1. Triangles Of Neck And Larynx Flashcards
(85 cards)
1
Q
What is at the vertebral level of C3-C4?
A
- Body of hyoid bone
- Upper margin of thyroid cartilage
- Bifurcation of common carotid artery
2
Q
What is at the vertebral level of C5-C6?
A
- Arch of cricoid cartilage
- Superior end of esophagus
- Superior end of trachea
3
Q
Boundaries of anterior triangle
A
- Midline of neck
- SCM
- Lower border of mandible
4
Q
Boundaries of posterior triangle
A
- SCM
- Trapezius m.
- Clavicle
5
Q
Submandibular triangle
A
- Anterior belly of digastric
- Posterior belly of digastric
- Inferior border of mandible
6
Q
Boundaries of submental triangle
A
- Midline of neck
- Anterior body of digastric m.
- Body of hyoid
7
Q
Boundaries of muscular triangle
A
- Body of hyoid
- Superior belly of omohyoid
- SCM
8
Q
Boundaries of carotid triangle
A
- Posterior belly of digastric m.
- Superior belly of omohyoid m.
- SCM
9
Q
Contents of the floor of the posterior triangle
A
- Splenius capitis m.
- Levator scapulae m.
- Scalene mm. (posterior, middle, anterior)
10
Q
Arteries in the posterior triangle (most important)
A
- thyrocervical trunk
- transverse cervical a.
- deep cervical a. (II)/dorsal scapular a.(III)
- superficial cervical a.
- suprascapular a.
- transverse cervical a.
11
Q
Veins in the posterior triangle
A
- External jugular vein (EJV)
- Subclavian vein (SV)
12
Q
Nerves in the posterior triangle
A
- Cervical plexus (cutaneous branches)
- Lesser occipital n.
- Greater auricular n.
- Transverse cervical n.
- Supraclavicular n.
- Ansa cervicalis
- Spinal accessory n.
- Phrenic n.
- Roots of the brachial plexus
13
Q
- Contraction or shortening of SCM causes head to tilt ____ and face to tilt _____ affected side.
- What is this called?
A
- Head tilts toward; face tilts away
- Torticollis
14
Q
Muscles of the anterior triangle
A
- Suprahyoid muscles (elevate hyoid and larynx)
- Mylohyoid m.
- Stylohyoid m.
- Digastric m. (anterior & posterior bellies)
- Geniohyoid
- Infrahyoid muscles (depress hyoid & larynx)
- Sternohyoid
- Omohyoid
- Sternothryoid
- Thyrohyoid
15
Q
Arteries of the anterior triangle
A
From the external carotid artery:
- superior thyroid a
- lingual a.
- facial a.
- ascending pharyngeal a.
- occipital a.
- posterior auricular a.
- maxillary a.
- superifical temporal a.
16
Q
Triangles within the anterior triangle
A
- Submandibular
- Submental
- Carotid
- Muscular (omotracheal)
17
Q
What are the contents of the submandibular triangle?
A
- Submandibular gland
- Submandicular lymph nodes
- Hypoglossal nerve (CN XII)
- Nerve to myolohyoid m.
- Facial artery and vein
18
Q
What are the contents of the submental triangle?
A
- Submental lymph nodes
- Small veins that unite to form anterior jugular vein
19
Q
What are the contents of the carotid triangle?
A
- Carotid sheath: CCA, ICA, IJV, vagus n, deep cervical LN, carotid sinus n., sympathetic nerve fibers
-
Not within the carotid sheath:
- Arteries: branches of the ECA
- Nerves: internal and external laryngeal nerves, hypoglossal nerve, spinal accessory nerve, ansa cervicalis
20
Q
What are the contents of the muscular triangle?
A
- Muscles: sternohyoid m., sternothyroid m., thryohyoid m.
- Viscera: thyroid gland, parathyroid glands, larynx, trachea, esophagus
- Arteries: common carotid a., superior thyroid a., inferior thyroid a.
- Veins: anterior jugular v., thyroid v. (superior, middle, inferior)
- Nerves: ansa cervicalis, external laryngeal v., recurrent laryngeal v.
21
Q
Vasculature of the carotid triangle
A
External carotid a.
- Ascending pharyngeal a.
- Occipital a.
- Posterior auricular a.
- Superior thyroid a.
- Lingual a.
- Facial a.
22
Q
Which structure is an important baroreceptor (arterial BP)?
A
carotid sinus
23
Q
What structure is an important chemoreceptor (O2 levels in blood)?
A
carotid body
24
Q
sole motor supply to the diaphragm
A
phrenic n.
25
clinical importance of the phrenic n.
* sole motor supply to diaphragm =\> phrenic n. must be identified during thoracic surgery and preserved
* phrenic n. arises from neck =\> pt w/ spinal cord injuries below neck are still able to breathe effectively despite paralysis of lower limbs
26
Where is the phrenic n.?
superficial to the **anterior scalene m**.
27
cervical plexus
anterior rami of C1-C4
28
thin connective tissue layer that lies between dermis and investing layer of deep cervical fascia
subcutaneous layer (superficial fascia)
29
contents of the superficial fascia
* cutaneous nerves
* blood and lymphatic vessels
* superficial lymph nodes
* fat
* platysma m.
30
(1) muscle of facial expression
(2) innervation of this muscle
(1) platysma m.
(2) Facial N. (CN VII)
31
layers of the **deep cervical fascia**
1. investing layer
2. pretracheal layer
3. prevertebral layer
32
* most superficial of the 3 deep cervical fascial layers
* surrounds entire neck
* encloses sternocleidomastoid and trapezius m.
* encloses parotid and submandibular glands
* extends to manubrium, clavicles, acromion, spines of scapula
deep cervical fascia
33
* located in the anterior region of the neck
* blends with **fibrous pericardium of the heart**
* muscular layer (infrahyoid muscles), buccopharyngeal fascia, and a visceral layer
pre-tracheal layer
34
* encloses the vertebral column and associate muscles
* extends laterally as the axillary sheath into the arm
* extends from cranial base to mediastinum
pre-vertebral layer
35
Where is the **retropharyngeal space**?
posterior to the pharynx
36
Boundaries of the **retropharyngeal space**
* anterior: buccopharyngeal fascia
* posterior: pre-vertebral fascia
* laterally: carotid sheaths
37
Where does the retropharyngeal space extend to?
* superiorly to the base of the skull
* inferiorly to the mediastinum
38
When would a retropharyngeal abscess develop?
secondary to lymphatic drainage or contiguous spread of URI or oral infections
39
Retropharyngeal abscess/swelling causes?
* cause difficulty in swallowing and speaking
* can be life-threatening
40
muscles of larynx
* cricothyroid m.
* thyro-arytenoid m.
* posteriorcrico-arytenoid m.
* lateral crico-arytenoid m.
* transverse and oblique arytenoids m.
* vocalis m.
41
innervation of the cricothyroid m.
external laryngeal nerve (CN X)
42
innervation of all muscles of the larynx (except cricothyroid m.)
inferior laryngeal nerve (terminal part of recurrent laryngeal n.)
43
runs superficially and laterally across the phrenic n. and anterior scalene m.
transverse cervical a.
44
* branch of the thyrocervical trunk
* passes inferolaterally across the anterior scalene m. and phrenic n.
* travels with the suprascapular n.
suprascapular artery
45
route of external jugular vein (EJV)
* begins _inferior to the angle of the mandible_ by the union of **posterior retromadibular v.** & **posterior auricular v.**
* anterior to the SCM
* drains into the **subclavian v.**
46
route of subclavian vein
* anterior to the anterior scalene m.
* joins with **internal jugular v**. to form the **brachiocephalic v.**
47
Occipital triangle (posterior)
1. Boundaries
2. Contents
1. Boundaries
* SCM
* trapezius m.
* inferior belly of the omohyoid
2. Contents
* part of EJV
* posterior branches of cervical plexus of n.
* spinal accessory nerve (CN XI)
* trunks of brachial plexus
* cervicodorsal trunk
* cervical lymph node
48
Omoclavicuar/subclavian triangle (posterior)
1. Boundaries
2. Contents
1. Boundaries
* SCM
* inferior belly of the omohyoid
* clavicle
2. Contents
* subclavian a.
* part of subclavian v.
* suprascapular a.
* supraclavicular lymph nodes
49
Floor of the submandicular triangle
* Myolohyoid m.
* Hypoglossus m.
* Middle pharyngeal constrictor
50
Floor of the submental triangle
myolohyoid m.
51
Contents of the **carotid sheath**
* Medial: carotid arteries
* Lateral: internal jugular vein
* Posterior: vagus n.
* Anterior/embedded: ansa cervicalis
52
Branches of the vagus nerve
* Pharyngeal branch
* Superior laryngeal
* Internal branch of the superior laryngeal n.
* External branch of the superior laryneal n.
* Carotid body branch
53
anatomist reference to superior thoracic aperture where food and air may enter
thoracic inlet
54
clinician reference to superior thoracic aperture where arteries and nerves emerge
thoracic outlet
55
contents of the thoracic inlet/outlet
* lung apex
* subclavian a. and v.
* brachial plexus
* vagus n.
* phrenic n.
* thoracic duct
* right lymphatic duct
* sympathetic chain
* trachea
* esophagus
56
Which branches of the cervical plexus provide sensory innervation: superficial or deep?
superficial branches
57
Which branches of the cervical plexus provide motor innervation: sueprficial or deep?
deep branches
58
Location of **superior cervical ganglion**
C1-C2
59
Location of **middle cervical ganglion**
C6 (level of cricoid cartilage)
60
Location of **inferior cervical ganglion**
anterior to TP of C7
61
when inferior cervical ganglion fuses with 1st thoracic ganglion in 80% population
stellate (cervicothoracic) ganglion
62
What bones attach to the investing layer of the deep cervical fascia?
1. occipital and temporal bones
2. zygomatic arches
3. inferior border of mandible
4. hyoid bone
5. SP of cervical vertebrae
\*extends to manubrium, acromion/spine of scapula, and clavicles
63
location of the **thyroid**
* deep to sternothyroid and sternohyoid m.
* vertebral levels C5-T1
* isthmus anterior to 2nd/3rd tracheal rings
64
arteries of the **thyroid**
* superior thyroid a. (anterior-superior aspects)
* inferior thyroid a. (posterior-inferior aspects)
* thyroid ima a. (anterior to trachea, 10% pop)
65
veins of the **thyroid**
superior, middle, and inferior thyroid veins form **thyroid plexus of veins**
66
route of **recurrent laryngeal nerves**
* ascend in a groove between trachea and esophagus
* pass deep to posteromedial surface of lateral lobes of thyroid gland
67
What binds thyroid gland to the trachea and cricoid cartilage of the larynx?
ligaments
68
location of the **larynx**
vertebral levels C3-C6; connected to pharynx and trachea
69
functions of the **larynx**
phonation and patent airway
70
* located at C4
* contain: laminae, laryngeal prominence, superior thyroid notch, superior and inferior thyroid horn
thyroid cartilage
71
* located at C6
* signet ring shaped
* laminae
* arch
cricoid cartilage
72
cartilage of the laryngeal skeleton and membranes
* thyroid
* cricoid
* epiglottic
* arytenoid
* corniculate
* cuneiform
73
aperture for **internal branch of superior laryngeal n.** and **superior laryngeal a.**
thyroihyoid membrane
74
location of cricothyrotomy
cricothyroid membrane
75
Identify:
* epiglottic ligament
* vocal ligament
* cricothyroid joint
76
extends from laryngeal inlet, through which it communicates with laryngopharynx, to the inferior border of the cricoid cartilage; continuous with trachea
laryngeal cavity
77
between laryngeal inlet and vestibular folds
laryngeal vestibule
78
between vestibular and vocal folds
laryngeal ventricle
79
between vocal folds and inferior border of cricoid cartilage
infraglottic cavity
80
space between vocal folds
rima glottidis
81
* accompanies internal branch of superior laryngeal n.
* supplies superior larynx above vocal folds
superior laryngeal a.
82
* accompanies inferior laryneal n.
* supplies inferior larynx below vocal folds
inferior laryngeal a.
83
innervates sensory above vocal folds
internal branch of superior laryngeal n.
84
innervates cricothyroid muscle (motor)
external branch of superior laryngeal n.
85
* terminal branch of recurrent laryngeal n.
* sensory below vocal folds
* motor of all muscles of larynx except cricothyroid
internal laryngeal n.
