Sectional Imaging of the Head and Neck

Question 1

List the sutures of an infant’s skull.

Which bone does each suture separate?

Answer 1

1- The metopic suture separates the two frontal bones.

2 - The coronal suture separates the frontal bones from the parietal bones.

3 - The sagittal suture separates the two parietal bones.

4 - The lambdoid suture separates the parietal bones from the occipital bone.

Question 2

What are the anterior and posterior fontanelles?

Where are they located?

Answer 2

• The anterior fontanelle is the membranous gap at the point where the coronal suture meets the metopic and sagittal sutures.
• The posterior fontanelle is the membranous gap at the point where the lambdoid suture meets the sagittal suture.

Question 3

What does a depressed fontanelle indicate?

Answer 3

Dehydration.

Question 4

What does a bulging fontanelle indicate?

Answer 4

Raised intracranial pressure.

Question 5

Give an example of a clinical use of the anterior fontanelle.

Answer 5

It can be used to generate ultrasound scans of the head.

Question 6

Which suture is lost along with the anterior fontanelle in development?

Answer 6

The metopic suture.

Question 7

Define craniosynostosis.

Answer 7

Premature fusion of the sutures of a developing skull, resulting in a malformed skull due to a lack of growth.

Question 8

What is a Jefferson fracture?

When does it occur?

Answer 8

• A fracture of the atlas (C1) vertebra, which always occurs at 2 or more points (broken polo mint analogy).
• It occurs with forced:

1 - Hyperextension.

2 - Hyperflexion.

3 - Hyper rotation.

4 - Excessive loading.

Question 9

Define comminuted fracture.

Answer 9

A break of bone into more than two fragments.

Question 10

What is a hangman’s fracture?

When does it occur?

Answer 10

• A bilateral fracture of the axis (C2) vertebra at the pedicles (broken polo mint analogy).
• It occurs with forced hyperextension of the neck.

Question 11

Describe the organisation of the branches of the aorta.

Answer 11

1 - The first branch on the right is the brachiocephalic trunk.

• This gives rise to the right common carotid artery and the right subclavian artery.

2 - The first branch on the left is the left common carotid artery.

3 - The second branch on the left is the left subclavian artery.

Question 12

Which branches arise from the common carotid arteries?

At which vertebral level does the bifurcation of the common carotid arteries occur?

Answer 12

• The external and internal carotid arteries.

- The bifurcation of the common carotid arteries occurs at vertebral level C3 / C4.

Question 13

List the arteries that supply the head and neck.

Answer 13

1 - External carotid artery.

2 - Internal carotid artery.

3 - Vertebral arteries.

Question 14

From which artery do the left and right vertebral arteries arise?

Answer 14

The subclavian arteries.

Question 15

Through which structures do the vertebral arteries travel to reach the head and neck?

Answer 15

The transverse foramen of the cervical vertebrae.

Question 16

Through which structure do the common carotid arteries travel through the neck?

Which structures accompany the common carotid arteries in the carotid sheath?

Answer 16

• The carotid sheath.

- They are accompanied by the internal jugular vein and the vagus nerve.

Question 17

Describe the lower venous system of the head and neck.

Answer 17

• The right and left jugular veins (internal and external) receive blood from the head and neck.
• They meet the right and left subclavian veins beneath the clavicles.
• The left subclavian vein merges with the left jugular vein (internal and external), forming the left brachiocephalic vein, and vice versa to form the right brachiocephalic vein.
• The left and right brachiocephalic veins merge to form the superior vena cava.

Question 18

Where is the common carotid artery located in relation to the internal jugular vein?

Answer 18

The common carotid artery is more medial, whereas the internal jugular is more lateral.

Question 19

Give an example of a feature of a benign lymph node.

Answer 19

The lymph node is oval in shape rather than spherical (malignant lymph nodes are spherical as they become packed full of cells).

Question 20

What is the bright area in the middle of some lymph nodes as seen on an ultrasound scan?

Is this normal?

Answer 20

An echogenic fatty hilum, which is a normal finding.