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Head And Neck > General Organisation Of Head And Neck > Flashcards

General Organisation Of Head And Neck Flashcards

1
Q

What are the components of the Head

A

Scalp
Skull
Brain and its coverings (meninges)

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2
Q

Define the region of the neck

What are the divisions of the Cranium?

A

Extends from lower margin of mandible to suprasternal notch of the manubrium and the upper border of clavicle

Neurocranium (around brain) and viscerocranium (facial skeleton)

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3
Q

What are the 2 main vessels in the face

A

Facial artery and vein

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4
Q

Describe the branches of the Aortic Arch

A

AA-> Brachiocephalic trunk, Left common carotid artery, left subclavian artery

BC Trunk-> Right Subclavian and Right common carotid artery

(The common carotids split at C4 bone into internal- neurocranium and external- viscerocranium )

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5
Q

Outline the boundaries of the Anterior and Posterior triangles in the neck

A

Anterior triangle:

Superior boundary- Mandible (Inferior border)
Medial boundary- Imaginary mid-saggital line
Lateral boundary- SCM Muscle (Anterior border)

Posterior triangle:

Anterior boundary- SCM Muscle (Posterior border)
Posterior boundary- Trapezius muscle (Anterior border)
Inferior boundary- Clavicle (Superior border)

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6
Q

Compare the routes of the structures passing through the Anterior and Posterior neck triangles

A

Anterior: Structures passing between head and thorax

Posterior: Structures passing between thorax/ neck and upper limb

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7
Q

Name the 3 boundaries of the Carotid Triangle (within the anterior triangle)

A
  • Superior: Digastric Post. Belly
  • Anterior: Omohyoid Sup. Belly
  • Lateral: SCM
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8
Q

Neck structures are compartmentalised by layers of cervical fascia. Name the layers.

A
  1. Superficial cervical fascia

Deep cervical fascia:

  1. Investing Layer (most superficial, surrounds entire neck)
  2. Pretrachial Layer (Anterior and lateral neck only)
  3. Carotid Sheath (formed from parts of other 3 layers)
  4. Prevertebral Layer (deepest)
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9
Q

State the contents of the Superficial Cervical Fascia

Remember: SCALP

A 
Superfical blood vessels
Cutaneous nerves 
Adipose 
Lymph nodes 
Platysma
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10
Q

Name the Superior, Posterior and Inferior attachments of the Investing Layer

A

Superior: Lower mandible, Mastoid Process, Superior Nuchal Line, External Occipital Protuberance

Posterior: Ligamentum Nuchae and Spinous Processes

Inferior: Upper Manubrium, Clavicle, Acromion and Spine of Scapula

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11
Q

Name the Superior and Inferior attachments of Pretrcheal layer

A

Superior: Hyoid bone

Inferior: Extends into thorax and blends with fibrous pericardium

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12
Q

What are the 2 layers of the Pretracheal layer

What does each layer enclose?

A

Muscular layer encloses Infrahyoid muscles

Visceral layer enclosed Trachea, Oesophagus, Thyroid Gland

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13
Q

What is the pretracheal layer called as it runs posteriorly to enclose muscles of the pharynx and oesophagus?

What are this structure’s superior and inferior attachments

A

Buccopharyngeal fascia

Superior: Base of skull
Inferior: Diaphragm

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14
Q

The Carotid Sheath is a tubular, fibrous structure.

Name its superior and inferior attachments
List its 3 main contents

A

Superior: Base of skull
Inferior: Arch of aorta

Common Carotid Artery
Internal Jugular Vein
Vagus Nerve (Cranial Nerve X)

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15
Q

State the Superior and Inferior attachments of the Prevertebral layer.

Describe its extension laterally

A

Superior: Base of skull
Inferior: T3 vertebrae

Extends laterally as the axillary sheath that surrounds the axillary vessels and Brachial Plexus of nerves running into upper limb

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16
Q

Fascial compartmentalisation of neck structures lead to spaces between fascial planes.

Infections/ abscesses between planes can cause these spaces to distend.

What is this kind of infection called?
List 4 sources (can spread)

A

Deep neck space infections. (Rare but dangerous)

Teeth
Pharynx tissues
Sinuses
Middle ear

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17
Q

Name the deep neck space between the Buccopharyngeal fascia and Prevertebral layer.

Up until the age of 3-4, what does the superior part of this space contain?

A

Retropharyngeal Space (allows pharynx to expand when swallowing)

Lymph nodes which drain areas of nose, oral cavity and upper pharynx.

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18
Q

Considering that the the Retropharyngeal Space extends into Mediastinum, where can infections spread into?

What can develop?

A

Can spread into thorax, risking Mediastininits (Rare but life threatening)

19
Q

List 6 signs of a Retropharyngeal Abscess

A
  • Bulge on Oropharynx
  • Sore throat
  • Hard to swallow
  • Stridor (high pitched wheezing sound caused by disrupted airflow)
  • Reluctance to move neck
  • High temperature
20
Q

List 4 signs of Retrosternal extension of a Goitre (T Gland enlargement)

A
  • Breathlessness and stridor (due to tracheal compression)

- Facial oedema (due to compression impeding venous drainage from head and neck)

21
Q

List the 2 groups of muscles of Head and Face and list their nerve supply

A

Muscles of facial expression (Including Buccinators and Occipitofrontalis)- Facial Nerve (CNVII) ( 5 key branches)

Muscles of Mastication (Chewing)- (Mandibular division of Trigeminal Nerve)

22
Q

The Facial Expression Muscles often lie in Subcutaneous tissue, and attach to Bone/ Fascia and to each other.

How do they act and what is the exception?

A

Act as Sphincters (Concentric) or Dilators around the orifices of the face (Eye orbits, Nose, Mouth)

Exception: Buccinators (Cheek muscles) keep the cheek taut, to keep food in the Oral Cavity Proper (prevent food gathering between teeth and cheek)

23
Q

Branches of the Facial Nerve innervate all the muscles of facial expression, as well as the Platysma muscle.

Outline the path of the facial nerve briefly

A
  1. Originates at Brainstem
  2. Exits at base of skull
  3. Runs superficially through parotid gland (Inferior and Anterior to ear) (So vulnerable to damage)
  4. In gland, the nerve divides into 5 key branches
24
Q

List the 5 key branches of the Facial Nerve (Cranial Nerve VII) from Superior to Inferior

Remember: To Zanzibar By Motor Car

A 
Temporal (Forehead level)
Zygomatic (Eye level)
Buccal (Cheek Level)
Marginal Mandibular (Chin Level)
Cervical (Neck Level) (This branch supplies Platysma)
25
Q

What will injury/ pathology of facial nerve cause?

A

Weakness of muscles of facial expression on that side (Ipsilateral), causing half of face to ‘droop’

26
Q

What is the most common non-traumatic cause of face paralysis? Describe this condition

A

Bell’s Palsy- Inflammation of facial nerve causes oedema and nerve compression as it runs through skull

27
Q

What set of symptoms is highly likely to be Parotid Cancer?

Why is this indicative?

A

Ipsilateral weakness of facial muscles + parotid enlargement

(Cancerous cells invade and damage the facial nerve as it runs through gland)

It is rare for Benign/ Inflammatory/ Infective conditions of the gland to cause damage to the facial nerve)

28
Q

Name the 4 Muscles of Mastication

What do they all act to do?

A
  • Temporalis (can be felt over temples when clenching jaw)
  • Masseter (can be felt at corner of jaw when clenching jaw)
  • Medial Pterygoid
  • Lateral Pterygoid (Assists Suprahyoid muscles in depressing mandible)

All act to move the Mandible at the Temporomandibular Joint (TMJ)

29
Q

The Trigeminal nerve (Cranial Nerve V) is the main sensory nerve of the face and scalp. Name the 3 branches

Which 2 are only sensory

A
  • Va (Opthalmic division)
  • Vb (Maxillary division)
  • Vd (Mandibular division)

Va and Vb are only sensory

30
Q

State the Origin, Insertion and Action of Temporalis

A

O: Temporal Fossa
Ins: Coronoid Process of Mandible

A: Elevates and Retracts Mandible

31
Q

State the Origin, Insertion and Action of Masseter

Most powerful mastication muscle

A

O:

  • Deep head: Zygomatic arch of temporal Bone
  • Superficial Head: Maxillary process of Zygomatic Bone

Ins: Ramus of Mandible

A: Elevates Mandible

32
Q

State the Origin, Insertion and Action of Lateral Pretygoid

A

O:

  • Superior Head: Greater wing of Sphenoid
  • Inferior Head: Lateral pterygoid plate of Spehnoid

Ins: Neck of Mandible

A: Protract mandible + side to side jaw movement (Also assists Suprahyoid muscles in mandible depression)

33
Q

State the Origin, Insertion and Action of Medial Pretygoid

A

O:

  • Deep: Lateral pterygoid plate of sphenoid bone
  • Superficial: Maxillary tuberosity and pyramidal process of palatine bone

Ins: Ramus of mandible (near Angle)

Action: Elevates mandible

34
Q

State the Action and Innervation of Orbicularis Oculi

A

A:p

  • Inner Palpebral: Gently closes eyelids
  • Outer Orbital: Tightly closes eyelids

Inn: Temporal and Zygomatic branches of facial nerve

35
Q

State the Origin, Insertion and Action of Orbicularis Oris

A

O: Maxilla

Ins: Skin and mucous membranes of lips

A: Lip compression and protrusion

36
Q

State the Origin, Insertion and Action of Buccinator

A

O: Maxilla and Mandible

Ins: Skin of lips and Orbicularis Oris

A: Pulls cheek inward against teeth (Keeps it taut)

37
Q

State the Origin, Insertion, Innervation and Action of Platysma

A

O: Fascia over Pec Major and Deltoid

Ins: Mandible

Inn: Facial Nerve cervical branch

A: Depression of mandible and angle of mouth

38
Q

State the Origin, Insertion, Innervation and Action of Sternocleidomastoid

A

O:

  • Sternal head: Manubrium
  • Clavicular head: Medial clavicle

Ins: Mastoid process + Lateral superior nuchal line

Inn: Accessory nerve (CN XI)

A: Ipsilateral head flexion and lateral neck flexion + Contralteral head rotation

39
Q

Which muscle is contracted in Torticollis?

Which muscle wastes when CN XI is damaged?

A

SCM

Trapezius

40
Q

Which muscles form the floor of the posterior triangle in the neck?

They also act as accessory muscles for respiration

A

Scalene muscles

41
Q

The Phrenic nerve descends along the surface of which muscle before entering thorax?

A

Anterior scalene

42
Q

The Infrahyoid muscles are strap-like and overlie the larynx and thyroid gland.

Name all 4 of them

A

2 Superficial:

  • Sternohyoid
  • Omohyoid (Superior belly- Intermediate tendon- Inferior belly)

2 Deep:

  • Thyrohyoid
  • Sternothyroid
43
Q

Compare the the functions of the Supra and Infrahyoid muscles

A

Supra: Elevate the hyoid + Depress the Mandible

Infra: Depress the hyoid and help to stabilise it

44
Q

Name the 4 Suprahyoid muscles

A
  • Digastric (Ant. and Post. bellies)
  • Mylohyoid
  • Genihyloid
  • Stylohyoid

Head And Neck (20 decks)

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