Anat of head and neck Flashcards by Rachel Muxlow

What are the layers of scalp?

SCALP
Skin
Cutaneous tissue - dense
Epicranial aponeurosis/galea aponeurotica
Loose areolar tissue
Pericranium

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What is a risk in superficial scalp lacerations?

Severe bleeding because of arteries in 2nd layer cannot retract

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What is the function of the epicranial aponeurosis?

Connect 2 frontalis bellies and 2 occipitalis bellies of occipitofrontalis muscle

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What is a risk of a laceration through the aponeurosis?

Wide, gaping wound in scalp

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What is the action of the frontalis muscle?

Elevation of eyebrows

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What innervates the frontalis muscle?

Temporal branch of the facial nerve

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What is the action of the occipitalis muscle?

Pulls scalp posteriorly and wrinkles skin on posterior neck

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What is the innervation of the occipitalis muscle?

Posterior auricular branch of the facial nerve

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What can occur in the loose areolar tissue layer?

Distension with fluid from injury or infection

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What is the significance of the loose areolar tissue layer?

Emissary veins though parietal foramen do not have valves - can carry infection into the brain - dangerous area of scalp

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What is the pericranium?

Periosteum covering outer surface of skull bones

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What can occur at the pericranium level?

Cephalhematoma - between pericranium and calvaria

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What causes a black eye/periorbital ecchymosis?

Extravasation of blood in 4th layer of scalp that gravitates down into eyelids because frontalis has no bony attachments

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What arteries go to the scalp in front of the auricle?

Supratrochlear
Supraorbital
Superficial temporal

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What arteries go to the scalp behind the auricle?

Posterior auricular
Occipital

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What veins make up the dangerous area of the face?

Supratrochlear vein and Supraorbital vein into Angular vein into Facial vein

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What does the retromandibular vein divide into?

Anterior and posterior divisions

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What forms the common facial vein?

Anterior division of retromandibular and facial vein

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What forms the subclavian vein from the head?

Posterior division of retromandibular and posterior auricular vein

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What does the occipital vein go into?

Sub-occipital plexus

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What does the common facial vein go to?

Internal jugular vein

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What does the posterior auricular vein become?

External jugular vein

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What nerves go in front of the auricle?

Supratrochlear
Supraorbital
Zygomaticotemporal
Temporal branch of facial
Auriculotemporal

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What nerves branch off from ophthalmic trigeminal for the scalp?

Supratrochlear
Supraorbital

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What nerve branches off from maxillary trigeminal for the scalp?

Zygomaticotemporal

What nerve branches off from mandibular temporal for the scalp?

Auriculotemporal

What nerves innervate the scalp behind the auricle and where do they branch from?

Great auricular Posterior auricular Lesser occipital Greater occipital Third occipital Posterior rami of C2-C3

What nerves branch off of ophthalmic trigeminal for the face?

Infratrochlear Lacrimal External nasal

What nerves branch off of maxillary trigeminal for the face?

Infraorbital Zygomaticofacial

What nerves branch off of mandibular trigeminal for the face?

Mental Buccal

What lymph nodes does the upper facial area drain into?

Preauricular/superficial parotid

What lymph nodes does the intermediate area of the face (maxillary) drain into?

Submandibular

What lymph nodes does the lower area (mandibular) area of the face drain into?

Submental

How much of saliva production is done by the parotid glands?

25%

What is the path of the parotid duct?

From anterior parotid gland, along masseter, and opens opposite to second upper molar tooth

What nerve innervates the the parotid?

Glossopharyngeal to lesser petrosal to relay in otic ganglion then into auriculotemporal nerve to the parotid

What are the structures within the parotid gland?

FRE: -Facial nerve -Retromandibular vein -ECA

What is another name for parotitis?

Mumps

What are clinical signs of parotitis/mumps?

Swelling of parotid gland Pain with compression of gland Paresis of five terminal branches of facial nerve

What are complications for parotitis/mumps?

Orchitis Meningitis

What is Frey's/Baillarger's syndrome?

Sweating and flushing of skin along distributions of the auriculotemporal nerve

What causes Frey's/Baillarger's syndrome?

After trauma or surgery auriculotemporal nerve that is supposed to innervate parotid reattaches to sweat glands in same region

What is the main artery of the face?

Facial artery

What is the path of the facial artery?

From external carotid around inferior mandible into face

What is an area of compression for the facial artery?

Anterior to masseter muscle

What arteries branch off from facial artery?

Superior and inferior labial arteries Angular artery Superficial temporal

What arteries branch off from internal carotid and go to the face and scalp?

Supraorbital Supratrochlear

What vein drains the face?

Facial vein

What part of the orbicularis oculi gently closes the eye?

Palpebral part

What part of the orbicularis oculi aids in draining tears?

Lacrimal part

What part of the orbicularis oculi tightly closes the eye?

Orbital part

What is the function of the buccinator?

Chewing, blowing, whistling

What nerve innervates the buccinator?

Facial nerve

What are the branches of the facial nerve?

Temporal Zygomatic Buccal Marginal mandibular Cervical

What are the branches of the trigeminal nerve?

Ophthalmic Maxillary Mandibular

What nerve innervates angle of the jaw?

Great auricular nerve from cervical plexus

What is the test for the temporal branch of the facial nerve?

Frown and wrinkle forehead

What is the test for zygomatic branch of the facial nerve?

Close eyes tightly

What is the test for the buccal branch of the facial nerve?

Puff up cheeks Smile and show teeth

What is the test for the cervical branch of the facial nerve?

Neck stress - platysma

What is a test of the marginal mandibular branch of the facial nerve?

Muscles of lower lip and chin

What are clinical features of Bell's palsy?

Transverse wrinkles of forehead disappear and eyebrows droop Eyeball of effected side rolls up with trying to close eyes Food gets accumulated in vestibule of mouth Speech and pursing of lips may be affected Angle of mouth remains motionless on effected side while smiling

What nerve is affected in Bell's palsy?

Facial nerve

What are possible causes of Bell's palsy?

Sudden exposure to cold Middle ear infections Fractures or tumors

What are ligaments of the TMJ?

Capsular ligament Lateral/temporomandibular ligament Sphenomandibular ligament Stylomandibular ligament

What type of joint is the TMJ?

Synovial bi-condylar - modified hinge

What nerves supply the TMJ?

Auriculotemporal nerve from posterior mandibular Masseteric nerve from anterior mandibular

What arteries run along the TMJ?

Superficial temporal artery Maxillary artery

What are the muscles of mastication?

Temporalis Masseter Lateral pterygoid Medial pterygoid

What innervates the muscles of mastication?

Mandibular division of trigeminal nerve

What are the three layers of deep cervical fascia?

Investing layer Pre-tracheal layer Prevertebral layer

What layer of deep cervical fascia surrounds the entire neck?

Investing layer

What layer of deep cervical fascia is limited to anterior neck from hyoid into thorax?

Pre-tracheal layer

What layer of deep cervical fascia continues with fibrous pericardium?

Pre-tracheal layer

What are the two parts of the pre-tracheal layer?

Muscular part Visceral part

What is the function of the muscular part of the pre-tracheal layer?

Encloses infrahyoid muscles

What is the function of the visceral part of the pre-tracheal layer?

Encloses thyroid gland, trachea, esophagus

What continues with the buccopharyngeal fascia of the pharynx?

Visceral part of the pre-tracheal layer of the deep cervical fascia

What is the function of the prevertebral layer of deep cervical fascia?

Tubular sheath for vertebral column and associated muscles

What structures pierce the carotid sheath?

External carotid Most tributaries of internal jugular vein 9th,11th, and 12th branches of the vagus nerve CNX

What makes up the retropharyngeal space?

Anterior - buccopharyngeal fascia Posterior - prevertebral fascia Carotid sheaths laterally Superiorly - base of skull Inferiorly - superior mediastinum of thorax

What is the function of retropharyngeal space?

For expansion of pharynx during deglutition

What is contained in the retropharyngeal space?

Loose areolar tissue Pharyngeal plexus of nerves and vessels

What makes up the roof of the posterior triangle?

Skin, superficial fascia, platysma, investing layer of deep cervical fascia

What structure is related to the roof of the posterior triangle?

External jugular vein

What are the nerves associated with the posterior triangle?

Lesser occipital Greater auricular Transverse cervical Supraclavicular Spinal accessory

What are the two subdivisions of the posterior triangle?

Occipital Supraclavicular

What makes up the floor of the occipital trangle?

Semispinalis, splenius capitus, levator scapulae, scalenus medius and posterior

What makes up the floor of the supraclavicular triangle?

Outer border of first rib, scalenus medius, first digitation of serratus anterior

What is Erb's point?

Region in upper trunk of brachial plexus where 6 nerves meet

What nerves meet in Erb's point?

C5, C6, suprascapular nerve, anterior and posterior nerve to subclavius

What is the first nerve to be damaged in posterior triangle neck surgeries?

Spinal accessory nerve

What are the actions of the sternocleidomastoid?

Flexion and rotation of neck Accessory muscle of respiration

What is a wry neck?

Applied spasm of sternocleidomastoid

What is torticullis?

Applied spasm of sternocleidomastoid and trapezius

What are signs of wry neck or torticollis?

Elevation of shoulder on affected side Stiffness and shortening of the neck muscles Limited ROM of neck

When is common to see enlargement of the Virchow's group of lymph nodes?

Malignant growth from stomach, testis, left thorax, other abdominal organs

What are the Virchow's group of lymph nodes?

Deep group of cervical/supraclavicular lymph nodes

What are the contents of the anterior triangle?

Carotid artery and its branches Internal jugular vein and its tributaries Four cranial nerves (1-12) - ansa cervicalis Submandibular and part of parotid

What are the anterior branches of the external carotid in the neck?

Superior thyroid Lingual Facial

What are the posterior branches of the external carotid in the neck?

Occipital Posterior auricular

What is the medial branch of the external carotid in the neck?

Ascending pharyngeal

What are the terminal branches of the external carotid off of the facial branch?

Maxillary Superficial temporal

Anat of head and neck Flashcards

(103 cards)