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Clinical Anatomy > Head and Neck III > Flashcards

Head and Neck III Flashcards

1
Q

What separates the anterior and posterior triangle?

A

SCM

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2
Q

What are the borders of the anterior triangle?

A

Lower border of mandible
Anterior border of SCM
Midline of neck

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3
Q

What are the borders of the posterior triangle?

A

Posterior border of SCM
Anterior portion trapezius
Middle 2/3 clavicle (sup. border)

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4
Q

Why is the posterior triangle clinically important?

A

Important for anaesthetists as brachial plexus in area
Insertion of central lines - if unable to bleed via superficial veins
Helps with giving Ab and taking blood

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5
Q

What are the 3 further triangles of the anterior triangle?

A

Carotid triangle
Digastric triangle
Muscular triangle

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6
Q

What are the borders of the carotid triangle?

A

Sup - posterior belly of digastric muscle
Lateral - medial border of SCM
Inferior - sup. belly omohyoid muscle

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7
Q

What are the contents of the carotid triangle?

A 
Carotid sheath (internal jugular, common carotid, vagus)
Hypoglossal nerve and ansa cervicalis (nerve roots C1-C3)
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8
Q

What are the borders of the digastric triangle?

A

Sup - body of mandible
Post - posterior belly of digastric muscle
Ant - anterior belly of digastric muscle
Base (back of triangle) - mylohyoid muscle

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9
Q

What are the contents of the digastric triangle?

A

Submandibular gland, lymph nodes, facial artery and vein and hypoglossal nerve

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10
Q

What are the boundaries of the muscular triangle?

A

Superolateral - sup. belly of omohyoid
Medial - midline of neck
Inferolateral - inferior portion of SCM

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11
Q

What are contents of the muscular triangle?

A

Strap muscles, external jugular vein, thyroid cartilage and gland, parathyroid gland and infrahyoid muscles

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12
Q

What are the boundaries of the neck?

A

Superiorly - clavicle and manubrium of sternum

Inferiorly - mandible, mastoid and superior nuchal lines

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13
Q

What are the layers of the neck?

A

Skin - outermost
Then investing layer
Pre-tracheal layer - purple zone
Deep fascia surrounds all deeper muscles of neck from anterior and posterior spinous

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14
Q

What is the atlas and axis?

A

C1 - Atlas

C2 - Axis

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15
Q

What is the dens of the axis?

A

Odontoid process

Facet for articulation with the anterior arch of the atlas

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16
Q

What is the uncinate process on cervical vertebral bodies?

A

Hook-shaped process located on the lateral or posterolateral margins of the superior endplates of the cervical vertebral bodies, most commonly found at the levels of C3-C7.

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17
Q

What structures go through the foramen transversium?

A

Gives way to vertebral artery, vein and sympathetic nerve plexus

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18
Q

What type of joint is the atlantoaxial joint?

A

Pivotal synovial joint

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19
Q

What type of joint is the zygapophysial joint?

A

Synovial facet joint

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20
Q

What type of joint is in between the intervertebral discs?

A

Cartilaginous joint

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21
Q

What is special about the transverse process of the 7th thoracic vertebrae?

A

It has no artery going through it

It only goes through the first 6

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22
Q

What is different about the spinous processes of the cervical vertebrae?

A

They are bifid - C3-C6

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23
Q

At what level is the carotid tubercle of Chassaignac?

A

C6

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24
Q

What articulations does the 1st rib make?

A

Thin part articulates with vertebrae

Flat part attaches to sternum

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25
Q

At what levels are the divisions of the scalene muscle?

A

Anterior - under SCM
C4 - C6
Middle - C3 - C8
Post - C6 - C8

Brachial plexus nerves run between anterior and middle scalene

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26
Q

What nerve supplies the SCM?

A

Acessory nerve - CNXI

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27
Q

What are the suprahyoid muscles and their innervation?

A

Digastric - ant belly - trigeminal nerve V3
post belly - facial nerve CNVII
Geniohyoid - fibres of C1
Mylohyoid - trigeminal nerve V3
Stylohyoid - facial nerve XII

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28
Q

What are the general actions of the suprahyoid muscles?

A

Elevate hyoid/larynx complex

Muscles that attach to hyoid - everything above it

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29
Q

What defines an infrahyoid muscle and what is the function of an infrahyoid muscle?

A

Everything below the hyoid

Depressing hyoid/larynx complex

30
Q

What are the infrahyoid muscles?

A

Sternohyoid
Omohyoid
Sternothyroid
Thryrohyoid

31
Q

What is the innervation of the infrahyoid muscles?

A

All supplied by C1-3 ansa cervicalis

Except thyrohyoid - innervated by hypoglossal nerve CNXII

32
Q

When are these muscles important clinically?

A

During surgical exposure of the thyroid gland

33
Q

What is the function of the strap muscles?

A

Anchor against upward pull

or depress larynx during swallowing and speaking

34
Q

What is the pharynx?

A

Fibromuscular tube attached to base of the skull superiorly

Continuous with nasal cavity, oral cavity and larynx

35
Q

What are the boundaries of the nasopharynx?

A

Goes from base of skull (basisphenoid and basiocciput) to tip of uvula
C1-C2
Ends at soft palate

36
Q

What are the functions of the nasopharynx?

A

Respiration as continuous w/ nasal cavity through choanae

37
Q

What is the nervous innervation of the nasopharynx?

A

Sensory - trigeminal nerve V2 (Maxillary)

38
Q

What are the boundaries of the oropharynx?

A

Runs from the tip of uvula to epiglottis

C2 - C3

39
Q

What is the function of the oropharynx?

A

Digestion + respiration

Becuase continuous w/ oral cavity through isthmus of fauces

40
Q

What is the location of the palatine tonsils?

A

Between palatoglossus + palatopharyngeal arches

41
Q

What is the location of the lingual tonsils?

A

Pharyngeal part of tongue

Post. aspect of foramen cecum

42
Q

What is the importance of the valleculae?

A

Important when need to do intubation

43
Q

Where does the salpingopharyngeal fold lie?

A

Overlies salpingopharyngeus muscle

Attaches at larynx area and wraps around to torus tubarius

44
Q

What is the action of the pharyngeus muscle and what is its nerve supply?

A

Raises pharynx and larynx when swallow + opens eustachian tube
Sensory glossopharyngeal nerve IX

45
Q

At what level does the laryngopharynx begin and what are its boundaries?

A

At C4-5
Located posterior to larynx
Continuous w/oesophagus inferiorly
Runs from tip of epiglottis to the superior border of cricoid cartilage C4-C6

46
Q

What is the function of the larynx?

A

Digestion and respiration - helps w/ support

47
Q

What is the epiglottis attached?

A

Epiglottis attached to thyroid cartilage –>larynx gets pulled up against it to prevent aspiration of food

48
Q

Where does the laryngeal inlet open?

A

Into anterior wall

49
Q

What is the piriform recess formed by?

A

Formed between the central part of larynx and lateral thyroid cartilage
Positioned inferior and lateral to epiglottis

50
Q

What is the clinical significance of the piriform recess?

A

Food can get stuck in this region - fishbone

51
Q

What is the valleculae?

A

Space anterior to epiglottis

Food and saliva held here temporarily when swallow

52
Q

What is the innervation of the laryngopharynx?

A

Glossopharyngeal nerve CNIX

53
Q

Where do the pharyngeal constrictor muscles originate and where are they located?

A

From the styloid process

Posterior wall of pharynx is where they are

54
Q

What do the constrictor muscles form in the midline?

A

All constrictor meet in the midline to form a constrictor raphe

55
Q

How are the muscles arranged?

A

Look like cups stacked

56
Q

Describe the attachments of the superior, middle and inferior pharyngeal constrictor muscles?

A

Superior - attaches pterygomandibular raphe, mandible, pterygoid hamulus (base of the skull)
Fn - helps initiation voluntary and some involuntary
Initiates contraction wave going down w/ bolus of food

Middle - attaches to hyoid bone (greater and lesser horn)
Stylohyoid ligament

Inferior - attaches to inferior portion of posterior cricothyroid
All wrap around in sheet and converge in midline to help w/ contraction L+R

57
Q

Which nerves run in between the constrictor muscles?

A

Mastoid, styloid and facial nerve comes in between them.

58
Q

Which nerve supplies the constrictor muscles and what are the constrictor muscles covered by?

A

All supplied the vagus nerve

Covered by a mucous membrane

59
Q

Which nerves control the gag reflex?

A

Sensory - glossopharyngeal

Motor - Vagus (to throw up)

60
Q

What is the function of the pharyngeal constrictor muscles?

A

Peristalsis - help food down

61
Q

What is the main arterial supply of the pharynx?

A

Superior thyroid and ascending branches of external carotid

62
Q

What is the venous drainage of the pharynx?

A

Venous plexus drains into internal jugular vein

63
Q

What is the blood supply for the palate and constrictor muscles?

A

Branches of maxillary artery - have ascending palatine artery

64
Q

What is the blood supply of the palatine tonsils?

A

Tonsillar branch of facial artery

65
Q

What is the blood supply of the middle and lower pharynx?

A

Inferior thyroid artery and inferior constrictor

Middle is supplied by multiple different arteries

66
Q

What is the nerve supply of the pharynx?

A

Pharyngeal branches of glossopharyngeal and vagus (supplies uvula) - gives sensory and motor
Maxillary V2 - sensory for nasopharynx

67
Q

What is halitosis?

A

Diagnosis for bad breath
Get formation of pockets because of raphes cricopharyngeal and thyropharyngeal from inferior constrictor forming pahryngeal pouch

Food can collect in these pouches
Patients will feel gurgling sensation at side trunk - cause lots of problem

68
Q

Where do the lymph nodes of the pharynx drain?

A

Into deep cervical nodes

69
Q

Describe the course of the lymph nodes of the pharynx

A

Run along the internal jugular vein

70
Q

Which lymph node does most of the lymph drain into?

A

Jugular digastric node - common and big one

V large where most lymph drains down

71
Q

What are the other lymph nodes in this area?

A

Infrahyoid and pretracheal nodes

72
Q

Which node is most likely to be inflamed?

A

Jugular digastric node

Important when assess patients to feel these nodes in the neck

Clinical Anatomy (10 decks)

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