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Anatomy Exam 3 > Interval 10: Head and Neck > Flashcards

Interval 10: Head and Neck Flashcards

1
Q

The skeletal muscles of the face and scalp include muscles of _________ and __________.

A
  • facial expression

- mastication

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2
Q

What nerves innervation the facial expression and mastication muscles? What are these muscles’ general functions?

A
  • Facial expression: facial nerve (CN VII) and act as sphincters and dilators of openings on the face
  • Mastication: mandibular nerve of CN V3 and act to move the mandible at the temporomandibular joint
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3
Q

What does TMJ stand for?

A

-Temporomandibular joint

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4
Q

The skin of the face and scalp is innervated by cutaneous branches of ____________.

A

-3 divisions of the trigeminal nerve and by cervical spinal nerves

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5
Q

What are the 3 branches of the trigeminal nerve?

A

V1: ophthalmic division
V2: Maxillary division
V3: Mandibular division

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6
Q

Branches of what 2 arteries supply the face and scalp?

A
  • external carotid

- ophthalmic

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7
Q

Tributaries of what 2 veins drain the face and scalp?

A

-retromandibular and facial veins

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8
Q

The parotid gland is situated in the lateral part of the face on the surface of the ___________. A deep part of the gland extends between the ramus of the mandible and the mastoid process.

A

-masseter muscle

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9
Q

Describe the route of the parotid duct

A

-cross the masseter, passes through the buccinator, and opens into the oral cavity near the second upper molar

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10
Q

What traverses the parotid gland and what innervates it?

A
  • traversed by muscular branches of the facial nerve, retromandibular vein, external carotid artery
  • innervated by glossopharyngeal nerve
  • *Note: the facial nerve DOES NOT innervate the gland, it just traverses it
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11
Q

The preganglionic parasympathetic fibers from the glossopharyngeal nerve synapse in the __________. The postganglionic parasympathetic fibers then travel to the parotid gland with the ___________ branch of the trigeminal nerve.

A
  • otic ganglion

- autriculotemporal nerve

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12
Q

What symptoms may a parotid gland tumor cause?

A

-may compress the muscular branches of the facial nerve and cause weakness of muscles of facial expressions on the side of the tumor

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13
Q

Define trigeminal neuralgia (tic douloureux). Which branch does it usually affect?

A
  • syndrome characterized by excruciating pain of sudden onset in the areas of distribution of one or more branches of the trigeminal nerve
  • usually the maxillary nerve, the ophthalmic division is rarely involved
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14
Q

The most common neuralgia associated with CNV2 and CNV3 divisions of the trigeminal nerve is the type associated with ________.

A

-dental caries (cavities)

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15
Q

Is the trigeminal nerve mixed, sensory, or motor?

A

-mixed; large sensory root and smaller motor root

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16
Q

Where does the sensory root of the trigeminal nerve arise from?

A
  • cell bodies in the trigeminal (gasserian) ganglion located in the lateral portion of the cavernous venous sinus
  • it passes posteriorly under cover of the superior petrosal venous sinus and tentorium cerebelli to penetrate the pons
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17
Q

The sensory fibers of which division of the trigeminal nerve are joined by the motor root?

A

-mandibular

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18
Q

Describe the composition of the ophthalmic division of the trigeminal nerve

A
  • only sensory
  • supplies bulb of eye, conjunctiva, lacrimal gland; parts of nasal mucousa, paranasal sinuses, and the cutaneous areas of the forehead, eyelids, and nose
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19
Q

Describe the composition of the maxillary division of the trigeminal nerve

A
  • only sensory
  • supplies skin on midface and lower eyelid, side of the nose, and upper lip; mucous membrane of the nasopharnyx, maxillary sinus, soft palate, tonsil, root of mouth; maxillary teeth and gingiva
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20
Q

Describe the composition of the mandibular division of the trigeminal nerve

A
  • largest of 3 divisions; mixed
  • sensory:temporal area, ear, cheek, lower lip, and lowerface; mucous membrane of cheek and tongue; mastoid air cells, lower teeth and gums, mandible, TMJ, parts of cranial dura mater
  • motor: muscles of mastication (masseter, temporalis, medial and lateral pterygoid), mylohyoid, anterior belly of digastric, tensor veli palatini and tensor tympani
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21
Q

What are the 2 compartments of the neck and where do they arise and extend?

A
  • visceral: anterior and extends from the base of the skull to the thoracic outlet
  • vertebral: posterior and extends from the foramen magnum to the thoracic outlet
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22
Q

What is found in the visceral compartment of the neck?

A

-hyoid bone, suprahyoid and infrahyoid muscles, pharynx, esophagus, larynx, and trachea

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23
Q

What surrounds the visceral compartment of the neck?

A
  • pretracheal layer of deep cervical fascia encloses structures
  • buccopharyngeal fascia is a continuation of the pretracheal fascia which surrounds the posterior aspect of the pharynx and esophagus
24
Q

What is found within the vertebral compartment of the neck?

A

-cervical vertebrae, skeletal muscles that attach to cervical vertebrae, ventral rami of the cervical plexus and brachial plexus, and vertebral arteries and veins

25
Q

What encloses the vertebral compartment of the neck?

A

-prevertebral layer of deep cervical fascia

26
Q

The prevertebral layer is separated from the buccopharyngeal fascia by the ____________.

A

-retropharyngeal space: a potential space

27
Q

Structures in the visceral compartment of the neck covered by pretracheal fascia glide against the ________________ during swallowing.

A

-prevertebral fascia

28
Q

An infection in the retropharyngeal space may spread where?

A

-inferiorly into the superior mediastinum

29
Q

Both compartments of the neck are partially covered by what 2 superficial muscles?

A
  • trapezius and sternocleidomastoid

- an investing layer of deep cervical fascia encloses both compartments and splits to enclose the trapezius and the SCM

30
Q

What does the superficial cervical fascia contains?

A

-platysma, a muscle of facial expression

31
Q

What are the bounds/borders of the posterior triangle of the neck?

A
  • trapezius
  • posterior border of the SCM
  • clavicle
32
Q

What does the floor of the posterior triangle contain? What covers these muscles?

A
  • anterior scalene, middle scalene, posterior scalene, levator scapulae, splenius capitis muscles
  • covered by prevertebral fascia
33
Q

What forms the root of the posterior triangle?

A

-investing layer of deep cervical fascia

34
Q

Describe how the external jugular vein is formed and its trajectory

A
  • formed by union of posterior auricular and retromandibular veins
  • crosses SCM obliquely, pieces the investing fascia, and drains into the subclavian vein
35
Q

The subclavian vein passes anterior to the _________________ and joins what vein to form the ____________.

A
  • phrenic nerve and anterior scalene

- joins internal jugular vein to form a brachiocephalic vein posterior to the medial end of clavicle

36
Q

What drains into the right and left brachiocephalic veins at their origins?

A
  • right lymphatic duct into the right brachiocephalic vein

- thoracic duct into the left brachiocephalic vein

37
Q

Name 3 arteries to course through the posterior triangle

A
  • suprascapular
  • transverse cervical
  • occipital arteries
38
Q

Where do the suprascapular and transverse cervical arteries arise from? Give their trajectory and what they supply.

A
  • arise from the thyrocervical trunk of the subclavian
  • pass anterior to the anterior scalene and phrenic nerve and cross the posterior triangle
  • supply trapezius, rhomboids, levator scapulae, and muscles that attach to the posterior aspect of the scapula
39
Q

Where does the occipital artery arise and what is its trajectory?

A

-arises from the external carotid artery and passes through the apex of the posterior triangle

40
Q

Describe the composition of the accessory nerve (CN XI), where it arises, its trajectory, and what it innervates.

A
  • skeletal motor axons arising from ventral roots of first 4-5 cervical nerves
  • enters subarachnoid space and pass through the foramen magnum into the cranial cavity; it exits the skills through the jugular foramen with other nerves
  • innervates SCM and trapezius
41
Q

Where does the accessory nerve exit the skull and what other nerves does it exit with?

A
  • jugular foramen

- glossopharyngeal and vagus nerves

42
Q

Lesions of accessory nerve is posterior triangle and inferior to the jugular foramen

A
  • PT: weakness in trapezius muscle; difficulty elevating scapula (shrugging shoulder) and laterally rotating scapula during abduction of arm
  • JF: weakness also in SCM; decreased ability to turn the chin to the side opposite of the lesioned nerve
43
Q

The phrenic nerve courses of the anterior surface of the ___________ deep to the ____________.

A
  • anterior scalene

- deep to prevertebral fascia

44
Q

The ventral rami and trunks of the brachial plexus and the subclavian artery pass between _____________.

A

-anterior and middle scalene muscles

45
Q

Where do the cutaneous branches of the cervical plexus emerge and what is their trajectory?

A
  • emerge posterior to the SCM approx. halfway between its sternal and mastoid attachments
  • arise from VR of C1-C4 spinal nerves and pierces the investing and superficial fascia
46
Q

List the 4 branches of the cutaneous branches of the cervical plexus and their segments

A
  1. Great auricular nerve (C2,C3)
  2. Lesser occipital nerve (C2)
  3. transverse cervical nerve (C2,C3)
  4. Supraclavicular nerves (C2, C3, C4)
47
Q

What does the cutaneous branches of the cervical plexus supply?

A
  • skin of the anterior and lateral neck including skin over the angle of the mandible
  • skin of the scalp posterior to the vertex of the skull
48
Q

What is the vertex of the skull?

A

-coronal plane through the most superior aspect of the cranium

49
Q

Explain to someone how to find the tendinous insertion of the SCM

A

-it is palpable just lateral to the suprasternal notch

50
Q

Boundaries of the anterior triangle of the neck

A
  • SCM
  • mandible
  • midline of the neck
51
Q

List the following structures from superior to inferior: Adam’s apple, hyoid bone, cricoid cartilage of trachea

A
  • hyoid bone
  • Adam’s apple: beginning of trachea; thyroid cartilage**
  • Cricoid cartilage***
52
Q

What is the movement of the trachea when swallowing?

A

-upward

53
Q

What is a tracheotomy?

A

-commonly performed procedure in which an incision in made and a tube inserted through the front of the neck into the lumen of the trachea to provide an airway

54
Q

2 potential sites of tracheotomy

A
  1. High trach: incision is made between cricoid cartilage and isthmus of thyroid gland
  2. Low trach:between 2-3 tracheal rings whith thyroid gland first being retracted upwards
55
Q

TracheOSTOMY

A

-when a round or square opening is made in the neck rather than a slit and the tracheal mucosa brought into continuity with the skin

56
Q

What must physicians be cautious of during a high vs. low tracheotomy?

A
  • High: care not to damage thyroid gland and its extensive blood supply and the anterior jugular veins which lie on either side of the midline
  • Low: more difficult due to presence of inferior thyroid venous plexus, and close proximity of pleural sacs, brachiocephalic veins, and jugular venous arch

Anatomy Exam 3 (9 decks)

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