Session 1 Flashcards

1
Q

How many cervical fascia are there?

A
  • Superficial cervical fascial layer

- 4 Deep cervical fascial layer

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2
Q

Where can the superficial cervical layer be found?

A

It is found just below the skin and largely contains adipose

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3
Q

What can be found within the superficial cervical layer?

A
  • External jugular vein
  • Cutaneous nerves
  • Superficial lymph nodes
  • Platysma
  • Fat
  • Superficial blood vessels
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4
Q

What are the 3 layers of the deep cervical fascia from superficial to deep?

A

From superficial to deep

  • Investing layer
  • Carotid sheath
  • Pre tracheal layer
  • Pre vertebral layer
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5
Q

Which fascial layer encloses the sternocleidomastoid, trapezius, submandibular and parotid salivary glands?

A

Investing layer

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6
Q

Where does the retropharyngeal space lie?

A

Pre-vertebral layer of fascia and the fascia surrounding the pharynx.

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7
Q

What are the complications of an infection that develops in the retropharyngeal space?

A

Can potentially spread from the neck into the thorax as far down as the posterior mediastinum risking development of a mediastinitis

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8
Q

What are the main muscle group of the face?

A
  • Muscles of facial expression

- Muscles of mastication

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9
Q

Which nerves supplies all of the muscles of mastication?

A

-Mandibular division of the trigeminal nerve

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10
Q

Which nerve supplies the muscles of fascial expression and superficial muscle of neck and chin?

A

-Facial nerve

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11
Q

What is Bell’s palsy?

A

Inflammation of the facial nerve causing facial paralysis

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12
Q

What are the main muscles of the neck?

A
  • Platysma
  • Sternocleidomastoid
  • Trapezius
  • Suprahyoids: attach to the hyoid and above it
  • Infrahyoids: attach to the hyoid bone and below it
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13
Q

What nerve supplies the muscles of the neck?

A

-Cranial nerves

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14
Q

What is the action of platysma muscle?

A

Depresses corners of the mouth

Contraction assists in depression of the mandible

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15
Q

What is the nerve supply of the platysma muscle?

A

Facial Nerve

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16
Q

What are the attachments of the sternocleidomastoid?

A
  • Arises from the sternum and clavicle

- Inserts into the mastoid process

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17
Q

What is the action of the sternocleidomastoid?

A
  • Contraction results in lateral flexion of the neck towards the side of the contraction
  • Both muscles contracting bring the skull forward or flexion of the neck
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18
Q

What can be used to examine the sternocleidomastoid?

A

Put hand on the patients neck and ask them to look over their shoulder

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19
Q

What is the nerve supply of the sternocleidomastoid?

A

Accessory nerve

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20
Q

What is the action of the trapezius?

A

Contraction causes the shoulder to be shrugged.

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21
Q

What can be used to test the accessory nerve?

A

Shrug against resistance to test damage to nerve that supplies the trapezius

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22
Q

What are the borders of the anterior triangle?

A

Superiorly: inferior border of the mandible
Laterally: Medial border of the sternocleidomastoid
Medially: Imaginary saggital line down the midline of the body

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23
Q

What are the borders of the posterior triangle?

A

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

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24
Q

What does inserting surgical airways carry the risk of?

A

Infection of the pre tracheal space

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25
Q

What do muscles of the fascial expression do?

A

Act as sphincters and dilators. Attach to bone and the skin/fascia of the face

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26
Q

What do muscles of mastication do?

A

Act to open and close the jaw

27
Q

What are the 3 branches of the trigeminal nerve?

A
  • Opthalmic division
  • Maxillary division
  • Mandibular division
28
Q

What does the trigeminal nerve do?

A
  • Main sensory nerve of the face and scalp

- Motor innervation to the muscles of mastication

29
Q

What does the facial nerve do?

A
  • Motor innervation to muscle of facial expression

- Other functions e.g. special sensory to tongue taste, parasympathetic innervation to salivary and lacrimal glands

30
Q

What are the main blood vessels of the head and neck?

A
  • Common carotid artery which is the main arterial supply via its terminal branches
  • Internal jugular vein which is the main vain drain head and neck structures. Also receives venous drain from the face via facial vein
  • External jugular vein which also receives veins draining the scalp and face and runs more superficially than the IJV
31
Q

What are the branches of the common carotid artery?

A
  • Internal carotid artery

- External carotid artery (facial artery branch supplies the face)

32
Q

Why is swallowing, movement of thence typically difficult and painful for a patient with a retropharyngeal abscess?

A

Compression of oesophagus causes pain to elicited when moving the neck or swallowing

33
Q

What are the branches of the facial nerve?

A

Superior to inferior

  • Temporal (above the eyes at side of head)
  • Zygomatic (nose region)
  • Buccal (mouth region above the lip)
  • Mandibular (mouth region below lip)
  • Cervical (neck region)
34
Q

What are the branches of the trigeminal nerve?

A
  • Opthalmic
  • Maxillary
  • Mandibular
35
Q

How would you test for the trigeminal nerve?

A

-Movement of the jaw

36
Q

How would you test for the facial nerve?

A
  • Smile
  • Frown
  • Closing eyes
  • Raising eyebrows
37
Q

What is the action of orbicularis oculi?

A
  • Closes the eyes
  • Inner part closes the eyes lightly
  • Outer part closes the eyes sharply
38
Q

What can be used to examine the orbicularis oculi?

A

Close the eyes tightly and stop me trying to open them

39
Q

What is the action of the levator palpebrae superioris?

A

Elevates the upper eyelid

40
Q

What is the innervation of the levator palpebrae superioris?

A

Oculomotor nerve

41
Q

What is the innervation of the orbicularis oculi?

A

Temporal and zygomatic branch of the facial nerve

42
Q

What is the action of the occipitofrontalis?

A

Elevation of the eyebrows

43
Q

What is the innervation of the occipitofrontalis?

A
  • Frontalis belly by the temporal branch

- Posterior auricular nerve for the occipital part

44
Q

What is the examination for for occipitofrontalis muscle?

A

Raise the eyebrow against resistance

45
Q

What is the action of the orbicularis oris?

A

Closes the mouth

46
Q

What is the innervation of the orbicularis oris?

A

Buccal branch of facial nerve

47
Q

What is the examination for the orbicularis oris?

A

Purse lips and try to pull it up

48
Q

What is the action of the Buccinator?

A
  • Keeps food from spilling into the cheek.
  • Flattens cheek and holds the cheek close to the teeth when chewing.
  • Prevents food pooling between cheek and gums
49
Q

What is the innervation of the Buccinator?

A

Buccal branch of the facial nerve

50
Q

What is the examination for the buccinator?

A

Blow out cheeks and resist expulsion of air

51
Q

What is the action of the medial pterygoid?

A

Elevates the mandible, closing the mouth.

52
Q

What is the innervation of the medial and lateral pterygoids?

A

Mandibular nerve

53
Q

What is the action of the lateral pterygoid?

A
  • Acting bilaterally
  • Protract the mandible
  • Pushing the jaw forwards
  • Unilateral action produces the ‘side to side’ movement of the jaw
54
Q

What is the action of the masseter?

A

Elevates the mandible, closing the mouth.

55
Q

What is the innervation of the masseter?

A

Mandibular branch of trigeminal nerve

56
Q

What is the action of temporalis?

A
  • Elevates the mandible, closing the mouth

- Also retracts the mandible, pulling the jaw posteriorly.

57
Q

What is the innervation of temporalis?

A

Mandibular branch of trigeminal nerve

58
Q

What is the examination for the temporalis?

A

Palpation during jaw clench

59
Q

What is the action of the sternocleidomastoid?

A
  • Head rotation to opposite side
  • Lateral neck flexion
  • Neck flexion
60
Q

What is an examination for the sternocleidomastoid muscle?

A

Shake their head

61
Q

What is the innervation of the trapezius?

A

Accessory nerve

62
Q

What is the examination of the trapezius muscle?

A

Tell them to lift their shoulders and try to stop them

63
Q

What layers would the scalpel penetrate before it reached the bone?

A
  • Skin
  • Dense Connective tissue
  • Epicranial aponeurosis
  • Loose areolar connective tissue
  • Periosteum
64
Q

How is spread of bleeding within the subperiosteal layer limited?

A

There are membranous gaps in the sutures which the blood goes into which limits the spread of bleeding within the sub-periosteal layer.