Applied Anatomy and Physiology of the Neck

Question 1

What is the pterion?

Answer 1

Area of weakness in the skull, point at which frontal, parietal, sphenoid and temporal bones join together.

Question 2

Which artery may be affected if there is trauma or injury to the pterion?

Answer 2

Middle meningeal artery

Question 3

What may happen the middle menigeal artery is injured?

Answer 3

Extradural or epidural haematoma

Question 4

How many cervical vertebrae are there?

Answer 4

7

Question 5

Which muscle server ates the anterior and posterior triangles of the neck?

Answer 5

Sternocleidomastoid muscle

Question 6

Muscles that are suprahyoid are found above the hyoid bone. Name the suprahyoid muscles.

Answer 6

Stylohyoid
Genitohyoid
Mylohyoid
Digastric

Question 7

Muscles that are infrahyoid are found below the hyoid bone. Name the infrahyoid muscles.

Answer 7

Sternohyoid
Sternothyroid
Thyrohyoid
Omohyoid

Question 8

Name the four subdivisions of the anterior triangle.

Answer 8

Muscular triangle
Carotid triangle
Submandibular triangle
Submental triangle

Question 9

Name the arteries found in the anterior triangle.

Answer 9

Common carotid- branches to give ECA and ICA
Superior thyroid artery
Inferior thyroid artery

Question 10

Name the veins found in the anterior triangle.

Answer 10

Anterior jugular veins
Inferior jugular veins
Superior thyroid vein
Middle thyroid veins

Question 11

Name the nerves found in the anterior triangle.

Answer 11

Vagus nerve
Hypoglossal nerve
Part of sympathetic trunk

Question 12

Sorry, don’t hate me…want to try and name the branches of the external carotid artery?

There’s eight… use this pneumonic:
Some Anatomists Like Freaking Out Poor Medical Students

Answer 12

Superior thyroid artery
Ascending pharyngeal artery
Lingual artery
Facial artery
Occipital artery
Posterior auricular artery
Maxillary artery
Superficial temporal artery

Question 13

What would you find in the area of the carotid bifurcation (approx. C4)?

Answer 13

Carotid body
Carotid sinus

Question 14

What is the role of the carotid sinus?

Answer 14

Dilation, acts as as baroreceptor for detecting blood pressure

Question 15

What is the role of the carotid body?

Answer 15

Chemoreceptor which detects acid based disturbances

Question 16

What is the anterior border of posterior triangle?

Answer 16

Sternocleidomastoid

Question 17

What is the posterior border of the posterior triangle?

Answer 17

Trapezius muscle

Question 18

What is the inferior border of the posterior triangle?

Answer 18

Middle 1/3 of clavicle

Question 19

Name the two divisions of the posterior triangle.
Which muscle separates these two divisions?

Answer 19

Occipital triangle
Subclavian triangle

Separated by omohyoid muscle

Question 20

What are the muscles of the posterior triangle?

Answer 20

Sternocleidomastoid
Splenius capitis
Levator scapulae
Anterior scalene
Middle scalene
Trapezius

Question 21

Name the most prominent artery of the posterior triangle.

Answer 21

Subclavian artery (third part)

Question 22

Name the vein found in the posterior triangle.

Answer 22

External jugular vein

Question 23

Name the nerves found in the posterior triangle.

Answer 23

Accessory nerve
Branches of cervical plexus
Upper brachial plexus

Question 24

A patient needs a lymph node biopsy from the posterior triangle of the neck.
Which nerve will the doctor have to be careful not to damage?

Answer 24

Accessory nerve

Question 25

What would happen if the accessory nerve was accidentally damaged when taking a lymph node biopsy?

Answer 25

Palsy Patient unable to shrug shoulders

Question 26

Name the two groups of lymphatic vessels which drain the head and neck.

Answer 26

Superficial lymph nodes Deep lymph nodes

Question 27

Where do the superficial lymph nodes drain?

Answer 27

Scalp, face and neck

Question 28

Where do superficial vessels then drain into?

Answer 28

Superficial ring of lymph nodes found at junction of head and neck.

Question 29

Where do the deep lymph nodes arise from and then what do they go onto form?

Answer 29

Arise from deep cervical lymph nodes. Converge to form right and left jugular lymphatic trunks

Question 30

What does the left jugular lymphatic trunk do?

Answer 30

Combines with thoracic duct at root of neck. Empties into venous system via left subclavian vein.

Question 31

What does the right jugular lymphatic duct do?

Answer 31

Forms right lymphatic duct at root of neck. Empties into venous system via right subclavian vein.

Question 32

Name the superficial groups of lymph nodes.

Answer 32

These are some of the ones felt in general examination! Occipital Pre auricular Post auricular Parotid Submental Submandibular

Question 33

Superficial nodes drain into deeper nodes. Name the deeper nodes.

Answer 33

Prelaryngeal Jugulodigastric (tonsilar) Subclavicular

Question 34

Virchow's node if seen in the left subclavicular nodes. What is the significance of this node?

Answer 34

Receives drainage from the abdomen- significant clinically as if enlarged, may suggest abdominal malignancy

Question 35

Name the first line of defence against microbes which enter the body via nose and mouth.

Answer 35

Waldeyer's Ring- oropharyngeal mucosa covering lymphatic tissue

Question 36

Name the lymphatic tissues found in Waldeyer's Ring.

Answer 36

Lingual tonsil Palatine tonsil Tubal tonsil Pharyngeal tonsil

Question 37

Which tonsils can be seen when looking inside someone's mouth?

Answer 37

Palatine tonsils

Question 38

If someone has tonsillitis, what may happen to other lymph nodes in the head and neck?

Answer 38

May also become inflamed

Question 39

Describe the thyroid gland.

Answer 39

Butterfly shape Largest endocrine gland Midline of superior neck.

Question 40

Which level would you find the thyroid gland?

Answer 40

C5-T1

Question 41

What joins the two lobes of the thyroid gland?

Answer 41

Isthmus

Question 42

Describe the parathyroid glands.

Answer 42

Small, brown, oval glands. Posterior aspect of thyroid.

Question 43

How many parathyroid glands are there?

Answer 43

Usually 4 2x superior 2x inferior

Question 44

What does the thyroid secrete?

Answer 44

Hormones which manage metabolism (T3, T4) Secretes calcitonin

Question 45

What does calcitonin do?

Answer 45

Controls calcium homesostasis

Question 46

What do the parathyroid glands secrete?

Answer 46

Parathyroid hormones which detect low levels of calcium and phosphate when they drop.

Question 47

Which organs do the parathyroid hormones work on to restore calcium ions to maintain homeostasis?

Answer 47

Skeleton Kidneys Intestine

Question 48

What is the arterial supply for the thyroid?

Answer 48

Superior thyroid artery (first branch of EXA) Inferior thyroid artery Thyroid ima- seen in 10% of people, extra blood supply

Question 49

What are the veins for the thyroid?

Answer 49

Superior thyroid veins Middle thyroid veins Inferior thyroid veins

Question 50

What is the arterial supply for parathyroid?

Answer 50

Inferior thyroid artery

Question 51

What are veins for the parathyroid?

Answer 51

Superior thyroid veins Middle thyroid veins Inferior thyroid veins

Question 52

What is one possible complication of getting the thyroid removed?

Answer 52

Developing a large blood clot (post-operative haematoma) which could lead to stridor and respiratory arrest.