Head & Neck Anat Flashcards
What are the boundaries of the neck?
Superior: Inferior border of mandible + mastoid process + superior nuchal line
Inferior: Thoracic inlet
Posterior: T1 vertebra
Anterior: 1st rib + costal cartilage + manubrium
Where is the thoracic outlet?
Space between clavicle and 1st rib
What bony landmarks are located adjacent to the occipital protuberance?
Superior nuchal line
The C3/4 vertebral level contains:
i) upper margin of ___________
ii) bifurcation of _____________
The C3/4 vertebral level contains:
i) upper margin of thyroid cartilage
ii) bifurcation of common carotid artery
The C6 vertebral level contains:
i) arch of _____________
ii) superior end of ____________
iii) superior end of ___________
The C6 vertebral level contains:
i) arch of cricoid cartilage
ii) superior end of esophagus
iii) superior end of trachea
What is the clinical name of the “Adam’s apple”?
Thyroid cartilage
What are the 3 superficial anterior structures of the neck (from superior to inferior)?
1) Hyoid bone
2) Thyroid cartilage
3) Cricoid cartilage
What are the bounds of the anterior triangle of the neck?
Base/superior: inferior margin of mandible
Lateral: Sternocleidomastoid
Medial: Midline of neck
Which structure divides the anterior and posterior triangles of the neck?
Sternocleidomastoid muscle
What are the bounds of the posterior triangle of the neck?
Base/inferior: Clavicle
Medial: posterior margin of sternocleidomastoid
Lateral: anterior margin of trapezius
How do the structures coursing through the anterior and posterior triangles of the neck differ?
Anterior: btwn head and thorax
Posterior: btwn thorax/neck and upper limb
Which structure separates the internal and external jugular vein?
Sternocleidomastoid
Which muscle can be found within the superficial fascia of the neck?
Platysma
Which muscles form the “wall” of the neck?
Anterior: SCM
Posteior: Trapezoids
Which group of muscles are found directly inferior to the hyoid bone?
Infrahydoid (Strap) muscles
What is the arrangement of the structures of the neurovascular bundle of the neck (lateral to medial)?
1) Internal jugular vein
2) Vagus nerve (CNX)
3) Carotid artery
Which muscles sandwich the brachial plexus at the neck?
Scalenus anterior and medius
Where is the phrenic nerve located with reference to the pre-vertebral muscles of the neck?
Anterior to scalenus anterior
What are the 3 groups of deep fascia in the neck/deep cervical fascia ?
1) Investing layer
2) Pre-vertebral fascia
3) Pre-tracheal layer
What is formed by the union/contribution of the 3 deep cervical fascia?
Carotid sheath
What are the muscles of the anterior triangle of the neck that attach to the hyoid bone?
1) Digastric (anterior and posterior) (suprahyoid)
2) Omohyoid (1/4 infrahyoid muscles)
What are the strap/infrahyoid muscles of the neck?
1) Omohyoid
2) Sternohyoid
3) Sternothyroid
4) Thyrohyoid
True or false: In the neck the vertebral vein and artery run together.
True
True or false: The arterial branches that supply the neck arise from both the internal and external carotid artery.
False.
Internal carotid no branches in neck.
All branches from external carotid.
Where does the vertebral artery arise from?
Subclavian artery
Describe the path of the vertebral artery.
Subclavian → vertebral artery
→ pass through foramen transversarium
→ enter cranial cavity with internal carotid
What are the branches of the external carotid artery?
Some – Superior thyroid
Anatomists – Ascending pharyngeal
Like – Lingual
Freaking – Facial
Out – Occipital
Poor – Posterior auricular
Medical – Maxillary
Students – Superficial temporal
Describe the innervation of the strap muscles of the neck?
By branches of the ansa cervicalis (branch of cervical plexus)
What structure connects the anatomical lobes of the thyroid gland?
Isthmus
Which structure at the 2nd-4th tracheal ring level of the neck maybe injured during a tracheostomy?
Isthmus of thyroid gland
What is the muscle between the thyroid and cricoid cartilage?
Cricothyroid muscle
Describe the collateral circulation supplying the thyroid gland.
1) Superior thyroid (from external carotid)
2) Inferior thyroid (from subclavian)
Describe the venous drainage of the thyroid gland.
1) Superior thyroid vein → internal jugular vein
2) Inferior thyroid vein → subclavian or brachiocephalic vein
Which nerve supplies the cricothyroid muscle?
External laryngeal nerve (branch of vagus nerve)
Which nerve is closely associated to the superior thyroid artery?
External laryngeal nerve
Which nerve is closely associated to the inferior thyroid artery?
Recurrent laryngeal nerve
What are the cervical lymph nodes?
1) Submental
2) Submandibular
3) Auricular
4) Mastoid
5) Parotid
6) Occipital
→ Drain to nodes surrounding internal jugular vein
7) Deep cervical nodes
→ thoracic duct (L) / R lymphatic trunk
What are the 2 structures located superior to the nasal ridge?
Depression: Nasion
Elevation: Glabella
The zygomatic arch is ___________ to the maxilla.
Lateral
Where is the pterion?
1 finger length lateral from lateral border of orbit and above zygomatic arch
What is the clinical significance of the pterion?
1) Thinnest part of skull
2) Middle meningeal artery and vein run directly deep
What are the layers of the scalp?
S - Skin
C - Connective tissue
A - Aponeurosis (Epicranial)
L - Loose areolar tissue
P - Pericranium
What bony landmark is located bilaterally on the anterior surface of the mandible?
Mental foramina
What bony landmark of the maxillary bone is located bilaterally below the orbits?
Infraorbital foramina
What bony landmark of the frontal bone is located bilaterally above the orbits?
Supraorbital ridge/foramina
What type of joint is formed between the bones of the skull?
Fibrous
What is the pterion formed by?
Junction of:
1) Frontal
2) Parietal
3) Temporal
4) Sphenoid bones
What is the biggest opening in the skull?
Foramen magnum
Which bones form the hard palate?
1) Maxilla
2) Palatine
What are the bounds of the scalp?
From supraorbital margin
to external occipital protuberance and superior nuchal line
What are the communications between the scalp and the cranial cavity?
Venous
- emissary vein (valveless)
(route of infection)
What are the 2 muscles that attach to the aponeurosis of the scalp?
1) Frontalis
2) Occipitalis
Why are longitudinal lacerations of the scalp more favorable than lateral?
Lateral → scalp will be pried open by action of occipitalis and frontalis muscles
What type of muscles close the eye and the mouth orifices?
Sphincteric
What are the sphincteric muscles of the eye?
Orbicularis oculi
What are the sphincteric muscles of the mouth?
Orbicularis oris
What type of muscles open the eye and mouth?
Levator
What are the levator muscles of the eye?
Levator palpebro superioris
What are the levator muscles of the mouth?
1) Levator labi superioris
2) Depressor labi inferioris
What muscle rests on the nasion of the face?
Procerus
What muscle is found deep to the frontalis?
Corrugator supercili
What are the muscles lateral to the mouth/nasal cavity?
Lateral to medial:
1) Risorius
2) Zygomaticus major
3) Zygomaticus minor
4) Levator labi superioris
5) Levator angularis oris
What are 3 fascial muscles inferior to the mouth?
1) Depressor angularis oris
2) Depressor labii inferioris
3) Platysma
4) Mentalis
Which 2 muscles are the parotid duct related to?
Courses superficial to masseter before piercing the buccinator
What are 3 muscles that move the ear?
Auricular
- superior
- anterior
- posterior
How would a botox injection of the corrugator supercilli and procerus cause a droopy eyelid?
Injection may spread to underlying levator palpebra superioris
What is the embryological origin of the muscles of facial expression?
2nd pharyngeal arch
What is the nerve that supplies the muscles of facial expression?
CNVII: Facial nerve
What is the nerve that is closely related to the parotid gland?
CNVII: Facial nerve
What are the terminal branches of the facial nerve?
Superior to inferior:
1) Temporal
2) Zygomatic
3) Buccal
4) Mandibular
5) Cervical
Describe the innervation of the muscles of the face.
Mainly by CNVII: facial nerve (LMN)
- receives bilateral UMN influence motor cortex
- EXCEPT lower part of face → only contralateral
What are the muscles of mastication supplied by?
Trigeminal
- all from 1st pharyngeal arch
Describe the sensory innervation of the head.
Front: CNV1-3 (ophthalmic, maxillary, mandibular)
Back: Cervical plexuses
- ventral rami (supply lateral behind ear to neck)
- dorsal rami (posterior skull)
Describe the arterial supply of the face?
1) Internal carotid → cranial cavity → orbit (opthalmic artery)
2) External carotid →
i) Facial
ii) Superficial temporal
iii) Maxillary → infraorbital
iv) Occipital
v) Posterior auricular
How does the facial nerve exit the skull before entering the parotid gland?
Stylomastoid foramen
Which muscles are (i) superficial (ii) deep to the rami of the mandible?
i) Masseter
ii) Medial pterygoid
What are the anterior relations of the parotid gland (3)?
Medial to lateral:
1) Medial pterygoid
2) Rami of mandible
3) Masseter
What are the posterior relations of the parotid gland(
Medial to lateral:
1) Sternocleidomastoid
2) Mastoid process
3) Digastric muscles
4) Styloid process
5) Styloid process muscles (styloglossus, stylohyoid, and stylopharyngeus)
What are the vessels that are within the parotid gland?
Deep to superficial:
1) External carotid artery
2) External carotid vein
3) Facial nerve
Describe the innervation of the parotid gland.
1) CNIX: Glossopharyngeal
What are the 2 sets of lymph nodes of the head and neck
1) Submandibular
2) Submental
3) Parotid
4) Mastoid
5) Occipital
All drain to:
6) Deep cervical lymph nodes (along internal jugular vein)
- R → right lymphatic trunk
- L → thoracic duct
