skull

Question 1

Supraorbital notch (foramen)

Answer 1

Supraorbital vessels/nerve

Question 2

Infraorbital foramen

Answer 2

Infraorbital nerve/vessels

Question 3

Optic Canal

Answer 3

Optic nerve; ophthalmic artery

Question 4

Superior orbital fissure

Answer 4

Ophthalmic veins; CN3-4, V-1, 6

Question 5

Inferior orbital fissure

Answer 5

Infraorbital nerve/vessels

Question 6

platysma

Answer 6

• Originates from the pectoral fascia below the clavicle.
• Inserts on the inferior border of the mandible and also into the risorius muscle and corner of the mouth (modiolus)
• cervical branch of VII-innervates all muscles on face
• Actions – tense skin of neck, aids in depression of mandible

Question 7

superficial fascia

Answer 7

• Layer of fatty connective tissue that lies between dermis of skin and investing layer of deep cervical fascia. Loose CT
• It contains cutaneous nerves, blood and lymphatic vessels, superficial lymph nodes, and variable amounts of fat.
• Anterolaterally it contains the platysma

Question 8

Fascia

Answer 8

A flat band of connective tissue deep to the skin that covers and either separates or binds the underlying tissue.

Question 9

Deep fascia

Answer 9

• These layers support viscera (e.g., the thyroid gland), muscles, vessels, and deep lymph nodes.
• deep cervical fascia also condenses around the common carotid arteries, internal jugular veins, and vagus nerves to form the carotid sheath.
• These fascial layers form natural cleavage planes through which tissues may be separated during surgery, and they limit the spread of abscesses (collections of pus) resulting from infections.
• deep cervical fascial layers also supplies the slipperiness that allows structures in the neck to move and pass over one another without difficulty, such as when swallowing and turning the head and neck

Question 10

investing fascia

Answer 10

• most superficial deep fascial layer
• Surrounds neck deep to skin and subcutaneous tissue
• Surrounds sternocleidomastoid, omohyoid and trapezius muscles
• Superiorly attaches to:
  
  • inferior border and angle of mandible
  • inferior border of body of hyoid bone
  • inferior border of zygomatic arch
  • mastoid and styloid processes
  • superior nuchal line and external occipital protuberance of skull

Question 11

investing fascia

Answer 11

• Inferior to the attachment of the mandible it encloses the submandibular gland
• Posterior to the attachment of the mandible it splits to surround the parotid gland
• A thickened modification of this layer is the stylomandibular ligament
• Inferiorly attaches to
  * manubrium of the sternum
  * clavicles
  * spines of the scapula and the ligamentum nuchae

Question 12

visceral fascia

Answer 12

• Lies deep to Investing Fascia
• Limited to anterior part of neck
• Arises superiorly from hyoid bone and a shared attachment with pharynx to the base of skull
• Extends inferiorly into the thorax and blends with pericardium of the heart
• Muscular part -encloses infrahyoid muscles
• Visceral part -encloses thyroid gland, pharynx, trachea and esophagus
• Visceral fascia that covers the pharynx is called buccopharyngeal fascia
• Visceral fascia surrounding the trachea and esophagus is referred to as the pretracheal fascia

Question 13

prevertebral fascia

Answer 13

• Forms a tubular sheath for the vertebral column and muscles associated with it
• Superiorly fixed to cranial base
• Inferiorly, the posterior portion blends with the investing fascia of the musculature of the back and anteriorly it blends with the anterior longitudinal ligament of the thoracic vertebrae
• Extends laterally and surrounds the brachial plexus and subclavian vessels as they pass from the neck to the axilla. This is called the Axillary Sheath

Question 14

alar fascia

Answer 14

• Formed by a division of the anterior aspect of the prevertebral fascia.
• Binds to the transverse processes bilaterally
• Separates the space between the viscera anteriorly and the vertebral column posteriorly. It divides this space into the retropharyngeal space (anterior) and the danger space (posterior)

Question 15

what is another name for alar space?

Answer 15

danger space

Question 16

occipital triangle (division of posterior triangle)

Answer 16

sternocleidomastoid, trapezius, omohyoideus

Question 17

subclavian triangle= supraclavicular triangle (division of posterior triangle)

Answer 17

inferior belly of the omohyoideus, clavicle, sternocleidomastoideus

Question 18

sternoclaidomastoid

Answer 18

• Origin: manubrium and medial 1/3 of clavicle
• Insertion: mastoid process
• Actions:flexes the neckdraws head to shoulder, turns face to opposite side,accessory muscle of respiration
• Innervation: Spinal accessory nerve

Question 19

trapezius

Answer 19

• Origin: Spines of thoracic vertebrae
• Insertion:spine and acromion of scapula, lateral 1/3 of clavicle
• Actions: elevation, depression, retraction and superior rotation of the scapula
• Innervation:Spinal accessory nerve

Question 20

omohyoid-inferior belly

Answer 20

• Origin:Superior border of scapula
• Insertion: Intermediate tendon
• Action: Depresses hyoid and larynx
• Innervation: Ansa cervicalis (listed as Ansa hypoglossi in the The Anatomical Basis of Dentistry)

Question 21

omohyoid- superior belly

Answer 21

• Origin: Intermediate tendon
• Insertion: Hyoid bone
• Action: Depresses hyoid and larynx
• Innervation: Ansa cervicalis

Question 22

posterior triangle boundaries

Answer 22

• Anterior – sternocleidomastoid
• Posterior – trapezius
• Inferior: middle third of clavicle
• Roof – deep investing fascia of the neck, superficial fascia and platysma, skin
• Floor – muscles to be described later and overlying prevertebral fascia. Information as to the muscles of the posterior triangle is provided in Table 5-2 of Liebgott.

Question 23

superficial sensory nerves of the neck

Answer 23

• Lesser occipital nerve (Ventral primary ramus of C2)
• Great auricular nerve (VPR of C2, C3)
• Transverse cervical nerve (VPR of C2, C3)
• Supraclavicular nerves (VPR of

Question 24

superficial motor nerves of the neck

Answer 24

-Accessory (XI and VPR of C1 - C5)
-Phrenic (VPR of C3, C4, C5)
Ansa Cervicalis (VPR of C1 (?), -C2, C3) -note: this is not found in the posterior triangle

Question 25

superficial venous drainage

Answer 25

- Anterior jugular, transverse cervical and suprascapular veins drains into the external jugular vein. - The external jugular vein is formed by the union of the posterior branch of the retromandibular vein and the posterior auricular vein.

Question 26

scalenes

Answer 26

Anterior : Transverse processes of C3 to C6 to insert on 1st rib. Bilaterally flexes the neck, singly flexes neck anterior. Innervation – VPR C4 – C7 (note: different than stated in book) Middle: Transverse processes of C2 to C7 to insert on 1st rib. Same actions as anterior scalene. Same innervation as anterior scalene (note: different than stated in book) Posterior: Transverse processes of C5 and C6 to insert on 2nd rib. Same actions as anterior and middle scalenes. Innervation – VPR of C5 to C8 Note: All are accessory muscles of respiration