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207 Cards in this Set
- Front
- Back
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What is contained in the superficial cervical fascia?
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platysma, cutaneous nerves, superficial veins
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What structures does the investing layer enclose?
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trapezius and sternocleidomastoid, parotid and submandibular glands
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What structures does the pretracheal layer enclose?
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Muscular component - encloses infrahyoid muscles
Visceral component - encloses thyroid gland, trachea, esophagus, which is continuous with buccopharyngeal layer |
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The _________ is continuous with visceral layer (of pretracheal) and contains _________ and ________ arteries, _____________ vein and ___________ nerve
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carotid sheath, common and internal carotid, internal jugular, vagus
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What structures does the prevertebral layer enclose?
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prevertebral, scalene, levator scapulae, and intrinsic back muscles and extends laterally as axillary sheath
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What is the retropharyngeal space?
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potential space between prevertebral layer and buccopharyngeal fascia, which is continuous with superior mediastinum
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The retropharyngeal space is potential space between __________ and _____________, which is continuous with ______________
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prevertebral layer, buccopharyngeal fascia, superior mediastinum
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What is the posterior border of the posterior triangle?
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anterior border of trapezius
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What is the anterior border of the posterior triangle?
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posterior border of sternocleidomastoid
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What is the apex of the posterior triangle?
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attachment of trapezius and SCM to the occiput and mastoid process
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What is the base of the posterior triangle?
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mid region of clavicle
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What forms the floor of the posterior triangle?
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semispinalis capitis, splenius capitis, levator scapulae, posterior, middle, and anterior scalene muscles, and prevertebral layer of fascia
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What forms the roof of the posterior triangle?
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investing layer of deep fascia
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The posterior triangle is divided by the ________________ into the occipital triangle and the supraclavicular triangle (also called subclavian triangle and omoclavicular triangle)
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inferior belly of omohyoid muscle
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The inferior belly of the omohyoid muscle divides the posterior triangle into the _____________ and the _______________
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occipital triangle, supraclavicular triangle (or subclavian/omoclavicular triangle)
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What are the contents of the posterior triangle?
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- parts of cutaneous branches of cervical plexus (C!-C4)
lesser occipital (C2) great auricular (C2,3) transverse cervical (C2,3) supraclavicular (C3,4) - spinal accessory nerve (CNXI) - occipital, transverse cervical and suprascapular arteries - truncks of brachial plexus and suprascapular nerve - 3rd part of subclavian artery - cervical lymph nodes |
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What spinal nerve(s) is the lesser occipital nerve a branch of?
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C2
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What spinal nerve(s) is the great auricular a branch of?
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C2,C3
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What spinal nerve(s) is the transverse cervical nerve a branch of?
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C2,C3
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What spinal nerve(s) is the supraclavicular nerve a branch of?
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C3,C4
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What is the cutaneous innervation of the lesser occipital nerve?
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skin of the scalp behind auricle
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What is the cutaneous innervation of the great auricular nerve?
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skin of the auricle over angle of mandible
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What is the cutaneous innervation of the transverse cervical nerve?
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front of the neck
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What is the cutaneous innervation of the supraclavicular nerve?
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lower part of neck, shoulder, and upper part of chest
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What is the scalene hiatus (scalene gap)?
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-triangular space between anterior and middle scalene muscles
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What are the contents of the scalene hiatus (scalene gap)?
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-roots, forming the trunks, of brachial plexus
-2nd part of subclavian artery |
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What is the right subclavian artery a branch of?
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brachiocephalic trunk, level of sternoclavicular joint
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What is the left subclavian artery a branch of?
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from arch of aorta, disce between T3 and T4
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What is the anterior border of the anterior triangle?
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midline of neck
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What is the superior border of the anterior triangle?
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body of mandible
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What is the posterior border of the anterior triangle?
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anterior edge of sternocleidomastoid muscle
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Where is the apex of the anterior triangle located?
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jugular notch of manubrium
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What structures are located in the superficial fascia?
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platysma (CNVII), 4 cutaneous branches of cervical plexus (lesser occipital, great auricular, transverse cutaneous, and supraclavicular), external anterior jugular veins
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What are the 4 subdivisions of the anterior triangle?
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1) Digastric/Submandibular triangle
2) Submental triangle 3) Carotid triangle 4) Muscular triangle |
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Where is the submental triangle of the anterior triangle located?
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between midline, anterior digastric, hyoid and genu of mandible; may also be regarded as single triangle spanning midline
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Where is the submandibular triangle of the anterior triangle located?
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between bellies of digastric and mandible
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Where is the carotid triangle of the anterior triangle located?
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between superior omohyoid, sternocleidmastoid and posterior digastric
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Where is the muscular triangle of the anterior triangle located?
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between superior omohyoid, sternocleidomastoid and midline of neck
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What are the infrahyoid (strap) muscles?
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omohyoid (superior belly), sternohyoid, sternothyroid, thyrohyoid
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What are the suprahyoid muscles?
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anterior and posterior bellies of digastric, stylohyoid, mylohyoid, geniohyoid
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What forms the cervical plexus?
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ventral rami of C1-C4, deep to sternocleidomastoid
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Where is the 3rd part of the subclavian artery located?
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in the supraclavicular triangle
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The subclavian vein is ___________ to the anterior scalene
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anterior
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The subclavian artery continues as the _______________ at the outer border of the first rib
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axillary artery
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Where in the neck is the spinal accessory nerve (CNXI) located?
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slightly above the midpoint of SCM, lies on levator scapulae, enters the deeper aspect of trapezius
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Where is the carefree area of the neck?
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above the spinal accesory nerve in the posterior triangle
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What muscles does the ansa cervicalis innervate?
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infrahyoid muscles except for thyrohyoid (receives separate branch from C1 via hypoglossal nerve)
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What innervates the geniohyoid muscle?
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C1
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What innervates the stylohyoid and posterior belly of digastric muscles?
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facial nerve
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What innervates the mylohyoid and anterior belly of digastric muscles?
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mylohyoid nerve
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What is the opening for CNI?
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olfactory foramina in cribiform plate
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What is the opening for CNII?
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optic canal in sphenoid
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What is the opening for CNIII?
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superior orbital fissure in sphenoid
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What is the opening for CNIV?
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superior orbital fissure in sphenoid
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What is the opening for CNVi?
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superior orbital fissure in sphenoid
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What is the opening for CN VI?
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superior orbital fissure in sphenoid
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What is the opening for CNVii?
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foramen rotundum in sphenoid
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What is the opening for CNViii?
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foramen ovale in sphenoid
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What is the opening for CNVII?
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internal auditory meatus in temporal
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What is the opening for CNVIII?
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internal auditory meatus in temporal
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What is the opening for CNIX?
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jugular foramen between occipital/temporal
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What is the opening for CNX?
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jugular foramen between occipital/temporal
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What is the opening for CNXI?
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jugular foramen between occipital/temporal
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What is the opening for CNXII?
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hypoglossal canal in occipital
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What is a cranial suture?
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Where skull bones articulate
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What are the branches of the thyrocervical trunk?
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Normally branches into suprascapular, transverse cervical, and inferior thyroid (which gives off ascending cervical to deep muscles of neck)
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Where is the 2nd part of the subclavian artery in respect to the anterior scalene muscle?
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posterior to scalene
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Where is the 3rd part of the subclavian artery in respect to the anterior scalene muscle?
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lateral to scalene
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What are the branches of the costocervical trunk?
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deep cervical, to deep muscles of the neck, and superior intercostal to upper two intercostal spaces
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Where is the 1st part of the subclavian artery in respect to the anterior scalene muscle?
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medial to scalene
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What are the terminal branches of the external carotid artery?
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superficial temporal and maxillay
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What are the anterior branches of the external carotid artery?
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superior thyroid, lingual, facial
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What is the middle branch of the external carotid artery?
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ascending pharyneal
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What are the posterior branches of the external carotid artery?
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occipital and posterior auricular
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What is the arterial supply to the thyroid?
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superior thyroid (ECA) and inferior thyroid (thyrocervical trunk)
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What is the venous drainage of the thyroid?
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superior thyroid (IJV), middle thyroid (IJV), inferior thyroid (brachiocephalic vein)
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What muscle does the trochlear nerve (CNIV) innvervate?
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superior oblique
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What muscle does the abducens nerve (CNVI) innvervate?
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lateral rectus
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What is CNVIII responsible for?
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vestibulocochlear nerve, hearing and balance
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What muscles does the spinal accessory nerve (CNXI) innvervate?
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trapezius and SCM
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What muscles does the hypoglossal nerve (CNXII) innervate?
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muscles of the tongue
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What cranial nerves are located in the forebrain?
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Olfactory nerve (I) and Opthalmic nerve (II)
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What cranial nerves are located in the midbrain?
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Oculomotor (III), Trochlear (IV)
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What cranial nerves are located on the pons?
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Trigeminal (V), Abducens (VI), Facial (VII), Vestibulocochlear (VIII)
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What cranial nerves are located in the medulla?
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Glossopharyngeal (IX), Vagus (X), Spinal accessory (XI), Hypoglossal (XII)
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What are the parasympathetic cranial nerves?
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CNs III, VII, IX, and X
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_____________ leave the brain nuclei as ___ganglionic fibers to synapse in ganglia in the head and neck
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Parasympathetic, pre
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______________ leave the chain ganglia in the cervical part of the sympathetic chain as ____ganglionic fibers, then form a plexus around the carotid arteries and are carried throughout the head and neck
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Sympathetics, post
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CNIII (Oculomotor) synapses at which ganglion and travels along which branch of CNV? What is the target tissue?
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ciliary ganglion, V1, intrinsic muscles of the eye
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CNVII which innervates the lacrimal glands synapses at which ganglion and travels along which branch of CNV?
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ptergopalatine, V2?, V1
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CNVII which innvervates the submandibular and sublingual glands synapses at which ganglion and travels along which branch of CNV?
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submandibular, V3
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CNIX synapses at which ganglion and travels along which branch of CNV? What does it innervate?
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otic, V3, parotid gland
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Which branch(es) of CNV are purely sensory?
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V1 (opthalmic) and V2 (maxillary)
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Which branch of CNV is sensory and motor?
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V3 (mandibular)
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What are sweat glands of the head innervated by?
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postganglionic sympathetic fibers
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Which parasympathetic fibers in the head are attached to a branch of CNV?
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EVERY parasympathetic fiber
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Which cranial nerve supplies parasympathetics to every gland in the head except the parotid salivary gland? Which nerve supplies parasympathetics to the parotid gland?
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CNVII, CNIX
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Which nerve passes directly through the parotid gland?
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CNVII
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A patient is not able to follow the red pen during the H test. Which nerve is affected?
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Abducens (CNVI)
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What causes ptosis?
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sympathetic damage
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What supplies sensory innervation to the back of the scalp?
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dorsal rami of cervical spinal nerves
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What supplies sensory innervation to the upper part of the face (area until below the eye)?
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opthalmic branch of CNV (V1)
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What supplies sensory innervation to the middle part of the face (area below the eye until the mouth)?
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maxillary branch of CNV (V2)
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What supplies sensory innvervation to the lower part of the face (area below mouth)?
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mandibular branch of CNV (V3)
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Where does the opthalmic nerve exit?
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superior orbital fissure
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Where does the maxillary nerve exit?
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foramen rotundum
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Where does the mandibular nerve exit?
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foramen ovale
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What are the three important foramina for the trigeminal nerve on the face?
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supraorbital, infraorbital, mental
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What is the lateral border of the infratemporal fossa?
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ramus of mandible
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What is the medial border of the infratemporal fossa?
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lateral pterygoid plate
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What is the anterior border of the infratemporal fossa?
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posterior body of maxilla
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What is the posterior border of the infratemporal fossa?
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mastoid and styloid processes
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What is the superior border of the infratemporal fossa?
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infratemporal surface ofsphenoid
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What is the inferior border of the infratemporal fossa?
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insertion of medial pterygoid on angle of mandible
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What are the contents of the infratemporal fossa?
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pterygoid muscles, insertion of temporalis, maxillary artery and branches, pterygoid venous plexus, mandibular nerve (Viii) and branches, chorda tympani nerve, otic ganglion
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What are the muscles of mastication?
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temporalis, masseter, lateral pterygoid, medial pterygoid
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What action does the temporalis muscle have on the jaw?
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closes jaw
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What structure is the temporalis muscle attached to?
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coronoid process
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Where is the origin of the lateral pterygoid muscle?
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lateral side of lateral pterygoid plate
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Where does the superior head of the lateral pterygoid muscle attach to? Inferior head?
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articular disc, neck of mandibular condyle
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What is the action of the lateral pterygoid muscle?
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protrudes and opens jaw
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What nerve innervates the lateral pterygoid muscle?
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Viii, mandibular nerve
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What nerve innervates the medial pterygoid muscle?
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Viii, mandibular nerve
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What nerve innervates the medial pterygoid muscle?
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Viii, mandibular nerve
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What nerve innervates the masseter?
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Viii, mandibular nerve
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What is the origin of the medial pterygoid muscle?
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medial side of lateral pterygoid plate
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What is the action of the medial pterygoid muscle?
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closes jaw, with masseter
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Where is the masseter located?
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lies outside fossa
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What is the origin of the masseter?
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zygomatic arch
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What is the action of the masseter?
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closes jaw
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What muscles are supplied by the mandibular nerve?
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muscles of mastication (masseter, temporalis, lateral pterygoid, medial pterygoid), tensor tympani, tensor palatini, mylogyoid, anterior belly of digastric (I arch derivatives)
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What structures pass through the foramen ovale?
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Mandibular nerve, Accessory meningeal artery, lesser petrosal nerve, Emissary vein
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What is the somatic sensory innervation of the trigeminal nerve?
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dura mater, skin of anterior 2/3 of scalp, face, conjunctiva, mucous membranes of oral and nasal cavities, paranasal sinuses
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Branches of the trigeminal nerve (CN V) carry what type of autonomic fibers to target organ/tissue?
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parasympathetic postganglionic
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What is the path of the trigeminal nerve as it exits the skull?
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leaves cranial vault and enters dural recess (trigeminal/Meckel’s cave) which contains trigeminal/semilunar ganglion (somatic sensory)
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What are the sensory branches of the ophthalmic nerve?
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supraorbital, supratrochlear, lacrimal, infratrochlear, external nasal
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What are the sensory branches of the maxillary nerve?
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zygomaticotemporal, zygomaticaofacial, and infraorbital
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What are the sensory branches of the mandibular nerve?
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auriculotemporal, buccal, mental
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Where is the ophthalmic nerve located and where does it exit?
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lies in the lateral wall of the cavernous sinus and branches enter orbit via superior orbital fissure
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Where is the maxillary nerve located and where does it exit?
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lies in lateral wall of cavernous sinus and enters pterygopalatine fossa through foramen rotundum
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Where does the mandibular nerve exit?
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passes through foramen ovale and is joined by motor root of the trigeminal as it enters infratemporal fossa
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What muscles does the trigeminal nerve innervate? Which branch innervates them?
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temporalis, masseter, lateral pterygoid, medial pterygoid, mylohyoid, anterior belly of digastric, mylohyoid, The mandibular branch
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What is the sensory branch of the mandibular nerve?
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buccal
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What are the three main branches of the ophthalmic nerve?
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nasociliary, frontal, and lacrimal
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What are the branches of the nasociliary nerve?
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ethmoidal nerves, infratrochlear nerve, long ciliary neves, short ciliary nerves
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What are the branches of the frontal nerve?
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supraorbital and supratrochlear nerves
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What are the branches of the lacrimal nerve?
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no branches but carries parasympathetic fibers from pterygopalatine ganglion to lacrimal gland
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What is the function of the ethmoidal nerves?
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carry sensory from nasal cavity, sphenoid and ethmoid sinuses
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What is the function of the infratrochlear nerve?
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carries sensory from upper eyelid and skin of nose
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What is the function of long ciliary nerves?
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carry sympathetic fibers to iris, sensory from eye
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What is the function of short ciliary nerves?
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carry parasympathetic from ciliary ganglion to ciliary body and iris of eye, sensory from eye
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What is the function of the frontal nerve?
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divides into supraorbital and supratrochlear nerves carrying sensory from anterior scalp
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What is the function of the lacrimal nerve?
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carries sensory from upper eyelid and carries parasympathetic fibers from pterygopalatine ganglion to lacrimal gland
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What are the major branches of the maxillary nerve?
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zygomatic nerve, greater and lesser palatine nerves, nasopalatine nerve, and infraorbital nerve
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What are the branches of the zygomatic nerve?
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divides into zygomaticofacial and zygomaticotemporal nerves
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What are the functions of the zygomaticofacial and zygomaticotemporal nerves?
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carry sensory from cheek and temporal regions
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_______________________ has a communicating branch with lacrimal nerve which carries _______________________ fibers from pterygopalatine ganglion to lacrimal gland
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zygomaticotemporal, parasympathetic fibers
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What are the functions of the greater and lesser palatine nerves?
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sensory from mucosa of palate, lesser palatine carries some taste fibers from soft palate
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What is the function of the nasopalatine nerve?
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sensory from mucosa of nasal cavity and anterior palate
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What is the infraorbital nerve a continuation of?
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maxillary nerve in floor of orbit
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Where does the infraorbital nerve pass through?
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inferior orbital fissure, infraorbital groove, canal, foramen
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What is the function of the infraorbital nerve?
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sensory from skin of nose, cheek, lower lid, upper lip
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The infraorbital nerve gives off what branches?
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middle and anterior superior alveolar nerves (posterior arises from maxillary nerve) which are sensory from maxillary teeth
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What nerve gives off nerve to medial pterygoid?
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mandibular nerve
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What nerve supplies tensor tympani and tensor veli palatini?
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nerve to medial pterygoid
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What are the nerves of the posterior division of the mandibular nerve?
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auriculotemporal, lingual, inferior alveolar
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What is the function of the auriculotemporal nerve?
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sensory only from auricle, scalp and outer surface of tympanic membrane
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What is the function of the lingual nerve?
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somatic sensory from anterior 2/3 of tongue
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What is the function of the inferior alveolar nerve?
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mainly sensory from mandibular teeth but gives off nerve to mylohyoid
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What is the nerve to mylohyoid a branch of?
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inferior alveolar nerve
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What muscles does the nerve to mylohyoid supply?
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mylohyoid and anterior belly of digastric
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What are the nerves of the anterior division of the mandibular nerve?
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buccal nerve (sensory from cheek), motor branches to temporalis, lateral pterygoid and masseter
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What is the chorda tympani?
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branch of CN VII which joins lingual nerve
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What is the function of chorda tympani?
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carries taste fibers from anterior 2/3 of tongue and parasympathetic fibers to the submandibular ganglion which innervates sublingual and submandibular salivary glands
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Where does the facial nerve exit?
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leaves cranial vault via internal acoustic meatus, leaves meatus and passes through facial canal in petrous part of temporal bone
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What does the motor root of the facial nerve innervate?
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stapedius, stylohyoid, posterior belly of digastric, and muscles of facial expression
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What is the function of nervus intermedius?
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carries somatic sensory from external auditory meatus, parasympathetic preganglioncs and taste fibers
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What type of nerve fibers does the greater petrosal nerve carry?
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parasympathetic to pterygopalatine ganglion and taste from soft palate
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How does the facial nerve exit the skull?
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leaves cranial vault via internal acoustic meatus, leaves meatus and passes through facial canal in petrous part of temporal bone, canal takes sharp posterior turn an medial wall of middle ear, geniculate ganglion lies at the turn, canal turns inferiorly and ends at stylomastoid foramen
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What is the path of the chorda tympani nerve?
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leaves facial canal in posterior wall of middle ear and crosses middle ear cavity between malleus and incus on deep surface of tympanic membrane, enters infratemporal fossa via petrotympanic fissure, joins lingual nerve
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What kind of fibers does chorda tympani carry?
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parasympathetic fibers from nervus intermedius to lingual nerve; synapse in submandibular ganglion and postganglionics are distributed to submandibular and sublingual salivary glands; taste fibers from anterior 2/3 of tongue travel in lingual nerve and are carried in chorda tympani to nervus intermedius
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What kind of nerve fibers does the greater petrosal nerve carry?
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parasympathetic and taste fibers
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Where does the greater petrosal nerve branch off of facial nerve?
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leaves facial canal at geniculate ganglion
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Greater petrosal nerve is joined by ________________ carrying __________ fibers from carotid plexus to form nerve of pterygoid canal
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deep petrosal, sympathetic
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The __________ joins pterygopalatine ganglion in ___________
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nerve of pterygoid canal, pterygopalatine fossa
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Temporal branch of facial innervates...
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anterior and superior auricularis, frontalis, orbicularis oculi
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Zygomatic branch of facial innervates...
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orbicularis oculi
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Buccal branch of facial innervates...
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buccinator and other muscles between orbit and mouth
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Mandibular branch of facial innervates...
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muscles below mouth
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Cervical branch of facial innervates...
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platysma
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Posterior auricular branch of facial innervates...
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posterior auricularis and occipitalis
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What are the five layers of the scalp?
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skin, connective tissue, aponeurosis, loose connective tissue, pericranium
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What is the function of the connective tissue in the scalp?
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thin gibrofatty layer with abundant blood supply
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__________________ is a dense connective tissue connection between frontalis and occipitalis muscles
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epicranial aponeurosis/galea aponeurotica
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Epicranial aponeurosis is a dense connective tissue connection between what two muscles?
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frontalis and occipitalis
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What is the function of the loose connective tissue of the scalp?
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loosely connects aponeurosis to underlying periosteum and provides mobiity for three fused layers
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What is the pericranium?
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external periosteum over cranial bones
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Where is the origin and insertion of frontalis muscle?
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originates from skin and fascia of eyebrow and inserts into aponeurosis
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Where is the origin and insertion of occipitalis muscle?
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originates from superior nuchal line and inserts into aponeurosis
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What is the blood supply to the scalp?
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- supratrochlear and supraorbital from phthalmic branch of internal carotid
- superficial temporal, posterior auricular and occipital from external carotid |
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What veins connect the scalp veins with intracranial dural sinuses via emissary foramina?
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Emissary veins
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______________ and ______________ drain into angular and then into facial
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supratrochlear, supraorbital: there is also communication with sueior ophthalmic
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Superficial temporal drains into ___________
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retromandibular, the posterior branch of which joins the posterior auricular to form the external jugular
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What vein drains into cavernous sinus?
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Ophthalmic vein
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What are the sensory nerve branches of ophthalmic nerve (V1)?
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supratrochlear, supraorbital, lacrimal, infratrochlear
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What are the sensory nerve branches of maxillary nerve (V2)?
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infraorbital, zygomaticofacial, zygomaticotemporal
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What are the sensory nerve branches of mandibular nerve (V3)?
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mental, buccal, auriculotemporal
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