1. Organisation Of Head And Neck

Question 1

What is the Adam’s apple?

Answer 1

Thyroid cartilage

Question 2

Where can the thyroid gland be palpated?

Answer 2

Between the cricoid cartilage and suprasternal notch, between the two clavicles.

Question 3

What nerves are the supra-hyoid muscles innervated by?

Answer 3

Cranial nerves

Question 4

What are the infra-hyoid muscles innervated by?

Answer 4

Cervical nerves

Question 5

What nerve supplies muscles of facial expression?

Answer 5

Facial nerve

Question 6

What nerve supplies muscles of mastication and is the main sensory nerve of the face?

Answer 6

Trigeminal

Question 7

What muscle is found immediately beneath the skin in the superficial cervical fascia?

Answer 7

The 2 platysma muscles

Question 8

What is the action and innervation of the platysma muscle?

Answer 8

Action - depress corners of the mouth, draws the mandible down.
Innervation - facial nerve.

Question 9

What is the action (both individually and together) and innervation of the sternocleidomastoid?

Answer 9

Action - lateral flexion of the neck. Both together flex the neck.
Innervation - accessory nerve.

Question 10

What is the action and innervation of the trapezius muscle?

Answer 10

Action - elevation of shoulders.

Innervation - accessory nerve.

Question 11

How would you test a patient’s sternocleidomastoid muscle?

Answer 11

Hand on side of face, get them to press face into hand under resistance, feel sternocleidomastoid on side of neck opposite to hand.

Question 12

What are the 3 boarders of the anterior triangle of the neck?

Answer 12

Medial - midline of neck.
Lateral - anterior margin of sternocleidomastoid.
Superior - inferior margin of mandible.

Question 13

What are the 3 boarders of the posterior triangle of the neck?

Answer 13

Inferior - clavicle.
Lateral - anterior margin of trapezius.
Medial - posterior margin of sternocleidomastoid.

Question 14

What are the 3 boarders of the carotid triangle?

Answer 14

Medial - omohyoid.
Lateral - sternocleidomastoid.
Superior - digastric.

Question 15

The superficial cervical fascia is the loose connective tissue surrounding the outside of the neck just underneath the skin. What does it include?

Answer 15

Fat, platysma, cutaneous nerves, lymph nodes, superficial blood vessels.

Question 16

What are the 4 layers of deep cervical fascia, which are all dense connective tissue?

Answer 16

Investing layer.
Carotid sheath.
Pretracheal fascia.
Prevertebral fascia.

Question 17

Where is the retropharyngeal space found?

Answer 17

Between the pretracheal layer at a thickening called the buccopharyngeal fascia and the prevertebral layers of fascia.

Question 18

What are the two main areas in which infections can occur in the head?

Answer 18

Retropharyngeal space and pre-tracheal space.

Question 19

Which branch of the cranial nerve forms the trigeminal nerve?

Answer 19

Cranial nerve V.

Question 20

Which branch of the cranial nerve forms the facial nerve?

Answer 20

Cranial nerve VII

Question 21

What are the 3 main branches of the trigeminal nerve? Where can their sensory function be tested?

Answer 21

Va - ophthalmic division.
Vb - maxillary division.
Vc - madibular division.
Tested - in dermatomes.

Question 22

What are the 5 key extra-cranial branches of the facial nerve?

Answer 22

Temporal.
Zygomatic.
Buccal.
Mandibular.
Cervical.

Question 23

What are the main blood vessels of the neck?

Answer 23

Common carotid artery branching into the internal and external carotid (facial artery branch supplies face).
Internal jugular vein (venous drainage from face).
External jugular vein (venous drainage from scalp and face).

Question 24

What are the layers of the scalp from superficial to deep?

Answer 24

Skin, dense connective tissue containing major nerves and vessels, aponeurosis, loose connective tissue, periosteum, bone.

Question 25

What determines the direction and extent to which an infection within the neck may spread?

Answer 25

Natural cleavage planes of facial layers

Question 26

What is a retropharyngeal abscess usually secondary to?

Answer 26

Upper respiratory tract infection

Question 27

In which age is a retropharyngeal abscess most common?

Answer 27

Children under the age of 5 years

Question 28

Give 3 signs and symptoms of a retropharyngeal abscess

Answer 28

``` Visible bulge on inspection of the oropharynx. Sore throat. Difficulty swallowing. Strider. Reluctance to move their neck. High temperature. ```

Question 29

What type of cancer is a facial nerve palsy likely to be in the context of ipsilateral parotid enlargement?

Answer 29

Parotid cancer

Question 30

At what artery can the pulse be measured in the neck?

Answer 30

Facial artery

Question 31

What is important to remember to do when a patient presents with a laceration of the facial artery on one side of the face?

Answer 31

Compress the other side, as they have many anastomoses.

Question 32

How can an infection deep within the scalp beneath the aponeurotic layer spread intracranially?

Answer 32

Enters loose connective tissue, enters emissary vein which enters into cranial cavity.

Question 33

What does the carotid triangle contain?

Answer 33

Common carotid artery. Internal jugular vein. Hypoglossal and vagus nerves.