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MRCS part B anatomy > Head and neck original cards > Flashcards

Head and neck original cards Flashcards

(48 cards)

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1
Q

What is the nerve supply to the digastric muscle?

A

Anterior belly: V3–> inferior alveolar nerve–> nerve to mylohyoid
Posterior belly: facial nerve

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2
Q

Complications of thyroid surgery

A

Nerve injury
-Superior laryngeal: damage to cricothyroid, loss of high pitched voice
-Recurrent laryngeal: difficulty in phonation if unilateral, airway obstruction if b/l

-Hypocalcaemia
-Seroma

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3
Q

Nerves at risk during submandibular gland surgery

A

A facial sandwich

-Marginal mandibular branch of facial nerve
-Lingual nerve
-Hypoglossal
-Nerve to mylohyoid

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4
Q

Describe blood supply to thyroid gland

A

-superior thyroid arteries (branch external carotid)
-Inferior thyroid arteries (branch thyrocervical trunk of subclavian)
-Thyroid ima (<10%) (brachiocephalic, aortic arch)

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5
Q

Name nerves at risk during carotid endarterectomy

A

Ho’s like sucking great men’s anuses

  1. Hypoglossal
  2. Lingual
  3. Superior laryngeal branch (of vagus nerve)
    4: greater auricular
    5: Marginal mandibular
    6: ansa cervicalis
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6
Q

Name branches ophthalmic division trigeminal

A

NFL

-Nasociliary
-Frontal –> supraorbital, supratrochelar
-Lacrimal –> anterior/post ethmoidal, infratrochlear

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7
Q

Name branches maxillary btranch trigeminal

A

-INfraorbital
-Zygomatic
-Superior alveolar
-Palatine
-Pharyngeal
-Superior labial

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8
Q

What muscles do the marginal mandibular branch facial nerve supply?

A

-Depressor labii inferioris
-Depressor anguli oris
-Mentalis

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9
Q

What is surgical significance of course of marginal mandibular nerve?

A

Nerve runs inferior to mandible, is at risk of injury during surgery to submandibular gland excision/carotid endarterectomy

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10
Q

Branches external carotid artery

A

Some Anatomists Like Freaking out poor medical students
-Superior thyroid
-Ascending pharyngeal
-Lingual
-Facial
-Occipital
-Posterior auricular
-Maxillary
-Superficial temporal

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11
Q

Name branches facial nerve before it exits stylomastoid foramen (and their functions)

A

-Greater petrosal (parasympathetic to lacrimal glands)
-Nerve to stapedius (controls amplitude of sound waves
-Chorda tympani
–> sensory (taste anterior 2/3rd tongue)
–> parasympathetic (submandibular/sublingual)

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12
Q

Name extracranial branches of facial nerve before it enters parotid gland

A

Arseholes die slowly

-posterior auricular
-Posterior belly digastric
-Branch to stylohyoid

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13
Q

Name branches of facial nerve within substance parotid gland

A

Ten zulus buggered my cat

temporal
zygomatic
buccal
marginal mandibular
cervical

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14
Q

Branches mandibular branch V after exiting foramen ovale

A

-Nerve to medial pterygoid
-Tensor tympani
-Tensor veli palatini
-Then divides into anterior and posterior division

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15
Q

Describe anterior and posterior division V3

A

Anterior: 3 motor, 1 sensory
Posterior: 1 motor, 3 sensory

Anterior
-Motor nerves: masseteric, deep temporal, lateral pterygoid
-Sensory: buccal

Posterior:
-Motor: inferior alveolar (mixed nerve that gives nerve to mylohyoid–> supplies mylohyoid and anterior belly digastric)
-Sensory: inferior alveolar, auriculotemporal, lingual

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16
Q

Describe sensory branches V3

A

BAIL

Buccal
Auriculotemporal
Inferior alveolar
Lingual

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17
Q

Describe branches V3

A

Branches after exiting foramen
-Medial pterygoid
-Tensor tympani
-Tensor veli palatini
-Then divides into anterior and posterior division

Anterior division:
-Motor: masseteric, deep temporal, lateral pterygoid
-Sensory: buccal
Posterior division
-Motor-inferior alveolar
-Sensory-inferior alveolar, auriculotemporal, lingual

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18
Q

Which nerves lie in cavernous sinus?

A

3, 4, V1, V2, 6 (6 lies in centre, others lie on lateral wall-therefore first to be affected in cavernous sinus thrombosis)

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19
Q

Which arteries supply kiesselbach’s plexus

A

LEGS
-Facial artery–>labial–> superior labial
-Ophthalmic –> ethmoidal –> anterior ethmoidal
-Maxillary –. greater palatine
-Maxillary artery –> sphenopalatine artery

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20
Q

Which nerves supply external ear?

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A

Inferior: greater auricular (branch of cervical plexus C2,3)
Superior aspect: auriculotemporal (branch of V3)
Middle: lesser occipital (branch of cervical plexus C2)
External acoustic meatus: branches auriculotemporal + vagus (auricular branch vagus known as arnold’s nerve)

21
Q

Name intrinsic muscles of tongue

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A

Superior longutudinal
Inferior longitudinal
Transverse muscles
Vertical muscles

22
Q

Name extrinsic muscles of tongue and their actions

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A

Genioglossus: protrusion
Hyoglossus: depression
Styloglossus: elevation and retraction
Palatoglossus: depression of soft palate and elevation back of tongue

23
Q

What is the motor supply of the tongue?

Study These Flashcards
A

Hypoglossal nerve, except palatoglossus –> vagus nerve (via pharyngeal plexus)

24
Q

What is sensory supply of tongue?

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A

Anterior 2/3rd:
-General sensation: lingual nerve (branch V3)
-Taste sensation: chorda tympani (branch VII)

Posterior 2/3rd:
-Taste and general sensation: glossopharyngeal

25
Name muscles of mastication
Temporalis Masseter Lateral pterygoid Medial Pterygoid
26
Which nerve supplies muscles of mastication?
Mandibular division (V3) of trigeminal nerve)
27
Name boundaries of infratemporal fossa
Medial: lateral pterygoid plate Lateral: madibular ramus, coronoid process Anterior: maxilla POsterior: tympanic plate, mastoid and styloid processes temporal bone
28
Contents infratemporal fossa
Muscles: medial pterygoid, lateral pterygoid, temporalis and masseter originate and insert into its borders Vessels: Maxillary artery, pterygoid venous plexus Nerves: V3 and branches, otic ganglion, chorda tympani (follows course of lingual) Nerves: contents of OVALE
29
What is function of ciliary ganglion
Associated with oculomotor nerve, contributes to pupillary and accommodation reflex
30
What is function of pterygopalatine/sphenopalatine ganglion
Associated with greater petrosal nerve (branch of facial nerve) supplying lacrimal gland, paranasal sinuses and glands in palate and nasal cavity
31
What is function of submandibular ganglion
Associated with chorda tympani and lingual nerve supplying submandibular and sublingual glands
32
Otic ganglion
Associated with glossopharyngeal nerve secretomotor to parotid gland
33
What are the 4 main ganglia in head and neck region
Otic Pterygopalatine Submandibular Ciliary
34
Describe course of retromandibular vein
Superficial temporal + maxillary-->retromandibular vein--> anterior and posterior branches Anterior + anterior facial vein--> common facial--> IJ Posterior + posterior auricular--> external jugular--> subclavian -Formed by superficial temporal + maxillary -Descends within parotid deep to facial nerve -Then divides into anterior + posterior branches -Anterior branch joins anterior facial vein to form common facial vein --> drains into IJ -Posterior branch units with post. auricular vein to form ext jugular, drains into subclavian
35
Structures that attach to styloid process
3 muscles, 2 ligament Stylohyoid Styloglossus Stylopharyngeus Stylohyoid ligament Stylomandibular ligament
36
Structures attaching to mastoid process
Sternocleidomastoid Posterior belly digastric Splenius capitis Longissimus capitis
37
Name the structures within the substance of the parotid gland
For REAL Superficial to deep: -Facial nerve: 5 branches of facial nerve divide within parotid -Retromandibular vein -External carotid -Branches great auricular nerve -Lymph nodes
38
What is Frey's syndrome
-Gustatory sweating and erythema in territory auriculotemporal nerve -Auriculotemporal nerve carries parasympathetic innervation to parotid gland -Syndrome caused by misdirected healing, causing parasympathetic fibres to join sympathetic fibres of superior cervical ganglion which supply sweat glands and blood vessels -Therefore erythema and sweating instead of salivation
39
What is the functional loss due to oculomotor nerve palsy?
-Loss of levator palpebrae superioris, inferior oblique, medial, superior and inferior recti, sphincter pupillae -Down and out position of eye -Ptosis + mydriasis (pupil dilatation) -Pupillary dilatation is due to denervation of parasympathetic fibres carried along with oculomotor nerve
40
What is horner's syndrome?
Caused by disruption of sympathetic trunk (arising from spinal cord in chest to supply head and neck) on ipsilateral side Ptosis Anhydrosis Miosis (shrinking of pupil) Enophthalmos (sunken eyes) Loss of ciliospinal reflex: pupillary dilatation in response to pinching neck
41
What is anterior cord syndrome? what are its causes
Causes: -trauma to vertebra -spinal disc herniation -damage to aorta -Interruption anterior spinal artery, supplying anterior 2/3rd spinal cord -Complete loss of muscle strength below level of injury due to loss of descending motor fibres in corticospinal tract Sensation: --> loss of pain and temperature --> retain proprioception/vibration sense/fine touch
42
What is brown-sequard syndrome? what are its causes?
Causes: -Spinal cord tumours -Trauma -Ischaemia -Infections (TB) -Inflammatory and autoimmune disease Implications -Loss of sensation and motor function due to lateral hemi-section spinal cord -Ipsilateral spastic paralysis below level of lesion -Ipsilateral loss vibration, proprioception and fine touch -Contralateral loss of pain and temperature
43
Layers of lumbar puncture
1. skin 2. subcutaneous tissue 3. supraspinous ligament 4. interspinous ligament 5. ligamentum flavum 6. epidural space containing the internal vertebral venous plexus 7. dura mater 8. arachnoid mater 9. subarachnoid space
44
Describe anatomy of cervical plexus
-Plexus of C1-C4 -Anastamose with accessory nerve, hypoglossal nerve, sympathetic trunk -Has muscular and cutaneous branches
44
Name the four cutaneous branches of cervical plexus
-Lesser occipital nerve (C2 only): innervates lateral occipital region -Greater auricular nerve (C2,3): Inferior external ear, parotid region -Transverse cervical nerve (C2,3): anterior region of neck -Supraclavicular (C3,4): clavicular region, shoulder
45
Name four muscular branches of cervical plexus and their innervation
Communicating branches (C1): geniohyoid and thyrohyoid Ansa cervicalis (C1-3): innervates sternohyoid Segmental (C1-4): supplies anterior and middle scalene Phrenic (C3-5): diaphragm and pericardium
46
Horner's syndrome vs 3rd nerve palsy
Eyelid -Horner's syndrome: partial ptosis --> symp fibres control superior tarsal muscle (maintains elevation of eyelid) -3 Palsy-: complete ptosis --> controls levator palpebrae superioris--> opens eyelid Pupil -3: mydriasis -Horners: miosis Sweating -Sweating vs non sweating Horner's: loss of ciliospinal reflex
47
Causes of horner's
1st order neurone lesion: -MS -Brainstem tumour 2nd order neurone lesion -Apical lung tumour -Apical TB 3rd order neurone lesion -Herpes zoster

MRCS part B anatomy (16 decks)

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