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SA head and neck > S1) General Organisation of the Head & Neck > Flashcards

S1) General Organisation of the Head & Neck Flashcards

1
Q

Describe the anatomical location of the neck

A

The neck extends from the lower margin of the mandible to the suprasternal notch of the manubrium and the upper border of the clavicle below

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2
Q

Which nerve innervates the trapezius?

A

Accessory nerve

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3
Q

A series of muscles attach above and below the hyoid bone.

Identify them and their nerve supply

A
  • Supra‐hyoids supplied by cranial nerves
  • Infra‐hyoids supplied by cervical nerves (C1‐3)
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4
Q

Identify the origins and attachments of the platysma

A
  • Origin: lower mandible
  • Attachment: chest wall
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5
Q

What are the actions and properties of the platysma?

A
  • Property: superficial (lies in superficial cervical fascia) right under skin
  • Action: depresses the corners of the mouth and draw down the mandible
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6
Q

The platysma is a muscle of facial expression.

In light of this, which nerve innervates it?

A

Facial nerve

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7
Q

Describe the origins and attachments of the sternocleidomastoid muscle

A
  • Origin: mastoid process
  • Attachment: sternum (sternal branch) and clavicle (clavicular branch)
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8
Q

What are the actions of the sternocleidomastoid muscle?

A
  • Lateral flexion of the neck
  • Head rotation
  • Tilting chin up contralaterally
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9
Q

Which nerve innervates the sternocleidomastoid muscle?

A

Accessory nerve

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10
Q

Which muscle is contracted in the condition torticollis?

A

Sternocleidomastoid

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11
Q

What are the origins and attachments of the trapezius?

A
  • Origins: external occipital protuberance and superior nuchal line
  • Attachments: spine of scapula & lateral 1/3 of clavicle
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12
Q

What are the actions of the trapezius?

A
  • Elevation of the shoulders (shrug)
  • Rotate and retract the scapula
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13
Q

What happens when the accesory nerve is damaged?

A

Muscle wasting of the trapezius

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14
Q

The trapezius is innervated by the accesory nerve. How do we test the function of this nerve?

A

Test the actions of the trapezius muscle (shrug shoulders)

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15
Q

The anatomical borders divide the neck into two triangles.

Which borders form the anterior triangle?

A
  • Inferior margin of the mandible
  • Midline of the neck
  • Anterior margin of sternocleidomastoid
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16
Q

The anatomical borders divide the neck into two triangles.

Which borders form the posterior triangle?

A
  • Superior margin of clavicle
  • Anterior margin of trapezius
  • Posterior margin of sternocleidomastoid
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17
Q

What are the properties of the infra-hyoid muscles?

A
  • Infra hyoids muscles are ‘strap‐like’ muscles
  • They overlie the larynx and thyroid gland
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18
Q

What type of muscle is the omohyoid?

A

Infrahyoid

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19
Q

What type of muscle is the digastric muscle?

A

Suprahyoid muscle

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20
Q

Identify the carotid triangle

A
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21
Q

Which muscles form the carotid triangle?

A
  • Omohyoid
  • Sternocleidomastoid
  • Digastric
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22
Q

What are the fascial planes of the neck?

A

Fascial planes are collections of structures enveloped in concentric fascial layers creating compartments running through the neck

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23
Q

What is the function of the cervical fascia?

A
  • Forms natural planes
  • Ease of movement between structures
  • -* Contains spread of infection
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24
Q

What are the two forms of cervical fascia?

A

- Superficial cervical fascia: loose connective tissue (subcutaneous tissue)

- Deep cervical fascia: dense connective tissue

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25
Q

Describe the contents of the superficial cervical fascia

A
  • Superficial blood vessels
  • Cutaneous nerves
  • Adipose tissue
  • Lymph nodes
  • Platysma
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26
Q

Describe the contents of the deep cervical fascia

A
  • Investing layer (outer)
  • Carotid sheath
  • Pre tracheal fascia (intermediate)
  • Pre vertebral fascia (deep)
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27
Q

Describe the superior, inferior and posterior attachments of the investing layer of the deep fascia

A
  • Superior: lower border of the mandible, mastoid process, superior nuchal line and external occipital protuberance
  • Inferior: upper border of manubrium, clavicle, acromion and spine of scapula
  • Posterior: spinous process of the vertebrae and ligamentum nuchae
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28
Q

Describe the superior and inferior attachments of the pretracheal fascial layer

A
  • Superior: hyoid bone
  • Inferior: blends with fibrous pericardium in thorax
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29
Q

The pretracheal fascia consists of two layers.

Identify them and the structures they enclose

A
  • Muscular layer which encloses the infrahyoid muscles
  • Visceral layer which encloses the thyroid gland, trachea and oesophagus
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30
Q

What is the buccopharyngeal fascia and where is it found?

A
  • The buccopharyngeal fascia is the posterior continuation of the pretracheal fascia to invest the muscles of the pharynx, larynx and oesophagus
  • It extends from the base of the skull to the diaphragm
31
Q

What is the carotid sheath and where is it found?

A

The carotid sheath is a fibrous structure which extends from the base of the skull inferiorly to the aortic arch

32
Q

What are the contents of the carotid sheath?

A
  • Common carotid artery
  • Internal jugular vein
  • Vagus nerve (CN X)
33
Q

Describe the anatomical location of the prevertebral fascia

A
  • Extends from the base of the cranium to the T3 vertebra
  • Extends laterally as the axillary sheath that surrounds the axillary vessels and the brachial plexus
34
Q

Identify and describe the two deep neck spaces that communicate with the mediastinum

A
  • Retropharyngeal space (between prevertebral & buccopharyngeal fascia)
  • Pre-tracheal space (in front of pretracheal fascia)

They extend inferiorly into the mediastinum

35
Q

What is the danger with infections in the deep neck spaces?

A

Infections in the retropharyngeal and pretracheal spaces can potentially spread inferiorly to involve mediastinal structures (causing mediastinitus)

36
Q

Identify the key structures related to the cervical fascia in the cross section of the neck below:

A
37
Q

What are the two types of muscles of the face?

A
  • Muscles of facial expression
  • Muscles of mastication (chewing)
38
Q

Compare and contrast between muscles of facial expression and muscles of mastication in terms of action

A

- Muscles of facial expression: many act as dilators and sphinchters (guards a hole and can relax or contract)

- Muscles of mastication: act to open/close the jaw

39
Q

Which nerve innervates the muscles of facial expression?

A

Facial nerve (CN VII) - runs through parotid gland so vulnerable to damage from injury of parotid gland.

40
Q

Cranial nerve V is the trigeminal nerve.

What are its three branches? (supplies muscles of mastication)

A
  • V1 opthalmic division
  • V2 maxillary division
  • V3 mandibular division

(V1-3 are also referred to as Va-c)

41
Q

What are the motor and sensory functions of the trigeminal nerve?

A
  • Main sensory nerve of the face and scalp
  • Motor innervation to muscles of mastication
42
Q

There are 5 key extra-cranial branches providing motor innervation to the muscles of facial expression.

What are they?

A
  • Temporal
  • Zygomatic
  • Buccal
  • Mandibular
  • Cervical

Mnemonic: Ten Zombies Bruise My C**k

43
Q

What is the main artery supply to the head and neck?

A

Common carotid artery is the main arterial supply by its terminal branches:

  • Internal carotid artery
  • External carotid artery
44
Q

Compare and contrast the function of the internal and external jugular veins

A
  • Internal jugular vein (IJV) provides venous drainage for the head and neck structures mainly
  • External jugular vein (EJV) provides venous drainage for the scalp and face mainly (more superficial)
45
Q

Identify a vein that drains into the internal jugular vein

A

Facial vein

46
Q

In a patient with a retropharyngeal abscess, what might be expected with the extension of this infection to the deep neck space?

A
  • Difficulty breathing due to tracheal compression
  • Extension of infection into the mediastinum
  • Painful or difficulty swallowing due to oesphageal compression
47
Q

How can one test the function of the trigeminal nerve?

A

Ask the patient to open their mouth whilst you apply resistance under the jaw – note any deviation (jaw will deviate to side of lesion)

48
Q

How can one test the function of the facial nerve?

A
  • Assess patient’s face for any asymmetry
  • Ask the patient to perform facial expressions and assess power of movements
49
Q

What are the muscles of mastication?

A
  • Temporalis (temples)
  • Masseter (corner of jaw as you clench)
  • Lateral pterygoid *lie deep so can’t palpate*
  • Medial pterygoid
50
Q

State the action and innervation of the temporalis muscle

A
  • Action: elevates and retracts the mandible (lower jaw muscle) at TMJ
  • Innervation: mandibular branch (branch of trigeminal nerve)
51
Q

State the action and innervation of the masseter muscle

A
  • Action: elevates the mandible at TMJ (stronger than medial pterygoid)
  • Innervation: mandibular nerve (branch of trigeminal nerve)
52
Q

State the action and innervation of the lateral and medial pterygoids

A
  • Action of lateral pterygoids: protract the mandible, ‘side to side’ movement of the jaw
  • Action of medial pterygoids: elevates mandible at TMJ

- Innervation: mandibular nerve (branch of trigeminal nerve)

  • Originiate: pterygoid plates on base of skull
53
Q

State the action and innervation of the buccinator muscle

A
  • Action: flattens cheek & prevents food from pooling between cheek and gums
  • Innervation: buccal branch of facial nerve
54
Q

State the action and innervation of orbicularis oculi

A
  • Action: inner palpebral part gently closes the eyelid, outer orbital part forcefully closes the eyelid
  • Innervation: temporal and zygomatic branch of facial nerve
55
Q

State the action and innervation of the orbicularis oris

A
  • Action: closes mouth (pouts) helps keep fluid inside oral cavity

- Innervation: buccal branch of facial nerve

56
Q

The occipitofrontalis (frontalis and occipitalis) and its aponeurosis form one of the layers of the scalp.

State its action and innervation

A
  • Action: elevates eyebrows
  • Innervation: frontal belly (temporal branch of facial nerve) and occipital belly (posterior auricular branch)
57
Q

State the action and innervation of levator palpebrae superioris

A
  • Action: elevates upper eyelid
  • Innervation: oculomotor nerve
58
Q

What is Bell’s palsy?

A
  • Bell’s palsy is the inflammation of the facial nerve causing oedema and compression of the nerve as it runs through its bony canal within the temporal bone
  • This causes facial paralysis on the ipsilateral side of the injury
59
Q

Where can the facial pulse be palpated?

A

The pulse of the facial artery can be palpated as the artery winds around the inferior border of the mandible, just under the jaw

60
Q

What are the main neck muscles

A
  • Sternocleidomastoid
  • trapezius
61
Q

relevance of scalene Muscles

A
  • accessory muscles of respiration
  • form floor of posterior triangle
  • critical structures passing through : brachial plexus and subclavian muscles passing between anterior and middle
  • phrenic nerve runs along anterior
62
Q

carotid triangle

A

formed from supra and infra hyoid muscles

  • digastric
  • omohyoid
63
Q

muscles involved in depressing the mandible (lower jaw)

A
  • infrahyoids
  • lateral pterygoid
64
Q

occipitofrontalis

A
  • made up of frontal and occipital belly joined by aponeurosis
  • causes eyebrow contraction
65
Q

what are the dilators of the mouth?

A
  • risorius
  • zygomaticus

Both draw the the mouth superiorly and posteriorly to smile

66
Q

Where is the parotid gland located in the face?

A
67
Q

what are all the muscles of mastication and what are they innervated by

A
  • lateral pterygoid
  • middle pterygoid
  • temporalis
  • masseter

all inverted by the mandibular division of the trigeminal nerve

68
Q

role of the suprahyoid muscles

A

he suprahyoid muscles are a group of four muscles located above the hyoid bone in the neck, and they primarily function to elevate and stabilize the hyoid bone and the larynx during speech and swallowing.

69
Q

what are the supra hyoid muscles innervated by

A

→ posterior belly of the digastric muscle is innervated by the facial nerve

→ mylohyoid, geniohyoid, and stylohyoid muscles, are innervated by the hypoglossal nerve

70
Q

Which branch is the same in the facial and trigeminal nerve

A

mandibular

(maxillary does not arise from the facial nerve but from the trigeminal nerve)

71
Q

what complications arise if there is an infection in the pretracheal area

A

→ difficult to breath due to tracheal compression.

→ infection can spread to the mediastinum

→ pain or difficulty swallowing due to oesophageal compression

72
Q

where does the carotid sheath extend to

A

aortic arch

73
Q

which lymph nodes are deep cervical lymph nodes, lying deep to the investing layer

A

supraclavicular

jugulo-digastric

jugulo - omohyoid

SA head and neck (18 decks)

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