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MRCS Anatomy by Sanjid > Neck > Flashcards

Neck Flashcards

1
Q

Which nerves are commonly affected in a carotid endarterectomy (in carotid triangle)?

A

1) Hypoglossal
2) Lingual
3) Great auricular
4) Superior laryngeal
5) Superior fibres of ansa cervicalis

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2
Q

From which nerve roots does the phrenic nerve arise from?

A

C3, C4, C5

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3
Q

From which muscle does the phrenic nerve arise from?

A

Lateral border of anterior scalene

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4
Q

Which surface does the phrenic nerve descend down from the lateral border of the anterior scalene muscle?

A

Anterior surface of anterior scalene

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5
Q

Within which fascial layer of the neck does the phrenic nerve descend down?

A

Prevertebral layer of cervical fascia

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6
Q

Which structure does the phrenic nerve travel posterior to in the neck?

A

Subclavian vein

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7
Q

Which nerves are at risk in incisions within the submandibular triangle?

A

1) Nerve to mylohyoid
2) Marginal mandobular branch of the facial nerve (VII)
3) Lingual nerve (V3)
4) Hypoglossal nerve (XII)

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8
Q

What are the contents of the superficial fascia of the neck?

A

1) Platysma
2) Cutaneous nerves & vessels
3) External jugular vein
4) Superficial lymph nodes
5) Fat

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9
Q

What are the layers of the deep cervical fascia?

A

1) Investing layer
2) Pretracheal layer
3) Prevertebral layer

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10
Q

The investing layer of the neck surrounds the neck and wraps around 2 muscles, which ones are they?

A

1) Platysma

2) SCM

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11
Q

Which fascia surrounds the parotid gland?

A

Parotid fascia - split layer of investing fascia in the face

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12
Q

Which structures does the pretracheal layer envelop?

A

1) Trachea
2) Oesophagus
3) Thyroid
4) Parathyroid
5) Infrahyoid strap muscles

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13
Q

What is the posterior aspect of the pretracheal fascia?

A

Buccopharyngeal fascia - anterior border of retropharyngeal space

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14
Q

What does the prevertebral fascia cover?

A

1) Surrounds vertebral column
2) Scalene muscles
3) Prevertebral muscles
4) Deep muscles of the back
5) Forms floor of posterior triangle in neck

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15
Q

The prevertebral fascia in the floor of the posterior traingle goes onto form what structures in the arm?

A

1) Axillary sheath - surround brachial plexus and subclavian artery

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16
Q

What is the retropharyngeal space?

A

Between buccopharyngeal (pretracheal) and alar (prevertebral) fascias

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17
Q

What are the relations of the retropharyngeal space?

A 
SUPERIOR - Base of skull
INFERIOR - Superior mediastinum
LATERAL - Carotid sheath
ANTERIOR - Buccopharyngeal fascia
POSTERIOR - Alar fascia
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18
Q

What are the branches of the external carotid artery?

A

1) Superior thyroid (ANTERIOR)
2) Ascending pharyngeal (MEDIAL)
3) Lingual (ANTERIOR)
4) Facial (ANTERIOR)
5) Occipital (POSTERIOR)
6) Posterior auricular (POSTERIOR)
7) Maxillary (TERMINAL)
8) Superficial temporal (TERMINAL)

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19
Q

Common carotid artery bifurcates into internal & external carotid arteries at which level?

A

C4 within the carotid sheath at the level of upper border of thyroid cartilage

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20
Q

What are the branches of the subclavian artery?

A

VIT CD

1ST PART

1) Vertebral
2) Internal mammary
3) Thyrocervical trunk

2ND PART

1) Costocervical trunk
2) Dorsal scapular artery

3RD PART - NO BRANCHES

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21
Q

The inferior thyroid artery is a branch from which artery?

A

Thyrocervical trunk

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22
Q

What does the inferior thyroid artery supply?

A

1) Thyroid gland
2) Parathyroid glands
3) Upper 1/3 of oesophagus

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23
Q

What are the branches of the thyrocervical trunk?

A

ISAT

1) Inferior thyroid artery
2) Suprascapular artery
3) Ascending cervical artery
4) Transverse cervical artery

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24
Q

Which nerves arise from the roots of the brachial plexus?

A

1) Long thoracic nerve
2) Dorsal scapular nerve
3) Nerve to subclavius

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25
Q

Which is the only terminal nerve of the trunks of the brachial plexus?

A

1) Suprascapular nerve (Upper trunk)

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26
Q

What muscle is supplied by the external branch of superior laryngeal nerve?

A

Cricothyroid

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27
Q

What muscles are supplied by the inferior/recurrent laryngeal nerve?

A 
All intrinsic muscles of the larynx
EXCEPT CRICOTHYROID (this intrinsic muscle lies on the outside of the larynx)
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28
Q

Which vein does the superior and middle thyroid vein drain into?

A

Internal jugular vein

29
Q

Which vein does the inferior thyroid vein drain into?

A

Brachiocephalic vein

30
Q

How many lobes does the submandibular gland have?

A

1) Superficial lobe
2) Deep lobe
* * IN RELATION TO MYLOHYOID**

31
Q

Where is the submandibular gland located?

A

In submandibular triangle
Inferior to posterior 1/2 of mandible
Within submandibular fossa

32
Q

What is the relation of the hypoglossal nerve to the submandibular gland?

A

Superficial to the superficial lobe of the submandibular gland

33
Q

What is the relation of the lingual nerve to the submandibular gland?

A

Deep to the deep lobe of the submandibular gland & submandibular duct

34
Q

Through which fissure does the chorda tympani exit the skull?

A

Petrotympanic fissure
It then piggyback onto lingual nerve and travels to tongue
Provides taste to anterior 2/3

35
Q

What epithelium lines the lumen of trachea?

A

Pseudostratified ciliated columnar epithelium

36
Q

What epithelium lines the lumen of upper 1/3 of oesophagus?

A

Stratified squamous epithelium

37
Q

Where is the surgical tracheostomy incision made?

A

Between 2nd & 3rd tracheal cartilages/rings

38
Q

Where are percutaneous dilational tracheostomy incisions made?

A

1) Subcricoid cartilage

2) Between 1st & 2nd tracheal cartilages/rings

39
Q

What are the layers you incise through when performing a tracheostomy?

A
  • *SUPERFICIAL**
    1) Skin
    2) Sub-cutaneous fat
    3) Superficial cervical fascia
    4) Platysma
    5) Investing layer of deep cervical fascia
    6) Pre-tracheal fascia
    7) Strap muscles (sternothyroid & sternohyoid)
    8) Thyroid ithmus
    9) Tracheal rings
  • *DEEP**
40
Q

Which muscles are innervated by the ansa cervicalis?

A

All strap muscles

EXCEPT THYROHYOID & GENIOHYOID (C1)

41
Q

What are the nerve roots of ansa cervicalis?

A

C1, C2, C3

42
Q

What are the unpaired cartilages of the larynx?

A

1) Epiglottis
2) Thyroid
3) Cricoid

43
Q

What are the paired cartilages of the larynx?

A

Arytenoids
Cuneiforms
Corniculates

44
Q

What does the cricothyroid muscle do?

A

Lengthens vocal cord
Production of high pitched voice
Innervated by external branch of superior laryngeal nerve

45
Q

What does the posterior cricoarytenoids do?

A

Abducts the vocal cords

46
Q

What does the thyroarytenoids do?

A

Shortens vocal cords
Production of low pitched voice
OPPOSITE TO CRICOTHYROID

47
Q

What does the internal branch of the superior laryngeal nerve supply?

A

Mucosa above the vocal cords

48
Q

What supplies the mucosa below the vocal cords?

A

Recurrent laryngeal nerve

49
Q

Which pharyngeal muscles are found in the laryngopharynx?

A

Middle & Inferior pharyngeal constrictors

50
Q

Between which muscles are pharyngeal pouches found? (Zenker’s Diverticulum)

A

Thyropharyngeus & Cricopharyngeus

Inferior pharyngeal constrictors

51
Q

Through which structural defect does a pharyngeal pouch form?

A

Killian’s dehiscence

52
Q

Where does the internal carotid artery lie in relation to the external carotid artery at the level of bifurcation?

A

Posterolaterally

53
Q

The recurrent laryngeal nerve passes through which groove at the level of the thyroid?

A

The tracheo-oesophageal groove

54
Q

Which artery does the recurrent laryngeal nerve closely relate to?

A

Inferior thyroid artery

55
Q

Which nerve lies medially in the thyroid gland?

A

Recurrent laryngeal nerve

56
Q

Which muscles are innervated by the ansa cervicalis?

A 
GenioHyoid
ThyroHyoid
Superior Omohyoid
SternoThyroid
SternoHyoid
Inferior Omohyoid

“GHost THough SOmeone STupid SHot IOna

57
Q

Which part of the strap muscles should be dissected if need be?

A

Upper half - the ansa cervicalis supplies these strap muscles inferiorly

58
Q

What are the contents of the carotid sheath?

A 
Common carotid artery
Internal carotid artery
Internal jugular vein
Vagus nerve & part of RLN
Deep cervical LN
59
Q

What nerves provide parasympathetic innervation to the thyroid gland?

A

Vagus & recurrent laryngeal nerves

60
Q

What nerves provide sympathetic innervation to the thyroid gland?

A

deep cervical plexus

61
Q

Where are oxyphil cells found?

A

Parathyroid cells

62
Q

What level is the hyoid bone?

A

C3

63
Q

What level is the thyroid cartilage notch?

A

C4

64
Q

What level is the bifurcation of the common carotid arteries?

A

C4

65
Q

What level is the isthmus of the thyroid cartilage?

A

C4, C5

66
Q

What level is the cricoid cartilage?

A

C6

67
Q

What level does the larynx become the trachea?

A

C6

68
Q

What level does the pharynx become the oesophagus?

A

C6

69
Q

What level is the middle cervical ganglion?

A

C6

MRCS Anatomy by Sanjid (11 decks)

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