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Anatomy > Head and neck anatomy > Flashcards

Head and neck anatomy Flashcards

1
Q

What are the 5 muscles of the soft palate?

A
  • levator teni palatini
  • tensor veli palatini
  • musculus uvulae
  • palatoglossus
  • palatopharyngeus
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2
Q

The tensor veli palatini is a muscle of the soft palate; unlike the other four muscles, it does not receive innervation from the vagus nerve (CN X), which nerve innervates it?

A

The medial pterygoid nerve - a branch of the submandibular nerve of the trigeminal nerve (CN V)

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3
Q

What are the major compartments of the head?

A
  • 2 x ears
  • 2 x orbits
  • 2 x nasal cavities
  • 1 x oral cavity
  • cranial cavity
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4
Q

What do we call the posterior openings of the nasal cavities?

A

Choanae

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5
Q

What do we call the anterior openings of the nasal cavities?

A

The nares (nostrils)

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6
Q

Where are the maxillary sinsues found?

A

Below (inferior to) the orbits

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7
Q

What structure(s) separates(s) the oral cavity from the nasal cavities?

A

The hard and soft palate, which collectively make up the palate

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8
Q

What runs through the infratemporal fossa?

A

The mandibular nerve (V3), a division of CN V, the trigeminal nerve

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9
Q

What structure passes through the pterygopalatine fossa?

A

The maxillary nerve (V2), a subdivision of CN V - the trigeminal nerve

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10
Q

The pterygopalatine fossa is a very interesting space, since it can communicate with many other “spaces”. What can this fossa communicate with?

A
  • oral cavity
  • nasal cavities
  • cranial cavity
  • orbits
  • infratemporal fossa
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11
Q

The neck is made up of four major compartments, what are these?

A
  • cervical vertebra (and muscles for posture)
  • visceral compartment (glands i.e. thyroid, parathyroid and thymus)
  • 2 x vascular compartments (big blood vessels + vagus nerve)
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12
Q

What are the characteristics of the cervical vertebra?

A
  • small bodies
  • bifid spinous processes
  • transverse processes that contain a “hole” = foramen transversarium
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13
Q

How many muscles are above the hyoid, and what do we call them?

A

There are 4 muscles above the hyoid, called the suprahyoid muscles and they can be remembered as the DGMS:

  • digastric (ant. and post. belly)
  • geniohyoid
  • mylohyoid
  • stylohyoid
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14
Q

What are the four muscles located below the hyoid bone and what do we call them?

A

The four muscles below the hyoid bone are the infrahyoid muscles and they can be remembered as TOSS:

  • Thyrohyoid
  • Omohyoid
  • Sternohyoid
  • Sternothyroid
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15
Q

Is the hyoid bone found at the same cervical level in adults and children?

A

No. In infants, the hyoid bone is at level C2-C3 and with time it moves down to C4-C5 in adulthood.

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16
Q

What is a sistrunk procedure?

A

A surgical procedure used to remove a thyroglossal duct cyst.

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17
Q

Is the sternothyroid muscle an infra- or supra- hyoid muscle and what nerve innervates it?

A

The sternothyroid muscle is an infrahyoid muscle. It is innervated by the ansa cervicalis (anterior rami of C1-C3)

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17
Q

Is the sternothyroid muscle an infra- or supra- hyoid muscle and what nerve innervates it?

A

The sternothyroid muscle is an infrahyoid muscle. It is innervated by the ansa cervicalis (anterior rami of C1-C3)

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18
Q

The digastric muscle has two bellies - anterior and posterior - with each innervated by a different nerve. Which nerves innervate the digastric muscle?

A

The anterior belly is innervated by the mylohyoid nerve. The posterior belly is innervated by the facial nerve.

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19
Q

Is the omohyoid muscle an infra- or supra- hyoid muscle? Which nerve innervates it?

A

The omohyoid muscle is an infra-hyoid muscle; it is innervated by the the ansa cervicalis (C1-C3)

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20
Q

At what age is the anterior fontanelle closed in a newborn?

A

The anterior fontanelle is closed at ages 12-18 months after birth.

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21
Q

At what age is the posterior fontanelle closed in a newborn?

A

The posterior fontanelle closes 2-3 months after birth.

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22
Q

In some cases, there may be the genesis of anterolateral fontanelles in a newborn between the occipital, frontal and parietal bones. At what age does this close?

A

The anterolateral fontanelles are more rare in children, however, if present they close at 1-2 months after birth.

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23
Q

When do the milk teeth first erupt in a newborn? What is the order of teeth eruption?

A

Approximately 6 months after birth.

  1. 2 lower middle incisors erupt at 6-7 months
  2. 2 upper middle incisors erupt at 8-9 months
  3. 2 upper lateral incisors erupt at 9-10 months
  4. 2 bottom lateral incisors erupt at 11-12 months
  5. 4 x first molars erupt at 12-14 months
  6. 4 canines erupt at 14-20 months
  7. 4 x second molars erupt at 20-24 months
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24
Q

At what age do the permanent teeth erupt?

A

Permanent/secondary teeth in children erupt at 5-6 years of age.

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25
Q

When a child’s milk teeth are replaced by permanent teeth, which teeth are the first to appear?

A

First molars are the first permanent teeth to appear

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26
Q

At what age do the permanent premolars erupt?

A

Permanent premolars erupt at 9-12 years of age

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27
Q

At what age do the permanent second molars appear?

A

The permanent second molars appear at 12-13 years of age

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28
Q

When do the third permanent molars (wisdom teeth) appear?

A

Wisdom teeth appear between 17-25 years of age

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29
Q

When do permanent teeth start to erupt and what is the sequence of eruption?

A

Permanent teeth erupt at ages 5-6. The order is:

  1. First molars (5-6 years old)
  2. Bottom central incisors
  3. Top central incisors
  4. Top lateral incisors
  5. Bottom lateral incisors
  6. Bottom canines
  7. Top canines
  8. Premolars (9-12 years old)
  9. Second molars (12-13 years old)
  10. Third molars (wisdom teeth) (17-25 years old)
30
Q

What is the equation used to work out the number of permanent teeth in a child until they are 12 years old?

A

x = 4n - 20

x - number of permanent teeth
n - age of child, in years

31
Q

What is the equation used to work out the number of milk teeth in a child?

A

x = n - 4

x - number of permanent teeth
n - age of child, in months

32
Q

The spine of a newborn is straight and physiological curvature develops later. When does curvature of the cervical vertebra in a newborn happen?

A

Cervical lordosis happens at 2-3 months of age, when the child starts to hold up their head

33
Q

When does backward curvature (kyphosis) of the thoracic vertebrae happen in a newborn?

A

Thoracic kyphosis starts at 6-7 months, when the child sits independently.

34
Q

At 12+ months, there is curvature of the ______ part of the spine.

A

Lumbar lordosis starts at 12 months

35
Q

What is a major tell-tell sign of rickets in a child?

A

Delayed closure of the anterior and posterior fontanelles. For example, the posterior fontanelle should close the quickest at ca. 2-3 months; a child with rickets will still have a posterior fontanelle by this time.

36
Q

Rickets can cause malformations in the skull, what are some examples?

A
  • square-head due to flat occipital bone, aka caput quadratum
  • olympic forehead (frontal bone protrudes outwards)
  • buttocks-like skull (caput natiforme) - the parietal bones protrude outwards and the saggital suture dips
  • flat back of the head (occipital bone)
  • craniotabes (softening and flatness of occipital bones)
  • saddle-like deformation of head
  • macrocephaly
37
Q

Besides the skull, rickets can also affect the thorax. What changes to the thorax are seen in rickets?

A
  • pigeon chest (pectus carinatum)
  • funnel chest
  • Harrison fissure
  • rachitic rosary
38
Q

What other disturbances can rickets cause to the skeleton?

A
  • ‘rickety thickening’ of ankles and wrists in the epiphyses areas of these bones/ ‘string of pearls’ in the diaphyses of finger phalanxes
  • bow legs (X or O shaped)
  • kyphosis of lumbar region
  • delayed teeth eruption/change in order of teeth eruption
39
Q

What is the Sulkowitch’s test? How does it work?

A

A test used to measure [Ca2+] in urine.

2.5 mL of Sulkowitch’s reagent is added to 5 mL of urine, shaked and left for 30 seconds. The opacity indicates the level of Ca2+ present.

40
Q

What is scoliosis?

A

Scoliosis is lateral curvature of the spine.

41
Q

What is congenital dysplasia of the hip?

A

Congenital dysplasia of the hip is the hypoplasia of the cotyloid cavity, reduction in its depth and inadequate size of the femoral head.

42
Q

What are the clinical signs of congenital hip dysplasia?

A
  1. asymmetry of the thigh, skin folds, visible shortness of one extremity
  2. different level of knee joints
  3. level of abduction of legs
  4. pain upon (too much) abduction of leg(s)
  5. Marksa-Ortolani’s symptom
43
Q

Marksa-Ortolani’s test is used to detect for hip dislocation in a newborn. What is this test and how is it carried out?

A

The Marksa-Ortolani’s test is used to reduce a dislocated hip.

  1. start with the knees at the midline
  2. flex the knees and hips 90 deg. and abduct the legs
  3. Push inwards (posteriorly) - to put the hip back into position and adduct the knees

If a clicking sound is heard, this is the femoral head ‘popping out’ of the acetabulum.

44
Q

At what age can Marksa-Ortolani’s test be positive? When can this test no longer be used?

A

Ortolani’s test may be positive at ages 1-2 months. This test can no longer be used at 3+ months due to soft tissue contracture around the hip area.

45
Q

The Trendelenburgs’ test is used to test hip dislocation in older children (i.e. if it was missed in childhood etc.). How does this test work?

A
  1. The patient is standing on one leg; if the leg they are standing on is the leg with affected hip abductor muscles their trunk will tilt towards the affected side and their pelvis will tilt away from the affected side.
  2. The trunk tilts towards the affected leg to maintain centre of gravity and provide stability to the compromised pelvis.
46
Q

What muscles are involved in hip abduction? What nerve innervates them?

A
  • Gluteus medius
  • Gluteus minimus

Both muscles are innervated by the superior gluteal nerve

47
Q

What does the Trendelenburg sign test for?

A

Integrity of the hip abductor muscles:

  • gluteus minimus
  • gluteus medius
48
Q

What is the function of the hip abductor muscles (the gluteus minimus and gluteus medius)?

A

To maintain balance of the pelvis whe standing on one leg.

49
Q

What increases the likelihood of hip dysplasia in newborns?

A
  • female(s)
  • breech presentation during birth
  • family history of hip dysplasia
50
Q

What are the two major triangles of the neck? What are their borders?

A
  • Anterior cervical triangle
    (bordered by the midline of the neck, mandible and anterior portion of the sternocleidomastoid muscle)
  • Posterior cervical triangle
    (bordered by the posterior portion of the sternocleidomastoid muscle, clavicle and trapezius muscle)
51
Q

The anterior cervical triangle is further divided into four ‘sub’ triangles - three paired and one unpaired, what are the triangles called?

A

3 x paired triangles:

  • carotid triangle
  • muscular triangle
  • submandibular triangle

1 x unpaired triangle:
- submental triangle

52
Q

What are the borders of the submental triangle (a subdivision of the anterior cervical triangle of the neck)?

A

The submental triangle is bordered by both anterior bellies of the digastric muscles and the hyoid body (of the hyoid bone)

53
Q

What is Farabeuff’s triangle bordered by?

A
  • The common facial vein
  • hypoglossal nerve (CN XII)
  • internal jugular vein
54
Q

The submandibular triangle is also a ‘sub-triangle’ of the anterior cervical triangle. What are its borders?

A

The borders of the submandibuar triangle are the anterior and posterior bellies of the digastric muscles and the mandible.

55
Q

Does the internal carotid artery have any branches in the neck? What does the internal carotid artery supply?

A

The internal carotid artery does not have any branches in the neck.

This artery supplies the brain, eyes and orbits

56
Q

At what level of the cervical vertebra(e) does the common carotid artery bifurcate into the external and internal carotid arteries?

A

CIII - CIV

57
Q

What is found between cervical vertebrae CV and CVI?

A

Between CV and CVI, the cricoid cartilage and first ring of the trachea can be palpated

58
Q

What muscle groups are a part of the head? What do they do?

A
  • extraocular muscles (move the eyeball and open upper eyelid)
  • muscles of middle ear (adjust movement of middle ear bones)
  • muscles of facial expression (move face)
  • muscles of mastication (move the jaw - TMJ)
  • muscles of the soft palate (elevate and depress the palate)
  • muscles of the tongue (move and change contour of the tongue)
59
Q

What muscle groups are a part of the neck? What is their function?

A
  • muscles of the pharynx (constrict and elevate the pharynx)
  • muscles of the larynx (alter shape and size of pathway)
  • strap muscles (position the larynx and hyoid bone in the neck)
  • muscles of outer cervical collar (move the head and upper limb)
  • postural muscles in muscular compartment of the neck (position the head and neck)
60
Q

Who coined Lesser’s triangle?

A

German surgeon Ladislaus Leon Lesser (1846-1925)

61
Q

Where is Lesser’s triangle found? What are its borders?

A

Lesser’s triangle is found in the submandibular triangle. It is bordered by the anterior and posterior belly of the digastric muscle and the hypoglossal nerve (CN XII)

62
Q

Lesser’s triangle is also known as the _______ triangle because it contains the _______ artery.

A

Lesser’s triangle AKA the lingual triangle because it contains the lingual artery.

63
Q

Where is the best place to access the lingual artery?

A

Lesser’s triangle/lingual triangle is a good place to access the lingual artery - especially to stop severe bleeding in the oral cavity floor.

64
Q

Who is Pirogov’s triangle named after? Where is it found? What are its borders?

A
  • Pirogov’s triangle is named after Nikolai I. Pirogov (1810-1881)
  • It is found in the submandibular triangle
  • Its borders are the hypoglossal nerve, mylohyoid muscle and the intermediate tendon of the diagstric muscle
65
Q

Who was Beclard’s triangle named after? What are its borders?

A
  • Beclard’s triangle is named after French anatomist Pierre A. Beclard (1785-1825)
  • its borders are the posterior belly of the digastric muscle, major horn of the hyoid bone and the hyoglossus muscle
66
Q

Who is Farabeuf’s triangle named after? Where is Farabeuf’s triangle found? What are its borders?

A
  • Farabeuf’s triangle is named after French surgeon Louis Hubert Farabeuf
  • It is found within the carotid triangle
  • its borders are the internal jugular vein (IJV), hypoglossal nerve and common facial vein
67
Q

The muscular triangle is 1 of the 4 ‘sub’ triangles located within the anterior triangles of the neck, what are its borders?

A

The muscular triangle is bordered by the anterior midline of the neck, the anterior portion of the sternocleidomastoid muscle and the superior belly of the omohyoid muscle

68
Q

The infrahyoid muscles (TOSS) are found where? Remind yourself, what are the names of these muscles?

A

The TOSS muscles are found in the muscular triangle.

  • thyrohyoid
  • omohyoid
  • sternohyoid
  • sternothyroid
69
Q

What are the borders of the submental triangle?

A

The submental triangle is bordered by both anterior bellies of the digastric muscle and the hyoid bone. Its floor comprises the mylohyoid muscle.

70
Q

How many bones does the skull have?

A

The skull has 22 bones:

21 immovable bones
1 movable bones (mandible)

71
Q

What are the paired bones of the skull?

A 
2 x parietal
2 x temporal
2 x zygomatic
2 x lacrimal
2 x maxillary
2 x nasal
2 x palatine
2 x inferior concha
72
Q

What are the unpaired bones of the skull?

A
  • frontal
  • ethmoidal
  • sphenoid
  • occipital
  • vomer

Anatomy (14 decks)

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