Head and Neck 2 Flashcards
1
Q
List the muscles of mastication.
A
Temporalis
Medial pterygoid
Lateral pterygoid
Masseter
2
Q
What movements are associated with mastication?
A
Open and close mouth, move side to side, protrude/retrude
3
Q
What is the innervation of the temporalis muscle?
A
Mandibular nerve (V3) of trigeminal nerve (V)
4
Q
What are the actions of the temporalis muscle?
A
Elevates the mandible
Posterior fibres retrude the mandible
5
Q
What is the innervation of the masseter?
A
Mandibular nerve (V3)
6
Q
What is the action of the masseter?
A
Elevates the mandible
7
Q
What is the innervation of the medial pterygoid?
A
Mandibular nerve (V3)
8
Q
What are the actions of the medial pterygoid?
A
Elevation and protrudes mandible
9
Q
How many heads does the lateral pterygoid have?
A
2
10
Q
What is the innervation of the lateral pterygoid?
A
Mandibular nerve (V3)
11
Q
What are the actions of the lateral pterygoid?
A
Protrudes and depresses chin
Only mastication muscle to close mouth!!
12
Q
What connects the two bellies of the digastric muscle?
A
Intermediate tendon
13
Q
What innervates the anterior belly of the digastric muscle?
A
Mylohyoid nerve - branch of the inferior alveolar nerve (V3)
14
Q
What innervates the posterior belly of the digastric muscle?
A
Branch of facial nerve (VII)
15
Q
What is the action of the digastric muscle?
A
Elevates the hyoid bone
With the hyoid bone fixed, depresses the mandible
16
Q
What type of joint is the TMJ and its 2 parts?
A
Synovial joint
Hinge and plane
17
Q
Name the articular surfaces involved in the TMJ.
A
Condyle of mandible
Articular tubercle
Mandibular fossa
18
Q
What does the articular disc do in the TMJ.
A
Divides the joint cavity into superior and inferior compartments
19
Q
Name two other ligaments that connect the mandible to the cranium.
A
Stylomandibular ligament
Sphenomandibular ligament
20
Q
Where is the stylomandibular ligament found?
A
Styloid process to inner surface of mandible
21
Q
Where is the sphenomandibular ligament?
A
Lingula on the medial side of mandible
22
Q
What is the lingula?
A
Sharp edge of ramus of mandible
23
Q
List the movements of the mandible at the TMJ.
A
Depression Elevation Protrusion Retraction Lateral movements
24
Q
List the muscles responsible for the depression of the mandible.
A
Gravity Lateral pterygoid Digastric Geniohyoid Mylohyoid muscles
25
List the muscles responsible for elevation of the mandible.
Temporalis
Masseter
Medial ptyerygoid
26
List the muscles responsible for retraction of the mandible.
Posterior fibres of temporalis
Deep part of masseter
Geniohyoid and digastric
27
List the muscles responsible for protrusion of the mandible.
Lateral pterygoid assisted by medial pterygoid
28
What is the innervation of the sternomastoid?
```
Accessory nerve (XI)
Also innervates trapezius
```
29
What are the actions of the sternomastoid?
Flexes and laterally flexes neck
Rotates it so face is turned superiorly towards the opposite side
Both muscles acting together = draws head forward
30
What is torticollis?
Tumour/tension in the neck muscles
| Laterally flex towards the injured side
31
Where does the external jugular vein begin?
Angle of the mandible by the union
32
Which vein branches make up the external jugular vein?
Retromandibular and posterior auricular veins
33
Where does the external jugular vein cross?
Sternocleidomastoid
34
Which layer of cervical fascia does the external jugular vein pierce?
Investing layer
35
Where does the external jugular vein drain into?
Subclavian veins (behind the clavicle)
36
List the strap (infrahyoid) muscles.
Sternohyoid
Sternothyroid
Thyrohyoid
Omohyoid
37
Where is the sternohyoid muscle found?
```
Superficial
From manubrium (end of clavicle) to body of hyoid bone
```
38
Which is the longest/most medial/most superficial of the strap muscles?
Sternohyoid muscle
39
Where does the sternothyroid muscle lie?
Deep to sternohyoid muscle
| From posterior surface of manubrium to oblique line of thyroid cartilage
40
Where does the thyrohyoid muscle lie?
Above the sternothyroid muscle
| From oblique line of thyroid cartilage to lower border of body and greater horn of the hyoid
41
Where does the omohyoid muscle lie?
Consists of two bellies
Inferior is from the upper border of the scapula, passes forward deep to sternomastoid
Attaches to intermediate tendon which is held in place by a fibrous loop attached to clavicle
Superior belly is attached to hyoid
42
Name the scalene muscles of the neck.
Scalenus anterior
Scalenus medius
Scalenus posterior
43
Where does the scalenus anterior attach?
From transverse processes of cervical vertebrae to anterior part of first rib
44
What is the action of the scalenus anterior?
Flexes the neck forwards and laterally
| Elevates the first rib during forced inspiration
45
Where does the scalenus medius attach?
From transverse processes of cervical vertebrae to posterior aspect of first rib
46
Where does the scalenus posterior attach?
From transverse processes of lower cervical vertebrae to second rib
47
What is the other function of the scalene muscles?
Act as accessory inspiratory muscles to increase the size of the thoracic cavity
48
What is the function of the deep fascia of the neck?
Consists of layers which divide the neck into compartments and limits the spread of abscesses
49
Name the layers of deep fascia.
Investing layer
Pretracheal layer
Prevertebral layer
50
What lies in the investing layer of deep fascia?
SCM and trapezius muscle
51
What area is the pretracheal deep fasica layer limited to?
Anterior part of the neck
52
What does the pretracheal layer enclose?
Trachea, oesophagus, thyroid gland
53
What does the prevertebral layer form a sheath for?
Vertebral column and the muscles associated with it
54
What does the prevertebral fascia enclose?
Phrenic nerve
| Sympathetic chain ganglia
55
What is the carotid sheath?
Tube of fascia that extends from the base of the skull to the root of the neck
56
What does the carotid sheath contain?
Internal jugular vein
Common carotid artery
Internal carotid artery
Vagus nerve
57
Name the three types of lymph nodes.
Circular
Superficial
Deep
58
List examples of circular lymph nodes.
```
Occipital
Retromandibular
Parotid
Buccal
Submental
Submandibular
```
59
Where do the superficial lymph nodes lie?
Along the external jugular vein
60
Where do the deep cervical lymph nodes lie?
Internal jugular vein
61
Name two deep cervical lymph nodes.
Jugulodiagastric
| Jugulo-omohyoid
62
What do the lymph nodes drain into?
Eventually the deep lymph nodes drain into the right and left jugular trunks
63
Where do the lymph vessels of the forehead and anterior face drain into?
Submandibular lymph nodes, located along the inferior border of the mandible
64
Where does the lateral part of the face drain?
Into parotid nodes
65
Where does the central part of the lower lip and chin drain?
Submental nodes
66
Where does all the lymph from the head and neck drain?
Into the deep cervical lymph nodes which form a chain along the internal jugular vein
67
Where does the right jugular trunk drain?
Right lymphatic duct
68
Where does the left jugular trunk drain?
Thoracic duct
69
Where does the thoracic duct and right lymphatic duct carry lymph into the venous system?
At the junction of the internal jugular and subclavian veins
70
What does the right lymphatic duct drain?
Drains the right upper body
71
What does the thoracic duct drain?
Lymph from the rest of the body - both lower limbs and left upper quadrant
72
Where is the temporal fossa found?
Area superior to zygomatic arch
73
Where is the infratemporal fossa found?
Inferior and deep to the arch
74
What is the lateral wall of the infratemporal fossa?
Ramus of the mandible
75
What does the infratemporal fossa contain?
Two muscles of mastication - lateral and medial pterygoid
Mandibular division of CN V
Maxillary artery (a terminal branch of ECA, bigger branch)
76
What is the nerve supply of the masseter?
Masseteric nerve of V3
77
What is the inferior alveolar nerve a branch of?
V3
78
Which foramen does the inferior alveolar nerve enter?
Mandibular foramen
79
Which nerve emerges between the 2 heads of the lateral pterygoid muscle?
Buccal nerve
80
What is the principle action of the masseter muscle?
Elevates (and protrudes) the mandible
81
What is the innervation of the masseter?
Branch from anterior trunk of mandibular nerve (V3)
82
In the event of dislocation of the TMJ, in which direction would you expect the head of the mandible to move?
Pass anterior to articular tubercle (eminence)
83
In the dislocation of the TMJ, will the mouth be open or closed?
Open wide
84
What are the muscles that close the jaw?
| Temporalis, buccinator, medial pterygoid, lateral pterygoid, mylohyoid
Temporalis and medial pterygoid
85
Chorda tympani is a branch of which cranial nerve?
Facial nerve (VII)
86
Which part of the tongue does the chorda tympani carry taste sensation from?
Anterior 2/3rds of tongue
87
What is the nerve which supplies general sensation to the anterior 2/3rds of the tongue and which division of the trigeminal nerve is it a branch of?
Lingual nerve - branch of mandibular division (V3)
88
Which division of the trigeminal nerve has a motor component?
Mandibular (V3)
89
Explain why injury to the mandibular nerve does not cause paralysis of the whole digastric muscle?
The motor supply of the posterior belly of digastric is supplied by the facial nerve.
Only the anterior belly is supplied by the mandibular nerve.
90
What are the principle actions of the sternocleidomastoid, trapezius and strap muscles?
Sternocleidomastoid - acting alone, tilt the head on its own side and rotate so that the face is turned towards the opposite side, both muscles act to flex the neck
Trapezius: elevates, rotates, retracts scapula
Sternohyoid: depresses hyoid bone
Sternothyroid: depresses hyoid and larynx
Omohyoid: depresses hyoid
Thyrohyoid: depresses hyoid and elevates larynx
91
How do sternomastoid and scalenus anterior contribute to respiration?
Raise sternum and rib during forced inspiration
92
Where does cancer of the central part of the lower lip spread to?
Submental lymph nodes
93
Name the group of lymph nodes:
- upper lip and lateral part of lower lip pass into
- medial part of the lower lip
Submandibular nodes
| Submental nodes
94
What are the contents of the carotid sheath?
Common carotid artery
Internal carotid artery
Internal jugular vein
Vagus chain
95
Name the muscle that separates the anterior and posterior triangles of the neck.
Sternocleidomastoid
96
A muscle that elevates and retracts the mandible
Temporalis
97
What is attached to the articular disc of the TMJ?
Lateral pterygoid
98
Motor innervation to the medial pterygoid
Mandibular nerve
