HNS Flashcards
Level of opening of mouth
c1
Superior, middle, inferior cervical ganglion levels
c2, c6, c7
body of hyoid bone level
c3
bifurcation of common carotid level, WHat else happens at this level?
c4, laryngeal prominence
cricoid cartilage level
c6
what is at c6
cricoid and mid cervical ganglion
where do the trunks of the brachial plexus emerge
posterior to scalene anterior (and anterior to scalenus medius)
where are the subclavian veins and arteries relative to the scalenus anterior
vein anterior to scalene anterior
Arteries posterior
phrenic nerve relation to scalene
lies on the scalene anterior
mylohyoid innervation
V3 (mandibular division)
digastric innervation
anterior belly - V3
posterior - facial (VII)
strap muscle (infrahyoid) innervation
all innervated by ansa cervicalis (from cervical plexus) except from thyrohyoid which is innervated by c1 fibres that are travelling with hypoglossal nerve
central venous line/catheter access locations
Internal jugular (most common) Subclavian vein Femoral vein
contents of posterior triangle of neck
- Subclavian v and a
- external jug v
- trunks of brachial plexus
- phrenic nerve (lying on top of scalene anterior)
- vagus nerve
- spinal accessory nerve (NOT PART OF VAGUS, its the cranial accessory that is part of vagus. Remember it as cranial portions= parasympa so vagus)
origin and insertion of inferior oblique
origin: orbital plate of maxilla
insertion: posterior-lateral superior quadrant of the globe
origin and insertion of superior oblique
Origin: body of sphenoid
Insertion: via the trochlea (pulley) to the postero-lateral superior quadrant of the globe
Origin and insertion of LPS
Origin: lesser wing of sphenoid
Insertion: superior tarsal plate and skin of the eyelid
tarsal plate= the plate in the eye lid, this is covered by the skin
where do 3,4,5,6 pass through before going through the superior orbital fissure?
cavernous sinus
3 branches of opthalmic nerve V1
Lacrimal (smallest), Nasociliary, Frontal (largest)
which nerve out of 3456 pass through middle of cavernous sinus instead of lateral side
abducens
where do the two ophthalmic veins drain
Superior ophthalmic vein = cavernous sinus
Inferior ophthalmic vein = pterygoid plexus
innervation of lacrimal glands
Lacrimal nerve, containing fibres from:
Parasympathetic:
Parasympathetic secretomotor fibres of Facial Nerve (CN 7)
Sympa:
post ganglionic fibres from superior cervical ganglion,
Sensory:
Lacrimal nerve: branch of opthalmic nerve.
tear drainage pathway
superior and inferior canaliculus
then to lacrimal sac (dilated end of nasolacrimal duct)
then to nasolacrimal duct, then goes into nasal cavity (inferior to inferior nasal meatus
word for drooping of eyelid
ptosis
eye dilation
mydriasis
eye constriction
miosis
Horners syndrome cause + symptoms
- sympathetic dysfunction/cervical ganglion
leads to:
ptosis (sympathetic nerves innervating LPS)
mydriasis (no sympathetic dilation)
no sweating on face (anhidrosis)
abnormal alignment of eyes
strabismus
