HNS-2 Flashcards
What are the borders of the anterior triangle of the neck?
- Anterior border of sternocleidomastoid
- Inferior border of mandible
- Midline of neck
What muscles are in the anterior triangle?
- Platysma
- Mylohyoid
- Digastric
- Infrahyoid (strap) muscles
What blood vessels are in the posterior triangle of the neck?
- External jugular vein
- Subclavian artery
- Subclavian vein
What nerves are in the posterior triangle of the neck
- Trunks of the brachial plexus
- Phrenic nerve
- Vagus nerve
- Spinal accessory nerve
What are the borders of the posterior triangle of the neck?
- Sternocleidomastoid
- Clavicle
- Trapezius
What is number 1 on this diagram
Pretracheal Fascia
What is number 2 on this diagram?
Visceral compartment
What is number 3 on this diagram?
Vascular compartment
What is number 4 on this diagram?
Vertebral compartment
What is number 5 on this diagram?
Superficial fascia
What is number 6 on this diagram?
Carotid sheath (fascia)
What is number 7 on this diagram?
Investing fascia
What is number 8 on this diagram?
Prevertebral fascia
What is number 1 on this diagram
Infrahyoid muscles
What is number 2 on this diagram
Trachea
What is number 3 on this diagram
Esophagus
What is number 4 on this diagram
Internal jugular vein
What is number 5 on this diagram
Common carotid artery
What is number 6 on this diagram
Vagus nerve
What is number 7 on this diagram
Scalene muscles
What is number 8 on this diagram
Prevertebral fascia
What is number 9 on this diagram
Trapezius muscle
What is number 10 on this diagram
Investing fascia
What is number 11 on this diagram
Buccopharyngeal fascia
What is number 12 on this diagram
Carotid sheath fascia
What is number 13 on this diagram
Sternocleidomastoid muscle
What is number 14 on this diagram
Pretracheal fascia
What is number 15 on this diagram
Thyroid
What are the three branches of the aorta?
Brachiocephalic artery, Left common carotid and the left subclavian artery.
What is the first branch of the subclavian arteries
Vertebral branch
What is the course of the vertebral branch
The vertebral branch courses superiorly along each side of the neck region
What are the branches of the common carotid arteries
The external and internal carotids
What parts of the body do the external and internal carotids supply.
External - face (face is external part of head)
Internal - brain
What is number 1 in this diagram?
Superficial temporal artery
What is number 2 in this diagram?
Posterior auricular artery
What is number 3 in this diagram?
Occipital artery
What is number 4 in this diagram?
Ascending pharyngeal artery
What is number 5 in this diagram?
Internal carotid artery
What is number 6 in this diagram?
Common carotid artery
What is number 7 in this diagram?
Superior thyroid artery
What is number 8 in this diagram?
External carotid artery
What is number 9 in this diagram?
Lingual artery
What is number 10 in this diagram?
Facial artery
What is number 11 in this diagram?
Maxillary artery
What is number 1 on this diagram?
Maxillary vein
What is number 2 on this diagram?
Retromandibular vein
What is number 3 on this diagram?
Internal jugular vein
What is number 4 on this diagram?
Jugular venous arch
What is number 5 on this diagram?
Transverse cervical vein
What is number 6 on this diagram?
Supracapsular vein
What is number 7 on this diagram?
External jugular vein
What is number 8 on this diagram?
Anterior jugular veins
What is number 9 on this diagram?
Occipital vein
What is number 10 on this diagram?
Posterior auricular vein
What is number 11 on this diagram?
Facial vein
What is number 12 on this diagram?
Superficial temporal vein
Where does the facial vein drain into?
Internal jugular vein
Where do the opthalmic veins drain into and what is the clinical importance of this?
Cavernous sinus
- provides a potential route of infection back into the cranial cavity particularly from the eyes and nose
Where does the pterygoid plexus drain into?
Internal jugular vein
What is number 1 on the diagram
Opthalmic veins
What is number 2 on the diagram
Cavernous sinus
What is number 3 on the diagram
Pterygoid plexus of veins
What is number 4 on the diagram
Infra-orbital veins
What is number 5 on the diagram
Facial vein
What is number 6 on the diagram
Deep facial vein
Where are central lines normally placed?
Internal jugular vein (main approach) and the subclavian vein
What is number 1 on the diagram
Occipital nodes
What is number 2 on the diagram
Mastoid/post auricular nodes
What is number 3 on the diagram
Jugulodigastric nodes
What is number 4 on the diagram
Superficial cervical nodes
What is number 5 on the diagram
Deep cervical nodes nodes
What is number 6 on the diagram
Jugulo-omohyoid nodes
What is number 7 on the diagram
Submandibular nodes
What is number 8 on the diagram
Submental nodes
What is number 9 on the diagram
Pre-auricular/ Parotid nodes
Where do all of the superficial nodes in the head and neck drain into?
The deep cervical nodes
What is the function of the larynx
- Acts as a valve allowing air into the trachea
- Production of speech
What is the function of the arytenoid cartilage?
Articulation of speech via movement of the vocal folds
What is the function of the posterior crico-arytenid muscle?
Contraction of this muscle causes vocal folds to abduct (open)
What are the 3 large unpaired cartilages in the larynx?
- Cricoid
- Thyroid
- Epiglottis
What are the 3 pairs of smaller cartilages in the larynx?
- Arytenoid
- Corniculate
- Cuneiform
How is the larynx innervated?
Branches of the vagus nerve.
- Superior laryngeal nerve (branch of vagus) splits into the internal and external laryngeal nerve and theses innervated the larynx.
- Recurrent laryngeal nerve also supplies.
What is the effect of a lesion above the branches of the vagus nerve?
Lesion causes complete paralysis
What is the effect of a lesion in the internal laryngeal nerve?
Loss of sensation above the vocal folds
What is the effect of a lesion in the external laryngeal nerve
Paralysis of the cricothyroid muscle
What is the effect of a lesion in the recurrent laryngeal nerve
Paralysis of all muscles of the larynx except the cricothyroid and loss of sensation below the vocal folds
Name number 1 in the diagram of the larynx
Epiglottis
Name number 2 in the diagram of the larynx
Hyoid bone
Name number 3 in the diagram of the larynx
Thyroid cartilage
Name number 4 in the diagram of the larynx
Cricoid cartilage
Name number 5 in the diagram of the larynx
Laryngeal inlet
Name number 1 on this diagram of the larynx
Arytenoid cartilage
Name number 1 on this diagram of the posterior larynx
Laryngeal inlet
Name number 2 on this diagram of the posterior larynx
Epiglottis
Name number 3 on this diagram of the posterior larynx
Vestibule
Name number 4 on this diagram of the posterior larynx
Infraglottic space
Name number 5 on this diagram of the posterior larynx
Vestibular fold
Name number 6 on this diagram of the posterior larynx
Vocal fold
Name number 7 (pink highlight) on this diagram of the posterior larynx
Glottis
Name number 1 on this diagram of the vocal folds
Epiglottis
Name number 2 on this diagram of the vocal folds
Vocal fold
Name number 3 on this diagram of the vocal folds
Vestibular fold
Name number 4 on this diagram of the vocal folds
Cuneiform tubercle
Name number 5 on this diagram of the vocal folds
Corniculate tubercle
What group of muscles are important in the movement of the vocal cords
Arytenoid muscles
Name muscles 1-3
1) Cricothyroid muscle
2) Staight part
3) Oblique part
Name muscles 4 and 5
4) Posterior crico-arytenoid
5) Lateral crico-arytenoid
What are the 4 protective mechanims for the airway?
- Swallowing
- Gag reflex
- Sneezing
- Coughing
What is the blood supply of the thyroid gland
It is supplied by branches of the subclavian artery called inferior and superior thyroid arteries
Label this typical vertebra
1) Pedicle
2) Transverse process
3) Lamina
4) Spinous process
5) Vertebral arch
6) Vertebral body \
7) Superior articular process
8) Inferior articular process
What are the defining features of the cervical vertebra?
- Short Vertebral body
- Triangular vertebral foramen
- Short and bifid (splits in two) spinous process
What are the abnormal vertebra of the cervical spine called?
- Atlas (C1)
- Axis (C2)
What are the distinguishable features of the atlas?
Lack of vertebral body
What are the distinguishable features of the axis
Lack of vertebral body and presence of dens
What is the atlanto-occipital joint?
‘YES’ joint
- Allows the movement of the head up and down
What is the atlantoaxial joint and what dos it do?
‘NO’
- Allows rotation of the head towards left and right
Name 1-5 on this diagram of the atlas and axis
1) Atlanto-occipital joint
2) Cruciate ligament
3) Superior longitudinal band
4) Transverse ligament of atlas
5) Inferior longitudinal band
Name 6-8 on this diagram of the atlas and axis
1) Median
2) Lateral
3) Atlanto-axial joints
Name 9-12 on this diagram of the atlas and axis
9) Tectorial membrane
10) alar ligament
11) Accessory part of the tectorial membrane
12) Posterior ligament turning into tectorial membrane
What are the distinct features of thoracic vertebra?
- Circular vertebral foramen
- Long sloping spinous process
- Facets on transverse processes for articulation of ribs
- Heart shaped (this is a fat lie but whatever) vertebral bodies
What are the distinct features of the lumbar vertebra
- kidney shaped (this one I ACC believe), tall vertebral body
- Long and thin transverse processes
- Short and blunt spinous processes
- Triangular vertebral foramen
What is the function of the ligaments in the back?
To support the joints between vertebrae
What are the attachments of the anterior longitudinal ligamnent?
It is attached to the base of the skull and extends inferiorly to attach to the anterior surface of the sacrum
What are the attachments fo the posterior longitudinal ligament?
It is attached to the posterior surfaces of the vertebral bodies and lines the anterior surface of the vertebral canal
What are the attachments of the ligamenta flava?
- Pass between lamina of adjacent vertebra
What is the function of the ligamenta flava?
Resist separation of the lamina in flexuin and assist in extension back to anatomical positions
What are the attachements of the supraspinous ligament
Passes along the tips of the spinous processes of vertebra C7 to sacrum
What are the attachments of the ligamentum nuchae?
- Superiorly, attached to the external occipital protuberance (basically bit of occipital bone that sticks out the most)
- Inferiorly, attached to tip of spinous process of C7
- Attached to tubercle of C1 and spinous processesof other vertebra
What is the function of the ligamentum nuchae?
- Supports the head
- Resists flexion and facilitates return of head to anatomical position.
What are the attachments of the interspinous ligaments?
- Attach from base to apex of each spinous process
- Blend with supraspinous ligament and ligamenta flava
Name the ligaments shown in this picture?
1) Posterior longitudinal ligament
2) Anterior longitudinal ligament
3) Ligamenta flava
4) Supraspinous ligament
5) Intraspinous ligament
Name the ligaments shown in this picture?
1) Posterior longitudinal ligament
2) Anterior longitudinal ligament
3) Ligamenta flava
4) Supraspinous ligament
5) Intraspinous ligament
What are the 2 major types of joints between vertebrae?
- Symphyses between vertebral bodies (intervertebral discs)
- Synovial joints between articular processes (zygopophysial joints)
What is the role of the anulus fibrosus and how does it work?
Limits rotation between vertebrae via lamellar confuguration of fibrocartilage
What is the role of the nucleus pulposus and how does it work?
Absorbs compression forces between vertebrae because of its gelatinous nature
What is mechanism of the herniation of intervertebral discs?
1) Tear occurs in anulus fibrosus
2) Material of nucleus pulposus follows through tear
3) Impinges on neural structures causing back pain
Name number 1 on the diagram of neck muscles
Mandible
Name number 2 on the diagram of neck muscles
Hyoid bone
Name number 3 on the diagram of neck muscles
Thyrohyoid muscle
Name number 4 on the diagram of neck muscles
Sternothyroid
Name number 5 on the diagram of neck muscles
Thyroid gland
Name number 6 on the diagram of neck muscles
Second rib
Name number 7 on the diagram of neck muscles
Anterior belly of digastric muscle
Name number 8 on the diagram of neck muscles
Mylohyoid muscle
Name number 9 on the diagram of neck muscles
Omohyoid muscle
Name number 10 on the diagram of neck muscles
Thyroid cartilage
Name number 11 on the diagram of neck muscles
Sternocleidomastoid muscle
Name number 12 on the diagram of neck muscles
Sternohyoid muscle
Name number 13 on the diagram of neck muscles
Clavicle
Name number 14 on the diagram of neck muscles
Subclavius muscle
Name numbers 15 and 16 on the diagram of neck muscles
15) Posterior belly of digastric muscle
16) Stylohyoid muscle