Head and Neck Flashcards
Lymphatic drainage of oesophagus?
Upper third to deep cervical lymph nodes, middle third to pre- and para-aortic lymph nodes, lower third to coeliac plexus
The lymphatic drainage of the oesophagus is important surgically and is divided roughly into thirds. Lymph drains to the cervical neck lymph nodes, nodes around the aorta and abdominal lymph nodes in the coeliac plexus. Lymphatic drainage follows the blood supply.
What forms pterion?
Frontal + Parietal + Sphenoid + Temporal
Weak point in the skull
Associated with middle meningeal artery bleeds- extradural bleed
Point where emergency burr hole decompression
What passes through foramen Ovale?
O Otic ganglion- sits under it V V3- mandibular A Accessory meningeal artery L Lesser petrosal nerve E Emissary veins
Where is Whartons duct and Stensen duct?
Whartons- either side of frenulum- submandular
Stensen- upper 2nd molar buccal side-parotid
What is Frey’s syndrome?
Damage to auriculotemporal nerve
Neurovascular supply of the tongue?
Lymphatic drainage?
anterior 2/3 taste- facial nerve
Anterior 2/3 sensation- CN V (lingual branch of mandibular branch)
Posterior 1/3 taste and general sensation- glossopharyngeal nerve
All intrinsic muscles- CN XII
Arterial supply- paired sets lingual arteries from external carotid
Venous supply- dorsal lingual veins
Posterior third tumours of tongue metastasise to bilateral deep cervical nodes
Tip of tongue drains to sub mental nodes-> deep cervical nodes
Mid portion of tongue drains to submandibular nodes-> deep cervical nodes (more central regions may have bilateral deep cervical nodal involvement)
Lymph drainage of the tonsils?
arterial supply is from the tonsillar artery, a branch of the facial artery.
Its veins pierce the constrictor muscle to join the external palatine or facial veins. The external palatine vein is immediately lateral to the tonsil, which may result in haemorrhage during tonsillectomy.
Lymphatic drainage is the jugulodigastric node and the deep cervical nodes.
CSF pathway?
1) lateral ventricles (formed from choroid plexuses in all ventricles)
2) foramen of Munro
3) 3rd Ventricle
4) cerebral Aqueduct
5) 4th Ventricle
6) subarachnoid space by central Foramen of Magendie and lateral foramina of Luschka
7) Arachnoid granulations-> superior sagital sinus
Muscles of mastication
Masseter
Temporalis
Medial and lateral pteryogids
All supplied by CN V3
All muscles supplied by trigeminal?
Muscles of mastication Tensor tympani Tenor veli palatini Mylohyoid Anterior belly Digastric muscle
Muscles supplied by buccal branch of facial nerve?
Zygomaticus minor Elevates upper lip
Buccinator Pulls corner of mouth backward and compresses cheek
Levator anguli oris Pulls angles of mouth upward and toward midline
Orbicularis Closes and tightens lips together
Nasalis Flares nostrils and compresses nostrils
The orbicularis oris has innervation by both the buccal and marginal mandibular branches of the facial nerve.
Lymphatic drainage of the ear?
The lateral surface of the upper half drains to the superficial parotid lymph nodes
The cranial surface of the superior half drains to the mastoid nodes and deep cervical lymph nodes
The lower half and lobule drain into the superficial cervical lymph nodes.
muscles supplied by facial nerve?
muscles of facial expression, posterior belly of the digastric, stylohyoid and stapedius muscles
Contents of jugular foramen?
The jugular foramen may be divided into three compartments:
Anterior compartment transmits the inferior petrosal sinus
Middle compartment transmits cranial nerves IX, X and XI
Posterior compartment transmits the sigmoid sinus
Which thyroid cancer metastasise haematogenously?
Follicular thyroid cancer
Skull is the presenting site in 2-8%
