PRACTICE PRACTICAL EXAM HEAD AND NECK PART III

Spring 2016

Key on slide 13; Review slides 14-16

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1. IDENTIFY SPECIFIC STRUCTURE AT TIP OF ARROW

2. WHAT TYPE(S) OF MOVEMENT OCCUR AT THIS JOINT?

AP View Xray of patient with open mouth

33. IDENTIFY STRUCTURE FOUND IN THIS LOCATION.

44. IDENTIFY NERVE

55. IDENTIFY NERVE

LARYNX AND LARYGO‐PHARYNXIN POSTERIORVIEW (Pharynxopened)

66. WHAT IS THE SPECIFIC STRUCTURE (SPACE) THE TIP OF THE PROBE IS IN?

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7. A. IDENTIFY MUSCLEB. TYPES OF NEURONS THAT INNERVATE THIS MUSCLE

VIEW OF SUBOCCIPITAL MUSCLES (Muscles removed on left) 8

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8. WHAT NERVE INNERVATES THIS MUSCLE?

9. IDENTIFY ARTERY.

C2

C1

1010. IDENTIFY STRUCTURE AT TIP OF ARROW.

11. ACTION(S) OF THIS MUSCLE?

12. IDENTIFY MUSCLE.12

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13. IDENTIFY MUSCLE (BE SPECIFIC)

14. WHAT IS THE ANTERIOR ATTACHMENT OF THIS MUSCLE (BE SPECIFIC).

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15. WHAT IS THE SPECIFIC TERM FOR THIS REGION?

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. Branchiomotor8. Suboccipital nerve (dorsal ramus C1)9. Vertebral artery10. Pedicle of vertebra11. Extend C1-Occipital bone, Rotate C1-C212. Obliquus Capitis Inferior13. Superior Pharyngeal Constrictor14. Hyoid bone15. Oropharynx

1. Rectus Capitis Post. Minor- C1 to Occipital bone; Extend2. Rectus Capitis Post. Major- C2 to Occipital bone: Extend, Rotate3. Obliquus Capitis Superior- C1 to Occipital bone; Extend4. Obliquus Capitis Inferior -C2 to C1; Rotate

Rectus Capitis Post. Minor

Rectus Capitis Post. Major

Obliquus Capitis Superior

Obliquus Capitis Inferior

REVIEW: SUBOCCIPITALMUSCLES

All innervated by -Suboccipital N. (dorsal ramus C1)

Semi-spinalisreflected

SUBOCCIPITAL MUSCLES

ACTIONS DEDUCED FROM ORIGIN-INSERTION

1. Rectus Capitis Posterior Minor-Extend2. Rectus Capitis Posterior Major-Extend/rotate3. Obliquus Capitis Superior-Extend4. Obliquus Capitis Inferior-Rotate

SUBOCCIPITAL TRIANGLE = Rectus Capitis Posterior Major, Obliquus Capitis Inferior, Obliquus Capitis Superior

flex‐extend

rotate

OCCIPITALBONE

C1 - ATLAS

C2 - AXIS

Rectus CapitisPosteriorMinor

Rectus CapitisPosteriorMajor

Obliquus CapitisInferior

Obliquus CapitisSuperior

4. CRUCIATE (CROSS) LIGAMENT-parts

1) Transverse Ligament of Atlas

2) Superior Band to Occipital Bone

3) Inferior Band - Body of C2

REVIEW: LIGAMENTS OF CRANIO-VERTEBRAL JOINTS

INFERIORBAND

SUPERIORBAND

Tell Constrictors Apart by level

Superior Constrictor

Middle Constrictor

Inferior Constrictor

SUPERIOR CONSTRICTOR O - Pterygo-mandibular Raphe(Connective tissue 'ligament' from Medial Pterygoid plate to Mandible) CONTINUOUS ANT. WITH BUCCINATOR)MIDDLE CONSTRICTORO - HYOID

INFERIOR CONSTRICTORO - THYROID & CRICOID Cartilage

REVIEW: PHARYNX CONSTRICTOR MUSCLES

PTERYGO-MANDIBULAR RAPHE

BUCCINATOR