Week 2 Flashcards

1
Q

What are the anatomical features of the oral cavity

A
submental 
submandibular lymph nodes
submandibular glands 
mylohyoid raphe 
anterior belly of digastric 
mylohyoid muscle
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2
Q

What are the landmarks of the front of the neck

A
hyoid bone 
thyrohyoid muscle
laryngeal prominence
thyroid cartilage
cricoid cartilage 
sternothyroid muscle
thyroid gland
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3
Q

What are the landmarks of the anterior triangle of the neck

A
external carotid artery
external jugular vein 
cervical nodes
sternocleidomastoid muscle
omohyoid
common carotid artery
sternothyroid muscle 
super thyroid artery
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4
Q

What do the sub mandibular lymph nodes drain

A

the area of the mouth, nasal cavity & maxillary sinus as well as lower parts of the face

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5
Q

When may a patient see enlargement of lymph nodes

A

if px has disease
If they are painful and tender this points to an infection, on the other hand if they are painless then this may be a malignant change

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6
Q

What do the submental nodes drain

A

the most anterior parts of the lower parts of the mouth, this includes: lower lip, skin, chin, tip of the tongue &; floor of the mouth of the anterior teeth. These provide lymph to the submental lymph nodes

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7
Q

Describe the submandibular salivary glands

A

○ These glands are the size of a walnut

It is a mixed gland (serous and mucous secretions)

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8
Q

Where are the submandibular salivary glands found

A

in the floor of the mouth in the suprahyoid region of the neck and a large part of the gland is visible just beneath the superior border of the mandible

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9
Q

What is the function of the platysma

A

tenses the fascia on the anterior and lateral sides of the neck and upper chest as in snarling

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10
Q

What is fascia

A

a fascia is a band of connective tissue (collagen) beneath the skin that attaches, stabilizes and separates muscles and organs

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11
Q

What is the digastric muscle

A

○ The digastric muscle consists of an anterior belly and a posterior belly connected by an intermediate tendon

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12
Q

Where does the anterior belly of the digastric originate and insert

A

○ The anterior belly originates from the inferior border of the mandible towards the chin and it runs downwards and backwards to insert into the digastric tendon

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13
Q

Where does the posterior belly of the digastric arise

A

rior Belly of the Digastric
○ The posterior belly arises from behind the mastoid process of the temporal bone
○ It passes downwards and forwards towards the hyoid bone where it becomes the intermediate digastric tendon and joins with the anterior belly

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14
Q

How is the central tendon in the digastric held down to the hyoid bone

A

by the fascia

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15
Q

Where does the mylohyoid arise form

A

the medial surface of the body of the mandible

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16
Q

Where do the anterior fibres of the mylohyoid muscle attach

A

○ The anterior fibres join the fibres on the opposite side to form a median raphe and this mylohyoid raphe is attached to the mandible and the hyoid bone

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17
Q

What is the function of the mylohyoid

A

○ It raises the floor of the mouth during the first stages of swallowing, it helps depress the mandible when the hyoid bone is fixed and it aids in the elevation of the hyoid bone

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18
Q

Describe the position of the hyoid bone

A

○ Situated in the upper part of the front of the neck
○ Posterior and a little below inferior border of the chin
○ It lies at the level of C3
Horse shoe shaped

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19
Q

What muscles is the hyoid bone maintained by

A
§ Geniohyoid
			§ Hyoglossus
			§ Chondroglossus
			§ Middle constrictor of the pharynx
			§ Mylohyoid
			§ Omohyoid
			§ Sternohyoid
			§ Stylohyoid
			§ Thyrohyoid
Levator of the thyroid gland
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20
Q

What is the manubrium

A

Superior part of the sternum lying at level of T3-T4

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21
Q

Describe the position of the sternocleidomastoid muscle

A

○ Lies on side of the neck
○ Layer of deep cervical fascia encloses it, which splits to pass around it
○ Forms the boundaries of the posterior and anterior triangles of the neck

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22
Q

What covers the sternocleidomastoid at the root of the neck

A

platysma muscle

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23
Q

What are the 2 heads of the sternocleidomastoid

A

has a sternal and clavicular head

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24
Q

Where does the clavicular head arise from

A

○ The clavicular head is a wide muscular head arising from the upper surface of the medial third of the clavicle

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25
What does the sternocleidomastoid muscle do when 1 muscle acts
the head is tipped towards the shoulder on the same side and is rotated to direct the face towards the opposite side
26
When the two sternocleidomastoid muscles act together what happens
the head is moved forwards
27
Where does the external jugular vein lie
superficially in the neck on the lateral surface of the sternocleidomastoid muscle
28
What does the external jugular vein descend from
from the angle to the mid clavicle
29
What does the external jugular vein drain into
the subclavian as it passes the scalenus anterior
30
What does the external jugular vein lie in-between
between the investing layer of deep cervical fascia and the platysma muscle.
31
When does the external jugular vein pass into the posterior triangle
after piercing the deep cervical fascia
32
If the external jugular vein is extended, what is this a sign of
indicates congestive cardiac failure which results in an increased venous pressure or it may be a sign of obstruction further down which has resulted in a pressing on the veins causing them to fill up
33
Describe the thyroid cartilage
○ Largest and most prominent cartilage forming most of the anterior and lateral wall of the larynx ○ Consists of two laminae which are joined anteriorly to form the laryngeal prominence aka 'Adam's Apple'
34
How does the thyroid cartilage differ in males
considerably increases in size at puberty and the thyroid prominence becomes very distinct
35
What is the cricoid cartilage
○ Unlike the thyroid cartilage, the cricoid cartilage forms a complete ring ○ It is the only complete cartilaginous ring in the air passages ○ It comprises the most inferior and posterior part of the larynx and supports the entrance to the trachea
36
What is the sternohyoid muscle
○ Superficial | ○ One of the strap muscles that protects the thyroid gland and stabilizes the larynx during swallowing
37
Where does the sternohyoid muscle originate from
mainly from the posterior surface of the manubrium and the clavicle
38
What is the function of the sternohyoid muscle
It depresses the hyoid bone after it has been elevated during swallowing
39
What is the omohyoid muscle
○ Has a superior and inferior belly with an intermediate tendon
40
What is the superior belly of the omohyoid attached to
the lower border of the body of the hyoid bone and it runs down the anterior triangle of the neck
41
What is the inferior belly of the omohyoid attached to
The inferior belly runs across the posterior triangle and attaches to the scapula
42
What connects the two omohyoid bellies
Beneath the sternocleidomastoid muscle the intermediate tendon connects the two bellies
43
What is the thyrohyoid muscle
○ Small muscle and can be regarded as a continuation of the sternothyroid muscle
44
What does the thyrohyoid muscle arise from
○ Arises from the thyroid cartilage | ○ Inserts onto the hyoid bone
45
What is the function of the thyrohyoid muscle
It depresses the hyoid bone or raises the larynx
46
What does the sternothyroid muscle arise from
the posterior surface of the manubrium, below the origin of the sternohyoid
47
What does the sternothyroid muscle insert into
the thyroid cartilage
48
What is the function of the sternothyroid
Depresses the larynx after it has been elevated during swallowing and vocal movements
49
What is the laryngeal prominence
The laminae are fused together along the inferior two thirds at the median angle of the anterior border - this forms the laryngeal prominence called the Adam's apple ○ The side paths of the thyroid cartilage are what we call the laminae
50
What is the angle of fusion of the laminae for males and females
○ The angle of fusion is 90 degrees in male and 120 degrees in female - the shallower angle in the males determines the larger and more visible laryngeal prominence The greater the length of the laryngeal prominence the deeper the pitch as the vocal folds inside become longer
51
What is the thyroid gland
○ Lies on trachea Gland is closely related to the thyroid cartilage of the larynx and extends to the level of C5 to T1 ○ Consists of left and right lobe joined by an isthmus
52
What is the common carotid artery covered by
the sternothyroid, sternohyoid and sternocleidomastoid muscles and cervical fascia
53
What does the common carotid artery run close to
the thyroid gland and it makes its way up the neck and it is tucked behind the lobe of the gland
54
Where does the common carotid branch
about the level of the upper border of the thyroid cartilage and you can see the carotid artery splitting into two
55
What does the internal carotid artery arise from
as the medical branch of the common carotid artery at the level of the lower border of the third cervical vertebrae and upper border of the thyroid cartilage
56
What is the internal carotid artery enclosed with
the carotid sheath together with the internal jugular vein and Vagus nerve
57
What does the external carotid artery give off
○ Gives off the superior thyroid artery | Supplies blood to the neck, larynx, pharynx, face and scalp
58
Where does the superior thyroid artery arise from
just below the hyoid bone
59
What is the course of the superior thyroid artery
○ Runs downwards to the apex of the lobe of the thyroid gland
60
What does the superior thyroid artery supply
the upper part of the thyroid but also has branches that supply the sternocleidomastoid muscle and some of the strap muscles and the larynx
61
Where are the superior deep cervical lymph nodes
§ Lie deep to the sternocleidomastoid surrounding the superior portion of the internal jugular veins
62
Where do the superior deep cervical lymph nodes drain from
``` □ Posterior scalp and neck □ Auricle □ Tongue □ Larynx □ Thyroid gland □ Trachea □ Nasopharynx □ Nasal cavity Oesophagus ```
63
Where do the inferior deep cervical nodes drain from
□ Posterior scalp □ Superficial pectoral region □ Tongue □ Superior deep cervical lymph nodes
64
Where are the inferior deep cervical lymph nodes
§ Lie deep to the sternocleidomastoid, close to the inferior section of the internal jugular vein
65
What are the posterior boundaries of the neck
○ Anterior - posterior border of the sternocleidomastoid ○ Posterior - anterior border of the trapezius muscle ○ Inferior - middle 1/3 of the clavicle
66
What is the posterior triangle of the neck covered by
fascia
67
What are the features of the posterior triangle of the neck
``` Great auricular nerve external jugular vein transverse cervical nerve sternocleidmastoid phrenic nerve scalenus anterior muscle brachial plexus supraclavicular nodes supra scapular artery transverse cervical artery superficial cervical nodes scalenus medius trapezius accessory nerve ```
68
Which nerve is the largest of the ascending superficial branches of the cervical plexus
○ The great auricular nerve is the largest of the ascending superficial branches of the cervical plexus
69
What is the great auricular nerve derived from
the second and third cervical rami
70
What does the great auricular nerve travel around
the sternocleidomastoid and enters the deep fascia to run down the muscle along with the external jugular veins under the platysma muscle
71
Where does the great auricular nerve divide
○ The nerve reaches the parotid where it divides
72
What does the great auricular nerve supply
the skin of the angle of the mandible and onto the ear
73
What does the transverse cervical nerve arise from
C2 and C3
74
Where does the transverse cervical nerve pass
Passes towards the anterior triangle of the neck on the superficial surface of the sternocleidomastoid muscle ○ Passes underneath the external jugular vein
75
What does the transverse cervical nerve supply
most of the skin over the antero-lateral parts of the neck
76
Where does the sternocleidomastoid insert
§ Two heads merge and the muscle passes upwards to insert onto the mastoid process of the temporal bone and the adjacent part of the superior nuchal line
77
What does the accessory nerve supply
○ Supplies the two muscles - sternocleidomastoid and trapezius muscle
78
Where does the accessory nerve come out the skull
at the jugular foramen and makes its way down the neck and on its way down it gives a branch to the sternocleidomastoid and it continues across the triangle to supply the trapezius muscle
79
Why is the accessory nerve at risk in dissection
○ The nerve can be damaged in neck dissection operations leading to weakness and paralysis of the trapezius and sternocleidomastoid muscles
80
How is the accessory nerve tested
by shrugging the shoulders and turning the head
81
What is the transverse cervical artery and the supra scapular artery
○ Two arteries that are fairly small and come from the same source ○ They run across the lower neck
82
What is the phrenic nerve
○ Arises from cervical plexus ○ Takes fibres from C3, 4 & 5 ○ Provides the motor nerve supply to the diaphragm ○ We will see it resting on the scalenus anterior muscle
83
What is the scalenus anterior muscle crossed by
the subclavian vein at its attachment to the first rib, the phrenic nerve and prevertebral fascia
84
How is the scalenus anterior muscle and scalenus medius muscle separated
by the roots of the brachial plexus and the subclavian artery
85
Where does scalenus anterior muscle originate from
○ Comes from C3-C6 and attaches to the first rib
86
What is the function of scalenus anterior muscle
○ Helps flex and rotate the neck and raise the first rib
87
Describe scalenus medius muscle
○ Largest and longest scalene muscle | ○ Also goes from cervical vertebrae to the first rib
88
What is the function of scalenus medius
○ Helps flexes the neck and raise the ribs
89
Where does the brachial plexus sit
○ Sits in between the scalenus muscles | ○ Supplies the skin and musculature of the upper limb
90
Where does the brachial plexus begin and end
○ Begins in the root of the neck, passes through the axilla and runs through the entire upper extremity
91
What is the brachial plexus made up of
Made up of 3 large bundles ○ It is formed from C5 - T1 spinal nerves ○ It is a dense and huge structure and is very firm
92
Where does the trapezius muscle insert and originate from
○ Arises from external occipital protuberance and superior nuchal line at the back of the skull ○ Inserts at the shoulders and lateral third of the clavicle and the spine
93
What are the superficial cervical nodes and supraclavicular nodes
○ Occasional lymph nodes seen ○ Disease in areas of the neck or systemic disease may be noticed through enlargement of these ○ Supraclavicular nodes are also connected to the lymphatics in the chest so malignant disease in the chest can present with enlarged lymph nodes in the neck