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GSSE > head and neck > Flashcards

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

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2
Q

which spinal level does the accessory nerve come out at and cross the transverse processes of the atlas?

A

C1

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3
Q

which cervical level is the hyoid bone?

A

c3

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4
Q

at what cervical level does the cervical arteries bifurcate.

A

C4

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5
Q

Which vertebral level is the upper border of the thyroid cartilage

A

C4

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6
Q

at what vertebral level is the crichoid cartinage located?

A

C6

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7
Q

At which cervicallevel does the larynx become the trachea?

A

C6

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8
Q

Which vertebral vevel does the vertebral artery enter the trnasverse formaina of the cercical vertebrae?

A

c6

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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.

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10
Q

what are the four fascial layers in the neck?

A

prevertebral fascia
investing fascia
carotid sheath
pre tracheal fascia

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11
Q

all of the cervical nerve roots lie deep or superficial to the prevertebral fascia?

A

deep

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12
Q

Lymph nodes of the posterior triangle and the accessory nerve lie deep or superficial to the pre vertebral fascia?

A

superficial

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13
Q

the third part of the subclavian artery is deep or superficial to the prevertebral fascia?

A

deep to it (not the vein)

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14
Q

the strap muscles are deep or superficial to the pre-tracheal fascia?

A

superficial

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15
Q

the three infrahyoid strap muscles are?

A

sternohyoid
sternothyroid
omohyoid

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16
Q

the pretracheal fascia splits to enclose the thyroid true or false?

A

True

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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.

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18
Q

inferiorly the pretracheal fascia blends with which two structures?

A

the pericardium and the adventitia of the arch of the aorta

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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

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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.

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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)

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22
Q

what are the boundaries of the posterior triangle?

A

sternocleidomastoud, trapezius and clavicle

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23
Q

In which anatomical triangle in the neck can the subclavian arteries be found?

A

posterior triangle

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24
Q

what are the boundaries of the anterior triangle?

A

SCM, midnight and mandible

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25
Q

what three triangles is the anterior triangle subdivided into?

A

the carotid triangle
the digastric triangle
the submental triangle

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26
Q

what creates the borders of the carotid triangle within the anterior triangle?

A

SCM, posterior belly of dignastric and the superior belly of omohyoid.

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27
Q

what are the contents of the carotid triangle?

A

carotid bifurcation , branches of external carotid (except posterior auricular , hypoglossal, internal and external laryngeal nerves and lymph nodes.

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28
Q

what are the boundaries of the digastric triangle?

A

mandible and anterior and posterior bellies of digastric.

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29
Q

what are the contents of the digastric triangle?

A

submandubular gland and lymph node, facial, submental and myohyoid vessels, hypoglossal and myohyoid nerves.

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30
Q

what are the boundaries fo the submental triangle.

A

anterior belly of digastric, body of hyoid bone and the midline.

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31
Q

what are the contents of the submental triangle?

A

anterior jugular vein and lymph nodes.

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32
Q

the cervical plexus emerges from within which two muscles in the neck?

A

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.

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33
Q

what are the 4 supra hyoid muscles?

A

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.

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34
Q

of the infrahyoid muscles which ones are most superficial?

A

superior omohyoid and sternohyoid

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35
Q

All of the infrahyoid muscles are supplied by the ansa cervicalis except for one. Which one ?

A

thyrohyoid, C1

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36
Q

all of the muscles of the tongue are supplied by which nerve? except for which muscle ?

A

Hypoglosal
except:
palatoglossus (which is supplied by the pharyngeal plexus)

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37
Q

the anterior 2/3 of the tongue is innervated by which sensory nerves?
for common sense and for taste?

A
  1. lingual nerve (from V3)

2. cardatympani for taste (from facial)

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38
Q

the posterior 1/3 of the tongue is inervated by which nerve for taste?

A

glossopharyngeal nerve

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39
Q

at the back of the tongue at the area of the gag reflex, which nerve would stimulate this reflex?

A

afferent= glossopharyngeal

efferent = the superior laryngeal nerve (which is a branch of the vagus)

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40
Q

what are the 6 muscles of the pharynx?

the 3 regular ones and the 3 supplemental ones

A
  1. the superior middle and inferior constrictors

2. the stylo pharyngeus , the palatopharyngeus, the salpingo pharyngeus.

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41
Q

the inferior constructor is made up of 2 muscular parts> what are they called?

A

thyropharyngeus (most superior)

and crichopharyngeus

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42
Q

the nervous supply for the muscles of the pharynx is ____
with the exception of these two muscles_____ and _____
Which are supplied by ____ and ____

A

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

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43
Q

which location is susceptable for pharayngeal diverticulum?

A

Killians Dehissence at the inferior part of the pharyngeal constrictor Area of Laimer

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44
Q

the inferior thyroid arteries come off which artery?

A

the thyrocervical trunk off the brachiocephalic.

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45
Q

Which 3 nerves and 2 vessels are in the carotid sheath ?

A

internal carotid artery
internal jugular vein
cranual nerves 9 , 10 and 12
glossopharyngeam, vagal and accessory.

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46
Q

what are considered the “pillars “ of the palatine tonsil?

A

the palatopharyngeal arch and the palatoglossal arch (the arch being more anterior)

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47
Q

From which membrane can the remnants of the thyroglossal duct persist?

A

the thyrohyoid membrane

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48
Q

there is a formen in the thyrohyoid membrane, which nerve and which artery traverse through here?

A

Internal branch of superior laryngeal nerve
and
the superior laryngeal artery from superior thyroid artery

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49
Q

What is the blood supply to the larynx? above the folds and below the folds.

A

above the folds is the superior laryngeal branch of the superior thyroid artery

below the folds inferior laryngeal branch of the inferior thyroid artery

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50
Q

all of the muscles of the Larynx are innervated by the recurrent laryngeal nerve except ___ which is innervated by ___

A

crichothyroid

which is supplied by the external laryngeal nerve (a branch of the superior laryngeal nerve)

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51
Q

the recurrent laryngeal nerve devides into anterior and posterior divisions, which is motor and which is sensory?

A

Anterior - motor
and
posterior - sensory

52
Q

if the external laryngeal nerve is damaged or paralysed which pitch can you no longer sing?

A

high pitch

53
Q

the superior laryngeal nerve divides into which branches?

A

The internal and external layrngeal nerve

54
Q

the inferior laryngeal nerve divides into which two branches?

A

Anterior and posterior (from recurrent laryngeal nerve)

55
Q

what is an anomalous right inferior laryngeal nerve (not recurrent) associated with?

A

an anomalous right subclavian artery which moves around retro esophageally

56
Q

regarding the occulomotor nerve

what is the difference between palsy and and division of the sympathetic chain ?

A

palsy = complete ptosis

division of the sympathetic chain - partial ptosis.

57
Q 
list the nerve which innervates each of these eye muscles.
superior rectus
lateral rectus
medial rectus
superior oblique 
inferior oblique
A 
superior rectus: CN 3
lateral rectus: abducens
medial rectus: CN 3
superior oblique : trochlear nerve
inferior oblique : CN3
58
Q

All lymph nodes in the head and neck drain into which region?

A

the deep cervical lymph nodes

59
Q

the efferents from the deep cervical lymph nodes form ___ bilaterally?

A

the jugular trunks

60
Q

On the right side of the body the jugular trunk drains into the ____?

A

right lymphatic duct which empties into the right brachiocephalic vein

61
Q

the left jugular trunk drains into the ___

A

thoracic duct which drains into the left jugular vein at the junction of the left subclavian vein.

62
Q

is the recurrent laryngeal nerve infront or behind the pre tracheal facia?

A

the recurrent laryngeal nerve is always behind the pretracheal fascia

63
Q

at what thyroid level does the recurrent laryngeal nerve devide into anterior and posterior devision ?

A

at the level of the isthmus

64
Q

is the external laryngeal nerve infront or behind the superior thyroid artery?

A

behind the artery

65
Q

what other branches does the superiro thyroid artery give off before entering the pretracheal fascia and supplying the superior thyroid?

A

the sternoclidomastoid branch
and
the superior laryngeal branch

66
Q

which structures does the inferior thyroid artery supply as well as the inferior thryoid?

A

esophagus
and
lower larynx

67
Q

Which part of the thyroid is derived fromt he 5th pharyngeal pouch?

A

the C cells only

68
Q

are the lateral lobes of the thyroid infront or behind the infrahyoid strap muscles?

A

true, they are behind the sternohyoid and the thyrodyoid.

69
Q

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?

A

the jugular vein moves laterally the more inferior it goes.

70
Q

where is the sympathetic trunk located in relation to the cartoid sheath?

A

posterior to and outside the sheath

71
Q

Which two nerves run between the bifurcation of the internal and external carotid arteries?

A

The tongue/ pharynx related ones.
pharyngeal branch of vagus and the
glossopharyngeal

72
Q

Which two musclespass between the bifurcation of the internal and external carotid arteries ?

A

the tongue/ pharynx related ones from the styloid process.
They styloglossus and the
stylopharyngeus

73
Q

Which nerve is behind the carotid artery bifurcation?

A

the superior laryngeal (branch of the vagus) then it devised into internal and external .

74
Q

the external carotid artery is anterior or posterior to the posterior belly of digastric and stylohyoid?

A

the external carotid artery is posterior to the two muscles

75
Q

what arteries does the external carotid devide into within the substance of the parotid artery?

A

the maxillary

superficial temporal

76
Q

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?

A

Superior thyroid

lingual

facial

77
Q

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?

A

Occipital and posterior auricular

78
Q

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?

A

the ascending pahryngeal

79
Q

What is the first tributary to the internal jugular vein within the skull?

A

the inferior petrosal sinus meetign the sigmoid sinus

80
Q

what are the posterior relations of the jugular vein int he neck?

A

the cervical plexus on the levator scapulae and the scalenous medius

81
Q

the jugular vein terminates in which location?

A

between the sternal and clavicular heads of the SCM , where it joins the subclavicular and then runs into brachiocephalic.

82
Q

What emerges from inbetween the anterior and middle scalene?

A

the brachial and cervical plexus

83
Q

which scalene inserts onto the second rib?

A

the porterior scalene inserts onto the 2nd rib

the middle and anterior attach to the 1st rib.

84
Q

the phrenci nerve runs down the lateral surface of the anterior scalene and is plastered down to that muscle by which facia?

A

the prevertebral fascia

85
Q

discribe the downward path of the phrenic nerve over the anterior scalene.

A

It runs obliquely

86
Q

the subclavial artery is infront or behind the anterior scalene?

A

behind

87
Q

the jugular vein runs in front or behind the prevetebral fascia?

A

in front

doesnt want to get squished

88
Q

the common carotid artery is anterior or posterior to the inferior thyroid aftery?

A

common carotid is anterior to the inferior thyroid

89
Q

what is the venous drainage of the thyroid?

A

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
Q

the anterior jugular veins are anterior or posterior to the platysma?

A

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
Q

all of the teeth, lips, anterior tongue and nasal passages lymphatically drain to which area?
Except which teeth? which drain into the _____ area?

A

The submandibular area

the first 4 teeth drain into the submental

92
Q

the submandubular gland produces what type of fluid?

A

mixed mucus and serous.

93
Q

within the parotid gland the external carotid artery divides into which arteries?

A

the superifical temporal and the maxillary

94
Q

to surgically access the carotid sheath which vein needs to be incised in order to enter the sheath?

A

the facial vein

95
Q

When surgically entering the carotid artery bifurcation point which nerve do you need to take care not to cut?

A

the hypoglossal runs over each of them.

96
Q

what are two arteries that the auperior thyroid artery gives off?

A

an artery to SCM and the superior laryngeal artery

97
Q

what artery is commonly cut during mastoid srugery?

A

the posterior auricular from the external carotid artery.

98
Q

what nerve innervates the baroreceptors of the carotid sinus?

A

the baroreceptor branch of the glossopharyngeal nerve . Which medicated blood pressure responses in the medullary area.

99
Q

what is the carotid body and what does it do?

A

located behind the caoritd artery bifurcation , recoeves small glomeric arteries
chemoreceptors in the glomeric cells
conscerned with respiatory reflexes

100
Q

which part of the jugular foramen does the internal jugular vein come through?

A

the posterior compartment of the jugular formamen

101
Q

in relation to the scalenenus anterior where does the internal jugular meet the the subclavianvein

A

they join at the medial border of the scalenous anterius

102
Q

as the phrenic nerves enters the mediastinum does it go in front or behind the subclavian artery?

A

in front of the subclavian artery

103
Q

as the phrenic nerve inters the mediastinum is it in front or behind the subclavian vein

A

the phrenic nerves enters the mediastinum behind the subclavian vein and in front of the artery

104
Q

what is the embryonic origin of the glossopharyngel nerve?

A

the 3rd pharyngeal pouch

105
Q

glossopharyngeal nerve innervates which important muscle for swallowing?

A

stylopharyngeus

106
Q

the external branch of the superficial laryngeal nerve from the vagus innervates which muscle?

A

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
Q

the left recurrent laryngeal nerve goes down around the arch fo the aorta in what relation to the ligementum arteriosum ?

A

posterior to the ligamentum arteriosum

108
Q

which nerve crosses the posterior triangle to supply trapesius?

A

the accessory nerve

109
Q

how many teeth does the adult have?

A

32

110
Q

What connects the phsrynx to the base of the skull?

A

the pharyngobasilar fascia

111
Q

What is the name of the muscle in the inferior constrictor which acts like a sphincter and relaxes on swallowing?

A

crichopharyngeus

112
Q

what is the only known abductor of the vocal cords?

A

the posterior cricoarytenoid

113
Q

what is the histology of the epiglottis at the tip and at the base ?

A

the tip is stratified squamous , posterior is pseudostratified columnar

114
Q

damage to but not transection of the recurrent laryngeal nerve could cause what effect to the vocal cords?

A

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
Q

the TMJ is an atypical synovial joint, why?

A

it has no hyaline cartilage

116
Q

Facial nerve passes through petrosal bone from the internal acoustic meatus
To emerge out of which foramen?

A

the stylomastoid foramen

117
Q

the phrenic nerve enter the thorax in what relation to the vagus nerve?

A

anterior

118
Q

where does the subclavian vein meet the internal jugular vein ?

A

medial to the salaenous anterior.

119
Q

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?

A

Motor is buccinator nerve of the facial

sensory is buccal branch of mandibular.

120
Q

what type of fluid does the parotid gland make?

A

mainly serous

121
Q

What is the path of the middle minengial artery?

A

external carotid -> terminal branch in the partoid gland -> makes maxillary artery -> middle menengial

122
Q

the vretebral arteries enter the skull via which foramen?

A

foramen magnum

123
Q

what arteries arrise from the thyrocervical trunk?

A

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
Q

what are the three arteries in littles area?

A

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
Q

what is the blood supply to the tongue?

A

the lingual artery

GSSE (9 decks)

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