Head and neck week 1 Flashcards
What are the typical features of cervical vertebrae?
bifid spinous process
triangular vertebral foramen
transverse foramina
what are the atypical features of C1?
no vertebral body no spinous process articular facet for dens groove for vertebral arteries 'lateral masses'
describe the articulation between the skull and the atlas
the occipital condyles articulate with the superior articular facets of the atlas allowing flexion and extension of the head - nodding
what is C2 (axis) atypical?
the dens (odontoid process)
describe the 3 key features of the mandible?
Ramus
body
angle
label the following
label:
what are the borders of the anterior triangle of the neck?
SCM
midline
body of mandible
what are the borders of the posterior triangle of the neck?
clavicle
SCM
trapezius
what does the mandible articulate with?
temporal bone
what attaches to the coronoid process of mandible
temporalis
what are the suprahyoid muscles?
mylohyoid
stylohyoid
digastric (anterior belly)
geniohyoid
what are the 4 infrahyoids
sternothyroid
thyrohyoid
sternohyoid
omohyoid
what are the contents of the anterior triangle?
hyoid bone suprahyoid and infrahyoid muscles submandibular gland common carotid artery and bifurcation IJV facial artery hypoglossal nerve vagus nerve accessory nerve ?glossopharyngeal and facial?
identify the triangles within the anterior triangle particularly
outline the submental, submandibular, carotid and muscular triangles
what 3 structures divide the anterior triangle into the 4 smaller ones?
hyoid, omohyoid, digastric
how is the posterior triangle divided?
what is within the posterior triangle?
posterior belly omohyoid
vetebral muscles (splenius capitis, leveator scapulae, ant/mid/post scalene)
EJV - pierces investing fascia and drains into subclavian vein
Subclavian artery - between ant/med scalene
CN XI (accessory)
cervical plexus - nerve point 1/3 from mastoid process along posterior border of SCM
Brachial plexus trunks - between and/med scalene
what is the black arrow pointing to?
nerve point of neck - for cervical plexus block
what is the oral cavity proper?
space between the 2 arches (meaning between the mandible and the maxilla)
what is the oral cavity divided into?
oral cavity proper and vestibule
what is the vestibule?
space between the teeth and the lips/cheeks
what are deciduous/permanent teeth?
deciduous - primary dentition (children)
permanent - secondary dentition (adult)
how many deciduous teeth are there?
20
2 incisors, 1 canine and 2 molars in each quadrant
by what age should all deciduous teeth erupt?
3 years
how many permanent teeth are there?
32
2 incisors, 1 canine, 2 premolars, 3 molars in each quadrant
which is the first permanent tooth to erupt?
1st molar - erupts distal to primary dentition at age of around 6 years
what age does the permanent central incisors erupt?
7th year
when do the deciduous central incisors erupt?
8-10 months - first teeth
what arteries supply the neck mainly?
common carotid (mainly external carotid) and subclavian
name the branches of the ECA
some anatomists like freaking out poor medical students
what are the main branches of the subclavian artery?
vetebral
thyrocervical trunk
costocervical trunk
internal mammary
what are the main veins draining the neck and face?
where does the cervical plexus arise from?
C1-C4 anterior rami
what does the cervical plexus divide into?
ansa cervicalis (motor) cutaneous branches (sensory)
describe the origins and insertions of platysma
blends with superficial cervical fascia
originates from deltoid and pec major fascia
traverses the clavicle
inserts into facial muscles and inferior border of mandible
what are the layers of the deep cervical fascia?
investing
pre-tracheal (aka middle layer of deep fascia)
pre-vertebral (aka deep layer of deep fascia)
carotid sheath formed by all 3
describe the attachments of the investing layer of the deep cervical fascia
collar around neck
mandible mastoid process superior nuchal line external occipital protuberance spinous processes cervical vertebrae nuchal ligament manubrium upper border upper surface clavicle acromion spine of scapular
what does the investing fascia encircle?
SCM
Trapezius
submandibular and parotid salivary glands
what is the pre-tracheal fascia divided up into?
visceral (surrounds thyroid, trachea and oesophagus) and muscular portions (surrounds infrahyoids)
what are the attachments of the pre-tracheal fascia?
hyoid
buccopharyngeal membrane
fibrous pericardium
where does the buccopharyngeal membrane extend from and to?
base of skull to diaphragm
where is the retropharyngeal space?
between the buccopharyngeal membrane and the alar fascia
LNs here in children - can become suppurative eg. complication of tonsillitis - retropharyngeal abscess
what are the borders of the pre-vertebral fascia?
base of skull to T3 where it blends with the anterior longitudinal ligament
posteriorly - spinous processes
laterally extends as axillary sheath around axillary vessels and brachial plexus
what does the pre-vertebral fascia encircle?
verterbrae and muscles surrounding them
- levator scapulae
- splenius capitis
- scalenes
- longus capitis and colli
what is the alar fascia?
an anterior slip of the prevertebral fascia which extends from base of skull down to pre-tracheal fascia at level of around T2
the function is to prevent infection spreading from the retro-pharyngeal space to the danger space which is between the alar fascia and the pre-vertebral fascia as this space extends all the way down to the coccyx
red - efferent
blue - afferent
small dashes - parasympathetic
larger dashes - sympathetic
describe the course of the facial nerve
pons (as sensory (aka intermediate nerve) and motor root)
travel through internal acoustic meatus
leaves via the facial canal where it formms the geniculate ganglion then gives off its intracranial branches
leaves skull via the stylomastoid foramen
gives off EC branches
