Neck

Question 1

Which nerves are commonly affected in a carotid endarterectomy (in carotid triangle)?

Answer 1

1) Hypoglossal
2) Lingual
3) Great auricular
4) Superior laryngeal
5) Superior fibres of ansa cervicalis

Question 2

From which nerve roots does the phrenic nerve arise from?

Answer 2

C3, C4, C5

Question 3

From which muscle does the phrenic nerve arise from?

Answer 3

Lateral border of anterior scalene

Question 4

Which surface does the phrenic nerve descend down from the lateral border of the anterior scalene muscle?

Answer 4

Anterior surface of anterior scalene

Question 5

Within which fascial layer of the neck does the phrenic nerve descend down?

Answer 5

Prevertebral layer of cervical fascia

Question 6

Which structure does the phrenic nerve travel posterior to in the neck?

Answer 6

Subclavian vein

Question 7

Which nerves are at risk in incisions within the submandibular triangle?

Answer 7

1) Nerve to mylohyoid
2) Marginal mandobular branch of the facial nerve (VII)
3) Lingual nerve (V3)
4) Hypoglossal nerve (XII)

Question 8

What are the contents of the superficial fascia of the neck?

Answer 8

1) Platysma
2) Cutaneous nerves & vessels
3) External jugular vein
4) Superficial lymph nodes
5) Fat

Question 9

What are the layers of the deep cervical fascia?

Answer 9

1) Investing layer
2) Pretracheal layer
3) Prevertebral layer

Question 10

The investing layer of the neck surrounds the neck and wraps around 2 muscles, which ones are they?

Answer 10

1) Platysma

2) SCM

Question 11

Which fascia surrounds the parotid gland?

Answer 11

Parotid fascia - split layer of investing fascia in the face

Question 12

Which structures does the pretracheal layer envelop?

Answer 12

1) Trachea
2) Oesophagus
3) Thyroid
4) Parathyroid
5) Infrahyoid strap muscles

Question 13

What is the posterior aspect of the pretracheal fascia?

Answer 13

Buccopharyngeal fascia - anterior border of retropharyngeal space

Question 14

What does the prevertebral fascia cover?

Answer 14

1) Surrounds vertebral column
2) Scalene muscles
3) Prevertebral muscles
4) Deep muscles of the back
5) Forms floor of posterior triangle in neck

Question 15

The prevertebral fascia in the floor of the posterior traingle goes onto form what structures in the arm?

Answer 15

1) Axillary sheath - surround brachial plexus and subclavian artery

Question 16

What is the retropharyngeal space?

Answer 16

Between buccopharyngeal (pretracheal) and alar (prevertebral) fascias

Question 17

What are the relations of the retropharyngeal space?

Answer 17

SUPERIOR - Base of skull
INFERIOR - Superior mediastinum
LATERAL - Carotid sheath
ANTERIOR - Buccopharyngeal fascia
POSTERIOR - Alar fascia

Question 18

What are the branches of the external carotid artery?

Answer 18

1) Superior thyroid (ANTERIOR)
2) Ascending pharyngeal (MEDIAL)
3) Lingual (ANTERIOR)
4) Facial (ANTERIOR)
5) Occipital (POSTERIOR)
6) Posterior auricular (POSTERIOR)
7) Maxillary (TERMINAL)
8) Superficial temporal (TERMINAL)

Question 19

Common carotid artery bifurcates into internal & external carotid arteries at which level?

Answer 19

C4 within the carotid sheath at the level of upper border of thyroid cartilage

Question 20

What are the branches of the subclavian artery?

Answer 20

VIT CD

1ST PART

1) Vertebral
2) Internal mammary
3) Thyrocervical trunk

2ND PART

1) Costocervical trunk
2) Dorsal scapular artery

3RD PART - NO BRANCHES

Question 21

The inferior thyroid artery is a branch from which artery?

Answer 21

Thyrocervical trunk

Question 22

What does the inferior thyroid artery supply?

Answer 22

1) Thyroid gland
2) Parathyroid glands
3) Upper 1/3 of oesophagus

Question 23

What are the branches of the thyrocervical trunk?

Answer 23

ISAT

1) Inferior thyroid artery
2) Suprascapular artery
3) Ascending cervical artery
4) Transverse cervical artery

Question 24

Which nerves arise from the roots of the brachial plexus?

Answer 24

1) Long thoracic nerve
2) Dorsal scapular nerve
3) Nerve to subclavius

Question 25

Which is the only terminal nerve of the trunks of the brachial plexus?

Answer 25

1) Suprascapular nerve (Upper trunk)

Question 26

What muscle is supplied by the external branch of superior laryngeal nerve?

Answer 26

Cricothyroid

Question 27

What muscles are supplied by the inferior/recurrent laryngeal nerve?

Answer 27

``` All intrinsic muscles of the larynx EXCEPT CRICOTHYROID (this intrinsic muscle lies on the outside of the larynx) ```

Question 28

Which vein does the superior and middle thyroid vein drain into?

Answer 28

Internal jugular vein

Question 29

Which vein does the inferior thyroid vein drain into?

Answer 29

Brachiocephalic vein

Question 30

How many lobes does the submandibular gland have?

Answer 30

1) Superficial lobe 2) Deep lobe * * IN RELATION TO MYLOHYOID**

Question 31

Where is the submandibular gland located?

Answer 31

In submandibular triangle Inferior to posterior 1/2 of mandible Within submandibular fossa

Question 32

What is the relation of the hypoglossal nerve to the submandibular gland?

Answer 32

Superficial to the superficial lobe of the submandibular gland

Question 33

What is the relation of the lingual nerve to the submandibular gland?

Answer 33

Deep to the deep lobe of the submandibular gland & submandibular duct

Question 34

Through which fissure does the chorda tympani exit the skull?

Answer 34

Petrotympanic fissure It then piggyback onto lingual nerve and travels to tongue Provides taste to anterior 2/3

Question 35

What epithelium lines the lumen of trachea?

Answer 35

Pseudostratified ciliated columnar epithelium

Question 36

What epithelium lines the lumen of upper 1/3 of oesophagus?

Answer 36

Stratified squamous epithelium

Question 37

Where is the surgical tracheostomy incision made?

Answer 37

Between 2nd & 3rd tracheal cartilages/rings

Question 38

Where are percutaneous dilational tracheostomy incisions made?

Answer 38

1) Subcricoid cartilage | 2) Between 1st & 2nd tracheal cartilages/rings

Question 39

What are the layers you incise through when performing a tracheostomy?

Answer 39

* *SUPERFICIAL** 1) Skin 2) Sub-cutaneous fat 3) Superficial cervical fascia 4) Platysma 5) Investing layer of deep cervical fascia 6) Pre-tracheal fascia 7) Strap muscles (sternothyroid & sternohyoid) 8) Thyroid ithmus 9) Tracheal rings * *DEEP**

Question 40

Which muscles are innervated by the ansa cervicalis?

Answer 40

All strap muscles | EXCEPT THYROHYOID & GENIOHYOID (C1)

Question 41

What are the nerve roots of ansa cervicalis?

Answer 41

C1, C2, C3

Question 42

What are the unpaired cartilages of the larynx?

Answer 42

1) Epiglottis 2) Thyroid 3) Cricoid

Question 43

What are the paired cartilages of the larynx?

Answer 43

Arytenoids Cuneiforms Corniculates

Question 44

What does the cricothyroid muscle do?

Answer 44

Lengthens vocal cord Production of high pitched voice Innervated by external branch of superior laryngeal nerve

Question 45

What does the posterior cricoarytenoids do?

Answer 45

Abducts the vocal cords

Question 46

What does the thyroarytenoids do?

Answer 46

Shortens vocal cords Production of low pitched voice **OPPOSITE TO CRICOTHYROID**

Question 47

What does the internal branch of the superior laryngeal nerve supply?

Answer 47

Mucosa above the vocal cords

Question 48

What supplies the mucosa below the vocal cords?

Answer 48

Recurrent laryngeal nerve

Question 49

Which pharyngeal muscles are found in the laryngopharynx?

Answer 49

Middle & Inferior pharyngeal constrictors

Question 50

Between which muscles are pharyngeal pouches found? (Zenker's Diverticulum)

Answer 50

Thyropharyngeus & Cricopharyngeus | Inferior pharyngeal constrictors

Question 51

Through which structural defect does a pharyngeal pouch form?

Answer 51

Killian's dehiscence

Question 52

Where does the internal carotid artery lie in relation to the external carotid artery at the level of bifurcation?

Answer 52

Posterolaterally

Question 53

The recurrent laryngeal nerve passes through which groove at the level of the thyroid?

Answer 53

The tracheo-oesophageal groove

Question 54

Which artery does the recurrent laryngeal nerve closely relate to?

Answer 54

Inferior thyroid artery

Question 55

Which nerve lies medially in the thyroid gland?

Answer 55

Recurrent laryngeal nerve

Question 56

Which muscles are innervated by the ansa cervicalis?

Answer 56

``` GenioHyoid ThyroHyoid Superior Omohyoid SternoThyroid SternoHyoid Inferior Omohyoid ``` "GHost THough SOmeone STupid SHot IOna

Question 57

Which part of the strap muscles should be dissected if need be?

Answer 57

Upper half - the ansa cervicalis supplies these strap muscles inferiorly

Question 58

What are the contents of the carotid sheath?

Answer 58

``` Common carotid artery Internal carotid artery Internal jugular vein Vagus nerve & part of RLN Deep cervical LN ```

Question 59

What nerves provide parasympathetic innervation to the thyroid gland?

Answer 59

Vagus & recurrent laryngeal nerves

Question 60

What nerves provide sympathetic innervation to the thyroid gland?

Answer 60

deep cervical plexus

Question 61

Where are oxyphil cells found?

Answer 61

Parathyroid cells

Question 62

What level is the hyoid bone?

Answer 62

C3

Question 63

What level is the thyroid cartilage notch?

Answer 63

C4

Question 64

What level is the bifurcation of the common carotid arteries?

Answer 64

C4

Question 65

What level is the isthmus of the thyroid cartilage?

Answer 65

C4, C5

Question 66

What level is the cricoid cartilage?

Answer 66

C6

Question 67

What level does the larynx become the trachea?

Answer 67

C6

Question 68

What level does the pharynx become the oesophagus?

Answer 68

C6

Question 69

What level is the middle cervical ganglion?

Answer 69

C6