USMLE Step 1 Web Prep — Head and Neck: Part I

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SECTION III Gross Anatomy and Organogenesis Head and Neck
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C inica Corre ate Accessory Ner!e in t"e #osterior Triang e Lesions of the accessory nerve in the posterior triangle result in paralysis and wasting of the trapezius and weakness in elevating the shoulder !f the nerve is in"ured as it leaves the skull through the "ugular fora#en$ the sternocleido#astoid will also %e affected$ resulting in a weakness in the a%ility to turn the head to the opposite side

:&/ SLIDE ' of 22 .395415 >>> 00:04:3& SLIDE $ of 22 3954&0 >>> 00:0':00 SLIDE % of 22 T"oracic O&t et Syndrome (aused %y: 1 (ervical )i% & *ancoast +u#or )esults in co#pression of: .u%clavian artery Lower trunk %rachial ple-us 3954&5 >>> 00:0.

395430 >>> 00:09:41 SLIDE ( of 22 C inica Corre ate +he #ost significant artery of the e-ternal carotid syste# is the #iddle #eningeal artery !t arises fro# the #a-illary artery in the infrate#poral fossa and enters the skull through the fora#en spinosu# to supply skull and dura Lacerations of this vessel result in the epidural he#ato#a 395435 >>> 00:10:4& SLIDE ) of 22 .

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and Ske eta E ements Deri!ed .9ll other )ecurrent pul#onary arteries 5e-cept cricothyroid laryngeal laryngeal nerve #uscle6 cartilages :uctus arteriosus 23ote: 3erve is not derived fro# pharyngeal arch !t grows into the arch +a%le !!!4'41 5page &'96 .T"e Ne&ra . and Ske eta E ements Deri!ed .rom t"e #"aryngea Arc"es Contd2 Ner!e/ Artery 0Ne&ra 0Aortic Arc" Ske eta Arc" Ectoderm1 -esoderm1 -&sc e 0-esoderm1 0Ne&ra Crest1 ' 7 )ight and left !ntrinsic #uscles of laryn.uperior artery laryngeal nerve 9rch of aorta (aricothyroid #uscle 23ote: 3erve is not derived fro# pharyngeal arch !t grows into the arch +a%le !!!4'41 395455 >>> 00:&0:0.rom t"e #"aryngea Arc"es Contd2 Ner!e/ Artery 0Ne&ra 0Aortic Arc" -&sc e Ske eta 0Ne&ra Arc" Ectoderm1 -esoderm1 0-esoderm1 Crest1 3 !7 )ight and left co##on carotid )ight left co##on carotid arteries .tylopharyngeus #uscle 8reater horn and lower %ody of hyoid %one +hyroid cartilage 4 7 )ight su%clavian . 5page &'96 SLIDE 12 of 22 T"e Ne&ra .tapes & 0& 1uscle of facial Lesser horn and upper e-pression %ody of hyoid %one . Arteria . Arteria . -&sc& ar. -&sc& ar. and Ske eta E ements Deri!ed . -&sc& ar.:54 5page &'96 SLIDE 11 of 22 T"e Ne&ra .rom t"e #"aryngea Arc"es Ner!e/ Artery 0Ne&ra 0Aortic Arc" -&sc e Arc" Ectoderm1 -esoderm1 0-esoderm1 Ske eta 0Ne&ra Crest1 1 03 1uscles of #astication +ensor ty#pani #uscle 1a-illa 1andi%le !ncus 1alleus . Arteria .tapedious #uscle 23ote: 3erve is not derived fro# pharyngeal arch !t grows into the arch +a%le !!!4'41 395450 >>> 00:1.

rom t"e .3954'0 >>> 00:&1:&& SLIDE 13 of 22 3954'5 >>> 00:&&:4' SLIDE 1$ of 22 #o&c" 1 & 3 4 Ad& t Str&ct&res Deri!ed .pithelial lining of auditory tu%e and #iddle ear cavity .uperior parathyroid gland 5.06 SLIDE 1% of 22 C inica Corre ate +he DiGeorge se3&ence presents with i##unologic pro%le#s$ hypocalce#ia$ and #ay %e co#%ined with cardiovascular defects 5persistent truncus arteriosis6$ a%nor#al ears$ and #icrognathia 3954.pithelial lining of crypts of palatine tonsil !nferior parathyroid gland 5!*6 +hy#us 5+6 .5 >>> 00:&':30 SLIDE 1' of 22 .eta #"aryngea #o&c"es Ad& t Deri!ati!es .*6 <lti#o%ranchial %ody 5<=6 +a%le !!!4'4& 3954.0 >>> 00:&4:41 5page &.

3954/0 >>> 00:&.:3/ SLIDE 1( of 22 Tong&e and #a ate +he anterior t4o t"irds of t"e tong&e is associated with 5"aryngea arc" 1 8eneral sensation is carried %y the lingual %ranch of (3 0 +aste sensation is carried %y c"orda tym5ani of CN 6II 5>igure 1114'4.6 +he 5osterior one t"ird of t"e tong&e is associated with 5"aryngea arc" 3 8eneral sensation and taste are carried %y CN I7 3954/5 >>> 00:&/:30 SLIDE 1) of 22 .

395490 >>> 00:31:00 SLIDE 1* of 22 C inica Corre ate C eft i5 occurs when the #a-illary pro#inence fails to fuse with the #edial nasal pro#inence C eft 5a ate occurs when the palatines shelves fail to fuse with each other or the pri#ary palate 395495 >>> 00:31:&& SLIDE 2+ of 22 C inica Considerations . 5arat"yroid. SLIDE 21 of 22 C inica Considerations 0Contin&ed1 #"aryngea cyst occurs when pharyngeal grooves that are nor#ally o%literated persist$ for#ing a cyst usually located at the angle of the #andi%le Ecto5ic t"yroid.ctopic thyroid tissue is found along the #idline of the neck . or t"ym&s results fro# a%nor#al #igration of these glands fro# their e#%ryonic position to their adult anato#ic position .irst arc" syndrome results fro# a%nor#al for#ation of pharyngeal arch 1 %ecause of faulty #igration of neural crest cells$ causing facial ano#alies +wo well4descri%ed syndro#es are +reacher (ollins syndro#e and *ierre )o%in se?uence =oth defects involve neural crest cells #"aryngea fist& a occurs when pouch & and groove & persists$ there%y for#ing a fistula generally found along the anterior %order of the sternocleido#astoid #uscle 395500 >>> 00:3&:3.ctopic parathyroid or thy#us tissue is generally found along the lateral aspect of the neck 1ay %e an i#portant issue during neck surgery 395505 >>> 00:33:10 SLIDE 22 of 22 C inica Considerations 0Contin&ed1 T"yrog ossa d&ct cyst or fist& a occurs when parts of the thyroglossal duct persist$ generally in the #idline near the hyoid %one +he cyst #ay also %e found at the %ase of the tongue 5lingual cyst6 .