General Organisation of the Head and Neck

Question 1

What is the surface anatomy of the neck?

Answer 1

Thyroid cartilage

cricoid cartilage

Question 2

What groups can the facial muscles be described as?

Answer 2

Muscles of facial expression =

• orbicularis oculi
• orbicularia oris
• buccinator
• platysma
• frontalis

Muscles of mastication =

• masseter
• temporalis
• medial pterygoid
• lateral pterygoid

Question 3

Outline the platysma muscles

Answer 3

Origin = pect major, deltoid

Insertion = muscles of the face

Action = depress corners of the mouth, assist in depression of the jaw (test = tighten jaw)

Innervation = facial N (cranial nerve)

Question 4

Discuss the sternocleidomastoid

Answer 4

Origin = sternum, clavicle

Inserts = mastoid process

Action = lateral neck flexion, tilting chin to contralateral side. Both contraction = movement at the atlanto-occipital joint, and flexion for the neck (test = hand on pt neck and turn to look over shoulder)

Innervation = accessory N

Question 5

Discuss the trapezius

Answer 5

Origin = superior nuceal line, external occipital protrubance, spinal process T spine

Insertion = spine of scapular, lateral 3rd of clavicle, acromion

Action = elevation of shoulders (test = shrug against resistance)

Innervation = accessory N

Question 6

What is torticollis?

Answer 6

Distonic condition defined by asymmetrical head position

Distonic = abnormally contracting of its own accord

Question 7

What are the triangles of the neck?

Answer 7

Anterior triangle

posterior triangle

carotid

Question 8

What are the borders of the anterior triangle?

Answer 8

Anterior margin of SCM

Inferior margin of mandible

Midline of neck

Question 9

What are the borders of the posterior triangle?

Answer 9

Anterior margin of trapezius

Clavicle

Posterior margin of SCM

Question 10

What is the hyoid bone?

Answer 10

U shaped bone of the anterior neck

Base of the mandible (C3)

Question 11

Discuss the omohyoid

Answer 11

Infra-hyoid

Runs behind SCM

Runs through posterior triangle

Question 12

Discuss the digastric

Answer 12

Supra-hyoid

2 muscular bellies

Question 13

What are the borders of the carotid triangle?

Answer 13

Lat = Medial border of SCM

Inf = Superior belly of Omohyoid

Sup = Posterior belly of the Digastric

Question 14

What is the contents of the carotid triangle?

Answer 14

Common carotid artery which within bifurcates to external and internal carotid arteries

Internal jugular vein

Hypoglossal N, Vagus N

Question 15

What tissue type of the superficial cervical fascia?

Answer 15

Loose CT

Question 16

What tissue type of the deep cervical facia?

Answer 16

Dense CT

Question 17

What is the contents of the superficial cervical fascia?

Answer 17

Includes fat, platysma, cutaneous nerves, lymph nodes and superficial blood vessels

Question 18

What are the layers of the deep cervical fascia?

Answer 18

Investing layer

Carotid sheath

Pre tracheal fascia

Pre vertebral fascia

Question 19

Label this cross section of the neck

Answer 19

Question 20

What is the retropharyngeal space?

Answer 20

A space between the pretrachel and prevertebral fascial layers

Question 21

What is mediastinitus?

Answer 21

Inflam of tissues in the mediastinum

Can be caused by infections in the retropharyngeal and pre tracheal space extending inferiorly

Question 22

What is the nerve of facial expression?

Answer 22

Facial N (VII CN)

Question 23

What is the nerve of mastication?

Answer 23

Trigeminal (CN V)

Question 24

What is the main sensory N of the face?

Answer 24

Trigeminal N (V CN)

Question 25

What are the 3 branches of the trigeminal N?

Answer 25

Va – ophthalmic division

Vb – maxillary division

Vc – mandibular division

Question 26

What are the 5 key extra-cranial branches of the facial N?

Answer 26

To Zanzibar By Motor Car

Temporal

Zygomatic

Buckle

Mandibular

Cervical

Question 27

Outline the major arteries and veins of the head and neck

Answer 27

Common carotid artery = internal and external carotid artery

Internal jugular vein (IJV) – receives drainage from the facial vein

External jugular vein – receives drainage from the scalp and face

Question 28

Describe the layers of the scalp

Answer 28

SCALP

Skin = hair follicles and sebaceous glands

Dense connective tissue = richly vascularised

Epicranial aponeurosis = connects occipitalis and frontalis muscle

Loose areolar connective tissue = thin

Periosteum = outer layer of skull bones

Question 29

What is the danger area of the scalp and why?

Answer 29

Loose connective tissue

Pus and blood can spread easily within it = pass to cranial cavity via emissary veins = spread from scalp to meninges = meningitis

Question 30

Outline the blood supply of the scalp

Answer 30

Via the external carotid artery and ophthalmic artery (branch of internal carotid)

Superficial temporal = supplies the frontal and temporal regions

Posterior auricular = supplies area superiorly and posteriorly to the auricle

Occipital = supplies back of scalp

Question 31

What is the nervous innervation of the scalp

Answer 31

Trigeminal N

Cervical Ns

Question 32

The investing layer of deep cervical fascia splits to enclose which structures?

Answer 32

Sternocleidomastoid

Submandibular gland

Trapezius

Parotid gland

Question 33

A retropharyngeal abscess is suspected. What complications could occur due to extension of the infection from this deep neck space?

Answer 33

Difficulty breathing due to tracheal compression

Extension of infection into the mediastinum

Painful or difficulty swallowing due to oesphageal compression

Question 34

Where does caratid shealth connect to?

Answer 34

inferiorly fuses with the pericardial sac

superiorly attaches to the base of the skull