Anatomy Head, neck and spine Book Flashcards
Layers of scalp
Skin
Connective tissue
Aponeurosis- tendinous of epicranial muscles
Loose areolar tissue- potential spaces for infection or blood
Pericranium- held firmly to skull
Branches of external carotid
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Superficial temporal
Maxillary
some anatomist love fish other prefer sausage and mash
Where does the facial nerve leave the skull
Stylomastoid foramen
What leaves through foramen spinosum
Middle meningeal artery
Meningeal branch of mandibular
What passes through foramen Magnus
Medulla
Anterior and posterior spinal arteries
Dural veins
Spinal root of XI
Vertebral arteries
Subdivisions of triangles of neck
Anterior
Submental
Submandibular
Carotid
Muscular
posterior
Occipital
Supraclavicular
Borders of muscular triangle
Superiorly – hyoid bone.
Medially – imaginary midline of the neck.
Supero-laterally – superior belly of the omohyoid muscle.
Infero-laterally – inferior portion of the sternocleidomastoid muscle.
Contents of muscular triangle
Infrahyoid muscles -omohyoid, thyrohyoid, sternothyroid, sternohyoid
Thyroid
Parathyroid
Fascia levels in the neck
Superficial
Superficial Cervical Fascia- blends in with platysma
Deep
Investing -splits in 2 surrounding SCMand trapezius
Pretracheal - infrahyoid muscles then another layer with tracheal thyroid, para, oesophagus and vessels and nerves
Prevertebral - vertebrae and posterior neck muscles
Carotid- carotid arteries, internal jugular, and vagus
Suprahyoid muscles
Stylohyoid- superifical to diagastric
Digastric- superficial to mylo
Mylohyoid- forms floor
Geniohyoid-deep to the mylohyoid muscle
Carotid triangle boundaries
Superior – posterior belly of the digastric muscle.
Lateral – medial border of the sternocleidomastoid muscle.
Inferior – superior belly of the omohyoid muscle.
Contents of carotid triangle
Common carotid- which bifurcates within
Internal jugular vein
Hypoglossal
Vagus nerves
Boundaries of submental triangle
Inferiorly – hyoid bone.
Medially – midline of the neck.
Laterally – anterior belly of the digastric
Contents of submental triangle
Mylohyoid as floor
Submental lymph nodes
Boundaries of submandibular triangle
Superiorly – body of the mandible.
Anteriorly – anterior belly of the digastric muscle.
Posteriorly – posterior belly of the digastric muscle.
Contents of submandibular triangle
Submandibular gland
Lymph nodes
Facial artery and vein
Borders of occipital and subclavian triangle
Divided by omohyoid
Content of posterior triangle
Nerves
Accessory nerve
Phrenic nerve
Three trunks of the brachial plexus
Branches of the cervical plexus: Supraclavicular nerve, transverse cervical nerve, great auricular nerve, lesser occipital nerve
Vessels
External jugular vein
Subclavian artery
Muscles
Inferior belly of omohyoid
Scalene
Lymph nodes
Supraclavicular
Occipital
Bones forming pterion
Frontal
Sqaumous temporal bone
Sphenoid greater wing
Parietal
What structures to go through on an LP
L3/4 or L4/5
Suprapsinous
Interspinous
Ligamentum flavus
Dura and arachnoid mater
Contents of cavernous sinus
Medial to lateral
Internal carotid
Abducens
Oculomotor, trochlear superior lateral border V1, V2 infeiror lateral border
Sx of cavernous sinus thrombosis
Painful
Oedematous eye
Ipsilateral
Internal and external ophthalmoplegia with papilodema
Palsies
Can go from one sinus to next
Branches of subclavian artery
First - vertebral, internal thoracic, thyrocevical
Second - costocervical trunk
Third- dorsal scapular
Bones making up zygomatic arch
Temporal
Zygomatic
Maxilla
Fracture of zygomatic arch can damage
Zygomatic branch of facial nerve
Signs of longitudinal temporal bone fracture
Can affect vestibulocochelar and facial nerve
Parallel to long axis of petrous bone- most common
Tear of tympanic membrane
CSF otorrhoea
Facial nerve palsy
Conductive hearing loss
Signs of transverse temporal fracture
Usually cochlear or vestibular damage
Vertigo and SN hearing loss
Differentials of neck lumps
Cystic hygroma- left posterior
Cysts- fluctuant (sign it contains fluid)
Lymph nodes- non fluctuant
What forms external jugular
Retromandibular(formed by superfiical temporal and maxillary) and post auricular
Branches from posterior external and transverse cervical
External jugular in relation to scales anterior
Anterior
Most common site for cervical fracture
C7/T1
Types of cervical fractures
Clay Shoveler- spinous process of C6/7
Hangman - both peduncles of C2
Jefferson- burst C1-ant and post arch
Where caudal equine begins
L1
Middles meningeal artery forms from
Which branch is affected by pterion
Maxillary artery
Anterior
Relations of parotid gland
Superior - external acoustic meatus and temporalmandibular joint
Inferior - diagastric posterior belly
Medial - styloid
Anterior - masseter
Structures transversing parotid
Facial nerve
Retromandibular vein
External carotid
Fascia of parotid
Investing
Where duct of parotid comes out
Comes out anteriorly, running on lateral surface of master and pierces buccinator opposite second molar
Relations of sublingual gland and drainage
Bordered laterally by the mandible and medially by genioglossus
The submandibular duct and lingual nerve pass alongside the medial aspect of the sublingual gland.
Both glands (forms sublingual fold) unite around frenulum
Secretions drain into the oral cavity by minor sublingual ducts (of Rivinus)- then join submandibular to Sublingual papillae openiing
Blood supply of thyroid
Superior and inferior
Superior- branch of external
Inferior- thyrocevical trunk- from subclavian
Floor and roof of posterior triangle
Roof- investing facia, platysma
Floor- prevertebral fascia
Infratemporal boundaries
Lateral – condylar process and ramus of the mandible bone
Medial – lateral pterygoid plate; tensor veli palatine, levator veli palatine and superior constrictor muscles
Anterior – posterior border of the maxillary sinus
Posterior – carotid sheath
Roof – greater wing of the sphenoid bone
Floor – medial pterygoid muscle
Pretracheal fascia relation to strap muscles and level it runs to
Superficial and deep
From hyoid to arch of aorta
Deep investing fascia attachments
Mastoid
Superior nuchal line
Zygomatic process
Manidble
Manubrium
Clavicles
Scapulae spine
Acromion
Which structures does the deep investing fasciae envelop
SCM
Trapezius
Parotid
What does prevertebral fascia envelop and where does it run
Levator scapula
Scalenus
Subclavian artery
Skull to T3
Becomes axillary sheath inferior to clavicle
Which tracheal rings does thyroid overly
2-3rd by isthmus
Lateral from thyroid cartilage to 6th ring
What does isthmus lie deep to
Anterior jugular veins
Usually ligated with tracheostomy
Which nerves can be damaged in thyroid surgery
When ligating inferior thyroid artery- risk of damage to recurrent laryngeal
Hence why it is ligated far away from gland
Superior thyroid artery ligated more proximal
External branch of superior laryngeal
Supplies cricothyroid
Lies deep to upper pole of gland
Which nerve supplies internal carotid
IX- baroreceptors