Gross II Exam I pt 1

Parietal

Relating to lining of a cavity

Visceral

Covering of an organ

What is the motor innervation to the face?

facial nerve (CN VII)

What is the sensory nerve to the face?

Trigeminal nerve (CN V)

What are the 3 main subdivisions of the trigeminal?

Opthalamic (face and scalp)

Maxillary (cheek)

Mandibular (chin and temporal)

What are the divisions of the ophthalmic nerve?

Supraorbital, supratrochlear, external nasal, infratrochlear, lacrimal

What are the divisions of the maxillary nerve?

Zygomaticotemporal, zygomaticofacial, infraorbital

What is the clinical significance of the infraorbital nerve?

Most commonly injured with blow to the face

What are the branches of the mandibular nerve?

Auriculotemporal, buccal, mental

What is sudden severe pain in sensory area of the trigeminal nerve?

Trigeminal neuralgia

What branch is trigeminal neuralgia most common in?

Maxillary, 2nd most common in mandibular

What is Bell's Palsy?

Facial nerve paralysis (CN XII)

What is the main sensory of the occipital region?

Greater occipital posterior primary ramus C2

What is the main sensory of the upper posterior neck?

third occipital nerve (PPR C3)

What is the main sensory of lower posterior neck?

Posterior primary ramus C4

Is C1 posterior primary ramus sensory, motor, or both?

strictly motor

What supplies the anterior and lateral neck with sensory?

Anterior primary ramus of C2-C4

What is the cervical plexus?

anterior rami of C1-C4

What are the 4 sensory branches of the cervical plexus?

lesser occipital nerve (C2), great auricular nerve (C2 & C3), transverse cervical nerve (C2 & C3), and supraclavicular nerve (C3 & C4)

What does the lesser occipital (C2) supply?

Lateral part of occipital region, posterior to the ear

What does the greater auricular (C2,C3) nerve supply?

Angle of mandible and inferior to ear; accompanies the external jugular vein

What does the transverse cervical (C2, C3) nerve supply?

Anterior neck

What does the supraclavicular (C3,C4) supply?

Lateral surface of neck

What are the motor branches of cervical plexus?

Superior root (C1/C2), inferior root (C2/C3), ansa cervicalis (C1/C2/C3), phrenic nerve (C3/C4/C5)

What does ansa cervicalis supply?

3 of the 4 infrahyoid muscles: sternohyoid, sternothyroid, and omohyoid

What is the innervation of the platysma?

Cervical branch of facial nerve (CN VII)

What is the action of the platysma?

depresses mandible and corners of mouth

What is the innervation of sternocleidomastoid?

Accessory nerve (CN XI)

What is the function of sternocleidomastoid?

Flex head

What is the innervation of the trapezius?

Accessory nerve (CN XI) and C3/C4

What is the action of the trapezius?

Upper fibers elevate scapula, middle fibers retract scapula, lower fibers depress scapula

What muscle can experience problems due to texting and computer work?

Trapezius

What is pathological contraction of the SCM?

Torticollis

What direction is head tilted in torticollis?

Head towards affected side and face away from affected side

What are the three types of torticollis?

congenital, muscular, and spasmodic

What type of torticollis is strictly in infants?

Muscular; due to birth injury

What vein drains face, scalp, and brain?

External jugular vein

What forms the external jugular vein?

Retromandibular vein and posterior auricular vein

What vein sits on the lateral surface of the SCM?

External jugular

Where does the external jugular vein empty into?

Subclavian vein

What are the tributaries to the external jugular vein?

retromandibular vein, posterior auricular vein, posterior external jugular vein, anterior jugular vein, transverse cervical vein, and suprascapular vein

When will a patient present with a prominent external jugular vein?

Congestive heart failure or opera/bagpipe players

What divides the anterior and posterior triangles?

sternocleidomastoid

What are the borders of the posterior triangle?

Anterior: posterior SCM

Posterior: anterior trapezius

Inferior: superior border of middle clavicle

What are the borders of the anterior triangle?

Posterior: SCM

superior: mandible

Anterior: midline of neck

What are the 4 subdivisions of the anterior triangle?

Submental, submandibular, carotid, muscular

What are the boundaries of the submental triangle?

left and right anterior bellies of digastric, body of hyoid bone

What is the internal boundary of the submental triangle?

Mylohyoid muscle

What is the contents of the submental triangle?

minor veins and lymph nodes

What are the boundaries of the submandibular triangle?

the inferior border of the mandible, the anterior belly of digastric, and the posterior belly of digastric

What is the internal boundary of submandibular?

Mylohyoid and hypoglossus muscle

What is the contents of the submandibular triangle?

submandibular gland, internal carotid artery, facial artery, internal jugular vein, glossopharyngeal nerve, vagus nerve

What is the clinical significance of the submandibular triangle?

Use caution when palpating

What are the boundaries of the carotid triangle?

posterior belly of digastric, superior belly of omohyoid, and anterior border of sternocleidomastoid

What's the internal boundary of the carotid triangle?

Thyrohyoid, hypoglossus, inferior/middle constrictor muscles

What are the contents of the carotid triangle?

carotid arteries and internal jugular vein

What are the boundaries of the muscular triangle?

superior belly of omohyoid, anterior midline of the neck, and the anterior border of sternocleidomastoid

What is the internal boundary of the muscular triangle?

Posterior layer of pretracheal fascia

What are the contents of the muscular triangle?

sternohyoid, sternothyroid, thyroid gland, trachea, esophagus

Where does the common carotid artery bifurcate?

Carotid triangle

Where is the hyoid bone located?

between mandible and larynx

What is the clinical significance of the hyoid bone?

Can be broken in strangulation

What are the 4 functions of the infrahyoid muscles?

Swallowing, speech, breathing, depress mandible if hyoid is fixed

What is the innervation of all the infrahyoid muscles except the thyrohyoid?

Ansa cervicalis

What is the function of the omohyoid?

depresses hyoid bone and larynx

What is the function of the sternohyoid?

depresses hyoid bone and larynx

What is the function of the sternothyroid?

Depress larynx

What is the function of thyrohyoid?

depresses hyoid bone

What is the innervation of thyrohyoid?

C1 via hypoglossal nerve (CN XII)

What is the only infrahyoid muscle that doesn't insert in the hyoid?

Sternothyroid

What does the superficial cervical fascia do?

Encloses platysma and contains superficial nerves, veins, and lymph nodes

What are the 4 parts of the deep cervical fascia?

investing layer, pretracheal fascia, prevertebral fascia, carotid sheath

Describe the investing layer of cervical fascia

Splits to enclose the SCM and trapezius

What is in the pretracheal fascia

surrounds trachea, esophagus, thyroid gland

What is in the prevertebral fascia

vertebral column and associated muscles

What is in the carotid sheath?

common carotid artery, internal jugular vein, vagus nerve, internal carotid artery, deep cervical lymph nodes

Where does the carotid artery exit the carotid sheath?

Before giving off its branches

What is a clinical aspect of cervical fascia?

Channels for infection- allows an infection to spread from head to mediastinum directly

T/F Cancer involving deep cervical lymph nodes can compress internal jugular vein?

True

How can neck pain from adhesions in fascia layers be treated?

Myofascial release

What is the opening which structures of neck pass into the thorax?

Superior thoracic aperture

What are the boundaries of the thoracic aperture?

First thoracic vertebrae and ribs, and manubrium of sternum

What arteries are in the superior thoracic aperture?

Brachiocephalic trunk (right side only), left common carotid, left subclavian, internal thoracic

What vein is in the superior thoracic aperture?

Brachiocephalic vein (right and left)

What nerves are in the superior thoracic aperture?

Phrenic, vagus, recurrent laryngeal, sympathetic trunk

What viscera are in the superior thoracic aperture?

Trachea, esophagus, cervical pleura, apex of lung, thymus

What is a clinical aspect of the cervical pleura and apex of the lung in the superior thoracic aperture?

Broken rib can cause collapsed lung (atelactis)

The thymus is part of the ___ system and produces ____

Immune; t-lymphocytes

Where is the thymus located?

Behind the manubrium and inferior to thyroid gland

The thymus decrease/increase with age

Decrease

What is the blood supply to the thymus?

internal thoracic artery

What hormones does the thyroid gland produce?

Thyroxine and calcitonin

What are the 3 parts of the thyroid gland?

Right lobe, left lobe, isthmus

What is anatomical variation of the thyroid gland in 50% of population?

Pyramidal lobe

What is an anatomical variation of muscles of the thyroid?

Lavator granulae

Does the thyroid gland have good blood supply?

HIGHLY vascular

What is the blood supply to the thyroid?

Superior thyroid artery and inferior thyroid artery

What is an anatomical variation of the thyroid arteries in 10% of people?

Thyroid ima artery; can be damaged in tracheotomy

What is an abnormal swelling of the thyroid gland?

Goiter

What is a goiter due to dietary deficiency of iodine?

Endemic goiter