Learning & Test Objectives
- Fasciae and compartmentation.
- Arrangement of muscles within their functional groups.
- Origin and insertion, innervation, and function of muscles, vesseles and nerves of the head and neck.
- Upper GIT organs- syntopy, innervation and blood supply, gross structure and ultrastructure, function, salivary glands and ducts course.
- Topographical spaces and cavities of the head and neck.
- Identifying and drawing structures observed on cross-sections.
Description of the test
The test is held by the general rules of written tests (see Continuous Testing – Organisation).
The test will be focused on the origins, insertions, functions, innervations and groups of the muscles of the neck. Apart from the masticatory muscles, it is not required to know the precise origins and insertions of the mimetic muscles. Detailed knowledge of the innervation of the organs of the upper digestive tract is required from the oral cavity to the pharynx. At the end of the test, students will be required to draw and describe one of the required pictures (see list of required pictures).
Clinical notes
Facial clefts are caused by incomplete fusion of the lips, maxilla and hard palate.
Cheiloschisis – cleft lip
Gnathoschisis – cleft maxilla
Palatoschisis – cleft hard palate
Cheilognathopalatoschisis – combined cleft of all the above mentioned structures.
The danger triangle of the face (trigonum mortis) is an area richly supplied with blood, located between the angles of the mouth and root of the nose. Venous blood from this area drains into the intracranial venous sinuses, thus there is a risk of a pathological process spreading to the intracranial space from this area.
An orthopantomograph (OPG) is an X-ray image that clearly shows the facial part of the skull with the teeth in both dental arcades.
When performing first aid, the tongue must be prevented from falling backwards and blocking the airways. This is done by moving the mandible forward (as the tongue is attached to the mandible by the genioglossus). The same effect can be achieved by bending the head backwards, which causes the root of tongue to move out of the laryngeal part of the pharynx.
During acute tonsillitis dead bacteria and denuded epithelial cells accumulate in the pits and crypts of the tonsil and a white exudate emerges on the surface. Swollen tonsils can narrow or even completely close the lumen of the pharynx, impairing swallowing or even causing asphyxiation. Inflammation of the palatine tonsils is also called angina tonsillaris.
The internal carotid artery runs close to the palatine tonsil in the parapharyngeal space. It can be damaged during a careless tonsillectomy as it runs about 25 mm dorsal to the tonsil. Nevertheless, the most common structure prone to bleeding during and after tonsillectomy is the paratonsillar vein (a tributary of the external palatine vein).
Oesophageal varices are a severe consequence of portal hypertension. The elevated portal vein pressure is transmitted to the veins in the submucosa of the cardia and lower part of the oesophagus. Blood stagnates in these veins, resulting in a dilated venous submucosal plexus in the cardia and lower third of the oesophagus. There is a risk of the rupture and life threatening bleeding from oesophageal varices.
Other interesting notes
According to the knowledge of tooth eruption, it is possible to estimate the age of a child with a discrepancy of about half a year.
Division of the parotid gland by the intraparotid plexus (branches of the facial nerve) into the superficial and deep part does not match exactly the morphological division into the pars superficialis and pars profunda.
The auditory tube / pharyngotympanic tube / Eustachian tube (tuba auditiva, tuba pharyngotympanica, salpinx) is a tube connecting the nasopharynx to the middle ear. It serves to equilibrate air pressure in the middle ear.
Pictures to draw
- Dental formula (for deciduous and permanent teeth)
- Innervation of the tongue (somatosensory and special sensory)
- Transverse section of the neck at the C6 level
