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ESA 4 > Session 1 Head & Neck > Flashcards

Session 1 Head & Neck Flashcards

1
Q

What are the muscles of mastication and there cranial nerve ?

A

Masseter
Medial and Lateral Pteygoid
Temporalis

Nerve : Trigeminal Nerve
Branches of the mandibular

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2
Q

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

A

Anterior - midline of neck
Posterior - anterior border of SCM
Superior - inferior margin of the mandible

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3
Q

What are the Branches of the facial nerve?

A 
Temporal 
Zygomatic 
Buccal 
Mandibular 
Cervical
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4
Q

What are the muscles of facial expression and nervous innervation ?

A

Occipitofrontalis- raises eyebrows and wrinkles the forehead
Orbicualris oris - closes the mouth , purses the lips
Orbicualris occuli - closes the eyes
Buccinator - pushes the cheek against the mouth and retracts the angle of the mouth
Zygomaticus - smiling, laughing and pushing out cheeks
Nasalis - opening and closing nostrils
Risorius - grinning
Platysma- depresses mandible and the angle of the neck

Nerve : facial nerve branches

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5
Q

What is the action of levator palpebrae superior ?

A

Keeps eyes open

Innervation by the occipital nerve.

Problems result in ptosis (unapposed closing of the eye)

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6
Q

What is the significance of the palperbral part of orbicualris occuli?

A

This is not under voluntary control and keeps eyes closed when you are sleeping or normal blinking.

Orbital part of muscle is under voluntary control

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7
Q

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

A

Anterior border- posterior border of SCM
Posterior border - anterior border of trapezius
Inferior - clavicle

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8
Q

Describe fucntion and location of the SCM ?

A

From: the mastoid process
To : clavicle and sternum

Unilateral action : turns the head to one side and chin superiorly when you contract left hand side the head moves to the right

Bilateral action :flexion at the neck and extension of the atlantooccipital joint

Nerve : Accessory nerve

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9
Q

Describe function of trapezius and innervation ?

A

From : base of skull, nucchal ligament, and spinous processes
To : Lateral 1/3 of clavicle, spine of scapula and the acromion

Function : (movements of scapula) extending the cervical spin.
Extension, Lateral flexion and rotation of atlantoocciptial and atlantoaxial neck

Nerve : accessory nerve

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10
Q

How would a patient with dystonic SCM Present?

A

Dystonia- state of abnormal muscle tone resulting in musclular spasm and abnormal posture

Dystonia would cause tilt/ rotation to one direction .
The tilt would be ipsilateral to the SCM effected causing rotation of the chin to the contralateral side.

This is called torticollis
Newborns : congential muscular torticollis

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11
Q

What is the major sensory nerve of the face and scalp ?

A

Trigeminal

Three branches :
Opthalmic
Maxillary
Mandibular

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12
Q

What is the nerve responsible for being able to taste?

A

Facial nerve

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13
Q

What are the layers of fascia in the neck?

A

Superficial layer - loose connective tissue ( platysma and EJV are here)
Deeper layers :
1) Investing layer: Trapezius, SCM, Parotid and Submandibular gland.
2) Pre tracheal layer : Trachea, pharynx, the infrahyoid muscles, oesophagus, larynx
3) carotid sheath : common carotid artery, IJV, Vagus nerve , deep cervical lymph nodes
4) pervertebral layer : vertebral column and muscles

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14
Q

What is the retropharyngeal space?

A

Bordered anteriorly by the pretracheal (buccopharyngeal) fascia and posteriorly by the pre vertebral fascia.
Split in the middle by ala fascia which splits the area into anterior (true space) : this ends at T1- T6 and the posterior (danger) space.
Danger space infections can lead to mediastinitis.

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15
Q

What is the trajectory of the facial nerve ?

A

Nerve will travel through the parotid gland.

Parotitis can effect the nerve.

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16
Q

How do you detect a lump in the thyroid gland?

A

When the patient swallows the lump will also move, as the pretracheal fascia is attached to the hyoid bone.

17
Q

What are retropharyngeal infections?

A

The danger space will extend to the diaphragm.
Classically more common in children : lymph nodes are present here.

Any upper respiratory infection can ultimately cause it.
Complications :abscess , sepsis , asphyxiation penumoniae, erosion of b/v, bone and organs.

18
Q

What are the layers of the scalp?

A 
Skin & subcutaneous fascia 
Dense connective tissue 
Epicranial aponeurosis 
Loose connective tissue - danger zone 
Periosteum
19
Q

Why does the scalp bleed profusely ?

A

Bleeds as :
Many anastomoses of b/v
Connective tissue maintains the patency of the lacerated b/v
If laceration penetrates the aponeurosis this is even worse

But middle meningeal artery prevents avascular necrosis

20
Q

What are the main blood vessels of the scalp?

A

Superficial temporal (From ECC)
Posterior auricular
Occipital

Supratrochlear (from ICC)
Supraorbital

21
Q

What are the key features of the cervical spine (typical) vertebrae?

A

Bifid spinous process
Body shaped concave superiorly and inferiorly
Transverse foramina (conduct the vertebral arteries, veins & nerves)
Large vertebral foramen
Horizontally aligned articular processes

22
Q

What are the features of C1?

A

Lateral masses articulate with the occipital condyles
Posterior and anterior arch
No vertebral body
No spinous processes
Odd shaped foramen (narrower anteriorly and wider posteriorly)
Posterior arch has a groove for the vertebral artery.

23
Q

What are the key features of C2?

A

Dens (remnant of the body of the C1)
Large spinous process
This is the strongest of the cervical vertebrae.

24
Q

What are the key features of C7?

A

Vertebrae prominens
No bifid spinous process
Transverse foramina only has the accessory vertebral veins

25
Q

What is cervical spondylosis?

A

Cervical spondylosis
• Degenerative osteoarthritis of intervertebral joints in cervical spine
• Pressure on nerve roots leads to radiculopathy:
Dermatomal sensory symptoms: paraesthesia, pain
Myotomal motor weakness
• Pressure on the cord leads to myelopathy (less common):
(Global weakness,Gait dysfunction, Loss of balance & Loss of bladder and bowel control)

26
Q

What injuries does hyperextension of the neck cause?

A

Hyperextension causes :
Hangmans fracture : fracture of the C2 within the pars interarticularis area, the pedicles; C2& C1 will move anteriorly on C3.
Peg fracture (dens)
Rupture of the transverse ligament
Tearing of the anterior longitudinal ligament (prevents hyperextension)

27
Q

What injuries does hyperflexion cause?

A

Tearing of the supraspinous ligament
Effects the lower cervical vertebrae
Vertebral body fracture

28
Q

What is a Jeffersons fracture?

A

This is a fracture of the C1, a burst fracture, where regions of the posterior and anterior arch are broken.

29
Q

What movements occur at the atlantooccipital and the atlantoaxial joint?

A

Atlantooccipital - nodding of the head

Atlantoaxial - rotation of the head

ESA 4 (15 decks)

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