HNS 2 Flashcards
What are the three functions of the neck?
structural (supports and moves the head), visceral (contains airway + oesophagus), conduit for blood vessels (to head) and nerves (to thorax)
What are fascia?
connective tissue that contian mainly collagen fibres that separate compartments
function of fascia
prevents spread of infection and houses different structures
what are 5 fascia?
superficial, pretracheal, carotid sheath, investing and prevertebral (back of neck) fascia
what does the superficial fascia contain?
platysma
what does the carotide sheath contain
vascualr compartment on the left and right sides of the neck (bvs and nerves)
what does the pretracheal fascia contain?
-trachea
-oesophagus
-thyroid gland
-infrahyoid muscle
what does the prevertebral fascia contain?
-is the back of then neck and contains many muscles and vertebrae
what does the investing layer contain?
sternocleidomastoid muscle and trapezius muscle
what is the anterior triangle of the neck made up of?
-mainly muscles (platysma, deeper: mylohyoid, digastric and infrahyoid (strap) muscles)
-blood vessels: carotid arteries
What is the posterior triangle of neck made up of?
-external jugular vein (from brachiocephallic vein)
-subclavian artery and vein
-trunks of the brachial plexus
-phrenic nerve
-vagus nerve
-spinal accessory nerve
trunks of the brachial plexus supplies?
upper limb
phrenic nerve supplies?
diaphragm
vagus nerve supplies?
respiratory, cardiovasuclar, and GI responses
the spinal accessory nerve [IX] supplies?
the pair of muscles in the neck
what are the 4 infrahyoid (strap) muscles of the anterior triangle (look at diagram to help you remember)
-thyrohyoid
-sternothyroid
-sternohyoid
-omohyoid
What is the larynx?
a hollow structure composed of cartilages, membranes and muscles that acts as a valve (epiglottis) and sound producer
what are the 3 laryngeal cartilages?
cricoid, cricoarytenoid and thyroid
the opening from the infraglottic space (going into trachea) to vestibule is called?
the glottis
what are the muscles of the larynx
anterior: cricothyroid muscle (straight and oblique)
posterior: posterior and lateral crico-arytenoids
oblique + transferse arytenoids, vocalis muscle
what are the ligaments of the larynx
-vocal ligament
-lateral cricothyroid ligament
What nerve innervates the larynx?
vagus nerve
what are the 4 protective mechanisms for the airway?
-swallowing
-gag reflex (CNIX)
-sneezing
-coughing
lesion to vagus nerve causes?
complete paralysis of larynx
vagus nerves branch into?
superior (to internal and external) and recurrent laryngeal nerve (goes into thorax and then back to thorax)
lesion to internal layngeal nerve causes?
loss of sensation above the vocal folds
lesion to external layngeal nerve causes?
paralysis of cricothyroid (anterior)
lesion to recurrent laryngeal nerve causes?
paralysis of all muscles of larynx except cricothyroid and loss of sensation below the vocal folds
why must surgery of thyroid be done carefully?
the recurrent laryngeal nerve (left and right) runs close to the thyroid and therefore damage can cause paralysis of larynx (+ sensation loss below vocal folds)
Why should eye infections be of concern?
the opthalmic veins drains back into the cavernous sinus which is situated deep in cranial cavity.
This can provide a potential route of infection into cranial cavity
where can we put in a central venous line to measure central venous pressure?
-internal jugular vein (middle of neck)
-subclavian veins
what nodes are right next to the internal jugular vein?
deep cervical nodes
what is the function of the vertebral column?
support, protection and movement
what are the regions of the vertebral column?
-cervical (7), thoracic (12), lumbar(5), sacral (5 fused), coccygeal (4 fused)
what structures are in the vertebral column
bone, ligaments and intervertebral discs (cartilage)
what movements can the vertebral column allow?
extension, flexion, lateral flexion and rotation
how does the vertebral column provide support and protection?
-supports body weight, the head and upper limps (aid movements)
-transmit forces
-protects spinal cord
how does the vertebral column provide movement?
-upper limbs and ribs (extrinsic muscles)
-postural control and movement (intrinsic muscles)
What makes up a typical vertebrae?
vertebral body, vertebral arch and pedicles
what is the vertebral body
major weight bearing part
what is the verterbral arch
-it forms roof of vertebral canal and has projections for attachment of muscles and ligaments + sites of articulation for adjacent vertebrae
what are the pedicles of typical vertebrae?
they anchor the vertebral arch to the verebral body
describe a typical cervical vertebrae
-rectangular bodies with concave superior and convex inferior surface with uncus of body (uncinate process)
-triangular vertebral foramen
-has foramen transversarium (for arteries)
-oblique, relatively horizontal articular facets
-perforated transverse processes w/ a+p tubercles
-bifid spinous process
describe a typical thoracic vertebrae
-columnar, heart-shaped bodies
-circular vertebral foramen
-has 2 costal facets each side (1 on transverse process)
-nearly vertical articular facets posteriorly and anteriorly
-long and sloping spinous process overlapping inferior vertebra
describe a typical lumbar vertebrae
-massive columnar kidney-shaped body
-triangular vertebral foramen
-nearly verticle articular facets
-short, broad and blunt spinous process
-long slender lateral transverse processes
what are the two atypical vertebrae
C1 and C2
what joint is the yes joint? (nodding)
atlanto-occipital joint
what is the atlanto-occipital joint made up of?
2 ligaments: alar ligament and cruciate/cruciform ligament
what is the no joint?(shaking head)
atlanto-axial joint (between C1 and C2)
what is ligament flava and function
ligament that connect the lamina adjacent vertebrae and maintain the alignment of the spine.
what muscles are used in flexion (starting from extended position then forward)
rectus abdominis and psoas major
what muscles are used in extension (starting from extended position forwards then backwards)
erector spinae and gluteus maximus
what muscles are used in lateral flexion
-rhomboids
-serratus anterior
-external oblique (anterior)
-internal oblique (anterior)
-internal and external obliques (lateral part)
-quadratus lumborum
what muscles are used in rotation
sternocleidomastoid, splenius, transversospinalis, iliocostalis and longissimus, external and internal oblique
intervertebral discs role
weight bearing and osme degree of flexibility
oculomotor nerve function
motor: levator palpebrae superioris, all rectus (except LR), and inferior oblique
parasympathetic: motor to sphincter pupillae, ciliary muscles for accommodation (ciliary ganglion-changing pupil size and lens thickness)
optic nerve nerve function
vision
trochlear nerve function
motor: superior oblique
trigeminal nerve function
motor: muscles of mastication
sensory: proprioception from muscles of mastication; discriminative touch and vibration from head + sensation of A2/3 of tongue; pain and temperature of head
abducens (VI) nerve function
motor: lateral rectus
facial nerve function
sensory: a2/3(t, external auditory meatus + deeper parts of auricle and skin posterior to ear
motor: muscles of facial epression; pm in lacrimal, sublingual and submandibular gland
vestibulocochlear nerve function
balance and hearing
glossopharyngeal nerve function
sensory: p1/3 (s+t), tonsils and pharynx (gag); chemo+baroreceptors in carotid and i+e surfaces of tympanic membrane
motor: stylopharyngeus, pm in parotid gland
vagus nerve function
sensory: base of tongue + epiglottis, posterior meninges, external acoustic meatus and skin posterior to ear; larynx, trachea, oesophagus, thoracic and abdominal viscera; stretch receptors in aortic arch
motor: pharyngeal muscles; cricothyroid, pm to smooth muscles and glands of the pharynx, larynx and thoracic and abdominal viscera; cardiac muscles
hypoglossal nerve function
Hyoglossus, genioglossus, styloglossus and all intrinsic muscles of the tongue
what are the branches of the external caroitid
-superficial temporal
-maxillary
-posteiror auricular
-facial
-occipital (crosses over internal)
-lingual(under facial)
-ascending pharyngeal
-superior thyroid
superficial temporal artery appears where?
arising up anterior to ear
posterior auricular artery location
rising up behind ear
maxillary artery location
brached off external carotid at the zygomatic level
facial artery lcoation
branched off external carotid at the mandibular level
location of lingual artery
branched off external carotid below facial artery
ascending pharyngeal artery location
after superior thyroid artery (goes downwards), one of the first branches of external carotid and rises up
occipital artery location
after facial artery, branch of external carotid artery
auriculotemporal nerve location
in front of ear going uo
