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didactic year > Anatomy-Neck > Flashcards

Anatomy-Neck Flashcards

1
Q

Platysma

A

Broad muscle extending from the chest and shoulder muscle to the side of the chin
Most superficial
In subcutaneous tissue
Cannot be seen unless it is being tensed

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2
Q

What is the action of the platysma?

A

Tenses the skin of neck and lower face

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3
Q

Innervation for the platysma

A

Cranial nerve 7 (facial nerve)

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4
Q

Sternocleidomastoid (SCM)

A

Divides anterior and posterior triangles
EJV descends superficial to SCM
IJV descends deep to SCM
Landmark for IJV central line placement

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5
Q

Action of SCM

A

Contralateral rotation
Ipsilateral flexion

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6
Q

Innervation of SCM

A

Cranial nerve 11 (accessory nerve)

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7
Q

SCM attachments

A

Sternal/clavicular attachments up to mastoid process

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8
Q

Upper trapezius (UT)

A

Superficial muscle that creates contour of neck/shoulder
SCM and UT originate in same embryo structure and then split, thus they have same innervation

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9
Q

Innervation of UT

A

Cranial nerve 11 (accessory nerve)

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10
Q

4 infrahyoid muscles

A

Sternohyoid
Sternothyroid
Thyrohyoid
Omohyoid

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11
Q

Actions of the infrahyoid muscles

A

Depress hyoid bone and assist in swallowing

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12
Q

Innervation of infrahyoid muscles

A

Ansa cervicalis

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13
Q

Sternohyoid attachments

A

Manubrium (sternum) and hyoid

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14
Q

Sternothyroid attachments

A

Manubrium and thyroid cartilage

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15
Q

Thyrohyoid attachments

A

Thyroid cartilage and hyoid bone

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16
Q

Omohyoid attachments

A

Scapula (inferior head) and hyoid (superior head)

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17
Q

Fascial sling

A

Anchors omohyoid to clavicle

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18
Q

What does the superior head of the omohyoid separate in the anterior triangle?

A

Muscular triangle and carotid triangle

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19
Q

4 suprahyoid muscles

A

Digastric
Mylohyoid
Geniohyoid
Stylohyoid

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20
Q

Action of the suprahyoid muscles

A

Assist with swallowing

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21
Q

Mylohyoid attachments

A

Mandible and hyoid

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22
Q

Mylohyoid Innervation

A

Cranial nerve 5 (trigeminal nerve)

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23
Q

Geniohyoid attachments

A

Mandible (superior to mylohyoid) and hyoid

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24
Q

Geniohyoid Innervation

A

Cranial nerve 12 (hypoglossal)

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25
Q

Stylohyoid attachments

A

Styloid process (pointy- temporal bone) and hyoid

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26
Q

Stylohyoid Innervation

A

Cranial nerve 7 (facial nerve)

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27
Q

Digastric posterior belly attachments

A

Mastoid process to hyoid

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28
Q

Digastric anterior belly attachments

A

Hyoid bone and mandible

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29
Q

Digastric posterior belly Innervation

A

Cranial nerve 7 (facial nerve)

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30
Q

Digastric anterior belly Innervation

A

Cranial nerve 5 (trigeminal)

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31
Q

Digastric

A

Anterior belly is inferior to Mylohyoid

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32
Q

Floor of mouth

A

Mylohyoid and Geniohyoid

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33
Q

Stylohyoid

A

Forms a “tunnel“ for Digastric muscle to pass through (superficial to Digastric)

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34
Q

Prevertebral muscles and their location

A

Longus Colli
Longus Capitis
Rectus Capitis Anterior
Rectus Capitis Lateralis
Located within preverteberal space and posterior to danger space

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35
Q

Prevertebral muscle actions

A

Neck flexion

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36
Q

Longus Capitis

A

Cervical vertebrae and occipital bone

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37
Q

Longus Colli

A

cervical vertebrae

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38
Q

Three scalene muscles

A

Anterior, middle, posterior

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39
Q

Scalene muscle actions

A

Elevate rib cage
Ipsilateral lateral flexion
Accessory respiratory muscles

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40
Q

Anterior and middle scalene attachment

A

Cervical spine and 1st rib

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41
Q

Posterior scalene attachment

A

Cervical spine and 2nd rib

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42
Q

Clinical application of scalenes

A

COPD: increase work of breathing causes overuse of scalenes (elevated shoulders)
TOS (thoracic outlet syndrome): scalenes compress brachial plexus and other thoracic vessels

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43
Q

Cervical viscera

A

3 layers
Endocrine- thyroid and parathyroid
Respiratory- larynx and trachea
Alimentary- pharynx and esophagus

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44
Q

Upper esophageal sphincter (UES)

A

Circular muscle at the back of the throat that opens to allow a mass of food to enter the esophagus

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45
Q

Lower esophageal sphincter (LES)

A

Prevents reflux from the stomach
“not true sphincter”

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46
Q

Pharyngeal constrictor muscles and their location

A

Superior, middle, inferior
Location: Anterior to retropharyngeal space

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47
Q

Superior constrictor

A

Attaches in the cheek

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48
Q

Middle constrictor

A

Attaches to hyoid bone

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49
Q

Inferior constrictor

A

Attaches to thyroid and cricoid cartilage

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50
Q

Brachial Plexus

A

Emerges between Anterior and middle scalenes

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51
Q

Cricothyroid muscles is innervated by

A

External branch of superior laryngeal nerve

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52
Q

Larynx

A

The hollow muscular organ forming an air passage to the lungs and holding the vocal cords

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53
Q

Larynx is innervated by

A

Cranial nerve 10 (Vagus nerve)

54
Q

Right recurrent laryngeal nerve

A

Loops around right subclavian artery

55
Q

Left recurrent laryngeal

A

Loops under aortic arch

56
Q

Deep cervical fascia layers

A

Investing
Pretracheal
Prevertebral
Carotid sheath

57
Q

Investing layer

A

Surrounds neck
Envelopes trapezius and SCM

58
Q

Pretracheal layer (PTL)

A

Surrounds thyroid, trachea, and esophagus
Made of two layers (visceral and muscular)
-Muscular: infrahyoid and suprahyoid muscles
-Visceral: larynx,trachea,pharynx

59
Q

Buccopharyngeal fascia

A

Thin external fascial lining of the pharyngeal constrictor muscles

60
Q

Pre vertebral layer

A

Wraps around scalene muscles and pre vertebral muscles

61
Q

Carotid sheath

A

The deep fascia that covers the
common carotid artery
Internal carotid artery
internal jugular vein
Vagus nerve

62
Q

Alar fascia

A

Connects the right and left carotid sheaths

63
Q

Potential anatomical space

A

Retropharyngeal
Danger space
Pre vertebral

64
Q

Retropharyngeal space

A

Between buccopharyngeal fascia and alar fascia
Posterior to esophagus
URI can spread here
trauma/abscess —-> dysphagia “grinding” sensation throat when turn head R/L

65
Q

Danger space

A

Between the alar fascia and the prevertebral fascia
Infection can easily spread down into thorax

66
Q

Action of the intrinsic laryngeal muscle

A

Production of sound

67
Q

Palatopharyngeal muscle

A

Ascends from back wall of pharynx to the uvula forming the palatopharyngeal arch located posterior to tonsils

68
Q

Muscles of pharynx

A

Palatopharyngeal and Cricopharyngeal m. (UES)

69
Q

Muscles of larynx

A

Cricothyroid and intrinsic laryngeal m.

70
Q

Posterior triangle borders

A

SCM, upper trapezius, clavicle

71
Q

Posterior triangle muscles

A

Scalenes, inferior omohyoid, levator scapula, splenius capitus

72
Q

Posterior triangle nerves

A

CN 11 (accessory), brachial plexus, supraclavicular nerve

73
Q

Posterior triangle vessels/lymph

A

External jugular vein, subclavian arteries + veins, smaller arteries
supraclavicular lymph nodes

74
Q

Anterior triangle borders

A

SCM, midline (hallucinate), mandible

75
Q

Anterior triangle subdivisions

A

Submandibular, carotid, muscular, submental

76
Q

Submandibular borders

A

Anterior Digastric, Posterior Digastric, mandible

77
Q

Submandibular content

A

Submandibular gland, CN 12, submandibular lymph nodes

78
Q

Carotid triangle borders

A

SCM, posterior digastric, superior omohyoid

79
Q

Carotid triangle content

A

Carotid sheath, (CCA,ICA,CN 10 (vagus) IJV), CN 11, CN 12

80
Q

Muscular triangle border

A

SCM, Midline, Superior omohyoid

81
Q

Muscular triangle content

A

Infrahyoid muscles, thyroid and parathyroid glands

82
Q

Submental triangle borders (only one triangle)

A

Hyoid bone,right anterior digastric, left anterior digastric

83
Q

Submental triangle content

A

Submental lymph nodes

84
Q

Heart sends blood to the body via the

A

Aortic arch

85
Q

3 large branches emerge from the aortic arch

A
  1. Brachiocephalic trunk
    1a. R common carotid artery
    1b. R subclavian artery- which branches into R vertebral artery
  2. L common carotid artery
  3. L subclavian artery
86
Q

Blood in head and neck is supplied from

A

Common carotid and common vertebral arteries

87
Q

CCA ascends in

A

Carotid sheath with CN 10 (vagus nerve) ICA and IJV
***common site of artherosclerosis

88
Q

CCA divides into 2 branches

A

External carotid artery
Internal carotid artery

89
Q

ICA

A

Supplies brain (internal skull)
Ascends directly into the carotid canal and does not give off branches in the neck

90
Q

ECA

A

Supplies neck and external skull
Eight branches emerge from the ECA as it ascends in the neck

91
Q

Carotid body

A

Located at ICA/ECA bifurcation
Chemoreceptors monitors O2, CO2, and pH

92
Q

Carotid sinus

A

Enlargement in proximal ICA (ICA/ECA junction)
Baroreceptor monitors BP

93
Q

Eight branches of ECA (four we need to know)

A

Maxillary artery
Facial artery
Superior thyroid artery
Superficial temporal artery

94
Q

Vertebral artery

A

Originates in R/L subclavian artery, ascends through neck in openings at cervical vertebrae known as transverse foramen
Vertebral artery does not give off any branches
Enters skull through the foramen magnum and supplies brain

95
Q

Venous circulation of neck:
Major veins that drain the neck

A

Brachiocephallic vein
External jugular vein
Internal jugular vein
Vertebral veins

96
Q

Major vein of heart

A

Superior vena cava

97
Q

Brachiocephalic vein

A

Formed at junction of IJV and subclavian vein
All venous return coming from head and neck eventually drain into brachiocephalic veins
Brachiocephalic veins merge in SVC that drains into the heart

98
Q

Internal jugular vein

A

Located in carotid sheath descends to the neck deep to SCM
IJV drains internal skull and some veins of face
IJV eventually drains into Brachiocephalic trunk and sends blood back to heart via SVC

99
Q

External jugular vein

A

Superficial to SCM
Drains into subclavian vein
EJV drains the veins of face and scalp

100
Q

Jugular venous distension

A

Congestive pathologies such as R sided heart failure causes EJV to distend and can be observed/assessed during physical

101
Q

Vertebral vein

A

Descends through transverse foramen of the cervical vertebrae and drains blood to brachiocephalic vein which eventually sends blood to heart via SVC

Drains veins from head/scalp and sub-occipital plexus and from the vertebral column (vertebral plexuses)

102
Q

Lymph pathways in neck

A

A network of lymph nodes and lymph vessels that drain head and neck
The lymph nodes/vessels eventually drain into deep cervical lymph node chain that goes onto drain into the venous system via entry into either subclavian vein, IJV, or at the junction of the two
R side: R lymphatic duct
L side: thoracic duct

103
Q

Physical exam skills for lymph node

A

Recognizing and palpating for abnormal (enlarged, tender) lymph nodes

104
Q

Lymph nodes of neck (9 we have to know)

A

Occipital
Pre aurical
Post aurical
jugulodigastric
submandibular
submental
Superficial cervical-anterior
Deep Cervical
Supraclavicular/transverse cervical

105
Q

Jugulodigastric

A

Sentinel node
First to drain lymph from tonsils, pharynx, mouth, and face
Typically largest node

106
Q

Two nerve plexuses are located in the neck

A

Cervical plexus (C1-4): originates from spinal nerve roots
brachial plexus (C5-T1): originates from spinal nerve roots C5-T1, supplies arm

107
Q

3 cranial nerves travel through the triangles of the neck

A

CN 10
CN 11
CN 12

108
Q

Brachial plexus

A

Exits between anterior and middle scalene muscles

109
Q

Cervical plexus

A

Sensation to neck region
Motor output to some neck muscles (infra hyoid) and diaphragm (phrenic nerve)

110
Q

4 sensory nerves of cervical plexus + function

A

Lesser occipital (behind ear)
Greater auricular nerve (in front of ear)
transverse cervicalis
supraclavicular nerve

Supply sensation to the skin along the neck and in front of/behind the ear

111
Q

Motor nerves of neck

A

Phrenic nerve
Ansa cervicalis

112
Q

Cervical plexus nerve block

A

OR: localized anesthesia for a variety of procedures like carotid enderectomy, lymph node dissection, superficial neck structures etc
ED: may be used as localized anesthesia to insert jugular central venous catheters, massage clavicular fractures, repair lacerations, drain abscesses in the ear lobe/submandibular areas etc.

*use SCM as landmark because posterior SCM is where nerve block is

113
Q

Phrenic nerve

A

Supplies diaphragm and originates from nerve roots C3-5
Lays on anterior scalene and descends to thoracic cavity
“3-5 stay alive”

114
Q

Ansa cervicalis

A

Formed from nerve roots C1-C3
Subdivided into superior (C1, more anterior) and inferior loops (C2, C3)
Supplies infra hyoid muscles, loops around IJV and on top of carotid arteries

115
Q

CN 11

A

Descends deep to SCM across the posterior triangle to the trapezius

116
Q

CN 12

A

Emerges near IJV and heads towards the floor of the mouth

117
Q

Structures of posterior neck

A

Upper trap, sub-occipital region, C7 spinous process (most prominent)

118
Q

Structures of lateral neck

A

Upper trap, SCM, EJV, supraclavicular fossa, subclavian artery

119
Q

Structures of anterior neck

A

SCM, hyoid bone, thyroid cartilage, cricoid cartilage, thyroid gland, jugular notch of manubrium

120
Q

Hyoid

A

Keystone of neck
Only attached to muscles
Usually at C3 level

121
Q

Function of thyroid gland

A

Calcium homeostasis
Affects all areas of the body except itself and spleen

122
Q

Landmarks of AP “open mouth” view?

A

Dens and C2 body

123
Q

consequences of a fractured hyoid bone

A

Can result in aspiration pneumonia due to difficulty swallowing

124
Q

Paralysis of the platysma

A

Caused by injury to the cervical branch of the facial nerve

125
Q

Torticollis

A

Contraction or shortening of the cervical muscles that causes twisting of the neck and slanting of the head

126
Q

Endarterectomy

A

Opening an artery at its origin and stripping atherosclerotic plaque

127
Q

Spread of infection in neck if between investing and visceral pre tracheal

A

Can spread into thoracic cavity, anterior to pericardium

128
Q

Subclavian vein puncture

A

Normal point of central line placement
Wrong angle= perforated pleura, lung (pneumothorax) or perforated subclavian artery

129
Q

Injury to laryngeal nerves

A

Can cause vocal cord paralysis
Unilateral: opposite side muscles work overtime to compensate
Bilateral: voice near absent, stridor, noisy respiration

130
Q

External superior laryngeal nerve (damage)

A

Monotone (paralyzed cricothyroid can’t adjust cord length/tension)

didactic year (24 decks)

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