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Head And Neck > 1.1 - General Organisation & Muscles > Flashcards

1.1 - General Organisation & Muscles Flashcards

1
Q

How many cervical fascial layers are there in the neck?

A
  1. 1 Superficial and 3 deep.
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2
Q

What structures are contained within the superficial cervical fascial layer?

A

anterior and external jugular veins
cutaneous nerves
superficial lymph nodes
platysma muscle

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3
Q

what are the three deep cervical fascial layers?

A

superficial to deep

  1. investing layer
  2. pretracheal layer
  3. Prevertebral layer.
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4
Q

What is the carotid sheath

A

A fourth deep cervical fascial layer, composed of the 3 deep cervical fascia.

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5
Q

what is the contents of the carotid sheath?

A

the common carotid artery
internal jugular vein
the vagus nerve (CN X)
the deep cervical lymph nodes

The carotid artery lies medial to the internal jugular vein, and the vagus nerve is situated posteriorly between the two vessels.
In the upper part, the carotid sheath also contains the glossopharyngeal nerve (IX), the accessory nerve (XI), and the hypoglossal nerve (XII), which pierce the fascia of the carotid sheath.
The ansa cervicalis (from the cervical plexus) is embedded in the anterior wall of sheath.

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6
Q

Describe the location of the investing layer of fascia and what structures it encloses?

A

First deep cervical fascia. Surrounds the entire neck like a collar. Splits to enclose the sternocleidomastoid muscles and the trapezius muscles, and the submandibular and parotid salivary glands.

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7
Q

Describe the attachment points of the pretracheal cervical fascia

A

superior and anteriorly = hyoid bone

inferiorly = blends with the fibrous pericardium of the thorax

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8
Q

what 2 layers is the pretracheal fascia split into?

A
  1. Muscular layer - encloses the infra hyoid muscles

2. Visceral layer - encloses the thyroid gland, trachea and oesophagus

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9
Q

what is the buccopharangeal fascia?

A

a continuation of the pretracheal fascia as it continues posteriorly to invest the muscles of the pharynx and oesophagus.

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10
Q

describe the difference in structure between the superficial cervical fascia and the deep cervial fascia?

A

superficial cervical fascia is loose connective tissue largely containing adipose tissue.
deep cervical fascia is fibrous connective tissue

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11
Q

where does the carotid sheath extend from?

A

from the base of the skull, through the route of the neck, to the arch of the aorta.

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12
Q

what is the axillary sheath?

A

A lateral extension of the prevertebral sheath that surrounds the axillary vessels and the brachial plexus of nerves running into the upper limb.

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13
Q

what is the function of the deep cervical fascia?

A

allow structures to move and pass over each other with ease. Determine the direction and extent to which any infection occurring within the neck can spread.

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14
Q

What rare infection of the neck can pose a significant risk to life?

A

Deep neck space infections. Infections within the potential spaces between deep neck fascial planes. These spaces contain loose connective tissue.

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15
Q

What is the retropharangeal space?

A

A deep neck space that lies between the prevertebral layer of fascia and the buccopharyngeal fascia.

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16
Q

What is the function of the retropharyngeal space?

A
  1. Up until the age of 3-4 years, the superior part of the retropharyngeal space contains lymph nodes that drain areas of the nose, oral cavity and upper pharynx.,
  2. Allows pharynx to move freely on the vertebral column and expand during swallowing.
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17
Q

How might mediastinitis result due to a neck infection?

A

An infection of the retropharyngeal space may result in mediastinitis as the prevertebral fascia and the buccopharyngeal fascia both extend the length of the neck into the mediastinum.

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18
Q

When are retropharyngeal space infections commonly seen?

A

in children under the age of 5 due to lymph nodes in the upper respiratory tract.
Secondary to an upper respiratory tract infection.

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19
Q

what are the signs and symptoms of a retropharyngeal abscess?

A 
visible bulge on inspection of the oropharynx.
sore throat
difficulty swallowing
stridor
reluctance to move their neck
high temperature
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20
Q

How can neck swelling be localised to the thyroid gland?

A

asking patients to swallow and observe whether or not the lump/swelling moves. The thyroid gland is contained within the pretracheal fascia, which is attached to the hyoid bone. The hyoid bone and larynx move up with swallowing and so too will the thyroid gland.

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21
Q

What symptoms can a retrosternal extension of a goitre result in?

A

Compression of the trachea and venous blood vessels in the thoracic inlet can result in:
Stridor
Breathlessness
Facial oedema

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22
Q

what are the 2 broad groups of muscles of the head and face?

A

Muscles of facial expression

muscles of mastication

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23
Q

What is the action of the temporalis muscle?

A

muscle of mastication
elevated mandible
posterior fibres retract the jaw

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24
Q

What is the action of the Medial Pterygoid muscle?

A

elevation of the mandible

protrusion of mandible

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25
Q

What is the action of the masseter?

A

Main elevator of the mandible

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26
Q

What is the action of the zygomaticus?

A

dilates the mouth

draws angles of the mouth laterally and superiorly (smile)

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27
Q

What is the action of the risorius muscle?

A

pulls corner of mouth laterally (closed smile)

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28
Q

What is the action of the occipitofrontalis?

A

elevates eyebrows, wrinkles forehead

29
Q

What is the action of the palpebral orbiculares oculi?

A

innermost part

gently closes eyelid

30
Q

What is the action of the orbital orbicularis oculi?

A

outermost part,

squeezes eye shut forcibly

31
Q

What is the action of the orbiculares oris?

A

purses lips

32
Q

What is the action of the buccinators?

A

compresses cheeks against teeth during mastication. `Stops food pooling.

33
Q

What is the action of the platysma?

A

depresses angles of the mouth

tenses skin of the neck

34
Q

What is the action of the sternocleidomastoid muscles?

A

rotates the head to the contralateral side

laterally flexes the neck.

35
Q

What is the action of the lateral pterygoid?

A

depressing the mandible

protrudes the mandible

36
Q

what are all of the muscles of facial expression and the platysma innervated by?

A

Cranial nerve 7, the facial nerve.

37
Q

what are the 2 main blood vessels supplying the head and neck?

A

Common carotid artery

Subclavian vein

38
Q

What is the function of facial layers?

A

To compartmentalise structures in the neck

39
Q

What is enclosed by the prevertebral fascia?

A

The vertebral column and muscles associated with it

40
Q

Where does the infective source of a deep neck space infection originate from?

A

Teeth
Tissues of pharynx
Sinuses
Middle ear

41
Q

What significant anatomical structure is the facial nerve associated with? What clinical significance can this have?

A

CN VII and its branches run superficial to the parotid gland.
facial nerve is vulnerable to damage in pathology of the parotid gland

42
Q

What are common cause of unilateral facial nerve palsy?

A

Bell’s palsy
Facial injuries
Disease (cancer) or surgery of the parotid gland

43
Q

What is Bell’s palsy?

A

Inflammation of CN VII, likely viral aetiology. Most common cause of non-traumatic facial paralysis. Oedema.

44
Q

How does parotid cancer cause facial droop?

A

Cancerous cells invade and damage the facial nerve during its course through the gland.

45
Q

What are the 4 muscles of mastication?

A

Later Pterygoid
Medial pterygoid
Temporalis
Masseter.

46
Q

What innervates the muscles of mastication?

A

Mandibular division of the trigeminal nerve.

47
Q

What muscles act to depress the mandible?

A

Suprahyoids

Lateral pterygoid

48
Q

What are the key muscles in the neck?

A 
Trapezius
Sternocleidomastoid
Infrahyoid
Suprahyoid 
Scalene muscles (anterior/middle/posterior)
Platysma
49
Q

What forms the floor of the posterior triangle?

A

Scalene muscles

50
Q

What structures can be found between the anterior and middle scalene muscles?

A

Trunks of brachial plexus

Subclavian artery

51
Q

What do muscles of mastication act upon?

A

Act on the temporomandibular joint

52
Q

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

A

To Zanzibar by motor car

Temporal
Zygomatic
Buccal
Marginal mandibular
Cervical
53
Q

How might a patient with paralysis of the facial nerve present?

A

Unable to smile
Red eye ( no orbicularis oculi )
Eye droop
Unable to lift eyebrows

54
Q

What is the main sensory nerve of the face?

A

Trigeminal nerve CN 5

55
Q

What are the 3 sensory branches of the trigeminal nerve?

A 
Va = ophthalmic division 
Vb = maxillary division 
Vc = mandibular division
56
Q

When does the common carotid artery bifurcate?

A

Bifurcated to C4 spinal level into the external common carotid artery and the internal common carotid artery

57
Q

What innervated the suprahyoid muscles?

A

Mandibular nerve of trigeminal

58
Q

What innervates the infrahyoid muscles?

A

Cervical nerves (c1-3) via the cervical plexus

59
Q

What innervates the sternocleidomastoid muscle?

A

Accessory nerve (CN XI)

60
Q

What innervates the trapezius muscle?

A

Accessory nerve

61
Q

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

A

Superior : inferior border of mandible
Medial: imaginary mid sagittal line
Lateral : anterior border of SCM

62
Q

What are the anatomical borders of the posterior neck triangle?

A

Anterior: posterior border of SCM
Posterior : anterior fibres of trapezius
Inferior : clavicle

63
Q

What lies in the posterior triangle of the neck?

A 
Inferior belly of the omohyoid muscle (infrahyoid muscle)
Subclavian artery and vein
Trunks of brachial plexus 
Scalene 
External jugular vein
64
Q

What structures are in the anterior triangle of the neck?

A 
Suprahyoid muscles 
Internal jugular vein 
Carotid artery 
Vagus nerve 
Infrahyoid muscles 
Trachea, oesophagus
Thyroid
Larynx
65
Q

What are the boundaries of the carotid triangle?

A

Superior : posterior belly of digastric muscle
Medial : superior belly of omohyoid
Lateral : SCM muscle

66
Q

What key structure can be found in the carotid triangle?

A

Carotid sheath ( containing vagus nerve, common carotid artery, internal jugular vein, accompanying cervical lymph nodes)

67
Q

What is the function of the suprahyoid muscles?

A

Elevate the hyoid

Depress the mandible

68
Q

What is the function of the infrahyoid muscles?

A

Depress the hyoid

Stabilise the larynx

Head And Neck (13 decks)

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