Session 2 - Notes Flashcards
Give branches of external carotid
Some Superior Thyroid Anatomist Ascending Pharyngeal Like Lingual Fucking Facial Others Occipital Prefer Posterior Auricular Matt's Maxillary Scent Superficial Temporal
Give layers of scalp
Skin Connective tissue Aponeurosis Loose Connective Tissue Periosteum
Give arteries to the scalp
Supra orbital supra trochlear superficial temporal Posterior auricular Occipital artery
Why does the scalp often bleed profusely?
Numerous anastamoses
Walls of arteries are closely attached to connective tissue, which can be pulled done by occipitofrontalis
Why doesn’t loss of blood supply to scalp lead to bone necrosis?
Middle Meningeal Artery supplies
Outline how scalp veins connect to dural venous sinuses
The veins of the scalp connect to the Diploic Veins of the Skull via several valve-less Emissary Veins and therefore connect to the Dural Venous Sinuses.
What does connection of scalp to dural venous sinus mean?
that infection from the scalp can spread to the cranial cavity and affect the meninges.
What is at risk in a blow to the pterion?
Weak point of skull
Fracture at this point can rupture the middle meningeal artery, causing an extradural haemorrhage.
What is a craniotomy?
Access into cranial cavity. Bone and skin flap reflected inferiorly to preserve blood supply.
What is the dural venous sinus?
Endothelium lined spaces between the periosteal and meningeal layers of the dura.l
What is the dural venous sinus which connects with internal jugualar?
Sigmoid sinus (exits through jugular foramen)
Outline branches of the facial nerve
Facial Superior and inferior labial Maxillary Lateral nasal Angular Transverse Facial Supratrochlear Supraorbital
What is the cavernous sinus
A plexus of extremely thin-walled on the upper surface of the sphenoid bone
Name the 6 structures which run through the cavernous sinus
o Internal Carotid Artery o CN III – Oculomotor o CN IV – Trochlear o CN VI – Abducent o CN V – Trigeminal CN V 1 – Opthalmic CN V 2 – Maxillary
What is the danger of the cavernous sinus?
Veins of the face are valve-less
At the medial angle of the eye, the facial vein and the superior ophthalmic vein communicate and drain into cavernous sinus.
Infection -> Facial vein -> Dural venous sinus
Thrombophlebitis of facial vein -> Infected clot can travel to intracranial system
Why is internal jugular vein harder to see than external?
IJM lies under SCM
Give three terminal groups of lymph nodes and their significance
Jugulo-Digastric - Tonsillar node
Jugulo-omohyoid - Tongue node
Deep cervical nodes - Lie along the course of accessory nerve (both may be removed in malignancy)
Supraclavicular nodes - Virchow’s node associated with gastric carcinoma
What are the two final structures vessels drain into?
Thoracic duct
Right lymphatic duct
What happens in cervical metastases?
This procedure involves the removal, as a unit (en bloc), of the Internal Jugular Vein, Fascia, Lymph Nodes and the Submandibular Salivary Gland
Give four places skull fractures are commn
Squamous temporal bone and parietal bone
Foramen magnum and inner parts of sphenoid wing
Anterior cranial fossa (cribiform plate)
Name 7 types of skull fracture
Depressed fractur Linear calvarial fracture Comminuted fracture Counterblow fracture Simple fracture Compound fracture Basal skull fracture
What is a depressed fracture?
A severe, localised blow may result in a local indentation, in which a fragment of bone may compress or injure the underlying brain.
What is a linear calvarial fracture?
Trauma to the Calvaria often results in radiating linear fractures, the fracture lines radiating away from the point of impact in two or more directions.
What is a comminuted fracture?
The bone is broken into several pieces.
What is a counter blow fracturer?
No fracture occurs at the point of impact, but one occurs on the opposite side of the cranium.
What is a simple fracture?
A break without damage to skin
What is a compound fracture?
Involves a break in, or loss of, skin and splintering of bone accompanied by brain injury and bleeding
What is the pterion?
The Pterion is a ‘H-shaped’ junction of 4 bones, which lies on the lateral aspect of the skull and is the thinnest part of the Calveria. Bone fragments from fractures may rupture the Middle Meningeal Artery, leading to an Extradural Haemorrhage. The bones that make up the Pterion are: o Frontal o Parietal o Sphenoidal (greater wing) o Temporal
What can infection of the scalp lead to?
The Emissary Veins (see above) connect the superficial veins of the scalp with the Diploic Veins of the skull bones and with the Intracranial Venous Sinuses, providing a route for infection. Infection of the scalp may spread to the skull bones via these veins, causing Osteomyelitis.
Name 6 foramen of calvaria?
o Foramen Magnum o Foramen Ovale o Foramen Spinosum o Foramen Lacerum o Carotid Canal o Jugular Foramen
What do facial fractures often involve?
Nasal bones
What is a black eye?
Extravasation of blood into connective tissue around eye.
What can fracture of the dens cause?
Quadriplegia - if on spinal cord
Death - If in medulla
What happens in hyperflexion of cervical region?
o Head on collisions (car)
o Rupture of lower intervertebral discs (C5/C6 and C6/C7) resulting in compression of spinal roots C6 and C7
o Pain is felt in the neck, shoulder, arm and hand
What happens in hyper extension of cervical region#?
o Whiplash injury (rear-end car collision)
o Tearing of anterior and posterior longitudinal ligaments, fracture of cervical spinous processes, disc rupture, neck muscle injury, blood vessel injury
How does osteoarthritis effect the spine?
o Joints of the vertebral arches (zygopophyseal joints) are close to intervertebral foramina through which spinal nerves emerge
o When these joints are affected by Osteoarthritis (osteophyte formation), related spinal nerves are compressed, causing pain along dermatomes and muscle spasms along myotomes
What s a broken neck?
o Compression of the cervical spine against the shoulder
o May involve spinal cord damage
Partial or complete paralysis
Death
o Most common at C2, C6 and C7
o The most fatal injuries occur in the upper part of the spine (C1 or C2)
What is a jefferson fracture?
o Head first fall from height
o Diving head first into a pool
What is a hangman’s fracture?
Hyperextenion of the head on the neck
