Exam 1 Flashcards
Facial nerve paralysis?
Bell’s palsy
What is the motor innervation to the muscles of facial expression?
Branches of the facial nerve (7)
What is the sensory innervation to the face?
Branches of the trigeminal nerve (5)
The trigeminal nerve divides into three branches before emerging on the face. What are they and where are they distributed?
1) ophthalmic nerve: primarily to the face and scalp
2) maxillary nerve: primarily to the cheek and the area lateral to the orbit.
3) mandibular nerve: primarily to the chin and temporal region.
The ophthalmia nerve further divides into these 5 branches.
1) supraorbital nerve
2) supratrochlear nerve
3) external nasal nerve
4) infratrochlear nerve
5) lacrimal nerve
The maxillary nerve further divides into these three branches.
1) zygomaticotemporal nerve
2) zygomaticofacial nerve
3) infraorbital nerve
The mandibular nerve further divides into these three branches.
1) auriculotemporal nerve
2) buccal nerve
3) mental nerve
A condition characterized by sudden attacks of severe pain occurring in an area of sensory distribution of the trigeminal nerve.
Trigeminal neuralgia
Trigeminal neuralgia is often due to what and occurs most frequently in what division?
- Often due to touch.
- Most common in maxillary, then mandibular, then ophthalmic division.
- Cause is unknown.
- spinal trigeminal nucleus extends down to c4 and is involved with pain reception from the face.
The greater occipital nerve supplies what?
(Posterior primary ramus of C2) supplies the occipital region.
* behind the ear
The third occipital nerve supplies what?
(Posterior primary ramus of C3) supplies the upper part of the back of the neck.
* angle of mandible and area below the ear.
What does the posterior primary ramus of C4 supply?
Supplies the lower part of the back of the neck.
Which cervical nerve has no posterior root carrying sensory fibers and is strictly a motor nerve?
C1
The sensory innervation of the posterior aspect of the neck and scalp is from the posterior (dorsal) primary rami of which cervical nerves?
2 to 4
The cervical plexus is formed by the anterior primary rami of?
C1, C2, C3, and C4
What supplies sensory innervation to the skin of the upper arm?
C5, C6, C7, and C8
The lesser occipital nerve supplies what?
(C2) supplies the lateral part of the occipital region, posterior to the ear.
The great auricular nerve supplies what?
(C2, C3) supplies the angle of the mandible, and the area inferior to the ear. It accompanies the external jugular vein.
What does the transverse cervical nerve supply?
(C2,C3) supplies the anterior surface of the neck (the throat).
What does the supraclavicular nerve supply?
(C3,C4) supplies the lateral surface of the neck.
What are the three subdivisions of the supraclavicular nerve?
1) medial supraclavicular nerve
2) intermediate supraclavicular nerve
3) lateral supraclavicular nerve
The superior root (C1 or C1 and C2) of the ansa cervicalis descends from what nerve to join the inferior root?
Hypoglossal nerve.
The inferior root (C2 and C3) of the ansa cervicalis descends from the what to join the superior root?
Cervical nerve branches
The superior and inferior roots unite to form the ansa cervicalis, which as a whole (C1,C2,C3) supplies three of the four infrahyoid muscles. Name the three.
Sternohyoid, sternothyroid, and omohyoid
Where does the thyrohyoid muscle receive its innervation from?
C1 fibers through the Hypoglossal nerve.
True or false? The phrenic nerve is both motor and sensory.
True.
Where does the phrenic nerve originate from?
C3, C4 and C5 ( mostly c4)
The phrenic nerve is motor to the what and sensory to the what?
Motor to the diaphragm and sensory to some of the membranes of the thorax and abdomen.
Where can the phrenic nerve be found?
It can be found in the neck lying on the anterior surface of the anterior scalene muscle. It runs vertically down the muscle and into the thorax.
Origin of platysma
Superficial fascia over the pectoral is major and deltoid muscles.
Insertion of platysma
Lower border of the mandible and the angle of the mouth.
Nerve to platysma
Cervical branch of facial nerve
Function of platysma
Depresses the mandible and draws down the corner of the mouth.
Origin of SCM
Sternal head from the front of the manubrium, clavicular head from the medial third of the clavical.
Insertion of SCM
Lateral surface of mastoid process, lateral half of the superior nuchal line
Nerve for SCM
Accessory nerve (11)
Function for SCM
Chief flexor of head
What is the pathological contraction of the SCM?
Torticollis or wryneck
Fibrous tissue tumor which develops at or shortly after birth. SCM
Congenital
Due to birth injury. SCM
Muscular
Occurs in adults and is due to abnormal tonicity. Responds well to chiropractic. SCM
Spasmodic
Origin of trapezius
External occipital protuberance, ligamentum nuchal, and the spinous processes of the seventh cervical and all thoracic vertebrae.
Insertion of trapezius
Lateral third of the clavical, spine of the scapula, and acrimonious process
Nerve for trapezius
Accessory nerve and c3 and c4 from the cervical plexus.
Function of the trapezius
The upper portion elevates, the middle portion contracts, and the lower portion depresses the scapula.
Which vein drains the face and scalp, and also contains a large amount of cerebral blood?
External jugular vein.
The external jugular vein is formed immediately below the parotid gland by the union of what?
1) retromandibular vein
2) posterior auricular vein
The external jugular vein runs downward and backward along the lateral surface of what and empties into the what?
SCM; subclavian vein
There are 6 tributaries of the external jugular vein. What are they?
1) retromandibular vein
2) posterior auricular vein
3) posterior external jugular vein
4) anterior jugular vein
5) transverse jugular vein
6) suprascapular vein
When venous pressure is normal, the external jugular vein is what, topographically?
Invisible
In congestive heart failure, or obstruction of the superior vena cava, the external jugular vein becomes what throughout its length?
Very prominent
Superficial cervical lymph nodes are found where?
Found along the external jugular vein, superficial to the SCM.
The anterior triangle of the neck lies in front of the what and the posterior lies behind it.
SCM
What are the three boundaries of the posterior triangle?
1) anterior: posterior border of the SCM
2) posterior: the anterior border of the trapezius
3) inferior: the superior border of the middle third of the clavicle.
Important visceral structures of the neck are found in which triangle?
Anterior triangle
What are the three boundaries of the anterior triangle?
1) superior: the inferior border of the mandible
2) anterior: the anterior midline
3) posterior: the anterior border of the SCM
The apex of the anterior triangle lies where?
Inferiorly, at the jugular notch
The roof of the anterior triangle is formed by what?
Formed by the investing layer of the deep cervical fascia, the superficial cervical fascia, and the platysma.
What are the four subdivisions of the anterior triangle?
1) submental triangle
2) submandibular (diagastric) triangle
3) carotid triangle
4) muscular triangle
This subdivision of the anterior triangle is unpaired.
Submental triangle
What are the boundaries of the submental triangle?
The left and right anterior bellies of diagastric, and the body of the hyoid bone.
What is the floor of the submental triangle?
Mylohyoid muscle
What are the contents of the submental triangle?
Minor veins and lymph nodes
What are the boundaries of the submandibular (diagastric) triangle?
The inferior border of the mandible, the anterior belly of diagastric, and the posterior belly of the diagastric.
What is the floor of the submandibular triangle?
Mylohyoid and hyoglossus muscles
What are the contents of the submandibular triangle?
Submandibular gland, the internal carotid artery, facial artery, internal jugular vein, glossopharyngeal nerve and the vagus nerve.
What are the boundaries of the carotid artery?
Posterior belly of the diagastric, the superior belly omohyoid, and the anterior border of the SCM.
What is the floor of the carotid triangle?
Portions of the thyrohyoid, hyoglossus, and inferior and middle constrictor muscles
What are the contents of the carotid triangle?
Parts of the common and internal carotid arteries, the external carotid artery and three of its branches: the superior thyroid artery, lingual artery, and facial artery. There is also the corresponding tributaries of the internal jugular vein.
What are the boundaries of the muscular triangle?
Superior belly of omohyoid, anterior midline of the neck, and the anterior border of the SCM.
What is the floor of the muscular triangle?
Posterior layer of pretracheal fascia.
What are the contents of the muscular triangle?
Sternohyoid and sternothyroid muscles, thyroid gland, trachea, and esophagus.
What is the only bone in the body that does not articulate with another bone?
Hyoid bone
Where is the hyoid bone located and what does it do?
Between the mandible and larynx, and serves as a point of attachment for many muscles.
What are the three parts of the hyoid bone and which part is the attachment for the stylohyoid ligament?
1) body
2) greater horn
3) lesser horn: attachment for stylohyoid ligament.
What are the infrahyoid muscles primary function?
To move the hyoid bone and larynx
What are the four infrahyoid muscles?
1) omohyoid
2) sternohyoid
3) sternothyroid
4) thyrohyoid
Which two muscles make up the superficial layer of the infrahyoid muscles?
Omohyoid and sternohyoid
Which two muscles make up the deep layer of the infrahyoid muscles?
Sternothyroid and thyrohyoid
What is the origin of the omohyoid?
The inferior belly of omohyoid originates from the upper border of the scapula. It ends in an intermediate tendon located deep to the SCM. The superior belly of omohyoid extends upward from his tendon.
What is the insertion of the omohyoid?
The body of the hyoid bone
What is the nerve of the omohyoid?
Ansa cervicalis (C1,C2,C3)
What is the function of the omohyoid?
Depresses the hyoid bone and larynx
What is the origin of the sternohyoid?
The posterior surface of the mandibrium, and the medial end of the clavicle.
What is the insertion of the sternohyoid?
The body of the hyoid bone
What is the nerve of the sternohyoid?
Ansa cervicalis (C1,2,3)
What is the function of the sternohyoid?
Depresses the hyoid bone and larynx
What is the origin of the sternothyroid?
The posterior surface of the mandibrium, inferior to the origin of the sternohyoid
What is the insertion of the sternothyroid?
The oblique line on the lamina of the thyroid cartilage.
What is the nerve for the sternothyroid?
Ansa cervicalis (C1,2,3)
What is the function of the sternothyroid?
Depresses the larynx
What is the origin of the thyrohyoid?
The oblique line on the lamina of the thyroid cartilage.
What is the insertion of the thyrohyoid?
The body of the hyoid bone
What is the nerve to the thyrohyoid?
C1 through Hypoglossal nerve
What is the function of the thyrohyoid bone?
Depresses the hyoid bone
Why do we need muscles to depress the hyoid bone and larynx?
1) swallowing
2) speech
3) breathing
4) if the hyoid is fixed, the digastric will depress the mandible. ( if you need extra help opening the mouth)
A thin layer of connective tissue which encloses the platysma muscle, and contains cutaneous nerves, superficial veins and lymph nodes.
Superficial cervical fascia
This layer lies deep to the superficial fascia, and splits to enclose the SCM and trapezius.
Investing layer of the deep cervical fascia.
This layer encloses the thyroid gland, trachea, and esophagus.
Pretracheal fascia of the deep cervical fascia
This layer encloses the vertebral column and the deep muscles of the back
Prevertebral fascia of the deep cervical fascia
This layer is a cylinder of fascia which extends from the base of the skull to the root of the neck.
Carotid sheath
What does the carotid sheath contain?
1) common carotid artery
2) internal carotid artery
3) internal jugular vein
4) vagus nerve
5) deep cervical lymph nodes
* the external carotid artery exits the sheath before giving off its branches in the neck.
What are the two function of the fascia layers?
To provide a slippery surface to reduce friction during:
1) gross movement of the head and neck
2) swallowing
Review clinical significance of page 13
Page 13
What are he boundaries of the superior thoracic aperture?
1) first thoracic vertebra
2) first ribs and their cartilages
3) manubrium of sternum
The superior thoracic aperture is what shaped?
Kidney shaped
What are the four arteries that pass through the superior thoracic aperture?
1) brachiocephalic trunk
2) left common carotid artery
3) left subclavian artery
4) internal thoracic artery
What is the vein that passes through the superior thoracic aperture?
Brachiocephalic vein
What are the nerves that pass through the superior thoracic aperture?
1) phrenic nerve
2) vagus nerve
3) recurrent laryngeal nerve
4) sympathetic trunk
What are the viscera that pass through the superior thoracic aperture?
1) trachea
2) esophagus
3) cervical pleura
4) apex of lung
5) thymus
Review Potential for lung collapse with neck injury
Page 14
