Surface anatomy of the head and neck

Question 1

Describe the location of the ethmoid bone

Answer 1

Located in the midline of the anterior cranium, at the roof of the nasal cavity, between the two orbital cavities. Contributes to the wall of the orbit and forms part of the anterior cranial fossa.

Question 2

Describe the location of the sphenoid bone

Answer 2

Sits anteriorly in the cranium and contributes to the middle cranial fossa, lateral wall of the skull and the floor and sides of both orbits.

Question 3

Describe the location of the lacrimal bone

Answer 3

Sits inside the bony oribit. Takes up an area of the most anterior part of the medial wall of the orbit.

Question 4

Describe the location of the palatine bone

Answer 4

L-shaped bone which forms part of the nasal cavity and the hard palate. Located between the maxilla and the sphenoid bone.

Question 5

Describe the location of the inferior concha

Answer 5

Sits on the nasal septum, separating the nasal cavity into two bilateral symmetrical caves.

Question 6

Describe the location of the vomer

Answer 6

Runs vertically in the nasal cavity, separating left and right sides.

Question 7

Which bony landmarks can be palpated on the anterior aspect of the skull?

Answer 7

• Maxilla
• Zygoma
• Orbital margin
• Mental process of the mandible

Question 8

Which bony landmarks can be palpated on the lateral aspect of the skull?

Answer 8

• Angle of the mandible
• Zygomatic arch
• Mastoid process

Question 9

Which bony landmarks can be palpated on the posterior aspect of the skull?

Answer 9

Occipital protuberance

Question 10

Which structure is palpable just anterior to the tragus?

Answer 10

Condyle of the mandible

Question 11

How do you palpate temporalis?

Answer 11

Place your fingers on the side of your head just above the zygomatic arch and clench and relax the jaw.

Question 12

How do you palpate the masseter?

Answer 12

Place your fingers on the mandible slightly above and anterior to the angle of the mandible and clench and relax the jaw.

Question 13

What features of the TMJ permit the large range of movement?

Answer 13

Capsule and extracapsular ligaments

Question 14

How do you palpate frontalis?

Answer 14

Place your finger over your eyebrow and raise the same eyebrow

Question 15

How do you palpate orbicularis oculi?

Answer 15

Close your eyes and place your finger on the eyelid, then close your eyes tightly.

Question 16

How do you palpate zygomaticus major?

Answer 16

Place your fingers at the edge of the zygomatic arch and smile

Question 17

How do you palpate the orbicularis oris?

Answer 17

Close your lips and place your finger just above your top lip, then purse your lips.

Question 18

Following a cerebrovascular accident, the innervation to the facial muscles may be affected, altering the movement and appearance of the face.

Describe these changes and state which nerve is involved

Answer 18

• Hemiplegia - paralysis of one side of the face
• Hemiparesis - weakness of one side of the face
• Affects facial nerve

Question 19

How do you palpate the superficial temporal artery?

Answer 19

You can palpate it as it passes between the tragus and the neck of the mandible.

It is a terminal branch of the external carotid

Question 20

How do you palpate the facial artery?

Answer 20

You can palpate it as it croses the lower border of the body of the mandible halfway between the angle and the mental tubercle.

It is a branch of external carotid

Question 21

How do you palpate the supraorbital artery?

Answer 21

You can palpate it as it passes over the superior medial margin of the orbit.

It is a branch of the opthalmic artery.

Question 22

Which division of trigeminal also carries motor fibres?

Answer 22

Mandibular

Question 23

Which lymph nodes would enlarge as a result of an infection in the tongue?

Answer 23

• Anterior tongue infection - Submental nodes
• Lateral tongue infection - submandibular nodes
• Medial or posterior tongue infection - deep cervical nodes

Question 24

How do you palpate the cricoid cartilage?

Answer 24

Locate the laryngeal prominence (Adam’s apple) - this is the thyroid cartilage.

Pass your fingers from the thyroid cartilage downwards (3-4cm).

Question 25

How do you palpate the hyoid bone?

Answer 25

Locate the thyroid cartilage and pass your fingers upwards to palpate the hyoid bone (3-5cm below the mandible)

Question 26

Sternocleidomastoid is an important landmark for venous and lymphatic structures of the neck.

Which structures lie immediately beneath SCM?

Answer 26

Internal jugular vein

Question 27

How do you palpate the spinous process of the axis?

Answer 27

Locate the occipital protuberance.

Approximately 3cm down from the occipital protuberance you should be able to palpate the spinous process of C2.

Question 28

How do you palpate the common carotid artery?

Answer 28

Can be palpated just lateral to the thyroid cartilage and medial to SCM

Question 29

Where is the surface marking of the external jugular vein?

Answer 29

From the angle of the mandible to the middle of the clavicle

Question 30

Where is the surface marking of the internal jugular vein?

Answer 30

In a line from the lobe of the ear to the medial end of the clavicle