Head + neck anatomy contd Flashcards
Describe Wallenburg syndrome
Lateral medullary syndrome= stroke in vertebral/ Posterior inferior cerebellar arteries
Signs/ sx of Wallenburg syndrome
Horners (miosis, ptosis, anhydrosis, enophthlmos)
N+V/ vertigo
ipsilateral:
dysphagia
dysarthria
paralysis of vocal cord/ pharynx
contralateral:
loss of pain and temp sense
Signs and sx of infarction at:
ventral midbrain
ventral pons
Ventral midbrain= infarction of basilar artery= Weber syndrome
ipsilateral CN III palsy + contralateral hemiplegia
Ventral pons infarction:
ipsilateral CN 6 +7 palsy + contralateral hemiplegia/ hemiparesis
Borders of the posterior triangle of the neck
post aspect SCM
middle 1/3rd clavicle
ant aspect of trapezius
roof= investing fascia
floor= scalenus capitus, levator scapulae, ant/mid/post scalenes
Contents of the posterior triangle of neck
muscles:
splenius capitis
levator scapulae ant/mid/post scalenes
omohyoid (sup/inferior bellies)
nerves:
accessory nerve (CN 11)
Phrenic nerve (C3-5)
CERVICAL PLEXUS
BRACHIAL PLEXUS
Artery:
subclavian artery
Vein:
External jugular vein
What splits the posterior triangle and what are the compartments called
Omohyoid-inferior belly
Compartments:
occipital triangle-above
subclavian triangle-below omohyoid
Borders of the anterior triangle
body of mandible
anterior midline of neck
ant aspect of SCM
Compartments of the anterior triangle
Submental
submandibular
carotid
muscular
Borders of the submental triangle and contents
borders:
hyoid bone (inf)
anterior midline of neck
anterior belly of Digastric (lateral)
contents:
submental lymph nodes
Borders of the submandibular triangle and contents
borders:
mandible
anterior belly digastric
posterior belly digastric
contents:
submandibular salivary gland
facial artery + vein
lymph nodes
Borders of the carotid triangle and contents
borders:
anterior aspect SCM
posterior belly digastric
superior belly omohyoid
contents:
common carotid (bifurcates here)
internal jugular vein
hypoglossal nerve
vagus nerve
Name the infrahyoid muscles
thyrohyoid
sternothyroid
sternohyoid
omohyoid (superior + inferior)
Borders of the muscular triangle and contents
borders:
hyoid bone
anterior midline neck
anterior aspect SCM
Superior belly omohyoid
contents: (organs + muscles)
thyroid
parathyroid
pharynx
infrahyoid muscles
Name the suprahyoid muscles
mylohyoid
geniohyoid
stylohyoid
digastric (anterior+ posterior)
What are the layers of the neck
-skin
-superficial cervical fascia
-platysma (anterior)
-deep investing fascia (surrounds SCM + trapezius)
anteriorly= pre-tracheal fascia (posterior aspect called bulbopharyngeal fascia)
retropharyngeal space (b/w pretracheal + pre-vertebral)
laterally= carotid sheath x2
posteriorly= pre-vertebral fascia
Contents of pre-tracheal fascia
thyroid + parathyroid glands
trachea
oesophagus
infrahyoid muscles
Superior and inferior attachments of pre-tracheal fascia
superior= hyoid bone
inferior= pericardium
Contents of pre-vertebral fascia
Pre-vertebral muscles
vertebral column
scalene muscles
deep back muscles
brachial plexus
Superior and inferior attachments of pre-vertebral fascia
superior= base of skull
inferior= endothoracic fascia of rib cage
What is the axillary sheath a continuation of?
Pre-vertebral fascia that continues into the axilla (contains brachial plexus)
Contents of carotid sheath
Common carotid artery
Internal jugular vein
Vagus nerve
Lymphatics
Intrinsic muscles of the tongue and their actions
Genioglossus= protrude (Give)*
Hyoglossus= depress (Hides)
Styloglosses= retracts (back towards styloid)
Palatoglossus= elevates posterior tongue (back towards palate)
*pull larynx forward during swallowing
Location of parotid gland and anatomical relations
Anterior= masseter
superior= zygomatic arch
posterior= SCM + external ear
inferior= mandible
Duct draining Parotid gland and location of its opening in the oral cavity
Stenson’s duct (PS)
Opens at the upper 2nd molar b/l
Lobes of the parotid gland
Superficial and deep
What muscles does stenson’s duct cross/ pierce to arrive at the oral cavity
cross= masseter
pierce= buccinator
Glossopharyngeal nerve functions:
sensory
reflex
parasympathetic
motor
sensory + special sensory= posterior 1/3rd of tongue
reflex= gag reflex (afferent, efferent= CN 10)
Parasympathetic= supply to parotid gland [pre-ganglionic fibres (CN 9) to Otic ganglion from which post-ganglionic fibres (AURICULOTEMPORAL) to parotid gland]
Motor= innervates stylopharyngeus muscle (shortens + widens pharynx to elevate larynx during swallowing)
Which salivary gland empties via Whartons duct
Submandibular duct
Location of Whartons duct
Either side of the frenulum
What is a ranula and where does it arise
ranula= mucocele in the SUBLINGUAL glands
Which nerves are risk during parotid gland surgery
FACIAL NERVE
What structures pass through the parotid gland
Facial nerve
External carotid artery
Retromandibular vein
relationship of submandibular gland and:
-facial artery
-facial vein
-lingual nerve
-hypoglossal nerve
-facial artery= posterior to gland
-facial vein= superficial to gland
-lingual nerve=medial to gland/ lateral to Whartons duct
-hypoglossal nerve= below gland
Which nerves are risk during submandibular gland surgery AND what post-op features might they present with
Lingual nerve (V3)
Marginal mandibular (CN 7)
Hypoglossal nerve (CN 12)
V3= loss of taste/ sensation of posterior 1/3 tongue
CN7= drooping lower lip (ipsilateral)
CN12= tongue deviated TOWARDS side of lesion (ipsilateral intrinsic muscle paralysis)
