Blue Boxes Flashcards
investing layer of deep cervical fascia
- most superficial layer
- covers entire neck
- splits to encase trapezius and SCM
- will contain infections between it and muscular part of pretracheal fascia (muscular part surrounds infrahyoid muscles)
if infection is between investing layer and visceral part of pretracheal fascia, then infection can spread to ___________________
if infection is between investing layer and visceral part of pretracheal fascia, then infection can spread to THORACIC CAVITY anterior to pericardium
pretracheal fascia
Pretracheal fascia forms sling/trochlea to hold intermediate tendon of digastric muscle
-wraps around intermediate tendon of omohyoid muscle
abscess posterior to prevertebral layer of deep cervical fascia can extend ____________
abscess posterior to prevertebral layer of deep cervical fascia can extend laterally (posterior to SCM) and enter RETROPHARYNGEAL SPACE (retropharyngeal abscess), bulging into the PHARYNX (dysphagia, dysarthria)
congenital torticollis
- unilateral contraction/shortening of cervical muscles causing head twisting/slanting
- due to contractues from fibrous tissue tumors in SCM
-can be iatrogenic: caused by hematoma formation in SCM due to forceps-assisted delivery entrapping CN XI to SCM, causing denervation and fibrosis
subclavian venapuncture
- used to place central line or Swan-Ganz catheter
- thumb on midclavicular line, index finger on jugular notch
- needle enters just inferior to thumb/clavicle
- needle angled to advance toward index finger to end at the right venous angle
lesions of spinal accessory n (CN XI): how can it happen?
-can be damaged during surgery in lateral cervical region, penetrating trauma, cancerous cervical lymph nodes, or fractures of jugular foramen (exits cranium)
lesions of spinal accessory n (CN XI): effects?
- weakness in turning head to side contralateral to lesion
- weakness/atrophy of trapexius
- unilateral trapezius paralysis
endarterectomy
Atherosclerotic intimal thickening of internal carotid, causing TIA or stroke –> resolved by endarterectomy
- resolves stenosis by removal of plaque with the intima
- surgery poses risk to damaging CNs XI, XII, X (recurrent laryngeal), IX
carotid sinus hypersensitivity
- carotid sinus acts as a baroreceptor, modulates BP (CN IX)
- hypersensitivity: external pressure on carotid sinus will simulate elevated BP –> vagus nerve provides parasympathetic innervation to lower HR/BP
- results in syncope (from decreased cerebral perfusion) and cardiac ischemia
thyroid ima artery
- present in ~10% of patients
- may branch off any artery at root of neck
thyroglossal duct cysts
- thyroid initially develops in embryologic pharyngeal floor at the foramen cecum (becomes dorsum of postnatal tongue)
- moves to neck, anterior to hyoid bone, but remains attached to foramen cecum by thryroglossal duct
- thyroglossal duct usually degenerates, but can leave residual epithelium, forming thyroglossal duct cysts in neck
Le Fort I fracture
- horizontal fracture of maxilla
- superior to alveolar processes
- crosses nasal septum
- extends as far as pterygoid plates of sphenoid bone
Le Fort II fracture
- from posterolateral region of maxillary sinuses up thru infraorbital foramina
- from ethmoids to nasal bridge
- separates hard palate/central face from cranium
Le Fort III fracture
- horizontal fracture through the superior orbital fissures, ethmoid bone, nasal bones
- passes laterally across greater alae of sphenoid bone and frontozygomatic sutures
- includes fracture to zygomatic arches separating maxillary and zygomatic bones from the cranium
