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14. Head and Neck > 1. General Organisation of the Head and Neck > Flashcards

1. General Organisation of the Head and Neck Flashcards

1
Q

What are the main groups of muscles in the head?

A

Muscles of facial expression, muscles of the cheek (buccinators), occipitofrontalis muscle, and muscles of mastication.

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2
Q

What is the roles of the buccinators?

A

Keep the cheeks taut and aid in chewing.

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3
Q

Which nerve supplies the muscles of mastication?

A

Mandibular division of the trigeminal nerve (branch of CN V).

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4
Q

Which muscles does the facial nerve (CN VII) supply?

A

Superficial muscle of the neck and chin (platysma), muscles of facial expression, buccinators, muscles of the ear and the occipitofrontalis muscle.

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5
Q

Outline the path of the facial nerve (CN VII).

A

Exits the cranium and enters the parotid gland. Divides into extra-cranial branches.

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6
Q

What is a non-traumatic cause of facial paralysis?

A

Inflammation of the facial nerve near its exit from the cranium at the stylomastoid foramen.

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7
Q

What are the results of inflammation of the facial nerve at the stylomastoid foramen?

A

Oedema and compression of the nerve in the intracranial facial canal causing facial paralysis.

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8
Q

What is Bell’s palsy?

A

Compression of the facial nerve int he intracranial facial canal.

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9
Q

What is the presentation of Bell’s palsy?

A

The affected area sags and the facial expression is distorted.

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10
Q

How can the facial nerve be damage?

A

Cuts and in childbirth for children as the nerve is superficial. Surgery or disease of the parotid gland as it runs through the gland.

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11
Q

Why does parotid gland disease cause pain in the auricle, external acoustic meatus, temporal region, and TMJ?

A

The facial nerve runs through and is affected.

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12
Q

What is the arterial supply of the face?

A

Branches of the external carotid, majorly the facial artery.

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13
Q

Where can the pulse of the facial artery be palpated?

A

As the artery winds around the inferior border of the mandible.

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14
Q

Why must both facial arteries be compressed to stop bleeding in laceration?

A

The artery has lots of anastomoses with the other arteries of the face.

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15
Q

What is the main vein of the face and where does it drain?

A

The facial vein which drains into the internal jugular vein.

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16
Q

What are the minor veins of the face?

A

Superficial temporal vein, maxillary vein. These form the external jugular vein.

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17
Q

Where do the internal and external jugular veins drain?

A

Into the subclavian vein.

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18
Q

What is the importance of fascia in the neck?

A

It surrounds all structures in the neck and deep cervical fascia compartmentalise the neck. The planes determine direction of infection spread.

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19
Q

What is the superficial cervical fascia?

A

Layer of fatty connective tissue that lies between the dermis of the skin and the investing layer of deep cervical fascia.

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20
Q

What does the superficial cervical fascia contain?

A

Cutaneous nerves, blood and lymphatic vessels, superficial lymph nodes, and variable amount of fat. Anterolaterally it contains the platysma.

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21
Q

What is the platysma?

A

A broad, thin sheet of muscle in the subcutaneous tissue of the neck.

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22
Q

Where does the platysma develop from?

A

The second pharyngeal arch.

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23
Q

What supplies the platysma?

A

Branches of the facial nerve (CN VII).

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24
Q

What is the positioning of the platysma?

A

It covers the anterolateral aspect of the neck but inferiorly diverges to leave a gap anterior to the larynx and trachea.

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25
Q

What are the actions of the platysma?

A

Acting on superior attachment - tenses the skin.

Acting on inferior attachment - depresses mandible and draws corners of the mouth inferiorly.

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26
Q

What are the three layers of deep cervical fascia?

A

Investing, pretracheal, prevertebral.

27
Q

What does the deep cervical fascia form around the common carotid arteries, internal jugular veins, and vagus nerves?

A

Carotid sheath.

28
Q

What are the functions of the deep cervical fascia?

A

Support viscera and muscles, limit spread of abscesses, slipperiness to allow swallowing and turning of head and neck.

29
Q

What is the investing layer of the deep cervical fascia?

A

Most superficial layer, surrounds entire neck deep to skin.

30
Q

What does the investing layer of deep cervical fascia enclose?

A

Sternocleidomastoid, trapezius, submandibular and parotid salivary glands.

31
Q

What is the pretracheal layer of deep cervical fascia?

A

A thin layer on the anterior part of the neck extending inferiorly into the thorax to blend with fibrous pericardium and laterally to blend with carotid sheath.

32
Q

What does the muscular layer of the pretracheal layer of deep cervical fascia enclose?

A

Infrahyoid muscles.

33
Q

What does the visceral layer of the pretracheal layer of deep cervical fascia enclose?

A

Thyroid gland, trachea, oesophagus.

34
Q

What is the prevertebral layer of deep cervical fascia?

A

The innermost layer which forms a sheath for the vertebral column and associated muscles.

35
Q

What is the position of the prevertebral layer of deep cervical fascia?

A

From base of cranium of 3rd thoracic vertebra and extends laterally as axillary sheath that surrounds axillary vessels and brachial plexus.

36
Q

What is the carotid plexus?

A

Tubular, fibrous structure that extends from base of cranium to root of neck.

37
Q

What does the carotid plexus contain?

A

Common carotid artery, internal jugular vein, and vagus nerve (CN X).

38
Q

What are cleavage planes?

A

Planes formed by layers of deep cervical fascia that allow separation of tissue during surgery.

39
Q

What determines the direction in which abscesses in the neck may spread?

A

The deep fascial layers.

40
Q

Where can an abscess between the investing layer and muscular part of pretracheal surrounding infrahyoid muscles spread?

A

Up to the manubrim, but not past it.

41
Q

Where can an abscess between the investing layer and visceral pretracheal layers spread?

A

Into the thoracic cavity anterior to the pericardium.

42
Q

Where can pus from an abscess lying behind the prevertebral layer spread?

A

Laterally in the neck, which could perforate the fascial layer and enter the retropharyngeal space -> bulge in the pharynx.

43
Q

What is the result of pus spread into the retropharyngeal space?

A

Produces a bulge in the pharynx causing dysphagia and dsyphonia.

44
Q

What is the retropharyngeal space?

A

A potential space between prevertebral layer of fascia and the fascia surrounding the pharynx superficially.

45
Q

Why is the retropharyngeal space important?

A

It is a major route of spread of infection from the neck to the thorax.

46
Q

What are the borders of the anterior triangle of the neck?

A

Anterior - midline.
Posterior - anterior border of the sternocleidomastoid.
Superior - inferior border of the mandible.
Apex - jugular notch in manubrim.
Roof - superficial cervical fascia, containing the platysma.
Floor - pharynx, larynx, thyroid gland.

47
Q

What are the four sub-divisional triangles from the anterior triangle?

A

Submandibular (digastric) triangle, submental triangle, carotid triangle, and muscular (omotracheal) triangle.

48
Q

What is contained within the submandibular triangle?

A

Submandibular gland, submandibular lymph nodes, hypoglossal and mylohoid nerves, parts of facial artery and vein.

49
Q

What is contained within the submental triangle?

A

Submental lymph nodes, small veins which unite to anterior jugular vein.

50
Q

What is contained within the carotid triangle?

A

Carotid sheath (with common carotid artery, internal jugular vein, vagus nerve, deep cervical lymph nodes), thyroid gland, larynx, pharynx, external carotid artery and some branches, hypoglossal and spinal accessory nerves, and branches of cervical plexus.

51
Q

What is contained within the muscular triangle?

A

Sternothyroid, sternohyoid, thyroid, parathyroid.

52
Q

What are the borders of the posterior triangle of the neck?

A

Anterior - posterior border of sternocleidomastoid.
Posterior - anterior border of trapezius.
Inferior - middle third of clavicle, between trapezius and SCM.
Apex - where SCM and trapezius meet on superior nuchal line of occipital bone.
Roof - investing layer of deep cervical fascia.
Floor - muscles covered by prevertebral layer of deep cervical fascia.

53
Q

What are the subdivisional triangle of the posterior triangle of the neck?

A

Occipital triangle, and omoclavicular triangle.

54
Q

What are the contents of the occipital triangle?

A

Spinal accessory nerve (CN XI), trunks of brachial plexus, part of external jugular vein, posterior branches of cervical plexus, cervicodorsal trunk, cervical lymph node.

55
Q

What are the contents of the omoclavicular/subclavian triangle?

A

3rd part of subclavian artery, part of subclavian vein, suprascapular artery, supraclavicular lymph nodes.

56
Q

What attaches to the hyoid bone?

A

Suprahydoid muscle superiorly and infrahyoid muscle inferiorly.

57
Q

What is the job of the suprahyoid and infrahyoid muscles?

A

Steady or move hyoid and larynx.

58
Q

What are the suprahyoid muscles?

A

Mylohyoid, geniohyoid, stylohyoid, digastric muscles.

59
Q

What gives digastric muscles their name?

A

They have two bellies joined by an intermediate tendon.

60
Q

What allows digastric muscle tendons to slide?

A

The fibrous sling from pretracheal layer.

61
Q

What are the infrahyoid muscles?

A

Superficial plane - sternohyoid, omohyoid.

Deep plane - sternothyroid, thyrohyoid.

62
Q

Why are infrahyoid muscles called strap muscles?

A

They have a ribbon-like appearance.

63
Q

What do the infrahyoid muscles do?

A

Anchor the hyoid, sternum, clavicle, and scapula. Depress the hyoid and larynx during swallowing and speaking.

14. Head and Neck (11 decks)

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