TRIANGLES & ROOT OF THE NECK

Question 1

Boundaries of root of neck

Answer 1

Anterior. Manubrium and clavicles. Posterior. T1 vertebral body and superior margin of the scapula. Superior. C6 spinal level, approximately at the inferior poles of the thyroid gland. Inferior. Superior thoracic aperture.

Question 2

function of the muscles of the root of the neck

Answer 2

support the cervical and thoracic vertebrae (longus colli), the 1st 2 ribs of the thoracic cage with the cervical vertebrae (scalene muscles), and the laryngeal apparatus with the sternum and clavicle (infrahyoid muscles).

Question 3

Sternocleidomastoid (SCM) o,i,i,a,g

Answer 3

o:Manubrium & medial third of clavicle i:Lateral surface of mastoid process & occipital bone i: Motor:Accessory nerve (CN XI) Proprioception/Pain: C2+C3 nerves a: Bilaterally: flex head, raise thorax; Unilaterally: turns face toward opposite side g:neck

Question 4

SCM deviation if accessory nerve is severed on the left

Answer 4

SCM is stronger on the right, so neck will deviate to the left lesion to right: neck deviates to right

Question 5

Scalene (anterior) o,i,i,a,g

Answer 5

o:Anterior tubercles of transverse processes C3‐C6 i:Scalene tubercle on 1st rib i:Ventral rami of cervical nerves (C5‐C8) a:Elevates first rib g:Prevertebral

Question 6

Scalene (middle) oiiag

Answer 6

O: Posterior tubercles of transverse processes C2‐C7 vertebrae I: Upper surface of first rib (behind subclavian groove) I: Ventral rami of cervical nerves (C3‐C7) A: Elevates first rib G: Prevertebral

Question 7

Scalene (posterior) oiiag

Answer 7

O: Posterior tubercles of transverse processes C4‐C6 I: Outer surface of second rib I: Ventral rami of cervical nerves (C5‐C8) A: Elevates 2nd rib G: Prevertebral

Question 8

Scalene gap and what passes thru it

Answer 8

the gap between the insertion of the anterior scalene and middle scalene. The subclavian artery and brachial plexus travels thru the scalene (hoagland called it the subclavian gap in class) gap. THE SUBCLAVIAN VEIN DOES NOT PASS THRU THE SCALENE GAP (but rather sits superficial to the ant scalene

Question 9

Suprahyoid muscles and infrahyoid muscles

Answer 9

Supra hyoid : mylohyoid, digastric (ant+pst belly), stylohyoid, geniohyoid Infrahyoid: Omohyoid, sternohyoid, sternothyroid, thyrohyoid

Question 10

digastric oiiag (anterior belly)

Answer 10

O: Digastric fossa of mandible I: Intermediate Tendon attached to body of hyoid I: Mylohyoid nerve A: Elevates hyoid and floor of mouth; depresses mandible G: Suprahyoid

Question 11

digastric oiiag (posterior belly)

Answer 11

O: Mastoid notch of temporal bone I: Intermediate Tendon attached to body of hyoid I: Facial nerve (CN VII) A: Elevates hyoid and floor of mouth; depresses mandible G: Suprahyoid

Question 12

Mylohyoid oiiag

Answer 12

O: Mylohyoid line of the mandible I: Median raphe & hyoid bone I: Nerve to mylohyoid (branch of inferior alveolar nerve of CN V3) A: Elevates hyoid bone & tongue when speaking & swallowing; depresses mandible (floor of mouth) G: Suprahyoid

Question 13

Stylohyoid oiiag

Answer 13

o: Posterior border of styloid process i: Body of hyoid at junction with greater horn (slings around intermediate tendon) I: Facial nerve (CN VII) a: Elevates hyoid bone & base of tongue g: suprahyoid

Question 14

Geniohyoid oiiag

Answer 14

o: Inferior genial tubercle of mandible I: Hyoid bone I: C1 coursing with hypoglossal nerve (CN XII) a: Elevates the hyoid bone and tongue when speaking and swallowing; depresses mandible g: Suprahyoid

Question 15

Omohyoid oiiag

Answer 15

O: Inferior belly: from upper border of scapula via intermediate tendon I: Superior belly: to hyoid from intermediate tendon I: Ansa cervicalis A: Steadies & depresses hyoid bone G: Infrahyoid

Question 16

Sternohyoid oiiag

Answer 16

O: Posterior surface of manubrium I: Lower border of body of hyoid I: Ansa cervicalis A: Depresses larynx & hyoid bone, steadies hyoid bone G: Infrahyoid

Question 17

Sternothyroid oiiag

Answer 17

O: Posterior surface of manubrium I: Oblique line on lamina of thyroid cartilage I: Ansa cervicalis A: Depresses larynx & thyroid cartilage G: Infrahyoid

Question 18

Thyrohyoid oiiag

Answer 18

O: Oblique line on lamina of thyroid cartilage I:Lower border of body & greater horn of hyoid bone I: Thyrohyoid branch of C1 via hypoglossal nerve A: Depresses larynx & hyoid bone, elevates thyroid cartilage G: Infrahyoid

Question 19

Superficial fascia

Answer 19

superficial skin and fat contains the platysma muscle anything deep to the superficial fascia is considered deep fascia, contains the cutaneous nerves and vessels

Question 20

Investing layer of deep facia

Answer 20

like a body stocking going all around the neck up to the skull and down to the the thorax (it surrounds the entire neck deep to superficial fascia and also surrounds the superficial layer of the cervical fascia). has a superficial and deep layer. It invests (encloses) the trapezius and SCM muscles. Keeps infections deep (so an infection will go up and down not more superficial

Question 21

pretracheal layer of the deep cervical fascia

Answer 21

pretracheal layer is only in the anterior part of the neck, has a muscular layer and a visceral layer. Runs inferiorly from the hyoid bone to the thorax where it blends with pericardial fascia Muscular layer encloses the infrahyoid muscular group (omohyoid, sternothryroid, thyrohyoid, sternohyoid). Visceral layer encloses thyroid gland trachea+esophagus and is continuous posteriorly with the buccopharyngeal fascia which separates the esophagus from the prevertebral fascia *recurrent laryngeal nerve is located between esophagus and visceral layer.

Question 22

prevertebral fascia of the deep cervical fascia

Answer 22

approaches the anterior tubercles of the vertebrae, contributes the posterior portion of the carotid sheath splits into Alar facia Anteriorly and continues as Prevertebral fascia Posteriorly.

Question 23

Carotid Sheath

Answer 23

tubular, fascial investment that extends from base of skull to the root of the neck. Anteriorly it blends with the investing and pretracheal deep cervical fascia, posteriorly it blends with the prevertebral fascia. Main things in carotid sheath: IC 10 CCs in the IV (internal carotid, Vagus nerve (CN X), Common carotid, internal jugular vein). Ansa cervicalis runs along the lateral side of the carotid sheath but not inside it

Question 24

Retropharyngeal space

Answer 24

the space located behind the pharynx bordered by the alar facia of the prevertebral fascia, buccopharyngeal and the carotid sheath. Contains the sympathatic chain. Alar fascia interdigitates with the buccopharyngeal space at T1 so the retropharyngeal space ends and contains any infections above T1. Rice crisps sound when swallowing and air is in it

Question 25

Prevertebral space (Danger space #4)

Answer 25

the space located behind the alar fascia of the prevertebral between the alar and prevertebral. Infections here can go into the thoracic area and bathes the heart and lungs in bacteria

Question 26

Arteries of the root of neck

Answer 26

Left and right common carotid aa. which give off an internal and external branch. External branch has 8 branches that supplies the neck. Also have the subclavian that gives off the vertebral artery

Question 27

Veins of the root of the neck

Answer 27

The major drainage comes from the internal jugular vein. which meets up with subclavian to form brachiocephalic. This venous angle receives the thoracic duct

Question 28

branches of the external carotid

Answer 28

Superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular, superficial temporal, maxillary

Question 29

branches of subclavian that supply neck

Answer 29

VIT C D (Vitamin C and D)

V: vertebral artery

I: internal thoracic artery

T: thyrocervical trunk ( ISS inferior thyroid, superficial cervical, suprascapular)

C: costocervical artery (SD superior intercostal artery and deep cervical)

D: dorsal scapular artery

Question 30

anterior triangle of neck and subdivisions

Answer 30

Area infront of SCM to midline of neck,

subdivisions: Carotid, muscular, submandibular, submental