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Year 2 - HN&S anatomy > 3 - Neck and face > Flashcards

3 - Neck and face Flashcards

1
Q

What are the branches of the trigeminal nerve (CN V)

A

the ophthalmic nerve (V1)
the maxillary nerve (V2)
the mandibular nerve (V3)

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2
Q

What nerves exit the skull through the supraorbital fissure?

A 
oculomotor (III)
trochlear (IV)
opthalmic (V1)
abducens (VI)
(and superior ophthalmic vein)
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3
Q

What passes through the foramen rotunda?

A

maxillary division of the trigeminal (V2)

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4
Q

What passes through the foramen ovale?

A

mandibular division of the trigeminal (V3)

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5
Q

What passes through the foramen spinosum?

A

the middle meningeal artery and vein

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6
Q

What passes though the internal acoustic meatus?

A 
facial nerve (CN VII)
vestibulocochlear nerve (CN VIII)
labyrinthine artery
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7
Q

What passes though the jugular foramen?

A 
glossopharyngeal nerve (CN IX)
vagus nerve (CN X)
accessory nerve (CN XI)
sigmoid sinus (drains into the jugular vein)
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8
Q

What passes through the foramen magnum?

A

medulla of brain
vertebral arteries
spinal roots of accessory nerve (CN XI)

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9
Q

What are the anterior and posterior boundaries of the neck?

A

Anteriorly: from the lower border of the mandible to the manubrium of sternum
Posteriorly: from the superior nuchal line on the occipital bone to the intervertebral disc between CVII and T1

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10
Q

What are the fist few layers of the neck the are encountered?

A

Skin
Subcutaneous Fat
Platysma

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11
Q

What nerve is the platysma innervated by?

A

(by the cervical branch of the) facial nerve

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12
Q

What are the deep compartments of the neck?

What do they contain?

A
  • visceral - trachea, oesophagus and thyroid.
  • vascular (carotid sheath) - vagus nerve, common carotid and internal jugular
  • vertebral/muscular - vertebra and musculature
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13
Q

Name and describe the locations of the fascia of the neck

A
  • superficial fascia
  • investing fascia - surrounds all structures (more superficial of deep fascia)
  • pre-tracheal fascia surrounds the visceral compartment
  • carotid sheath surrounds vascular bundles
  • prevertebral fascia - surrounds vertebral compartment
    (^note that these are all deep cervical fascia)
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14
Q

Give the levels of the vertebra of the neck with the corresponding landmarks that are present at that level

A 
C1 - open mouth
C2 - superior cervical ganglion
C3 - body of the hyoid
C4 - upper body of the thyroid cartilage
      - bifurcation of the common carotid artery
C6 - cricoid cartilage
      - middle cervical ganglion
C7 - inferior cervical ganglion
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15
Q

What are the borders of the anterior triangle?

A

Anterior border of sternocleidomastoid
Midline
Inferior border of mandible

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16
Q

What are the contents of the anterior triangle?

A

Mainly muscles
Hyoid bone
Carotids and Internal Jugular Vein

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17
Q

What is the hyoid bone? Why is it important?

A

U shaped bone in the neck - important in swallowing and tongue movement
All anterior neck musculature relates to the hyoid
No bony articulations; suspended in space by an array of muscles and ligaments.

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18
Q

Name the deep muscles of the anterior triangle

A

Platysma

Suprahyoid (x4)
Mylohyoid, (Stylohyoid, Geniohyoid) and Digastric

Infrahyoid (x4) AKA Strap Muscles
Sternohyoid, Omohyoid, Sternothyroid and Thyrohyoid

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19
Q

Describe the innervation of the suprahyoid muscles

A
  • anterior innervation: Mylohyoid and Anterior belly of the Digastric
    Mandibular Division (V3) of the Trigeminal Nerve
  • Posterior Innervation: Stylohyoid and Posterior belly of the Digastric
    Facial Nerve (VII)
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20
Q

What are the attachments of the mylohyoid muscles?
Describe its innervation
State the function

A

Body of mandible (mylohyoid line)
Body of hyoid

innervated by V3

Support floor of oral cavity
Elevates the hyoid

21
Q

What are the attachments of the geniohyoid?

What is its innervation?

A

Internal aspect of mandible
Body of hyoid

innervated by C1 fibres, via hypoglossal

22
Q

Anterior belly of digastric:
What are the attachments?
Describe its innervation

A

Attachments:
Internal aspect of mandible
Tendon (attached to hyoid)

Innervation?
V3

23
Q

Posterior belly of digastric:
What are the attachments?
Describe its innervation

A

Attachments:
Mastoid process
Tendon (attached to body of hyoid)

Innervation?
VII (facial)

24
Q

Describe the innervation of the infrahyoid muscles

A

Thyrohyoid :
C1 fibres via the Hypoglossal Nerve (XII)

Omohyoid, sternohyoid and sternothyroid:
Ansa cervicalis (anterior rami of C1 to C3)
25
Q

Thyrohyoid muscle
What are the attachments?
Describe its innervation

A

Attachments:
Thyroid cartilage
(Greater horn of )hyoid

Innervation?
C1 via hypoglossal

26
Q

Omohyoid muscle
What are the attachments?
Describe its innervation

A

Attachments:
Sup. border of scapula
Body of hyoid

Innervation?
Ansa cervicalis

27
Q

Sternothyroid muscle
What are the attachments?
Describe its innervation

A

Attachments:
Posterior surface of manubrium
Thyroid cartilage

Innervation?
Ansa cervicalis

28
Q

Sternohyoid muscle

A

Attachments:
Posterior aspect of manubrium
Body of hyoid

Innervation?
Ansa cervicalis

29
Q

What are the borders of posterior triangle?

A

Posterior border of sternocleidomastoid
Anterior border of trapezius
Middle 1/3rd of clavicle

30
Q

Give the contents of the posterior triangle

A

3 vessels and 4 nerves

External jugular veins
Subclavian artery & vein

Trunks of brachial plexus
Spinal accessory
Phrenic nerve
Vagus nerve

31
Q

Through which foramen does the spinal accessory nerve exit the cranium?

A

Jugular foramen

32
Q

What does the spinal accessory nerve innervate?

A

sternocleidomastoid and trapezius

33
Q

How would you test for the function of the spinal accessory nerve?

A

shrug/raise shoulders

34
Q

the vagus nerve exits the cranium through which foramen?

A

Jugular foramen

35
Q

What does the vagus nerve innervate?

A

Larynx
Heart
Lungs
GI tract

36
Q

the vagus nerve travels in the ____

A

carotid sheath

37
Q

How do you test for the function of the vagus nerve?

A

gag reflex

38
Q

Describe the innervation of the phrenic nerve

A

Motor to diaphragm and sensory to peritoneum and pleura around diaphragm

39
Q

Where does the phrenic nerve lie in relation to the scalenes?

A

Lies anteriorly to scalenus anterior

40
Q

How is the brachial plexus formed?

What does it innervate?

A

Formed from anterior rami of C5-T1

Innervates the upper limb

41
Q

Give the origin and course of the carotids

A
  • Right CC is a branch of the brachiocephalic trunk
  • Left CC comes directly from aortic arch.
  • Both enter neck posterior to the sternoclavicular joints
  • Ascend in carotid sheaths
  • Bifurcate at the level of C4:
  • —-> External - supplies many arteries in the face and neck
  • —-> Internal - ascends into cranium before dividing
42
Q

Describe how you would find the carotid pulse

A
  • Anterior border of the sternocleidomastoid
  • Above and lateral to the hyoid bone
    (Basically any point above C6)
  • Keep the head straight because the sternocleidomastoid muscle protects the carotid sheath when the head is turned.
43
Q

Why would you use the carotid pulse?

A
  • Easy to find
  • Assess rhythm
  • Time murmurs
  • If radial pulse cannot be felt e.g. low blood pressure
  • Used to locate jugular vein (USS)
44
Q

Describe the branches of the subclavian artery

A
  • Vertebral artery
    —–> Ascend through foramen transversarium of cervical spine
    —–> Form the basilar artery
    Internal thoracic artery
    —–> Runs inside thoracic cage
    —–> Gives off anterior intercostal branches & perforating vessels of breast
  • Additionally, the inferior thyroid artery arises from the first part of the subclavian artery
45
Q

What is the foramen transversarium?

A

only found in the cervical vertebrae.

a gap on each of the transverse processes which contain the vertebral artery and vein and a sympathetic nerve plexus

46
Q

In what three locations are central venous lines/catheters placed?

A

Catheters can be inserted through a peripheral vein or a proximal central vein, most commonly:

  • internal jugular - neck
  • subclavian - thorax
  • femoral vein - groin
47
Q

Describe the general organisation of the lymph nodes in the neck

A
  • Organised in a ring
  • Each group drains area above it

Everything drains superficial to deep

48
Q

Describe the lymph drainage of the neck

A
  • All lymph nodes drain into the deep cervical nodes which lie along the internal jugular vein.
  • These converge to form the right and left jugular lymphatic trunks
  • Rt jugular lymphatic trunk empties into the rt lymphatic duct*
  • Lt jugular lymphatic trunk enters into the thoracic duct
49
Q

State the order of the cartilage in the neck and the corresponding vertebral levels

A 
hyoid = C3
thyroid = C4
cricoid = C6

Year 2 - HN&S anatomy (7 decks)

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