10: Anterior Neck

Question 1

separates post triangle from ant triangle

Answer 1

SCM

Question 2

borders of anterior triangle

Answer 2

mandible, midline of neck, anterior border of SCM

Question 3

4 triangles of the anterior triangle and what’s in them (general answer)

Answer 3

muscular (lots of muscles), carotid (carotid + internal jugular), submandibular (salivary gland), submental (mental means chin - region below chin)

Question 4

muscular triangle borders

Answer 4

lateral/superior: superior belly of omohyoid
lateral/inferior: SCM
medial: midline

Question 5

contents of muscular triangle

Answer 5

“strap muscles” - infrahyoid muscles
infra = below
below the hyoid bone

omohyoid
sternohyoid
sternothyroid
thyrohyoid

Question 6

superficial strap muscles

Answer 6

omohyoid

sternohyoid

Question 7

deep strap muscles

Answer 7

sternothyroid - attaches to thyroid cartilage

thyrohyoid

Question 8

infrahyoid muscles action

Answer 8

depress hyoid and larynx during swallowing and speaking

stabilize tongue with the suprahyoid muscles to provide a stable base for the tongue

Question 9

inervation to infrahyoid muscles

Answer 9

ansa cervicales of cerival plexus (C1-C3)

Question 10

muscles of the muscular triangle are all innervated by the ___except for ____

Answer 10

ansa cervicales

thyrohyoid (the short one): C1 (piggybacks with hypoglossal nerve)

Question 11

contents of the carotid sheath

Answer 11

common carotid artery - medial
internal jugular vein - lateral
vagus nerve - posterior
deep cervical lymph nodes

Question 12

also associated with the carotid sheath

Answer 12

CN 9, 11, and 12 pierce the sheath at the top

ansa cervicales embedded in anterior wall

Question 13

C1 fibers piggyback with and innervate

Answer 13

piggyback with hypoglossal nerve

innervate the thyrohyoid m.

Question 14

“viscera” deep to the strap muscles

Answer 14

from superior to inferior:
thyrohyoid membrane
thyroid cartilage (adam's apple)
cricothyroid membrane
cricoid cartilage
thyroid gland
trachea

Question 15

vagus nerve: 3 branches to the larynx

Answer 15

recurrent laryngeal
external laryngeal
internal largyngeal

Question 16

recurrent laryngeal n.

Answer 16

supplies all intrinsic muscles of the larynx EXCEPT for the cricothyroid muscle, which is innervated by the external laryngeal n.

Question 17

external laryngeal n.

Answer 17

innervates the cricothyroid mucles

Question 18

internal laryngeal n.

Answer 18

pierces thyrohyoid membrane with superior laryngeal artery (branch of external carotid a.)
THE ONE WE SAW ON THE PRACTICAL!

Question 19

left recurrent laryngeal n. (review)

Answer 19

wraps around aorta/ligamentum arteriosum

Question 20

right recurrent laryngeal n.

Answer 20

wraps under the R subclavian a./common carotid a.

Question 21

carotid triangle borders

Answer 21

posterior belly of the digastric m.
superior belly of omohyoid m.
SCM

Question 22

carotid triangle contents

Answer 22

carotid sheath - cc, internal jugular, vagus
ansa cervicales - embedded in carotid sheath
hypoglossal nerve XII
branches of external carotid a.

Question 23

to find the hypoglossal nerve

Answer 23

look under the tendon of the digastric m.

Question 24

follow the hypoglossal nerve to find

Answer 24

the superior limb of ansa cervicales

Question 25

superior root of the ansa cervicales

Answer 25

the more medial part of the loop

Question 26

cervical plexus - sensory and motor components

Answer 26

cutaneous: GA, LO, TC (from C2-C3) and SC (from C3-C4) motor: ansa cervicales - OH, ST, SH from C1-C3 and TH from C1 only

Question 27

branches of the external carotid a. in the carotid triangle

Answer 27

superior thyroid a. w superior laryngeal branch ascending pharyngeal a. lingual a. facial a. occipital a. "posterior auricular a." (out of triangle..)

Question 28

branches of external carotid a. NOT in the carotid triangle

Answer 28

maxillary a. | superficial temporal a.

Question 29

superior laryngeal artery travels with

Answer 29

the internal recurrent laryngeal n. and pierces through the thyrohyoid membrane

Question 30

carotid sinus

Answer 30

baroreceptor bulge in the internal carotid a. **innervated by CN 9

Question 31

cartotid body

Answer 31

chemoreceptor small hard thing in the crotch of the common carotid a. **innervated by CN 9

Question 32

what lies deep to the carotid sheath?

Answer 32

anterior scalene muscle branches of cervical arteries phrenic nerve (C3, C4, C5) sympathetic trunk/middle cervical ganglion

Question 33

phrenic nerve is composed of fibers from

Answer 33

C3, C4, and C5

Question 34

sympathetic chain

Answer 34

starting from superior to inferior: superior cervical ganglion - levels C1/C2 - LARGE middle cervical ganglion - lies on the anterior aspect of the inferior thyroid artery, near the cricothyroid cartilage - ON PRACTICE PRACTICAL cervicothoracic ganglion - aka stellate ganglion - posterior to the origin of the vertebral artery

Question 35

submandibular triangle borders

Answer 35

mandible posterior digastric anterior digastric

Question 36

submandibular triangle contents

Answer 36

``` mylohyoid stylohyoid anterior and posterior bellies of digastric facial artery and vein mylohyoid nerve (trigeminal -5) facial nerve (7) hypoglossal (12) submandibular salivary gland ```

Question 37

stylohyoid/posterior belly of digastric relationship

Answer 37

stylohyoid is supposed to run over/superficial to the digastric (but for some reason it's different on ours)

Question 38

contraction of the suprahyoid muscles

Answer 38

opens the mouth (moves mandible down)

Question 39

raphe

Answer 39

center of the mylohyoid, where it inserts on itself

Question 40

different innervation of the submandibular triangle

Answer 40

``` trigeminal nerve - mylohyoid nerve (5): ant. belly of digastric, mylohyoid facial nerve (7): post. belly of digastric, stylohyoid ```

Question 41

digastric/stylohyoid actions

Answer 41

elevates hyoid in swallowing | opens mandible

Question 42

mylohyoid actions

Answer 42

tightens and elevates oral floor draws hyoid forward in swallowing opens mandible, side to side movement (mastication)

Question 43

facial artery/vein

Answer 43

vein runs superficial to the submandibular gland, artery runs deep to it

Question 44

submental artery

Answer 44

from the facial artery | supplies mylohyoid and anterior belly of digastric

Question 45

submental triangle borders

Answer 45

an unpaired triangle anterior bellies of digastric hyoid bone

Question 46

submental triangle contents

Answer 46

mylohyoid (midline raphe) | small veins from anterior jugular v. (drain into external jugular v.)