thyroid and root of the neck Flashcards
what does CN I do? how do you test it?
olfaction. coffee or peppermint smell
could you use alcohol to test CN1?
nope. that would be pain => trigeminal
what does CN II do? how do you test it?
optic. test visual field and pupil dilation
what is the efferent portion of pupil dilation?
occulomotor CN III
what are CN III,IV, VI?
occulomotor, trochlear and abducens
How would you test V? what is the name of that nerve?
touch their face. preferably in a nice way. also check their chewing muscles V3 (have them bite and feel masseter) trigeminal
how would you test chordae tympani?
put a little drop of sugar water on the anterior 2/3 of their tongue. this is important if you do surgery for middle ear (cochlear implant)
how would you test VII? what is the name of that nerve.
make faces at them and have them copy
how would you test the reflex arc between V and VII
put cotton on the cornea. that eliccits response from trigeminal and the muscle movement of orbicularis oculi is VII
How would you test VIII in a not creepy way?
close eyes and make a noise on one side of the head. which ear did they use.
what does the weber test do?
tests which ear has better bone conduction. that ear will sense the sound louder when you put the tuning fork on the top of you head
is nostagmus normal?
yes. if you spin in a chair and stop, then your eyes will twitch. also bosma has it
what reflex arc tests CN IX and X? what happens?
gag reflex. elevate the palate.
patient says “ah” and uvula goes to the left. where is the lesion?
check this. its either CN IX or X. but it is on the side OPPOSITE of the direction of the uvula. here, lesion is on the right
how do you test CN XI and XII
ask if they can shrug their shoulders against resistance
tongue deviates to the left side. where is lesion?
you lost the left side of XII. “TOngue deviates TOwards”
what is afferent/efferent limb of the jaw jerk reflex?
V3/V3. both ways.
what is relationship between thyroid cartilage and thyroid gland?
cartilage is SUPERIOR to the gland (C5-T1)
what is relationship between hyoid bone and thyroid cartilage?
hyoid is SUPERIOR to the thyroid cartilage
which muscles form the lateral border of the isthmus of the thyroid? fascia?
sternohyoid and cricothyroid/ pretrachial fascia
what fascia layer is on the posterior portion of the thyroid?
buccopharyngeal attaches on the posterior portion and encloses the esophagus, trachea, recurrent laryngeal n., middle thyroid vein.
which fascia encloses the vagus nerve?
this is a trick question. the recurrent laryngeal nerve is a branch of vagus. its in the visceral layer of pretrachial fascia. the main trunk of the vagus is in the carotid sheath
what fascia is directly ANTERIOR to the vertebral body
prevertebral fascia
what are the two main arteries that go to the thyroid?
inferior thyroid that comes off the thyrocervical trunk and goes POSTERIOR to the carotid sheath; also superior thyroid off the EXTERNAL carotid
what are the three veins from the thyroid?
inferior drains drains to brachiocephalic v the middle and superior drain into internal jugular
what does the R recurrent laryngeal recurrent go around?
Right is the right subclavian and comes in more LATERALLY; left goes around the arch of the aorta
relationship between inferior thyroid artery and recurrent laryngial nerve
posterior to the lower branch of the artery and anterior to the upper branch of the artery
what artery can branch directly off the arch of the aorta or the brachiocephalic?
thyroid ima artery in 10-12% of people; if you don’t realize its there, you can tear a hole in this vessel. thats bad.
relationship between thyrocervical trunk and the phrenic nerve
the Artery is Anterior to the phrenic
review: where does the thoracic duct drain?
the angle between the L internal jugular and the L subclavian (venous angle)
what would you use a sestamibi scan for?
nuclear scan to light up the parathyroid. used for an adenoma
you might have to remove part of the hyoid bone in the removal of ____
cyst of thyroid or accessory thyroid gland
vagus nerve branches
what components do they have?
some motor to pharynx (gag reflex); superior laryngeal nerve this splits into internal laryngeal n (GVA) and external laryngeal nerve (SVE to cricothyroid and inferior constrictors); recurrent laryngeal is motor to vocal chords and some sensory below them (SVE and GVA)
what are the four branches of superior thyroid
infrahyoid, sup. laryngeal, cricothyroid, sup. thyroid
three branches of lingual a
deep lingual dorsal lingual, sublingual aa
occipital a comes off of the ???
ECA
what does cricothyroid m do
tilts forward to tighten the vocal fords
T/F the sympathetic chain is part of the carotid sheath.
false. its posterior to the sheath
phrenic neve is between what major vessels?
subclavian a/v
thyrocervical trunk is near???
medial edge of the anterior scalene m.
what branch of thyrocervical trunk is variable?
cervcodorsal trunk for ascending cervical a and transverse cervical a
what are the three large sympathetic ganglion?
superior(C1-C4/5), middle(C5-6), inferior cervical (C7-8/TI) ganglion
ansa cervicalis? ansa subclavia
loop of somatic nerves; loop of sympathetic nerves that is intuitively named because it loops around the subclavian artery
prevertebral fascia continues inferiorly as
axillary sheath
T/F cardiothoracic splancnic nerves are postganglionic
true! the splancnics in the ABDOMEN are preganglionic
which trunk sits posterior to the anterior scalene
costocervical trunk
where does dorsal scapular artery usually come off
dorsal scapular usually comes directly off the subclavian a.(dives between branches of brachial plexus)
remember army goes over the bridge
suprascapular goes over the ligament of the scapula, the nerve goes under
review: what type of nerves are in the carotid plexus?
sympathetics follow arteries!!
relationship between thoracic duct and the phrenic nerve
thoracic duct is anterior to the phrenic n.
