MRCS Head and neck

Question 1

List the cranial nerves located in the anterior triangle of the neck

Answer 1

1. Facial nerve - VII
2. Glossopharyngeal - IX
3. Vagus - X
4. Accessory - XI
5. Hypoglossal - XII

Question 2

The anterior triangle is further sub divided into 4 triangles, name these

Answer 2

1. Carotid
2. Submental
3. Submandibular
   Muscular

Question 3

Other than the common carotid, what structures are found in the carotid triangle ?

Answer 3

1. Internal jugular vein
2. Vagus nerve
3. Hypoglossal nerve

Question 4

What structures make the borders of the carotid triangle ?

Answer 4

Superior – posterior belly of the digastric muscle.

Lateral – medial border of the sternocleidomastoid muscle.

Inferior – superior belly of the omohyoid muscle.

Question 5

which subdivision of the anterior triangle can you find CN X and XII ?

Answer 5

Carotid triangle

Question 6

which nerve sends signals from the carotid sinus to the brain ?

Answer 6

Glossopharyngeal (CN IX)

Question 7

which lymph nodes drain from the floor of the mouth and parts of the tongue.

Answer 7

Submental lymph nodes.

Question 8

what important structure passes through the submandibular triangle ?

Answer 8

Facial artery

Question 9

Which triangle does the facial artery and vein pass through?

Answer 9

submandibular triangle

Question 10

What is the superior border of the muscular triangle?

Answer 10

Hyoid bone

Question 11

The submental triangle lies within the anterior triangle of the neck.

Which muscle forms the floor of the submental triangle?

Answer 11

Mylohyoid

Question 12

what anatomical spaces highlighted in yellow ?

Answer 12

Muscular triangle

Question 13

what structure forms the roof of the posterior triangle of the neck ?

Answer 13

Investing layer of fascia

Question 14

what muscles form the floor of the posterior triangle of the neck ?

Answer 14

Splenius capitis
Levator scapulae
Anterior, middle and posterior scalenes

Question 15

where are the internal and external jugular veins located ?

Answer 15

IJV - Anterior triangle
EJV - Posterior triangle

Question 16

True or false

The internal jugular vein travels through the posterior triangle of neck.

Answer 16

False

The internal jugular vein travels through the ANTERIOR triangle of neck.

Question 17

which layer of fascia forms the roof of the posterior triangle of the neck ?

Answer 17

Investing layer of fascia

Question 18

The accessory nerve is located in the posterior triangle. Which TWO nerve plexus’ are located in the posterior triangle ?

Answer 18

1. Cervical plexus
2. Trunks of the brachial plexus

Question 19

List the layer that make up the deep cervical fascia

Answer 19

1. Investing layer
2. pre tracheal layer
3. Pre vertebral layer
4. carotid sheath

These layers go from superficial to deep

Question 20

what are the anterior and posterior attachments of the investing layer of fascia in the neck

Answer 20

Anterior - Hyoid bone
Posterior - Nuchal ligament

Question 21

what two muscles are enveloped by the investing fascia

Answer 21

Sternocleidomastoid and Trapezius

Question 22

what organs are located in the pre tracheal fascia ?

Answer 22

Trachea, Oesophagus, thyroid gland

Question 23

The pre tracheal fascia is seperated into a muscular layer and a visceral later - what structure are located in these two layers ?

Answer 23

Muscular part – encloses the infrahyoid muscles.

Visceral part – encloses the thyroid gland, trachea and oesophagus.

Question 24

What structure is highlighted in red ?

Answer 24

Pre tracheal fascia

Question 25

The red line highlights the pre tracheal fascia in the neck. Name all the labelled structures

Answer 25

Question 26

Which potential space in the neck could allow for the tracking of pus into the posterior mediastinum?

Answer 26

Retropharyngeal space

Question 27

The retropharyngeal space extends from the base of the skull to the posterior mediastinum. Therefore infection can track from here into the mediastinum.
What structures make up the retropharyngeal space ?

Answer 27

buccopharyngeal fascia (posterior aspect of the visceral pretracheal fascia) and the prevertebral fascia.

Question 28

The prevertebral fascia forms the floor of which anatomical space?

Answer 28

Posterior triangle

Question 29

In which fascial layer is the platysma muscle found?

Answer 29

Superficial cervical

Question 30

Pus in the retropharyngeal space can track into what other space ?

Answer 30

Posterior mediastinum

Question 31

The inferior pharyngeal constrictor is split into two parts; what are those ?

Answer 31

the thyropharyngeus and the cricopharyngeus.

Question 32

The muscles of the pharynx are mostly innervated by the vagus nerve. Except which muscle and what nerve innervates it ?

Answer 32

stylopharyngeus - Innervated by the glossopharyngeal nerve.

Question 33

what nerve innervates the pharyngeal constrictors ?

Answer 33

Vagus

Question 34

The pharynx receives sensory innervation from what nerve ?

Answer 34

Glossopharyngeal

Question 35

Arterial supply to the pharynx is via ______

Answer 35

Branches of the external carotid

Question 36

Identify the longitudinal pharyngeal muscles in the picture

Answer 36

Question 37

what is the lymphatic drainage of the lingual tonsils ?

Answer 37

jugulodigastric and deep cervical lymph nodes.

Question 38

List the 4 tonsils

Answer 38

Palatine
Pharyngeal
Tubular
Lingual

Question 39

what lymphatic drainage do all tonsils have in common ?

Answer 39

They all drain into the deep cervical lymph nodes

Question 40

what is the arterial supply for the palatine tonsils ?

Answer 40

tonsillar branch of the facial artery.