Head and neck Flashcards
What is the superior border of the anterior triangle of the neck?
The inferior border of the mandible
What is the medial border of the anterior triangle of the neck?
The midline
What is the lateral border of the anterior triangle of the neck?
The anterior border of sternocleidomastoid
What are the contents of the anterior triangle?
Hyoid bone, supra and infra hyoid muscles, thyroid, larynx, trachea, parathyroid glands, common carotid and branches, internal jugular, vagus and recurrent laryngeal nerves.
What is the anterior border of the posterior triangle of the neck?
The inferior border of the strenocleidomastoid
What is the inferior border of the posterior triangle of the neck?
The middle third of the clavicle
What is the posterior border of the posterior triangle of the neck?
The anterior margin of trapezius
What is the apex of the posterior triangle of the neck?
The occipital bone (just behind the mastoid process)
What does the posterior triangle of the neck contain?
The levator scapulae, the scalene muscles, subclavian vein and artery, external jugular and vertebral veins, brachial plexus, accessory nerve
what are the 4 infrahyoid muscles?
sternohyoid, omohyoid, thyrohyoid and sternothyroid muscles
What is the superior border of the infratemporal fossa?
inferior surface of the greater wing of the sphenoid and temporal bone
What is the inferior border of the infratemporal fossa?
medial pterygoid muscle
What is the anterior border of the infratemporal fossa?
The posterior surface of the maxilla
What is the lateral border of the infratemporal fossa?
The medial border of the mandible
What is the medial border of the infratemporal fossa?
The lateral plate of the pterygoid process laterally and the pharynx and muscle of the soft palate
What is the posterior border of the infratemporal fossa?
The upper part of the carotid sheath and the styloid and condylar processes
Where is the sphenoethmoidal recess found?
Above the superior concha
What passes through the anterior compartment of the jugular foramen?
The inferior petrosal sinus
What passes through the intermediate compartment of the jugular foramen?
The glosspharyngeal IX, Vagus X and accessory nerves XI
What passes through the posterior compartment of the jugular foramen?
he posterior transmits the sigmoid sinus, which joins with the inferior petrosal to form the jugular vein within the foramen.
What passes through the foramen ovale? (4)
Mandibular nerve
Motor root of trigeminal nerve
Accessory meningeal artery
Lesser petrosal nerve
What does the inferior division of the oculomotor nerve supply?
The inferior and medial oblique and the inferior oblique
What is the action of the inferior rectus?
Depresses the globe
What is the action of the medial rectus?
Adducts the globe
What is the action of the inferior oblique?
Extorts and elevates the globe
Where is the nucleus of the vestibulococchlear nerve found?
The vestibulocochlear nuclei lie in the junction between the pons and medulla below the floor of the lateral angle of the fourth ventricle.
Which nerve supplies the inner mucosal membrane of the tympanic membrane?
Glossopharyngeal nerve
What is the nerve supply of the outer mental surface of the tympanic membrane?
the auriculotemporal, supplemented by the facial and vagus nerves
Bitemporal haemianopia is consistent with a lesion of which part of the optic tract?
The optic chiasm
Homonymous hemianopia is consistent with a lesion of which part of the optic tract?
The optic tract
Homonymous quadrantanopia is consistent with a lesion of which part of the optic tract?
The optic radiation
Macular sparing hemianopia is consistent with a lesion where?
Anterior visual cortex lesion
Hemianopia with peripheral sparing is consistent with a lesion where?
Posterior visual cortex
Which nerve supplies stylopharyngeus?
Glossopharyngeal IX
Which of the pharynx muscles is not supplied by the Vagus nerve (X)?
The stylopharyngeus
The pterion is a junction of which skull bones?
The frontal, sphenoid, temporal and parietal
Which is the only nerve to emerge from the pons?
The trigeminal
Which nerves emerge from the pontomedullary junction?
The abducens (VI), facial (VII) and vestibulococchlear (VIII)
Which laryngeal muscle does the superior laryngeal nerve supply?
The cricothyroid
What are the contents of the infratemporal fossa?
sphenomandibular ligament, temporalis, medial and lateral pterygoid muscles, the maxillary artery and pterygoid venous plexus, the mandibular nerve, branches of the facial nerve, the glossopharyngeal nerve and the otic ganglion
The nasopharynx has sensory supply from which cranial nerve?
The maxillary branch of the trigeminal nerve (V2)
Which nerves pass through the tendinous ring in the superior orbital fissure?
optic, oculomotor, abducent and nasociliary
Which nerves pass through the superior orbital fissure but outside the tendinous ring?
lacrimal, frontal and trochlear nerves
What are the contents of the submental triangle of the neck?
Anterior jugular vein, lymph nodes
What are the boundaries of the submental triangle of the neck?
Anterior belly of digastric, body of hyoid bone, midline
What are the boundaries of the digastric triangle?
Mandible, anterior and posterior bellies of digastric
What are the contents of the digastric triangle?
Submandibular gland and lymph nodes, submental and mylohyoid vessels, hypoglossal and mylohyoid nerves
What are the boundaries of the muscular triangle of the neck?
Sternocleidomastoid, superior belly of omohyoid, midline from hyoid bone to jugular notch
What are the contents of the muscular triangle of the neck?
Part of larynx and thyoroid gland; lymph nodes
What are the contents of the posterior triangle of the neck?
Occipital. transverse cervical, suprascapular and subclavian arteries; transverse cervical, suprascapular and external jugular veins; cervical plexus branches and brachial plexus trunks; omohyoid; lymph nodes
What are the boundaries of the carotid triangle of the neck?
Sternocleidomastoid, posterior belly of digastric, superior belly of omohyoid
What are the contents of the carotid triangle of the neck?
bifurcation of common carotid artery and branches of external carotid (except posterior auricular); hypoglossal, internal and external laryngeal nerves; lymph nodes.
Which nerve travels through the cavernous sinus?
Abducens nerve (VI)
Which nerves travel in the lateral wall of the cavernous sinus?
ophtalmic, trochlear, oculomotor and maxillary
Which cranial nerves emerge from the mesencephalon (midbrain)?
III and IV
What is the only nerve to emerge from the posterior midbrain?
The trochlear (IV)
Where would the CN III be compressed in a case of raised ICP?
Petrous temporal bone
Which nerve emerges between the pons and the olive?
CN VII facial nerve
Which nerves emerge lateral to the olive?
The glossopharyngeal (IX), vagus (X) and accessory (XI)
Which nerve emerges from between the pyramid and the olive?
The hypoglossal (XII)
Which three structures lie deep to hyoglossus?
glossopharyngeal nerve, lingual artery, stylohyoid ligament
Which three structures lie superficial to hyoglossus?
hypoglossal nerve, lingual nerve, submandibular duct
What are the layers of the scalp?
Skin Connective Tissue Aponeurosis Loose connective tissue Pericranium
What is the danger area of the scalp?
The fourth layer (loose connective tissue) emissary veins that go into the cranial cavity can track infection down into the cranium
What is the cutaneous innervation of the posterior scalp?
The greater and lesser occipital nerves
What is the cutaneous innervation of the anterior scalp?
Supraorbital and supratrochlear nerves
What is the cutaneous innervation of the lateral scalp?
The auriculotemporal nerve (CNV3) and the zygomaticotemporal nerve (CNV2)
What is the arterial supply of the scalp?
Branches from the internal and external carotid arteries-
External- occipital, posterior auricular and superficial temporal artery
Internal- supraorbital and supratrochlear arteries
What does the optic canal contain?
Optic nerve (CNII) and ophthalmic artery (from internal carotid, supplies orbit)
What goes through the superior orbital fissure?
Live Frankly To See Absolutely No Insult Lacrimal nerve Frontal nerve Trochlear nerve Superior division of oculomotor nerve Abducens nerve Nasociliary nerve Inferior division of oculomotor nerve
What goes through the inferior orbital fissure?
Inferior ophthalmic vein, CNV2 (infra orbital nerve), infra orbital artery and vein
What goes through the infraorbital foramen?
Inferior orbital nerve and artery
What goes through the mental foramen?
The mental nerve (CNV3)
Why is the pterion clinically significant?
The middle meningeal artery is directly under it. This can cause epidural haematoma
Where is the origin of the masseter?
The zygomatic arch
What goes through the cribriform foramem?
The branches of the olfactory nerve that then go on to synapse in the olfactory nerve in the cranium directly above
What is the importance of the crista galli?
Attachment of the flax cerebri
What goes through the foramen spinosum?
The middle meningeal artery that goes on to supply the dura mater
What goes through the foramen magnum?
The spinal cord and the vertebral arteries
What goes through the incisive foramen?
The incisive nerve and artery that supply the anterior part of the hard palate
What goes through the incisive foramen?
The incisive nerve and artery that supply the anterior part of the hard palate
Which pharyngeal arch do the muscles of mastication come from?
From the first pharyngeal arch
Which nerve supplies all the muscles of mastication?
Mandibular division of the trigeminal nerve (V3)
What is the origin of the lateral pterygoid muscle?
Upper: infratemporal surface of sphenoid
Lower: lateral surface of lateral pterygoid plate
What is the insertion of the lateral pterygoid?
Pterygoid fossa below the head of mandible, disc and capsule of TMJ
What is the action of the lateral pterygoid?
Protrudes jaw and opens mouth
What is the origin of the medial pterygoid?
Deep: medial side of lateral pterygoid plate and the fossa between the plates
Superficial: smaller. Tuberosity of maxilla and pyramidal process of palatine
What is the insertion of the medial pterygoid?
The ramus of the mandible
What is the action of the medial pterygoid?
Pulls mandible up, forwards and medial (ie closes mouth and chews)
What do the pterygoid muscles contain?
They contain venous plexus that connect with veins both inside (cavernous sinus) and outside the skull (facial veins)
All of the muscles of the pharynx bar one are supplied by..?
Pharyngeal plexus (IX, X and sympathetic)
Which muscle of the pharynx is not supplied by the pharyngeal plexus?
Stylopharyngeus
All of the muscles of the palate bar one are supplied by….?
Pharyngeal plexus (IX, X and sympathetic)
Which muscle of the palate is not supplied by the pharyngeal plexus?
Tensor veli palatini
Which nerve supplies tensor veli palatini?
Nerve to medial pterygoid (V3)
All muscles bar one of the tongue are supplied by…?
Hypoglossal (CNXII)
Which muscle of the tongue is not supplied by the hypoglossal?
Palatoglossus
Which nerve supplies palatoglossus?
Pharyngeal plexus (IX, X and sympathetic)
All of the facial muscles + buccinator bar one are supplied by..?
Facial (CNVII)
Which of the facial muscles + buccinator is not supplied by the facial nerve?
Levator palpebrae superioris
Which nerve supplies levator palpebrae superioris?
Occulomotor (III)
All of the muscles of mastication bar one are supplied by ….?
Mandibular division of the trigeminal nerve (V3)
Which of the muscles of mastication is not supplied by the mandibular division of the trigeminal nerve?
Buccinator
Which nerve supplies the buccinator?
The facial nerve (VII)
All the nerves of the larynx bar one are supplied by…?
The recurrent laryngeal nerve
Which nerve of the larynx is not supplied by the recurrent laryngeal nerve?
Cricothyroid
What passes through the greater palatine foramen?
Greater palatine nerve and artery that supply the hard palate
What passes through the lesser palatine foramen?
The lesser palatine nerve that supplies the soft palate
What passes through the petrotympanic fissure?
The chorda tympani nerve
What does the chorda tympani nerve supply?
Taste to anterior part of tongue, parasympathetics to submandibular and sublingual salivary glands
How many layers does the dura mater have?
2, the periosteal and meningeal layer. Mostly fused, but do split in some locations
What is different about the venous sinuses in the brain compared with normal veins?
No tunica media, no valves
What drains into the dural venous sinus?
Emissary veins (drain outer layers of scalp) and cerebral veins (drain brain)
What passes through the cavernous sinus?
The ICA and CN VI
What does the cavernous sinus communicate with?
The pterygoid venous plexus and the facial vein
What passes through the lateral wall of the cavernous sinus?
CN III, CN IV, CN V-1, CN V-2
What is the course of the middle meningeal artery?
It arises from the maxillary artery, traverses the foramen spinosum, courses on the inner surface of the pterion and supplies the dura mater
What is special about the arachnoid mater?
It has arachnoid granulations that project into the dura mater to drain CSF from the subarachnoid space
Where is the subarachnoid space?
Between the arachnoid mater and pia mater
What does the subarachnoid space contain?
CSF and blood vessels
What is the pia mater?
Innermost layer of meninges, intimately connected wtih grey matter, dives down into the sulci, surrouds blood vessels as they dive down into the vein as far as the capillaries
What connects the hyoid bone and the thyroid cartilage?
Thyrohyoid membrane
What pierces the thyrohyoid membrane?
The internal laryngeal nerve and the superior laryngeal vessels
What does the internal laryngeal nerve supply?
The mucous membranes above the vocal cords
What does the external laryngeal nerve supply?
The cricothyroid muscle
What goes through the stylomastoid foramen?
Facial nerve and stylomastoid artery
What artery does the stylomastoid artery arise from?
The posterior auricular artery
What passes into the pharynx above the superior constrictor?
The auditory tube and the levator and tensor muscles of the soft palate
What enters the pharynx between the superior and middle constrictor?
The stylopharyngeus muscle and the glossopharyngeal nerve
What enters the pharynx between the middle and inferior constrictor?
The internal laryngeal nerve and vessels
What enters the pharynx below the inferior constrictor?
The recurrent laryngeal nerve and accompanying vessels.
What are the branches of the maxillary artery?
DAM I AM Piss Drunk But Stupid Drunk I Prefer, Must Phone Alcoholics Anonymous
Deep Auricular Anterior tympanic Inferior alveolar Middle meningeal Accessory meningeal Masseteric Pterygoid Deep Temporal Buccinator Sphenopalatine Descending palatine Infraorbital Posterior suprerior alveolar Middle superior alveolar Pharyngeal Anterior superior alveolar Artery of the pterygoid canal
What does the mandibular branch of the trigeminal nerve innervate for motor?
My Anus Temporarily Meets the Toilet Mylohyoid Anterior belly of digastric Tensor veli palatini Masticatory muscles Tensor tympani
What passes through the superior orbital fissure?
Lazy French Tarts Sit Naked In Anticipation
- Lacrimal
- Frontal
- Trochlear
- Superior division of oculomotor
- Nasociliary
- Inferior division of oculomotor
- Abducens nerve
Branches of external carotid in order? (Some American Ladies Found Our Pyramids Most Satisfactory)
Superior thryoid, ascending pharyngeal, lingual, facial, occipital, posterior auricular, maxillary, superficial temporal
Branches of superior thyroid artery? (I Shall Squeeze Charlie’s Glutes)
Infrahyoid, Superior laryngeal, Sternocleidomastoid, Cricothyroid, Glandular
If you got an abscess in the first mandibular molar would it point to the neck?
No only true of third mandibular molar
What is the main sensory supply to the back of the head?
greater occipital nerve