1) General Organisation of Head & Neck

Question 1

What are the palpable features of the anterior neck?

Answer 1

Hyoid bone, thyroid cartilage and cricoid cartilage

Question 2

What is the function of the thyroid and cricoid cartilage?

Answer 2

Support and protect underlying larynx

Question 3

What muscles attach at the hyoid bone?

Answer 3

Supra and infra-hyoid muscles

Question 4

What are the three main muscles of the neck?

Answer 4

Platysma
Sternocleidomastoid
Trapezius

Question 5

Describe the position of platysma:

Answer 5

Anterolateral neck, superficial

Overlies sternocleidomastoid

Question 6

What is the function of platysma?

Answer 6

Draws corners of mouth inferiorly

Draws skin of neck superiorly

Question 7

What is the nerve supply to platysma?

Answer 7

Facial nerve

Question 8

What are the functions of sternocleidomastoid?

Answer 8

Lateral flexion of neck, rotates chin superiorly

Together: flex neck and extend at atlanto-occipital joint

Question 9

What is the nerve supply to sternocleidomastoid and trapezius?

Answer 9

Accessory nerve

Question 10

What is the function of trapezius?

in terms of the neck

Answer 10

Elevates and rotates scapula - shrug shoulders

Question 11

What are the boundaries of the anterior triangle of the neck?

Answer 11

Inferior margin of mandible
Anterior margin of SCM
Midline of neck

Question 12

What are the boundaries of the posterior triangle of the neck?

Answer 12

Posterior margin of SCM
Anterior margin of trapezius
Clavicle

Question 13

Why are the anatomical triangles of the neck important?

Answer 13

Defining pathology as different structures e.g. LN chains run in the triangles

Question 14

What are the functions of cervical fascia?

Answer 14

Form natural planes
Allows ease of movement between structure e.g. when swallowing
Contains spread of infection

Question 15

What does the superficial cervical fascia contain?

What type of connective tissue is it?

Answer 15

Loose CT containing fat, platysma, cutaneous nerves, lymph nodes and superficial blood vessels

Question 16

What are the layers of deep cervical fascia?

Answer 16

Investing layer
Carotid sheath
Pre-tracheal fascia
Pre-vertebral fascia

Question 17

What are the two layers of the pre-tracheal fascia?

Answer 17

Muscular and visceral

Question 18

How can you tell if a swelling in the neck is a goitre?

Answer 18

Will move upon swallowing

Question 19

What are the complications of a goitre?

Answer 19

Compress trachea: breathlessness and stridor

Compress veins: facial oedema

Question 20

What is contained in the carotid sheath?

Answer 20

Common carotid artery, internal jugular vein and vagus nerve

Question 21

What does the pre-vertebral layer surround?

Answer 21

Vertebral column and associated muscles

Question 22

What is the clinical significance of the retropharyngeal space?

Answer 22

Allows infection to spread into the mediastinum = mediastinitis

Question 23

Which other space runs into the thorax?

Answer 23

Pre-tracheal space

Question 24

What fascia splits the retropharyngeal space into two?

What is the posterior area called?

Answer 24

Alar fascia

Danger space

Question 25

What are the three key branches of the trigeminal nerve?

Answer 25

Ophthalmic, maxillary and mandibular

Question 26

What cranial nerves are the trigeminal and facial nerve?

Answer 26

Cranial nerve V and cranial nerve VII respectively

Question 27

What does the trigeminal nerve innervate?

Answer 27

Muscles of mastication | Main sensory to face and scalp

Question 28

What are the five key branches of the facial nerve?

Answer 28

Temporal, zygomatic, buccal, mandibular, cervical

Question 29

What does the facial nerve innervate?

Answer 29

Muscles of facial expression | Special sensory to tongue-taste, PSNS to salivary and lacrimal glands

Question 30

What is the main arterial supply to the face?

Answer 30

Common carotid via internal and external carotid (facial artery)

Question 31

What is the main venous drainage of the face?

Answer 31

Internal jugular via facial vein

Question 32

Give examples of the muscles of mastication:

Answer 32

Temporalis Masseter Pterygoids (lateral and medial)

Question 33

Give examples of the muscles of facial expression:

Answer 33

``` Orbicularis oculi Levator palpebrae superioris Occipitofrontalis Buccinator Zygomaticus Orbicularis oris ```

Question 34

What is the danger area of the scalp and what does this mean?

Answer 34

Loose CT, allows spread of infection to meninges

Question 35

What is the arterial supply to the scalp? (broad)

Answer 35

External carotid and ophthalmic arteries

Question 36

What is the nerve supply to the scalp? (broad)

Answer 36

Trigeminal and cervical nerves

Question 37

Why do scalp lacerations bleed profusely?

Answer 37

Pull of occipitofrontalis prevents closure of bleeding vessels and skin Vasoconstriction prevented by adherence of blood vessels to dense CT Many anastomoses

Question 38

What is the clinical significance of the path of the facial nerve?

Answer 38

Passes through parotid gland where it can be damaged e.g. tumour or surgery