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Clinical Anatomy > Neck > Flashcards

Neck Flashcards

1
Q

Boundaries of posterior triangle

A

Anterior - posterior border of SCM
Posterior - anterior border of trapezius
Base - Middle third of clavicle

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2
Q

Where is the retro pharyngeal space?

A

Anterior to prevertebral fascia, behind the pharynx

Extends from base of skull to the mediastinum

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3
Q

Clinical features of retropharyngeal abscess

A 
Commonly in young children, after a URTI 
Neck help rigid and upright 
Systemically unwell
Airway compromise 
Dysphagia
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4
Q

Investigation and management of retropharyngeal abscess

A

Investigations: CT neck
Management: secure airway, IV antibiotics, surgery - incision and drainage

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5
Q

Complications of retropharyngeal abscess

A

Airway obstruction

Mediastinitis

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6
Q

What is Ludwigs angina?

A

Infection of the space between the floor of the mouth and mylohyoid, most commonly associated with dental infection

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7
Q

Clinical features of Ludwigs angina

A 
Swelling of floor of mouth 
Painful mouth 
Protruding tongue
Airway compromise 
Drooling
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8
Q

Investigation and management of Ludwigs angina

A

Investigation: CT neck, OPG
Management: secure airway, IV antibiotics, surgery to drain any collection of fluid

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9
Q

Where is the parapharyngeal space?

A

Postero-lateral to the oropharynx and nasopharynx, which is divided by the styloid process.

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10
Q

Clinical features of parapharyngeal abscess

A 
Present similarly to peritonsilar abcsess:
History of febrile illness
Odynophagia
Trismus (spasm of jaw muscles)
Reduced neck movement 
Swelling in neck around upper SCM
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11
Q

Complications of parapharyngeal abscess

A

Spread to carotid sheath structures

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12
Q

Management of parapharyngeal abscess

A

Secure airway, IV antibiotics, surgical drainage

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13
Q

Cause of epiglottitis

A

Normally haemophilus influenzae

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14
Q

Presentation of epiglottitis

A

Mainly seen in children aged 2-6, is an emergency
Strider
Drooling
Pyrexia

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15
Q

Management of epiglottitis

A

Secure the airway - intubation

IV antibiotics

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16
Q

Possible causes and locations of neck lumps

A 
Parotid neoplasm
Jugulodigastric node
Submandibular gland
Carotid body tumour or aneurysm 
Thyroglossal cyst (midline between hyoid bone and thyroid gland)
Branchial cyst (anterior border of SCM) 
Thyroid nodule
Virchows node
17
Q

Investigation of neck lumps

A

Ultrasound guided fine needle aspiration

18
Q

Nasopharynx borders

A

Superiorly bounded by base of skull

Inferiorly by imaginary line at level of soft palate

19
Q

Contents of nasopharynx

A

Adenoids

Eustachian tube opening

20
Q

Oropharynx borders

A

Level of soft palate to superior border of epiglottis

21
Q

Oropharynx contents

A

Palatine tonsils, anterior and posterior arches

22
Q

Hypo pharynx borders

A

Superior border of epiglottis to inferior border of cricoid cartilage
Posterior to the larynx

23
Q

Muscles of the pharynx

A

Superior constrictor
Middle constrictor
Inferior constrictor
Cricopharyngeus

24
Q

What is Killians dehiscence?

A

Area of deficient muscle between inferior constrictor and cricopharyngeus
Site of pharyngeal pouch formation

25
Q

Presentation of pharyngeal pouches

A

Dysphagia
Delayed regurgitation of food
Recurrent chest infections from aspirated food

26
Q

Muscles that elevate and depress the pharynx

A

Stylopharyngeus
Salpingopharyngeus
Palatopharyngeus

27
Q

What is obstructive sleep apnoea?

A

Complete obstruction of the airway during sleep which requires the patient to wake up and alter position to open the airway again.
Lead to poor nights sleep and strain on CVS system

28
Q

Commonest causes of obstructive sleep apnoea in a child vs in an adult

A

Child - Adenotonsillar hypertrophy

Adult - Obesity, obstructive lung disease, right heart failure

29
Q

Treatment of obstructive sleep apnoea

A

Advice and lifestyle changes eg weight loss
CPAP - Continuous positive airway pressure
Mandible at positioning devices
Surgery - adenotonsillectomy in children

30
Q

Bacterial causes of tonsillitis

A 
Beta haemolytic streptococci
Staphylococci
Streptococcus pneumoniae 
Haemophilus influenzae 
Escherischia coli
31
Q

Viral causes of tonsillitis

A

Rhinovirus
Adenovirus
Enters virus
Epstein-Barr virus

32
Q

Clinical features of tonsillitis

A 
Pyrexia
Dysphasia
Lymphadenopathy
Odynophagia
Trismus
Swollen tonsils with or without exudate 
Referred pain
33
Q

Management of tonsillitis

A

Analgesia
Antibiotics (not amoxicillin - causes rash in presence of EBV)
Drainage of peritonsilar abscess
Tonsillectomy in recurrent tonsillitis

34
Q

Boundaries of anterior triangle

A

Medical - midline of neck
Lateral - medial border of SCM
Superior - lower border of mandible

Clinical Anatomy (6 decks)

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