HNS Flashcards
What are the layers of the scalp?
SCALP
Skin
Connective tissue layer (superficial fascia)
Aponeurotic layer (epicranial aponeurosis, galiaaponeurotica)
Loose areolar tissue
Pericranium
What is the nerve supply to the anterior 1/2 of scalp?
Branches of trigeminal nerve
What is the nerve supply of the posterior 1/2 of scalp?
C2/C3
What are the capsules of the parotid gland?
True = condensed connective Tissue
False = deep Fascia around gland
What structures are embedded in the parotid gland?
Facial nerve (most superficial)
Retromandibular vein
External carotid
Auriculo-temporal nerve
What does the facial nerve divide into in the parotid gland?
Temporal branch
Zygomatic branch
Buccal branch
Mandibular branch
Cervical branch
How is the retromandibular vein formed in the parotid gland?
Maxillary + superficial temporal veins
What does the external carotid artery divide into in the parotid gland?
Maxillary artery
Superficial temporal artery
What nerve is injured during parotid gland surgery?
Facial N.
What nerve is injured during the superficial dissection of the parotid gland?
Greater auricular nerve
Where does the parotid duct open?
Into the vestibule of mouth opposite upper 2nd molar tooth
What is the nerve supply of the parotid gland?
Sensory = auriculo-temporal nerve
Sympathetic = superior cervical sympathetic ganglion around external carotid artery
Parasympathetic = otic ganglion
What are the boundaries of the posterior triangle of the neck?
Anterior = post. Border of Sternomastoid muscle
Posterior = ant. Border of trapezius
Base = middle 1/3 of clavicle
Apex = meeting between sternomastoid + trapezius
What are the contents of posterior triangle of neck?
Muscles = inferior belly of omohyoid
Nerves (ABC):
1. Accessory nerve
2. Trunks of Brachial plexus
3. Phrenic nerve
4. Cervical plexus
Vessels:
1. Third part of subclavian artery
2. External jugular vein
What are the borders of the anterior triangle of the neck?
Anterior = ant. Midline of neck
Posterior = ant. Border of sternomastoid muscle
Superiorly = lower border of mandible
How is the anterior triangle divided?
2 bellies of the digastric muscle + superior belly of omohyoid muscle
Digastric triangle (submandibular)
Muscular triangle
Carotid triangle
What are the contents of the carotid triangle?
Carotid sheath (common carotid, internal carotid, vagus nerve + IJV)
Ansa cervicalis + sympathetic trunk
What are the contents of the submandibular triangle?
Submandibular gland
Submandibular nodes
Facial vessels
Hypoglossal nerve
What are the nerve supplies for the digastric muscle?
Anterior belly = nerve to mylohyoid from trigeminal N.
Posterior belly = facial n.
What are the contents of the carotid sheath?
Common + internal carotid arteries
Internal jugular vein
Vagus nerve
What is the origin of the two heads of the sternomastoid muscle?
Sternal head = front of manubrium sterni
Clavicular head = upper surface of medial 1/3 of clavicle
What is the nerve supply of the sternomastoid muscle?
Spinal root of accessory nerve
What is the ansa cervicalis formed from?
Upper root = descends hypoglossi (c1)
Lower root = descends cervicalis (c2/c3)
What are the branches of the ansa cervicalis?
GHost THought SOmeone STupid SHot Irene
1. GenioHyoid
2. ThyroHyoid
3. Superior Omohyoid
4. SternoThyroid
5. SternoHyoid
6. Inferior Omohyoid
What are the three scalene muscles?
Scalenus anterior
Scalenus medius
Scalenus posterior
What passes through anterior + middle scalenes?
Brachial plexus
Subclavian artery
DEEPER
What passes anterior to anterior scalene muscle?
Subclavian vein
Phrenic nerve
What are the dural venous sinuses divided into it?
Single + Paired
What is the site of the superior sagittal sinus?
Along upper border of falx cerebri
What are the borders of the cavernous sinus?
Medial = pituitary gland + sphenoidal air sinus
Lateral = temporal lobe
Superior = internal carotid artery + optic chiasma
Inferior = body of sphenoid + sphenoidal air sinus
What structures are inside the cavernous sinus?
Lateral wall = oculomotor, trochlear, ophthalmic, maxillary
In cavity = internal carotid artery, abducens nerve
Where are the foramina in the skull found?
All in sphenoid except:
Jugular foramen = temporal bone
Stylomastoid foramen = temporal bone
Foramen magnum = occipital bone
What are the contents of foramen ovale?
OVALE
Otic ganglion
V3 of trigeminal nerve
Accessory meningeal artery
Lesser petrosal nerve
Emissary veins
What are the contents of the foramen spinosum?
Middle meningeal artery
Meningeal branch of mandibular nerve
What are the contents of the foramen rotundum?
Maxillary nerve (V2)
What are the contents of the jugular foramen?
Anterior = inferior petrosal sinus
Intermediate = glossopharyngeal, vagus, accessory nerve
Posterior = sigmoid sinus
What are the contents of stylomastoid foramen?
Stylomastoid artery
Facial nerve
What are contents of superior orbital fissure?
Live Free To See No Insult At All
Lacrimal nerve
Frontal nerve
Trochlear nerve
Superior division of oculomotor nerve
Nasociliary
Inferior division of oculomotor nerve
Abducens nerve
What are the contents of the foramen magnum?
Anterior + posterior spinal arteries
Vertebral arteries
Spinal accessory nerve entering skull
What is the parasympathetic nerve supply of the lacrimal gland?
Pterygopalatine ganglion
What muscle acts on the upper eyelid?
Levator palpebrae superioris
What is the nerve supply to the levator palpebrae superioris?
Superior division of oculomotor nerve
What nerves supply the muscles acting on the eyeball?
All are oculomotor except:
LR6 = lateral rectus = abducens
SO4 = superior oblique = trochlear
What nerve supplies the muscles of mastication?
Mandibular nerve
What is the action of mastication + the muscles suppling it?
Ter = temporalis = elevation + retraction
Mep = masseter + medial pterygoid = elevation + protrusion
Lpd = lateral pterygoid = protrusion + depression
What is the origin of the middle meningeal artery?
1st part of maxillary artery + enters through foramen spinosum
Runs beneath pterion
What does rupture of middle meningeal artery cause?
Extradural haematoma
What are the deep relations of the submandibular salivary gland?
Mylohyoid muscle
Submandibular duct
Hyoglossus muscle
Lingual nerve
Submandibular ganglion
Hypoglossal nerve
What is the path of the submandibular (Wharton’s) duct?
Arises from anterior part of deep part of gland
Opens in floor of mouth on sublingual papilla at side of frenulum of tongue
What is the nerve supply of the submandibular (Wharton’s) duct?
Submandibular ganglion
What is the thyroid gland formed of?
2 lateral lobes
Isthmus
Pyramidal lobe
What is the position + extension of the thyroid gland?
Anteriorly:
- lateral lobes = from oblique line to 5th tracheal ring
- isthmus = in front of 2/3/4th tracheal ring
Posteriorly:
Lateral lobes opposite 5/6/7 cervical + 1st thoracic vertebrae
What is the arterial supply to the thyroid gland?
Superior thyroid artery from external carotid
Inferior thyroid artery from thyrocervical trunks of subclavian
Thyroida ima artery from arch of aorta
What is the venous drainage of thyroid gland?
Superior thyroid veins = end in IJV
Middle thyroid veins = end in IJV
Inferior thyroid veins = end in brachiocephalic veins
What is the embryology of the parathyroid gland?
Superior = from 4th pharyngeal pouch
Inferior = from 3rd pharyngeal pouch
What is the nerve supply of the tongue?
Motor: all are hypoglossal, except: palatoglossal = pharyngeal plexus
Sensory:
1. Anterior 2/3rd = general (lingual), taste (chorda tympani)
2. Posterior 1/3rd = general + taste (glossopharyngeal)
3. Root of tongue = general + taste (vagus)
What is the lymphatic drainage of the tongue?
Apical = tip of tongue to submental LN
Marginal = side of tongue to submandibular LN to ipsilateral deep cervical LN
Central = midline of tongue to bilateral deep cervical LN
Posterior = deep cervical LN
