Neck

Question 1

what forms the borders of posterior triangle

Answer 1

sternocleidomastoid muscle at anterior
trapezius muscle at posterior
clavicle inferior

Question 2

what is a good clinical test for accessory nerve

Answer 2

shrugging shoulders - trapezius

moving head side to side - SCM

Question 3

what structures lie over the SCM muscle

Answer 3

external jugular vein, transverse cervical nerve, great auricular nerve

Question 4

what might be clinical sign of congestive heart failure

Answer 4

distended external jugular vein when sitting up

Question 5

what does the great auricular nerve supply

Answer 5

sensation to the angle of mandible and ear

Question 6

what muscles lie deep to SCM in posterior triangle

Answer 6

scalenus anterior and middle

Question 7

where does the phrenic nerve lie

Answer 7

along scalenus anterior, supplies the diaphragm from c3,4,5

Question 8

what vessels and nerves lie deep to SCM in posterior triangle

Answer 8

transverse cervical artery, suprascapular artery, brachial plexus and phrenic nerve

Question 9

if removing the superficial lymph nodes from the posterior triangle what structure must be preserved and how can it be tested clinically

Answer 9

accessory nerve, as it runs near here, can ask patient to shrug shoulders and look side to side after surgery to ensure it is intact

Question 10

why might forensics be interested in a fracture of the hyoid bone

Answer 10

often fractured due to strangulation

Question 11

what are suprahyoid muscles and their attachments

Answer 11

mylohyoid - mylohyoid line of mandible to hyoid bone
anterior belly of digastric - digastric fossa of mandible, central tendon held to hyoid with fascia
geniohyoid - inferior tubercles of mandible to hyoid
stylohyoid - styloid process to mandible

Question 12

what are infrahyoid muscles, their attachments and movements

Answer 12

strap muscles
sternohyoid - manubrium of sternum to hyoid bone
omohyoid - scapula to hyoid bone
regulate position of hyoid bone
sternothyroid - manubrium of sternum to thyroid cartilage
thyrohyoid - thyroid cartilage to hyoid bone

Question 13

where does the external jugular vein lie

Answer 13

superficial to the SCM muscle

Question 14

what level does the common carotid bifurcate

Answer 14

at thyroid cartilage - into external and internal

Question 15

what is present in the internal carotid artery

Answer 15

carotid sinus, baroreceptors - special receptors to detect the blood pressure going to the brain, supplied by glossopharyngeal nerve

Question 16

how could you check clinically if hypoglossal nerve had been damaged in surgery

Answer 16

stick tongue out

Question 17

what is the laryngeal prominence

Answer 17

prominence of thyroid cartilage, due to testosterone increasing the size at puberty

Question 18

what cartilages are present in anterior neck

Answer 18

thyroid cartilage, cricoid cartilage and cricothyroid membrane between

Question 19

what can be seen in the eyes if a person has hyperthyroidism

Answer 19

proptosis - thickening of fat at eye, or goitre

Question 20

what can be seen if the person has hypothyroidism

Answer 20

puffy face, dry hair

Question 21

what vessels drain into the internal jugular vein

Answer 21

facial vein, superior and middle thyroid vein

Question 22

describe digastric muscle

Answer 22

2 bellies - anterior and posterior. anterior runs from mandible to hyoid bone, posterior runs from base of skull near mastoid process to hyoid bone. bellies meet at central tendon which is held down to hyoid bone by loop of fascia. mylohyoid runs deep to this muscle

Question 23

how to tell the difference between facial artery and lingual artery

Answer 23

facial - more twisted, runs superficial to submandibular gland, enters face around massetter muscle
lingual - runs deep to gland, enters tongue

Question 24

what structure runs near the internal and external carotid arteries

Answer 24

hypoglossal nerve

Question 25

name the extrsinic muscles of the tongue, their innervation and action

Answer 25

hyoglossus - lower tongue - hypoglossal nerve
genioglossus - stick tongue out - hypoglossal nerve
styloglossus - moves tongue backwards and upwards for swallowing - hypoglossal nerve
palatoglossus - moves soft palate down - vagus nerve

Question 26

what is the difference between the extrinsic and intrinsic muscles of tongue

Answer 26

extrinsic change direction of tongue, intrinsic change the shape of the tongue

Question 27

what might the appearance of the tongue suggest is present

Answer 27

smooth - anaemia

blue - respiratory problems

Question 28

what area does the submental lymph nodes drain

Answer 28

chin and lower lip

Question 29

what areas does the submandibular lymph nodes drain

Answer 29

superficial anterior face - cheek, lips, tongue, gums, palate, nose
maxillary and paranasal sinuses

Question 30

what areas does the parotid lymph nodes drain

Answer 30

posterior face

Question 31

what other lymph nodes drain posterior face and head

Answer 31

posterior-auriculo nodes and occipital nodes

Question 32

what do the deep cervical lymph nodes drain

Answer 32

everything from the more superficial nodes - submandibular and submental
also deep tongue, pharynx, larynx

Question 33

what is a large deep cervical lymph node

Answer 33

jugulo-digastric node - drains palatine tonsil

Question 34

if someone had an enlarged submandibular lymph node where would you check

Answer 34

tongue, palate, gums, face - if nothing, may be in sinuses

Question 35

what can cause an enlarged lymph node

Answer 35

malignancy - normally painless
infection - painful and tender
or past infection - fibrous

Question 36

what would you check if a patient presented with enlarged supra clavicular lymph nodes

Answer 36

all other nodes draining into here - check submandibular and deep cervical
if nothing - check the chest and abdomen

Question 37

what causes generalised enlarged lymph nodes

Answer 37

systemic disease of lymph nodes - lymphoma, glandular fever