Session 1

Question 1

Two muscle groups of the face? Nerve supply and role?

Answer 1

Muscles of facial expression-facial nerve-allow facial movements.

Muscles of mastication-Trigeminal nerve- movement of the jaw at the temperomandibular joint.

Question 2

Which gland is associated with the facial nerve and explain?

Answer 2

Facial nerve passes through the parotid gland then divides into 5 different branches of the facial nerve

Question 3

Name the 5 different branches of facial nerve from top of head to bottom

Answer 3

1. Temporal
2. Zygomatic (zygoma)
3. Buccal (cheek)
4. Marginal mandibular (chin)
5. Cervical (neck)

Question 4

Role of Trigeminal nerve and a few notes?

Answer 4

Sensory nerve of the face. Has three branches. 1 branch (mandibular division) provides motor function for muscles of mastication.

Question 5

3 branches of trigeminal nerve and what area?

Answer 5

1. Ophthalmic (forehead,eyes,top of nose)
2. Maxillary (bottom half of nose and top lip)
3. Mandibular (bottom bit going up to temple)

See diagram

Question 6

Describe routes of the three aortic trunks and what they become

Answer 6

R trunk: brachial cephalic trunk splits into RCC artery and R subclavian artery.

Middle: LCC artery

Left: L subclavian artery

Question 7

What artery supplies the face?

Answer 7

External carotid artery

Question 8

What veins drains head and neck? Difference and clinical relevance?

Answer 8

IJV and EJV. EJV is much more superficial and as it’s so easily seen, when testing for venous pressure it’s important to get IJV and not confuse them to get the true pressure.

Question 9

Two muscles supplied by the accessory nerve? Action and location?

Answer 9

Sternocleidomastoid- forms Ant/post triangles. Laterally Flexes neck and rotates chin contralaterally. Attachments are in the name.

Trapezius- see esa 2 but rotates scapula after 90 degree arm abduction.

Question 10

Borders of both triangles in the neck?

Answer 10

Posterior- Ant border= post border of SCM Post border= ant border of trapezius
Floor= superior border of clavicle

Anterior- Ant border= Ant border of SCM
Post= midline of neck
Roof= inf margin of mandible

Question 11

Relevance of both cervical triangles?

Answer 11

Anterior Contains structures passing between head and neck such as thorax and thyroid gland.

Posterior contains brachial plexus/subclavian A and V/scalenes at floor/Omohyoid/EJV

Question 12

What 2 BV’s run very deep together in the neck? And what triangle are they found one?

Answer 12

IJV and carotid artery. In carotid triangle made from digastric post belly(sup border). sup belly of omohyoid (med border) and SCM (lat border).

Question 13

Describe the supra/infra hyoid muscles

Answer 13

Supra- above hyoid bone, important 2 are digastric ant belly and post belly. They elevate the hyoid and depress the mandible.

Infra- strap muscles, down midline of neck. overlying larynx and thyroid. Depress and stabilise the hyoid.

Question 14

Role of fasciae compartments in neck?

Answer 14

Form natural planes, allow ease of movement between structures thus swallowing.

Question 15

Relevance of retropharangeal space?

Answer 15

Can allow spread of infection as communicates with mediastinum. Amusing mediastinitus.

Question 16

Go to pg 26 of 1st head and neck lecture and try to label all the different fascia and other structures

Answer 16

See picture

Question 17

Role of lymphatic system?
Lymphodoema?
Lymphadenopathy?

Answer 17

Clears excess fluid from interstitial space and immunity as source of lymphocytes.
Lymphodoema= abnormal swelling
Lymphadenopathy= swollen lymph node due to infection or tumour

Question 18

What do lymph nodes do?

Answer 18

They are physical filters, full of b/t lymphocytes which proliferate in response to antigens.

Question 19

How would you distinguish lymphadenopathy between an infection of malignancy?

Answer 19

Infection- history of cold, tender, mobile.

Malignancy- hard, non tender, rubbery, fast growing.

Question 20

Where are deep/superficial lymph nodes found?

Answer 20

Superficial- very palpable in superficial fascia

Deep- deeper than investing layer, often associated with IJV in the carotid sheath.

Question 21

8 different superficial lymph nodes? Note: look at pg 12 of session 1 for good diagram.

Answer 21

1. submental
2. submandibular
3. Pre auricular
4. post auricular
5. Occipital
6. Superficial cervical
7. Posterior cervical
8. Anterior cervical

Question 22

Clinical relevance of pre auricular lymph draining

Answer 22

Drains the eyes, so in conjunctivitis, pre auricular lymph nodes by ear will swell

Question 23

Superficial lymph nodes to deep to where?

Answer 23

Venous circulation

Question 24

Notes on three deep lymph nodes?

Answer 24

Lie close to IGV usually in carotid sheath, deep to SCM. Names describe location.

1. Jugulo-digastric
2. Jugulo-omohyoid
3. Supraclavicular (chest/oesophageal/stomach cancer)

Question 25

Describe Waldeyer’s ring?

Answer 25

Collection of lymphoid tissue in upper aero digestive tract. Pharyngeal tonsil (upper so nasal obstruction if inflamed), Palatine tonsils (on sides, are seen in tonsillitis), lingual (below tongue)

Question 26

Possible neck lumps on midline?

Possible neck lumps laterally?

Answer 26

Thyroid goitre, Dermoid cyst (congenital and moves), thyroglosal duct cyst (attached to tongue thus moves).

Branchial cyst (congenital), submandibular salivary gland infection/tumour.

For both- anything to do with lymphadenopathy

Question 27

1. What muscle closes/squeezes eye shut?
2. what muscle bring lips together/pouts?
3. What muscles raises eyebrows/wrinkles forehead

Answer 27

1. Orbicularis oculi (sphincter)
2. Orbicularis Oris (sphincter)
3. Occipitofrontalis

Question 28

What do the medial/lateral pyterigoids do?

Answer 28

Lateral- depresses mandible, opening jaw, laaaa

Medical- elevates mandible moving jaw forward

Question 29

What tenses skin on neck and depresses angles of mouth?

Answer 29

Platysma

Question 30

What elevates the mandible(closes jaw) and retracts jaw?

Answer 30

Temporalis

Question 31

Which 4 face muscles are mastication? (Move TMJ)

Answer 31

Temporalis, Masseter, pyterygoids

Question 32

What do buccinators do?

Answer 32

Are cheek muscles which compress cheek against teeth to keep food in mouth.

Question 33

Masseter?

Answer 33

Elevates mandible (closes jaw)

Question 34

What does the zygomaticus do?

Answer 34

Allows smiling by bringing angles of mouth laterally and superiority.

Question 35

Risorious?

Answer 35

Moves angles of mouth laterally again allowing a smile

Question 36

5 layers of scalp starting superficially?

For each give common problems linked to structure

Answer 36

Skin- sebaceous gland so cysts

DCT-rich with BV’s tightly adhered to CT so if lacerated there is profuse bleeding.

Epicranial aponeurosis- tendon connecting occipitalis and frontalis

LCT-emissary veins connecting intracranial which can spread infection.(Danger Area)

Periosteum-continuous with endosteum at sutures

Question 37

Arterial supply to scalp?

Answer 37

External carotid branches;
Superficial temporal- frontal/temporal region
Occipital- back of head
Posterior auricular- superiorly and posteriorly to auricle

Internal carotid branch = ophthalmic artery(supratrochlear and supraprbital)

Question 38

Venous drainage in scalp?

Answer 38

Superficial follows the arteries.

Deep by pterygoid venous plexus (between temporalis and lateral pterygoid) and drains into maxillary vein.