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Transcript
PRACTICE PRACTICAL EXAM
HEAD AND NECK PART III
Spring 2016
Key on slide 13; Review slides 1416
1
1. IDENTIFY
SPECIFIC
STRUCTURE
AT TIP OF
ARROW
2. WHAT
TYPE(S) OF
MOVEMENT
OCCUR AT
THIS JOINT?
2
AP View Xray of patient with open mouth
3
3. IDENTIFY
STRUCTURE
FOUND IN THIS
LOCATION.
4. IDENTIFY
NERVE
5. IDENTIFY
NERVE
4
5
6
LARYNX AND LARYGO‐
PHARYNX
IN POSTERIOR
VIEW (Pharynx
opened)
6. WHAT IS
THE SPECIFIC
STRUCTURE
(SPACE) THE
TIP OF THE
PROBE IS IN?
7
7. A. IDENTIFY
MUSCLE
B. TYPES OF
NEURONS
THAT
INNERVATE
THIS MUSCLE
VIEW OF SUBOCCIPITAL MUSCLES (Muscles removed on left)
8
9
C1
8. WHAT
NERVE
INNERVATES
THIS
MUSCLE?
C2
9. IDENTIFY
ARTERY.
10
10. IDENTIFY
STRUCTURE
AT TIP OF
ARROW.
11
12
11. ACTION(S)
OF THIS
MUSCLE?
12. IDENTIFY
MUSCLE.
13. IDENTIFY
MUSCLE (BE
SPECIFIC)
13
14
14. WHAT IS
THE
ANTERIOR
ATTACHMENT
OF THIS
MUSCLE (BE
SPECIFIC).
15. WHAT IS
THE SPECIFIC
TERM FOR
THIS
REGION?
14
KEY
1. Spinous process (bifid) of C2 vertebra (Axis)
2. Rotate C1-C2 (shake head 'no')
3. Pharyngeal tonsil (roof of nasopharynx)
4. Accessory nerve (CNXI)
5. Vagus nerve (CNX)
6. Piriform recess (popcorn 2, lateral to
laryngeal inlet)
7. A. Stylopharyngeus, B. Branchiomotor
8. Suboccipital nerve (dorsal ramus C1)
9. Vertebral artery
10. Pedicle of vertebra
11. Extend C1-Occipital bone, Rotate C1-C2
12. Obliquus Capitis Inferior
13. Superior Pharyngeal Constrictor
14. Hyoid bone
15. Oropharynx
Rectus Capitis Post. Minor
REVIEW: SUBOCCIPITAL
MUSCLES
Rectus Capitis Post. Major
Obliquus Capitis Superior
Obliquus Capitis Inferior
Semispinalis
reflected
1. Rectus Capitis Post. Minor
- C1 to Occipital bone; Extend
2. Rectus Capitis Post. Major
- C2 to Occipital bone: Extend,
Rotate
3. Obliquus Capitis Superior
- C1 to Occipital bone; Extend
4. Obliquus Capitis Inferior C2 to C1; Rotate
All innervated by Suboccipital N. (dorsal
ramus C1)
SUBOCCIPITAL MUSCLES
ACTIONS DEDUCED FROM ORIGIN-INSERTION
OCCIPITAL
BONE
flex‐extend
C1 - ATLAS
rotate
C2 - AXIS
Rectus
Capitis
Posterior
Minor
Rectus
Capitis
Posterior
Major
Obliquus
Capitis
Superior
Obliquus Capitis
Inferior
1. Rectus Capitis
Posterior MinorExtend
2. Rectus Capitis
Posterior MajorExtend/rotate
3. Obliquus Capitis
SuperiorExtend
4. Obliquus Capitis
InferiorRotate
SUBOCCIPITAL TRIANGLE = Rectus Capitis Posterior Major,
Obliquus Capitis Inferior, Obliquus Capitis Superior
REVIEW: LIGAMENTS OF CRANIO-VERTEBRAL JOINTS
SUPERIOR
BAND
4. CRUCIATE
(CROSS)
LIGAMENTparts
1) Transverse
Ligament of
Atlas
INFERIOR
BAND
2) Superior
Band to
Occipital Bone
3) Inferior Band
- Body of C2
REVIEW: PHARYNX CONSTRICTOR MUSCLES
BUCCINATOR
SUPERIOR
CONSTRICTOR
O - Pterygomandibular Raphe
(Connective tissue
'ligament' from
Medial Pterygoid plate
to Mandible)
CONTINUOUS ANT.
WITH BUCCINATOR)
Superior
Constrictor
Middle
Constrictor
Inferior
Constrictor
PTERYGOMANDIBULAR
RAPHE
MIDDLE
CONSTRICTOR
O - HYOID
INFERIOR CONSTRICTOR
O - THYROID & CRICOID
Cartilage
Tell Constrictors Apart by level