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Head And Neck Esa 3 > Session 2 > Flashcards

Session 2 Flashcards

1
Q

Describe main arteries of the neck on the right. Look at diagrams after.

A

Brachiocephalic splits into subclavian and common carotid. CC has know branches until it bifurcated at C4 (superior border of thyroid cartilage) level into internal and external common carotid.
Subclavian has important branches coming from it such as internal thoracic, vertebral artery and inferior thyroid. The thyrocevical trunk is key.

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2
Q

Main arteries coming of thyrocervical trunk?

A

Inferior thyroid artery.
Ascending and transverse cervical.
Suprascapular for shoulder.

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3
Q

Describe the route of the vertebral artery

A

Passes through the transverse foramina C6-C1, then passes not the skull via the foremen magnum. The 2 vertebral arteries join to form the basilar artery. They can supply the brain.

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4
Q

Does the internal carotid give of branches and how does it enter the skull?

A

No.

Via the Carotid canal through petrous part of temporal bone. Then courses through the cavernous sinus.

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5
Q

Which is more medial the internal or external carotid artery?

A

The external

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6
Q

Borders of the carotid triangle and what does it contain?

A

Internal jugular vein laterally, common carotid artery and bifurcation and vagus nerve.
Anterior sternocleidomastoid, sup belly of omohyoid and post belly of digastric.

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7
Q

Clinical relevance to bifurcation of common carotid?

A

Due to turbulence a thermos and stenosis can occur limiting blood to brain of embolus to brain.

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8
Q

2 important features at the CCA bifurcation?

A

Carotid sinus-contains baroreceptors to detect Arterial BP.

Carotid body-contains chemoreceptors to detect o2 levels.

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9
Q

Clinical relevance of carotid triangle?

A

Vagus nerve accessible, carotid pulse, carotid/IJV surgery.

Importantly carotid massage-in VT can gently massage putting pressure on baroreceptors so seams like high arterial BP. Will then try and lower via vasodilation (decreased sympathetic on a1) and bradycardia (increase parasympathetic on m2)

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10
Q

What is the cavernous sinus?

A

Plexus of thin walled veins on upper surface of the sphenoid. Internal carotid artery and cranial nerves 3,4,5,6 pass through

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11
Q

Ophthalmic artery comes of the? And what branches does it give?

A

Internal carotid artery.

Ophthalmic gives ant/post ethmoidal arteries. Supra-orbital artery and supratroclear artery.

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12
Q

6 branches and two terminal branches of external carotid artery?

A 
Superficial temporal (terminal) 
Superior thyroid
Ascending pharyngeal 
Occipaital
Posterior auricular
Lingual 
Facial
Maxilarry (terminal)
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13
Q

Describe blood supply to the scalp

A

Rich with many anastomoses

2 internal carotid- supra-orbital and supra trochleal

3 external carotid- occipital, superficial temporal, posterior auricular

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14
Q

Layers of the scalp? And what layer contains vessels of the scalp?

SCALP

A 
Skin
DCT (vessels)
Aponeurosis 
LCT
Periosteum
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15
Q

3 reasons why the scalp gets profuse bleeding?

Why no bone necrosis to skull if scalp arteries damaged?

A

Full of anastomoses, artery walls close the CT limiting constriction and occiptalfrontalis contracts on both sides of injury causing bleeding due to opposing pull.

Because middle meninges artery mainly supplies the skull.

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16
Q

Describe superficial arteries of face again use images.

A 
Two internal (supras)
Maxillary
Labial (sup/inf)
Facial
Transverse facial
Lateral nasal 
Angular
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17
Q

2 important branches of maxillary?

A

Middle meningeal and septal branch of sphenopalatine (nose bleeds)

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18
Q

Arterial supply to nasal area?

A

Different branches form kiesselbach area most importantly formed from sphenopaletine and ethmoidal. Area is common sight for epistaxis.

19
Q

Main blood supply to skull/dura? how does it enter the skull And relevance of pterion?

A

Middle meningeal enters via foremen spinosum.

Pyerion is thin part of skull thus rupture common.

20
Q

What happens if middle meningeal rupture?

A

Extradural haemorrhage

21
Q

Describe drainage of Supra orbital/trochlear veins

A

Drain into angular vein at medial angle of eye which then drains into facial vein (labial veins do the same) then into the common facial vein into the IJV. Other veins tend to accompany there arteries like occipital vein.

22
Q

How come infection of scalp can spread to cranial cavity and meninges?

A

Valveless emissary veins connect veins of the scalp to diploic veins of the skull and this duralumin venous sinuses.

23
Q

How can infection of facial vein spread to Dural venous sinuses?

A

Facial vein is valveless and connected to ophthalmic vein draining into cavernous sinus. Moreover deep fasciae veins drain into pyterigoid venous plexus.

Issue in thrombophlebitis of fasciae vein.

24
Q

Where does the jugular vein leave and name 5 sinus’

A

Jugular foramina

Sigmoid sinus (IJV continuation)
Transverse 
Cavernous
Inf sagittal 
Sup sagittal
25
Q

How to measure JVP

A

Head slightly to left and at 45 degrees. Palpitations through sternocleidomastoid

26
Q

How is the cranium divided?

How many bones in the skull?

A

Neurocranium (8)

Viscerocranium (14j

22

27
Q

Describe splitting and development of neurocranium and viscerocranium

A

Neurocranium- calvaria, cranial floor.
Vault bones begin as membranes then intramembranous ossification. Floor as cartilage then endochondral ossification.

Viscerocranium- cartilage or membranes but structures develop from pharyngeal arches.

28
Q

5 bones of calvaria?

A 
Frontal
Parietal
Temporal
Occipital
Greater wing of the sphenoid bone
29
Q

3 calvaria joints and 2 meeting points.

A
  1. Coronal suture
  2. Sagittal suture
  3. Lambdoid suture

1/2 meet at bregma
2/3 meet at lambda

30
Q

What are fontanelles?

2 roles?

Dates of fusion?

Name of early fusion?

A

Large areas of unossified membranous gaps between flat bones on calvaria.

Allow skull size alteration in childbirth and allows growth if the brain.

Ant- 18 months-2 Year’s
Post- 1-3 months

Craniosynostosis

31
Q

Use of anterior fontanelles for doctors?

A

Intra cranial pressure and hydration

32
Q

Structure of calvaria bones and reason?

A

Trilaminar with compact, diploe (spongy), compact.

Provides strength without too much weight

Also shrink wrapped in periosteum, continuous and strongly adhered to sutures.

33
Q

3 depressions of cranial floor?

Some important bones? 3 anterior

A

Anterior,middle,posterior

Frontal-ant
Ethmoid-ant
Sphenoid-ant/middle contains sella turcica

34
Q

4 parts of temporal bone?

A

Petrous part
Squamous part
Zygomatic
Mastoid

35
Q

Relevance of petrous part?

A

Internal carotid artery enters skull via and houses middle and inner ear structures.

36
Q

Notable parts of occipital bone?

A

External occipital protuberance
Superior Michal line
Foramen magnum (vertebral arteries)

37
Q

Two types of cranial vault fractures?

A

Linear- no bone displacement

Comminuted- multiple fractures lines with fragments depressed or non depressed

38
Q

Most common cranial fault fractures?

A

Pterion, ruptures middle meningeal artery, extradural haemorrhage(intracranial)

39
Q

2 basilar fractures?

A

Blood around eyes (anterior cranial fossa) from orbital plate fracture.

Blood in ear drum (middle cranial fossa) can be petrous part.

40
Q

5 bones of viscerocranium?

A 
Zygomatic 
Maxillary
Nasal 
lacrimal
Mandible
41
Q

Common fracture or gash sites of face?

A

Supraorbital-gash

Zygomo and it’s arch fracture

Nasal bone

42
Q

What’s important to note about a mandible fracture?

A

There is usually 2 fracture lines.

43
Q

Type of joint, nerve and how two cavities in temporomandibular joint?

Clinical conditions?

A

Synovial hinge joint, fibrocartilaginous disc divides into 2 cavities, nerve is auriculotemporal nerve.

TMJ disorder-locking and pain
Dislocation
Arthritis

44
Q

Anatomy of TMJ?

Describe its movement and dislocation

A

Mandibular fossa
Mandibular condole
Fibrocartilaginous disc
Articular tubercle

Inferior half rotation in hinge action, then superior half glide forward as condylar slide forward onto articular tubercle. Anterior Dislocation if past and mouth is locked open muscles of mastication contract keeping joint locked like that.

Head And Neck Esa 3 (12 decks)

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