Neck

Question 1

Which muscle if the most medial of the suprahyoid muscles

Answer 1

Geniohyoid is the most medial of the suprahyoid muscles, which makes it easy to identify on cadavers

Question 2

Where does the pharynx end

Answer 2

The pharynx begins at the base of the skull and ends at the inferior border of the cricoid cartilage – this is approximately C6.

Question 3

Where do the sensory branches of the cervical plexus enter the skin?

Answer 3

Middle of the posterior border of the sternocleidomastoid muscle. Erbs point and this is a good area to enter LA for a cervical plexus block

Question 4

What is the main blood supply of the parathyroid gland

Answer 4

Inferior thyroid

Question 5

Cervical plexus nerve roots

Answer 5

C1-C4

Question 6

Flexion and extension at the atlantoaxial joint is limited?

Answer 6

Flexion and extension at the atlantoaxial joint is limited by the tectorial membrane.

Question 7

Level of the hyoid bone

Answer 7

C3

Question 8

Level of the cricoid cartilage

Answer 8

C6

Question 9

Level of carotid bifurcation

Answer 9

C4

Question 10

Which region of the scalp does the lesser occipital nerve give cutaneous supply to?

Answer 10

Posterio-superior

Question 11

The suboccipital nerve innervates all of the suboccipital muscles. From which nerve root does it arise?

Answer 11

C1

Question 12

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

Answer 12

Retrophyrangeal space

Question 13

Scalene muscle innervation

Answer 13

Anterior Scalene (Attaches to 1st rib)
Anterior rami of C5-C6.

Middle ((Attaches to 1st rib))
Innervation: Anterior rami of C3-C8.

Posterior Scalene (Attaches to 2nd rib)
Innervation: Anterior rami of C6-C8.

Question 14

Which part of the brachial plexus crosses the floor of the posterior triangle?

Answer 14

Trunks

Question 15

During embryonic development, where does the thyroid gland begin development?

Answer 15

Base of the tongue

Question 16

Phrenic nerve is known to travel immediately underneath which layer of neck fascia?

Answer 16

Pre-vertebral

Question 17

Which nerve moves through the posterior fossa of the skull

Answer 17

Facial nerve

Question 18

Most superficial structure for submandibular gland excision

Answer 18

Marginal mandibular

Question 19

Vocal cords are formed by the free edge of what

Answer 19

Conus elasticus (cricothyroid ligament part)

Question 20

What is the berry’s ligaments

Answer 20

The suspensory ligament of the thyroid gland (Berry’s ligament), is a suspensory ligament that passes from the thyroid’s sheath to the thyroid itself, and on to the cricoid cartilages that encircle the trachea.

Question 21

Larynx supply

Answer 21

Cricothyroid and muscles that are supraglottic and sensation are supplied by the superior laryngeal nerve
Subglottic sensation and all other intrinsic muscles of the larynx rec lar

Question 22

For vocal cords

Answer 22

They are formed by the intrinsic ligaments
Cricothyroid lig: True vocal cords
Vestibula ligament/folds: Quadrangular membrane

Question 23

About the intrinsic muscles

Answer 23

Cricothyroid
‘singer’s muscle’.
Innervation: External laryngeal nerve (branch of superior laryngeal).
Thyroarytenoid

Thyroarytenoid muscle acts to relax the vocal ligament, allowing for a softer voice.

Posterior cricoarytenoid
Only muscle capable of widening the rima glottidis.

The lateral cricoarytenoid muscles are the major adductors of the vocal folds. They narrow the rima glottidis, modulating the tone and volume of speech.

The transverse and oblique arytenoids muscles adduct the arytenoid cartilages, closing the posterior portion of rima glottidis. This narrows the laryngeal inlet.

Attachments: Spans from one arytenoid cartilage to the opposite arytenoid.
Actions: Adduction of the arytenoid cartilages.
Innervation: Inferior laryngeal nerve (branch of recurrent laryngeal).

Question 24

Where does the right jugular lymphatic duct open

Answer 24

The right lymphatic duct empties into the right subclavian vein at the venous angle.

Question 25

The flexion and extension of the head produced by the atlantoaxial joint is limited by which of the following structures?

Answer 25

tectorial membrane

Question 26

Brachial plexus nerve block

Answer 26

The brachial plexus courses between the bellies of the anterior scalene and middle scalene muscles.

In upper limb surgery, the brachial plexus can be infiltrated with local anaesthetic to avoid the use of a general anaesthetic – known as an interscalene block.

Question 27

What is the innervation of the thyrohyoid muscle

Answer 27

C1 from the hypoglossal. The rest of the strap muscles are ansa cervicalis

Question 28

A surgeon is performing a radical neck dissection, and wishes to preserve the phrenic nerve. It is known to travel immediately underneath which layer of neck fascia?

Answer 28

Prevertebral fascia

Question 29

Into which vein do the anterior jugular veins empty?

Answer 29

Subclavian vein

Question 30

Motor branches of the cervical nerves

Answer 30

Phrenic C3-C5
Ansa cervicals C1-C3 Infrahyoid muscle supply
Some more not-so-important ones
C1 to geniohyoid and thyrohyoid and moves with the hypoglossal nerve

Question 31

What are the sensory branches of the cervical nerves

Answer 31

Greater Auricular nerve: C2 and C3
Transverse cervical: C2 and C3 posterior aspect of the sternocleidomastoid, and supplies sensation to the anterior neck.
Lesser occipital C2 and C3
Supraclavicular C3 and C4 supplies the supraclavicular fossa

Question 32

Waldeyer ring cell anatomy

Answer 32

Phyrangeal and tubal and cilliated pseudostrat
Lingual and palatine are stratified non-keratinised squamous epithelium.

Question 33

What forms the axillary sheath

Answer 33

BP and SCA are covered by prevert fascia and this later becomes the axillary sheath

Question 34

Which chain of lymph nodes is found along with internal jugular vein

Answer 34

Deep cervical

Question 35

Parathyroid glands

Answer 35

Superior glands are more constant in position than the inferior glands. They are present on post upper pole.

Question 36

What is the piriform fossa

Answer 36

On either side of the laryngeal inlet where food can get stuck. It has a rich lymphatic supply and is hence also known as the silent area for tumours that drain into the deep cervical nodes

Question 37

What is the lymphatic drainage of the larynx

Answer 37

Superior to vocal codes is upper deep cervical
Inf is lower deep cervical

Question 38

What is the functional purpose of the Sibson’s Fascia?

Answer 38

It prevents the lungs from rising further into the neck during inspiration

Question 39

What vessel is lateral to the inferior parathyroid gland

Answer 39

Common carotid

Question 40

At which of the following levels does the inferior thyroid artery enter the thyroid gland?

Answer 40

C6