Head & Neck 1 Flashcards Preview

ESA 4 - 2017 - Incomplete/Some errors > Head & Neck 1 > Flashcards

Flashcards in Head & Neck 1 Deck (57)
Loading flashcards...
1
Q

What is the difference between the viscerocranium and the neuro cranium

A

Viscerocranium - bones of the face

Neurocranium - Bones surrounding the brain

2
Q

To remind you of all the MSK you’ve forgotten, how many cervical vertebrae are there? Specific features?

A

7 - foramina in transverse processes, relatively small bodies

3
Q

From top to bottom list the four notable structures in the neck that are in line with the trachea

A

Hyoid bone
Thyroid cartilage
Cricoid cartilage
Thyroid gland

4
Q

Name the three notable muscles in the neck

A

Platysma
Sternocleidomastoid
Trapezius

5
Q

Other than muscle function, what is worth remembering about the SCM and Trapezius muscles

A

Their borders form important anatomical boundaries of the neck

6
Q

Platysma: shape and position?

A

Broad, sheet-like, v. superficial (within superficial fascia), overlies SCM

7
Q

Platysma: action?

A

Draws corners of mouth inferiorly and skin of neck superiorly (if teeth clenched)

8
Q

Platysma: innervation?

A

Facial Nerve - CN VII

9
Q

SCM: attachments and position?

A

Mastoid process, Clavicle and Sternum

Deep to platysma but palpable and visible

10
Q

SCM: action? (unilateral AND bilateral please)

A

Unilateral - lateral flexion of the neck (i.e. ear to shoulder while rotating chin superiorly)
Bilateral - flexion at neck, extension at atlanto-occipital joint

11
Q

SCM: innervation?

A

Accessory nerve - CN XI

12
Q

As Trapezius is in MSK as well let’s do it all in one

A

Arises - back of skull, nuchal ligament, spinous processes of vertebrae
Attaches - lateral 1/3 of clavicle, acromion, spine of scapula
Actions - shrugs, rotates scapula
Nerve - Acessory CN XI

13
Q

What are the borders of the anterior triangle of the neck?

A

Midline of the neck
Anterior margin of SCM
Inferior margin of mandible

14
Q

What are the borders of the posterior triangle?

A

Anterior margin of trapezius
Clavicle
Posterior margin of SCM

15
Q

What is the function of the fascial planes in the neck?

A

Organises structures into compartments
Ease of movement while swallowing
Containing spread of infection

16
Q

How many layers of cervical fascia are there?

A

5 - 1 superficial and 4 deep

17
Q

What are the contents of the superficial layer of fascia?

A
Loose connective tissue
Fat 
Platysma
Cutaneous nerves 
Lymph nodes 
Superficial blood vessels
18
Q

Name each of the deep layers, superficial to deep if you please

A

Investing
Pretracheal
Prevertebral
Carotid Sheath(s)

19
Q

Investing layer: what does it surround?

A

All neck structures -

It splits into 2 in order to completely surround the SCMs and Traps

20
Q

Investing layer: attachments?

Hint: 7

A

External occipital protuberance, superior nuchal line, hyoid bone, clavicle, manubrium, scapular spine, ligamentum nuchae

21
Q

Pretracheal layer: position?

A

anteriorly in neck - spans between hyoid bone and thorax (fuses there with pericardium)

22
Q

Pretracheal layer: what structures are contained within it?
Hint: 4

A

Trachea, oesophagus, thyroid gland and infrahyoid muscles

23
Q

What are the infrahyoid muscles?

A

4 muscles (obviously) located inferiorly to the hyoid bone that work to depress the hyoid bone or thyroid cartilage

24
Q

What can the pretracheal layer be subdivided into?

Hint: 2 parts

A

Muscular and visceral parts;
Muscular - encloses the infrahyoids
Visceral - encloses the rest

25
Q

Prevertebral layer: what does it surround?

A

The vertebral column and its associated muscles

26
Q

Prevertebral layer: attachments?

A

base of skull, transverse processes and vertebral bodies of vertebral column as well as ligamentum nuchae and endothoracic fascia of ribcage

27
Q

Prevertebral fascia: other anatomical significance?

Hint: boundaries

A

Forms the floor of the posterior triangle of the neck AND the axillary sheath

28
Q

Carotid sheaths: what are they?

A

Paired structures formed from contributions of the other deep layers

29
Q

Carotid sheaths: what do they contain?

Hint: 4

A

Common carotid artery (bifurcates in it)
Internal jugular vein
Vagus nerve
Cervical lymph nodes

30
Q

Carotid sheaths: clinical relevance?

A

Their organisation into a column running from the skull base to the thoracic mediastinum creates a pathway for infection to spread (mediastinitus)

31
Q

Retropharyngeal and pre-tracheal spaces: why?

A

Allow spread of infection within them - e.g. tracheostomy could introduce bacteria into pretracheal space

32
Q

What are the two broad sets of muscles of the face and their respective innervation?

A

Muscles of facial expression - Facial nerve CN VII

Muscles of mastication - Trigeminal nerve CN V

33
Q

What other function does the trigeminal nerve have? Which branches are involved?

A
Sensory to the face and scalp 
(Roughly top to bottom) 
Opthalmic
Maxillary
Mandibular
34
Q

What is the cranial nerve number of the facial and trigeminal nerves?

A

Trigeminal - V

Facial - VII

35
Q

Name the terminal branches of the facial nerve

Hint: 5

A
Temporal 
Zygomatic 
Buccal 
Marginal mandibular
Cervical
36
Q

Facial nerve: other functions?

A

SS (special sensory) tongue

Parasympathetic innervation to salivary and lacrimal glands

37
Q

Clinical relevance: how can the fascial layers aid in diagnosing goitres?

A

The thyroid gland is enclosed in pretracheal fascia, in turn attached to the hyoid which moves up in swallowing, therefore so will a goitre

38
Q

Clinical relevance: signs of a retrosternal goitre?

A

Compression = breathlessness, stridor, facial oedema

39
Q

How is the facial nerve tested?

A

Forehead creasing, keeping eyes shut against resistance, revealing the teeth and puffing out the cheeks

40
Q

How is the trigeminal nerve tested?

A

Sesory testing with cotton buds

Corneal reflex

41
Q

Orbicularis oculi: action an innervation?

A

Closes the eyelid and scrunches the eye

Facial nerve

42
Q

Levator palpebrae: action and innervation?

A

Opens the eyelids

Oculomotor nerve CN III

43
Q

Orbicularis Oris: action?

A

Purses lips

44
Q

Buccinator: action?

A

Compresses cheeks against teeth and is involved in blowing (not that kind)

45
Q

Pterygoids, lateral and medial: actions?

A

Clenching jaw and moving it anteriorly

46
Q

Temporalis: action?

A

Crushing food in molars

47
Q

What is the scalp?

A

The 5 layers of skin and subcutaneous tissue that cover the bones of the cranial vault

48
Q

Now name the layers of the scalp. Hint: SCALP is a pseudo-mnemonic

A
Skin 
(Dense) Connective tissue 
(Epicranial) Aponeurosis
Loose areolar connective tissue 
Periosteum
49
Q

Why does the scalp bleed so much?

A

The dense connective tissue layer has lots of blood vessels that are tightly attached preventing them from constricting if lacerated

50
Q

Which muscles are connected by the epicranial aponeurosis?

A

Occipitalis and frontalis

51
Q

Clinical relevance: scalp infections?

A

Can spread to cranial cavity via emissary veins, could cause meningitis

52
Q

Scalp: arterial supply?

A

Opthalmic and external carotid

53
Q

Scalp: which branches of external carotid are involved?

A

Roughly anterior to posterior; superficial temporal, occipital, posterior auricular

54
Q

Scalp: superficial venous drainage?

A

Follows arterial supply via veins with the same names

55
Q

Scalp: deep veous drainage?

A

Pterygoid venous plexus - draining into the maxiallry vein

56
Q

Scalp: additional venous drainage?
Hint: anastomoses

A

Scalp veins connect to diploic veins of the skull via valveless emissaary veins connecting scalp to dural venous sinuses

57
Q

Scalp: innervation?
Hint: 6 nerves from 2 sources

A

4 fromTrigeminal; supratrochlear, supraorbital, zygomaticotemporal and auriculotemporal
2 from cervical nerves; lesser and greater occipital nerves (C2 & 3)