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C&M Neuroanatomy > Week 2: Head and Neck 1 - Front of neck > Flashcards

Week 2: Head and Neck 1 - Front of neck Flashcards

1
Q

Where is the hyoid bone located?

A
  • C3 Vertebral level

- just above the thyroid cartilage

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2
Q

At what vertebral level is the thyroid cartilage?

A

C4-5

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3
Q

Where is the cricoid cartilage?

A
  • below the thyroid cartilage

- C6 vertebral level

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4
Q

Where is the trachea?

A
  • can be felt at the anterior neck below the larynx

- spans vertebral levels C6-T4

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5
Q

Where does the sternocleidomastoid muscle run between?

A

from the mastoid process of temporal bone (behind ear) to the sternum

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6
Q

What are the anterior and posterior triangles of the neck divided by?

A

sternocleidomastoid muscle

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7
Q

What are the boundaries of the posterior triangle?

A

base - clavicle
anterior boundary - posterior margin of sternocleidomastoid
posterior boundary - anterior margin of trapezius

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8
Q

What are the contents of the posterior triangle?

A
  • trunks of the brachial plexus
  • spinal accessory nerve (CN VI)
  • inferior belly of omohyphoid muscle
  • external jugular vein
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9
Q

Stab wounds in the posterior triangle may damage the upper trunk of the brachial plexus and/or the apex of the lung - why?

A

apex of lung is between the clavicles and the cricoid cartilage

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10
Q

What would happen if the external jugular vein is severed?

A

air will be drawn into the vein, producing cyanosis and can stop blood flow through the right atrium

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11
Q

Which muscles are supplied by the accessory nerve? (CN XI)

A
  • sternocleidomastoid muscle

- trapezius

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12
Q

Explain how we can follow the external jugular vein down its course?

A
  • forms near the angle of the mandible and descends through the neck coursing medially to laterally across the sternocleidomastoid muscle towards the middle of the clavicle to drain into the subclavian vein
  • follow imaginary line from earlobe, across angle of mandible to the middle of clavicle, passing superficial to SCM
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13
Q

What are the boundaries of the anterior triangle?

A

posterior boundary - anterior margin of sternocleidomastoid

anterior boundary - midline of neck

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14
Q

What are the contents of the anterior triangle?

A
  • lobes of the thyroid gland
  • suprahyoid muscles
  • infrahyoid muscles
  • common carotid artery
  • internal and external carotid arteries
  • internal jugular veins
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15
Q

Where do the infra hyoid muscles lie?

A

distal to the hyoid bone

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16
Q

What is the function of the infra hyoid muscles?

A

depressing the hyoid bone during swallowing

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17
Q

What are the 4 infra hyoid muscles?

A
  • sternohyoid
  • sternothyroid
  • thyrohyoid
  • omohyoid
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18
Q

Which two infra hyoid muscles are superficial?

A

omohyoid and sternohyoid

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19
Q

Which two infra hyoid muscles are deeper?

A

sternothyroid and thyrohyoid

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20
Q

Which nerve are the infra hyoid muscles innervated by?

A

sternohyoid, sternothyroid, omohyoid - ansa cervicalis

thyrohyoid - branch of the ventral ramus of C1 from the cervical plexus

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21
Q

Where are the supra hyoid muscles?

A
  • lie above the hyoid bone

- form the floor of the mouth

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22
Q

What is the function of the supra hyoid muscles?

A

moving the hyoid bone during swallowing

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23
Q

What are the two bellies of digastric muscle and where do they arise from?

A

anterior belly - arises from the digastric fossa of the mandible
posterior belly - arises from the mastoid process of the temporal bone

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24
Q

What are the functions of the digastric muscles?

A
  • stabilises the hyoid during swallowing - this protects the airway while eating
  • depresses the mandible for jaw opening, chewing and speech
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25
Q

What are the 4 suprahyoid muscles?

A
  • mylohyoid muscle
  • digastric muscle
  • stylohyoid muscle
  • geniohyoid muscle
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26
Q

What is a cricothyroidotomy/ laryngotomy?

A
  • An incision made through the skin and cricothyroid membrane to establish a patent airway during life-threatening situations e.g airway
  • Surgical incision into the larynx, typically to provide an air passage when breathing is obstructed
27
Q

What is a tracheotomy?

A

Opening created at the front of the neck so a tube can be inserted into the trachea to:

  • help you breath
  • to bypass an obstructed airway
  • to clean and remove secretions from the airway
  • alternative airway for breathing
28
Q

What 3 important structures are surrounded by the carotid sheath?

A
  1. common carotid artery
  2. internal jugular vein
  3. vagus nerve
29
Q

Where does the IJV drain blood from?

A

brain, skull and superficial parts of neck and face

30
Q

What is the course of the IJV?

A

From the earlobe, across the angle of mandible to the middle of the clavicle, passing deep to the SCM then joins the subclavian

31
Q

What is the carotid sheath?

A

thick layer of fascia in the neck

32
Q

How do we find the carotid pulse?

A

by palpating lateral to the upper border of the thyroid cartilage and just medial to the anterior border of sternocleidomastoid

33
Q

Why should you not palpate both sides of the common carotid artery at once, or rub the vessel?

A
  • will reduce and/or compromise cerebral blood flow

- rubbing the vessel can decrease heart rate, sometimes enough to cause fainting

34
Q

At which vertebral level does the carotid birfurcation into the internal and external carotid arteries lie?

A

4th cervical vertebra

35
Q

Which laryngeal landmark lies at the level of the carotid bifurcation?

A

laryngeal prominence

36
Q

What is the significance of the vagus nerve?

A
  • descends within the carotid sheath

- gives off important branches that are involved in control of speaking and swallowing

37
Q

Explain the process of phonation (speaking)

A
  1. production of sound begins at larynx
  2. at rest, the folds of the vocal cords in the larynx are separated
  3. during phonation, they are adducted, obstructing the flow of air
  4. pressure builds up, the folds are forced apart, air escapes and then the folds then return to the adducted position
  5. rapid repetition of these movements results in vibration of the folds, giving rise to sound waves
38
Q

How do we vary pitch?

A

by altering the length and tension of the vocal folds (which alters the frequency of their vibration
these features are adjusted by the intrinsic muscles of the larynx

39
Q

What are the other functions of the larynx, besides phonation?

A

protects the lower airways and facilitates respiration

40
Q

Which cranial nerve supplies the intrinsic muscles of the larynx? What is the exception?

A
  • the inferior laryngeal branch of the recurrent laryngeal nerve
  • the cricothyroid muscle is the exception, as it is supplied by the superior laryngeal nerve
41
Q

What is the loudness of sound produced by the larynx related too?

A

the pressure of the expired air

42
Q

What is the quality/ timbre of the voice dependant on?

A

resonating chambers above the vocal cord

43
Q

What is articulation?

A

sound is broken up into recognisable vowels and consonants by movement of the lips and tougue

44
Q

Which cranial nerve supplies the muscle responsible for movements of the lip?

A

facial nerve

45
Q

Which cranial nerve supplies the muscle responsible for movements of the tongue?

A

hypoglossal nerve

46
Q

What is the function of the vagus nerve?

A

supplies both motor and sensory fibres to the larynx

47
Q

What branches does the vagus nerve give off to the larynx ?

A
  1. superior laryngeal nerve

2. recurrent laryngeal nerve

48
Q

Where does the left recurrent laryngeal nerve arise?

A

Arises from the vagus to the left of the arch of the aorta

49
Q

Which artery is the recurrent laryngeal nerve closely related too?

A

Inferior thyroid artery – a branch of the thyrocervical trunk, which arises from the first part of the subclavian artery

50
Q

Which artery is the superior laryngeal nerve closely related too?

A

Superior thyroid artery – a branch of the external carotid artery

51
Q

What does the internal laryngeal branch supply?

A

supplies sensation to the mucosa from the epiglottis

52
Q

What are the 3 subdivisions of the pharynx and what separates them?

A 
1. nasopharynx
separated by roof of soft palate
2. oropharynx
separated by superior border of epiglottis
3. laryngopharynx
53
Q

Explain the first stage of swallowing

A
  • voluntary
  • food is moistened with saliva and masticated
  • bolus of food travels from oral cavity into the oropharynx
54
Q

What are the four muscles of mastication?

A
  1. masseter
  2. temporalis
  3. medial pterygoid
  4. lateral pterygoid
55
Q

What nerve are the muscles of mastication innervated by?

A

the mandibular branch of the trigeminal nerve (CNV)

56
Q

Explain the remainder stages of swallowing

A
  • involuntary
  • controlled by a series of reflexes involving cranial nerve IX and X
  • laryngeal pharynx opens
  • epiglottis tilts downwards
  • bolus moves into oesophagus
  • laryngeal pharynx closes
57
Q

Which cranial nerve supplies sensory fibres to the posterior third of the tongue and the oropharynx?

A

glossopharyngeal nerve

58
Q

When the bolus comes into contact with the soft palate, it tenses. wHY?

A

To prevent aspiration

59
Q

What are the muscles of the pharynx and soft palate innervated by?

A

pharyngeal plexus

60
Q

What is the pharyngeal plexus formed from?

A
  • the pharyngeal branch of the glossopharyngeal nerve (CN IX)
  • the pharyngeal brach of the vagus nerve
  • autonomic fibres
61
Q

Are the vocal cords open or closed when we swallow?

A

tightly closed

62
Q

What happens to the vocal cords when we breath?

A

they abduct/ open

63
Q

What happens to the vocal cords when we speak?

A

air causes the vocal folds to vibrate between open and closed positions when we talk

C&M Neuroanatomy (44 decks)

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