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mrcs > Head + neck anatomy contd > Flashcards

Head + neck anatomy contd Flashcards

1
Q

Describe Wallenburg syndrome

A

Lateral medullary syndrome= stroke in vertebral/ Posterior inferior cerebellar arteries

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2
Q

Signs/ sx of Wallenburg syndrome

A

Horners (miosis, ptosis, anhydrosis, enophthlmos)

N+V/ vertigo

ipsilateral:
dysphagia
dysarthria
paralysis of vocal cord/ pharynx

contralateral:
loss of pain and temp sense

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3
Q

Signs and sx of infarction at:

ventral midbrain
ventral pons

A

Ventral midbrain= infarction of basilar artery= Weber syndrome

ipsilateral CN III palsy + contralateral hemiplegia

Ventral pons infarction:
ipsilateral CN 6 +7 palsy + contralateral hemiplegia/ hemiparesis

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4
Q

Borders of the posterior triangle of the neck

A

post aspect SCM
middle 1/3rd clavicle
ant aspect of trapezius

roof= investing fascia
floor= scalenus capitus, levator scapulae, ant/mid/post scalenes

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5
Q

Contents of the posterior triangle of neck

A

muscles:
splenius capitis
levator scapulae ant/mid/post scalenes
omohyoid (sup/inferior bellies)

nerves:
accessory nerve (CN 11)
Phrenic nerve (C3-5)
CERVICAL PLEXUS
BRACHIAL PLEXUS

Artery:
subclavian artery

Vein:
External jugular vein

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6
Q

What splits the posterior triangle and what are the compartments called

A

Omohyoid-inferior belly

Compartments:
occipital triangle-above
subclavian triangle-below omohyoid

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7
Q

Borders of the anterior triangle

A

body of mandible
anterior midline of neck
ant aspect of SCM

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8
Q

Compartments of the anterior triangle

A

Submental
submandibular
carotid
muscular

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9
Q

Borders of the submental triangle and contents

A

borders:
hyoid bone (inf)
anterior midline of neck
anterior belly of Digastric (lateral)

contents:
submental lymph nodes

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10
Q

Borders of the submandibular triangle and contents

A

borders:
mandible
anterior belly digastric
posterior belly digastric

contents:
submandibular salivary gland
facial artery + vein
lymph nodes

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11
Q

Borders of the carotid triangle and contents

A

borders:
anterior aspect SCM
posterior belly digastric
superior belly omohyoid

contents:
common carotid (bifurcates here)
internal jugular vein
hypoglossal nerve
vagus nerve

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11
Q

Name the infrahyoid muscles

A

thyrohyoid
sternothyroid
sternohyoid
omohyoid (superior + inferior)

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11
Q

Borders of the muscular triangle and contents

A

borders:
hyoid bone
anterior midline neck
anterior aspect SCM
Superior belly omohyoid

contents: (organs + muscles)
thyroid
parathyroid
pharynx
infrahyoid muscles

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12
Q

Name the suprahyoid muscles

A

mylohyoid
geniohyoid
stylohyoid
digastric (anterior+ posterior)

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13
Q

What are the layers of the neck

A

-skin
-superficial cervical fascia
-platysma (anterior)
-deep investing fascia (surrounds SCM + trapezius)

anteriorly= pre-tracheal fascia (posterior aspect called bulbopharyngeal fascia)

retropharyngeal space (b/w pretracheal + pre-vertebral)

laterally= carotid sheath x2

posteriorly= pre-vertebral fascia

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14
Q

Contents of pre-tracheal fascia

A

thyroid + parathyroid glands
trachea
oesophagus
infrahyoid muscles

15
Q

Superior and inferior attachments of pre-tracheal fascia

A

superior= hyoid bone
inferior= pericardium

16
Q

Contents of pre-vertebral fascia

A

Pre-vertebral muscles
vertebral column
scalene muscles
deep back muscles
brachial plexus

17
Q

Superior and inferior attachments of pre-vertebral fascia

A

superior= base of skull
inferior= endothoracic fascia of rib cage

18
Q

What is the axillary sheath a continuation of?

A

Pre-vertebral fascia that continues into the axilla (contains brachial plexus)

19
Q

Contents of carotid sheath

A

Common carotid artery
Internal jugular vein
Vagus nerve
Lymphatics

20
Q

Intrinsic muscles of the tongue and their actions

A

Genioglossus= protrude (Give)*
Hyoglossus= depress (Hides)
Styloglosses= retracts (back towards styloid)
Palatoglossus= elevates posterior tongue (back towards palate)

*pull larynx forward during swallowing

21
Q

Location of parotid gland and anatomical relations

A

Anterior= masseter
superior= zygomatic arch
posterior= SCM + external ear
inferior= mandible

22
Q

Duct draining Parotid gland and location of its opening in the oral cavity

A

Stenson’s duct (PS)

Opens at the upper 2nd molar b/l

23
Q

Lobes of the parotid gland

A

Superficial and deep

24
Q

What muscles does stenson’s duct cross/ pierce to arrive at the oral cavity

A

cross= masseter
pierce= buccinator

25
Q

Glossopharyngeal nerve functions:
sensory
reflex
parasympathetic
motor

A

sensory + special sensory= posterior 1/3rd of tongue

reflex= gag reflex (afferent, efferent= CN 10)

Parasympathetic= supply to parotid gland [pre-ganglionic fibres (CN 9) to Otic ganglion from which post-ganglionic fibres (AURICULOTEMPORAL) to parotid gland]

Motor= innervates stylopharyngeus muscle (shortens + widens pharynx to elevate larynx during swallowing)

26
Q

Which salivary gland empties via Whartons duct

A

Submandibular duct

27
Q

Location of Whartons duct

A

Either side of the frenulum

28
Q

What is a ranula and where does it arise

A

ranula= mucocele in the SUBLINGUAL glands

29
Q

Which nerves are risk during parotid gland surgery

A

FACIAL NERVE

30
Q

What structures pass through the parotid gland

A

Facial nerve
External carotid artery
Retromandibular vein

31
Q

relationship of submandibular gland and:
-facial artery
-facial vein
-lingual nerve
-hypoglossal nerve

A

-facial artery= posterior to gland

-facial vein= superficial to gland

-lingual nerve=medial to gland/ lateral to Whartons duct

-hypoglossal nerve= below gland

31
Q

Which nerves are risk during submandibular gland surgery AND what post-op features might they present with

A

Lingual nerve (V3)
Marginal mandibular (CN 7)
Hypoglossal nerve (CN 12)

V3= loss of taste/ sensation of posterior 1/3 tongue

CN7= drooping lower lip (ipsilateral)

CN12= tongue deviated TOWARDS side of lesion (ipsilateral intrinsic muscle paralysis)

mrcs (21 decks)

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