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(4) Head & Neck - Sessions > (1.1) Muscles, Fascia, Planes and Regions > Flashcards

(1.1) Muscles, Fascia, Planes and Regions Flashcards

0
Q

What structures are enclosed by the Pretracheal layer?

A

Muscular part encloses Infrahyoid muscles

Visceral art encloses Thyroid gland + Trachea + Oesophagus (anterior to posterior)

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1
Q

What are fasica? What are their roles in the head and neck?

A

Fascia = connective tissues that separate organs and anchor them to the body
Compartmental
Allows structures to glide over each other
Determines spread of infections/metastasis

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2
Q

What are the terminates of the prevertebral layer of the deep cervical fascia? What structures does it enclose?

A

Superiorly attaches to the base of cranium
Inferiorly attaches to T3
Laterally becomes Axillary Sheath
Encloses the vertebrae + the muscles associate with them

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3
Q

What is the Axillary Sheath?

A

A continuation of Prevertebral layer, enclosing the first portion of the Axillary Artery and Vein and the Brachial Plexus

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4
Q

Describe and draw a simple diagram of the layers in the neck.

A

Skin

Superficial cervical facia: containing Subcutaneous fat + neurovasculatres + Platysma (anterior only)

Deep cervical fascia

  • Investing: invests SMC & Trapezius
  • Pretracheal: from Hyoid bone and blends with Pericardium
    • Muscular part: encloses Infrahyoid muscles
    • Visceral part: encloses Thyroid gland, Trachea, Oesophagus
  • Prevertebral Layers: surrounds vertebral column and associated structures
    • anteriorly: attached to transverse process and vertebral bodies of the vertebral column
    • posteriorly - attached to ligamentum nuchae at T3
    • becomes Axillary Sheath inferiorly, surrounding first portion of Brachial Plexus & Axillary A and V
  • Carotid Sheath: fusion of the above three deep fascia
    • contains Common Carotid A (medially) + Internal Jugular V (laterally) + Vagus V (dorsally)

https://cfaascience.files.wordpress.com/2010/09/neckfascia.jpg

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5
Q

What is the embryonic origin of Facial Nerve? Hence what muscles does it innervate?

A

2nd Pharyngeal arch

Innervate muscles of facial expression

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6
Q

What is the embryonic origin of muscles of facial expression? Hence what nerve are they innervated by?

A

2nd Pharyngeal arch

Innervated by facial nerve

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7
Q

What is the major route of the spread of infection from the neck to the diaphragm? What may be the consequences of if pus accumulates?

A
  • Within the Retropharyngeal space = between the visceral part of the Pretracheal layer and Prevertebral layer
  • Abscess -> Dysphagia / Dysphonia (inability to use vocal cords) / Dysarthria (dysfunction of the muscles used to speak)
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8
Q

What may be the consequences due to paralysis of Orbicularis Oculi?

A

Exposure Keratitis = dried out cornea
Ectropion = ulcerated corneal surface, unable to close the eyelids -> lacrimal fluid isn’t spread over the cornea, to remove debis

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9
Q

A gentleman came in to complain that he hasn’t been able to blow his flute after his surgery on parotid gland, what has happened here?

A

Surgical accidentally damage the facial nerve -> denervation to Buccinator

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10
Q

What muscle is responsible for wrinkling the forehead + raising the eyebrows?

A

Occipitofrontalis

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11
Q

What is the difference between Facial paralysis and Bell’s palsy?

A
  • Facial paralysis: known causes + doesn’t recover

- Bell’s palsy = idiopathic + recovers

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12
Q

Where are the facial nerve most at risk of damage?

A
  • Middle ear pathology
  • Parotid gland
  • Stylomastoid foramen of Temporal bone where it leaves Facial Canal
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13
Q

What is the embryonic origin of muscles of facial mastication? Hence what nerve are they innervated by?

A

1st Pharyngeal arch

innervated by Mandibular division of Trigenminal nerve

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14
Q

What action does the Platysma produce? What is its innervation?

A
  • Depresses Mandible

- Innervated by branches of Facial Nerve

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15
Q

What actions does the Trapezius produce? What is its innervation?

A
  • Superior fibres: rotate Scapula for arm abduction >90
  • Middle fibres: retract Scapula
  • Lower fibres: depress Scapula
  • Innervated by Accessory Nerve (CN XI)
16
Q

What actions does the Sternocleidomastoid produce? What is its innervation?

A
  • Bilaterally: elevate the head
  • Unilaterally: rotates the head medially
  • Innervated by Accessory Nerve (CN XI)
17
Q

What are the two attachments of the distal Sternocleidomastoid?

A
  • Medial 1/3 Clavicle

- Sternum

18
Q

What are the four Suprahyoid muscles? What is their action?

A
  • Geniohyoid
  • Mylohyoid
  • Stylohyoid
  • Digastric - 2 bellies, anterior & posterior
  • They elevate Hyoid bone & Larynx to initiate swallowing
19
Q

What are the four Infrahyoid muscles? What is their action?

A
  • Sternohyoid (superficially)
  • Omohyoid (superficially) - 2 bellies, superior & inferior
  • Thyrohyoid (deep)
  • Sternothyroid (deep)
  • They depress Hyoid bone & Larynx during swallowing
20
Q

What are the boundaries of Posterior Triangle?

What 2 further triangles can the Posterior Triangle be divided into?

A
  • Inferiorly: middle 1/3 of Clavicle
  • Medially: lateral border of Sternocleidomastoid
  • Laterally: medial border of Trapezius
  • Occipital Triangle
  • Subclavian (Omoclavicualr) Triangle
    http: //teachmeanatomy.info/neck/areas/posterior-triangle/
21
Q

What are the boundaries of Anterior Triangle?

What further four triangles can the Anterior Triangle be devided into?

A
  • Superiorly: Mandible
  • Laterally: medial border of Sternocleidomastoid
  • Medially: imaginary midline
  • Carotid Triangle
  • Submandibular (Diagastric) Triangle
  • Submental Triangle
  • Muscular (Omotracheal) Triangle
    http: //teachmeanatomy.info/neck/areas/anterior-triangle/
22
Q

What structures are found in the Submental Triangle?

A
  • Submental lymph nodes
23
Q

What structures are found in the Submandibular Triangle?

A
  • Submandibular gland & lymph nodes
  • Parts of Facial artery & vein
  • Hypoglossal (CN XII) & br. of Inferior Alveolar (CN Viii) nerves
25
Q

What structures are found in the Muscular Triangle?

A
  • Thyroid & Parathyroid glands
  • Sternohyoid muscle
  • Omohyoid muscle
  • Thyrohyoid muscle
  • Sternothyroid muscle
26
Q

What structures are found in the Carotid Triangle?

A
  • Carotid Sheath (Common Carotid A, Internal Jugular V, Vagus N & SNS fibres)
  • Thyroid gland
27
Q

What structures are found in the Carotid Sheath? Describe their positions of each other.

A
  • Common Carotid Artery medially (bifurcates, only ICA within the Sheath above C4)
  • Internal Jugular Vein laterally
  • Vagus Nerve dorsally
  • Carotid Sinus & Body
  • SNS fibres surrounding Carotid A
27
Q

Where can the Carotid pulse be felt?

A

Larynx & Middle 1/3 of front edge of Sternocleidomastoid

28
Q

What structures can be found in the Occipital Triangle?

A
  • Trunks of Brachial Plexus

- Accessory Nerve (CN XI)

29
Q

How is the Jugular Venous Pressure measured? What is its significance? How to interpret it?

A
  • Patient lies at 45 angle, looking to the left
  • Indirect measurement of the pressure in right atrium e.g. systemic venous pressure
  • Normally pulsation
30
Q

What structures can be found in the Subclavian Triangle?

A
  • Subclavian A & V
  • Supraclavicular lymph nodes
  • Suprascapular Artery
31
Q

How may a person with damaged Sternocleidomastoid present with?

A

Torticollis = head tilt & rotated to the side that isn’t damaged

32
Q

A 5 year old boy has been diagnosed with Quinsy, from where may an infection spread?

A

Quinsy = peritonsillar abscess

Through Parapharyngeal space -> affecting contents within Carotid Sheath

34
Q

How can infections in the neck spread to the thorax?

A
  • Draining into the retropharyngeal space which extends to the diaphragm
  • Down the carotid sheaths as they extend from the base of the skull to the thorax
35
Q

How may an infection in the superficial skin abscess spread?

A

Not further back into the neck as the Investing layer prevents it

36
Q

How may an infection posterior to the Prevertebral fascia spread?

A

Perforates through Prevertebral fascia into the Retropharyngeal space and spread down the diaphragm

37
Q

How may an infection between the Visceral part of Pretracheal and the Prevertebral fascia spread?

A

Infection spreads inferiorly to the anterior to Pericardium (e.g. anterior Mediasternum)

(4) Head & Neck - Sessions (11 decks)

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