Head and Neck RCA 2

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Author:
vickrum
ID:
302422
Filename:
Head and Neck RCA 2
Updated:
2015-10-01 04:05:39
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MICN301
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Description:
Muscles of mastication
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  1. Name the muscle, origin, insertion, innervation and action
    • Temporalis
    • - Origin: floor of the temporal fossa
    • - Insertion: coronoid process and anterior border of ramus of mandible
    • Innervation: deep temporal branches of mandibular nerve (V3)
    • Actions: elevates mandible; posterior fibres retrude mandible
  2. Name the muscle, origin, insertion, innervation and action
    • Masseter
    • - Origin - zygomatic arch
    • - Insertion - lateral surface of ramus of mandible
    • Innervation: masseteric nerve from mandibular nerve (V3)
    • Action: elevates mandible
  3. Name the muscle, origin, insertion, innervation and action
    • Medial pterygoid
    • - Origin- medial surface of lateral pterygoid plate
    • - Insertion- medial surface of ramus of mandible
    • Innervation: mandibular nerve (V3) via nerve to medial pterygoid
    • Action: elevates and protrudes mandible
    • #
    • Lateral pterygoid
    • Origin: two heads;
    • - upper; infratemporal surface of greater wing of sphenoid
    • - lower: lateral surface of lateral pterygoid plate
    • Insertion; neck of mandible, capsule & disc of Temporomandibular joint (TMJ)
    • - Innervation: lateral pterygoid nerve from mandibular nerve (V3)
    • - Action: protrudes and depresses chin
    • #
    • *Buccinator + parotid duct
  4. Name the muscle, origin, insertion, innervation and action
    • Digastric muscle
    • Origin - two bellies;
    • - Anterior; antero-medial surface of mandible
    • - Posterior: medial side of mastoid process
    • Insertion; intermediate tendon to hyoid bone
    • Innervation: anterior belly by mylohyoid nerve, branch of inferior alveolar n. (V3)
    • - Posterior belly by a branch of facial nerve (VII)
    • Action: elevates the hyoid
    • - With the hyoid bone fixed, depresses the mandible
  5. Temporomandibular joint (TMJ); What contributes to the articulation?

    What other feature is in the joint space?
    • Modified hinge synovial joint
    • Articular surfaces include;
    • - condyle of the mandible,
    • - the articular tubercule (temporal bone)
    • - the mandibular fossa of the temporal bone
    • #
    • An articular disc divides the joint cavity into superior and inferior compartments
  6. What ligaments exist at the TMJ (3)?
    • Lateral ligament: Laterally capsule is thickened as the lateral ligament
    • #
    • There are two other ligaments that connect mandible to the cranium
    • - Stylomandibular ligament: Runs from styloid process to angle of the mandible
    • - Sphenomandibular ligament: Runs from the spine of the sphenoid to the lingula on the medial side of the mandible
  7. What movements of the mandible are allowed at the TMJ (5)? What happens with the disk and tubercle on depression of the mandible?
    • Depression
    • Elevation
    • Protrusion
    • Retraction
    • Lateral movement
    • #
    • When mandible is depressed during mouth opening, the condyle rotates on inferior surface of the disc (hinge movement)
    • Both structures move anteriorly on articular surface (gliding movement)
    • Until condyle lies inferior to tubercle
  8. Name the muscle, origin, insertion, innervation and action
    And the vessel
    • Sternomastoid muscle
    • #
    • Origin - mastoid process and superior nuchal line
    • Insertion; 2 heads
    • - Sternal head; manubrium of sternum
    • - Clavicular head; medial third of clavicle
    • Innervation: accessory nerve (XI), and C2 and 3 nerves
    • Actions: flexes neck and rotates it so face is turned superiorly towards the opposite side
    • - both muscles acting together - draw head forwards
    • #
    • External jugular vein
    • Begins near the angle of the mandible by the union of;
    • - posterior division of retromandibular
    • - posterior auricular veins
    • It crosses sternomastoid and pierces the investing layer of cervical fascia and terminates in the subclavian vein
  9. Describe the muscles which anchor the hyoid bone and their innervation and functions
    • Infrahyoid (Strap) muscles: Following four strap muscles anchor the hyoid bone (they fix and steady it)
    • Why?: so that the suprahyoid muscles can act to depress the hyoid and larynx during swallowing and speaking
    • Innervation: They are supplied by branches arising from the cervical plexus
  10. What are the four Infrahyoid (strap) muscles?
    • Sternohyoid: positioned superficially
    • - origin; manubrium & medial end of clavicle
    • - insertion; body of hyoid bone
    • Sternothyroid: lies deep to sternohyoid
    • - origin; posterior surface of manubrium
    • - insertion;: oblique line of thyroid cartilage
    • Thyrohyoid:
    • - origin; oblique line of thyroid cartilage
    • - insertion; lower border of body and greater horn of hyoid
    • #
    • Omohyoid: consists of two bellies
    • - Inferior; arises from upper border of scapula and passes forward deep to the sternomastoid
    • -  -  it attaches to the intermediate tendon which is held in place by a fibrous loop attached to the clavicle
    • - Superior belly is inserted into the hyoid
  11. Name the muscle, origin, insertion, innervation and action
    • Scalenus anterior muscle (or anterior scalene muscle )
    • - Origin; transverse processes of cervical vertebrae
    • - Insertion; anterior part of first rib
    • - Innervation: lower cervical spinal nerves
    • - Function: flexes the neck forwards and laterally, elevates 1st rib during forced inspiration
    • Scalenus medius: everything is the same as the anterior muscle except;
    • - Insertion; posterior aspect of first rib
    • - Function: flexes neck laterally only
    • #
    • Other practise anatomy labels;
    • - Sternomastoid muscle
    • - Levator scapulae muscle
    • - Omohyoid muscle (inferior belly)
    • - Sternothyroid muscle
    • - Sternohyoid muscle
    • - Thyrohyoid muscle
  12. Describe the three layers of the Deep Fascia of the Neck
    • Investing layer of cervical fascia: Surrounds all structures in the neck and lies between the superficial fascia and muscles
    • - it splits to enclose SCM & trapezius muscles
    • Pretracheal fascia: limited to anterior part of the neck
    • - Lies deep to the infrahyoid muscles, and splits to enclose thyroid, trachea, and oesophagus
    • Prevertebral fascia: forms a tubular sheath for the vertebral column and the muscles associated with it
    • Carotid sheath(es): Tube of fascia that extends from base of the skull to root of the neck. It contains 4 things;
    • - Common and internal carotid arteries
    • - Internal jugular vein
    • - Vagus nerve (X)
  13. Describe the Lymphatic drainage of the face
    • Lymphatic vessels in forehead and anterior part of face accompany other facial vessels
    • - and drain into the submandibular lymph nodes, located along the inferior border of the mandible
    • From lateral part of the face drains into parotid nodes
    • Central part of lower lip and chin drain into submental nodes
    • #
    • All the lymph from the head and neck eventually drains into the deep cervical lymph nodes
    • - which forms a chain along the internal jugular vein
  14. With exception of the atypical C1 and C2, how can we tell the cervical vertibrae from the rest?
    • Body: Small & square shaped
    • - concave superior surface & convex inferior surface
    • Vertebral foramen (canal): large and triangular
    • Transverse processes: transverse foramina (small or absent in C7)
    • - vertebral arteries pass through, except C7
    • Spinous process: short and bifid
    • - process of C7 is long
  15. Describe the differences in C1 and C2
    Describe the joints these vertebrae are involved in
    • The atlas (C1)
    • - has no spinous process or body
    • - consists of two lateral masses connected by anterior and posterior arches
    • - Atlanto-occipital Joints: superior articular facets receive occipital condyles of the skull, permit nodding of the head
    • #
    • The axis (C2)
    • The distinguishing feature is the dens which projects superiorly from the body
    • - Transverse ligament of the atlas: a strong band extending between medial surfaces the lateral masses. It holds the dens of C2 against the anterior arch of C1
    • - Alar ligaments: extend from sides of the dens to lateral margins of foramen magnum. They check excessive rotation of the head and atlas relative to the axis.
    • Atlantoaxial Joints: permit head to be moved from side to side.
    • - Dens acts as a pivot that allows 'skull and C1' as a unit to rotate on C2
  16. What is this nerve? Give its function
    • Phrenic nerve: Takes origin from C4 but receives contributions from C3 to C5
    • - Function: sole motor supply to diaphragm and also sensory to its central part
    • Location: forms at the superior lateral border of the scalenus anterior (anterior scalene muscle)
    • - descends across the muscle and passes between subclavian vein and subclavian artery to enter the thorax
  17. Name the artery labeled CYAN and its tributaries;
    • Inferior thyroid artery
    • The thyrocervical trunk arises from the subclavian artery, medial to the scalenus anterior muscle
    • It has 3 branches; largest and most important is the Inferior thyroid artery
    • - passes to the inferior pole of the thyroid gland (pulled back in the picture)
  18. Name the branches of the external carotid artery (6)

    • Superior thyroid artery: most inferior of
    • the three anterior branches in the neck
    • - Runs deep to the infrahyoid muscles to reach superior pole of thyroid gland
    • Lingual artery: arches
    • superoanteriorly and passes deep to the hypoglossal nerve
    • - disappears deep to the hyoglossus muscle of the tongue.
    • Facial artery: arises either in common with the lingual artery or immediately superior to it
    • Ascending pharyngeal artery: first or second branch and arises from medial side
    • - ascends on the pharynx
    • Occipital artery: arise from posterior surface
    • - passes posteriorly along the posterior belly of digastric to posterior part of the scalp
    • Posterior auricular artery: small posterior branch which ascends posterior to the external auditory meatus
  19. Name this vein, give its path and give its tributaries
    • Internal jugular vein: Drains blood from the brain and superficial parts of the face and neck
    • - Path: commences at the jugular foramen, runs inferiorly through the neck in the carotid sheath, and unites with the subclavian vein
    • Tributaries are;
    • - facial
    • - lingual: deep lingual veins are where sublingually taken drugs are rapidly absorbed
    • - pharyngeal
    • - superior and middle thyroid veins
  20. Describe the nerve supply of the pharynx
    • The pharynx receives nerves from three sources;
    • - pharyngeal branch of the vagus: motor supply to muscles of pharynx & soft palate, and also carries sensory information from laryngopharyx
    • - glossopharyngeal nerve: sensory supply to pharynx except nasopharynx (by pharyngeal branch of V2)
    • - branches from the superior cervical ganglion (sympathetic)
    • These nerves form a plexus in the submucosa termed "pharyngeal plexus"
  21. Muscles of the Soft Palate (4)
    Name the muscles, origin, insertion, innervation and actions


    • The soft palate is the muscle part of the roof of the oral cavity
    • Tensor palati muscle:
    • - Origin; scaphoid fossa of medial pterygoid plate and cartilage of auditory tube.
    • - Path; the muscle passes inferiorly; its tendon hooks around the hamulus of medial pterygoid plate
    • - Insertion; expands & joins opposite tendon to form palatine aponeurosis
    • - Innervation; branch of mandibular nerve (V3)
    • - Actions; tenses soft palate, opens the auditory tube
    • Levator palati:
    • - Origin; cartilage of auditory tube and petrous part of temporal bone
    • - Insertion; palatine aponeurosis
    • - Innervation; pharyngeal plexus (pharyngeal branch of vagus)
    • - Action; elevates soft palate
    • Palatoglossus muscle:
    • - Origin; arise from the of the palatine aponeurosis
    • - Path; runs downwards forming the palatoglossal arch
    • - Insertion; inserted to the side of the tongue
    • - Innervation; pharyngeal plexus (pharyngeal branch of vagus)
    • - Action; pulls the tongue up & constrict the oropharyngeal isthmus
    • Palatopharyngeus muscle:
    • - arise from the palatine aponeurosis & runs down into the oropharynx forming the palatopharyngeal arch
    • - action - elevate the larynx & pharynx or depress the soft palate
  22. Describe five regions into which infections of nasal cavities may spread.
    • 1. The anterior cranial fossa through the cribriform plate of the ethmoid bone
    • 2. The nasopharynx and retropharyngeal soft tissues
    • 3. The middle ear through the auditory tube
    • 4. The paranasal sinuses
    • 5. The lacrimal apparatus and conjunctiva through the nasolacrimal duct

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