Review Lecture

solved by C.W.T suliman qaralleh

The Brain & Cranial Nerves

Main Cerebral Sulci

Central Sulcus: separates the frontal from parietal lobes Located between 2 important gyri: Precentral gyrus (frontal lobe) Postcentral gyrus (parietal lobe)

Precentral Gyrus
The primary motor area (motor neurons) Controls voluntary movement on opposite side of the body Because: Nerve fibers from precentral gyrus

cross over to other side within medulla oblongata

Motor control in precentral gyrus is represented in an inverted position

Postcentral Gyrus
The primary sensory area (sensory nerve cells)

Receives inputs for: pain, temperature, touch & pressure

Receives the sensations from opposite side of the body

Site of cross over

1- Spinal cord : general senstion 2- Medulla oblongata : fine sensation ( fine touch ) or vibration

Main Cerebral Sulci

Central Sulcus separates the frontal from parietal lobes Lateral Sulcus (separates the temporal from the frontal and parietal lobes ) Parieto-occipital Sulcus Calcarine Sulcus: on medial surface of occipital lobe communicates with the parietooccipital sulcus ( anteriorly ) region of visual interpretation

Main Functional Regions in Cerebrum

1. Motor area: location Precentral gyrus 2. Sensory area: location Postcentral gyrus

3. Auditory area: interpretation of sound location In the middle of the superior temporal gyrus

4. Visual area: interpretation of vision medial aspect of occipital lobe (post. pole of cerebrum)
5. Motor Speech area: (Brocas area) Planning & production of speech in a comprehensive way location In the middle of inferior frontal gyrus 6. Wernickes (Language) area interprets the meaning of speech by recognizing spoken words Location In the posterior part of the superior temporal gyrus

Clinical: Brocas Aphasia

Difficulty in speech due to damage to brocas area The person knows what he wants to say but cannot speak

expressive aphasia
non-fluent aphasia

Main Functions of The Following Brain Parts:

Thalamus its a major relay station for sensory pathways

Hypothalamus links 2 systems The nervous system with the endocrine system

Pons Contains bundles of axons that connect the 2 halves of cerebellum Bundles of axons connect Controls arousal Medulla Oblongata: Site of crossing over of motor bundles Contains nuclei of cranial nerves VIII XII Cardiovascular center (Fxn: control heart rate) Respiratory rhythmicity area (Fxn : control respiration rate ) Cerebellum coordination of muscle tone & movements on same side of body Regulates posture & balance

Arteries of The Brain

The main arteries of the Brain Include: 2 ICA 2 Vertebral a.

Read Your Textbook for Detailed Anatomy of arterial bld. supply to the brain

Internal Carotid Artery

Read Your Text
5 branches 1. Ophthalmic a.: to orbit, through optic canal 2. Ant. Cerebral a.: runs in longitudinal fissure medial surface of cerebrum until parieto- occipital sulcus 3. Middle cerebral a.: largest branch of ICA runs in lat. Sulcus most lat. Surface of cerebrum 4. Post. Communicating a. 5. Choroidal a.

Medial Surface

Lateral Surface

Vertebral Arteries
The 2 vertebral a. join at lower border of Pons to form: Basilar artery V. a. branches: (4) post. Meningeal a. ( dura mater) ant. & post. Spinal a. ( spinal cord) post. Inf. Cerebellar a. (cerbulum) medullary a. (medulla oblongata)

Basilar Artery
4 branches arteries to cerebellum Labyrinthine artery Pontine a.

Post. Cerebral a.: turns backward at midbrin supply: occipital lobe inferolateral Part of temporal lobe & the medial part of temporal lobe

Circulus Arteriosus Circle of Willis

Anastomosis between branches of 2 ICA & 2 vertebral a. Consists of: ant. Communicating a.

ant. Cerebral a.
ICA Post. Communicating a post. Cerebral a. basilar a.

Cranial Nerves
12 pairs PNS

Fxn.
Skull Foramina Site of brain they appear

The Parotid & Temporal Region

Parotid Region
Extends between: the ramous of the mandible anteriorly & the mastoid process posteriorly

Contains: Parotid Gland & Str. Inside it

Structures Within Parotid Gland

1. Superficial: Facial n. & its terminal branches

2. Middle: Retromandibular V. & the terminal part of superficial temporal

and maxillary veins

3. Deep: ECA & its terminations ( the beginning part of maxillary a. and superficial temporal a.) )

4. Parotid L.N.: distributed within & on the gland drain into DCLN

Relations to The Parotid Gland

The Temporal Region

The region that situated on the side of the head Boundaries: Sup.& post.: sup. Temporal line Ant.: frontal process of zygomatic bone Inf.: Zyg. arch *continues inf. & deep to zyg. Arch with infratemporal region

Contents of Temporal Region

1. Temporalis m. Originates from the whole floor of the temporal region insertion into the coronoid process of the mandible and the anterior border of the ramous innervated by two nerves we name them the temporal nerves coming from the anterior division of the mandibular nerve action elevation (the anterior part of it) and retraction (the posterior part of it 2. Temporal fascia 3. Deep temporal a. origin from the maxillary a. & nerves ( the same as arteries ) 4. Superficial Temporal a. & v.: pass posterior to the TMJ

5. Auriculotemporal nerve: from the posterior division of mandibular nerve pass posterior to superficial temporal vessels

Infratemporal ( included) & Pterygopalatine Fossae ( not included)

Boundaries of Infratemporal Fossa

Superior: Temporal & greater wing of sphenoid Anterior: Post. Maxilla Posterior: styloid process Inferior: angle of mandible

Medial: Lat. Pterygoid plate (of sphenoid )

Lateral: Ramus of mandible

Contents of Infratemporal Fossa

Muscles med. & lat. Pterygoids Nerves - V3 & its branches - otic ganglion - chorda tympani

Artery maxillary a.
Veins pterygoid venous plexus max. vein Ligament: spheno-mandibular ligament

Maxillary Artery
Largest terminal branch of external carotid a. Arises post. to the neck of the mandible Divided by lat. Pterygoid Into 3 parts: 1. Mandibular (1st) 2. Pterygoid (2nd) 3. Pterygopalatine (3rd)

Pterygoid Venous Plexus

Communicates with: Anteriorly facial vain Via inf. Ophthalmic vain and deep facial vain Superiorly cavernous sinuses Via emissary vain Drains into maxillary vain

The Oral Cavity & Salivary Glands

Oral Cavity
The cavity that extends from lips to pharynx & contains the tongue & teeth 2 parts: 1. Vestibule: space between ? contains ? divides into sulci: labial & buccal 2. Oral cavity proper: enclosed by teeth

* The vestibule communicates with cavity proper at: 1. ?? & 2. ??

Oral Cavity Proper

Space that enclosed by teeth & bounded: Roof: hard palate Floor: reflection of M.M. under the tongue Ant.: communicates with Vestibule Post.: communicates with oropharynx

Innervation of The Teeth

Muscles of The tongue

2 types
Intrinsic: not attached to bone 3 directions: longi., transv., & vertical

Action: change tongue shape Extrinsic: 4 (5 ) muscles innervation by hypoglossal nerve Except the palato-glossus ( pharyngeal nerve)

Extrinsic Muscles of The Tongue

(Read your text for detailed anatomy)

Innervation to The Tongue

Sensory: general: Ant. 2/3 trigeminal Post. 1/3 glosso-pharyngeal Special:Ant. 2/3 corda timpani (facial) Post. 1/3 glosso-pharyngeal Motor: hypoglossal nerve Except the palato-glossus ( pharyngeal nerve)

Arterial Blood Supply to The Tongue

Lingual a.: from external carotid pass deep to hyoglossus m. Branches: 3 Dorsal lingual (pos. part of the tongue ) Deep lingual ( ant. Part ) Sub lingual Tonsillar a.

Ascending pharyngeal a.

Submandibular Salivary Gland

Mixed gland (mucous & serous, mainly serous) Rests on post. Border of ant. Belly of digastric 70 % of secretion 2 parts: large superficial small deep

* Relations to superficial & deep parts: READ YOUR TEXT

Sublingual Salivary Gland

Mixed gland (mainly mucous) Beneath m.m. of floor of mouth Opens into the floor of mouth: 8-20 ducts (subling. Fold) * Relations to the gland: READ YOUR TEXT

Nasal Conchae & Meatuses

Conchae: bony elevations that project inf. Like scrolls 3 (sup., mid., inf.,) from ethmoid bone (sup. / mid.) inf. conchae ( inf.) Beneath each concha is a meatus (passage)

Sup. Meatus: pos. ethmoidal Mid. Meatus: all except pos. ethmoidal and sphenoid Inf. Meatus: naso lacremal duct

Muscles of The Soft Palate (Read the table in your book)

Tensor veli palatini forms P. aponeurosis Levator veli palatini

Palatoglossus m. forms ? Palatopharyngeus m. forms ? Musculus uvulae elevates uvula

Uvula: a conical projection from post. Border of soft P.

4 degrees of cleft palate 1st : cleft uvula 2nd: + cleft of 2o palate 3rd: + cleft on one side of 1o palate 4th: + cleft on both sides of 1o palate

Components of Larynx Cartilages Membranes & ligaments Muscles

Intrinsic Muscles
2 groups - control Laryngeal inlet (2 muscles): oblique arytenoid ( action close ) thyroepiglottic (action wide )

- move vocal folds (5 muscles): cricothyroid thyroarytenoid lateral cricoarytenoid posterior cricoarytenoid transverse arytenoid Read the table in your book for the Origin?, Insertion?, Nerve supply?, & Action of these muscles

Nerve supply
Sensory
above vocal fold internal laryngeal branch of superior laryngeal branch of ? below vocal fold recurrent laryngeal n.

Motor
Recurrent laryngeal n. supply all intrinsic muscles except cricothyroid muscle which is supplied by

External larynx nerve

Muscles of Pharynx

(Read your text for origin, insertion, innervation & action of these muscles)
6 Muscles 3 constrictors: Sup., mid. & inf. - Run in circular direction & attached post. to pharyngeal raphe - The successive contraction of these muscles produces the action of swallowing Overlap each other in the direction of inferior to superior ( the inferior constrictor is covering the lower part of the middle constrictor and the middle constrictor is covering the lower part of the superior constrictor )

Killians Dehiscence
Inferior constrictor m. consists of 2 parts:
- Sup.: thyropharyngeus - Inf.: cricopharyngeus

* A weak area presents between The 2 parts of inf. constrictor m. m.m. may protrude giving rise to a pharyngeal pouch

3. Stylopharyngeus m.: styloid process post. Border of

thyroid cartilage pass between superior and middle constrictor muscles Innervation pharyngeal plexus 4. Palatopharyngeus m.: Palatal apon. post. Border of thyroid cartilage Palatopharyngeal fold 5. Salpingopharyngeus m.: Auditory tube (medial end) Blends with palatopharyngeus

*All of these muscles help elevate the pharynx

Nasopharynx
Post. To nasal cavity & above the soft palate

Lined by respiratory epithelium

Contains: - auditory tube: opens into the middle ear On the lateral walls of the nasopharynx - Tubal tonsil: aggregation of lymph nodules around the auditory tube

- Tubal elevation & Salpingopharyngeal fold

- Pharyngeal tonsil (adenoid): in the submucosa of
the roof of the nasopharynx

Oropharynx
Post. To oral cavity & opens to it Through oropharyngeal isthmus Between the soft palate superiorly and the posterior 3rd of the tongue inferiorly At the level of C2 and C3

The floor is made by: post. 1/3 of tongue & the valleculae Contains: Palatine tonsils: between ? over sup. Constrictor m. tonsillar bed

Relations of Palatine Tonsils

Ant.: palatoglossal fold Post.: palatopharyngeal fold Sup.: soft palate Inf.: posterior 3rd of the tongue Medially: the cavity of the oropharynx Laterally: superior constrictor muscle

Laryngeopharynx
From epiglottis to cricoid C.

At vertebral level
C4, C5 & C6 Lined by stratified squamous epithelium Contains: - Piriform fossa

Piriform Fossa
A small recess (depression) on Each side of laryngeal inlet Bounded: Med.: qudrangular membrane Lat.: thyroid cartilage

Fxn. prevent swallowing of sharp and foreign objects * Internal laryngeal n. pass In the fossa just beneath the m.m.

Pharyngeal Gaps
4 gaps Above sup. Constrictor m.:

Between sup. & mid. Constrictor m.:

Between mid & inf. Constrictors:

Below inf. Constrictor: