Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*RACS ENT Fellowship > Anatomy - Neck > Flashcards

Anatomy - Neck Flashcards

1
Q

PREVERTEBRAL MUSCULATURE

Muscles

A
  1. Rectus Capitis Anterior RCA and RCL lie side-by-side
    * Lat mass of atlas to front of foramen magnum
  2. Rectus Capitis Lateralis
    - Lat mass of atlas to jugular process of occipital bone
  3. Longus capitis
    - Anterior tubercle C3-6 to basiocciput
    - Insert in line with Scalenus Anterior
  4. Longus Colli 3 sets of fibres
  5. Upper - Anterior tubercle atlas to TP C3-5
  6. Middle - C2-4 bodies to TP C7-T3
  7. Lower - T1-3 bodies to TP C5-6
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

PREVERTEBRAL MUSCULATURE

Nerve supply

A

Nerve supply:

RCA/RCL - Anterior ramus of C1

Longus capitis - Anterior rami C1-4

Longus colli - Segmental supply from anterior rami

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PREVERTEBRAL MUSCULATURE

Draw

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Lingual Nerve

Course (& relations in infratemporal fossa)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cervical Plexus

Definition & location

A

Cervical Plexus:

  • Anterior rami of C1-5
  • Deep to Prevertebral fascia, lies on surface of scalenus anterior (in series with brachial plexus)
  • Proprioceptive fibres to SCM (C2-3), Trapezius (C3-4)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cervical Plexus

Branches (Muscular)

A

Cervical plexus nerves - muscular

  1. C1 loop (hitchhiking) - joins XII -> superior root of ansa, and thyrohyoid & geniohyoid
  2. C2/3 & C3/4 - to SCM & trap (mostly proprioceptive)
  3. Inferior root of ansa cervicalis - C2/3, spirals lateral to IJV
  4. Phrenic - C4 (3/5) - over scalenus anterior, behind PVF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cervical Plexus

Branches (Cutaneous)

A

Cervical plexus nerves - cutaneous

  1. Lesser occipital - C2 - hooks around XI, skin post neck / sup nuchal line
  2. Great auricular nerve - C2/3 - skin AOM / parotid fascia, auricle - cranial & lower lateral
  3. Transverse cervical nerve - C2/3, midline of neck chin - sternum
  4. Supraclavicular - C3/4 - lower neck / shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Supra & Infra Hyoid muscles

Muscles

Origin & Insertion

Innervation

A

Suprahyoid muscles:

  1. Mylohyoid- Mylohyoid line to hyoid and midline raphe, post 1/4 into body hyoid
    - N. to Mylohyoid (V3) from IAN
  2. Geniohyoid- genial tubercle to body of hyoid (deep to MH)
    - C1 direct branch (hitch-hiking XII)
  3. Digastric- medial mastoid tip to lesser horn of hyoid to digastric fossa (inf surface of mandible)
    - ABD - N to MH (V3), PBD - VII
  4. Stylohyoid- High/posterior styloid to lesser horn of hyoid (straddles PBD)
    - VII

Infrahyoid muscles:

  1. Sternohyoid- Hyoid to undersurface of manubrium
  2. Omohyoid- Hyoid, intermediate tendon, transverse scapular lig
  3. Sternothyroid- deep to S/H, oblique line of thyroid cartilage to sternum
  4. Thyrohyoid
    - 1-3 supplied by ansa, 4 by C1 fibres (hitch-hiking XII)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Layers of Cervical fascia

Superficial

A

Superficial

  • Encases platysma
  • Extends to the face as SMAS layer, up to zygomatic arch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Layers of Cervical fascia

Deep

A

Deep

1. Superficial layer-

a. 2 glands (SM/Parotid, separated by Stylomandibular lig
b. 2 muscles- SCM and Trapezius
c. 2 spaces- supraclavicular, suprasternal space of Burns
d. Att to - hyoid, sup nuchal line, mandible, zygomatic arch, spine scapula, lat clavicle, jug notch.
e. Forms stylomandibular lig, sling for omohyoid to clavicle (see fig), forms clavipectoral fascia (pierced by EJV)

2. Middle layer-

a. Muscular- surrounds infrahyoid straps. Hyoid - clavicle/sternum
b. Visceral- surrounds trachea/thyroid/oesophagus/pharynx. Includes BP fascia
- Continuous with aortic arch and fibrous pericardium

3. Deep layer-

a. Alar - BOS-T2 (joins with visceral layer of MLDCF)
b. Prevertebral - BOS-Coccyx. Invests phrenic, brachial plexus, vertebral/subclavian vessels (not vein) and gives rise to Axillary

Sheath

Pierced by 4 br of cervical plexus (Great auricular, Lesser Occipital, Transverse Cervical, supraclavicular)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cervical Fascia

Label layers and structures:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Deep Neck Spaces

  1. Entire Neck

Boundries & Contents

A

Entire neck

  1. Superficial - Deep to platysma. Contains fat, LNs, EJV
  2. Retropharyngeal - Visceral MLDCF in front, alar DLDCF behind. Down to T2 where these layers meet.

X-Ray measurements 7, 14, 21:

  • C2 <7mm
  • C6 <14mm (child <15yrs)
  • C6 <21mm (adult)
    3. Danger - BOS —> diaphragm. Between alar and prevertebral region
    4. Visceral Vascular - Carotid sheath formed by contributions from each layer of DCF
    5. Prevertebral - BOS —> coccyx
  • Prevertebral muscles - longus capitis/colli, scalenes - ant/mid/post
  • Nerves - Phrenic, brachial plexus
  • Vessels - Vertebral artery/vein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Deep Neck Spaces

  1. Suprahyoid

Boundries & Contents

A

Above Hyoid

  1. Peritonsillar - Tonsil capsule, sup constrictor, ant/post tonsil pillars
  2. Parapharyngeal - see separate card
  3. Parotid - enclosed within the parotid fascia (splitting of the SLDCF)
  4. Submandibular
    - Subdivided to the Sublingual and Submandibular by the mylohyoid
    - Sublingual: mandible, mylohyoid, genioglossus/geniohyoid, FOM mucosa
    - Contents - XII, Lingual N, IX, Lingual artery/vein, SLG, SM duct and deep part of SMG
    - Submandibular: mandible, hyoid, mylohyoid, SLDCF
    - Contents - SM gland, facial artery/vein, LNs, fat, digastric muscles
  5. Temporal - continuous w. masticator, temporalis muscle divides into superficial & deep
  6. Masticator
    - SLDCF splits to encompass the muscles of mastication:
    - Contents - LP, MP, masseter, IAN, body / ramus mandible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Deep Neck Spaces

  1. Infrahyoid

Boundries & Contents

A

Below Hyoid

  1. Pretracheal
    - aka anterior visceral space, enclosed by visceral MLDCF, thyroid cart -> arch aorta
  2. Suprasternal space of Burns
  3. Supraclavicular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Carotid Shealth

Define

Relationships

Contents

A

Arch of aorta to skull base

Comprised of fascia from all 3 layers of deep cervical fascia

Relationships:

Medial - pharynx

Lateral - deep lobe parotid, styloid apparatus

Anterior - ITF

Posterior - cervical SNS trunk and prevertebral fascia

Contents:

  1. ICA
  2. IJV
  3. X- lies deep in the groove between the IJV and ICA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Carotid Sheath

Relationship to Lower Cranial Nerves

A

Lower Cranial Nerves:

IX - Emerges between IJV/ICA and curves medially between forks of ICA/ECA

X - Travels within carotid sheath, deep in groove between IJV/ICA

XI - Emerges between IJV/ICA and curves laterally anterior to IJV

  • 90% in front of IJV, 5% behind, 5% through

XII - Emerges from hypoglossal canal medial to sheath

  • Curls down behind inferior vagal ganglion and forward around ICA/ECA deep to IJV

Rules:

  • Always arteries deep, veins superficial
  • Runs just above greater horn of hyoid and passes forward on hyoglossus (deep to mylohyoid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Structures running between ECA & ICA bifurcation

A

Passing between the forks of the ICA/ECA:

  1. Styloid process and stylohyoid lig
  2. Styloglossus and Stylopharyngeus
  3. CN IX
  4. Pharyngeal branch of CN X
  5. Tract of a branchial fistula
18
Q

PARAPHARYNGEAL SPACE

Boundaries

Divisions

A

Def: An inverted pyramid shape

Potential space lateral to upper pharynx, filled with fat and areolar tissue

Boundaries

Superior (base) - base of skull (temporal/sphenoid)

Inferior (apex) - junction of digastric tendon with lesser horn of hyoid

Anterior - Pterygomandibular raphe and medial pterygoid fascia

Posterior - Pre-vertebral fascia

Medial - Buccopharyngeal fascia overlying sup constrictor and pharyngobasilar fascia. Fascia from TVP to medial pterygoid

Lateral - Fascia overlying medial pterygoid, mandibular ramus, PBD and deep lobe of parotid

Division is by the Styloid process

tensor-vascular-styloid fascia

  1. Prestyloid - Fat, deep lobe parotid, LNs, Styloglossus, Stylopharyngeus, V3 branches, TVP, LVP, IMA, asc palatine a, asc pharyngeal a
  2. Post-styloid - Cartoid sheath (ICA, IJV, X), SNS trunk, IX, XI, XII, IMA, paraganglionic tissue
19
Q

PARAPHARYNGEAL SPACE

Communcations

Pathology

A

Communications

Medial - peritonsillar space

Anterolateral - Masticator space

Posteromedial - Retropharyngeal space

Inferomedial - Submandibular space

Lateral - Parotid space

Posterior - Carotid sheath contents

Superior - ITF

Pathology:

80% benign, 20% malignant (mostly salivary)

20
Q

Temporal Fossa

Boundries

Superficial temporal line

Contents

A

Boundaries:

Superiorly - by the superior temporal line.

Inferiorly - zygomatic arch (arbitrary designation)

Floor - bones of the lateral aspect of the skull, including a portion of the frontal, GW sphenoid, the temporal, and the parietal bones

Separated inferior from infratemporal fossa by the infratemporal crest of the greater wing of sphenoid

Superior temporal line:

Anteriorly - Zygomatic process of the frontal bone

Arches posteriorly over the parietal bone before descending to the temporal bone, where it blends into the zygomatic process

Attachment of temporalis fascia

Vertical groove on squamous temporal bone = superficial temporal vessels

Contents:

Temporalis muscle - attaches superiorly to inferior temporal line

21
Q

INFRATEMPORAL FOSSA

Boundaries

Contents

A

A space lying beneath the base of skull between side wall of pharynx and ramus of mandible

Boundaries

Superior - IT surface of greater wing of sphenoid, Squamous temporal bone

  • Continous with temporal fossa laterally (infratemporal crest marks this transition)

Inferior - Opens into the neck

Anterior - Posterior surface of maxilla and IOF

Posterior - Upper carotid sheath

Medial - Lateral surface of lateral pterygoid plate, TVP/LVP/superior constrictor, pterygomaxillary fissure (connects to PPF)

Lateral - Ramus of mandible and its coronoid process

Contents:

Medial pterygoid

Lateral pterygoid

Insertion of temporalis into coronoid process

Internal maxillary artery

Pterygoid venous plexus

V3 and branches (+ otic ganglion, chorda tympani)

PSAN (of V2)

22
Q

MUSCLES OF MASTICATION

Origins & insertions

A

1. Medial pterygoid

  • Origin
  • Deep head: Medial surface LPP, fossa between MPP/LPP
  • Superficial head: maxillary tuberosity and pyramidal process of palatine bone
  • Insertion
  • Angle of mandible (broad insertion)

2. Lateral pterygoid

  • Origin
  • Upper head - Infratemporal surface of skull (GW sphenoid)
  • Lower head - Lateral surface of LPP
  • Insertion
  • Pterygoid fovea (beneath medial end of mandibular head)
  • Articular disc and capsule of TMJ
    3. Temporalis
  • Origin - Temporal fossa
  • Insertion - Coronoid process and down ramus to buccinator insertion
    4. Masseter
  • Origin - Zygomatic arch
  • Insertion - 3 heads of masseter fuse anteriorly
  • Posteriorly they diverge from one another
  • Superficial - broad attachment - body, angle, ramus
  • Intermediate - ramus
  • Deep - ramus
  • Between the heads: sup / intermed = masseteric artery, intermed / deep = masseteric nerve
23
Q

Int Maxillary Artery

Parts & their boaders

A

Terminal branch of ECA (with superficial temporal a.)

Winds around neck of mandible and passes fwd between neck and sphenomandibular lig

3 parts: before, on and beyond lateral pterygoid muscle

24
Q

Int Maxillary Artery

1st part

A

1st part: all through bony foramina

  1. Inferior alveolar a. - mandibular foramen
  2. Middle meningeal a. - foramen spinosum
  3. Accessory meningeal a. - foramen ovale
  4. Deep auricular a. - through bony-cartilagenous junction of EAC (tympanosquamous fissure - schultz notes)
  5. Anterior tympanic a. - petrotympanic fissure
25
Q

Int Maxillary Artery

2nd part

A

2nd part: muscular branches

  1. Medial pterygoid
  2. Lateral pterygoid
  3. Temporal
  4. Lingual Nerve branch (check)
  5. Buccal Nerve branch
26
Q

Int Maxillary Artery

3rd Part

A

3rd part: all through bony foramina in PPF

  1. Posterior superior alveolar a.- foramina in posterior wall of maxilla
  2. Greater palatine a.- greater palatine foramen
  3. Pharyngeal a.- Palatovaginal canal
  4. A. of Vidian canal- Vidian canal
  5. Infraorbital a - infraorbital foramen

Artery then leaves sphenopalatine foramen, changing its name

27
Q

Pterygopalatine Fossa

Draw structure and communications

A
28
Q

Pterygopalatine Fossa

Draw structure and communications & contents

A
29
Q

Pterygopalatine Ganglion

Branches

A

Branches of the Pterygopalatine Ganglion:

  1. Nasopalatine N - SP foramen
    - Septum + incisive gum of hard palate (descends down incisive foramen)
  2. Lat Post Sup Nasal Ns - SP foramen
    - Postersup quadrant of LNW
  3. Greater Palatine N - GP foramen/canal (junction of maxilla and palatine bone)
    - Mucosa of hard palate
    - Nasal branches - posteroinf quadrant LNW + med wall max sinus
  4. Lesser Palatine Ns - Lesser palatine foramina (behind GPN)
    - Soft palate and tonsil mucosa
  5. Pharyngeal N - Palatovaginal canal
    - Nasopharynx mucous membrane
  6. Orbital branches - IOF
    - Orbital periosteum, orbitalis muscle
    - Sphenoid/ethmoid sinuses
30
Q

Pterygopalatine Fossa

Boundries

A

Lies between back of maxilla and pterygoid process of sphenoid

Boundaries:

  1. Posterior - sphenoid bone - a. root of pterygoid process (incl Vidian Canal), b. greater wing (incl Foramen Rotundum)
  2. Medial - palatine bone (incl notch for SP foramen)
  3. Anterior - posterior wall of maxilla - leads to IOF
  4. Roof - a. body of sphenoid, b. orbital process of palatine bone
  5. Lateral - pterygomaxillary fissure (leads to ITF)
31
Q

Pterygopalatine fossa

Contents

A

Contents:

  1. V2
    - Meningeal branch (to MCF)
    - Zygomatic Nerve (arises in PPF and runs to IOF above V2), takes the secretomotor fibres from the ganglion (pass to lacrimal gland via Lacrimal branch of V1)
    - Post Sup Alveolar N - Exits via Pterygomaxillary Fissure to posterior surface of maxilla
    - V2 exits through IOF to become ION
    - Ganglionic branch
  2. Pterygopalatine Ganglion
    - Connected to V2 by short trunk (inf/med to V2)
    - Only cell bodies are PSNS (SNS and sensory fibres ‘relay station’)
    - Autonomic root is Vidian N (PSNS- GSPN, SNS- ICA plexus via DPN)
    - Fibres arise in Superior Salivary Nucleus
  3. Maxillary Artery 5 branches accompany the 5 nerves of the PPG
    - Vessels lie in front of nerves
32
Q

Tongue

Definition, parts, papillae, folds

A

Mass of skeletal muscle with midline fibrous septum covered by mucous membrane

  • Keratinising stratified squamous epithelium

Parts of the tongue:

  • Dorsum, tip, ventral surface, base (BOT is oropharynx not oral cavity)

Papillae:

  1. Filiform- velvety appearance
  2. Fungiform- discrete pink pinheads (bears the taste buds)
  3. Circumvallate- 12, form a V in front of sulcus terminalis (marks division of oral cavity and oropharynx

Folds:

Median glossoepiglottic, lateral glossoepiglottic

33
Q

Tongue

Muscles

A

Muscles:

1. Intrinsic x4 shape no bony attachments

  • longitudinal (sup/inf), vertical, transverse

2. Extrinsic x 4 position

  • Genioglossus - bulk of tongue. Genial tub to mucous memb + hyoid (i.e. geniohyoglossus)
  • Hyoglossus - length of greater horn/body of hyoid (free ant + post borders)
  • Styloglossus - low/ant styloid to interdig with hyoglossus
  • Palatoglossus - undersurface of palate to interdig with styloglossus
34
Q

Tongue

Blood supply

& Course of Lingual Artery

A

Blood supply:

Lingual A. - above greater horn of hyoid

  • Dorsal lingual branches to posterior tongue

Asc Pharyngeal, tonsil branches of Facial- small contributions

Lingual v. - tributaries run with Lingual a.

Deep Lingual v. (visible in FOM) + sublingual v. — vena comitants of XII

35
Q

Tongue

Nerve supply

A

Nerve supply:

Anterior 2/3 - sensation- Lingual N., Taste- chorda tympani

Posterior 1/3 - IX (sensation + taste), X (internal branch of SLN- ant valleculla)

Motor - all CN XII except palatoglossus (pharyngeal plexus)

** taste travels to nucleus tractus solitarius

36
Q

Tongue

Embryology

A

Embryology:

Appears during Week 4 - as the tuberculum impar.

2 lateral swellings appear either side of the tuberculum —> fuse to form the midline fibrous septum (Arch I)

Base of tongue is formed from the hypobranchial eminence (Arch III). This joins with the lateral swellings at the sulcus terminalis to form the tongue

Tongue muscles derived from suboccipital myotomes (ie not supplied by branchial arch nerves - XII instead)

Migrate forward into the sac of mucous membrane derived from arches I, III, IV

37
Q

Mucosa of the upper aerodigestive tract

Definintion

A

Mucosa definition:

Mucosa / mucous membrane is lining consisting of epithelium and an underlying connective tissue (lamina propria)

38
Q

Mucosa of the upper aerodigestive tract

Nose

Nasopharynx

A

Nasal cavity

Vestibule = keratinising stratified squamous epithelium

Nasal cavity = ciliated pseudostraified columnar epithelium, also contains goblet cells

Olfactory epithelium = olfactory cells, supporting cells, basal cells, brush cells

Nasopharynx

Ciliated pseudostraified columnar epithelium

Adenoid = Ciliated pseudostraified columnar epithelium

39
Q

Mucosa of the upper aerodigestive tract

Oral cavity

Oropharynx

Hypopharynx

A

Oral cavity

Masticatory surfaces: gingiva, hard palate, dorsum of tongue ant 2/3 (ectodermal origin) = keratinising stratified squamous epithelium

Other surfaces = non-keratinising stratified squamous epithelium (eg. labial, buccal, alveolar)

Specialised mucosa: Filiform papillae = tips are partially keratinised, Fungiform/foliate papillae = non-keratinised

Oropharynx

Palatine + lingual tonsils = non-keratinising stratified squamous epithelium

Tonsil crypts = lymphoepithelium (single layer squamous epithelium)

Dorsum of tongue (post 1/3) / circumvalate papilla (Endodermal origin) = non-keratinising stratified squamous epithelium

Hypopharynx

Non-keratinising stratified squamous epithelium

40
Q

Mucosa of the upper aerodigestive tract

Larynx

Trachea

Bronchioles

Oesophagus

A

Larynx

Cilated pseudostratified columnar epithelium EXCEPT

Vocal folds = stratified squamous epithelium (transition point is superior and inferior arcuate line)

Epiglottis:

Lingual + apical laryngeal surface = non-keratinising stratified squamous epithelium

Laryngeal surface = ciliated pseudostraified columnar epithelium

Trachea

Ciliated pseudostratified columnar epithelium

Terminal bronchioles

Non-ciliated simple cuboidal epithelium

Oesophagus

Non-keratinising stratified squamous epithelium

Abrupt transition to simple columnar epithelium of stomach @ gastro-oesophageal junction or Z-line

Z-line is 3cm proximal to lower oesophageal sphincter

41
Q
A

*RACS ENT Fellowship (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions