Week 1

Question 1

A 17-year-old girl arrives at the emergency department with a knife wound to the scalp that is bleeding profusely. The vessels that are most likely the source of the bleeding are located in which of the following layers of the scalp?

Skin
Aponeurotic Layer
Loose Connective Tissue 
Connective Tissue (Dense)
Pericranium

Answer 1

Connective Tissue (Dense)

Question 2

What are the THREE major branches the subclavian artery gives off in the neck?

Answer 2

Vertebral, thyrocervical and internal thoracic arteries

Question 3

A tumour of the parotid gland might affect which of the followings?

Ability for my stapedius muscle to pull on my stapes
Facial muscles
Ability to keep my eyelid open
Sternocleidomastoid

Answer 3

Facial muscles

Question 4

A 62-year-old woman attends the pre-op clinic as she is due to have a parotidectomy (removal of the parotid gland). She is warned about possible complications including weakness of the muscles of her face and loss of sensation of the skin of her face especially around the ear lobe. The branches of which cranial nerves could be damaged during the procedure to cause these symptoms?

Facial nerve and Glossopharyngeal Nerve
Facial nerve and Trigeminal Nerve
Cranial nerves VII and VIII
Cranial nerves VI and VII

Answer 4

Facial nerve and Trigeminal Nerve

Question 5

Why is this cricothyroid ligament clinically significant?

Answer 5

The cricothyroid ligament is the surface landmark for performing an emergency tracheotomy

Question 6

How can you make the sternocleidomastoid muscle stand out?

Answer 6

Ipsilateral flexion and rotate the head to the opposite side

Question 7

Anterior triangle borders

Answer 7

Superior: inferior border of mandible
Lateral: anterior border of SCM
Medial: sagittal line down midline of neck

Question 8

Posterior triangle borders

Answer 8

Anterior: posterior border of SCM
Posterior: anterior border of trapezius
Inferior: middle 1/3 of clavicle

Question 9

Posterior triangle further divisions and border

Answer 9

Supraclavicular (below) and occipital triangles (above) separated by the inferior belly of the omohyoid muscle

Question 10

Which cranial nerve passes across the posterior triangle?

Answer 10

Accessory nerve CN XI

Question 11

Which cranial nerve passes through the parotid gland?

Answer 11

Facial nerve CN VII

Question 12

The function of fascia in the neck

Answer 12

Enveloping organs in the neck
Separating organs in the neck so that they can move against each other
Forming compartments between tissues
Binding tissues of the body together.

Question 13

What are the 2 main divisions of fascia in the neck and their subdivisions?

Answer 13

Superficial fascia (loose connective tissue) &
Deep fascia (dense irregular connective tissue)
- Investing fascia
- Pretracheal fascia
- Prevertebral fascia
- (Carotid sheath)

Question 14

What is the embryological origin of fascia

Answer 14

Mesenchymal origin

Question 15

What is the difference between the retropharyngeal space and the danger space?

Answer 15

In healthy patients, the danger space is indistinguishable from the retropharyngeal space. It is only visible when distended by fluid or pus, below the level of T1-T6, since the retropharyngeal space variably ends at this level.

Retropharyngeal space is posterior to the pretracheal layer. It extends from the base of the skull to a variable position between T1-T6 vertebral bodies. It is anterior to the danger space.

Danger space is a potential space posterior to the retropharyngeal space. It connects inferiorly to the mediastinum at the diaphragm, meaning infections can spread from the pharynx to the mediastinum.

Question 16

Name the suprahyoid muscles. What is their function in general terms?

Answer 16

Mylohyoid: forms the floor of the mouth
Geniohyoid
Anterior and posterior bellies of digastric
Stylohyoid

Raise the hyoid bone and thus the larynx during swallowing to avoid food etc. going down into the lungs

Question 17

Name the infrahyoid muscles. What is their function?

Answer 17

Thyrohyoid (deep)
Sternothyroid (deep)
Sternohyoid
Superior and inferior bellies of omohyoid

Stabilise the hyoid and thus the larynx and lower it after swallowing

Question 18

In new-born babies, how and why might the sternocleidomastoid muscle be damaged?

Answer 18

During delivery especially with forceps, the SCM is at risk due to trauma due to compression damage or stretching during a difficult birth.

Question 19

How would a person with a dystonic (hypertonic) sternocleidomastoid muscle present? What is this condition called?

Answer 19

Iipsilateral tilt to the lesion with contralateral rotation of the chin.

Such a presentation is known as torticollis. In newborns this is known as congenital torticollis.

Question 20

What is the motor innervation of the sternocleidomastoid muscle in the neck?

Answer 20

Spinal accessory nerve (CN XI)

Question 21

Why are the 2 sphincter muscles of the face (orbicularis oris and oculi) some of the most important muscles of facial expression?

Answer 21

Contribute to expression
Anchors into which the majority of the other small muscles attach

Orbicularis oculi also aids in the protection of the cornea. Loss of orbicularis oris may lead to drooling, and is commonly seen in facial nerve palsy (Bell’s Palsy).

Question 22

Which cranial nerve supplies the motor innervation to the muscles of the face?

Answer 22

Facial nerve (VII)

Question 23

What nerves provide sensory innervation to the face and neck?

Answer 23

Face: The cutaneous branches of the 3 divisions of the trigeminal nerve
CN V: ophthalmic (V1), maxillary (V2) and mandibular (V3)

Neck: The cutaneous branches of the cervical nerves from the cervical plexus.