LESSON #27 (6 HOURS)

 

Lesson No 27

Theme. VIII, IX cranial nerves. Head and neck parts of vagus nerve. Practical skills on vessels and nerves of the head and neck

  

Am: Study the structural and topographical peculartes of vestibulo-cochlear, glossopharyngeal and vagus nerves.

 

Professional orientation of students. Anatomical peculiarities of the 8th cranial nerve and auditory pathway are necessary for otology therapy and surgery, also for traumatology and oncology. Knowledge the topography and supplying regions of glossopharyngeal nerve is the base for understanding the physiology and neuropathology. Anatomical peculiarities of the branches of glossopharyngeal are necessary for neurological therapy and surgery, also for traumatology and oncology. If the vagus nerve is damaged there is impairment of function in the throat and the larynx: unilateral paralysis of the levator veli palatini muscle causes the soft palate and the uvula to the displaced to the intact side. The vocal cord on the affected side will remain immobile in the cadaver position (recurrent laryngeal nerve palsy) as a result of paralysis of the internal laryngeal muscles.

 

I.                  Practical work 9:00-12:00 am (4 hours)

 

1)    Methodology of Practical Class.

 

Work 1. Finding and demonstrating 8ts pair of cranial nerves.

 

Work 2. Make auditory way scheme. At the demonstration to pay attention to topography of neurons, forming of lateral lemniscus and 4th neurons axon ends.

 

Work 3. Middle cut of neck conduct from top to bottom via  the  thyroid cartilage to the breastbone. Then lower make a horizontal cut to scapula. Preparation skin. Then separate subdermal muscles.

Work 4. For the broad access to deep structures you need to recut in saggital area part of the breastbone and clavicles. Then carefully stand out a sternocleidomatoid muscle, reject upwards and outwards.

 

Work 5. Find and recut back venter of stylohyoid muscle. Find glossopharyngeal  nerve which passes on medial and then on lateral and frontal surfaces of this muscle.

 

Work 6. For preparation nerves near the base of skull necessary to cut and delete salivary gland. Delete the branch of  mandible from joint.

 

 

2) Basic Level:

1.      Skeleton of thoracis cage, neck and skull.

2.      Muscles of the neck and head.

3.      Organs of the neck and head.

 

3) llustratve materals:

1.      Demonstration corpse.

2.      Study corpse.

3.      Skeleton.

 

4) Demonstrate on preparations:

1.     Vagus nerve

2.     Vestibulo-cochlear nerve in internal acoustic meatus

3.      Glossopharyngeal nerve

 

II.               Seminar discussion 12:30 am 14:00 pm (2 hours)

 

1) Special attention should be paid to the following questions:

1.      Where are located hearing receptors?

2.      Location and parts of 8th cranial nerve.

3.      Where are located nuclei of 8th cranial nerve?

4.      Which formations form subcortical acoustic centres?

5.      Name cortical acoustic centre.

6.      Describe auditory pathway.

7.      Which nuclei (name, function) belong to glossopharyngeal nerve?

8.      Describe the topography of the glossopharyngeal nerve.

9.      Which branches does glossopharyngeal nerve give off?

10.  Where are located sensory ganglia of glossopharyngeal nerve? What is its term?

11.  Describe the topography of the tympanicus and petrosus minor nerves. What do they supply?

12.  Describe the topography of the r. sinus carotici and rr. tonsillares. What do they supply?

13.  Describe the topography of the rr. Pharyngei and rr. lingules. What do they supply?

14.  Which muscles are supplied by glossopharyngeal nerve?

15.  How is innervated middle ear?

16.  How is innervated larynx?

17.  How is innervated pharynx?

18.  How is innervated dura mater encephali?

19.  How is innervated external ear?

20.  How are innervated trachea, bronchi and lungs?

21.  How are innervated oesophagus and stomach?

22.  Which nuclei does vagus nerve have? (name, function)

23.  Describe the parts and topography of the vagus nerve.

24.  Where are located sensory ganglia of vagus nerve?

25.  Which branches does vagus nerve give off in head region? What do they supply?

26.  Which branches does vagus nerve give off in neck? What do they supply?

 

. Independent students work 14:15pm 15:00 pm

 

1. During operation surgeon can see that the inferior alveolar nerve and vessels are contents of

A.              Mental foramen

B.               Angle of mandible

C.               Mandibular notch

LESSON #27 (6 HOURS)

LESSON #27 (6 HOURS)

 

Lesson No 27

Theme. VIII, IX cranial nerves. Head and neck parts of vagus nerve. Practical skills on vessels and nerves of the head and neck

  

Am: Study the structural and topographical peculartes of vestibulo-cochlear, glossopharyngeal and vagus nerves.

 

Professional orientation of students. Anatomical peculiarities of the 8th cranial nerve and auditory pathway are necessary for otology therapy and surgery, also for traumatology and oncology. Knowledge the topography and supplying regions of glossopharyngeal nerve is the base for understanding the physiology and neuropathology. Anatomical peculiarities of the branches of glossopharyngeal are necessary for neurological therapy and surgery, also for traumatology and oncology. If the vagus nerve is damaged there is impairment of function in the throat and the larynx: unilateral paralysis of the levator veli palatini muscle causes the soft palate and the uvula to the displaced to the intact side. The vocal cord on the affected side will remain immobile in the cadaver position (recurrent laryngeal nerve palsy) as a result of paralysis of the internal laryngeal muscles.

 

I.                  Practical work 9:00-12:00 am (4 hours)

 

1)    Methodology of Practical Class.

 

Work 1. Finding and demonstrating 8ts pair of cranial nerves.

 

Work 2. Make auditory way scheme. At the demonstration to pay attention to topography of neurons, forming of lateral lemniscus and 4th neurons axon ends.

 

Work 3. Middle cut of neck conduct from top to bottom via  the  thyroid cartilage to the breastbone. Then lower make a horizontal cut to scapula. Preparation skin. Then separate subdermal muscles.

Work 4. For the broad access to deep structures you need to recut in saggital area part of the breastbone and clavicles. Then carefully stand out a sternocleidomatoid muscle, reject upwards and outwards.

 

Work 5. Find and recut back venter of stylohyoid muscle. Find glossopharyngeal  nerve which passes on medial and then on lateral and frontal surfaces of this muscle.

 

Work 6. For preparation nerves near the base of skull necessary to cut and delete salivary gland. Delete the branch of  mandible from joint.

 

 

2) Basic Level:

1.      Skeleton of thoracis cage, neck and skull.

2.      Muscles of the neck and head.

3.      Organs of the neck and head.

 

3) llustratve materals:

1.      Demonstration corpse.

2.      Study corpse.

3.      Skeleton.

 

4) Demonstrate on preparations:

1.     Vagus nerve

2.     Vestibulo-cochlear nerve in internal acoustic meatus

3.      Glossopharyngeal nerve

 

II.               Seminar discussion 12:30 am 14:00 pm (2 hours)

 

1) Special attention should be paid to the following questions:

1.      Where are located hearing receptors?

2.      Location and parts of 8th cranial nerve.

3.      Where are located nuclei of 8th cranial nerve?

4.      Which formations form subcortical acoustic centres?

5.      Name cortical acoustic centre.

6.      Describe auditory pathway.

7.      Which nuclei (name, function) belong to glossopharyngeal nerve?

8.      Describe the topography of the glossopharyngeal nerve.

9.      Which branches does glossopharyngeal nerve give off?

10.  Where are located sensory ganglia of glossopharyngeal nerve? What is its term?

11.  Describe the topography of the tympanicus and petrosus minor nerves. What do they supply?

12.  Describe the topography of the r. sinus carotici and rr. tonsillares. What do they supply?

13.  Describe the topography of the rr. Pharyngei and rr. lingules. What do they supply?

14.  Which muscles are supplied by glossopharyngeal nerve?

15.  How is innervated middle ear?

16.  How is innervated larynx?

17.  How is innervated pharynx?

18.  How is innervated dura mater encephali?

19.  How is innervated external ear?

20.  How are innervated trachea, bronchi and lungs?

21.  How are innervated oesophagus and stomach?

22.  Which nuclei does vagus nerve have? (name, function)

23.  Describe the parts and topography of the vagus nerve.

24.  Where are located sensory ganglia of vagus nerve?

25.  Which branches does vagus nerve give off in head region? What do they supply?

26.  Which branches does vagus nerve give off in neck? What do they supply?

 

. Independent students work 14:15pm 15:00 pm

 

1. During operation surgeon can see that the inferior alveolar nerve and vessels are contents of

A.              Mental foramen

B.               Angle of mandible

C.               Mandibular notch

D.              Mandibular canal

E.               None of these

 

2. During operation surgeon can see that the maxillary nerve passes through the next region and contains

A.              Rotundum foramen,motor fibres

B.               Oval foramen,sensory fibres

C.               Rotundum foramen,sensory fibres

D.              Rotundum foramen,parasymphatetic fibres

E.               None of these

 

3. The patient has a lesion of the trigeminal nerve, it would result in weakness of

A.              Moving the eyeball

B.               Closure the eyes

C.               Compression the teeth

D.              Lifting the upper eyelid

E.               Contraction of tongue

 

4. The patient has the lesion of the facial nerve, it would result in weakness of

A.              Contraction of masseter muscle

B.               Contraction of zygomatic muscle

C.               Compression the teeth

D.              Protrubing the mandible

E.               None of these

 

5. The patient has the lesion of the facial nerve, it would result in weakness of

A.              Contraction of masseter muscle

B.               Contraction of bucinator muscle

C.               Protrubing the mandible

D.              Compressing the teeth

E.               None of these

 

6. The patient has the lesion of the trigeminal nerve, it would result inweakness of

A.              Contraction of masseter muscle

B.               Contraction of platisma

C.               Contraction of temporal muscle

D.              Contraction of tongue muscle

E.               None of these

 

Student should know:

structure of VIII, IX cranial nerves. Head and neck parts of vagus nerve.

 

Student should be able to:

1.   demonstrate on preparations  vagus nerve

2.   demonstrate on preparations   vestibulo-cochlear nerve in internal acoustic meatus

3.   demonstrate on preparations    glossopharyngeal nerve

 

Correct answers for tests and situational tasks:

1-d; 2-c; 3-c; 4-b; 5-b; 6-c

References:

 

) basic

 

1.     Atlas of Human Anatomy/ Frank H. Netter,- 5 edition, - 2011 by Saunders, an Imprint of Elsevior Inc.

2.     Gray's Anatomy for Students: With STUDENT CONSULT Online Access, 2e, - 2010. 2092 p. Richard L. Drake Ph.D, A. Wayne Vogl, Adam W.M. Mitchell, Printed in Canada.

3.      Materials preparation for lectures

http://intranet.tdmu.edu.ua/data/kafedra/internal/index.php?&path=anatomy/lectures_stud/en/med/lik/ptn/1/

4.     Materials preparation for practical classes

http://intranet.tdmu.edu.ua/data/kafedra/internal/index.php?&path=anatomy/classes_stud/en/med/lik/ptn/1/

    b) additional

1.     Human anatomy & physiology /Elaine N. Marieb, Katja Hoehn., San Francisco : Benjamin Cummings, c2010., 8th ed.

2.     F.H. Netter. Atlas of Human Anatomy. Cba Pharmaceutcals Dvson, 1994. 514 p.

3.     Synelnkov R.D. The atlas of anatomy of the man. n 4-th volumes. -: Medcna, 1991.

4.     Reminetskyy B.Y., Fedonyuk Y.I. Human anatomy. Notes. 136 p.

5.     Lectures.

 

Methodical instructions have been prepared by: Assistant Prof. Gavlich O. B.

 

 

The instruction was discussed and confirmed at the department meeting

12.06.2013. Protocol number 11