final mini exam Flashcards
What is the superior and inferior attachment for the sternocleidomastoid?
- sup: mastoid process
inf: manibrium and clavicle
What is the division between the anterior and posterior triangles?
*sternocleidomastoid
What is the platysma innervated by?
- facial nerve
What does the platysma attached to?
- go through superior fascia and attach to superficial fascia/skin or both and also attached to bone at the other end
- line of mandible
What are the causes of a retropharyngeal abcess?
- penetrating injury, dental injection, most common cause upper respiratory infection
Where is the retropharngeal abcess infection from?
*base of skull to mediastinum (bifurcation of the trachea)
What can happen if the retropharyngeal abcess ruptures?
- go inferior to mediastinum (pericarditis)
- go laterally into corotid sheath ( clot int jugular vein)
- go posterior to vertebral column (dislocation of axis and atlas)
The investing fascia surrounds?
*trapezius and sternocleidomastoid
What is the treatment for a retropharyngeal abcess?
- drain (transoral)
- external drainage
- antibiotics
What are the signs of a retropharyngeal abcess?
*change in voice, difficulty swallowing, swelling in back of throat, lots of upper respiratory infection
What can a retropharyngeal abcess get large and do?
*compress trachea
What is the hyoid hanging by?
*supported by muscles and ligaments
What is the sternocleidomastoid innervated by?
*spinal accessory nerve (11th cranial nerve)
What do the suprahyoid muscles do?
*elevate hyoid and larynx, depress mandible, contract floor of mouth (during swallowing)
What is the suprahyoid muscles innervated by?
*V3 (mandibular branch of trigeminal nerve, VII facial, XII hypoglossal)
What do the infrahyoid muscles do?
*depress hyoid and larynx
What is the infrahyoid innervated by?
*ansa cervicalis (C1-C3)
What is the biggest salivary gland?
*parotid gland
What is the parotid gland covered by?
*dense fascia
What vein buldges with tension pneumothorax and cardiac tamp?
- external jugular vein
What kind of nerve fibers are in the nerve point of the neck?
- sensory fibers
* nerves emerge from deep and go superficial
What does the hypoglossal nerve innervate?
*tongue structures
What artery has multiple branches?
*external carotid artery
What artery has no branches?
*internal carotid artery
What artery delivers blood to the brain?
*vertebral artery
What is the carotid body for?
*chemoreceptor for oxygen
What do the walls for the carotid sinus contain?
*pressure receptors to monitor BP
What is a common spot for atherosclerosis plaque?
*carotid sinus
What sound will you here during auscultation in someone with an atherosclerotic plaque?
*bruit sound
What does the thyroid gland regulate?
*metabolism, secretes calcitonin (Ca regulation)
What are the complications of removing the thyroid gland?
- parathyroid insufficiency
- cut recurrent laryngeal nerve
- ima art
What does the parathyroid gland secrete?
- parathyroid hormone (high) for blood Ca levels (increase blood Ca levels)
What does the thyroid gland migrate from?
*tissue that becomes posterior tongue
What is a thyroglossal duct cyst?
*when thyroglossal duct remains patent and forms a cyst, in midline
What does the synovial membrane secrete?
*synovial fluid (for lubrication)
What percent of people are missing the acetabular branch?
*20%
What supplies the head of the femur with blood?
*acetabular branch
What supplies blood to the head and neck of the femur?
*retinacular arteries
What is an avascular necrosis?
- bone without blood, aseptic wasting of bone
* get artificial hip
How do you get avascular necrosis?
*break affects retinacular arteries
What are the signs of avascular necrosis?
*shorten limb, lateral rotation
Where do most breaks occur?
*surgical neck
What is a synovial joint and what is inside it?
- surrounded by CT (fibrous capsule)
* lining inside is synovial membrane
What can a dislocated head of the femur cause and how can it happen?
- shorten limb and medial rotation
* hitting dash in accident
What ligament extends the knee?
*anterior cruciate ligament taught
What ligament flexes the knee?
- posterior cruciate ligament taught
What is a epicondyle?
*places ligaments attach to
What do the anterior and posterior cruciate ligaments restrict?
- restrict anterior and posterior movement of tibia with respect to femur and allows rotation
What is the medial meniscus and what kind of movement does it allow?
- fibrocartilage C shaped
* movement little on tibial plato (attach by coronary ligaments)
What is the medial meniscus attached to?
*tibial collateral ligament
Why are the lateral meniscus and fibular collateral ligament not attached?
*popliteal ligament is here
What are the signs and treatment of a popliteal aneurysm?
- painless, pulse
* stent
What are the signs of a herniated synovial membrane?
- bursa
* bakers cyst
What is bursa?
*enlargement from extra friction
What is a bakers cyst and what are the treatment?
- post buldge (sign), pain increase with extension, or no pain
- drainage
How is the anterior cruciate ligament damaged?
*lateral impact to knee, forceful abduction of leg
What are the signs of a torn anterior cruciate ligament?
- anterior drawer sign
- unhappy triad (pop feel, torn ACL, medial collateral ligament rupture, meniscus tear)
- knee tender at MCL, knee swelling
What tear is more rare?
*posterior cruciate ligament
How is the PCL torn?
*hard impact to knee when fully flexed
What are the signs of a torn PCL?
*posterior drawer sign
What gland can develop a tumor?
*parotid gland
What does the epicranial aponeurosis glide on?
*guides on loose CT
What is the motor innervation of the facial muscles?
*facial nerve
Where does the facial bone emerge?
*Fallopian canal tunnels through bone of skull
What is Bell’s palsy, signs and treatment?
- viral infection (cause facial nerve to swell and impacts function of nerve)
- unilateral, paralysis of facial nerve, dropping of corner of mouth
- lots of tearing, can’t blink completely, can’t close eye
- sudden onset, bad in 24-48 hrs, couple of wk (3-6) months all gone
- antiinflammatory, and antiviral
What is the most powerful crushing muscle?
*masseter
What are the muscles of mastication innervated by?
*trigeminal nerve, 5th cranial nerve
What are the muscles of mastication?
*temporalis, masseter, medial/lateral pterygoid
What divides into sup and inferior labial arteries?
*facial artery
What is the terminal branch of the facial artery?
*angular artery
What kind of pain is trigeminal neuralgia and where is it found more in?
- electrical pain (shocking and brief)
- unilateral, in people over 50yrs
- more in women
- felt in maxillary and mandibular nerve
What is trigeminal neuralgia triggered/caused by?
- normal sensations (shaving)
* compression of vessel by root of trigeminal nerve
What are the treatment for trigeminal neuralgia?
*anticonvulsants (inhibit firing of nerves), surgical decompression of nerve (insert pad between art and nerve)
What innervates the back of the head?
*C1-C3
What are the branches of the trigeminal nerve?
*opthalmic nerve, maxillary, mandibular
Where does the middle meningeal artery go?
*through foramen spinosum (passes through pterion and can get injured)
What is an injured middle meningeal artery called?
*epidural hematoma
What is the posterior border of the middle cranial fossa?
*petris
Where does the pituitary gland at?
- turkish saddle
* cavernous venosus here
What is the dural venous sinus?
*split dura matter in 2 layers and blood runs through
What contains stem cells for bone?
*periosteum
Why can no infection go to the top of the skull?
*epicranial aponeurosis and fascia of temporalis are stitched together
Why can infection go to the scalp?
*anterior frontal bellies attach to skin (so infect can go to upper eyelid)
Why do scalp injuries bleed so much when injured?
- holds branches of internal/external carotid artery
* anastomatic network
What happens when the scalp gets hit/hurt?
- scalp gaps when hit (opens vessels up even more, more bleeding)
- infection can spread all way across top of head
What do arachnoid granulation do?
*reabsorb CSF and bring it back to blood
What collects blood from the brain and meninges?
*inferior sagittal sinus
What runs between the scalp and superior sagittal sinus?
*emissary vein
What happens if you have an infection in emissary vein?
- keep scalp open
* direct link to brain (meningitis and brain abcesses)
What drains into the cavernous sinus?
*superior ophthalmic vein
Where does the carotid art go through?
*cavernous sinus
What is a straight shot into the brain?
*internal vertebral venous plexus
What join to form the basilar artery?
*vertebral artery
What becomes the middle cerebro artery?
*internal carotid artery
What is in the cerebro arterial circle?
- posterior cerebral artery
- posterior communicating artery
- anterior cerebral artery
- anterior communicating artery
What is a basal skull fracture, signs, and treatment and what can it develop?
- hard enough impact (car accident)
- dura matter tears and arachnoid can tear too, crack in skull
- CSF rhinorrhea (runny nose)
- can develop arteriovenous fistula (pulsating exophthalmos (buldging eye))
- risk of meningitis and brain abcesses
- heal spontaneous, surgically patech
What is involved in an arteriovenous fistula?
*interior carotid artery and cavernous sinus
What is the danger triangle of the face drained by?
*facial vein
What can a change in pressure in the danger triangle of the face cause?
*blood to go to cavernous sinus
Where is a common place of a Berry aneurysm to occur?
*cerebral arterial circle
