neck

Question 1

nerve innervating platysma?

Answer 1

cervical branch of the facial nerve

Question 2

nerve innervating sternocleidomastoid

Answer 2

spinal accessory nerve

Question 3

what innervates the majority of strap muscles except the thyrohyoid

Answer 3

ansa cervicalis

Question 4

nerve innervating the thyrohyoid

Answer 4

C1 via the hypoglossal

Question 5

nerve innervating anterior belly of digastric

Answer 5

nerve to mylohyoid

posterior belly innervated by facial n.

Question 6

nerve innervating posterior digastric belly

Answer 6

facial nerve

Question 7

function of the hypoglossal and test for its function?

Answer 7

supply the intrinsic and extrinsic tongue muscles/ ask patient to stick out their tongue

Question 8

boundaries of the carotid triangle?

Answer 8

superiorly: posterior belly of the digastric
Posteriorly: SCM
Anteriorly: superior belly of the omohyoid

Question 9

contents of carotid triangle

Answer 9

internal jugular vein, common carotid artery, vagus nerve

Question 10

function of the vagus nerve in the neck

Answer 10

motor and sensory innervation of larynx

Question 11

function of the internal branch of the vagus nerve

Answer 11

sensory innervation to larynx above vocal folds

Question 12

what are the boundaries of the anterior neck triangle?

Answer 12

superiorly: mandible lower border
Medially: midline of the neck
Laterally: sternocleidomastoid

Question 13

what are the boundaries of the posterior triangle?

Answer 13

anteriorly: posterior border of sternocleidomastoid
posteriorly: anterior border of trapezius
Inferiorly: middle third of clavicle

Question 14

what muscle divides the posterior triangle into the occipital and supraclavicular triangles?

Answer 14

omohyoid inferior belly!

Question 15

function of the spinal accessory nerve/appearance?

Answer 15

motor supply to SCM and trapezius/ wavy appearance!

Question 16

function of phrenic and nerve roots it arises from?

Answer 16

motor innervation to diapghragm/ C3/C4 and C5

Question 17

what are the contents of the posterior triangle

Answer 17

Transverse cervical, greater auricular, supraclavicular and lesser occipital nerves giving cutaneous supply
Phrenic supplying motor
Brachial plexus giving mixed innervation

Question 18

stab wound to the posterior triangle consequence

Answer 18

can affect spinal accessory, supraclavicular nerves and greater auricular
could cause trapezius paralysis
parathesia to skin over shoulder

Question 19

what forms the floor of the posterior triangle?

Answer 19

Splenius capitis, levator scapulae, scalenus medius and scalenus posterior

Question 20

which foramina does the vagus leave the skull?

Answer 20

jugular foramen

Question 21

name the compartment that the vagus nerve is found in and the sheath its in

Answer 21

cin the neurovascular compartment in the carotid sheath

Question 22

what spinal segment does the brachial plexus arise from

Answer 22

C5-T1

Question 23

A 39-year-old man with fracture proximal shaft of the right humerus was posted for open reduction and internal fixation. While communicating with the patient to evaluate the effect of the block by pin prick method, hoarseness of the voice gradually increased to a stage of whispering.

Based on the anatomy of the region and the signs/symptoms described, which nerve is most likely to be inadvertently affected by the interscalene block in this patient?

Answer 23

recurrent laryngeal nerve

Question 24

A 48-yr-old woman was admitted for treatment of a persistent complex regional pain syndrome type I of the right hand. It was decided to start treatment by means of continuous interscalene analgesia. Three days later the patient exhibited Horner’s syndrome on the ipsilateral side, including meiosis (pupillary constriction), ptosis (drooping of the eyelid), anhydrosis (absence of perspiration) on the whole ipsilateral side of the face.

Based on the anatomy of the region and the signs/symptoms described, which nerve is most likely to be inadvertently affected by the interscalene block in this patient?

Answer 24

Sympathetic chain

Question 25

muscle deep to the external jugular vein?

Answer 25

SCM

Question 26

2 tributaries forming the common facial vein

Answer 26

The facial vein and the retromandibular vein

Question 27

lymph nodes around external jugular vein

Answer 27

superficial cervical lymph nodes

Question 28

lymph nodes around internal jugular vein

Answer 28

deep cervical lymph nodes

Question 29

2 veins that form the brachiocephalic?

Answer 29

the internal jugular and subclavian veins

Question 30

Enlargement of the thyroid gland is quite common, known as goitre. Sometimes this goitre can extend behind the sternum, known as a retrosternal goitre (see pot provided). What signs/symptoms might a patient with such a condition have?

Answer 30

difficulty breathing/ swallowing
Stridor/ high pitched and noisy respiration
fullness in lower neck elevated when swallowing
dilation of superficial veins in neck