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Head and Neck > Session 1 - organisation of the neck > Flashcards

Session 1 - organisation of the neck Flashcards

1
Q

What is the action and innervation of the Platysma muscle

A

Action- depresses the corners of the mouth and assists in depression of the jaw and draws down the lower lip
Innervation- cervical branch of facial nerve

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2
Q

What is the action and innervation of the Sternocleidomastoid muscle

A

Action- lateral flexion of the neck, tilting chin up on controlateral side
I- Accessory nerve

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3
Q

What is Torticollis

A

Involuntary contraction of the Sternocleidomastoid

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4
Q

What is the action and innervation of the Trapezius muscle

A

A-Superior fibers contract to elevate the shoulders (shrug) and rotate the scapula on the back
i-Accessory nerve

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5
Q

What are the borders of the anterior triangle of the neck

A

Imaginary mid-line of neck, inferior margin of mandible, anterior margin of sternocleidomastoid

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6
Q

What are the borders of the posterior triangle of the neck

A

Posterior margin of sternocleidomastoid, anterior margin of trapezius, clavicle

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7
Q

What are the borders of the carotid triangle

A

Sup: Posterior belly of the digastric muscle
Lat: Medial border of the sternocleidomastoid muscle
Inf: Superior belly of the omohyoid muscle

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8
Q

What are the main contents of the carotid triangle

A

Common carotid artery, internal jugular vein hypoglossal nerve and vagus nerve, carotid sinus (baroreceptors)

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9
Q

What are the five fascial planes of the neck

A 
Superficial cervical fascia
Investing layer
Carotid Sheath
Pre tracheal 
Pre vertebral
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10
Q

What space in the fascia when infected is at risk of allowing further spread of infection inferiorly to involve the mediastinal structures

A

The retropharyngeal space

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11
Q

What is a complication of infection of the medastinal structures

A

mediastinitus

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12
Q

What nerve innervates the muscles of facial expression

A

Facial nerve

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13
Q

What nerve innervates the muscles of mastication

A

Trigeminal nerve

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14
Q

What are the three key branches of the trigeminal nerve

A

Va- opthalmic division
Vb-maxillary division
Vc-mandibular division

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15
Q

What nerve provides the main sensory innervation for the face and scalp

A

Trigeminal nerve

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16
Q

Name the five key extra-cranial branches

A 
Temporal
Zygomatic
Buccal
Mandibular
Cervical
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17
Q

What structures does the Internal jugular vein drain

A

Head and neck

also receives venous drainage from the face (facial nerve)

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18
Q

What the external jugular vein drain

A

Scalp and face

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19
Q

What area is defined as the neck

A

from the lower margin of the mandible to the suprasternal notch of the manubrium and the upper body of the clavicle

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20
Q

what is found in the superficial cervcial layer

A

loose connective tissue largely containing adipose
superficial blood vessels e.g. external jugular vein
cutaneous nerves
superficial lymph nodes
Platsyma muscle

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21
Q

what does the investing layer enclose

A

sternocleidomastoid and trapezius muscles and the subamndibular and parotid salivary glands

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22
Q

what does the pretracheal layer enclose

A

muscular layer- infrahyoid muscles

visceral layer- thyroid gland, trachea and oesophagus

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23
Q

what is enclosed in the carotid sheath

A

common carotid artery
internal jugular vein
vagus nerve

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24
Q

what is the action and innervation of the orbicularis oculi muscle

A

A: it closes the eye
I: temporal and zygomatic branches of the facial nerve

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25
Q

how do you examine orbucularis oculi

A

close eyes and resist opening

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26
Q

What are the three parts of orbucularis oculi and what are there functions

A
  1. orbital- surrounds orbital margin - thick muscle used to consciously close the eye- used for forceful closure
  2. palpebral- found in the eyelid- used for unconscious light closure of the eye in blinking/sleep
  3. lacrimal- from lacrimal bone to lacrimal sac - acts as tear pump
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27
Q

What is the action and innervation of levator palpebrae superioris

A

A: elevates upper eyelid
I: oculomotor nerve

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28
Q

examination of oculomotor nerve

A

inspection of eye for ptosis

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29
Q

what is the the action and innervation of occipitofrontalis

A

A:elevates eyebrows
I: frontal belly - temporal branch of the facial nerve
occipital belly- posterior auricular branch of facial nerve

30
Q

how do you examine occipitofrontalis

A

elevate eyebrows against resistance

31
Q

what is the action and innervation of orbicularis oris

A

A: closes mouth
I: buccal branch of facial nerve

32
Q

how do you examine orbicularis oris

A

inspection of the face - drooping angle of the mouth in CNVII palsy

33
Q

what is the action and innervation of buccinator

A

A: flattens cheek - holds cheek close to teeth when chewing - prevents food pooling between cheek and gums

34
Q

how do you examine the action of buccinator

A

blow out cheeks and resist expulsion of air

35
Q

what is the action of the lateral and medial pterygoid

and innervation

A

lateral- protrude mandible, opens jaw, contralateral excursion
medial- elevation and contralateral excursion
I- mandibular branch of the trigeminal nerve

36
Q

how do you examine the medial and lateral pterygoids

A

open mouth against resistance and move jaw side the to side

37
Q

what is the action ad innervation of masseter

A

action: elevates mandible (closes jaw), stronger then medial pterygoid
innervation: mandibular branch of trigeminal nerve

38
Q

how do you examine the masseter muscle

A

palpation during jaw clench

39
Q

what is the action and innervation of temporalis

A

action- elevates mandible (also retrusion of mandible)

40
Q

how do you examine the temporalis

A

palpation during jaw clench

41
Q

what is the action and innervation of the sternocleidomastoid

A

action- head rotation to opposite side (one side contracts). lateral neck fexion (one side contracts). neck flexion (both contract)
innervation- accessory nerve

42
Q

how do you examine SCM

A

turn head against resistance (remember to right=left SCM)

43
Q

What is the action and innervation of trapezius

A

A- upper and lower fibers rotate scapula (acromion and inferior angles move up). middle fibres retract scapula . when scapulae stable, contraction of both sides extends the neck
I- accessory nerve

44
Q

how do you examine trapezius

A

get them to elevate shoulder

45
Q

what are the contents of the skin of the scalp

A

hair follicles and sebaceous glands

46
Q

why does profuse bleeding of the scalp occur

A

the blood vessels are highly adherent to the deep connective tissue and so cannot constrict if fully lacerated

47
Q

what muscles does the epicranial aponeurosis connect

A

the occipitalis and frontalis muscles

48
Q

what is the function of the loose areolar connective tissue and what does it contain

A

it is a thin connective tissue layer that separates the periosteum of the skull from the epicranial aponeurosis.
It contains numerous blood vessels, including emissary veins. which connect the veins of the scalp to the diploic veins and intracranial venous sinuses.

49
Q

where does the periosteum become continuous with endosteum

A

at suture lines

50
Q

in which layer of the scalp is a scalp infection most likely to occur and why is this dangerous

A

the area of loose CT
pus and blood spread easily within it and pass into the cranial cavity along emissary veins. so infection can spread from the scalp to the meninges causing meningitis

51
Q

which two main arteries does the scalp receive its blood supply from?

A

the external carotid artery and the opthalmic artery (via internal carotid artery)

52
Q

which three branches of the external carotid artery are involved in supplying the back of the scalp and which region do they supply

A

superficial temporal- supplies the frontal and temporal regions
posterior auricular- supplies the area superiorly and posteriorly to the auricle
occipital- supplies the back of the scalp

53
Q

which branches of the opthalmic artery supply the scalp

A

supra orbital and supratrochlear arteries

54
Q

which veins drain the superficial scalp

A

superifical temporal, occipital, posterior auricular, supraorbital and supratrochlear

55
Q

what drains the deep temopral region of the skull

A

the pterygoid venous plexus

56
Q

where is the pterygoid plexus located

A

between the temporalis and lateral pterygoid

57
Q

what does the ptergoid plexus drain into

A

the maxillary vein

58
Q

which trigeminal nerves innervate the scalp

A

supratrochlear, supraorbital, zygomaticotemporal, auriculotemporal

59
Q

which cervical nerves innervate the scalp

A

lesser occipital nerve

greater occipital nerve

60
Q

why do deep lacerations of the scalp tend to bleed profusely

A
  • The pull of the occipitofrontalis muscle prevents the closure of the bleeding vessel and surrounding skin.
  • The blood vessels to the scalp are adhered to dense connective tissue, preventing the vasoconstriction that normally occurs in response to damage.
  • The blood supply to the scalp is made up of many anastomoses, which contribute to profuse bleeding.
61
Q

why does loss of blood supply to the scalp NOT lead to bone necrosis?

A

most of the blood supply to the scull is from the middle meningeal artery

62
Q

what are emissary veins

A

The emissary veins connect the extracranial venous system with the intracranial venous sinuses. They connect the veins outside the cranium to the venous sinuses inside the cranium. They drain from the scalp, through the skull, into the larger meningeal veins and dural venous sinuses.

63
Q

what symptoms does a retro-pharyngeal abscess present with?

A

visible bulge on inspection of the oropharynx, sore throat, difficulty swallowing, stridor, reluctance to move their neck and a high temperature

64
Q

why does a lump associated with the thyroid gland move up when swallowing

A

the thyroid gland is enclosed in pre tracheal fascia which is attached to the hyoid bone, the hyoid bone and larynx move up on swallowing.

65
Q

If a goiter extends retrosternally, what symptoms may be present and why?

A

breathlessness and stridor due to tracheal compression and facial odema because of compression of the veins draining the head and neck

66
Q

what is the likely cause of parotid enlargement resulting in ispilateral facial palsy?

A

parotid cancer

67
Q

what is the major artery supplying the face

A

facial artery

68
Q

what is the major vein draining the face

A

facial nerve

69
Q

where can the pulse of the facial artery be palpated

A

the inferior border of the mandible

70
Q

why is it necessary to compress both facial arteries if one is bleeding

A

many anastomoses with other arteries of the face

Head and Neck (11 decks)

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