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Anatomy > H&N Fascia & Musculature > Flashcards

H&N Fascia & Musculature Flashcards

1
Q

S.C.A.L.P. layers

A

Skin

Connective tissue

Aponeurosis

Loose areolar tissue

Pericranium

{Skin, connective tissue, and aponeurosis are the first three layers that are intimately connected and move as a unit}

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2
Q

Skin

A

thin layer containing hair follicles, and sweat and sebaceous glands

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3
Q

Connective tissue

A

thick, dense, and richly vascular subcutaneous layer with cutaneous nerves

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4
Q

Aponeurosis

A

flat, broad, strong tendon that serves as muscle attachment

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5
Q

Loose areolar tissue

A

sponge-like, allows free movement of above 3 layers. May swell due to infection or injury

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6
Q

Pericranium

A

dense layer of connective tissue forming the outer membrane of cranium (periosteum)

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7
Q

What are the layers of the neck?

A

skin

platysma

superficial fascia

deep fascia

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8
Q

Platysma

A

broad, thin sheet of muscle. Covers anterolateral part of neck. External jugular vein and main cutaneous nerves of neck are deep to the platysma; mm men use to shave

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9
Q

Superficial fascia

A

layer of fatty subcutaneous tissue surrounding the whole neck. Located between skin and investing layer of deep cervical fascia

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10
Q

Deep fascia

A
  • Allow separation of tissue during surgery, and limit spread of infection.
  • Permit sliding of structures pass over one another without difficulty
  • several layers that compartmentalize structures in the neck:
    • Investing; surrounding whole neck in red
    • Pretracheal;
    • Prevertebral spinal cord and mm
    • Carotid sheath anterior portion, where the trachea, esophagus, major vessels (vagus nerve and carotid)
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11
Q

Investing?

attachments?

A

Investing: encircles the entire neck deep to superficial fascia

  • Superior attachment
  • Superior nuchal line of the OB
  • Mastoid process of the TB
  • Zygomatic arches
  • Inferior border of mandible
  • Hyoid bone
  • Spinous process of cervical vertebrae
  • Inferior attachment
  • Manubrium
  • Clavicles
  • Acromions and spines of scapula
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12
Q

Pretracheal

A

Pretracheal: surrounds structures in the anterior part of neck

  • Attachments: extends from hyoid bone to thorax, where it blends with pericardium
  • Muscular part: encloses infrahyoid muscles
  • Visceral part: encloses thyroid gland, trachea, esophagus, and pharynx
  • Buccopharyngeal fascia: posterior continuation of visceral part of pretracheal layer; little portion in green on figure
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13
Q

Prevertebral

A

surrounds vertebral column and associated muscles

  • Attachments: extends from cranial base superiorly and blend inferiorly to the endothoracic fascia, communicating with the mediastinum
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14
Q

Carotid sheath

A

surrounds common and internal carotid aa., internal jugular v., and vagus n. (CN X); seen in brown in fig. below

  • Attachments: extends from cranial base to root of neck, where it communicates with the mediastinum
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15
Q

layers that contribute to the formation of the carotid sheath?

A

Investing, pretracheal, and prevertebral layers contribute to the formation of the carotid sheath

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16
Q

Alar fascia

A

thin layer of fascia

  • Attachments: extends from cranial base to root of neck
  • Attached at the midline to buccopharyngeal fascia and laterally to carotid sheath
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17
Q

Retropharyngeal space

A

interfascial space between pretracheal (anteriorly), prevertebral (posteriorly), and carotid sheaths (laterally); area in black box

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18
Q

general characteristis of mm of facial expression

A
  • Located in subcutaneous tissue of scalp, face, and neck
  • Move skin and change facial expression to convey mood
  • Attachment originates from deep fascia and bone and insert on skin
  • Innervation by the facial nerve (CN VII)
  • Muscles
    • Scalp and forehead
    • Mouth, lips, and cheeks
    • Eyes, ear, and nose
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19
Q

what is the major MOTOR nerve to the head

A

Facial nerve (CN VII)

makes the mm move

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20
Q

mm of forehead & scalp

A

frontalis

occipitalis

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21
Q

frontalis

A
  • Attachment: skin of eyebrows and root of nose
  • Function: elevates eyebrow and wrinkles forehead
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22
Q

Occipitalis

A
  • Attachment: the lateral 2/3rds of the superior nuchal line
  • Function: draws scalp back and wrinkles back of head
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23
Q

frontalis and occipitalis is connected by?

A

galea APONEUROTICA

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24
Q

Muscles of mouth, lips, and cheeks

A
  • Levator labii superioris
  • Zygomaticus major
  • Depressor anguli oris
  • Depressor labii inferioris
  • Platysma
  • Levator anguli oris
  • buccinator
  • orbicularis oris
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25
Q

Levator labii superioris

A
  • A: from infraorbital margin to skin of upper lip
  • F: elevates upper lip
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26
Q

Zygomaticus major

A
  • A: zygomatic bone to angle of mouth
  • F: elevates the corner of mouth
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27
Q

Depressor anguli oris

A
  • A: anterolateral base of mandible to angle of mouth
  • F: depresses corner of mouth
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28
Q

Depressor labii inferioris

A
  • A: from mandible to skin of lower lip
  • F: depresses lower lip
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29
Q

Platysma

A
  • A: from fascia and skin over clavicular region to base of mandible, angle of mouth, lower part of face
  • F: depresses mandible, tenses skin of inferior face and neck
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30
Q

Levator anguli oris

A
  • Deep to levator labii superioris m, and accessory muscle to zygomaticus major
  • A: from maxilla (just below infraorbital foramen) to angle of mouth
  • F: elevates corner of the mouth
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31
Q

Buccinator (not involved in mastication)

A
  • Deep to the Masseter. Forms principal substance of cheeks
  • A: anteriorly angle of mouth and posteriorly to mandible, maxilla, and pterygomandibular raphe tendon, a tendinous extension of buccopharyngeal fascia.
  • F: mastication (keeps cheeks taut), smiling
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32
Q

Orbicularis oris

A
  • A: encircles mouth and attaches into upper and lower lips. Oral sphincter
  • F: Articulation and mastication
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33
Q

Muscles of eyes

A

orbicularis oculi

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34
Q

Orbicularis oculi

A
  • A: Circular muscle around orbital margin into eyelids, sphincter of eyes
  • F: Closes orbital opening, encourages flow of tear by helping empty lacrimal sack
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35
Q

muscles of the ear

A
  • Auricularis anterior
  • Auricularis posterior
  • Auricularis superior
    • A: skin of the auricle of ear
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36
Q

muscles of the nose

A

Procerus

nasalis

depressor septi

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37
Q

Procerus

A
  • A: from forehead to skin over bridge of nose
  • F: depresses medial angle of eyebrows (when very serious)
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38
Q

Nasalis

A
  • A: from maxilla to bridge and alar cartilage of nose
  • F: Widen nasal aperture
39
Q

Depressor septi

A
  • A: from incisive fossa of maxilla to nasal septum
  • F: Depresses and widen nasal aperture
40
Q

muscles of mastication (4)

A

temporalis

masseter

medial pterygoid

lateral pterygoid

41
Q

all muscles of mastication is innervated by:

A

CN V3

the mandibular branch of the trigeminal nerve

42
Q

Temporalis

A
  • Occupies temporal fossa
  • A: from temporal fossa to coronoid process of mandible
  • F: elevation, retraction, lateral excursion of mandible
43
Q

Masseter (superficial to the buccinator)

A
  • Very strong, thick muscle
  • A: zygomatic arch to lateral surface of ramus and angle of mandible
  • F: elevation, and protraction of mandible, clenches teeth
44
Q

Medial pterygoid

A
  • Located in the infratemporal fossa.
  • A: from lateral pterygoid plate and maxillary tuberosity to medial (or internal) surface of ramus and angle of mandible
  • F: elevation, protraction, and lateral excursion of mandible. Synergistic with masseter m.
45
Q

Lateral pterygoid

A
  • Deep in the temporal fossa. Short, strong, and runs horizontally
  • A: lateral pterygoid plate and greater wing of sphenoid to neck of mandible and penetrating the TMJ capsule inserts on the articular disc
  • F: depression, protraction, and lateral excursion of mandible
46
Q

muscles of the neck

A
  • sternocleidomastoid (SCM)
  • Suprahyoid mm:
    • Digastric (two bellies)
    • Mylohyoid
    • Geniohyoid
  • Infrahyoid mm:
    • Omohyoid (“omo” shoulder)
    • Sternohyoid
    • Sternothyroid
    • Thyrohyoid (voice production)
  • Prevertebral mm:
    • Anterior scalene
    • Middle scalene
    • Posterior scalene
    • Longus capitis
    • Longus colli
  • Posterior cervical mm:
    • Trapezius
    • Splenius capitis
    • Splenius cervicis
    • Semispinalis capitis
  • Suboccipital mm & triangle:
    • Rectus capitis posterior major
    • Rectus capitis posterior minor
    • Obliquus capitis superior
    • Suboccipital triangle
47
Q

Sternocleidomastoid (SCM)

A
  • Bisects the neck diagonally
  • A: from mastoid process and lateral 1/2 of superior nuchal line to manubrium of sternum and medial 1/3rd of clavicle
  • F: Unilaterally-rotating head to left and right; Bilaterally-flexes neck
  • I: accesory nerve (CN XI)
  • Clinical relevance: unilateral contraction used to test integrity of SCM and accessory nerve (CN XI)
48
Q

CN XI

innervates?

A

accessory nerve

  • innervates ONLY two muscles:

trapezius

sternocleidomastoid

49
Q

Suprahyoid mm

A

digastric (two bellies)

mylohyoid

geniohyoid

50
Q

Digastric (two bellies)

A
  • A: mandible and mastoid process of TB. Both bellies attach to intermediate tendon, which is tied down to the hyoid bone by a sling of fascia
  • F: Depress mandible, open mouth, and elevate hyoid bone
  • I: Posterior belly—facial nerve (CN VII) Anterior belly—trigeminal nerve (CN V)
51
Q

Posterior belly of the digatric mm

innervation

A

facial nerve (CN VII)

52
Q

Anterior belly of the digastric mm

innervation?

A

trigemical nerve (CN V)

53
Q

Mylohyoid

A
  • A: medial surface of mandible to hyoid bone
  • F: elevates hyoid, floor of mouth, and tongue during swallowing and speaking
  • I: trigeminal nerve (CN V)
54
Q

Geniohyoid

A
  • A: from genio (or bend) of mandible to hyoid bone
  • F: elevate hyoid, shortens floor of mouth
  • I: C1 via hypoglossal nerve (CN XII)
55
Q

Infrahyoid muscles

A
  • Omohyoid (S) (“omo” shoulder)
  • Sternohyoid (S)
  • Sternothyroid (D)
  • Thyrohyoid (D)

(S) superficial

(D) deep

56
Q

Omohyoid (S) (“omo” shoulder)

A
  • A: superior border of scapula and hyoid bone Both bellies attached to intermediate tendon, which is tied down to clavicle by sling of fascia
  • F: Depress, retracts, and steadies hyoid
  • I: Ansa cervicalis (cervical loop)
57
Q

Sternohyoid (S)

A
  • A: from manubrium of sternum and medial end of clavicle to hyoid
  • F: Depress hyoid bone after elevation during swallowing
  • I: Ansa cervicalis
58
Q

Sternothyroid (D)

A
  • A: from manubrium of sternum to thyroid cartilage of larynx
  • F: Depress hyoid and larynx
  • I: Ansa cervicalis (cervical loop)
59
Q

Thyrohyoid (D)

A
  • voice production
  • A: from thyroid cartilage of larynx to hyoid bone
  • F: Depress hyoid bone and elevate larynx
  • I: C1 via hypoglossal nerve (CN XII)
60
Q

Prevertebral mm

A
  • LOCATION: deep to prevertebral fascia and posterior to retropharyngeal space.
  • anterior scalene
  • middle scalene
  • posterior scalene
  • longus capitis
  • longus colli
61
Q

Anterior Scalene

A
  • A: from transverse process of C3 – C6 to 1st rib
  • F: flex neck, and elevates 1st rib
  • I: Cervical spinal nerves C4 – C6
62
Q

Middle Scalene

A
  • A: from posterior tubercle of transverse process of C5 – C7 to 1st rib
  • F: flex neck laterally, and elevates 1st rib
  • I: Anterior rami of cervical spinal nerves
63
Q

Posterior Scalene

A
  • A: from posterior tubercle of transverse process of C5 – C7 to 2nd rib
  • F: flex neck laterally, and elevates 2nd rib
  • I: Anterior rami of spinal nerves C7 – C8
64
Q

which muscle lies between subclavian artery and vein?

A

anterior scalene

65
Q

what structures run posterior to the anterior mm?

A

brachial plexus

phrenic nerve

subclavian artery

66
Q

only structure that is anterior to the anterior scalene muscle is?

A

the subclavian vein

67
Q

Longus capitis

A
  • A: from basilar part of OB to anterior tubercles of C3 – C6 transverse processes
  • F: Flexion of head
  • I: anterior rami of spinal nerves C1 – C3
68
Q

Longus colli

A
  • A: from anterior tubercle of C1, bodies of C1 – C3, and transverse processes of C3 – C6 to bodies of C5 – T3, and transverse processes of C3 – C5
  • F: flexion of the neck (bilateral) and slight rotation of neck to contralateral side (unilateral)
  • I: Anterior rami of spinal nerves C2 – C6
69
Q

Posterior cervical mm

A
  • trapezius
  • splenius capitis
  • splenius cervicis
  • semispinalis capitis
  • supoccipital mm:
    • rectus capitis posterior major
    • rectus capitis posterior minor
    • obliquus capitis inferior
    • obliquus capitis superior
  • suboccipital triangle:
    • obliquus capitis inferior
    • obliquus capitis superior
    • rectus capitis posterior major
70
Q

Trapezius

A
  • A: medial third of superior nuchal line, nuchal ligament, spinous processes of cervical, thoracic, lumbar and sacral spinous processes to lateral third of clavicle, and acromion and spine of scapula
  • F: elevate retract, and rotate scapula superiorly
  • I: accessory nerve (CN XI)
71
Q

Splenius capitis

A
  • A: from nuchal ligament and spinous processes of C7 – T6 to mastoid process of TB and lateral third of superior nuchal line
  • F: extend H&N (bilaterally), rotate and flex the head to same side
  • I: posterior rami of cervical spinal nerves
72
Q

Splenius cervicis

A
  • A: from nuchal ligament and spinous processes of C7 – T6 to transverse processes of C1 – C4
  • F: extend H&N (bilaterally), rotate and flex the head to same side
  • I: posterior rami of cervical spinal nerves
73
Q

Semispinalis capitis

A
  • A: from transverse processes of C4 – T12 to OB and spinous processes of cervical and thoracic vertebrae
  • F: extend head and neck, and rotate them contralaterally
  • I: posterior rami of spinal nerves
74
Q

suboccipital mm

A

Rectus capitis posterior major

Rectus capitis posterior minor

Obliquus capitis inferior

Obliquus capitis superior

75
Q

Rectus capitis posterior major

A

A: from spinous process of C2 to inferior nuchal line

76
Q

Rectus capitis posterior minor

A

A: from tubercle on posterior arch of Atlas to inferior nuchal line

77
Q

Obliquus capitis inferior

A

A: from spinous process of Axis to lateral mass of Atlas

78
Q

Obliquus capitis superior

A

A: from lateral mass of Atlas to inferior nuchal line

79
Q

Suboccipital triangle

A
  • Boundaries: Obliquus capitis inferior, obliquus capitis superior, and rectus capitis posterior major
  • Contains: vertebral artery and suboccipital nerve
  • Clinical relevance: The vertebral artery is accessed here in order to conduct angiography of the circle of Willis.
  • All muscles in the suboccipital triangle are innervated by the suboccipital nerve (posterior ramus of C1)
80
Q

mm associated to styloid process

A

stylohyoid

styloglossus

stylopharyngeus

81
Q

Stylohyoid

A
  • A: from styloid process to hyoid bone
  • F: elevates and retracts hyoid bone
  • I: facial nerve (CN VII)
82
Q

Styloglossus

A
  • Extrinsic tongue muscle
  • A: from styloid process to tongue
  • F: retract and curls (elevates sides) tongue
  • I: hypoglossal nerve (CN XII)
83
Q

Stylopharyngeus

A
  • A: from styloid process to thyroid cartilage of pharynx
  • F: elevates pharynx
  • I: glossopharyngeal nerve (CN IX)
84
Q

extrinsic tongue mm

A

genioglossus

hyoglossus

styloglossus

85
Q

Genioglossus

A
  • A: from mental spine to dorsum of tongue
  • F: protrudes and depresses tongue
  • I: hypoglossal nerve (CN XII)
86
Q

Hyoglossus

A
  • A: from hyoid bone to inferolateral aspect of tongue
  • F: retrudes and depresses tongue
  • I: hypoglossal nerve (CN XII)
87
Q

anterior cervial region (anterior triangles)

A

submental triangle

submandibular triangle

carotid triangle

muscular triangle

88
Q

Submental triangle

A
  • Area inferior to the chin
  • Boundaries: between R & L anterior belly of digastric m. and body of hyoid
  • Content: submental lymph nodes, small veins joining to form anterior jugular v.
89
Q

Submandibular triangle

A
  • Glandular area
  • Boundaries: between anterior and posterior bellies of digastric and inferior border of mandible
  • Content: submandibular gland, submandibular lymph nodes, hypoglossal nerve (CN XII), mylohyoid nerve, parts of facial artery and vein
90
Q

Carotid triangle

A
  • Vascular area
  • Boundaries: between anterior border of SCM, superior belly of omohyoid, and posterior belly of digastric
  • Content: common carotid artery, internal jugular vein, vagus nerve (CN X), external carotid artery, hypoglossal nerve (CN XII), branches cervical plexus, thyroid gland, larynx, and pharynx
91
Q

Muscular triangle

A
  • Boundaries: anterior border of SCM, superior belly of omohyoid, and median plane of neck
  • Content: infrahyoid muscles, thyroid, and parathyroid glands
92
Q

posterior cervical region (posterior triangles)

A

occipital triangle

omoclavicular (subclavian) triangle

93
Q

Occipital triangle

A
  • Content: part of external jugular vein, posterior branches of cervical plexus, accessory nerve (CN XI), brachial plexus, cervical lymph node
94
Q

Omoclavicular (subclavian) triangle

A

Content: subclavian artery, subclavian vein, and suprascapular artery

Anatomy (10 decks)

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