Head and Neck

Question 1

Name the cranial bones that make up the skull.

Answer 1

parietal (2), occipital, frontal, temporal (2), ethmoid (2) and sphenoid (2)

Question 2

Name the sutures in the skull

Answer 2

Coronal - between frontal and parietal
sagittal - between 2 parietal
lambyoid - between parietal and temporal

Question 3

what are sutures and why are they relevant at birth

Answer 3

fibrous joints, at birth the bones are unfused to allow them to glide over one another during birth

Question 4

What is the pterion?

Answer 4

At the squamous temporal bone, where the middle meningeal artery is very superficial, if trauma occurs here, high chance of rupture resulting in extradural haemorrhage

Question 5

At what level does the common carotid bifurcate?

Answer 5

C4 - internal and external

Question 6

What percentage of brain blood supply does the internal carotid provide, and what other vessels contribute?

Answer 6

80%, the vestibular arteries provide the rest (branch of external)

Question 7

Name the branches of the external carotid artery

Answer 7

ascending pharyngeal, superior thyroid, lingual, facial, occipital, maxillary, superficial temporal, posterior auricular

Question 8

what is the cavernous sinus

Answer 8

a large vein in which several veins from the face drain into, lies near the opic chiasm and eventually drains into the internal jugular vein

Question 9

what structures run through the cavernous sinus

Answer 9

internal carotid artery, CN III, IX, X & XI

Question 10

what veins made up the retromandibular vein

Answer 10

the superficial temporal vein and the facial vein

Question 11

how can infections be passed from the face to internal carotid artery

Answer 11

boils or abcess, get infection into facial vein, this anastomoses with the opthalmic vein which drains into the cavernous sinus. the internal carotid artery runs through the sinus so the infection could get into it

Question 12

what are the divisions of the trigeminal nerve and what do they supply

Answer 12

a - opthalamic, sensory innervation to forehead, supraoribital, lacrimal
b - maxillary, sensory innervation infraorbital, also to all upper teeth via superior, anterior and middle alveolar nerve
c - mandibular, motor to muscles of mastication and sensory to lower teeth, inferior alveolar nerve

Question 13

in which position is the TMJ most stable

Answer 13

when the jaw is elevated and teeth occluded

Question 14

what prevents the jaw from dislocation

Answer 14

the articular tubercle, when the condyle of mandible moves forward, this prevents any further movement

Question 15

why do you need to be careful when manipulating a dislocated jaw back into position?

Answer 15

dislocation causes stretch on the alveolar nerve and vessels, manipulation in the wrong way could cause further damage

Question 16

what ligament is the most important in providing stability to the TMJ

Answer 16

the lateral ligament, which is a thickening of the capsule

Question 17

what divides the neck into the anterior and posterior compartments

Answer 17

the sternocleidomastoid muscle

Question 18

what muscles lie in the anterior compartment of the neck?

Answer 18

anterior belly of digastric, mylohyoid and infrahyoid muscles (Strap muscles)

Question 19

what is the clinical role of the pre-tracheal fascia?

Answer 19

It encloses the thyroid gland, when swallowing, this moves up and then back down, allows you to feel the thyroid gland and check for any swelling

Question 20

what nerves are situated in the anterior neck?

Answer 20

vagus nerve, phrenic nerve and hypoglossal nerve

Question 21

what muscles are found in the posterior triangle and what nerve supplies these?

Answer 21

sternocleidomastoid and trapezius - both supplied by the accessory nerve - CNXII

Question 22

name the 5 terminal branches of the brachial plexus.

Answer 22

axillary, radial, musculocutaneous, median, ulnar

Question 23

How can you decide is facial paralysis is due to a stroke or bell’s palsy?

Answer 23

In a stroke, the forehead is spared, in bell’s palsy it is paralysed

Question 24

What are the two techniques used to remove a tumour from the parotid gland?

Answer 24

need to dissect out the facial nerve first so it is not damaged. Dissected out in anterograde - the main branch found first then other branches dissected out. Retrograde - smaller branches found and then dissected back to main branch

Question 25

What nerves innervate the eye muscles?

Answer 25

CN III - superior and medial rectus, inferior oblique
CN IV - superior oblique
CN VI - lateral rectus

Question 26

Describe innervation of tongue.

Answer 26

Anterior 2/3rds - sensory - trigeminal, taste - facial

Posterior 1/3rd - sensory and taste - glossopharyngeal

Question 27

What nerves innervate the major salivary glands?

Answer 27

Submandibular and Sublingual - facial

Parotid - glossopharyngeal