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MRCS A > HNS > Flashcards

HNS Flashcards

1
Q

What are the layers of the scalp?

A

SCALP
Skin
Connective tissue layer (superficial fascia)
Aponeurotic layer (epicranial aponeurosis, galiaaponeurotica)
Loose areolar tissue
Pericranium

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2
Q

What is the nerve supply to the anterior 1/2 of scalp?

A

Branches of trigeminal nerve

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3
Q

What is the nerve supply of the posterior 1/2 of scalp?

A

C2/C3

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4
Q

What are the capsules of the parotid gland?

A

True = condensed connective Tissue
False = deep Fascia around gland

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5
Q

What structures are embedded in the parotid gland?

A

Facial nerve (most superficial)
Retromandibular vein
External carotid
Auriculo-temporal nerve

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6
Q

What does the facial nerve divide into in the parotid gland?

A

Temporal branch
Zygomatic branch
Buccal branch
Mandibular branch
Cervical branch

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7
Q

How is the retromandibular vein formed in the parotid gland?

A

Maxillary + superficial temporal veins

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8
Q

What does the external carotid artery divide into in the parotid gland?

A

Maxillary artery
Superficial temporal artery

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9
Q

What nerve is injured during parotid gland surgery?

A

Facial N.

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10
Q

What nerve is injured during the superficial dissection of the parotid gland?

A

Greater auricular nerve

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11
Q

Where does the parotid duct open?

A

Into the vestibule of mouth opposite upper 2nd molar tooth

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12
Q

What is the nerve supply of the parotid gland?

A

Sensory = auriculo-temporal nerve
Sympathetic = superior cervical sympathetic ganglion around external carotid artery
Parasympathetic = otic ganglion

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13
Q

What are the boundaries of the posterior triangle of the neck?

A

Anterior = post. Border of Sternomastoid muscle
Posterior = ant. Border of trapezius
Base = middle 1/3 of clavicle
Apex = meeting between sternomastoid + trapezius

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14
Q

What are the contents of posterior triangle of neck?

A

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

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15
Q

What are the borders of the anterior triangle of the neck?

A

Anterior = ant. Midline of neck
Posterior = ant. Border of sternomastoid muscle
Superiorly = lower border of mandible

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16
Q

How is the anterior triangle divided?

A

2 bellies of the digastric muscle + superior belly of omohyoid muscle

Digastric triangle (submandibular)
Muscular triangle
Carotid triangle

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17
Q

What are the contents of the carotid triangle?

A

Carotid sheath (common carotid, internal carotid, vagus nerve + IJV)
Ansa cervicalis + sympathetic trunk

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18
Q

What are the contents of the submandibular triangle?

A

Submandibular gland
Submandibular nodes
Facial vessels
Hypoglossal nerve

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19
Q

What are the nerve supplies for the digastric muscle?

A

Anterior belly = nerve to mylohyoid from trigeminal N.
Posterior belly = facial n.

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20
Q

What are the contents of the carotid sheath?

A

Common + internal carotid arteries
Internal jugular vein
Vagus nerve

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21
Q

What is the origin of the two heads of the sternomastoid muscle?

A

Sternal head = front of manubrium sterni
Clavicular head = upper surface of medial 1/3 of clavicle

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22
Q

What is the nerve supply of the sternomastoid muscle?

A

Spinal root of accessory nerve

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23
Q

What is the ansa cervicalis formed from?

A

Upper root = descends hypoglossi (c1)
Lower root = descends cervicalis (c2/c3)

24
Q

What are the branches of the ansa cervicalis?

A

GHost THought SOmeone STupid SHot Irene
1. GenioHyoid
2. ThyroHyoid
3. Superior Omohyoid
4. SternoThyroid
5. SternoHyoid
6. Inferior Omohyoid

25
Q

What are the three scalene muscles?

A

Scalenus anterior
Scalenus medius
Scalenus posterior

26
Q

What passes through anterior + middle scalenes?

A

Brachial plexus
Subclavian artery

DEEPER

27
Q

What passes anterior to anterior scalene muscle?

A

Subclavian vein
Phrenic nerve

28
Q

What are the dural venous sinuses divided into it?

A

Single + Paired

29
Q

What is the site of the superior sagittal sinus?

A

Along upper border of falx cerebri

30
Q

What are the borders of the cavernous sinus?

A

Medial = pituitary gland + sphenoidal air sinus
Lateral = temporal lobe
Superior = internal carotid artery + optic chiasma
Inferior = body of sphenoid + sphenoidal air sinus

31
Q

What structures are inside the cavernous sinus?

A

Lateral wall = oculomotor, trochlear, ophthalmic, maxillary
In cavity = internal carotid artery, abducens nerve

32
Q

Where are the foramina in the skull found?

A

All in sphenoid except:
Jugular foramen = temporal bone
Stylomastoid foramen = temporal bone
Foramen magnum = occipital bone

33
Q

What are the contents of foramen ovale?

A

OVALE
Otic ganglion
V3 of trigeminal nerve
Accessory meningeal artery
Lesser petrosal nerve
Emissary veins

34
Q

What are the contents of the foramen spinosum?

A

Middle meningeal artery
Meningeal branch of mandibular nerve

35
Q

What are the contents of the foramen rotundum?

A

Maxillary nerve (V2)

36
Q

What are the contents of the jugular foramen?

A

Anterior = inferior petrosal sinus
Intermediate = glossopharyngeal, vagus, accessory nerve
Posterior = sigmoid sinus

37
Q

What are the contents of stylomastoid foramen?

A

Stylomastoid artery
Facial nerve

38
Q

What are contents of superior orbital fissure?

A

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

39
Q

What are the contents of the foramen magnum?

A

Anterior + posterior spinal arteries
Vertebral arteries
Spinal accessory nerve entering skull

40
Q

What is the parasympathetic nerve supply of the lacrimal gland?

A

Pterygopalatine ganglion

41
Q

What muscle acts on the upper eyelid?

A

Levator palpebrae superioris

42
Q

What is the nerve supply to the levator palpebrae superioris?

A

Superior division of oculomotor nerve

43
Q

What nerves supply the muscles acting on the eyeball?

A

All are oculomotor except:
LR6 = lateral rectus = abducens
SO4 = superior oblique = trochlear

44
Q

What nerve supplies the muscles of mastication?

A

Mandibular nerve

45
Q

What is the action of mastication + the muscles suppling it?

A

Ter = temporalis = elevation + retraction
Mep = masseter + medial pterygoid = elevation + protrusion
Lpd = lateral pterygoid = protrusion + depression

46
Q

What is the origin of the middle meningeal artery?

A

1st part of maxillary artery + enters through foramen spinosum
Runs beneath pterion

47
Q

What does rupture of middle meningeal artery cause?

A

Extradural haematoma

48
Q

What are the deep relations of the submandibular salivary gland?

A

Mylohyoid muscle
Submandibular duct
Hyoglossus muscle
Lingual nerve
Submandibular ganglion
Hypoglossal nerve

49
Q

What is the path of the submandibular (Wharton’s) duct?

A

Arises from anterior part of deep part of gland
Opens in floor of mouth on sublingual papilla at side of frenulum of tongue

50
Q

What is the nerve supply of the submandibular (Wharton’s) duct?

A

Submandibular ganglion

51
Q

What is the thyroid gland formed of?

A

2 lateral lobes
Isthmus
Pyramidal lobe

52
Q

What is the position + extension of the thyroid gland?

A

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

53
Q

What is the arterial supply to the thyroid gland?

A

Superior thyroid artery from external carotid
Inferior thyroid artery from thyrocervical trunks of subclavian
Thyroida ima artery from arch of aorta

54
Q

What is the venous drainage of thyroid gland?

A

Superior thyroid veins = end in IJV
Middle thyroid veins = end in IJV
Inferior thyroid veins = end in brachiocephalic veins

55
Q

What is the embryology of the parathyroid gland?

A

Superior = from 4th pharyngeal pouch
Inferior = from 3rd pharyngeal pouch

56
Q

What is the nerve supply of the tongue?

A

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)

57
Q

What is the lymphatic drainage of the tongue?

A

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

MRCS A (3 decks)

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