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Head, Neck and Neuroanatomy > Session 1 - General Organisation of the Head and Neck > Flashcards

Session 1 - General Organisation of the Head and Neck Flashcards

1
Q

What are the layers of cervical fascia?

A

1) Superficial cervical fascia

Deep cervical fascia:

2) Investing layer
3) Pre-tracheal layer
4) Pre-vertebral layer

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2
Q

What structures are found within the superficial cervical fascia?

A

Superficial blood vessels, e.g. External jugular vein
Cutaneous nerves
Superficial lymph nodes
Platysma

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3
Q

The carotid sheath is formed by which layers of cervical fascia?

A

The 3 deep layers - investing, pretracheal and prevertebral

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4
Q

What structures run through the carotid sheath?

A 
Main structures:
Common and internal carotid arteries
Internal jugular vein 
Vagus nerve (CN X)

Also present:
Some deep cervical lymph nodes
Carotid sinus nerve
Sympathetic nerve fibres (carotid peri-arterial plexuses)

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5
Q

What layer of fascia lies directly behind the oesophagus and muscles of the pharynx?

A

Buccopharyngeal fascia

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6
Q

Where is the retropharyngeal space found?

A

Between the buccopharyngeal fascia and the pre-vertebral fascia

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7
Q

Why is the retropharyngeal space needed?

A

To allow the pharynx and oesophagus to expand on swallowing

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8
Q

Retropharyngeal space infections are most commonly seen in people of what age?

A

Children, usually under the age of 5

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9
Q

What does the retropharyngeal space contain up to the age of 3-4 years?

A

Lymph nodes

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10
Q

How far could an infection in the retropharyngeal space potentially spread to?

A

From the neck into the thorax, and potentially as far down as the posterior mediastinum.
This could possibly result in the rare but life-threatening condition mediastinitis.

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11
Q

Infection in the retropharyngeal space is usually secondary to what kind of infection?

A

Upper respiratory tract infection (e.g. Infection of the nasal cavity, nasopharynx, oropharynx)

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12
Q

A retropharyngeal infection may develop into what?

A

A retropharyngeal abscess

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13
Q

How would a retropharyngeal abscess present?

A 
A visible bulge on inspection of the oropharynx
Sore throat
Difficulty swallowing 
Stridor (high pitched breathing sound)
Reluctance to move their neck 
High temperature
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14
Q

Why does the thyroid gland move upwards on swallowing?

A

The thyroid gland is enclosed by pre-tracheal fascia, which is attached to the hyoid bone. They hyoid bone and the larynx move up on swallowing, therefore so does the thyroid gland.

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15
Q

Why can goitre sometimes extend retrosternally?

A

The lower limit of the pre-tracheal fascia extends into the thorax

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16
Q

What complications can a retrosternal extension of goitre lead to?

A

Compression of other structures running through the root of the neck such as the trachea and venous blood vessels.
This can lead to symptoms such as breathlessness and stridor due to tracheal compression, and facial oedema due to compression of venous drainage from the head and neck.

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17
Q

What is the purpose of the buccinators?

A

They keep the cheek taut and aid in chewing, ensuring food stays within the oral cavity proper when eating (rather than ‘pooling’ between the cheek and teeth).

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18
Q

What are the four muscles of mastication?

A

Masseter
Temporalis
Medial pterygoid
Lateral pterygoid

19
Q

What are the divisions of the trigeminal nerve (CN V)?

A 
Ophthalmic division (Va)
Maxillary division (Vb)
Mandibular division (Vc)
20
Q

What nerve supplies the muscles of mastication?

A

Mandibular division of the trigeminal nerve

21
Q

What is the action of the muscles of mastication?

A

They act to move the mandible at the temporomandibular joint (TMJ)

22
Q

Which muscles are supplied by the facial nerve (CN VII)?

A

Platysma, muscles of facial expression, buccinators, muscles of the ear, occipitofrontalis

23
Q

What are the five main terminal branches of the facial nerve?

A 
Temporal 
Zygomatic 
Buccal 
Mandibular 
Cervical
24
Q

Facial nerve palsy seen with ipsilateral parotid enlargement is highly likely to be due to what?

A

Parotid cancer

It is quite rare for benign, infective or inflammatory conditions of the parotid gland to cause a facial nerve palsy.

25
Q

What is the most common cause of facial paralysis?

A

Bell’s palsy

26
Q

What is Bell’s palsy?

A

A condition that causes temporary weakness or paralysis of the muscles in one side of the face. Inflammation around the facial nerve causes oedema and therefore compression of the nerve as it runs through its bony canal within the petrous part of the temporal bone.

27
Q

Most arteries supplying structures in the face and neck are branches of what artery?

A

The external carotid artery

28
Q

The external carotid artery terminates as what two arteries?

A

Superficial temporal artery

Maxillary artery

29
Q

Where do the facial artery and vein run from and to?

A

From the medial angle of the eye to the inferior border of the mandible

30
Q

The facial vein drains into what vein?

A

Internal jugular vein

31
Q

Which veins drain into the external jugular vein?

A

Superficial temporal vein

Maxillary vein

32
Q

The internal and external jugular veins drain into what vein?

A

Subclavian vein

33
Q

Why do scalp wounds bleed heavily?

A

Blood vessels supplying the scalp arise from the internal and external carotid arteries. These anastomoses provide a rich blood supply to the tissues, therefore scalp wounds bleed heavily.

34
Q

In which fascial layer does the platysma lie?

A

Superficial cervical fascia

35
Q

What is the action of the platysma?

A

Depresses the corners of the mouth

Assists in depression of the jaw

36
Q

Which nerve innervates the sternocleidomastoid?

A

Accessory nerve

37
Q

Where does the sternocleidomastoid originate and insert?

A

Originates - clavicle and sternum

Inserts - mastoid process

38
Q

What is the action of the sternocleidomastoid?

A

Lateral flexion of the neck, tilting the chin up to contralateral side

39
Q

How do you test the sternocleidomastoid?

A

Look over shoulder against resistance

40
Q

What is torticollis?

A

Twisting of the neck due to involuntary contraction of the sternocleidomastoid.

41
Q

What is the action of the trapezius muscle?

A

Elevation of the shoulders

42
Q

What are the borders of the anterior triangle of the neck?

A

Midline of the neck
Inferior margin of the mandible
Anterior margin of the sternocleidomastoid

43
Q

What are the borders of the posterior triangle of the neck?

A

Posterior margin of sternocleidomastoid
Anterior margin of the trapezius
Clavicle

Head, Neck and Neuroanatomy (12 decks)

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