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Head and Neck > Week 1.1 - Regions of head and neck > Flashcards

Week 1.1 - Regions of head and neck Flashcards

1
Q

Which nerve innervates SCM?

A

-CN XI (accessory)

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2
Q

Describe the insertions of trapezius

A
  • Superior nuchal line to T12

- Lateral 1/3 clavicle

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3
Q

What is the bare area of the clavicle?

A

-Middle 1/3 where no muscles attach

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4
Q

Which two major vessels are covered by SCM?

A
  • Common carotid

- Internal Jugular

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5
Q

Describe the borders of the anterior triangle

A
  • Imaginary midline -> medial border
  • Anterior border of SCM -> lateral argin
  • Mandlible - superior margin
  • Floor -> vertebrae
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6
Q

Describe the borders of the posterior triangle

A
  • Anterior -> Posterior border of SCM
  • Posterior -> Anterior border of Trapezius
  • Inferior -> Clavicle
  • Floor -> Scalene
  • Roof -> fascia
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7
Q

Describe the subdivisions of the anterior triangle

A 
-Hyoid bone divides anterior triangle into 4 smaller triangles:
Submandibular
Submental
Muscular
Carotid
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8
Q

What is the purpose of fascial planes in the neck?

A
  • Compartmental
  • Allow easy independent movement
  • Determine the spread of infection
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9
Q

List the layers of the neck

A
  • Skin
  • Superficial fascia
  • Subcutaneous fat
  • Platysma
  • Deep cervical fascia (investing fascia)
  • Pretracheal fascia
  • Carotid sheaths
  • Prevertebral fascia
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10
Q

What muscles are observed in a cross-section of the neck?

A
  • Playsma
  • SCM
  • Trapezius
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11
Q

Which muscles are invested by the deep cervical fascia?

A
  • SCM

- Trapezius

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12
Q

What is the main advantage of pretracheal fascia?

A

-Allows for independent movement of the trachea

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13
Q

What does the pretracheal fascia enclose?

A
  • Trachea
  • Oesophagus
  • Thyroid
  • Infrahyoid muscles
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14
Q

What do the carotid sheaths enclose?

A
  • Vagus nerve
  • Internal Jugular
  • Common Carotid
  • Deep cervical LNs
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15
Q

Describe the orientation of the vagus, internal jugular and the carotids

A
  • carotid is anteriomedial
  • IJV is anteriolateral
  • Vagus is posterior
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16
Q

What does the prevertebral fascia enclose?

A

-Vertebral column and paraspinal muscles

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17
Q

State the distribution of the prevertebral fascia

A

-Base of skull to T2/3

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18
Q

What is the clinical importance of the prevertebral fascia spanning down to T2/T3?

A

-Infection in the neck can track to the mediastinum

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19
Q

Give an example of infection which commonly occur in the superficial layers of the neck
Why is it contained within the superficial layers?

A
  • Cellulitis

- Limited due to superficial fascia

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20
Q

What is the retropharygeal space and why is it clinically significant?

A
  • Space between the pretracheal fascia and prevertebral fascia
  • Split into two -> true retropharyngeal (between pretreacheal and alar fascia) and danger space (between alar fascia and prevertebral fascia
  • True retropharyngeal connects to superior mediastinum
  • Danger space connects to diaphragm so infections can track into the thorax
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21
Q

What is often the cause of a retropharyngeal abscess?

A

-Rare but infection from node of rouviere

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22
Q

How would someone with a retropharyngeal abscess present?

A

-Fixed neck due to pain

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23
Q

What structures does the anterior triangle contain?

A
  • Common carotid
  • Internal jugular
  • Deep cervical LNs
  • CN VII, IX, X, XI and XII
  • Submandibular, thyroid and parathyroid gland
  • Hyoid bone
24
Q

What structures does the posterior triangle contain?

A
  • CN XI
  • Subclavian artery
  • External jugular vein
  • Brachial plexus trunks
  • Lymph nodes
25
Q

At what point does the CCA divide?

A

-C4

26
Q

Which artery, external or internal carotid, has 0 branches in the neck?

A

-Internal

27
Q

What is the clinical significant of infections in the parapharyngeal space? What is often the cause of an abscess here?

A
  • Asbcesses can lead to compression of the carotid sheath. This can lead to internal jugular vein thrombosis and affect other carotis sheath structures upto the mediastinum
  • Poor dentition or tonsilitis
28
Q

What does the pretracheal fascia fuse with inferiorly?

A

-Pericardium

29
Q

What are the two layers of pretracheal fascia?

A
  • Muscular layer anteriorly

- Visceral layer posteriorly

30
Q

Describe the hyoid bone and where is it?

A

-Horseshoe shaped bone situated at the level of C3

31
Q

What is the function of the hyoid bone?

A

-Elevate the larynx during swallowing

32
Q

Which group of muscles elevate the hyoid during swallowing?

A

-Suprahyoid

33
Q

Which group of muscles depress the hyoid during swallowing and speech?

A

-Infrahyoid

34
Q

Name the suprahyoid muscles

A
  • Digastric
  • Mylohyoid
  • Stylohyoid
  • Geniohyiod
35
Q

Name the infrahyoid muscles

A
  • Thyrohyoid
  • Sternothyroid
  • Sternohyoid
  • Omohyoid
36
Q

Which hyoid muscles have two bellys? Why is this significant?

A
  • Digastric
  • Omohyoid
  • The bellys change direction and thus are used as a landmark muscle
37
Q

What is the first branch of the internal carotid artery?

A

-Ophthalmic

38
Q

Name the branches of the external carotid artery

A
  • Superior Thyroid
  • Ascending pharyngeal
  • Lingual
  • Facial
  • Occipital
  • Posterior auricular
  • Superficial temporal
  • Maxillary
39
Q

Which branches are the terminating branches of the external carotid artery?

A
  • Superficial temporal

- Maxillary

40
Q

Which artery is the major supply to the face?

A

-Facial from ECA

41
Q

What are the main three veins which join to form the EJV?

A
  • Superior temporal
  • Maxillary
  • Posterior auricular
42
Q

State the muscles of facial expression

A
  • Frontalis
  • Oblicularis Oculi
  • Oblicularis Oris
  • Zygomaticus Mj and Mn
  • Buccinator
43
Q

Which nerve supplies the muscles of facial expression?

A

-Facial (CNVII)

44
Q

State the muscles of mastication

A
  • Masseter
  • Temporalis
  • Medial pterygoid
  • Lateral pterygoid
45
Q

Which nerve supplies the muscles of mastication?

A

-Trigeminal (CNV3 - mandibular branch)

46
Q

How do you differentiate a lower motor lesion to CNVII?

A

-Paralysis of the face including the forehead

47
Q

State the branches of facial nerve

A
  • Temporal
  • Zygomatic
  • Buccal
  • Maxillary
  • Cervical
48
Q

State the branches of cranial nerve V

A
  • ophthalmic (V1)
  • Maxillary (V2)
  • Mandibular (V3)
49
Q

In brief, describe the functions of each of the branches of trigeminal nerve

A
  • V1 -> sensory afferent from scap, forehead, nose and eyes
  • V2 -> Sensory afferent from lower eyelid, cheek, nares, upper lip/teeth, palette and sinuses
  • V3 -> Sensory afferent from lower lip/teeth, gums, chin/jaw, motor supply to MoM
50
Q

What does chronic neck pain usually indicate?

A

-Bony abnormalities eg osteoarthritis

51
Q

What is the most common, non-traumatic, cause of facial paralysis?

A

-Inflammation of facial nerve at stylomastoid foramen leading to oedema and compression of nerve (bells palsy)

52
Q

Where is facial pulse?

A

-Middle inferior mandible

53
Q

What is clinically significant about laceration to facial artery?

A

-Requires compression of both arteries to stop the bleed due to anastamoses

54
Q

Why is deep cervical fascia advantageous durng surgery?

A
  • forms natural cleavage planes allowing separation of tissues
55
Q

Which anatomical triangle is identified in order to fit a central line?

A

-Carotid triangle

56
Q

How does bells palsy present?

A
  • Paralysis of facial muscles on effected side
  • Loss of integrity of oral cavity
  • Inability to close eyelid
57
Q

Describe the insertions of sternocleidomastoid

A
  • From tip of mastoid process
  • One head to sternum
  • One head to medial 1/3 clavicle

Head and Neck (18 decks)

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