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Hello, everybody. Welcome to the Surgical Society's um Anatomy Review. So, um thanks to everybody for voting on the poll last week just to see which section that we were struggling with the most. Um I would definitely agree with you in that. I struggle most with head and neck. So, um hopefully this, some of this stuff helps. Uh Basically, what we're going to be doing is covering the triangles of the neck here. Um I'm gonna draw them on hopefully live um probably have some technical issues, but that's OK. I'm going to do the same with the infra and suprahyoid muscles. Um There's a good wee um Pneumonic here or two Pneumonics that actually help you remember them. So we'll do that and then we're gonna do this. One's quite quick as well. It's just a Pneumonic on the external carotid arteries on their branches. And then we'll basically just overlay that um with the venous drainage and only two of the names are different, which is quite helpful. And um the last bit is cranial foramen uh or for. So I struggled with that a lot. I thought it was just like uh irreducibly complex. The first time I saw it and um after doing a bit of studying on it, it's, it's not so bad. Um There's a wee pneumonic to help us remember the 12 training nerves. So that bit will probably take the longest. But I think it's, I think it's probably the best bit. So if you can hang in until then or even just skip ahead until you see this, that's, that's up ground. So we'll make a wee start here. So firstly, um the submental uh like sub triangle is basically comprised of the um anterior belly of the digastric muscle, the hyoid and then the midline of the neck. So let's see if this lets me draw it on. Yeah, grand technology is working. The next one is the submandibular muscle. So that basically the superior border of that is the mandible. Um The, what would you say the anterior border is the, the anterior digastric muscle and the posterior or lateral. Obviously, if you're facing on, it'll be more lateral um is the digastric posterior. So I'm not gonna see there we go. Submandibular triangle. So um the carotid one, I don't think this is like perfectly the scale, but it's, it might be a wee bit bigger on this diagram than in real life. But it's basically the sternocleidomastoid run down here, the omohyoid uh superior part and um the digastric posterior. So we'll draw that on. Grand. Next is the muscular um triangle. So that's basically the like superior border again of the um our superior belly of the omohyoid, uh just the other side. Um And then the lateral border would be the sternocleidomastoid below. And then I think it stretches the whole way around. So, all right. Not bad, right. And um, we're into the posterior triangle now. So that's really pretty easy. It's just the oc clavicular. There's this wee to one here um in his shoulder and clavicle referring to the clavicle. So can't really go wrong with that one and then occipital. So this is basically the closest part of the I put um on the diagram. So basically a school um and the borders or the sternocleidomastoid the trap and then the omohyoid inferior one. It's quite a big one as well. See if the snaps in the position. Yeah, not too bad. Um Yeah, I should have mentioned for the occipital or sorry, the Viar, I do their own car. Um There we go, the oc clavicular. Um The borders are the stern clad of myoid, the clavicle and the inferior belly of the muscle. So we'll move on to this uh Pneumonic. It's quite helpful. Um So basically for suprahyoid muscles. Um Doctor L like this, he thought it was quite funny. So um it's my genie dig style and that basically um correlates to the mylohyoid, the geniohyoid digastric and a stylohyoid. So we'll draw all these on now. Um I'm going to do the mylohyoid on this side because it's quite big and like it, um, covers the, a lot of the other, the other ones. So, so here here and, um, and then let's go next to the genio high, which basically goes from the highway up to the Mandible as well, but it's not as, uh, not as large. So we do, we go here, um, and then we have the digastric. So that was, you can see that over here, I'll change the color of this. Um You can see that over here and it has two bellies. So we'll try and draw both of them. Um So that one goes here, you know, gone. So basically goes from the mastoid process um to the hyoid and then up to the mandible. Um And then we've just got the hyoid. So it's probably easier to draw it on this left hand side um model. But this is the styloid process here. This, we like sharp bit, it just collects into the or attaches into the, the hyoid there and basically pins down the two bellies of the digastric muscles. So um we move on then and we'll do the infrahyoid. So the new monitor, this is toss down food which helps you um correlate the functions of the muscle roughly to be in like um helping to swallow. Um So we'll do that there. These are a bit easier to remember in terms of like their names, roughly correlate with um with their structure. So the first one is thyrohyoid and we'll do, it's a bright red color. So it basically just goes from the bottom of the thyroid up to the bottom or, yeah. Yeah. Bottom of the thyroid to the bottom of the hyoid. Um, the omohyoid again, easier to come over here. Um Let's see. Yeah, it'll come over here to the left. You can see it, it attaches to the scapula crosses under the sternomastoid and then comes up into um the front, the anterior triangle of the neck there and attaches to the Highwood. Um So it would be, you probably draw it on something like close it orange, right? So I'm gonna go see her. Obviously, it's going across the front and there's no Sterno and Melasoides on this model. So, um next one's a sternohyoid. So that's gonna go from the sternum the whole way up to the hyoid bone there and I'll do that in a sort of a darker brown doing this side as well. And it's roughly just the position of it anyway. And then there's the sternothyroid. So that one pretty similar, but it doesn't go as high. So, uh as the name suggests. So just Sterno to thyroid, stern to thyroid, what does it attach? Right. Right. Right. So those are the two new monarchs, basically my genie dig style super high and um toss down food for, in, for Highwood. Um really helpful in questions where you once, you know, that mnemonic, you can see one of them is completely um out of place and doesn't, can't form a correct answer. So this one shouldn't take too long. Basically. Just um Gerry's used this um pneumonic before and it's to describe some of the main branches of the external carotid. So it's if you go from the bottom to the top, here it is here. Oops, it's uh some anatomists like freaking out per medical students. So some with for superior thyroid anatomists, a sign of fal like is lingual freaking facial out occipital, poor, posterior orre medical maxillary, um superficial temporal is uh for students. So you can see, yeah, better marker here, the pain. So this is the external carotid coming up here. The first one is the superior thyroid, second is ascend of pharyngeal. Next is lingual. Next is facial and you could, they're quite easy to remember where they're going as well. Um The next one is occipital. So going all the way back here, uh posterior auricular uh maxillary and then superficial temporal and these wee blue ticks basically just I mean the um a vein with the same name uh runs in the same path or like alongside it. So, apart from occipital, which is just called the posterior external jugular and then the f in jail is just like a extension of the um internal juggler, it's not on the external all righty. So this is probably the bit that's going to be the most help. Um Fair pl if you've stayed, if you've listened to my voice the whole way through this um but this should help our go a long way, right? So 12 cranial nerves and the neon for remembering them is 000, to touch and feel very good velvet uh heaven. So those stand for olfactory optic oculomotor truck layer, trigeminal abducens, facial vestibular coch layer, um glossopharyngeal vagus, accessory and hypoglossal. So if we start with the um first cranial nerve, so the olfactory nerve in a good color here, right? Sweet. So this is the cribiform plate here. Um And it's where the olfactory nerve passes through. So it basically sends a bunch of nerve fibers through the cribiform plate to reach the sinuses um where it could detect like uh smells and odors. And the best way to remember this is smell a plate of food. Um because the optic nerve is passing through the cribiform plate here, right? Next one is the second cranial nerve. So don't not, it was a bit too bad, I say and sweet. Next one is the um second cranial nerve and that's the optic nerve um as you can see there. So this passes through here and the easiest way to remember it is without that wee red line there. Um That sort of structure here basically reminds me of that wee Tortoise from Kung Fu Panda master Gue. I think his name is. Um So there's his eyes there. And if you remember where his eyes are, you remember where the optic nerve is. Um And where you'd expect it to see in the optic canal. So next one, the reason I chose this, so I've got these two here. Sweet. Um The reason why I chose this sort of semi unannotated um image was because it has the superior orbital fissure level quite well. So that's normally quite hard to see from this angle, but they've highlighted it in green. Um And if you were to think of like um the optic canal only having like one nerve going through in it throughout the optic nerve, this next one is probably best conceived like the a London underground carriage because there's six nerves and multiple vessels. Um any nerve that allows the eye to move goes through here. Um So they're so these are like the oculomotor. So we're taking these off as we go um truck there, all three branches of the ophthalmic nerve, which is actually a branch of the trigeminal itself. And then we have the Abducens nerve. So we're halfway already. Um So it sounds like a lot. But as long as you remember, if that's like a VIP taxi for one nerve, this is basically a London underground. Um That's probably the best analogy. So first you go underneath to find it, um trains also move. So that helps you sort of be reminded that the nerves, all these nerves in here help move the eye and then you get off the train. So that reminds you about like the ophthalmic nerve all righty. So a change color here. Next, we've got the and row of foramina here. So if we're working roughly like medial to lateral, we've got the foramen rotundum, the foramen ovale and then the foramen spinosum same here on this side easier, right? And so one thing we have to remember is that the trigeminal nerve, the one that had its first one of its branches going through here, the ophthalmic branch, um it has three branches that run through three adjacent for Remini. So um we've already covered the first one ophthalmic um which runs through the superior orbital fissure. Um And we can remember the next few, we're using some more pneumonics. So the maxillary nerve runs through the Foramina rotundum, which is this one here. Same on the side. So rotundum ovally spinosum, we're in rotundum now. So the good new for that is your rot in max security prison because one of the trigeminal nerve branches is the maxillary nerve. Um So you're brought in max security prison. OK. Um The last branch of the trigeminal nerve is the mandibular nerve which runs through the Foramina Valley. This big one here, same on that side. Um Oval man is a pretty easy way to remember it, but I've heard Americans using the Pneumonic a real man drinks oval tea, which is like, I think it's their equivalent of like horlick. So that doesn't make sense. But if it sticks and it helps you remember it uh good on you, right? Um So again, like the three branches of the trigeminal nerve that pass through the adjacent foramina are the ophthalmic um which passes through the superior orbital fissure here, the maxillary nerve which passes through the foramen rotundum. This we circle uh remember that using the, your rot and ma security prison and then the mandibular nerve which passes through the Foramina Valley Grant. So the most lateral uh foramen in this wee cluster is the Foramen spinosum. Um The best way to think of what passes through here is just remembering like spinosum for spine and the three things that passed through or the meningeal branch of the mandibular nerve, the middle meningeal artery and the metal manage or vein, right? So this one's quite good. So it's the just referring to um this foramina here. So it's the Foramen uh lacerum. Uh this can be probably just thought of as like a trap door or a fool's gold of the cranium um because it's like big and fairly central. So you think that um this is gonna have loads of really important big structures in it, but it, it doesn't actually. So it's in reality, it's filled with cartilage at birth. So it's not a real Foramen at life. It's just like a cartilage in this junction. Um So it's best thought of as like a trap door. So if we ever got the option like in an exam for the root of any big vessels or cranial nerves, and we pick the foramen lacerum and it will lacerate our grades. So that's probably the best way to think about it. Um, uh another thing that makes it sort of trapped do is at the post zero lateral edge. So these wee two green dots that have added in um that's actually the carotid, it's the exit of the carotid canal. So it's sort of hidden away um from view. The next one is the red dot here. So that's the external acoustic meatus. So if we come down here, you can see that and it's easily recognized mostly just because of its proximity to where the ears would be in the inner ear canal. Um And what goes through here is the facial nerve and the vestibulo cochlear nerve. So we're getting there. So um external acoustic meatus need to just remember vestibular cochlear and facial grant. So we're nearly there. Um Next, we have the jugular foramen, which is just here. We're going red. Now, this is the jugular for Eamon here and probably the best. There's a Pneumonic to remember it and it's a wee bit spicy. So it's basically jugs X XX. And that basically reminds us that the first three cranial nerves with an X in their numeral pass through here. So that is the um vagus, which is 10 and accessory 11. So we're nearly there. And a good, the last good point to um state would probably be that just because like you can see on this side, especially, I've marked out it in green. This is the Condylar canal. Um And you could probably think it, of, think of it as like the con man of the cranium because it's proximity and how easy it is to see beside the jugular foramen, you'd think something else important goes through there. Like maybe the last cranial nerve, the hypoglossal nerve, but it doesn't um it really just has the one we to vein that passes, passes through it. And um what actually houses the hypoglossal nerve, which is the last cranial nerve. Is this wee one here, the wee orange one. And the best way to think about that is like um hypo means, you know, under or below. So it's lower than you think it would be. Um So just to round that off, um we've gone through this mnemonic uh and basically correlated each of the nerves to which uh corresponding foramen they uh leave out of. So, yeah, I'll say it really um Hopefully that give you a wee bit of context uh or for others, it was just a bit of revision. Um Yep. Thank you very much.