Regional Head and Neck

Question 1

Name the bones involved with the neck

Answer 1

Mandible
Clavicle
Sternum
C-spine
Mastoid Process
Hyoid Bone

Question 2

Describe the sternocleidomastoid muscle

Answer 2

Attachments: Manubrium and Medial Clavicle and Mastoid process (of the temporal bone) (Superior nuchal line)
Innervation: Accessory nerve (Cranial nerve XI)
Function: Rotate, Flex and Extend the Head (Used as an accessory muscle in inspiration)

Question 3

Describe the trapezius muscle

Answer 3

Broad, flat and triangular muscle
Attachments: Originates the skull, spinous processes of C7-T12 and the ligamentum nuchae. Inserts into the clavicle, acromion and the scapula spine.
Innervation: Accessory nerve (Cranial nerve XI)
Function:To elevate the scapula and rotate it during abduction of the arm, and to retract the scapula and pull the scapula inferiorly

Question 4

What are the triangles of the neck?

Answer 4

Anterior and Posterior triangles
They are anatomical divisions created by the muscles of the head and neck. They are used clinically to locate structures that pass through the neck.

Question 5

What are the borders of the anterior triangle?

Answer 5

Superiorly – Inferior border of the mandible (jawbone)
Laterally – Medial border of the sternocleidomastoid
Medially – Imaginary sagittal line down midline of body

Question 6

What are the borders of the posterior triangle?

Answer 6

Anterior: Posterior border of the SCM.
Posterior: Anterior border of the trapezius muscle.
Inferior: Middle 1/3 of the clavicle.

Question 7

What are the functions of fascial planes?

Answer 7

Compartmental
Ease of movement during movement (swallowing)
Forms natural planes
Determine the spread of infection

Question 8

Name layers of the neck, from superficial to deep

Answer 8

Skin
Subcutaneous fat
Platysma muscle (only in anterior portion)
Deep cervical fascia

Question 9

Describe the platysma muscle

Answer 9

Attachments: Originates from the fascia of the pectoralis major and deltoid. insert into the muscles of the head.

Innervation: Cervical branch of the facial nerve (Motor)

Function:Draws the corners of the mouth inferiorly and widens it (as in expressions of sadness and fright). Also draws the skin of the neck superiorly when teeth are clenched

Question 10

Describe the superficial cervical fascia

Answer 10

Lies between the dermis and the deep cervical fascia

It contains:
•Neurovascular supply to the skin
•Superficial veins (e.g. the external jugular vein)
•Superficial lymph nodes
•Fat
•Platysma muscle

Question 11

Name the layers of the deep cervical fascia

Answer 11

Investing layer
Pretracheal layer
Prevertebral layer
Carotid sheaths

Question 12

Describe the investing layer of the deep cervical fascia

Answer 12

It is the most superficial of the deep cervical layers

It surrounds all structures in the neck, apart from the platysma.

It splits in two and envelopes the SCM and Trapezius muscles.

Question 13

Describe the pretracheal layer of the deep cervical fascia

Answer 13

It is situated anteriorly in the neck

It encloses viscera:
•Trachea
•Oesophagus
•Thyroid

Question 14

Describe the carotid sheaths of the deep cervical fascia

Answer 14

Paired structures formed by contributions from the pretracheal, prevertebral, and investing fascia layers

They contain:
•Common carotid artery (ant-med)
•IJV(ant-lat)
•Vagus nerve (post)
•Deep cervical lymph nodes

Question 15

Describe the prevertebral layer of the deep cervical fascia

Answer 15

It is situated posteriorly and surrounds the vertebral column and the surrounding muscles

It goes from the base of the Skull to the level of T2/3

Question 16

Tell me about the retropharyngeal space and why it is clinically important

Answer 16

It is a potential space.

It sits posterior to pretracheal layer and anterior to the prevertebral space.

It runs from the base of the skull to the bottom of the diaphragm.

Important because if there is an infection then it can run down and infect the mediastinum.

Question 17

Tell me about the parapharyngeal space and why it is clinically important

Answer 17

It is a potential space

It sits parallel (lateral) to the pharynx

Infections normally due to problems of the teeth

Tends not to run further down than T2/3 level (that’s where the prevertebral layer ends)

Can be dangerous because they are close to the IJV and carotid artery and so can sometimes cause thrombosis of these.

Question 18

Describe the hyoid muscle

Answer 18

A free-floating, horseshoe shaped bone, that lies at the level of C3 and is a common attachment site for most of the hyoid muscles

Question 19

What are the two categories of hyoid bone?

Answer 19

Suprahyoid

Infrahyoid

Question 20

Name the suprahyoid muscles and give their function

Answer 20

Digastric
Mylohyoid
Stylohyoid
Geniohyoid

Elevate hyoid and larynx during swallowing

Question 21

Name the infrahyoid muscles and give their function

Answer 21

Sternohyoid
Omohyoid
Sternohyoid
Thyrohyoid

Depress hyoid during speech

Question 22

Are there any branches of the internal carotid artery in the neck?

Answer 22

NO!!!!!!!

There are no branches of the internal carotid artery in the neck.