Head/Neck

Question 1

Neck Constrictors

Answer 1

Attach to skull base, hyoid bone, thyroid, & cricoid cartilages
Form posterior pharynx wall
Move food bolus down to the esophagus
Superior, middle, & inferior constrictors

Question 2

Posterior Neck Structures

Answer 2

Dorsal

Vertebrae, epaxial muscles, & prevertebral muscles

Question 3

Hyoid

Answer 3

Mobile bone
Does not articulate w/ other bones
Suspended in the neck at C3 via muscles & ligaments
Attachment site for several neck muscles

Question 4

Strap Muscles

Answer 4

Superficial (ventral)

Attach to hyoid bone

Question 5

Sternohyoid

Answer 5

Sternum → thyroid cartilages

Sternum → hyoid body

Question 6

Thyrohyoid

Answer 6

Thyroid cartilage → hyoid body & greater horn

Question 7

Mylohyoid

Answer 7

Mandible inner surface → hyoid body

Question 8

Scalene

Answer 8

Key neck landmark surrounding vertebrae
Brachial plexus emerges b/w anterior & middle scalene
Anterior
Middle
Posterior

Question 9

Carotid Sheath

Answer 9

Contains common carotid, Vagus nerve X, & internal jugular vein

Question 10

Sternocleidomastoid

Answer 10

Common origin from mastoid process → sternal & clavicular head
Cervical plexus emerges posterior to sternocleidomastoid

Question 11

Trapezius

Answer 11

Arises from scapula
Upper (cranial) & lower (caudal) fibers
Upper fibers attach to occiput at skull base

Question 12

Anterior Triangle

Answer 12

Sternocleidomastoid = key
L & R triangles meet at midline
Continues superiorly to lower jaw border & inferiorly to sternum manubrium
Carotid triangle

Question 13

Posterior Triangle

Answer 13

Sternocleidomastoid = key
Trapezius posterior border
Clavicle inferior border

Question 14

Larynx

Answer 14

C3-6

Mobile ↑↓ swallowing & speech

Question 15

Cervical Plexus

Answer 15

Sensory head & neck

Question 16

Thyrohyoid Membrane

Answer 16

Connects thyroid cartilage & hyoid bone

Question 17

Thyroid Cartilage

Answer 17

Shield-shaped lamina
Superior & inferior cornu
Inferior cornu articulate w/ cricoid

Question 18

Cricoid Cartilage

Answer 18

Ring-shaped cartilage
Only complete ring
Located b/w trachea & thyroid
Arytenoids articulation

Question 19

Arytenoids

Answer 19

Triangle pyramid w/ vocal & muscular process
Vocal process attaches vocal ligaments
Muscular process attaches muscles that move vocal cords
Arytenoid muscles draw the arytenoids together

Question 20

Vocal Cords

Answer 20

Cone-shaped ligament free edge

Muscles change rima glottidis shape & tension

Question 21

Cricothyroid

Answer 21

Tensor
Innerved by external laryngeal nerve
Rotates thyroid cartilage
Pulls thyroid down to stretch & tighten vocal cords

Question 22

Posterior Cricoarytenoid

Answer 22

ABDuctor
Rotate vocal process laterally (outward)
Opens rima

Question 23

Lateral Cricoarytenoid

Answer 23

ADDuctors
Rotates vocal process medially
Closes rima

Question 24

Vocalis

Answer 24

Relaxer

Runs on the ligaments

Question 25

Glossopharyngeal

Answer 25

Cranial nerve IX
Motor & sensory to pharynx
Taste posterior 1/3 tongue

Exits posterior cranial fossa via jugular foramen

Question 26

Swallowing

Answer 26

26 muscles
5 cranial nerves controlling muscle movements & sensory input (V, VII, IX, X, XII)
Failure → dysphagia

Question 27

Extrinsic Tongue Muscles

Answer 27

Move the tongue as whole
Innervated via hypoglossal nerve
Intrinsic muscles shaped the tongue

Question 28

Palate Muscles

Answer 28

Palate actively raised & lowered during swallowing
Raisers & tensors- levator veli palatini
Depressors - palatopharyngeus

Question 29

Voluntary Swallowing

Answer 29

Styloglossus & hyoglossus contract pulling tongue back & up
Intrinsic tongue muscles arch tongue upward & backward
Pushes bolus up against hard palate
Palatoglossus contraction squeezes food out oral cavity into oropharynx
Soft palate rises w/ palatini muscle to close off opening b/w nasopharynx & oropharynx
Larynx elevates to meet the epiglottis (stylopharyngeus, stylohyoid, thyrohyoid, & palatopharyngeus muscles) & epiglottis actively pulled down

Question 30

Swallowing Steps

Answer 30

1. Seal nasopharynx - lift soft palate
2. Propel bolus - raise hypoid bone & larynx w/ strap muscles
3. Seal pharyngeal inlet - stop food from moving back into oropharynx by tightening external tongue muscles & upper constrictors
4. Clear bolus - restore hyoid & larynx to original position w/ strap muscles
   Contract middle & inferior constrictors

Question 31

Vagus

Answer 31

Cranial nerve X
Motor & sensory to pharynx & larynx, autonomic PSNS to thorax & abdomen, & sensory taste

Exits via jugular foramen
Nerve damage → relaxed vocal cords
Stridor & hoarse voice

Question 32

Superior Laryngeal

INTERNAL

Answer 32

Pierces through thyrohyoid ligament & provides sensory superior to vocal folds

Question 33

Superior Laryngeal

EXTERNAL

Answer 33

Posterior to sternothyroid & then enters to become motor to cricothyroid
Nerve damage → anesthetizes superior larynx & paralyzes cricothyroid
Voice lower & more monotone

Question 34

Recurrent Laryngeal Nerve

Answer 34

Ascends b/w esophagus & trachea
Becomes inferior laryngeal, enters deeps to inferior constrictor, & motor to all other muscles

L loops around subclavian
R loops around aorta

Question 35

Unilateral RLN

Answer 35

Unilateral nerve damage → significant voice loss

Question 36

Bilateral RLN

Answer 36

Bilateral nerve damage → EMERGENCY (both cords paramedian)