Red Tigers: Head and Neck (Mostly clinical notes) Flashcards
Accessory Nerve innervates?
Trapezius
External Jugular catheterization is done in what part of the respiratory cycle :
Inspiration
The ansa cervicalis innervates all of the ff. except
Geniohyoid
A deep cut to the SCM will most definitely cut what adjacent muscle
Platysma
Abducent nerve: eyeball movement
Eyeball moves laterally
Eye movement: Trochlear n
Eyeball moves downward lateral
Eyeball movement: Oculomotor n
Eyeball moves upward, downward, medial
Cutaneous branch of cervical plexus except
Ansa Cervicalis (part of the Muscular Branch)
Exposure of these muscles for removal of nontoxic goiter
Sternothyroid, Thyrohyoid, Sternocleidomastoid
Mixed nerve except
abducens (motor only)
1st part of subclavian artery:
Vertebral artery and Internal thoracic artery
Phrenic nerve is what type of nerve?
mixed
Cleft palate surgery is done at __ months
At 12 to 18 months
Transmits olfactory n. from nasal cavity to the olfactory bulb
Cribriform plates
Note: CN 1 is the only nerve that passes in the anterior cranial fossa
Can be seen and palpated when acting unilaterally to flex and rotate head to one side, so that ear approach shoulder and chin turns in the opposite direction
Sternocleidomastoid
Fascia of the platysma-
Investing fascia
Veins which are responsible for an infection in the scalp to go intracranially
Emissary veins
What articulates with the hyoid bone?
It does not articulate with any bone
External jugular vein-
Useful for assessment of venous filling with patient sitting @ 30 degree
Superior orbital fissure transmits-
CN 3, 4, 5(V1), and 6
Occurs in infants due to a fibrous tissue in the SCM that may have developed due to difficult labor
Congenital Torticollis
Danger zone of the scalp-
Loose areolar tissue
Five Branches of facial nerve for facial expression
Temporal, Zygomatic, Buccal, Mandibular and Cervical
Infection can spread in this space and inferiorly into the mediastinum-
Retropharyngeal space
Trigeminal neuralgia-
Characterized by episodes of intense pain lasting a few sec in areas innervated by CN5 (usuallly mandibular n.)
Distribution of relaxed skin tension lines-
Kraissl’s lines
The most frequent carried out method for face lift surgery-
SMAS (superficial musculoaponeurotic system)
A severe form of cervico-fascial infection/ cellulitis
Ludwig’s angina
The cervical dome of the pleura is _____ to the scalenus anterior
Posterior
Thyroid cancer would most likely spread/metastasize to which lymph nodes?
Tracheal lymph nodes
A. 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?-
Inferior thyroid artery
A 10 y.o. child has an ext ear infection. which group of lymph nodes would ultimately be most involved?
Mastoid nodes
What is the action of the thyrohyoid?
Depress the hyoid bone
A 15 y.o. boy playfully choked his friend who transiently lost consciousness for 5 seconds. what is responsible for the fainting?-
Carotid sinus
Which vessel forms part of the circle of willis?
Internal carotid artery
Which branch of the vagus nerve supplies the Cricothyroid muscle?
Ext. Laryngeal branch
During a thyroid surgery, one must carefully ligate which vessels?
Inferior thyroid vessels
What nerve is closely related to the lower border of the post belly of the digastric m?
Hypoglossal n.
To determine if an anterior neck mass is part of the thyroid gland, you must ask your patient to:
Swallow
A patient with a goiter may present with symptoms of:
Difficulty of breathing
Unilateral injury to the recurrent laryngeal nerve will result to:
Hoarseness
A complication that may be associated with thyroid surgeries is a metabolic disturbance in the serum levels of:
Calcium
A 35 y.o. vendor was struck in the r. temporal region with a bat. a hematoma developed in the same area. what vessels would be most likely involved?-
Superior temporal vessels
What divides the subclavian v. into 3 parts?
Scalenus anterior
Bleeding from the upper limb may be controlled by compression of this structure in the neck. what is this structure?
Subclavian artery
Which branch of the vagus nerve supplies the Cricothyroid muscle?
Ext. Laryngeal branch
To avoid injury to the recurrent laryngeal n during a thyroid surgery, one must carefully ligate which vessels?
Inferior thyroid vessels
35 y.o. vendor was struck in the r. temporal region with a bat. a hematoma developed in the same area. what vessels would be most likely involved?
Superior temporal vessels
Bleeding from the upper limb may be controlled by compression of this structure in the neck. what is this structure?
Subclavian artery.
An open biopsy 1.5cmx1.5cm lymph node on the r. post. triangle of the neck was performed. 3 months later the patient complained he could hardly shrug his r. shoulder. what was injured during the biopsy?
Accessory n .
A 35 y.o. obese patient came to the emergency room with purplish face and with difficulty of breathing after eating seafood marinara. she was allergic to shrimps. endotracheal intubation was attempted 4 ties 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? transverse, about the level of the cricothyroid membrane A nontoxic goiter was surgically removed. to have a better exposure, some muscles have to be cut. what are these muscles?.
Sternothyroid, Thyrohyoid, Sternocleidomastoid.
What fascial space is involved in Ludwig’s angina?
Submandibular space
A deep incised wound that cuts the sternocleidomastoid m would also absolutely injure what adjacent m?
Platysma
What is involved in congenital torticollis?
Sternocleidomastoid m
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?
The dental infection spread via the fascial planes and spaces, later entering the retropharyngeal space, eventually gaining access to the mediastinum.
What is the nerve supply to the omohyoid?
Ansa cervicalis.
What nerve supplies the carotid sinus?
Glossopharyngeal n.
What v. drains into the external jugular v.?
Ant jugular v.
These nerves are responsible for the general sensation of the nasal cavity, EXCEPT
Olfactory nerve
Smell is a SPECIAL sense. General sensation is governed by the CN V1
What nerve goes together with Parotid duct/Stensen’s duct
Facial nerve (buccal branch)
Buccal branch of the facial nerve supplies _____ while Buccal nerve of the trigeminal (V3) supplies _____
CN VII supplies buccinator muscle (motor) while CN V3 supplies skinof the cheek (sensory)
Muscle for Grimace
Risorius m.
Where does maxillary sinus drain?
Middle meatus
Nasal septum is composed of the ff except-
Nasal bone. (septal cartilage, vomer, ethmoid bone only)
What opens into the Inferior meatus
Nasolacrimal duct
Lies deep in the parotid gland
Internal Carotid A.
Where does chorda tympani arise?-
CN VII, Facial nerve
Roof of the middle ear
Tegmen tympani
Anterolateral surface is related to the roots of the upper molar and premolar in front of the face.
Maxillary Sinus
Membranous labyrinth is filled with-
Endolymph