Test 2 SamSam General knowledge, clinicals, other

If the neck of the humerus is fractured what is likely injured
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what is the most dislocated carpal bone?lunatewhat is the carpal tunnel?flexor rentinaculum is a double layer membrane covering the carpal groove anteriorly and produces the carpal tunnelwhat goes through the carpal tunnel?transmission of the flexor muscles (FDP, FPL, FDS), and the median nervewhat is carpal tunnel syndrome?compression of the median nerve in the tunnel, and is very painfulwhat causes carpal tunnel syndrome?due to hypothyroidism rheumatoid arthritis, pregnancy amyloidosis most common cause is repetitive motion like typingwhat makes the borders of the axillary region? and what shape does it make?pectoralis major latissimus dorsi ribs and intercostal muscles humerus coracobrachialisTendonopathy of the supraspinatus?usually from baseball calcification, pain tendon rupture if greater then 40 avulsion of the greater tub - younger peoplerotator cuff function?help maintain the stability of the shoulder jointwhat muscles make up the rotator cuff?Supraspinatus infraspinatus teres minor subscapulariswhat does paralysis of the subscapularis muscle do?Maximal lateral rotationDorsal group that insert into the humerus? - could be wrong on this one, just might ask itSupraspinatus Infraspinatus Teres Minor Deltoid subscapularis Teres major Latissimus dorsiVentral muscle group that inserts into the humerus? - could be wrong on this one, just might ask itCoracobrachialis Pectoralis Minor Pectoralis MajorWhat does paralysis of the serratus anterior muscle cause?Winged scapulaWhat is winged scapula with serratus anterior muscle?Cant lift the arm past 90 degreesDifferential diagnosis of winged scapula, rhomboid or serratus anterior M?If the rhomboid muscle is damaged you have winged scapula but you can still elevate the arm over 90 degrees if the serratus anterior muscle is damaged you cant lift your arm over 90 degreeswhat nerve is responsible for biceps jerk?C5-C6What nerve is responsible for triceps jerk?C7-C8what is Erb Duchenne paralysis?it is a upper brachial plexus lesion C5-C6 Traction of the arm at birth or falling on the shoulder may damage the upper part of the plexus - roots pulled out of spinal cord Signs: Deltoid and supraspinatus are paralyzed (no arm abduction) Infraspinatus paralysis leads to medial rotation of the arm. Biceps and Brachialis are also paralyzed (no elbow flexion) . Loss of Biceps and supinator (weak supination) Adductors of shoulder are mildly affected (pectoralis major and Latissimus dorsi)What happens if the deltoid and supraspinatus are paralyzed?no arm abductionwhat does infraspinatus paralysis lead to?medial rotation of the armwhat if the biceps and brachialis are paralyzed?no elbow flexionloss of biceps and supinator?weak supinationwhat is a lower brachial plexus lesion?not as common as the upper injuries is a paralysis of the intrinsic muscle of the hand ( small muscle) with anesthesia is the result of an upward pull of the shoulder klumpkes paralysiswhat is Klumpkes paralysis?C8-T1 is an injury to the C8-T1 roots following a forced abduction of the shoulder signs are atrophic paralysis of the forearm, and small muscles of the hand - claw hand, and often a sympathetic palsy - horners syndrome - lower bracial plexus lesionWhat is claw hand likely the result of?Klumpkes paralysis - injury to C8-T1 rootswhat structures pass through the carpal tunnelFlexor digitorum superficialis and profundus, Flexor pollicis longus and Median nerve. Flexor carpi radialis has its own canal in the groove of trapezium.what colors are the palmarcarpal tendon sheathsgreenWhat is the beer drinking muscle?Brachioradialiswhat is elbow tendinitis?LAteral epicondylitis or tennis/golfers elbow Periosteal irritation, painwhat is the extensor retinaculmcovers the carpal bones dorsally and has a septae which produces 6 tendon compartments through which tendon of the extensor muscles and the abductor pollicis longus pass dorsal tendon sheaths palmarcarpal tendon sheaths?what is duppuytrens contracture?: progressive fibrosis, thickening and shortening of the aponeurosis leads to partial flexion of the ring and small finger.how do you know if the radial nerve is damaged?no extension of the elbow ( the elbow is flexed) no triceps reflex wrist drop = all extensor muscles and supinator are paralyzed, thumb is flexed and adducted sensory loss, dorsolateral lower brachial region, posterior surface of the forearm, dorsum of the hand and radial side of the proximal phalangeshow do you know the nerve in the radial groove is injured?usually in fractures of the humerus triceps muscle is usually working wrist drop and sensory loss in dorsolateral aspect of the forearm and handnerve injury in the forearmhere the deep radial nerve is injured ( wrist drop) extension of the thumb and metacarpal joint is disturbed, while sensation is usually perservedhow do you know the median nerve is injured above the elbow?muscles in the arm wont be affected forearm and hand muscles are affected 1 all flexors of the wrist are paralyzed except: 2 flexor carpi ulnaris and ulnar part of the flexor digitorum profundus 3. thumb flexors and abductor paralyzed but not adductor = ulnar n/ ape hand 4 flexion at metacarpophalangeal joints possible = intact interossei mm and ulnar N 6 1st and 2nd lumbircals lost function and all together inability to fully flex index and middle fingers ( hand of papal benediction) pronation of the forearm and paralyzed and sensory loss over the median N areawhat is the hand of papal benediction?1st and second lumbircals lost function and all together inability to fully flex index and middle fingers - indicator of median nerve injury above the elbowwhat is ape handthumb flexor and abductor are paralyzed but not adductor = ulnar nerve and indicator of a median nerve injury above the elbow or injury at the wrist jointwhat are indicators of injury at the wrist joint?suicide or injury, hand out of car window short muscles of the thumb are paralyzed, not adductor thenar muscles atrophy ( flattended, ape hand) flexor pollicis longus functioning sensory loss over medial N areasaturday night palsy?radial nerve damagehoneymoon palsayradial nerve damageinnervation of the hand is mainly by the?ulnar nerve, on the ulnar side, median nerve on the middle?what are indicators that the ulnar nerve is injured at the wrist?1- fingers are hyper extended at metacarpophalangeal joints and flexed at the interphalangeal joints ( paralysis of interossei mm and 2 medial lumbircals) - claw hand 2, tendon of the flexor digitorum perfundus ( 2 medial ones) paralyzed, therefore flexion of the ring and little finger isnt pssible at distal phalangeal joints 3. small muscles of the little finger are paralyzed 4. abduction and adduction of the fingers are impaired = paralysis of interossei MM, piano playing and writing are imparied Sensory loss over ulnar innervating areawhat is claw hand?Fingers are hyperextended at metacarpophalangeal joints and flexed at interphalangeal joints (paralysis of interossei MM and 2 medial lumbricalswhat happens if the tendon of flexor digitorum perfundus, the two medial ones are paralyzed and what does it indicate?ulnar nerve injury at the wrist flexion of the ring and little finger is not possible at distal phalangeal jointswhat are indicators that the ulnar nerve is injured at the elbow?1 paralysis of flexor carpi ulnaris and medial portion of the flexor digitorum profundus 2. ulnar deviation of the wrist is weakened, hand is abducted and extended 4- Abduction and Adduction of the fingers are impaired ( paralysis of interossei MM, piano playing, writing.. Impaired) 5- Sensory loss over ulnar innervating area.what are borders of the infraclavicular region? and what is it called? and what innervates the skin?deltopectoral triangle borders : the clavicle, deltoid, pectoralism major Skin innervation: medial, intermediate and Lateral supraclavicular nerves (cervical plexus) On deltoid region: innervation by axillary nervewhat are the borders of the axillary region made of? and what does it make?Pectoralis Major, Latis dorsi, ribs and intercostal muscles, humerus and coracobrachialisauxillary artery has how many branches?6 Deep brachial goes behind the humerous, and goes into he radial groovevolkmanns ischemic contracturemay be claw hand dup contractureradial and ulnar artery ?come into the hand and 2 times they meet each other deep palmar arch = more proximal - mainly formed by raidal artery superfical palmar arch = distal, mainly formed by ulnar artery a tiny branch of radialwhat are the 5 groups of lymoh nodes int he axillary region?pectoral medial apicial central subscapularWhere might breast cancers give metastasis to?the axillary lymph node due to 75% of the brest lymphatics draining here remove of the lymph nodes may be nessesary or even masectomy which is removal of the breastwhat is lymphangitis?inflammation of the walls of the lymphatic vesselswhat is volkmanns ischemic contracture?is a permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers. It is more common in children Passive extension of fingers is restricted and painful. Volkmann's Ischemic Contracture is the direct result of undiagnosed Compartment Syndrome. It is excruciatingly painful and disabiling ny fracture in elbow region or upper arm may lead to Volkmann's ischemic contracture but commonly caused due to supracondylar fracture of the humerus. Volkmann's contracture results from acute ischaemia/necrosis of the muscle fibres of the flexor group of muscles of the forearm, especially M. flexor digitorum profundus and M. flexor pollicis longus which becomes fibrotic and short. It is caused by obstruction on the brachial artery near the elbow, possibly from improper use of a tourniquet, improper use of a plaster cast, or compartment syndrome. It is also caused by fracture of forearm bones which cause profuse bleeding from major blood vessels of forearm.what is in the anterior brachial region?Brachial fascia Cephalic vein Basilic vein Basilic hiatus Medial antebrachial cutaneous N. lymph nodes Medial brachial cutaneous N. Intercostobrachial N.what is in the medial bicipital groove?its between the biceps and intermuscular septa contains the Median N, Brachial artery and veins and basilic vein, medial cutaneous antebrachial nerve and ulnar N. medially. Deep in this region, proximally , the radial nerve takes a posterior directionwhat is in the quaderangular space?Teres Minor Teres Major Humerus Long head of Triceps Radial nerve is found deep in the posterior brachial region in radial groove of humerus accompanied by deep brachial A and V.what is in the cubital fossa superfically?Basilic vein Antebrachial Basilic vein Cephalic and Median cubital vein Medial cutaneous antebrachial nerve lateral antebrachial cutaneous nerve (branch of musculocutaneous N.)what is in the cubital fossa deep?Biceps Brachii M. Bicipital aponeurosis Brachialis M Pronator teres Brachioradialis Radial artery and veins recurrent radial A. Median N. Ulnar nerve Radial N. Superficial Radial N. Deep radial N. Supinator musclearteries of the forearm and hand?Radial artery Ulnar artery Deep palmar arch Principal artery of the thumb Superficial palmar arch common digital arteries common palmar digital arteries Dorsal carpal branchwhat is int he anterior antebrachial region?Anastomoses between cephalic and basilic antebrachial veins Medial cutaneous antebrachial N. Radial artery and veins Superficial Radial N. Ulnar N Ulnar artery and veinswhat is in the anterior carpal region?Antebrachial fascia, tendon of palmaris longus Pronator quadratus Radial A. Flexor carpi radialis Median N. Ulnar artery Ulnar nerve Flexor carpi ulnaris Palmar aponeurosiswhat is in the palm of the hand?Superficial palmar arch Deep palmar arch median nerve ulnar nervewhat is in the dorsum of the hand?Radial artery enters the Snuffbox and gives a dorsal branch which produces the dorsal arterial arch of the hand. Then it gives the principal artery of the thumb and then a main branch to join the deep palmar arch.what does the snuffbox border?Tendon of extensor pollicis longus (superior) tendons of the ext. pollicis brevis and abductor pollicis longus (inferiorly).what are the contents of the snuff box?radial artery superficial radial Nhow is the upper limb connected to the trunk?by the shoulder girdlewhat is the shoulder girdle?scapula clavicleglenoid cavity?site of articulation with the head of the humerus - lateral angle of the scapulasuprascapular notch?is bridged at its upper boundary by the superior transverse scapular ligament the suprascapular nerve and vessels run through thisossification of the clavicle occurs where and when? what about the ends?connective tissue(membraneous ossification) during fetal development the ends have endochondral ossification which appears 10+ years , and the ossified centers fuse after thatdescribe the abnormal ossifications of the clavicle and skull bonesfontanelles not fully ossified at birth, can indicate diseasenerve injuries for different fractures of parts of the humerusaxillary ulnar radial medianan ulnar collateral ligament injury in a sprain may lead toabnormal abduction of the forearma radial (lateral) collateral ligament injury in a sprain may lead toabnormal adduction of the forearmcolles fracturefalling on the hand with the arm extended distal end of radius fractures and posterior dislocation of the radius = dinner fork shape of the forearm - silver fork deformity - might injure the median and ulnar nerves aswellwhat are the most common fractures of the skeletal system?upper extremity fractureswhat percentage of bone fractures are in the carpal bones and what is the most affected part? and second?18% scaphoid triquetral fractures - 14% of wrist injurieshow does the carpal groove become the carpal tunnel?the flexor retinaculum covers the carpal groove forming ithow is carpal tunnel syndrome treated?early surgery is possible but typically local steroid injection or splinting oral steroids or ultrasound are other options surgical treatment = division of the flexor retinaculumwhat is the pyramid shaped space in the axillary regionthe axilla or the armpit has the neurovasculature of the upper limbwhat are the primary structures of the axillary regiondistal portions of the brachial plexus axillary artery and its branches axillary vein,a nd related axillary lymph nodes and the lmyphatic vesselswhat is c5-t1brachial plexus originates fromwhat is in the rotator cuff?supraspinatus, infraspinatus, teres minor, subscapularis - all help maintain the stability of the shoulder jointdescribe rotator cuff injurytendinopathy of the suprascapularis , calcification, pain, tendon rupture, avulsion,what is winged scapula which muscle might be involved in a winged scapula what are signs/symptoms of axillary nerve damagecant elevate above 90 degrees - damage to long thoracic nerve serratus anterior fracture of the surgical neck of the humerus loss of sensation over the lateral side of the proximal part of armulnar medial collateral ligament injury in a sprain may lead to an ....abnormal abduction of the forearma radial lateral collateral ligament inury in a sprain may lead to aabnormal adduction of the forearmwhat bone is a boat shapescaphoidwhats most commonly fractured in the wristscaphoidwhats most commonly dislocated in the wristlunatewhere does the tendon of the long head of the biceps brachi pass throughthe shoulder joint and the intertubercular ( bicipital)structures that pass through the carpal tunnelseveral tendons protected by sheaths - to protect against friction + provide synovial fluid flexor digitorum superficialialis profundus median nerve between them flexor pollicis longus flexor carpi radialis - own canal in in the groove of trapeziumwhat is the septae6 tendon compartments on the dorsal aspect of the wrist formed by the extensor retinaculum connected deep to the bones around the carpal area through its extensions called septaewhat are the muscles in the posterior aspect of the forearm generally do?extensors/dorsiflexors of the wrist and handwhat happens if axillary nerve is damaged?loss of abduction of the armwhat are the motor and sensory losses due to injury to the musculocutaneous nerveelbow flexion and supinationhow is blood supplied to the upper limbs?subclavian arterywhich subclavian branches off of the bracicephalic trunkright sidethe subclavian passes through the scalene gap and reaches the axillary region accompanied by what, which is then crosses beneath the clavicle and becomes whatsubclavian vein, and the lower part of the brachial plexus becomes the axillary artery, and veinwhat is the scalene gap?between the anterior and middle scalene muscles and the first ribwhat are the branches of the axillary artery?the highest is the thoracic artery, thoracoaromial artery lateral thoracic artery, subscapular artery, and the anterior and posterior circumflex humeral arterieswhat does the axillary artery become and wherebrachial artery, and when it passes through the lower boundary of the teres major or the latissumus dorsi of the brachial region of the armwhat happens to the brachial artery?it has 1 major branch the deep brachial artery, which goes to the backside of the humerus, and the brachial artery then runs down and divides into the radial and ulnar arteries in the elbow regionwhat happens to the ulnar artery?gives off the common interosseous artery which divide into the anterior and posterior interosseous arteries that run near the interosseous membranewhat are the superficial and deep palmar arches?the radial and ulnar arteries join each other twice by branches forming archeswhat do the superficial and deep palmar arches give off too?superficial and deep palmar arterieswhat happens to the radial arterybranches off into the dorsal carpal arterywhat happens to the dorsal carpal artery?branches off into the dorsal metacarpal and digital arteries providing a blood supply to the handwhat do the palmar digit veins drain intosuperficial venous palmar archwhere do the superical venous palmar arch drain into - fuzzy in book not 100median antebrachial veinwhere do the median antebriachial braichial veins drain intobasilic and brachial veinswhere do the the deep palmar veins drain intoradial and ulnar veinwhere do the radial and ulnar vein drain intobrachial Veinwhere do the brachial , celephalic , and basillic vein drain intoaxillary veinwhat does the axillary vein drain intosubclavian veinwhat merges with the subclavian vein and drains intoright jugular, and brachiocephalic veinwhat do the brachiocephalic veins drain into?the superior venacavawhere does the superior vena cava drain intoright atrium of the heartwhere do the lymphatics of the upper limb arise from? and who do they travel withcutaneous and palmar lymph plexus and they travel with superficial veinswhere do all lymphatics reach?humeral axillary lymph nodesfrom the humeral axillary lymph node what is it drained by? and then where does it goapical lymph nodes, which it then goes into the right or left subclavian trunkwhere do the lymphatics of the left side of the subclavian trunk go?thoracic ductlymph node groups in axillary?5 groups pectoral medial apical central subscapulardraininge of lymph nodessubclabian lymphatic trunk to right lymphatic duct to right venous angleforamen lassoruminteral coratid goes over, covered by cartilage so nothing really goes throughwhat does the axillary region house?the neurovasculature of the upper limbwhat does the axillary region border?the pectoralis major anteriorly, latissimus dorsi posteriorly, serratus anterior medially, and the humerus, and coracobrachialis laterallywhat are the main structures in the axillary region?distal part of the brachial plexus, including cords and major nerves axillary artery and its branches axillary vein axillary lymph nodeswhat do the axillary lymph nodes drain? and what groups are they organized into?the upper limb and breast organized into pectoral lateral apical subscapular and centralwhat of the 5 groups drains whatlateral = upper limb pectoral = mammry gland subscapular = posterior part of the shoulder central- drains all above and the central and others drain into the apical groupwhat does the superfical fasciacalled the brachial fascia beneath the skin has the basilic hiatus - where the basilic vein and the medial cutaneous antebrachial nerve pass throughwhere is blood pressure takenusually the brachial artery using a sphygmometer - can be done in the leg too thowhat is int he radial spiral groove?radial nerve and the deep brachial artery and veinwhat does the deep brachial artery branch into?the radial and middle collerateral arterieswhere is blood withdrawn?the anterior cubital region = medial cubital veinwhere is the origin of the flexor muscles of the wrist?the posterior cubital regionwhere are the anterior interosseous nerve and vessels found?interosseous membrane deep in the anterior antebrachial regionwhat is the anterior part of the wrist called?anterior volar capral regionwhat is in the anterior volar carpal regiontendon of palmaris longus, flexor retinaculum, carpal tunnel, the ulnar nevre and vesseels pass through guyons canalwhat is in the posterior carpal regionsuperficial branches of the basilic and cephalic veins extensor retinaculum branches of the superficial radial nerve dorsal branch of the ulnar nervewhat does the extensor retinaculum doforms 6 tendon compartments for which the tendons of the antebrachial region passsuperficial palmar arch is mainly supplied by what?Ulnardeep palmar arch is mainly supplied by what?Radialthe skull is covered by skin and is called what? and what else is it covered byscalp, and subcutaneous tissues that overlay a thin layer of musclewhat are the two parts of the skullfacial skeleton, and the neurocraniumwhat does the cranium consist of8 bones, the frontal, parietal, occipital, temporal, sphenoid, and ethmoidwhat is the upper part of the skull called? and what is it made ofcalvaria - cranial vault frontal, parietal, and occipitalwhat are the sutures of the skullsites of articulation between the bones of the skull coronal, saggital, and lamboidwhat are sutures the site of?intermembraneous growth - remain ossified to allow new bone formation at the edges of the overlapping bone fronts, and thus remain patent till around 30what is the facial skeleton composed of14 bones, most of which are paired zygomatic maxilla nasal bones lacrimal bones palatine bones inferior nasal conchae mandible - unpaired and vomer - un pairedhow do bones of the skull develop? and what do they consist of?intermembraneous ossification consist of a peripheral compact part - cortex, and a central part occupied by a spongy bone - dipolewhat are sutures?continueous jointswhat are fontanelles?unossified areas between the bones that are found during infancy and early childhood theres large anterior and posterior fontanelles and smaller mastoid and sphenoidal fontanelleswhen do fontanelles ossify?6-36 months after birthwhat is the nasionwhere the frontal bones articulate with the nasal boneswhere is the gabella?where a unibrow would be in the centerwhat does the maxillary cone suture with and wheresuperolaterally with the zygomatic bone and nasal superomediallyNasal conchae?in the nasal cavity found laterally superior and middle are parts of lateral masses of the ethmoid bone , inferior conchae are separate independent facial boneswhat bones join together to form the orbitszygomatic, maxillary, ethmoid, frontal, lacrimal, palatine,area where the coronal, and saggital suture meet?bregmaarea where the lambdoid and saggital suture meet?lambdawhat is below the zygomatic arch and behind the mandiblethe external acoustic meatuswhat does the styloid process give origin too?number of the muscles of the tongue, pharynx, and hyoid bonewhat does the ptrygopalatine fossa communicate with through the inferiro orbital fissure anteriorly and what does the petrygopalatine fossa communicate with laterally though the ptrygomaxillary fissure?Orbit, infratemporal fossawhat makes up the hard palateit is the roof of the oral cavity made by the palatine process of the maxilla and the horizontal plate of the palatine bonechoanaeflank the vomer they are posterior openings to the nasal cavity at the enterance to the nasopharynxwhat is the strongest and largest facial bone?mandiblewhat part of the mandible articulates with the temporal bone?condyloid processwhat is the alveolar process?has several alveoli that provide space for the roots of the lower row of teethwhat does the inferior alveolar nerve do?supplies sensory innervation to the lower teethwhat innervates the face?3 branches of the trigeminal nerve opthalmic branch innervates the skin of the forehead medially via the supratrochlear and supraorbital nerves and laterally via the zygomaticotemporal nervewhat muscles are involved in mastication?masseter, medial and lateral pterygoid , and the temporalisDescribe bells palsyinjury to CN7 causes partial paralysis of mimetic muscles of the facebotoxmuscles relaxwaht gives the blood supply to the head and neckcommon carotid more specifically the external carotid, the internal goes into the skull through the carotid foramen and supplies the brain through the anterior and middle cerebral arterieswhere does the left common carotid artery originate, right?left = Arch right - brachiocephalic trunkwhat are branches of the external carotid?superficial temporal, superior thyroidal, ascending pharyngeal, lingual, facial, occipital, posterior auricular, maxillarywhat is the dialated part of the common carotid called, that bifurcatescarotid sinuswhat primarily returns blood from the head and neckinternal/external/ anterior jugular vein, subclavian veinwhere does the venacava enter the heart?right atrium, inferior vena cava also brings to right atriumcarotid duct?,opens by the upper 2nd molarcarotid glandfacial nerve passes through and branches off 5 times, = innervation to facial expression muscles, CN 7 = minemtic musclesmumpswhen carotid gland becomes swelled, and compresses the nerve, and paralysis of the mucles of 1 side of the face, = bells palsybranches of external carotidfacial, temporal, facial artery becomes angular arterysub mandibular triangle = know borders , contents pic 8326 branchial arches6 branchial arches during embryonic life, and each 1 has 1 nerve artery and vein, and later on branch more give rise to the structres of the face and neck, bones and mucles, and innervated by the nerve tot htat brachial archtounge57 910 12branchail arch 1CN 5Branchial arch 2CN 7Branchial Arch 3CN9Branchial arch 4 and 6vegus nerve - biggest nerve/ parasympathetic nerve, also sensory components, as a mainBranchial Arch 5digirnies degenerates?all muscles of the larynx is NN byCN10 - supererior linergial nerve / inferior = reccurent laringeal nerve?intermatic/posttramtichitch hiking where a nerve joins another to go somewhere,sentinel node / virchowswollen node in root of neck = intraabdominal cancer = cancer of the stomach,trachotomycut through the 1st and second cartilage loops of the trachae,a and put a tube in or cut through the 3/4/5th loop mar cut brachiocephalic veinema thyroid arterymay cut on neck if doing a trachestructures in danger for trachotomyleft brachiocephalic A anterior Thyroid vein ema thyroid artery recurrent laringeal nerve = horsenessremove parathyroid glands?messes up calcium in blood, and messes with muscles, so have to replace whole lifewhere does blood from the head and neck return primarily from?though the internal and external and anterior jugular veins, subclavian vein, and some veins in the posterior of the neckwhat supplies blood to the forehead region of the scalp, and superficial temporal posterior auricular?supraorbital and supratrochlear branches of the opthalmic arteryhow do large hematomas develope in the scalp?head injuries due to a loose subaponeurotic layer, and infections reaching this layer may spread widely to the dura by means of emissary veins, dipolic veins between the bony tables of the skull can also spread infectionwhere do the supraorbital, infraorbital and mental nerves exit the skull?their foraminawhat are trigger points to trigeminal neuralgia ?the foramina i think for the supra orbital mental and infra orbiralwhat is the mental artery a branch of?inferior alveolar Nbranches of the facial artery?inferior and superior labial arterieswhere veins join to the cavernous sinusangular vein dorsal nasal vein, opthalmic and other orbital veins - infections of the face reach the cerebral venous sinuses and meningesparatoid ductalso known as stensens duct, is accompanied by the facial arterywhat drains the petrygoid venus plexusmaxillary veinotic ganglionparasympathetic fibers from the inferior salviary nucleus CN 9 IX and through the auriculotemporal nerve anatomosing with the facial nerve to the parotoid glandhow can mandibular nerve block be achieved?by injection of local anesthesia around the mandibular nerve in the infratemporal fossawhat is extraoral approach of mandibular nerve blockauriculotemporal inferior alveolar lingual and buccal nerves are anesthetizedwhat is the intraoral approach of mandibular nerve blockthrough the buccal mucosa , the inferior alveolar and lingual nerves are anesthetizedborders of the sub mandibular triangleborders = base of the mandible anterior belly of the digastic muscle - NN by CN V3 - angular tract of the cervical fascia -posterior belly of the digastic muscle - posterior boundarycontents of the submandibular trianglesub mandibular gland and lymph nodes submandibular duct facial artery submental artery facial vein - drains into external jugular vein mylohyoid nerve- from CN V3 - NN anterior belly of the digastic M, and myohyloid mylohyoid artery The linguinal N - branch of V3 hypoglossal N CN 12 - NN intrinis mucles of the toungewhat does the inguninal nerve carry?general sensory fibers and special sense fibers from the anterior 2/3 of the tongue. also has parasympathetic fibers that connect to the submandibular ganglion via ganglionic branchesmuscular triangle what does it border?superiro belly of the omohyoid, sternocleidomastoid median line of the neckwhat are the contents of the muscular triangleright and left anterior jugular veins sternohyoid sternothyroid thyrohyoid - innervated by the deep cervical ansacarotid triangle borderssuperior = posterior belly of the digastric muscle medial = supeior belly of the omohyoid muscle lateral = sternocleidomastoid muscle - skin of the traignle is NN by the cervical plexus nerveswhat are the contents of the carotid triangleinferior root of the cervical ansa internal jugular carotid sinus - dialsated part of the common carotid external carotid branches into the ascending pharyngeal, superior thyroid lingual and other arteries vagus nerve upper root of the cervical ansa hypoglossal nervehow is the parasympathetic nervous system activated with arteriesbaroreceptors in the wall of the common carotid senses when blood pressure is high and activates the aprasympathetic nervous system by a reflex mechanismwhat is the carotid bodychemoreceptor that can sense the high CO2 and low o2 in blood is innervated by CN 9 and CN10 and sympathetic nerveshow does carotid angiography work?contrast medium is injected into the internal carotid by catheridization of the femoral artery, the catheter is then directed under x ray to reach the artery, and then the contrast medium is then injected. - direct puncture is rarely necessary it is a xray diagnosis of cerebral vascular diseasesScalene gap - bookformed from the anterior and middle scalene muscles and the first rib, transmits part of the brachnial plexus and the subclavian artery in the root of the neckthyroidlargest endocrine gland in the body c5-t1 levels right lobe left lobe and isthmus thyroid enlargent also known as goiter extends posteriorly and inferiorlythyroids blood supplysuperior thyroid artery comes from the common or external carotid artery inferior thyroid artery comes from the thyrocervical of the subclavian artery, and the small ima artery - some peoplethyroid and drainagetons of veins drain into thyroid veins blood flow to is about 5 ml/g*minhyperthyroidismblood flow to the thyroid is increased = skinny i think, hypo = fatstructure of thyroidseries of follicles that contain colloid - contains thyroglobulin - precursor of thyroid hormonescalcitoninparafollicular cells make, and it lowers the blood canclium levels by inhibiting bone reabsorptiontriidothyronine T3 and thyroxine T4regulate metabolismperifollicular endothelial cellsblood supply to follicles in the thyroidfollocular cellspredominante cell in the thyroid, require iodine to synthesize the idothyronine hormones T3 and T4what mainly supplies the oxygenated blood to the face?mostly by the external carotid and partly by the internal carotid aka most comes from the facial artery which is a branch of the external forehead = supratrochlear A suborbital = opthalmic A anatomose with the dorsal nasal A cming from the ophthalmic AVeins of the face?facial vein anatomoses via the angular vein, with the dorsal nasal vein - this is super important since it allows a direct connection to the caverous sinus - through which infection ex froma furuncle on the lip may get into the skullwhat are all the mimetic muscles innervate by?branches of the facial nerve, temporal, zygomatic, buccal , and marginal mandibularWhat is trigeminal neuralgia?also known as tic douloureux A disorder of unknown etiology (cause) associated with intractable pain along the 3 branches of trigeminal nerve but especially along maxillary and mandibular nerves. A simple trigger such as touch, cold or hot can start the pain.how is trigeminal neuralgia treated?Therapy: Carbamazepine, radiofrequency destruction of the branches involved. Alcohol or Glycerin injection around the trigeminal ganglion. Transection of the sensory root. Vascular decompression of the trigeminal ganglion.Congenital and Spasmodic Torticollis (Wry neck)Congenital Torticollis: Most common type of Torticollis. Fibromatosis (fibrous tissue tumor) of Sternocleidomastoid M. Head turns to the side and face away from the affected side. Leads to stifness of the neck due to fibrosis and shortening of the sternocleidomastoid. Injury during delivery may also result in Torticollis. (muscle tear and hematoma leads to fibrosis) Therapy: division of the muscle below XI nerve or from its distal attachment.what does injury to the platysma do?*Injury to this nerve leads to paralysis of platysma (skin falls away from the neck by folds).**Spasmodic Torticollis (Wry neck)SpasmodicTorticollis: Cranial dystonia (abnormal tonicity) Between 20-60 years of age. Unknown cause. May involve bilateral neck muscles especially the Sternocleidomastoid M. Unilateral deviation of the head. (turning, tilting, flexion or extension of the neck) May involve other muscles in the body. Therapy: myotomy or also section of the spinal Accessory N. and upper cervical ant. rootswhat is goiter?Enlargement of Thyroid gland (nonneoplastic and noninflammatory). Usually not upward shift. Endemic in areas deficient in Iodine in food. Swelling in the neck which may disturb trachea, esophagus and/or laryngeal nerves. Exophthalmic goiter is due to excessive production of thyroxin.ThyroidectomyRemoval of thyroid due to cancer. Subtotal due to preservation of Parathyroid glands and recurrent as well as superior laryngeal nerves. Inadvertent removal of parathyroid glands lead to tetany, severe convulsion and muscle spasm due to decrease in serum Ca++ and may lead to immediate respiratory failure.parathyroid glands?Parathyroid glands: Usually 4, one upper and one lower gland per each thyroid lobe. They are external to thyroid capsule and internal to the connective tissue sheath. Function: Produce parahormon, controlling the metabolism of P and Ca++. - Ca = calctonin