head and neck Flashcards
1
Q
The extansors and the flexors of the nexk are supplied by which rami in the neck?
A
the extensors are from the posterior rami and the flexors are the anterior rami
2
Q
which spinal level does the accessory nerve come out at and cross the transverse processes of the atlas?
A
C1
3
Q
which cervical level is the hyoid bone?
A
c3
4
Q
at what cervical level does the cervical arteries bifurcate.
A
C4
5
Q
Which vertebral level is the upper border of the thyroid cartilage
A
C4
6
Q
at what vertebral level is the crichoid cartinage located?
A
C6
7
Q
At which cervicallevel does the larynx become the trachea?
A
C6
8
Q
Which vertebral vevel does the vertebral artery enter the trnasverse formaina of the cercical vertebrae?
A
c6
9
Q
When the inferior thyroid artery crossess to enter the thyroid are they anterior or posterior to the sympathetic chain?
A
behind the sympathetic chain.
10
Q
what are the four fascial layers in the neck?
A
prevertebral fascia
investing fascia
carotid sheath
pre tracheal fascia
11
Q
all of the cervical nerve roots lie deep or superficial to the prevertebral fascia?
A
deep
12
Q
Lymph nodes of the posterior triangle and the accessory nerve lie deep or superficial to the pre vertebral fascia?
A
superficial
13
Q
the third part of the subclavian artery is deep or superficial to the prevertebral fascia?
A
deep to it (not the vein)
14
Q
the strap muscles are deep or superficial to the pre-tracheal fascia?
A
superficial
15
Q
the three infrahyoid strap muscles are?
A
sternohyoid
sternothyroid
omohyoid
16
Q
the pretracheal fascia splits to enclose the thyroid true or false?
A
True
17
Q
the pretrachial fascia is adherant to the thyroid in what location?
A
thyroid rings 2 and 4 and as the isthmus. makes the thyroid move on swallowing.
18
Q
inferiorly the pretracheal fascia blends with which two structures?
A
the pericardium and the adventitia of the arch of the aorta
19
Q
what are the three contents of the carotid sheath ?
A
the internal juguar vein, the carotid artery and the last 4 cranial nerves 9 -12
9: gloccopharyngeal
10: vagus
11: accessory
12: hypoglossal
20
Q
what is the superior and inferior margins of the carotid sheath ?
A
superior incluses the base of skull at the carotid canal
inferiorly the vessels fo the aortic arch.
21
Q
what is posterior to the carotid sheath and anterior to the prevertebral fascia?
A
the sympathetic chain (attached to the front of the prevertebral fascia)
22
Q
what are the boundaries of the posterior triangle?
A
sternocleidomastoud, trapezius and clavicle
23
Q
In which anatomical triangle in the neck can the subclavian arteries be found?
A
posterior triangle
24
Q
what are the boundaries of the anterior triangle?
A
SCM, midnight and mandible
25
what three triangles is the anterior triangle subdivided into?
the carotid triangle
the digastric triangle
the submental triangle
26
what creates the borders of the carotid triangle within the anterior triangle?
SCM, posterior belly of dignastric and the superior belly of omohyoid.
27
what are the contents of the carotid triangle?
carotid bifurcation , branches of external carotid (except posterior auricular , hypoglossal, internal and external laryngeal nerves and lymph nodes.
28
what are the boundaries of the digastric triangle?
mandible and anterior and posterior bellies of digastric.
29
what are the contents of the digastric triangle?
submandubular gland and lymph node, facial, submental and myohyoid vessels, hypoglossal and myohyoid nerves.
30
what are the boundaries fo the submental triangle.
anterior belly of digastric, body of hyoid bone and the midline.
31
what are the contents of the submental triangle?
anterior jugular vein and lymph nodes.
32
the cervical plexus emerges from within which two muscles in the neck?
anterior to scalenus medius and cvered by the prevebrebral fascia the SCM is in front of it . It does not lie in the posterior triangle.
33
what are the 4 supra hyoid muscles?
myohyoid then below myohyoid is the anterior belly of digastric and geniohyoid side by side.
the stylohyoid attaches to the far end of the hyoid and up to the stylus process.
34
of the infrahyoid muscles which ones are most superficial?
superior omohyoid and sternohyoid
35
All of the infrahyoid muscles are supplied by the ansa cervicalis except for one. Which one ?
thyrohyoid, C1
36
all of the muscles of the tongue are supplied by which nerve? except for which muscle ?
Hypoglosal
except:
palatoglossus (which is supplied by the pharyngeal plexus)
37
the anterior 2/3 of the tongue is innervated by which sensory nerves?
for common sense and for taste?
1. lingual nerve (from V3)
| 2. cardatympani for taste (from facial)
38
the posterior 1/3 of the tongue is inervated by which nerve for taste?
glossopharyngeal nerve
39
at the back of the tongue at the area of the gag reflex, which nerve would stimulate this reflex?
afferent= glossopharyngeal
efferent = the superior laryngeal nerve (which is a branch of the vagus)
40
what are the 6 muscles of the pharynx?
| the 3 regular ones and the 3 supplemental ones
1. the superior middle and inferior constrictors
| 2. the stylo pharyngeus , the palatopharyngeus, the salpingo pharyngeus.
41
the inferior constructor is made up of 2 muscular parts> what are they called?
thyropharyngeus (most superior)
| and crichopharyngeus
42
the nervous supply for the muscles of the pharynx is ____
with the exception of these two muscles_____ and _____
Which are supplied by ____ and ____
main supply: pharyngeal plexus from vagus
except
stylopharyngeus which is supplied by the glossopharyngeal nerve
crichopharyngeus which is supplied by the recurrent and external laryngeal nerves
43
which location is susceptable for pharayngeal diverticulum?
Killians Dehissence at the inferior part of the pharyngeal constrictor Area of Laimer
44
the inferior thyroid arteries come off which artery?
the thyrocervical trunk off the brachiocephalic.
45
Which 3 nerves and 2 vessels are in the carotid sheath ?
internal carotid artery
internal jugular vein
cranual nerves 9 , 10 and 12
glossopharyngeam, vagal and accessory.
46
what are considered the "pillars " of the palatine tonsil?
the palatopharyngeal arch and the palatoglossal arch (the arch being more anterior)
47
From which membrane can the remnants of the thyroglossal duct persist?
the thyrohyoid membrane
48
there is a formen in the thyrohyoid membrane, which nerve and which artery traverse through here?
Internal branch of superior laryngeal nerve
and
the superior laryngeal artery from superior thyroid artery
49
What is the blood supply to the larynx? above the folds and below the folds.
above the folds is the superior laryngeal branch of the superior thyroid artery
below the folds inferior laryngeal branch of the inferior thyroid artery
50
all of the muscles of the Larynx are innervated by the recurrent laryngeal nerve except ___ which is innervated by ___
crichothyroid
| which is supplied by the external laryngeal nerve (a branch of the superior laryngeal nerve)
51
the recurrent laryngeal nerve devides into anterior and posterior divisions, which is motor and which is sensory?
Anterior - motor
and
posterior - sensory
52
if the external laryngeal nerve is damaged or paralysed which pitch can you no longer sing?
high pitch
53
the superior laryngeal nerve divides into which branches?
The internal and external layrngeal nerve
54
the inferior laryngeal nerve divides into which two branches?
Anterior and posterior (from recurrent laryngeal nerve)
55
what is an anomalous right inferior laryngeal nerve (not recurrent) associated with?
an anomalous right subclavian artery which moves around retro esophageally
56
regarding the occulomotor nerve
| what is the difference between palsy and and division of the sympathetic chain ?
palsy = complete ptosis
| division of the sympathetic chain - partial ptosis.
57
```
list the nerve which innervates each of these eye muscles.
superior rectus
lateral rectus
medial rectus
superior oblique
inferior oblique
```
```
superior rectus: CN 3
lateral rectus: abducens
medial rectus: CN 3
superior oblique : trochlear nerve
inferior oblique : CN3
```
58
All lymph nodes in the head and neck drain into which region?
the deep cervical lymph nodes
59
the efferents from the deep cervical lymph nodes form ___ bilaterally?
the jugular trunks
60
On the right side of the body the jugular trunk drains into the ____?
right lymphatic duct which empties into the right brachiocephalic vein
61
the left jugular trunk drains into the ___
thoracic duct which drains into the left jugular vein at the junction of the left subclavian vein.
62
is the recurrent laryngeal nerve infront or behind the pre tracheal facia?
the recurrent laryngeal nerve is always behind the pretracheal fascia
63
at what thyroid level does the recurrent laryngeal nerve devide into anterior and posterior devision ?
at the level of the isthmus
64
is the external laryngeal nerve infront or behind the superior thyroid artery?
behind the artery
65
what other branches does the superiro thyroid artery give off before entering the pretracheal fascia and supplying the superior thyroid?
the sternoclidomastoid branch
and
the superior laryngeal branch
66
which structures does the inferior thyroid artery supply as well as the inferior thryoid?
esophagus
and
lower larynx
67
Which part of the thyroid is derived fromt he 5th pharyngeal pouch?
the C cells only
68
are the lateral lobes of the thyroid infront or behind the infrahyoid strap muscles?
true, they are behind the sternohyoid and the thyrodyoid.
69
as the internal jugular and carotid come out of the base of the skull they are located the carotid calan infront of the jugular foramen. As they traverse inferiorly how does the position of the jugular change?
the jugular vein moves laterally the more inferior it goes.
70
where is the sympathetic trunk located in relation to the cartoid sheath?
posterior to and outside the sheath
71
Which two nerves run between the bifurcation of the internal and external carotid arteries?
The tongue/ pharynx related ones.
pharyngeal branch of vagus and the
glossopharyngeal
72
Which two musclespass between the bifurcation of the internal and external carotid arteries ?
the tongue/ pharynx related ones from the styloid process.
They styloglossus and the
stylopharyngeus
73
Which nerve is behind the carotid artery bifurcation?
the superior laryngeal (branch of the vagus) then it devised into internal and external .
74
the external carotid artery is anterior or posterior to the posterior belly of digastric and stylohyoid?
the external carotid artery is posterior to the two muscles
75
what arteries does the external carotid devide into within the substance of the parotid artery?
the maxillary
| superficial temporal
76
before entering the partoid gland the external coratod artery gives off 6 branches. 3 anterior and 2 posterior and 1 deep. Which are the three anterior branches?
Superior thyroid
lingual
facial
77
before entering the partoid gland the external coratod artery gives off 6 branches. 3 anterior and 2 posterior and 1 deep.
Which are the two posterior branches?
Occipital and posterior auricular
78
before entering the partoid gland the external coratod artery gives off 6 branches. 3 anterior and 2 posterior and 1 deep. Which is the deep branch?
the ascending pahryngeal
79
What is the first tributary to the internal jugular vein within the skull?
the inferior petrosal sinus meetign the sigmoid sinus
80
what are the posterior relations of the jugular vein int he neck?
the cervical plexus on the levator scapulae and the scalenous medius
81
the jugular vein terminates in which location?
between the sternal and clavicular heads of the SCM , where it joins the subclavicular and then runs into brachiocephalic.
82
What emerges from inbetween the anterior and middle scalene?
the brachial and cervical plexus
83
which scalene inserts onto the second rib?
the porterior scalene inserts onto the 2nd rib
| the middle and anterior attach to the 1st rib.
84
the phrenci nerve runs down the lateral surface of the anterior scalene and is plastered down to that muscle by which facia?
the prevertebral fascia
85
discribe the downward path of the phrenic nerve over the anterior scalene.
It runs obliquely
86
the subclavial artery is infront or behind the anterior scalene?
behind
87
the jugular vein runs in front or behind the prevetebral fascia?
in front
| doesnt want to get squished
88
the common carotid artery is anterior or posterior to the inferior thyroid aftery?
common carotid is anterior to the inferior thyroid
89
what is the venous drainage of the thyroid?
Superior and inferior thyroid veins
superior thyroid vein drains into internal jugular or facial vein
inferior thyroid vein drains into the plexus, which lies in the pre tracheal fascia , drain into the pretracheal fascia .
90
the anterior jugular veins are anterior or posterior to the platysma?
they are posterior to the platyma , then descend and peirce the deep fascia in the suprasternal space. Once is has entered the deep fascia it moves laterally behind the SCM to join the external jugular.
91
all of the teeth, lips, anterior tongue and nasal passages lymphatically drain to which area?
Except which teeth? which drain into the _____ area?
The submandibular area
| the first 4 teeth drain into the submental
92
the submandubular gland produces what type of fluid?
mixed mucus and serous.
93
within the parotid gland the external carotid artery divides into which arteries?
the superifical temporal and the maxillary
94
to surgically access the carotid sheath which vein needs to be incised in order to enter the sheath?
the facial vein
95
When surgically entering the carotid artery bifurcation point which nerve do you need to take care not to cut?
the hypoglossal runs over each of them.
96
what are two arteries that the auperior thyroid artery gives off?
an artery to SCM and the superior laryngeal artery
97
what artery is commonly cut during mastoid srugery?
the posterior auricular from the external carotid artery.
98
what nerve innervates the baroreceptors of the carotid sinus?
the baroreceptor branch of the glossopharyngeal nerve . Which medicated blood pressure responses in the medullary area.
99
what is the carotid body and what does it do?
located behind the caoritd artery bifurcation , recoeves small glomeric arteries
chemoreceptors in the glomeric cells
conscerned with respiatory reflexes
100
which part of the jugular foramen does the internal jugular vein come through?
the posterior compartment of the jugular formamen
101
in relation to the scalenenus anterior where does the internal jugular meet the the subclavianvein
they join at the medial border of the scalenous anterius
102
as the phrenic nerves enters the mediastinum does it go in front or behind the subclavian artery?
in front of the subclavian artery
103
as the phrenic nerve inters the mediastinum is it in front or behind the subclavian vein
the phrenic nerves enters the mediastinum behind the subclavian vein and in front of the artery
104
what is the embryonic origin of the glossopharyngel nerve?
the 3rd pharyngeal pouch
105
glossopharyngeal nerve innervates which important muscle for swallowing?
stylopharyngeus
106
the external branch of the superficial laryngeal nerve from the vagus innervates which muscle?
the crichothyroid
The cricothyroid muscle is the only tensor muscle of the larynx aiding with phonation. It is innervated by the superior laryngeal nerve. Its action tilts the thyroid forward to help tense the vocal cords.
107
the left recurrent laryngeal nerve goes down around the arch fo the aorta in what relation to the ligementum arteriosum ?
posterior to the ligamentum arteriosum
108
which nerve crosses the posterior triangle to supply trapesius?
the accessory nerve
109
how many teeth does the adult have?
32
110
What connects the phsrynx to the base of the skull?
the pharyngobasilar fascia
111
What is the name of the muscle in the inferior constrictor which acts like a sphincter and relaxes on swallowing?
crichopharyngeus
112
what is the only known abductor of the vocal cords?
the posterior cricoarytenoid
113
what is the histology of the epiglottis at the tip and at the base ?
the tip is stratified squamous , posterior is pseudostratified columnar
114
damage to but not transection of the recurrent laryngeal nerve could cause what effect to the vocal cords?
the posterior cricoaretenoid is most vulnerable (it is the only abductor of the cords) therefore the cords will be forves into adduction causing a horse voice or if bilaterally cannot breath .
Vs transection which leaves the cords half abducted or half adducted and this results in not being able to speak or cough.
115
the TMJ is an atypical synovial joint, why?
it has no hyaline cartilage
116
Facial nerve passes through petrosal bone from the internal acoustic meatus
To emerge out of which foramen?
the stylomastoid foramen
117
the phrenic nerve enter the thorax in what relation to the vagus nerve?
anterior
118
where does the subclavian vein meet the internal jugular vein ?
medial to the salaenous anterior.
119
the buccinator muscle is not technically a muscle of mastication however it does help get bolus from the vestibule to the teeth.
What is the motor supply and what is its sensory nerve supply?
Motor is buccinator nerve of the facial
| sensory is buccal branch of mandibular.
120
what type of fluid does the parotid gland make?
mainly serous
121
What is the path of the middle minengial artery?
external carotid -> terminal branch in the partoid gland -> makes maxillary artery -> middle menengial
122
the vretebral arteries enter the skull via which foramen?
foramen magnum
123
what arteries arrise from the thyrocervical trunk?
the inferior thyroid -> giving off -> the ascending cervical (supplies the prevertebral muscles)
the transverse vervical -> trap and rhomboid muscles
suprascapular (to supply the shoulder area)
124
what are the three arteries in littles area?
sphenopalatine -> formerly the maxillary but name changed when going through the sphenopalatine formamen
septal branch of the superior labial
ascending branch of greater palatine
these three arteries make the kieselbacks plexus
125
what is the blood supply to the tongue?
the lingual artery
