HNS

Question 1

Level of opening of mouth

Answer 1

c1

Question 2

Superior, middle, inferior cervical ganglion levels

Answer 2

c2, c6, c7

Question 3

body of hyoid bone level

Answer 3

c3

Question 4

bifurcation of common carotid level, WHat else happens at this level?

Answer 4

c4, laryngeal prominence

Question 5

cricoid cartilage level

Answer 5

c6

Question 6

what is at c6

Answer 6

cricoid and mid cervical ganglion

Question 7

where do the trunks of the brachial plexus emerge

Answer 7

posterior to scalene anterior (and anterior to scalenus medius)

Question 8

where are the subclavian veins and arteries relative to the scalenus anterior

Answer 8

vein anterior to scalene anterior

Arteries posterior

Question 9

phrenic nerve relation to scalene

Answer 9

lies on the scalene anterior

Question 10

mylohyoid innervation

Answer 10

V3 (mandibular division)

Question 11

digastric innervation

Answer 11

anterior belly - V3

posterior - facial (VII)

Question 12

strap muscle (infrahyoid) innervation

Answer 12

all innervated by ansa cervicalis (from cervical plexus) except from thyrohyoid which is innervated by c1 fibres that are travelling with hypoglossal nerve

Question 13

central venous line/catheter access locations

Answer 13

Internal jugular (most common) Subclavian vein Femoral vein

Question 14

contents of posterior triangle of neck

Answer 14

• 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)

Question 15

origin and insertion of inferior oblique

Answer 15

origin: orbital plate of maxilla
insertion: posterior-lateral superior quadrant of the globe

Question 16

origin and insertion of superior oblique

Answer 16

Origin: body of sphenoid

Insertion: via the trochlea (pulley) to the postero-lateral superior quadrant of the globe

Question 17

Origin and insertion of LPS

Answer 17

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

Question 18

where do 3,4,5,6 pass through before going through the superior orbital fissure?

Answer 18

cavernous sinus

Question 19

3 branches of opthalmic nerve V1

Answer 19

Lacrimal (smallest), Nasociliary, Frontal (largest)

Question 20

which nerve out of 3456 pass through middle of cavernous sinus instead of lateral side

Answer 20

abducens

Question 21

where do the two ophthalmic veins drain

Answer 21

Superior ophthalmic vein = cavernous sinus

Inferior ophthalmic vein = pterygoid plexus

Question 22

innervation of lacrimal glands

Answer 22

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.

Question 23

tear drainage pathway

Answer 23

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

Question 24

word for drooping of eyelid

Answer 24

ptosis

Question 25

eye dilation

Answer 25

mydriasis

Question 26

eye constriction

Answer 26

miosis

Question 27

Horners syndrome cause + symptoms

Answer 27

• sympathetic dysfunction/cervical ganglion
  leads to:
  ptosis (sympathetic nerves innervating LPS)
  mydriasis (no sympathetic dilation)
  no sweating on face (anhidrosis)

Question 28

abnormal alignment of eyes

Answer 28

strabismus