Neck Triangles, Carotid And Branches, Thyroid And Salivary Glands, Brachial Plexus, Veins Of Head And Neck 2019

Question 1

External Jugular catheterization is done in what part of the respiratory cycle?

A. Inspiration
B. Expiration

Answer 1

A. Inspiration

*The vein is catheterized about halfway between the level of the cricoid cartilage and the clavicle. The passage of the catheter should be performed during INSPIRATION when the valves are open.

Question 2

What nerve supplies the omohyoid muscle?

Answer 2

Ansa cervicalis

Question 3

A deep incised wound that cuts the sternocleidomastoid

muscle would also absolutely injure what adjacent muscle?

Answer 3

Platsyma

Question 4

A complication that may be associated with thyroid surgeries is a metabolic disturbance in the serum levels of?

Answer 4

Calcium

Question 5

Superior thyroid artery drains into?

Answer 5

External Carotid Artery

Question 6

Internal thoracic and vertebral arteries are branches of? (Vertebral artery is a branch of?)

Answer 6

1st part of Subclavian artery

*The first part of the subclavian artery extends from the origin of the subclavian artery to the medial border of the scalenus anterior muscle. This part gives off the VERTEBRAL ARTERY, the THYROCERVICAL TRUNK and the INTERNAL THORACIC ARTERY.

Question 7

The subclavian artery is divided into 3 by what

muscle?

Answer 7

Scalenus anterior

*The scalenus anterior muscle passes anterior to the artery on each side and divides it into three parts.

Question 8

What is/are the branches of the common carotid artery?

Answer 8

No branches

*The common carotid has no branches except its two terminal branches.

Question 9

What fascial space is involved in Ludwig’s angina?

Answer 9

Submandibular space

*Ludwig angina is an acute infection of the submanidbular fascial space and is commonly secondary to dental infection.

Question 10

What encloses the strap muscles?

Answer 10

Pretracheal layer

Question 11

Where does the external jugular vein drain?

Answer 11

Subclavian vein

*It descends across the sternocleidomastoid muscle and deep to the platysma muscle and drains into the SUBCLAVIAN VEIN behind the middle of the clavicle.

Question 12

Patient with high blood pressure has a resulting lower blood pressure because of?

Answer 12

Carotid sinus is massaged

Question 13

Frey’s syndrome?

Answer 13

Auriculotemporal nerve and greater auricular nerve

Question 14

What is the action of the thyrohyoid?

Answer 14

Depresses the hyoid bone (also elevates the thyroid

cartilage)

Question 15

Involved in Congenital torticollis?

Answer 15

Sternocleidomastoid

Question 16

The hyoglossus muscle forms the floor of what triangle?

A. Submandibular triangle
B. Carotid triangle
C. Muscular triangle
D. Supraclavicular triangle

Answer 16

A. Submandibular triangle

Question 17

Branches of 3rd part of subclavian artery?
A. Costocervical trunk
B. Thyrocervical trunk
C. NOTA

Answer 17

C. NOTA

• Costocervical trunk - 2nd part
• Thyrocervical trunk - 1st part

Question 18

Unilateral injury to recurrent laryngeal nerve will result to?

Answer 18

Hoarseness

Question 19

A 35 y.o. vendor was struck in the right temporal region with a bat. A hematoma developed in the same area. What vessels would be most likely involved? (Hit by a bat at the temporal area what vessels are likely to be hit?)

A. Superior temporal vessels
B. Posterior auricular artery

Answer 19

A. Superior temporal vessels

Question 20

Baby with cervical rib? Occur in infants due to a fibrous tissue tumor in the sternocleidomastoid muscle that develops during utero-

Answer 20

Congenital torticollis

Question 21

Hyoid bone articulates with?

Answer 21

It does not articulate with other bones.

Question 22

6 cm skin laceration was sustained by a 28 y.o. male taxi driver in a vehicular accident. Laceration was sutured at the ER and wound healing was uneventful. One month after, he came back to complain of distortion of shape of the mouth. What was injured?

A. Spinal accessory nerve
B. Transverse cervical nerve
C. Lesser occipital nerve
D. Cervical branch of CN VII

Answer 22

D. Cervical branch of CN VII

Question 23

Open biopsy of 1.5cm x 1.5cm lymph node was done. 3 months later, patient complained that he could hardly shrug his shoulders. What was injured during the biopsy?

Answer 23

Accessory nerve

Question 24

Internal carotid artery lies _____ to external carotid artery.

A. Anterior
B. Posterior
C. Medial
D. Lateral

Answer 24

B. Posterior

Question 25

Parotid gland is supplied by the:

Answer 25

Great auricular nerve (C2 & C3)

*The great auricular nerve (C2 and C3) ascends across the sternocleidomastoid muscle and divides into branches that supply the skin over the angle of the mandible, parotid gland and on both surfaces of the auricle.

Question 26

Origin of great auricular nerve?

A. 2nd cervical nerve
B. 1st cervical nerve
C. 3rd cervical nerve
D. 4th cervical nerve

Answer 26

A. 2nd cervical nerve

Question 27

What encloses the trapezius?

Answer 27

Investing layer

*The investing layer is a thick layer that encircles the neck. It splits to enclose the TRAPEZIUS and STERNOCLEIDOMASTOID muscles.

Question 28

Union of superficial temporal and maxillary veins?

Answer 28

Retromandibular vein

Question 29

Important route for spread of Infection?

Answer 29

Emissary veins

Question 30

After an extensive neck surgery, paralysis of the right

diaphragm was noted. Which is most likely injured during surgery?

Answer 30

Phrenic nerve

Question 31

A patient with huge goiter may present with symptoms of?

Answer 31

Difficulty of breathing

Question 32

Case: Patient has an increased heart rate… then decreased. What is responsible for decreased cardiac heart rate?

Answer 32

Carotid sinus

Question 33

A 35 y.o. obese patient came to ER with purplish face and with difficulty of breathing after eating seafood marinara. She was allergic to shrimps. Endotracheal intubation was attempted 4 times but failed due to severely swollen vocal cords and epiglottis. An emergency tracheostomy is to be performed by you. To encounter less bleeding, which incision would you make on the neck?

Answer 33

Transverse, about the level of the cricothyroid membrane

Question 34

A nontoxic goiter was surgically removed to have a better exposure, some muscles have to be cut. What are these muscles?

Answer 34

Sternothyroid, Thyrohyoid, Sternocleidomastoid

Question 35

A 40 y.o. male patient with HIV developed a dental abscess from a carious molar. after 3 weeks the patient
developed high grade fever, severe chest pain, and difficulty of breathing. A chest xray revealed a widened
mediastinum w/ min free air in the sup. mediastinum indicating mediastinitis. Are the 2 infections interrelated?

Answer 35

The dental infection spread via the fascial planes and

spaces, later entering the retropharyngeal space, eventually gaining access to the mediastinum.

Question 36

What nerve supplies the carotid sinus?
A. Glossopharyngeal nerve
B. Phrenic nerve
C. Vagus nerve

Answer 36

A. Glossopharyngeal nerve

*The glossopharyngeal nerve also conducts sensation from the pharynx and the back of the tongue and carries impulses, which influence the arterial blood pressure and respiration from the carotid sinus and carotid body.

Question 37

What vein drains into the external jugular vein?

Answer 37

Anterior jugular vein

Question 38

Thyroid cancer would most likely spread/metastasize to which lymph nodes?

Answer 38

Tracheal lymph nodes

Question 39

A 10 y.o. child has an external ear infection. Which group of lymph nodes would ultimately be most involved?

Answer 39

Mastoid nodes

Question 40

65 y.o. female has had a tracheostomy for 2 yrs now. She suddenly had copious/massive bleeding from the tracheostomy. What vessel is involved?

Answer 40

Inferior thyroid artery

Question 41

A 15 y.o. boy playfully choked his friend who transiently lost consciousness for 5 seconds. What is responsible for the fainting?

Answer 41

Carotid sinus

Question 42

Which branch of the vagus nerve supplies the cricothyroid muscle?

Answer 42

External laryngeal branch

*Superior laryngeal nerve divides into the internal and external laryngeal nerves. The EXTERNAL LARYNGEAL NERVE is motor and is located close to the superior thyroid artery; it supplies the CRICOTHYROID MUSCLE.

Question 43

During a thyroid surgery, one must carefully ligate which vessels?

Answer 43

Inferior thyroid vessels

Question 44

What nerve is closely related to the lower border of the posterior belly of the digastric muscle?

Answer 44

Hypoglossal nerve

Question 45

To determine if an anterior neck mass is part of the thyroid gland, you must ask your patient to?

Answer 45

Swallow

Question 46

Bleeding from the upper limb may be controlled by compression of this structure in the neck. What is this structure?

Answer 46

Subclavian artery

Question 47

To avoid injury to the recurrent laryngeal nerve during a thyroid surgery, one must carefully ligate which vessels?

Answer 47

Inferior thyroid vessels

Question 48

The cervical dome of the pleura is ___ to the scalenus anterior?

Answer 48

Posterior

Question 49

Position to expose the external jugular vein?

Answer 49

Lying 30 degrees at a horizontal angle

Question 50

Can be seen and palpated when acting unilaterally to flex and rotate

Answer 50

Sternocleidomastoid