Week 1 Flashcards by Becky Mladenovic

Superior and inferior boundaries of the neck

Suprasternal notch of the manubrium to the lower margin of the mandible

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Broad functions of neck fascia

Superficial surrounds structures in the neck
Deep layers compartmentalise the neck to prevent spread of infection, form natural planes for surgery and ease movement between structures

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Where is the superficial cervical fascia

Between the dermis and deep cervical fascia

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What is the structural difference between the superficial and deep cervical fascia

Superficial is loose connective tissue

Deep is dense connective tissue

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What does the superficial cervical fascia contain

Fat
Platysma
Cutaneous nerves
Lymph nodes
Superficial blood vessels e.g external jugular vein

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What are the deep cervical fascia layers (superficial to deep)

Investing
Pretracheal
Prevertebral
Carotid sheath

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What is the investing layer connected to

Completely surrounds the neck and subcutaneous tissue attaching to the:
Posterior- external occipital protuberance and nuchal ligament
Inferior - scapula spine, acromion, clavicle and manubrium
Superior - lower border of mandible and mastoid process

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What structures does the investing layer enclose

Sternocleidomastoid
Trapezius
Submandibular and parotid glands

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What is the suprasternal space

Space between the 2 heads of SCM formed by the investing layer of deep fascia

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2 parts of the pretracheal layer

Visceral - encloses thyroid gland, larynx, trachea and oesophagus
Muscular - encloses infrahyoid muscles

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What are the infrahyoid muscles

Muscles running inferiorly from hyoid anterior to the visceral pretracheal layer

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What cartilage can be felt in the neck

Thyroid superiorly

Cricoid inferiorly

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What contributes to the visceral pretracheal layer

Buccopharyngeal fascia posteriorly

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What is the pretracheal fascia attached to

Hyoid to the pericardium

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What is the prevertebral fascia attached to

Surrounds the cervical vertebra and associated pre- and para- vertebral muscles attaching to:
Base of skull
Transverse processes up to T3
Endothoracic fascia of rib cage

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What does the axillary sheath enclose and what does it arise from

Encloses scalenes, subclavian artery and brachial plexus

Arises from the lateral prevertebral layer of deep cervical fascia

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What forms the carotid sheath

All layers of the deep cervical fascia

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Where does the carotid sheath run from and to

From the thoracic mediastinum to the base of skull

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What is contained in the carotid sheath

Common carotid artery
Internal jugular vein
Vagus nerve
Deep cervical lymph nodes

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Where is the retropharyngeal space

Between the pretracheal and prevertebral layers

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Risk in infection of retropharyngeal space

Mediastinitis

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Risk in infection pretracheal space

Anterior mediastinitis

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Where is the pretracheal space

Between investing layer and visceral pretracheal layer

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Action of the platysma

Draws corners of the mouth inferiorly

Draws skin of neck superiorly if teeth are clenched

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Innervation of platysma

Facial nerve (cervical branch)

Attachments of sternocleidomastoid

Originates from the mastoid process | Splits into 2 heads which insert on the clavicle and sternum

Unilateral action of the SCM

Lateral flexion of neck (ear towards shoulder)

Bilateral action of SCMs

Flexion at neck | Extension at atlanto-occipital joint

Innervation of SCM

Accessory nerve

Attachments of trapezius

Originates from base of skull, nuchal ligament and spinous processes of vertebra Inserts on lateral 1/3 clavicle, acromion and scapula spine

Action of trapezius

Elevates and rotates scapula

Innervation of trapezius

Accessory nerve

Borders of anterior triangle

Superior - inferior margin of mandible Medial - midline of neck Lateral - anterior margin of SCM

Borders of the posterior triangle

Inferior - clavicle Medial - posterior margin of SCM Lateral - anterior margin of trapezius

Innervation of muscles of facial expression

Facial nerve

Innervation of muscles of mastication

Trigeminal nerve (mandibular branch)

Branches of the trigeminal nerve

Ophthalmic Maxillary Mandibular

Branches of the facial nerve

``` Temporal Zygomatic Buccal Marginal mandibular Cervical ```

What are the muscles of facial expression and what does each do

``` Occipitofrontalis - has a frontal and occipital belly connected to a common tendon Orbicularis oculi Orbicularis oris Buccinator Mentalis Platysma ```

Action of occipitofrontalis

Frontal - elevate eyebrows, wrinkles skin on forehead and protracts scalp Occipital - retracts scalp

Action of orbicularis oculi

Firmly closes eyelids

Action of orbicularis oris

Firmly closes mouth, protrusion of lips and resists distension when blowing

Action of buccinator

Press the cheeks against the gums and blows out cheeks

Action of mentalis

Elevates and protrudes the lower lip

What are the muscles of mastication

Temporalis Masseter Pterygoids

Action of temporalis

Elevates and retracts mandible to close the jaw

Action of masseter

Elevates the mandible to close the jaw

Action of medial pterygoid

Elevates and protrudes the mandible

Unilateral action of lateral mandible

Swing the jaw to the contralateral side

Bilateral action of lateral pterygoid

Protracts the mandible and depresses the chin

Where is the border between the scalp and face

Eyebrows

Layers of the scalp

Skin - contains hair follicles and sebaceous glands Dense CT - highly vascularised and innervated Epicranial aponeurosis - connects occipitalis and frontalis muscles Loose areolar CT Periosteum

Blood supply of the scalp

``` External carotid artery Ophthalmic artery (branch of internal carotid) ```

Branches of external carotid artery supplying scalp

Superficial temporal - frontal and temporal regions Posterior auricular - superior and posterior to auricle Occipital - back of scalp

Venous drainage of the scalp

``` Superficial veins: Superficial temporal Occipital Posterior auricular Supraorbital Supratrochlear ``` Deep veins (in temporal region): Pterygoid venous plexus H

What do the veins of the scalp drain into

Maxillary vein??

Sensory innervation of the scalp

Trigeminal nerve CN5 | Occipital nerve CN2

Why do scalp lacerations bleed profusely

Pull of occipitofrontalis muscle prevents closure of bleeding vessel and surrounding skin Blood vessels are adhered to dense CT which prevents vasoconstriction Many anastomoses

What branches of the ophthalmic artery supply the scalp

Supraorbital | Supratrochlear

What so the supraorbital and supratrochlear veins unite to form and where. What does this drain into

Angular vein at the medial angle of the eye | Drains into the facial vein

What do the veins of the scalp connect. What's the clinical relevance of this

Connect to dural venous sinuses by diploid veins via several valveless emissary veins Scalp infection spread to meninges

Week 1 Flashcards

(61 cards)