Head & Neck III Flashcards
Where is the angle of Louis?
- T4/T5
What separates the anterior and posterior triangles of the neck?
- SCM muscle
What are the borders of the anterior triangle?
- Lower border of the mandible
- Anterior portion of the SCM
- Midline of the neck
What are the 3 other triangles within the anterior triangle?
- Digastric
- Muscular
- Carotid
What divides the carotid and the muscular triangle?
- omohyoid
What separates the carotid and the carotid triangle?
- digastric
What are the borders of the posterior triangle?
- Posterior border of SCM
- Trapezius
- Part of the clavicle
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Label this image


What is contained in the muscular triangle?
- strap muscles
What is contained in the carotid triangle?
- carotid sheath
What is contained in the submandibular triangle?
- digastric
What are the 4 structures in the anterior triangle?
- common carotid artery
- vagus (X)
- ansa cervicalis
- internal jugular vein
What are the 2 structures in the muscular triangle?
- strap muscles
- external jugular vein
What does the facial nerve supply?
- posterior belly and mylohyoid
What is the neck bounded by?
- clavicles and manubrium of the sternum, inferiorly,
- the mandible, mastoid processes and superior nuchal lines, superiorly.
Why is the posterior surface of the neck longer than the anterior surface?
- because the upper 3 cervical vertebrae are overlapped by the facial skeleton.
What are the 4 layers of the neck?
- Skin
- Investing layer (around the muscles)
- Deep fascia surrounds all the muscles in the neck and the posterior of the spinous process
Label these layers of the neck


What are the 10 lymph nodes of the head and the neck?
- submental
- submandibular
- parotid, superficial and deep
- posterior auricular
- occipital
- jugulodigastric
- jugulo omohyoid
- supraclavicular
- deep cervical lymph chain
- superficial cervical lymph chain
What are the 4 supra-hyoid muscles?
- digastric
- geniohyoid
- mylohyoid
- stylohyoid
What are the 4 infra-hyoid muscles?
- sternohyoid
- omohyoid
- sternothyroid
- thyrohyoid
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What are the actions of the suprahyoid and infrahyoid?
- suprahyoid - elevate
- infrahyoid - depress
What does the ansa cervicalis do?
- innervates the omohyoid, sternohyoid and sternothyroid
What is the thyrohyoid innervated by?
- thyrohyoid which is a branch of the hypoglossal
What is the origin of the omohyoid?
- inferior belly : superior border of scapula
- superior belly : intermediate tendon
What is the insertion of the omohyoid?
- inferior belly : intermediate tendon
- superior belly : body of hyoid bone, lower border
What is the action of the omohyoid?
- depresses hyoid bone and larynx
What is the innervation of the omohyoid?
- ansa cervicalis C1, C2 C3
What is the origin of the sternohyoid?
- manubrium of sternum, posterior aspect
What is the insertion of the sternohyoid?
- body of hyoid bone lower border
What is the function of the sternohyoid?
- depresses hyoid bone and larynx
What is the innervation of the sternohyoid?
- ansa cervicalis C1, C2, C3
What is the origin of the sternothyroid?
*
What is the insertion of the sternothyroid?
- oblique line of thyroid cartilage
What is the action of the sternothyroid?
- depresses larynx
What is the innervation of the sternothyroid?
- ansa cervicalis C1, C2, C3
Where is the origin of the digastric (posterior belly)?
- digastric notch of temporal bone at the base of the skull
Where is the insertion of the digastric (posterior belly)?
- intermediate tendon which passes through sling of fascia on greater horn of hyoid bone
What is the action of the posterior belly of the digastric?
- raises hyoid bone
What is the innervation of the posterior belly of the digastric?
- facial nerve (cranial nerve VII)
Where is the origin of the anterior belly of the digastric?
- intermediate tendon
Where is the insertion of the anterior belly of the digastric?
- digastric fossa on the mandible
What is the action of the anterior belly of the digastric?
- elevates the hyoid bone
What is the innervation of the anterior belly of the digastric?
- nerve to mylohyoid
- cranial nerve V3
Where is the origin of the mylohyoid?
- mylohyoid line of medial aspect of mandibular body
Where is the insertion of the mylohyoid?
- median raphe and body of hyoid bone
What is the action of the mylohyoid?
- elevates hyoid bone, base of tongue and floor of mouth
What is the innervation of the mylohyoid?
- nerve to mylohyoid
- cranial nerve V3
Where is the origin of the geniohyoid?
- inferior genial tubercle of mandible
Where is the insertion of the geniohyoid?
- body of hyoid bone
What is the action of the geniohyoid?
- elevates hyoid bone
- protracts hyoid bone
What is the innervation of the geniohyoid?
- AR of C1
Where is the origin of the stylohyoid?
- styloid process
Where is the insertion of the stylohyoid?
- greater horn of hyoid bone
What is the action of the stylohyoid?
- elevates hyoid bone
What is the innervation of the stylohyoid?
- facial nerve - cranial nerve VII
What is the innervation of the SCM?
- spinal accessory nerve
What innervates the scalene muscles?
- C4, C5, C6
Label this image with
1) dens
2) atlas
3) axis
4) foramen transversarium


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Label this image


What is the pharynx divided into?
- nasopharynx, oropharynx and laryngopharynx
Where does the nasopharynx run from and to?
- base of the skull to tip of uvula at C1-C2
How is the nasopharynx continuous with the nasal cavity?
- choanae
what nerve gives sensory innervation to the nasopharynx?
- maxillary (V2) sensory
Label these 3 structures


What kind of a scan is this and how can you tell?

- coronal CT scan
- air is black
What is the drainage from the maxilla?
- uncinate process
What is the function of the ethmoid air cells?
- drain between the sphenoid and the ethmoid
What kind of a scan is this and how can you tell?

- MRI
- you can see tissue
Label these sinuses


What cell type is found in the conchae?
- ciliated pseudostratified columnar epithelium
Where does the frontal sinus drain?
- into the superior concha
Where does the oropharynx run from and to?
- from tip of uvula to epiglottis at C2-C3
How is the oropharynx continuous with the oral cavity?
- isthmus of the fauces
Label these 4 structures


What is the function of the salpingopharyngeus muscle?
- elevates pharynx + larynx
- opens eustachian tube
What nerve gives sensory innervation to the oropharynx?
- glossopharyngel nerve CN X
At what vertebral level is the larynx found?
- C4- C6
Label these structures




What is the piriform recess?
- muscosal recess formed between central part of larynx and lateral thyroid cartilage
What is the clinical significance of the piriform recess?
- food can get stuck here
What is the posterior wall of the pharynx enclosed by?
- three constrictor muscles (superior, middle and inferior).
What are the constrictor muscles innervated by?
- vagus
What are the efferent and afferent components of the pharyngeal (gag) reflex?
- afferent limb of the reflex is supplied by the glossopharyngeal nerve (cranial nerve IX)
- The efferent limb is supplied by the vagus nerve
Where does the middle constrictor attach?
- greater horn of the hyoid bone
- lesser horn of hyoid bone
- stylohyoid ligament
Where does the superior constrictor attach?
- pterygomandibular raphe
- mandible
- pterygoid hamulus
Where does the inferior constrictor attach?
- cricoid cartilage
- oblique line of thyroid cartilage
How are the constrictor muscles arranged?
- stacked like cups
What 2 structures form the pharyngeal pouch and what is the significance of this?
- The thyropharyngeal and the cricopharyngeal from the inferior constrictor can form a pharyngeal pouch
- food can collect there
What is the blood supply to the upper pharynx?
- branches of external carotid
What is the blood supply to the palatine tonsil?
- tonsillar branch of facial artery
What is the blood supply of the lower pharynx?
- inferior thyroid artery which is a branch of thyrocervical trunk
What are the 2 branhces of the maxillary artery?
- ascending palatine artery
- tonsillar branch
What is the blood supply to the constrictor muscles?
- ascending pharyngeal artery
What is the blood supply to the lower pharynx?
- inferior thyroid artery
Where do the lymph vessels of the pharynx drain?
- into deep cervical nodes
What node drains the palatine tonsils?
- jugulodigastric
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