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Head & Neck > 1) General organisation of H&N > Flashcards

1) General organisation of H&N Flashcards

1
Q

What are the major muscle groups in the head?

A

Muscles of facial expression
Buccinators (muscles of cheek)
Occipitofrontalis muscle
Muscles of mastication

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2
Q

What are the actions of facial muscles?

A

Move the skin & change facial expressions
Sphincters & dilators (open & close eyes, mouth)
Buccinators keep cheeks taut & aid chewing

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3
Q

What is the innervation of the muscles of mastication?

A

Mandibular division of the Trigeminal nerve (CNViii)

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4
Q

What does the facial nerve (CNVII) innervate?

A

Platysma (superficial muscle of neck & chin)
Muscles of facial expression
Buccinators
Muscles of the ear
Occipitofrontalis muscle
(CN VII enters the parotid gland where it divides into extra-cranial branches)

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5
Q

Name a non-traumatic cause of facial paralysis

A

Inflammation of CN VII near its exit from cranium at stylomastoid foramen

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6
Q

Describe Bell’s palsy

A

Inflammation causes oedema & compression of facial nerve in intracranial facial canal
Affected area sags, facial expression distorted, face appears passive or sad

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7
Q

What injuries can occur to the branches of the facial nerve?

A

Branches are superficial
Injured in wounds, cuts & childbirth
Parotid gland surgery or disease (pain in auricle of ear, external acoustic meatus, temporal region & TMJ)

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8
Q

What is the arterial supply to the face?

A 
Facial artery (main supply)
External carotid artery (branches)
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9
Q

Describe the facial artery

A

Artery winds round inferior border of mandible.
Pulse can be palpated
Lots of anastomoses, if lacerated both facial arteries must be compressed

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10
Q

Describe the venous drainage of the face

A 
Facial vein (main) drains into the Internal Jugular vein
Superficial temporal, maxillary & other veins form the EJV
Both IJV & EJV drain into subclavian vein
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11
Q

Describe the fascia surrounding structures in the neck

A

Covered by layer of subcutaneous superficial fascia
Compartmentalised by deep cervical fascial layers
(determine direction infection may spread)

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12
Q

Describe the superficial cervical fascia

A

Fatty connective tissue
Lies between dermis of skin & investing layer of deep cervical fascia
Thin anteriorly
Contains cutaneous nerves, blood & lymph vessels and anterolaterally the Platysma

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13
Q

Describe the platysma

A

Broad thin sheet of muscle, tenses the skin
Develops from 2nd pharyngeal arch
Supplied by branches of facial nerve (CN VII)
Covers anterolateral aspect of neck
Inferiorly, gap anterior to larynx & trachea
Depresses the mandible, draws corners of mouth inferiorly (grimace)

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14
Q

Describe the layers of the deep cervical fascia in the neck

A

3 layers:
Investing
Pretracheal
Prevertebral

Condenses around common carotid arteries, IJVs & Vagus nerve to form CAROTID SHEATH

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15
Q

What are the functions of the deep cervical fascia in the neck?

A

Support (viscera e.g. thyroid gland, muscles, vessels & deep lymph nodes)
Limit the spread of abscesses from infections
Slipperiness allows structures to move and pass over one another (swallowing, turning head)

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16
Q

Describe the investing layer of deep cervical fascia

A

Most superficial
Surrounds entire neck deep to skin
Encloses: SCM, Trapezius, Submandibular & Parotid salivary glands

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17
Q

Describe the pretracheal layer of deep cervical fascia

A

Thin layer, anterior part of neck only
Inferiorly extends into thorax & blends with fibrous pericardium, laterally blends with carotid sheath
Muscular layer: encloses Infrahyoid muscles
Visceral layer: Thyroid gland, trachea, oesophagus

18
Q

Describe the prevertebral layer of deep cervical fascia

A

Innermost layer of deep fascia
Sheath for vertebral column & assoc. muscles
From base of cranium of 3rd thoracic vertebrae
Extends laterally as axillary sheath (axillary vessels & brachial plexus)

19
Q

What is the carotid sheath?

A

Tubular, fibrous structure
Base of cranium to root of neck
Contains: Common carotid artery, IJV, CN X (Vagus)

20
Q

What are cleavage planes?

A

Layers of deep cervical fascia form natural cleavage planes

Separation of tissues during surgery

21
Q

If an infection occurs between the investing layer and muscular part of the pretracheal layer surrounding the infrahyoid muscles, where will it spread?

A

Won’t spread beyond the manubrium

22
Q

If an infection occurs between the investing layer and visceral pretracheal layers, where will it spread?

A

Into the thoracic cavity anterior to the pericardium

23
Q

Where will pus from an abscess behind the prevertebral layer extend?

A

Laterally in the neck
May perforate fascial layer and enter retropharyngeal space
Bulge in pharynx (retropharyngeal abscess) causing dysphagia (difficulty swallowing) & dysphonia (difficulty speaking)

24
Q

What is the retropharyngeal space?

A

Potential space between prevertebral fascia and superficial fascia surrounding pharynx
Major route of spread of infection from neck to thorax
Space runs to diaphragm

25
Q

Name the borders of the anterior triangle of the neck

A 
Anterior - mid-line
Posterior - anterior border of SCM
Superior - inferior border of mandible
Apex - jugular notch in the manubrium
Roof - superficial cervical fascia & platysma
Floor - pharynx, larynx, thyroid gland
26
Q

What are the 4 triangles within the anterior triangle?

A

Submandibular (digastric) triangle
Submental triangle
Carotid triangle
Muscular (omotracheal) triangle

27
Q

Contents of the submandibular (digastric) triangle

A

Submandibular gland & lymph nodes
Hypoglossal & mylohyoid nerves
Parts of facial artery & vein

28
Q

Contents of the submental triangle

A

Submental lymph nodes

Small veins which unite to form ant. jugular vein

29
Q

Contents of the carotid triangle

A 
Carotid sheath (CCA, IJV, Vagus N, Deep cervical lymph nodes)
Thyroid gland
Larynx & Pharynx
ECA & some branches
Hypoglossal & spinal accessory nerves
Branches of cervical plexus
30
Q

Contents of the muscular (omotracheal) triangle

A

Sternothyroid
Sternohyoid
Thyroid
Parathyroid

31
Q

Name the borders of the posterior triangle of the neck

A

Anterior - posterior border of SCM
Posterior - anterior border of Trapezius
Inferiorly - middle third of clavicle, between trapezius & SCM
Apex - where SCM & Trapezius meet on sup. nuchal line of occipital bone
Roof - Investing layer of deep cervical fascia
Floor - Muscles covered by prevertebral deep cervical fascia

32
Q

What are the 2 triangles within the posterior triangle?

A

Occipital triangle

Omoclavicular (subclavian) triangle

33
Q

Contents of the occipital triangle

A 
Spinal accessory nerve (CN XI)
Trunks of brachial plexus
Part of EJV
Posterior branches of cervical plexus
Cervicodorsal trunk
Cervical lymph node
34
Q

Contents of the omoclavicular (subclavian) triangle

A

3rd part Subclavian artery
Part of subclavian vein
Suprascapular artery
Supraclavicular lymph nodes

35
Q

What is the function of the hyoid bone?

A

Anterolateral part of neck:
Attachments for Suprahyoid muscles superiorly, Infrahyoid muscles inferiorly

(muscles steady or move hyoid & larynx)

36
Q

Name the suprahyoid muscles

A

Mylohyoid
Geniohyoid
Stylohyoid
Digastric muscles (ant. & post. bellies joined by tendon & fibrous sling)

37
Q

What are the functions of the suprahyoid muscles?

A

Constitute the floor of the mouth
Support hyoid - base for tongue to function
Elevate hyoid & larynx (swallowing & tone prod.)

38
Q

Name the infrahyoid muscles

A

Superficial plane:
Sternohyoid
Omohyoid (sup. & inf. bellies joined by tendon & fibrous sling)

Deep plane:
Sternothyroid
Thyrohyoid

39
Q

What are the functions of the infrahyoid muscles?

A

“strap muscles” - (ribbon-like)
Anchor the hyoid, sternum, clavicle & scapula
Depress the hyoid & larynx (swallowing & speaking)

Work with suprahyoids to steady hyoid & provide firm base for tongue

40
Q

What are the muscles of mastication?

A

Masseter
Temporalis
Medial pterygoid
Lateral pterygoid

Head & Neck (12 decks)

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