Session 1 Flashcards
Two muscle groups of the face? Nerve supply and role?
Muscles of facial expression-facial nerve-allow facial movements.
Muscles of mastication-Trigeminal nerve- movement of the jaw at the temperomandibular joint.
Which gland is associated with the facial nerve and explain?
Facial nerve passes through the parotid gland then divides into 5 different branches of the facial nerve
Name the 5 different branches of facial nerve from top of head to bottom
- Temporal
- Zygomatic (zygoma)
- Buccal (cheek)
- Marginal mandibular (chin)
- Cervical (neck)
Role of Trigeminal nerve and a few notes?
Sensory nerve of the face. Has three branches. 1 branch (mandibular division) provides motor function for muscles of mastication.
3 branches of trigeminal nerve and what area?
- Ophthalmic (forehead,eyes,top of nose)
- Maxillary (bottom half of nose and top lip)
- Mandibular (bottom bit going up to temple)
See diagram
Describe routes of the three aortic trunks and what they become
R trunk: brachial cephalic trunk splits into RCC artery and R subclavian artery.
Middle: LCC artery
Left: L subclavian artery
What artery supplies the face?
External carotid artery
What veins drains head and neck? Difference and clinical relevance?
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.
Two muscles supplied by the accessory nerve? Action and location?
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.
Borders of both triangles in the neck?
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
Relevance of both cervical triangles?
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
What 2 BV’s run very deep together in the neck? And what triangle are they found one?
IJV and carotid artery. In carotid triangle made from digastric post belly(sup border). sup belly of omohyoid (med border) and SCM (lat border).
Describe the supra/infra hyoid muscles
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.
Role of fasciae compartments in neck?
Form natural planes, allow ease of movement between structures thus swallowing.
Relevance of retropharangeal space?
Can allow spread of infection as communicates with mediastinum. Amusing mediastinitus.
Go to pg 26 of 1st head and neck lecture and try to label all the different fascia and other structures
See picture
Role of lymphatic system?
Lymphodoema?
Lymphadenopathy?
Clears excess fluid from interstitial space and immunity as source of lymphocytes.
Lymphodoema= abnormal swelling
Lymphadenopathy= swollen lymph node due to infection or tumour
What do lymph nodes do?
They are physical filters, full of b/t lymphocytes which proliferate in response to antigens.
How would you distinguish lymphadenopathy between an infection of malignancy?
Infection- history of cold, tender, mobile.
Malignancy- hard, non tender, rubbery, fast growing.
Where are deep/superficial lymph nodes found?
Superficial- very palpable in superficial fascia
Deep- deeper than investing layer, often associated with IJV in the carotid sheath.
8 different superficial lymph nodes? Note: look at pg 12 of session 1 for good diagram.
- submental
- submandibular
- Pre auricular
- post auricular
- Occipital
- Superficial cervical
- Posterior cervical
- Anterior cervical
Clinical relevance of pre auricular lymph draining
Drains the eyes, so in conjunctivitis, pre auricular lymph nodes by ear will swell
Superficial lymph nodes to deep to where?
Venous circulation
Notes on three deep lymph nodes?
Lie close to IGV usually in carotid sheath, deep to SCM. Names describe location.
- Jugulo-digastric
- Jugulo-omohyoid
- Supraclavicular (chest/oesophageal/stomach cancer)
Describe Waldeyer’s ring?
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)
Possible neck lumps on midline?
Possible neck lumps laterally?
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
- What muscle closes/squeezes eye shut?
- what muscle bring lips together/pouts?
- What muscles raises eyebrows/wrinkles forehead
- Orbicularis oculi (sphincter)
- Orbicularis Oris (sphincter)
- Occipitofrontalis
What do the medial/lateral pyterigoids do?
Lateral- depresses mandible, opening jaw, laaaa
Medical- elevates mandible moving jaw forward
What tenses skin on neck and depresses angles of mouth?
Platysma
What elevates the mandible(closes jaw) and retracts jaw?
Temporalis
Which 4 face muscles are mastication? (Move TMJ)
Temporalis, Masseter, pyterygoids
What do buccinators do?
Are cheek muscles which compress cheek against teeth to keep food in mouth.
Masseter?
Elevates mandible (closes jaw)
What does the zygomaticus do?
Allows smiling by bringing angles of mouth laterally and superiority.
Risorious?
Moves angles of mouth laterally again allowing a smile
5 layers of scalp starting superficially?
For each give common problems linked to structure
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
Arterial supply to scalp?
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)
Venous drainage in scalp?
Superficial follows the arteries.
Deep by pterygoid venous plexus (between temporalis and lateral pterygoid) and drains into maxillary vein.
