S1 L1 General Organisation of the Head and Neck Flashcards
- *General organisation of the Head:**
- Broadly, what does the head include?
- Name the 2 divisions of the skull
- 2 main groups of muscles in the head
- Blood vessels supplying the face
- Neck extends from… (anatomically)
- Broadly, what does the head include?
Cranium (skull), face, scalp, meninges, brain, sensory organs
- Name the 2 divisions of the skull
Neurocranium, viscerocranium
- 2 main groups of muscles in the head
Muscles of facial expression, muscle of mastication
- Blood vessels supplying the face
Facial artery and vein
- Neck extends from… (anatomically)
Lower margin of the mandible (jaw) to the suprasternal notch of the manubrium and the upper border of the clavicle
- *Muscles of Face and Scalp: divided into two groups -**
- Name both groups, broad role of them
- Name nerves for each group and the cranial nerves
don’t learn origins and insertions
Muscles of facial expression
• Dilators or sphincters
• Attach to bone, the skin/fascia of the face,
other muscles
— Nerve: Facial nerve, CN VII
Muscles of mastication There are 4
• Open or close the jaw
• Act on the temporomandibular joint
— Nerve: Trigeminal nerve, CN V
Muscles of Facial Expression
*Innervation by extracranial branches of the Facial nerve
- How many branches?
- Name all the branches
- What is the mnemonic?
- Relationship with parotid gland
- How many branches?
5 - Name all the branches (named in accordance with ‘region’ going to supply)
Temporal branch
Zygomatic
Buckle
Marginal mandibular
Cervical - What is the mnemonic?
TO ZANZIBAR BY MOTOR CAR - Relationship with parotid gland?
Nerve and branches run relatively superficial within the gland and are vulnerable to damage in facial injuries
- *Muscles of Facial expression (1/2)**
- 3/6 of them
- Name them and state nerve innervation
- *Muscles of Facial expression (2/2)**
- The other 3/6 of them
- Name them and state nerve innervation
Clinical correlate:
Damage to facial nerves:
- Example of what can damage facial nerves
- How might it look
- Example of what can damage facial nerves
Parotid gland cancer
- How might it look
see pic
- *Muscles of Mastication and Sensation from the Face Branches of the ________ nerve**
- Fill in the gap above
- How many branches
- Name the branches
- Which portion of the face do they supply?
- Which are sensory, which are motoe?
- Fill in the gap above
Trigeminal nerve
- How many branches
3
- Name the branches
Va Opthalmic division
Vb Maxillary division
Vc Mandibular division
- Which portion of the face do they supply?
see image
- Which are sensory, which are motor?
Va and Vb ONLY sensory
Vc is BOTH sensory and motor
- *Muscles of Mastication**
- List the 4
- Nerve supply for each
Lateral pterygoid muscle role: (wrong in pic attached) Depresses mandible (opens the jaw) remember: la.... for lateral, opens the jaw
- *Blood vessels of the Head and Neck**
- List the ‘plan’ of the arteries in the H and N
- List the ‘plan’ of the veins in the H and N
- *Main blood supply to face**
- State (and which artery it is from)
- *Much of the Superficial Anatomy of the Neck is Palpable**
- Which structures can you normally (non-pathological) palpate?
- Which structure should not be palpated?
- Which structures can you normally (non-pathological) palpate?
Thyroid cartilage
Cricoid cartilage
- Which structure should not be palpated?
Thyroid gland
- *Muscles of the Neck**
- List 6 muscles of the neck
- Name their nerves
- Where are the s___ h____ and i___ h_____ located (describe using a landmark)
- List 6 muscles of the neck and nerves
Platysma - Facial nerve
Trapezius - Accessory
Sternocleidomastoid - Accessory
Scalene - Anterior branches of cervical spine
Supra-hyoid - Cranial nerve
Infra-hyoid - Cranial nerve (CN1-3)
- Supra- and infra- hyoids located above and below the hyoid bone
- *What do the following muscles ‘look like’**
- Platsyma
- SCM
- Trapezius
- *How to test if the following muscles are working:**
- Plastysma
- SCM
- Trapezius
- *Clinical correlates**
- What does damage to the accessory nerve look like?
- What may patients describe?
- *Anatomical borders divide the neck into two triangles - Anterior Triangle**
- Borders of the Anterior Triangle
Remember we have two anterior triangle
- *Anatomical borders divide the neck into two triangles - Posterior Triangle**
- Borders
Remember we have two posterior triangle
- *Exploration of the Neck - Posterior Triangle**
- What are the contents
- *Exploration of the Neck – Anterior View**
- Contents
- *Carotid Triangle - Smaller triangle within anterior triangle**
- Borders
- Why is this triangle important
MUST BE SPECIFIC:
- Superior belly of omohyoid
- Posterior belly of digastric
- *Supra and infra-hyoid muscles**
- position of these muscles
- *Label the following imaging**
- label fascia
- label organs
- etc
- *Clinical correlates: Retrophrangeal Space infections**
- What is this?
- Age range (likely)
- Why this age range?
- Space allows the phranyx to move more freely, but problem…
- Where may it spread and why?
- Signs and symptoms
- Risk of developing what?
- What is this?
The retropharyngeal space is one deep neck space (there are others) and lies between the prevertebral layer of fascia and the buccopharyngeal fascia)
- Age range (likely)
Up until the age of 3- 4 years.
- Why this age range?
Up until the age of 3- 4 years, the superior part of this space contains lymph nodes, which drain areas of the nose, oral cavity and upper pharynx.
- Space allows the phranyx to move more freely, but problem…
While this ‘space’ between fascial planes allows the pharynx to move freely on the vertebral column and expand during swallowing, it presents significant problems should infection spread to and collect here.
- Where may it spread and why?
As the retropharyngeal space lies between fascial layers that extend the length of the neck, into the mediastinum, retropharyngeal infections may spread inferiorly into the thorax, risking the development of mediastinitis
- Signs and symptoms
visible bulge on inspection of the oropharynx, sore throat, difficulty
swallowing, stridor, reluctance to move the neck and a high temperature
- Risk of developing what?
mediastinitis (rare, but life-threatening condition).
- *Clinical correlates: One sided fascial weakness due to problem with fascial nerves**
- One major cause (linked to a gland)
- This cause leads too (description of the gland, and the weakness)
- Why are the nerves affected?
- Other conditions (rarer) that can also cause these symptoms (also linked to this specific gland)
- One major cause (linked to a gland)
Parotid cancer
- This cause leads to… (description of the gland, and the weakness)
Weakness of the facial muscles on one side in association with an
ipsilateral parotid gland enlargement (highly likely to be a parotid
cancer).
- Why are the nerves affected?
The cancerous cells invade and damage the facial nerve
during its course through the gland.
- Other conditions (rarer) that can also cause these symptoms (also linked to this specific gland)
Rare - for benign, infective or inflammatory conditions of the parotid gland e.g. as can occur in mumps, to cause damage to the facial nerve and thus these conditions are not typically associated with facial muscle weakness.
