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MRCSA anatomy > Head and Neck > Flashcards

Head and Neck Flashcards

1
Q

What structures pass through the cribriform plate?

A

Olfactory (I) nerve bundles

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2
Q

What structures pass through the optic canal?

A

Optic nerve (II) including central artery of retina
Ophthalmic artery

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3
Q

What structures pass through the superior orbital fissure?

A

Oculomotor nerve (III)
Trochlear nerve (IV)
Lacrimal, front and nasociliary branches of ophthalmic nerve (V1)
Abducens nerve (VI)
Superior ophthalmic vein

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4
Q

What structures pass through foramen rotundum?

A

Maxiliary nerve (v2)

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5
Q

What structures pass through Foramen ovale?

A

O tic ganglion
V3 (Mandibular nerve:3rd branch of trigeminal)
A ccessory meningeal artery
L esser petrosal nerve
E missary veins

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6
Q

What structures pass through foramen spinosum?

A

Middle meningeal artery and vein

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7
Q

What structures pass through foramen lacerum?

A

nothing

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8
Q

What structures pass through carotid canal?

A

internal carotid artery
internal carotid nerve plexus

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9
Q

What structures pass through internal acoustic meatus?

A

facial nerve (VII)
vestibulocochlear nerve (VIII)
labyrinthine artery

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10
Q

What structures pass through jugular foramen?

A

Inferior petrosal sinus
Glossopharyngeal nerve (IX)
Vagus nerve (X)
Accessory nerve (XI)
Sigmoid sinus -> internal jugular vein
Posterior meningeal artery

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11
Q

What structures pass through hypoglossal canal?

A

Hypoglossal nerve (XII)

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12
Q

What structures pass through the foramen magnum?

A

medulla oblongata
meninges
vertebral arteries
meningeal branches of vertebral arteries
spinal roots of accessory nerves

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13
Q

What passes through the mandibular foramen?

A

inferior alveolar neurovasscular bundle

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14
Q

what does the inferior alveolar neurovascular bundle innervate?

A

mandibular teeth and supplies them with blood

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15
Q

What are the first and 2nd most commonly fractured facial bones?

A
  1. nasal bone
  2. mandible (at cuspid area and 3rd molar)
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16
Q

What sort of joint is the TMJ?

A

synovial joint between the mandibular fossa and the articular tubercle of the temporal bone and head of mandible

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17
Q

How many synovial cavities in TMJ?

A

2 separated by an articular disc of fibrocartilage

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18
Q

What is a Jefferson fracture?

A

fracture of the atlas usually across the anterior and posterior arches (method blow to top of head)

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19
Q

What is a hangman fracture?

A

fracture of the axis involving the dens or across the neural arch between superior and inferior articular facets

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20
Q

What type of joint is the Atlanto- occipital joint?

A

biaxial condyloid synovial joint between atlas and occipital condyles (nodding)

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21
Q

What type of joint is the Atlanto-axial joint?

A

uniaxial synovial joints (head turning)

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22
Q

what is the purpose of the alar internal craniocervical ligaments?

A

limit rotation

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23
Q

What are the 3 ear ossicles?

A

malleus, incus, stapes

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24
Q

Which muscles attache to the auditory ossicles?

A

tensor tympani (to malleus)
stapedius (to stapes)

dampen large vibrations

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25
Q

what is the function of the ossicles?

A

they amplify sonic vibrations from the tympanic membrane and transmit them to the inner ear

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26
Q

Where are all muscles of facial expression derived from embryologically?

A

2nd pharyngeal (branchial) arch

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27
Q

what are all muscles of facial expression innervated by?

A

terminal branches of the facial nerve (CNVII)

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28
Q

What structures pass through the parotid gland?

A

Facial nerve (Mnemonic: The Zebra Buggered My Cat; Temporal Zygomatic, Buccal, Mandibular, Cervical)
External carotid artery
Retromandibular vein
Auriculotemporal nerve

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29
Q

Anterior relations of the parotid?

A

masseter, medial pterygoid, superficial temporal and maxillary artery, facial nerve, stylomandibular ligament

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30
Q

Posterior relations of the parotid?

A

posterior belly digastric muscle, sternocleidomastoid, stylohyoid, internal carotid artery, mastoid process, styloid process

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31
Q

Innervation of the parotid?

A

Parasympathetic-Secretomotor
Sympathetic-Superior cervical ganglion
Sensory- Greater auricular nerve

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32
Q

What supplies common sensation to the anterior 2/3 of the tongue?

A

The lingual branch of the mandibular division of the trigeminal nerve

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33
Q

What nerve supplies taste to the anterior 2/3 of the tongue?

A

chorda tympani branch of the facial nerve

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34
Q

What supplies common sensation + taste to the posterior 1/3 of the tongue?

A

lingual branch of the glossopharyngeal nerve

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35
Q

Which nerve supplies the intrinsic muscles of the tongue?

A

All intrinsic muscles of the tongue are supplied by the hypoglossal nerve

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36
Q

What are the branches (in order) of the external carotid artery?

A

She Always Likes Friends Over Papa, Sister and Mama

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

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37
Q

Where does the external carotid artery terminate?

A

It terminates by dividing into the superficial temporal and maxillary arteries in the parotid gland.

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38
Q

Which lymph nodes do the lateral surface of the upper half of the ear drain to?

A

superficial parotid lymph nodes

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39
Q

Which lymph nodes do the cranial surface of the superior half drain to?

A

mastoid nodes and deep cervical lymph nodes

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40
Q

Which lymph nodes do the lower half and lobule drain into?

A

superficial cervical lymph nodes

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41
Q

Paired cartilaginous aspects of the larynx?

A

arytenoid, corniculate and cuneiform

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42
Q

Single cartilaginous aspects of larynx?

A

thyroid, cricoid and epiglottic

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43
Q

Structures within the parotid gland- superficial to deep?

A

Facial nerve
Retromandibular vein
External Carotid

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44
Q

Motor functions of the trigeminal nerve (v3)?

A

Motor
Distributed via the mandibular nerve.
The following muscles of mastication are innervated:
Masseter
Temporalis
Medial pterygoid
Lateral pterygoid

Other muscles innervated include:
Tensor veli palatini
Mylohyoid
Anterior belly of digastric
Tensor tympani

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45
Q

Contents of cavernous sinus?

A

Mnemonic for contents of cavernous sinus:
O TOM CAT

Occulomotor nerve (III)
Trochlear nerve (IV)
Ophthalmic nerve (V1)
Maxillary nerve (V2)
Carotid artery
Abducent nerve (VI)
T

OTOM=lateral wall components
CA= components within sinus

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46
Q

What is the cavernous sinus?

A

cavernous sinuses are paired and are situated on the body of the sphenoid bone

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47
Q

lateral /medial relations of the cavernous sinus?

A

Lateral: Temporal lobe
Medial:Pituitary fossa
Sphenoid sinus

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48
Q

Cavernous sinus blood supply

A

Ophthalmic vein, superficial cortical veins, basilar plexus of veins posteriorly.

Drains into the internal jugular vein via: the superior and inferior petrosal sinuses

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49
Q

What does the vagus carry afferent fibres from?

A

pharynx, larynx, oesophagus, stomach, lungs, heart and great vessels

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50
Q

What are the two types of efferent vagus fibres?

A
  1. preganglionic parasympathetic fibres -> innervate smooth muscle of the innervated organs
  2. direct skeletal muscle innervation -> larynx and pharynx
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51
Q

Where does the vagus arise from in the brain?

A

medulla oblongata

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52
Q

cranial and caudal relations of the vagus?

A

cranial - glossopharyngeal
caudal - accessory

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53
Q

Muscular contributions of first pharyngeal arch?

A

Muscles of mastication:
-Anterior belly of digastric
-Mylohyoid
-Tensor tympanic
-Tensor veli palatini

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54
Q

Skeletal contributions of first pharyngeal arch?

A

Maxilla
Meckels cartilage
Incus
Malleus

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55
Q

Artery contributions of first pharyngeal arch?

A

Maxillary
External carotid

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56
Q

Muscular contributions of 2nd pharyngeal arch?

A

Buccinator
Platysma
Muscles of facial expression
Stylohyoid
Posterior belly of digastric
Stapedius

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57
Q

Cranial nerve for first pharyngeal arch?

A

CNV - trigeminal

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58
Q

Cranial nerve for 2nd pharyngeal arch?

A

CNVII - facial

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59
Q

Skeletal contributions for 2nd pharyngeal arch?

A

Stapes
Styloid process
Lesser horn and upper body of hyoid

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60
Q

Artery contributions of 2nd pharyngeal arch?

A

Inferior branch of superior thyroid artery
Stapedial artery

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61
Q

Muscular contributions 3rd pharyngeal arch?

A

Stylopharyngeus

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62
Q

Skeletal contributions 3rd pharyngeal arch?

A

Greater horn and lower part of hyoid

63
Q

Endocrine contributions 3rd pharyngeal arch?

A

Thymus
Inferior parathyroids

64
Q

Artery 3rd pharyngeal arch?

A

Common and internal carotid

65
Q

Muscular contributions 4th pharyngeal arch?

A

Cricothyroid
All intrinsic muscles of the soft palate

66
Q

Skeletal contributions 4th pharyngeal arch?

A

Thyroid and epiglottic cartilages

67
Q

Endocrine contributions 4th pharyngeal arch?

A

Superior parathyroids

68
Q

Artery contributions 4th pharyngeal arch?

A

Right- subclavian artery, Left-aortic arch

69
Q

Muscular contributions 6th pharyngeal arch?

A

All intrinsic muscles of the larynx (except cricothyroid)

70
Q

Skeletal contributions 6th pharyngeal arch?

A

Cricoid, arytenoid and corniculate cartilages

71
Q

Artery contributions 6th pharyngeal arch?

A

Right -Pulmonary artery, Left- Pulmonary artery and ductus arteriosus

72
Q

What is the action of scalenus anterior and scalenus medius?

A

Elevate 1st rib and laterally flex the neck to same side

73
Q

What is the action of scalenus posterior?

A

Elevate 2nd rib and tilt the cervical spine

74
Q

Innervation of scalene?

A

Spinal nerves C4-6

75
Q

origin of scalenes?

A

Transverse processes C2 to C7

76
Q

Relation of brachial plexus to scalenes?

A

The brachial plexus pass between the anterior and middle scalenes through a space called the scalene hiatus/fissure.

77
Q

Relation of subclavian artery to scalenes?

A

The subclavian artery pass between the anterior and middle scalenes through a space called the scalene hiatus/fissure.

78
Q

Relation of subclavian vein to scalenes?

A

The subclavian vein passes anteriorly to the anterior scalene as it crosses over the first rib.

79
Q

Relation of phrenic nerve to scalenes?

A

The phrenic nerve passes anteriorly to the anterior scalene as it crosses over the first rib.

80
Q

Which cranial nerves may be injured in submandibular gland excision?

A

Marginal mandibular branch of the facial nerve
Lingual nerve
Hypoglossal nerve

81
Q

Superficial relations of the submandibular gland?

A

Platysma, deep fascia and mandible
Submandibular lymph nodes
Facial vein (facial artery near mandible)
Marginal mandibular nerve
Cervical branch of the facial nerve

82
Q

Deep relations of the submandibular gland?

A

Facial artery (inferior to the mandible)
Mylohyoid muscle
Sub mandibular duct
Hyoglossus muscle
Lingual nerve
Submandibular ganglion
Hypoglossal nerve

83
Q

Sympathetic innervation to the submandibular gland? (Whartons duct)

A

Derived from superior cervical ganglion

84
Q

Parasympathetic innervation to submandibular gland?

A

Submandibular ganglion via lingual nerve

85
Q

Borders of the posterior triangle of the neck?

A

Apex: Sternocleidomastoid and the Trapezius muscles at the Occipital bone
Anterior: posterior border of SCM
Posterior: anterior border of trapezius
Base: Middle third of the clavicle

86
Q

Contents of the posterior neck triangle (nerves)?

A

Accessory nerve
Phrenic nerve
Three trunks of the brachial plexus
Branches of the cervical plexus: Supraclavicular nerve, transverse cervical nerve, great auricular nerve, lesser occipital nerve

87
Q

Contents of the posterior triangle of the neck (vessels)?

A

External jugular vein
Subclavian artery

88
Q

Contents of the posterior triangle of the neck? (muscles)

A

Inferior belly of omohyoid
Scalene

89
Q

Contents of the posterior triangle fo the neck (lymph nodes)?

A

Supraclavicular
Occipital

90
Q

branches of the subclavian artery?

A

Vertebral artery
Internal thoracic artery
Thyrocervical trunk
Costocervical trunk
Dorsal scapular artery

91
Q

Arterial blood supply of the thyroid?

A

Superior thyroid artery (1st branch of external carotid)
Inferior thyroid artery (from thyrocervical trunk)
Thyroidea ima (in 10% of population -from brachiocephalic artery or aorta)

92
Q

Venous supply of the thyroid?

A

Superior and middle thyroid veins - into the IJV
Inferior thyroid vein - into the brachiocephalic veins

93
Q

Boundaries of the anterior triangle of the neck?

A

Anterior border of the Sternocleidomastoid
Lower border of mandible
Anterior midline

94
Q

Boundaries of the anterior triangle of the neck?

A

Anterior border of the Sternocleidomastoid
Lower border of mandible
Anterior midline

95
Q

Contents of the digastric triangle?

A

Submandibular gland
Submandibular nodes
Facial vessels
Hypoglossal nerve

96
Q

Contents of the muscular triangle?

A

Strap muscles
Jugular vein

97
Q

Contents of the carotid triangle?

A

Carotid sheath (Common carotid, vagus and internal jugular vein)
Ansa cervicalis

98
Q

Nerve supply to digastric muscle?

A

Anterior: Mylohyoid nerve
Posterior: Facial nerve

99
Q

Which skull foramina lie within the sphenoid bone?

A

Foramen ovale
Foramen spinosum
Foramen rotundum
Superior orbital fissure

100
Q

Which skull foramina lie within the temporal bone?

A

Stylomastoid foramen
Jugular foramen

101
Q

Which skull foramina lie within the occipital bone?

A

Foramen magnum

102
Q

Which bone does the Foramen lacerum/ carotid canal lie in?

A

Located between the sphenoid, the apex of the petrous temporal and the basilar part of the occipital

103
Q

Branches of the cerebral portion of the internal carotid?

A

Mnemonic for branches of the cerebral portion of the internal carotid artery ‘Only Press Carotid Arteries Momentarily’

Only = Opthalmic
Press = Posterior communicating
Carotid = Choroidal
Arteries = Anterior cerebral
Momentarily = Middle cerebral

104
Q

Where does the common carotid branch into the internal carotid?

A

opposite the upper border of the thyroid cartilage

105
Q

Path of the internal carotid?

A

superiorly to enter the skull via the carotid canal. From the carotid canal it then passes through the cavernous sinus, above which it divides into the anterior and middle cerebral arteries.

106
Q

anterior relations of the internal carotid?

A

Sternocleidomastoid
Lingual and facial veins
Hypoglossal nerve

107
Q

lateral relations of the internal carotid?

A

Internal jugular vein (moves posteriorly at entrance to skull)
Vagus nerve (most posterolaterally)

108
Q

Medial relations of the internal carotid?

A

External carotid (near origin)
Wall of pharynx
Ascending pharyngeal artery

109
Q

Posterior relations of the internal carotid?

A

Longus capitis
Pre-vertebral fascia
Sympathetic chain
Superior laryngeal nerve

110
Q

which vessels is the circle of willis primarily formed from ?

A

two internal carotid arteries and two vertebral arteries

111
Q

What is each half circle of willis formed by?

A
  1. Anterior communicating artery
  2. Anterior cerebral artery
  3. Internal carotid artery
  4. Posterior communicating artery
  5. Posterior cerebral arteries and the termination of the basilar artery
112
Q

Branches of the vertebral arteries?

A

PAP
Posterior spinal artery
Anterior spinal artery
Posterior inferior cerebellar artery

113
Q

Branches of the basilar arteries?

A

Anterior inferior cerebellar artery
Labyrinthine artery
Pontine arteries
Superior cerebellar artery
Posterior cerebral artery (at the point where it bifurcates)

114
Q

Below which spinal level will lower motor neurone symptoms be present?

A

For lesions below L1 LMN signs will occur

115
Q

what is the blood supply of the oesophagus?

A

cervical oesophagus - inferior thyroid artery
thoracic oesophagus- direct branches from thoracic aorta
lower oesophagus - left gastric artery

116
Q

where do the inferior and superior parathyroid glands originate from embryologically?

A

inferior - third pharyngeal pouch
superior - fourth pharyngeal pouch

117
Q

Which muscles of the larynx are supplied by the recurrent laryngeal nerve?

A

posterior cricoarytenoid
lateral cricoarytenoid
thyroarytenoid
transverse and oblique arytenoid
vocalis

118
Q

Which muscle of the larynx is supplied by the external laryngeal nerve?

A

cricothyroid

119
Q

which nodes do the supraglottic part of the larynx drain to?

A

Upper deep cervical nodes

120
Q

which nodes do the subglottic part of the larynx drain to?

A

Prelaryngeal and pretracheal nodes and inferior deep cervical nodes

121
Q

What is the lymphatic drainage of the vocal cords?

A

lymphatic watershed (no lymphatic drainage)

122
Q

which sinus drains the superior meatus?

A

Posterior ethmoidal sinus

123
Q

which sinus drains the middle meatus?

A

Frontal sinus, maxillary sinus ,anterior and middle ethmoidal sinus

124
Q

which sinus drains the inferior meatus?

A

Nasolacrimal duct

125
Q

which sinus drains the sphenoethmoidal recess?

A

sphenoidal sinus

126
Q

which muscles are innervated by ansa cirvicalis?

A

GHost THought SOmeone Stupid Shot Irene

GenioHyoid
ThyroidHyoid
Superior Omohyoid
SternoThyroid
SternoHyoid
Inferior Omohyoid

127
Q

What are the branches of external carotid artery?

A

External carotid artery branches mnemonic:

‘Some Angry Lady Figured Out PMS’

Superior thyroid (superior laryngeal artery branch)
Ascending pharyngeal
Lingual
Facial (tonsillar and labial artery)
Occipital
Posterior auricular
Maxillary (inferior alveolar artery, middle meningeal artery)
Superficial temporal

128
Q

which blood vessel supplies the nasal cavity?

A

sphenopalatine artery

129
Q

what signs may be seen in cavernous sinus syndrome?

A

Diagnosis is based on signs of pain, opthalmoplegia, proptosis, trigeminal nerve lesion (opthalmic branch) and Horner’s syndrome.

130
Q

Blood supply of the lacrimal system?

A

Lacrimal branch of the opthalmic artery. Venous drainage is to the superior opthalmic vein.

131
Q

Innervation of lacrimal gland?

A

The gland is innervated by the secretomotor parasympathetic fibres from the pterygopalatine ganglion which in turn may reach the gland via the zygomatic or lacrimal branches of the maxillary nerve or pass directly to the gland

132
Q

What do the preganglionic lacrimal fibres travel to the pterygopalatine ganglion in?

A

in the greater petrosal nerve (a branch of the facial nerve at the geniculate ganglion).

133
Q

Which nerve provides sensory innervation to the angle of the jaw?

A

The angle of the jaw is innervated by the greater auricular nerve. (C2-C3)

134
Q

Muscles innervated by the trigeminal nerve?

A

Muscles of mastication
Mylohyoid
Anterior belly of digastric
Tensor tympani
Tensor palati

135
Q

Path of nerves involved in resizing the pupils

A

pretectal nucleus in midbrain -> Edinger - Westphal nucleus -> motor axons from here pass along with the oculomotor nerve -> ciliary ganglion neurones ->the parasympathetic axons from this then innervate the iris

136
Q

Branches of the internal carotid artery?

A

Anterior and middle cerebral artery
Ophthalmic artery
Posterior communicating artery
Anterior choroid artery
Meningeal arteries
Hypophyseal arteries

137
Q

What is the function of the sub-occipital muscles?

A

connect atlas to axis
connect atlas to the base of the skull

Innervated by nerves from the c1 root

138
Q

Suprahyoid muscles?

A

Mylohyoid, Stylohyoid, Geniohyoid and Digastric

My Gravy Spoon Darling

139
Q

Infrahyoid muscles?

A

Sternohyoid, Omohyoid, Sternothyroid and Thyrohyoid

TOSS

140
Q

Suprahyoid anterior muscle innervation?

A

Mylohyoid and Anterior belly of the Digastric

Mandibular Division of the Trigeminal Nerve (V3)

141
Q

Suprahyoid posterior muscle innervation?

A

Stylohyoid and Posterior belly of the Digastric
Facial Nerve (VII)

142
Q

Geniohyoid innervation?

A

C1 fibres via the Hypoglossal Nerve (XII)

143
Q

Infrahyoidmuscle innervation?

A

Thyrohyoid:
C1 fibres via the Hypoglossal Nerve (XII)

Omohyoid, sternohyoid and sternothyroid:
Ansa cervicalis (anterior rami of C1 to C3)

144
Q

Contents of posterior triangle?

A

3 vessels and 4 nerves
External jugular veins
Subclavian artery & vein
Trunks of brachial plexus
Spinal accessory
Phrenic nerve
Vagus nerve

145
Q

Contents of the carotid sheath?

A

IJV
Carotids
Vagus

146
Q

Structures anterior to posterior surrounding scalenes?

A

Contents of carotid sheath:
(IJV, Carotids, Vagus)
SC vein
Phrenic nerve
Scalenus Anterior
Brachial plexus roots and SC artery
Scalenus Medius

147
Q

What does the vagus nerve innervate?

A

Larynx
Heart
Lungs
GI tract

148
Q

Origins of phrenic nerve?

A

C3,C4,C5

149
Q

What does the phrenic nerve innervate?

A

Motor to diaphragm and sensory to peritoneum and pleura around diaphragm

lies anterior to scalenus anterior

150
Q

What does the subclavian artery enter the thorax between?

A

-between subclavian artery and vein

151
Q

Which artery supplies the thyroid gland?

A

2 pairs of arteries:
-Superior thyroid artery: First branch of the external carotid
-Inferior thyroid artery: Arises from the first part of the subclavian artery
This artery does not only supply the thyroid, but also supplies the superior oesophagus and the trachea.*

152
Q

which veins drain the thyroid gland?

A

pairs of superior, middle and inferior thyroid veins

Superior and middle thyroid veins: Drain into the internal jugular vein*

Inferior thyroid vein: Drains into brachiocephalic trunk*

153
Q

uses of central lines?

A

Monitoring CVP and JVP
Monitoring central venous saturation
Delivery of toxic drugs
Antibiotics
Drugs that are prone to cause phlebitis in peripheral veins e.g. chemotherapy
Central feeding
Dialysis

154
Q

Complications of central lines?

A

Puncturing common carotid
Nerve damage
Air embolism
Thrombosis
Infection

MRCSA anatomy (7 decks)

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