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YR2: Head, Neck and Spine > Session 3: Neck and Face > Flashcards

Session 3: Neck and Face Flashcards

1
Q

What are the 3 main functions of the neck?

A

Structural: support + move head
Visceral functions
Conduit for blood vessels + nerves

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2
Q

How are the components of the functions of the neck divided structurally?

A

Structural: inside prevertebral fascia
Visceral: inside or associated with pretracheal fascia
Blood vessels + nerves: inside or associated with carotid sheaths

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3
Q

What are the 2 large muscles that are found on the anterior and posterior sides of the neck?

A

Anterior: sternocleidomastoid
Posterior: trapezius

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4
Q

What are the contents of the carotid sheath?

A

Internal jugular vein
Common carotid artery
Vagus nerve

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5
Q

What are the contents of the visceral fascia?

A

Oesophagus
Trachea
Thyroid Gland

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6
Q

What is the name given to the fascia between the posterior aspect of the oesophagus and the anterior part of the prevertebral fascia?

A

Buccopharyngeal fascia

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7
Q

Which fascia splits in 2 around the sternocleidomastoid and trapezius?

A

Investing layer

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8
Q

What important structures are at each of the vertebral levels C1-C7?

A

C1: Open mouth
C2: Superior cervical ganglion
C3: Body of hyoid
C4: Birfurcation of common carotid + Upper border of thyroid cartilage
C6: Cricoid cartilage + Middle cervical ganglion
C7: Inferior cervical ganglion

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9
Q

What are the 2 triangles of the neck? State their borders.

A

Anterior triangle: mandible, anterior border of sternocleidomastoid + midline from mandible to sternum
Posterior triangle: posterior border of sternocleidomastoid, anterior border of trapezius + clavicle

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10
Q

What are the main muscles in the anterior triangle?

A

Platysma
Mylohyoid
Digastric: anterior belly + posterior belly
Infrahyoid (strap muscles)

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11
Q

Which blood vessels and nerves are in the posterior triangle?

A 
External jugular vein  
Subclavian artery 
Subclavian vein
Trunks of brachial plexus  
Phrenic nerve  
Vagus nerve
Spinal accessory nerve
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12
Q

Which smaller nerves are found in the posterior triangle of the neck?

A

Lesser occipital nerve
Greater auricular nerve
Transverse cervical nerve
Supraclavicular nerves

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13
Q

Where do the trunks of the brachial plexus emerge?

A

Posterior to scalenus anterior

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14
Q

Where are the subclavian artery and vein relative to the scalene muscles?

A

Subclavian artery = posterior to scalenus anterior

Subclavian vein = anterior to scalenus anterior

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15
Q

Where is the phrenic nerve relative to the scalene muscles?

A

Phrenic nerve lies on the anterior surface of scalene anterior

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16
Q

Which spinal nerves contribute to the superior, middle and inferior trunks of the brachial plexus?

A 
Superior = C5 + C6 
Middle = C7 
Inferior = C8 + T1
17
Q

Which spinal nerves contribute to the phrenic nerve and what is its main function?

A

C3, C4 + C5
Motor supply of the diaphragm
Sensory innervation to the diaphragmatic pleura + peritoneum

18
Q

What is platysma innervated by?

A

Facial nerve (cervical branch)

19
Q

What is mylohyoid innervated by?

A

Mandibular division of trigeminal nerve

20
Q

What are the anterior and posterior bellies of the digastric muscle innervated by?

A

Anterior: mandibular division of trigeminal nerve
Posterior: facial nerve

21
Q

What are the infrahyoid muscles innervated by?

A

Ansa cervicalis = omohyoid + sternothyroid + sternohyoid

C1 fibres via hypoglossal nerve = thyrohyoid

22
Q

What are the clinical applications of a carotid pulse?

A

Measuring pulse rate

23
Q

List the main sites of access for central venous lines.

A

Internal jugular (most common)
Subclavian vein
Femoral vein

24
Q

What are the uses of central venous lines?

A

Long-term access e.g. for chemotherapy drugs
Administering drugs that can cause phlebitis
Parenteral nutrition
Monitoring blood pressure

25
Q

What are the complications of insertion of central venous lines?

A 
Accidental arterial puncture  
Tracheal injury 
Arrhythmia 
Emboli 
Infection  
Pneumothorax or haemothorax
26
Q

Where does the accessory nerve exit the skull?

A

Begins in upper spinal cord + ascends to enter the skull through the foramen magnum
Leaves via the jugular foramen

27
Q

What does the accessory nerve innervate?

A

Trapezius

Sternocleidomastoid

28
Q

How would you test the function of the accessory nerve?

A

Ask the patient to shrug their shoulders + hold it there

29
Q

What are the 4 infrahyoid muscles and where are they attached?

A

Omohyoid: superior border of scapula –> hyoid
Sternohyoid: sternum –> hyoid
Sternothyroid: sternum –> thyroid cartilage
Thyrohyoid: thyroid cartilage –> hyoid

30
Q

Name the 5 groups of superficial lymph nodes around the head, their location + drainage, beginning posteriorly

A

Occipital (attachment of trapezius to skull) drain posterior scalp + neck
Mastoid nodes (posterior to ear, near attachment of sternocleidomastoid) drain posterolateral half of scalp
Pre-auricular + Parotid (anterior to the ear) drain anterior surface of auricle, anterolateral scalp, upper half of the face, eyelids + cheeks
Submandibular (Inferior to body of mandible) drain structures along path of facial artery as high as forehead + gingivae, teeth + tongue
Submental (inferior + posterior to chin) drain centre part of lower lip, chin, floor of mouth, tip of tongue + lower incisors

31
Q

Where do the occipital + mastoid nodes drain?

A

To superficial cervical nodes along the external jugular vein

32
Q

Where do the pre-auricular, parotid, submandibular + submental nodes drain?

A

To the deep cervical nodes

33
Q

What are the superficial cervical nodes?

A

A collection of lymph nodes along the EJV on the superficial surface of the sternocleidomastoid.
Send vessels towards deep cervical nodes

34
Q

What are the deep cervical nodes?

A

a collection of lymph nodes that form a chain along the IJV
Divided into upper + lower groups where the intermediate tendon of the omohyoid crosses the CCA + IJVs
Form the right + left jugular trunks, which empty into the right lymphatic duct on the right or thoracic duct on the left

35
Q

What is indicated by soft, tender and inflamed lymph nodes?

A

Acute inflammatory process, most likely infective

36
Q

What is indicated by firm, multi nodular, large volume, rubbery nodes?

A

Lymphoma

YR2: Head, Neck and Spine (6 decks)

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