Fiser Chapter 19 HEAD AND NECK Flashcards
Anterior neck triangle
SCM, sternal notch, inferior border of digastric muscle
Contains carotid sheath
Posterior neck triangle
SCM posterior border, trapezium, clavicle
Contains accessory nerve (to SCM, trap, platysma) and brachial plexus
Parotid vs sublingual vs. submandibular gland secretions
Parotid -> serous
Sublingual -> mucin
Submandibular -> 50/50
False versus true vocal cords
False are superior to true in larynx
Location of vagus nerve in neck
Between carotid and IJ
Location of phrenic nerve in neck
On top of anterior scalene muscle
Location of long thoracic nerve in neck
Posterior to middle scalene muscle
Sensory nerve to face
Trigeminal with ophthalmic, maxillary, mandibular branches
Mandibular branch also gives taste to anterior 2/3 of tongue, floor of mouth, gingiva
Motor nerve to face
Facial nerve with temporal, zygomatic, buccal, marginal mandibular, cervical branches
Taste nerves
Trigeminal anterior 2/3 of tongue
Glossopharyngeal posterior 1/3 of tongue
Swallowing nerve
Glossopharyngeal (motor to stylopharyngeus, also taste posterior 1/3 tongue)
Motor nerve to tongue
Hypoglossal (motor to all of tongue except palatoglossus): tongue deviates toward same side of injury
Laryngeal muscle innervation
Superior laryngeal nerve innervates cricothyroid muscle
Recurrent laryngeal nerve innervates all the rest
Gustatory sweating after parotidectomy
Frey’s syndrome: injury to auriculotemporal nerve, that then cross-innervates with sympathetic fibers to sweat glands of skin
Thyrocervical trunk branches
STAT:
Suprascapular artery
Transverse cervical artery
Ascending cervical artery
inferior Thyroid artery
External carotid artery branches
STAPLF (like staple) OPAMST
- Superior thyroid artery
- Ascending pharyngeal
- Lingual
- Facial
- Occipital
- Posterior auricular
- Maxillary
- Superficial temporal
Trapezius flap blood supply
transverse cervical artery
Pectoralis major flap blood supply
Either thoracoacromial artery or internal mammary artery
Torus palatine and Toru mandibular
Congenital bony mass on upper palate of mouth, or on lingual surgace of mandible
Tx: Nothing
Radical versus modified radical neck dissection
Radical: takes accessory nerve, SCM, IJ, omohyoid, submandibular gland, sensory nerves C2-C5, cervical branch of facial nerve, ipsilateral thyroid
Modified: leaves accessory nerve, SCM, IJ
No mortality difference between them. Most morbidity occurs from accessory nerve resection
Most common cancer of oral cavity, pharynx, and larynx; risk factors
Squamous cell carcinoma
Risk factors tobacco and EtOH
Erythroplakia versus leukoplakia
Erythroplakia more premalignant
Oral cavity borders
Mouth floor, anterior 1/3 of tongue, gingiva, hard palate, anterior tonsillar pillars, lips
Most common site for oral cavity CA
Lower lip (more common than upper lip d/t sun exposure)