Flashcards in 01 - General Organisation Of The Head & Neck Deck (32):
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What are the different layers of fascia in the neck?
Superficial cervical fascia
Deep cervical fascia (investing, pretracheal, and prevertebral)
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What is the superficial cervical fascia?
What does it contain?
A layer of fatty connective tissue between the dermis of the skin and the investing layer of deep cervical fascia.
Cutaneous nerves, blood, lymphatic vessel and nodes and the platysma muscle
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What does the platysma muscle develop from?
What nerve innervates it?
What does it do?
Second pharyngeal arch
Branches of the facial nerve
Tenses the skin and also helps to depress the mandible and draw the corners of the mouth inferiorly
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What are the functions of the deep cervical fascia?
Support the viscera, muscles, vessels and lymphatics
Limit the spread of abscesses that result from infection
Allow structures in the neck to move other each other e.g. Swallowing
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Describe the investing layer of deep cervical fascia.
What structures does it contain?
It surrounds the entire neck deep to the skin
Forms a double envelope around SCM and trapezius. Also contains the submandibular and parotid salivary glands
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Where does the pretracheal layer of deep cervical fascia extend to?
It extends in to the thorax and merges with the fibrous part of the pericardium
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What are the two parts of the pretracheal layers of deep cervical fascia?
What structures do they contain?
Muscular layer that encloses the infrahyoid muscles
Visceral layer that encloses the thyroid gland, trachea and oesophagus
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What does the prevertebral layer of deep cervical fascia begin and end?
What structures does it contain?
It forms a sheath around the vertebrae and surrounding muscles
It extends from the base of the cranium to t3 and extends laterally out to the axillary sheath
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Describe the carotid sheath
What structures does it contain?
Where does it start and end?
Extends from the base of the cranium to the root of the neck
lies lateral to the pretracheal sheath but they are in continuity with each other
Contains the common carotid artery, internal jugular vein and vagus nerve
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The anterior triangle of the neck has anterior, posterior and superior borders. What structures make up these borders?
A - midline
P - anterior border of SCM
S - inferior border of the mandible
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The anterior triangle of the neck can be further sub-divided in to four triangles. What are these four triangles?
Submandibular, submental, carotid and muscular triangles
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What does the submandibular triangle contain?
Submandibular gland, submandibular lymph nodes, hypoglossal and mylohyoid nerves and parts of the facial artery and vein
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What does the submental triangle contain?
Submental lymph nodes and small veins which unite to form the anterior jugular vein
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What does the carotid triangle contain?
Carotid sheath, thyroid gland, larynx, pharynx, external carotid artery, hypoglossal and spinal accessory nerves and branches of the cervical plexus
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What does the muscular triangle contain?
Sternothyroid, sternohyoid and thyrohyoid muscles
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The posterior triangle of the neck has anterior, posterior and inferior borders. What structures make up these borders?
Anterior - posterior border of SCM
Posterior - anterior border of trapezius
Inferior - middle third of the clavicle between the two muscles
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The posterior triangle of the neck can be further sub-divided in to two triangles. What are these two triangles?
Occipital and omoclavicular (also known as supraclavicular)
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What does the occipital triangle contain?
Spinal accessory nerve and trunks of the brachial plexus
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What does the omoclavicular triangle contain?
It contains the third part of the subclavian artery and part of the subclavian vein
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If an infection occurs between the investing layer and the muscular part of the pretracheal layer, where can the infection spread?
It won't spread beyond the manubrium
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If an infection occurs between the investing layer and the visceral part of the pretracheal layer, where can the infection spread?
In to the thoracic cavity anterior to the pericardium
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What is meant by the retropharyngeal space?
It is a potential space between the alar fascia and the pretracheal fascia. It is a major route of spread of infection from the neck to the thorax. The space runs to the diaphragm.
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What is the purpose of the suprahyoid muscles?
What are the four suprahyoid muscles?
Elevate the hyoid and larynx during swallowing. Together they contribute to the floor of the mouth
Digastric, mylohyoid, stylohyoid and geniohyoid
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What is the purpose of the infrahyoid muscles?
What are the four infrahyoid muscles?
They anchor the hyoid, sternum, clavicles and scapula. They also depress the hyoid and larynx during swallowing and speaking
Sternohyoid, omohyoid, sternothyroid, thyrohyoid
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What is the function of the buccinators?
They help keep the cheeks taut and aids in chewing
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In new-born babies, how and why might the sternocleidomastoid muscle be damaged?
In forceps delivery, the SCM is at risk of trauma, due to compression damage or being pulled during a difficult birth
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How would a person with a damaged sternocleidomastoid muscle present?
They would present with with tilt and rotation of the head towards the normal side
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Why might a fracture of the lower mandible cause numbness of the lower lip?
Involvement of the inferior alveolar nerve that lies within the bone. It's terminal branches exit the mandible through the mental foramen where they supply the mucous membrane of the lower lip and chin
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At what level does the left recurrent laryngeal nerve recur?
Transverse thoracic plane
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Apart from thoracic pain and possible complications arising from blood clots, what other significant clinical complaint might a patient present with an undiagnosed aneurysm of the arch of the aorta?
Hoarse voice due to damage to the left recurrent laryngeal nerve causing a unilateral palsy of the vocal cords on the left
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What is meant by the 'danger space'?
Pre-vertebral space
It is between the pre-vertebral fascia and the alar fascia
It extends slightly further down in to the mediastinum than the retropharyngeal space
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