Clinical Anatomy

Question 1

Why do superficial cut wounds of the neck bleed profusely?

Answer 1

Because retraction of the divided Platysma keeps the cut veins open. The veins are unable to retract due to their attachment to the deep cervical fascia.

Question 2

Why are ugly scars left after stitching of a neck incision.

Answer 2

While closing an incision in the neck, platysma must be stitched as a separate layer to prevent adhesion of skin to deeper neck muscles.
Such adhesions cause the overlying skin to move whenever the deeper muscles contract or relax and the wound will heal with an ugly scar.

Question 3

Clinical manifestations of the fracture of spine of sphenoid.

Answer 3

Relations of the spine:

• Medially - Cartilaginous part of Auditory tube and Chorda Tympani nerve.
• Laterally - Auriculotemporal nerve.

Thus, fracture of the sphenoidal spine can cause :

1) Damage to Auriculotemporal nerve causes loss of secretomotor supply to the parotid gland.
2) Damage to Chorda tympani causes loss of secretomotor supply of the Submandibular and Sublingual Salivary glands. (The Chorda tympani forms parasympathetic root of Submandibular Ganglion)
3) Damage to Chorda tympani also causes loss of taste sensation on anterior 2/3rd of the corresponding side of thigh tongue.

Question 4

Describe Frey’s Syndrome.

Answer 4

• In case of a penetrating wound to the parotid gland, the Auriculotemporal nerve and the Great Auricular nerve may get damaged. During the healing process, some sceretomotor fibres of the Auriculotemporal nerve may grow out and join the great auricular nerve, which supplies the sweat glands and cutaneous receptors for pain over the parotid region.
  -Thus when the patient eats, beads of perspiration appear on the skin over the parotid gland, the skin becomes red, hot and painful.
  -This is because a stimulus intended for salivation stimulates the sweat glands through the fibres of Great auricular nerve.
  This is called Frey’s syndrome.