigeminal nerve Great auricular nerve(C2, C3 from cervical plexus) 2. Supra trochlear nerve of ophthalmic division of trigeminal nerve Lesser occipital nerve(C2, from cervical plexus) 3. Zygomaticotemporal nerve- branch of maxillary nerve Greater occipital nerve(C2, dorsal ramus) 4. Auriculotemporal nerve- branch of mandibular nerve Third occipital nerve(C3, dorsal ramus ) Motor nerve 5. Temporal branch of facial nerve- frontalis Posterior auricular branch of facial nerve- occipitalis
  • 5. Spotter -2 2. A) Identify the pinned structure (Orbicularis oculi) B) Mention its parts. Parts: – Orbital – Palpebral – Lacrimal C) Mention its nerve supply and action. – Tight closure of eye lids – Gentle closure of eyelid as in blinking and sleeping – Dilates lacrimal sac for suction of lacrimal fluid Nerve suppy: Temporal and zygomatic branch of facial nerve D) Mention its clinical importance. – Eyes cannot be closed in Bell’s palsy of infra nuclear lesion of facial nerve
  • 6. Spotter -3 3. A) Identify the pinned structure (Upper Eye lid) B) Mention its nerve supply (motor & sensory). Motor supply: Oculomotor nerve to LPS Sensory nerve: Ophthalmic nerve branches
  • 7. Spotter -4 4. A) Identify the pinned structure (Buccinator) B) Mention its parts and attachment. – ORIGIN: – Upper fibres: Maxilla opposite to molar teeth – Lower fibres: Mandible opposite to molar teeth – Middle fibres: Pterygomandibular raphe – INSERTION: – Upper fibres: Straight to upper lip – Lower fibres: Straight to lower lip – Middle fibres: Decussate C
  • 8. Spotter- 4 Cont… C) Mention its nerve supply and action. – NERVE SUPPLY: – Buccal branch of facial nerve – ACTION: – Flattens the cheek against gums and teeth – Prevents accumulation of food in vestibule – Whistling muscle D )Mention the structures piercing it. – Parotid duct – Buccal branch of mandibular nerve E) Mention its clinical importance. – Food accumulates between cheek and teeth in Bell’s palsy (infranuclear lesion of facial nerve)
  • 9. Spotter -5 5. A) Identify the pinned structure (Frontalis) B) Mention its nerve supply and action. – N.S: Temporal branch of facial nerve – Action: Horizontal wrinkles over the forehead
  • 10. Spotter - 6 6. A)Identify the pinned structure (Orbicularis oris) B) Mention its parts. – Intrinsic part (deep stratum) – Extrinsic part C) Mention its nerve supply and action. Action: – Closure of lips – Protrudes the lips Nerve supply: – Buccal branch of facial nerve D) APPLIED ANATOMY – Unable to protrude the lips as in whistling – Mouth deviated to normal side when attempted to smile in infra nuclear lesion of facial nerve
  • 11. Spotter -7 7. A) Identify the tied structure (Facial artery) B)Mention its branches in the face.(SIL mnemonics)  Superior labial  Inferior labial  Lateral nasal C) What is it a branch of? External carotid artery
  • 12. Spotter - 8 8. A) Identify the pinned area (Dangerous area of face) B) Mention its clinical importance. Infection from this area taken retrograde to cavernous sinus through deep facial--- pterygoid venous plexuses– emissary vein--- Cavernous sinus
  • 13. Spotter -9 9. A)Identify the pinned structure (Auricle) B)Mention the muscles attached to it.  Auricuris superior  Auricuris Anterior  Auricuris Posterior C)Mention its nerve supply (motor & sensory).  Motor: Facial nerve  Sensory: Auriculotemporal nerve
  • 14. Spotter -10 10. A) Identify the pinned structure (Anterior Belly of digastric muscle) B) Mention its attachments.  Origin: Digastric fossa of mandible  Insertion: Common tendon to hyoid bone C) Mention its development.  First pharyngeal arch D) Mention its nerve supply.  Nerve to mylohyoid(Mandibular nerve branch)
  • 15. Spotter -11 11. A)Identify the pinned structure (Posterior Belly of digastric muscle) B) Mention its attachments  Origin: Mastoid notch  Insertion: Common tendon to hyoid bone C) Mention its development.  Second pharyngeal arch D) Mention its nerve supply.  Facial nerve
  • 16. Spotter -12 . A) Identify the pinned structure (Mylohyoid) B) Mention its attachments.  Origin: Mylohyoid line of mandible  Insertion: Hyoid bone C) Mention its development.  First pharyngeal arch D) Mention its nerve supply.  Nerve to mylohyoid (Mandibular nerve branch)
  • 17. Spotter -13 13. A)Identify the tied structure (Hypoglossal nerve) B) Mention the muscles supplied by it. Muscles of tongue – Genioglossus, Hyoglossus, Styloglossus – Intrinsic muscles: Superior and inferior longitudinal, vertical and transverse
  • 18. Spotter -14 14. A)Identify the pinned structure (Sternocleidomastoid ) B) Mention its attachments. Origin: – Sternal head : Anterior surface of manubrium sternum – Clavicular head: Superior surface of medial 2/3rd of clavicle Insertion: Lateral surface of Mastoid process C)Mention its nerve supply and action. N.S: – Spinal Accessary nerve(Motor) – Ventral rami C2, C3(Proprioception) D)Mention its clinical importance. – Wry neck or Torticollis
  • 19. Spotter -15 15. A) Identify the pinned structure (Trapezius) B) Mention its attachments. C) Mention its nerve supply and action. – Spinal accessory nerve and C3 and C4 fibres – Action: Over head abduction of shoulder along with serratus anterior
  • 20. Spotter -16 16. A) Identify the tied structure (Common carotid artery) B) What is it a branch of? – Right side : Brachiocephalic trunk – Left side: Arch of Aorta C) Mention its level of bifurcation or termination. – Disc between C3 and C4 D) Where are its pulsations felt? – Carotid tubercle on C6 vertebra E) Mention its branches. – External and internal carotid artery
  • 21. Spotter -17 17. A) Identify the tied structure (External carotid artery) B) What is it a branch of? – Common carotid artery C)Mention its branches – Superior thyroid artery – Lingual artery – Facial artery – Posterior auricular artery – Occipital artery – Ascending pharyngeal artery – Maxillary artery terminating branches – Superficial temporal artery
  • 22. Spotter -18 18. A)Identify the tied structure (Internal carotid artery) B)What is it a branch of? – Common carotid artery C) Mention its branches. – Ophthalmic artery – Middle cerebral artery – Anterior cerebral artery – Superior and inferior hypophyseal artery
  • 23. Spotter -19 19. A)Identify the tied structure (Internal jugular vein) B)Mention its origin and termination. – Origin: Sigmoid sinus – Termination: Subclavian vein – C)Mention its tributaries. – Inferior petrosal sinus – Lingual vein – Common facial vein – Pharyngeal vein – Superior thyroid vein – Middle thyroid vein – 4th vein of Kocher – Occipital vein
  • 24. Spotter -20 20. A)Identify the tied structure (Vagus nerve) B) Mention its branches in the neck. – Pharyngeal branch – Superior laryngeal nerve – Recurrent laryngeal nerve on right side
  • 25. Spotter -21 21. A) Identify the pinned space (Suboccipital triangle) B) Mention its boundaries. – Superomedially: Rectus capitis posterior minor and major – Superolaterally: Superior oblique – Inferior: Inferior oblique – Floor: Posterior arch of atlas, Posterior atlantoccipital membrane C) Mention its contents. – Third part vertebral artery – Suboccipital venous plexuses – Suboccipital nerve
  • 26. Spotter -22 22. A)Identify the tied structure (External jugular vein) B)Mention its tributaries. – Posterior external jugular vein – Suprascapular vein – Transverse cervical vein C)Mention its formation and termination. – Formation: Posterior Auricular vein joins with posterior division of retromandibular ven – Termination: Subclavian vein
  • 27. Spotter - 23 23. Identify the pinned structure (Falx cerebri) a) Mention its attachments. • Anterior end : Crita galli • Posterior end: upper Surface of tentorium cerebelli • Upper margin: Sagittal sulcus • Lower margin: Free b) Mention the sinuses related to it. • Superior sagittal sinus along upper margin • Inferior sagittal sinus along lower margin • Straight sinus along attachment to tentorium cerebelli
  • 29. Spotter -24 24. Identify the pinned structure (Falx cerebelli) a) Mention its attachments. • Base: Attached to inferior surface of tentorium cerebelli • Apex: Attached to foramen magnum • Posterior margin: To internal occipital crest • Anterior margin: Free and concave b) Mention the sinus related to it • Occipital sinus
  • 30. Spotter -25 25. A) Identify the pinned structure (Tentorium cerebelli) B) Mention its attachment FREE MARGIN: – U- shaped and free – Ends of ‘U’ attached to anterior clinoid process – Tentorial Notch: Occupied by midbrain and superior vermis of cerebellum ATTACHED MARGIN: – Posterolaterally: Attached to transverse sulcus and posteroinferior angle of parietal bone – Antero laterally: Superior border of Petrous part of temporal bone and posterior clinoid process – At the point of meeting of both margin: Pierced by 3rd and 4th cranial nerve – Meckel’s cave formed by evagination of inferior layer of tentorium over trigeminal ganglion lies along attached margin TWO SURFACES: – Upper surface: Posterior end of falx cerebri attached – Lower surface: Upper end of falx cerebelli attached C). Mention the sinuses related to it. – Transverse sinus – Superior Petrosal sinus – Straight sinus
  • 32. Spotter - 26 26. A) Identify the probed space (Internal acoustic meatus) B) Mention the structures passing through it. – Facial nerve – Glossopharyngeal nerve – Labyrinthine vessels
  • 33. Spotter - 27 27. A) Identify the probed space (Jugular foramen) B) Mention the structures passing through it. – 9th, 10th, 11th cranial nerve, – Internal jugular vein – Inferior petrosal sinus
  • 34. Spotter - 28 28. A) Identify the pinned structure (Parotid gland) B) Mention its secretomotor pathway. Inferior salivary nucleus in the medulla oblongata Glossopharyngeal nerve (9th cranial) Tympanic branch Tympanic plexus Lesser Petrosal nerve Otic ganglion Auriculotemporal nerve (postganglionic fibres) Parotid gland c) Mention the structures present within it. – External carotid artery – Retromandibular vein – Facial vein – PAROTID LYMPH NODE
  • 35. Spotter - 29 29. A) Identify the tied structure (Parotid duct) B) Where does it open? Opposite to the crown of upper second molar tooth C) Mention the structures pierced by it. – Buccal pad of fat – Buccopharyngeal fascia – Buccinator muscle & – Buccal mucosa
  • 36. Spotter - 30 30. A) Identify the pinned structure (Submandibular gland) B)Mention its secretomotor pathway. Superior salivary nucleus Nervous intermedius Facial nerve Chorda tympani Joins lingual nerve Submandibular ganglion (Relay) (Postganglionic fibres) Submandibular salivary gland
  • 37. Spotter 30 cont… C) Where does its duct open? Opens on the summit of sublingual papillae at the side of frenulum of tongue D) Mention the artery which grooves it. Facial artery E) Name the muscle which divides it into two parts. Mylohyoid muscle
  • 38. Spotter - 31 31. A) Identify the pinned structure (Temporalis) B)Mention its nerve supply and action. Temporal branch of mandibular nerve Action: Elevation and Retraction of TMJ C)Mention its attachments. Origin: Temporal surface and fascia Insertion: Coronoid process D) Mention its development First pharyngeal arch 31
  • 39. Spotter -32 32. A) Identify the pinned structure (Masseter) B) Mention its nerve supply and action. – Massetric nerve of mandibular nerve C) Mention its attachments. Origin: – Superficial fibres: Ant. 2/3rd of zygomatic arch – Middle fibres: Deep surface of zygomatic arch – Deep fibres: Posterior 1/3rd of Zygomatic arch Insertion: Lateral surface of ramus of Mandible D) Mention its development First pharyngeal arch
  • 40. Spotter - 33 33. A) Identify the pinned structure (Medial pterygoid) B)Mention its nerve supply and action. –Nerve to medial pterygoid of mandibular nerve C) Mention its attachments. Origin: – Superficial fibres-:Maxillary tuberosity – Deep fibres: Medial surface of medial pterygoid plate Insertion: Pterygoid fovea D) Mention its development –First pharyngeal arch
  • 41. Spotter - 34 34. A) Identify the pinned structure (Lateral pterygoid) B) Mention its nerve supply and action. – Posterior division of mandibular nerve C)Mention its attachments. – Upper fibre: infratemporal surface and crest of sphenoid bone – Lower fibres: Lateral surface of Lateral pterygoid plate D)Mention its development – First pharyngeal arch
  • 42. Spotter - 35 35. A) Identify the tied structure (Lingual nerve) B) Mention its distribution. – Anterior 2/3rd of Tongue – Submandibular and Sublingual salivary gland C) Mention its clinical importance. – During extraction of 3rd molar teeth , care should be take not to injure lingual nerve
  • 43. Spotter - 36 36. A) Identify the tied structure (Inferior alveolar nerve) B) Mention its distribution. – Mylohyoid branch: To mylohyoid and anterior belly of digastrics – Branches in the mandibular canal to lower teeth and gum – Mental nerve: Supplies skin over chin, mucous membrane of lower lips and incisive branch to gums of canine and incisor teeth C)Mention its clinical importance. – In extraction of mandibular teeth, inferior alveolar nerve is anaesthetised
  • 44. Spotter - 37 37. A)Identify the tied structure (Maxillary artery) B) Mention its parts – Mandibular – Pterygoid – Sphenopalatine C) Which structure divides it into three parts? – Lateral pterygoid D) Mention the branches of first part. – Deep auricular – Anterior tympanic – Middle meningeal – Accessory Meningeal – Inferior Alveolar
  • 45. Spotter -38 38. A)Identify the tied structure (Frontal nerve) B)What is it a branch of? – Ophthalmic division of Trigeminal nerve C) Mention its branches – Supra trochlear – Supraorbital
  • 46. Spotter - 39 39. A) Identify the pinned structure (Superior rectus muscle) B)Mention its attachments C)Mention its nerve supply & actions – Nerve supply: Oculomotor nerve – Actions: Elevation , adduction and intorsion
  • 47. Spotter - 40 40. A) Identify the pinned structure (Superior oblique muscle) B) Mention its attachments C)Mention its nerve supply & actions – Nerve supply: Troclear nerve – Actions: Depression , abduction and intorsion
  • 48. Spotter - 41 41. A) Identify the pinned structure (Lateral rectus muscle) B) Mention its attachments C) Mention its nerve supply & actions – Nerve supply: Abducent nerve – Actions: Abduction
  • 49. Spotter - 42 42. A) Identify the pinned structure (Levator palpebrae superioris muscle) B)Mention its attachments C)Mention its nerve supply & actions Nerve supply: – Voluntary part: Oculomotor nerve – Involuntary part: sympathetic fibre from superior cervical ganglion Action: Elevation of upper eyelid D) Mention its clinical importance – Drooping of eyelid- Ptosis
  • 50. Spotter - 43 43. A)Identify the tied structure (Optic nerve) B)Mention its function – Vision C)Mention its blood supply – Branches of ophthalmic artery D)Mention its clinical importance – Blindness
  • 51. Spotter - 44 40. A) Identify the pinned structure (Thyroid gland - lobe) B) Mention its anterior/ posterolateral/medial relations C) Mention its development – Median endodermal thyroid diverticulum D) Mention its blood supply. E) Mention its clinical importance – Goitre – Thyroidectomy F) Why do its swellings move up with deglutition? – Suspensory ligament of Berry attached to cricoid cartilage
  • 53. Spotter - 45 43. A)Identify the pinned structure (Thyroid cartilage) B) Mention its histological structure – Hyaline cartilage C) Name any two muscles attached to it. – Thyrohyoid, Sternothyroid
  • 55. Spotter - 46 46. A)Identify the pinned structure (Cricoid cartilage) B)Mention its histological structure – Hyaline cartilage C)Name any two muscles attached to it. – Cricothyroid and Posterior cricoarytenoid
  • 57. Spotter - 47 47. A) Identify the pinned structure (Epiglottis) B)Mention its histological structure – Elastic cartilage C)Name any two muscles attached to it. – Aryepiglotticus
  • 58. Spotter - 48 48. A) Identify the pinned structure (Vestibular fold) B)Mention the structure present deep to it. – Conus elasticus C)Mention its nerve supply – Internal laryngeal nerve D)Mention the space below it. – Sinus of larynx 48
  • 59. Spotter - 49 49. A)Identify the pinned structure (Vocal fold) B) Mention the structure present deep to it. – Vocalis C) Mention its nerve supply – Recurrent laryngeal nerve D)Mention the space above it. – Sinus of larynx E) Mention its clinical importance – Teacher’s nodule 49
  • 60. Spotter - 50 50. A)Identify the probed space (Sinus of larynx) B) Mention its boundaries.  Above: Vestibular fold  Below : Vocal fold
  • 61. Spotter - 51 50. A)Identify the probed area (Pyriform fossa) B) Mention its boundaries  Medially: Aryepiglottic fold  Laterally: Thyroid cartilage C) Mention the nerve related to it  Internal laryngeal nerve D) Mention its clinical importance  Removal foreign antibodies injure the internal laryngeal nerve resulting in supra epiglottic part anesthetised .
  • 62. Spotter - 52 52. A)Identify the probed area (Tonsillar fossa) B) Mention its boundaries  Anterior: Palatoglossal arch  Posterior: Palatopharyngeal arch  Above : Soft palate  Below: Posterior 1/3rd of Tongue C) Mention the structure located in it  Palatine tonsil D)Mention its clinical importance.  Tonsilitis
  • 63. Spotter - 53 53. A)Identify the pinned structure (Palatine tonsil) B)Mention the structures forming its bed Pharyngobasilar fascia Superior Constrictor Palatopharyngeus Superior Constrictor Buccopharyngeal Fascia Stlopharyngeus Glossopharyngeal nerve C)Mention its clinical importance  Tonsillitis
  • 64. Spotter - 54 54. A)Identify the pinned space (Vallecula) B) Mention its boundaries  Medial: Median Glossoepiglottic fold  Lateral: Lateral glossoepiglottic fold C) Mention its nerve supply  Internal laryngeal nerve
  • 65. Spotter - 55 55. A) Identify the pinned structure (Dorsum of tongue) B) Mention its development C) Mention its sensory nerve supply D) Mention the muscles present in the organ E) Mention the motor nerve supply of the organ F) Mention the lymphatic drainage of the organ G) Mention the blood supply of the organ H) Mention its clinical importance
  • 66. Spotter - 56 56. A)Identify the pinned structure (Genioglossus). B) Mention its attachments Origin:  Upper genial tubercle of mandible Insertion:  Upper fibres to tip of tongue  Middle fibres to dorsum of tongue  Lower fibres to hyoid C)Mention its development  Occipital myotomes D)Mention its nerve supply.  Hypoglossal nerve E)Mention its action & clinical importance  Retracts the tongue  Depresses the tongue  Protrudes the tongue
  • 67. Spotter - 57 57. A)Identify the probed space (Vestibule of mouth) B) Name the structure which opens into it.  Parotid ducts  Buccal glands
  • 68. Spotter - 58 59. A)Identify the pinned structure (Soft palate) B) Mention the muscles present in it  Tensor veli palatini  Levator veli palatini  Musculus uvula  Palatoglossus  Palatopharyngeus C) Mention its development (muscles)  Tensor veli palatini- from First pharyngeal arch  All others: 6th pharyngealarch D) Mention its motor nerve supply.  Pharyngeal plexus except tensor veli palatini by mandibular nerve
  • 69. Spotter - 59 59. A) Identify the probed space (Auditory tube) B)Name the cavities connected by it.  Nasopharynx to middle ear cavity C)Mention its development.  First and second pharyngeal pouch
  • 70. Spotter - 60 60. A)Identify the pinned structure (Salpingopharyngeal fold) B)Mention the muscle present in it & its nerve supply. Salphingopharyngeus muscle Nerve Supply: Pharyngeal plexus
  • 71. Spotter - 61 61. A)Identify the pinned space. (Inferior meatus) B) Mention the structures opening into it.  Nasolacrimal duct
  • 72. Spotter - 62 62. A) Identify the pinned space ( middle meatus) B) Mention the structures opening into it  Frontal air sinus  Anterior Ethmoidal air sinus  Middle Ethmoidal air sinus  Maxillary air sinus
  • 73. Spotter - 63 63.A)Identify the pinned space ( superior meatus) B) Mention the structures opening into it.  Posterior ethmoidal air sinus
  • 74. Spotter - 65 65. A)Identify the pinned structure (Nasal septum) B) Mention the components forming it. Bony part:  Vomer  Perpendicular plate of ethmoid... margins contributed by  Rostrum of sphenoid  Nasal spine of frontal bone  Nasal crest of nasal bone, maxilla and palatine bone Cartilagenous part:  Septal cartilage  Septal process of inferior nasal cartilage Cuticular part: Fibro fatty tissue covered by skin. Its lower margin known as Columella
  • 75. Spotter 65 cont.. C)Mention its blood supply.  Anterosuperior: Anterior ethmoidal artery  Posterosuperior: Posterior ethmoidal artery  Anteroinferior: Superior labial branch of facial artery  Posteroinferior: Sphenopalatine artery D)Mention its nerve supply.  Special sensory: Olfactory nerves  General sensory:  Anterosuperior: Anterior ethmoidal nerve  Posterosuperior: Posterior superior medial nasal branch of pterygopalatine ganglion  Anteroinferior: Anterior superior alveolar nerve of maxillary nerve  Posteroinferior: Nasopalatine nerve of pterygopalatine ganglion
  • 76. Spotter - 66 66. A)Identify the pinned space (Frontal air sinus) B)Where does it open? Middle meatus of nose C)Mention its blood supply. D)Mention its nerve supply. E)Mention its clinical significance.
  • 77. Spotter - 67 67. A)Identify the pinned space (Sphenoidal air sinus) B) Where does it open? Sphenoethmoidal recess C)Mention its blood supply. D)Mention its nerve supply. E)Mention its clinical significance.