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Head and Neck Anatomy > Neurovascular Structures of the Neck 1 > Flashcards

Neurovascular Structures of the Neck 1 Flashcards

1
Q

What can think of the neck as?

A

We can think of the neck as a tube through which structures pass through to get to the trunk.

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2
Q

The upper parts of which passageways pass through the neck?

A

The upper parts of the respiratory and digestive passageways pass through the neck.

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3
Q

What direction do arterial and venous blood travel in in the neck?

A

Arterial blood travels upwards towards the head and the neck and venous blood travels downwards through the veins.

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4
Q

Aside from arteries and veins what else travels through the neck?

A

Cranial nerves that leave the brain will pass through foramina in the base of the skull and then they will also run down the neck.

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5
Q

What are 2 important functions of the neck?

A

Stability and mobility. Neck needs a strong musculoskeletal framework and it also has to be mobile.

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6
Q

How is stability and mobility of the neck achieved?

A

It is achieved by the 7 cervical vertebrae.

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7
Q

How do pairs of spinal nerves leave the cervical vertebrae?

A

They leave through the intervertebral foramen.

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8
Q

How many pairs of cervical spinal nerves do we have?

A

There are 8 pairs instead of 7.

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9
Q

Why are there 8 and not 7 pairs of cervical vertebrae?

A

Because the first of these pairs leaves leaves the column above the 1st cervical vertebrae.

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10
Q

What do the first 4 cervical spinal nerves supply?

A

They supply several neck muscles and are involved in cutaneous sensation in the neck.

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11
Q

What do the lower pairs of cervical spinal nerves supply?

A

They join the brachial plexus and run into the axilla and onwards to supply the upper limb.

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12
Q

Posteriorly what is the cervical vertebral column surrounded by?

A

There is a thick extensor mass.

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13
Q

Why must the extensor mass on the back of the neck be particularly powerful?

A

Because in the upright position the head falls against the chest at rest therefore you need a strong extensor mass to maintain the upright position of the head.

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14
Q

What are the prevertebral flexor muscles on the front of the cervical column like?

A

They are rather weak because in the upright position they are aided by gravity.

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15
Q

Aside from the flexor and extensor muscles what other sets of muscles does the cervical column give rise to?

A

It gives rise to muscles that suspend the scapula on the back of the rib cage and to another set of muscles that run down the first 2 ribs at the thoracic ribs – these are the scalene muscles.

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16
Q

What are all of the muscle groups of the cervical column surrounded by?

A

They are covered by fascia which is especially well defined over the prevertebral muscles. In front of the prevertebral muscles it is called prevertebral fascia.

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17
Q

What is the ligamentum nuchae?

A

This is a thick bit of the prevertebral fascia in the midline posteriorly between the extensor muscles.

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18
Q

How many major compartments are there in the neck?

A

2 - the anterior compartment and the posterior compartment.

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19
Q

What does the anterior compartment consist of?

A

It transmits the upper parts of the respiratory and digestive tracts which are the trachea and the oesophagus as well as other neurovascular structures.

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20
Q

What does the posterior compartment consist of?

A

It consists of the cervical vertebral column and its surrounding musculature.

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21
Q

What are the anterior and posterior compartments enclosed by on the outside of the sheath?

A

They are enclosed by a sheath of investing or deep cervical fascia which covers the anterior and posterior compartments like a stocking.

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22
Q

Where do neurovascular structures and lymph nodes lie?

A

They lie on either side of the structures in the anterior compartment

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23
Q

What type of gland is the thyroid gland?

A

It is an endocrine gland.

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24
Q

Where does the thyroid lie?

A

The thyroid gland straddles the neurovascular structures and the lymph nodes that lie on either side of the anterior compartment. The thyroid gland lies across the root of the neck.

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25
Q

What are the foramina that are present in the cranial base from front to back?

A
  1. foramen ovale
  2. smaller foramen spinosum
  3. neat round entrance to the carotid canal
  4. irregular jugular foramen between the temporal and occipital bones
  5. stylomastoid foramen between the styloid and mastoid process
  6. anterior condylar foramen
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26
Q

Where is anterior condylar foramen?

A

In line with the 1st cervical vertebrae in the base of the skull, just above the occipital condyle.

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27
Q

What is the anterior condylar foramen also called?

A

It is also called the hypoglossal canal.

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28
Q

What is the hole at the root of the neck?

A

This is the superior aperture of the thorax or the thoracic inlet.

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29
Q

What are the boundaries of the superior aperture of the thorax?

A
  • first thoracic vertebrae
  • first 2 ribs
  • manubrium
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30
Q

What passes through the superior aperture of the thorax?

A
  • airway
  • oesophagus
  • vessels
  • nerves
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31
Q

What are 2 of the branches of the aorta?

A
  • brachiocephalic artery – RIGHT
  • common carotid artery – LEFT
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32
Q

What happens to the brachiocephalic artery before it ascends through the superior aperture of the thorax?

A

It divides.

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33
Q

What is one of the branches of the brachiocephalic artery?

A

The right common carotid artery.

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34
Q

How do the left and the right common carotid arteries ascend the neck?

A

They ascend on the side of the midline tubes.

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35
Q

What happens to the common carotid arteries at the level of the upper border of the thyroid cartilage?

A

They bifurcate into the interal and external carotid arteries.

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36
Q

What ist he internal carotid artery destined to supply?

A

It is destined to supply the brain.

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37
Q

On its way to the base of the skull, does the internal carotid artery give off any branch?

A

No it doesnt give off any branches to the neck on the way to the skull.

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38
Q

How does the internal carotid artery enter the cranial cavity?

A

It enters the cranial cavity by passing through the carotid canal.

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39
Q

Where does the internal carotid artery emerge?

A

It emerges close to the pituitary fossa.

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40
Q

What does the external carotid artery supply?

A

It supplies much of the neck, face and scalp.

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41
Q

What do the branches of the external carotid artery form?

A

They form the carotid tree.

42
Q

Where does the common carotid artery bifurcate?

A

It bifurcates at the upper border of the thyroid cartilage.

The upper border of the thyroid cartilage can be easily palpated in the living subject.

43
Q

Aside from the bifurcation of the common carotid artery, what other branch of the external carotid artery arises at the level of the upper border of the thyroid cartilage?

A

The superior thyroid artery.

44
Q

Where can we palpate the hyoid bone?

A

This can be palpated in the neck just above the thyroid cartilage.

45
Q

Where does the lingual artery arise from?

A

This is a branch of the external carotid artery that arises at the hyoid bone.

The hyoid bone is palpable in the neck just above the thyroid cartilage.

46
Q

Where does the facial artery arise from?

A

This is also a branch of the external carotid artery that arises just above the lingual artery.

At the point where the facial artery arises, the mandible = lower jaw overlaps the carotid tree.

47
Q

What does the facial artery need to do in order to reach the facial region?

A

The artery has to curl around the lower border of the mandible.

In this position it can be felt pulsating in the living subject.

48
Q

What happens to the external carotid artery after it has given off its branches?

A

It continues upwards.

We need to remove the mandible to expose it.

49
Q

Where does the external carotid artery divide into its 2 terminal branches?

A

It divides in the deep part of the neck, deep to the mandible and within the substance of the parotid salivary gland.

50
Q

What are the 2 terminal branches of the external carotid artery?

A
  • superficial temporal branch
  • maxillary artery
51
Q

How does the superficial temporal branch reach the superficial tissues of the temple and scalp?

A

It curls behind the neck of the mandible to reach the tissues of the temple and the scalp.

52
Q

What is the path of the maxillary artery and what does it supply?

A

This passes inwards towards the midline and towards its partner on the other side. On the way to the midline, it supplies the upper jaw and the back of the nose and the upper part of the pharynx.

53
Q

Is the carotid system the only artery supply to the neck?

A

No - the arteries carrying blood from the aorta to the upper limbs also cross the root of the neck and give branches to structures in the head and the neck – these are the right and left subclavian arteries.

54
Q

How can we best see the branches of the subclavian artery?

A

From the front at the root of the neck.

55
Q

Which branch of the subclavian artery supplies the brain?

A

The vertebral artery.

56
Q

What is the path of the vertebral artery?

A
  1. runs to vertebral column in the neck from origin
  2. climbs through a series of foramina in the transverse processes of the cervical vertebrae
  3. reaches the cranial cavity
  4. enters cranial cavity through foramen magnum to supply the brain
57
Q

What do the branches of the costocervical trunk supply? (this is a branch of the subclavian artery?

A
  • one branch supplies the deep muscles in the back of the neck
  • one branch supplies the upper 2 intercostal space.
58
Q

What does the internal thoracic artery supply? (branch of the subclavian)

A

This supplies the upper intercostal spaces and some of the small muscles of the neck. Descends into the thorax to supply some of the thoracic wall.

59
Q

What does the thyrocervical trunk divide into?

A

This is a short thick branch that divides into the inferior thyroid artery and 2 further branches.

Inferior thyroid supplies the thyroid gland.

2 further branches supply shoulder region and scapular muscles.

60
Q

What are the most important branches of the subclavian artery?

A
  • inferior thyroid artery
  • vertebral artery
  • internal thoracic artery.
61
Q

Why is the inferior thyroid artery important?

A

Because it has a close relationship with a nerve that runs to the larynx.

62
Q

Why is the vertebral artery important?

A

It supplies the brain.

63
Q

How does the internal jugular vein enter then neck?

A

After draining blood from the brain via intracranial venous sinuses, it enters the neck through the jugular foramen.

64
Q

What arteries does the internal jugular vein follow downwards to the root of the neck?

A

It follows the internal and then common carotid arteries to the root of the neck, sometimes travelling lateral to these arteries.

65
Q

On the way down the root of the neck where do the internal jugular veins recieve superficial venous drainage from?

A

They recieve superficial venous drainage from the scalp, face and neck + deep venous tributaries of the neck.

66
Q

What do the internal jugular veins join with to form the brachiocephalic vein?

A

They join with the subclavian vein to form the brachiocephalic vein.

67
Q

What do the 2 brachiocephalic veins join to form?

A

They run behind the manubrium to join to form the superior vena cava.

68
Q

Why is the surface marking of the internal jugular vein important?

A

Because this is used to pass catheters to the heart.

69
Q

Where does the jugular foramen lie?

A

It lies in front of the arch of the atlas at the skull base. When the face is turned to the side, this is midway between the mastoid process and the tragus of the auricle.

70
Q

After passing through the jugular foramen, what is the path of the internal jugular vein?

A

It passes directly towards and then behind the sternoclavicular joint. It lies beneath the cleft between the 2 heads of the sternocleidomastoid muscle here.

71
Q

Where are the lymphatics of the neck?

A

They lie along the vascular pathways in the neck

72
Q

Where are the lymph nodes in the neck?

A

They lie at various intervals along the lymphatics.

73
Q

Where are the lymph nodes especially numerous?

A

They are especially numerous beside the internal jugular vein.

74
Q

How do cranial nerves enter the neck?

A

They enter the neck through foramina in the base of the skull.

75
Q

How many divisions does the 5th cranial nerve = trigeminal nerve have?

A

It has 3 division.

76
Q

Where does the mandibular division of the trigeminal nerve pass down towards?

A

It passes down towards the mouth and the mandible.

77
Q

What is the 7th cranial nerve?

A

This is the facial nerve.

78
Q

Where does the facial nerve run to?

A

It runs towards the muscles of facial expression.

79
Q

Aside from the mandibular divison of the trigeminal nerve and the facial nerve, what other nerves leave the cranial base and travel in the neck?

A
  • 9th = glossopharyngeal nerve
  • 10th = vagus
  • 11th = hypoglossal
80
Q

How does the mandibular nerve leave the cranial cavity?

A

Through the foramen ovale.

81
Q

How does the facial nerve leave the cranial cavity?

A

Through the stylomastoid foramen.

82
Q

Where can we find the stylomastoid foramen?

A

Between the styloid and mastoid process on the skull base.

83
Q

Where does the mandibular nerve travel in relation to the mandible?

A

It travels deep to the mandible.

84
Q

Where does the facial nerve travel in relation to the mandible?

A

It travels superficial to the mandible.

85
Q

The mandibular nerve innervate?

A

It innervates structures in the mouth.

86
Q

What does the facial nerve innervate?

A

It innervates muscles of the face.

87
Q

What cranial nerves emerge together through jugular foramen?

A

9th, 10th and 11th.

(glossopharyngeal, vagus and accessory)

88
Q

How does the 12th cranial nerve emerge from the posterior cranial fossa?

A

It emerges through the anterior condylar foramen or hypoglossal canal.

89
Q

At first, what are all of the cranial nerves in the neck arranged close to?

A

They are all arranged closed to the internal carotid artery and the internal jugular vein.

90
Q

When the cranial nerves in the neck are traced down the neck how are they arranged?

A

They are arranged close to the carotid tree and its branches and the subclavian artery and its branches. Therefore they form neurovascular bundles.

91
Q

Where does the glossopharyngeal nerve run towards?

A

It runs to the pharnx and the posterior part of the tongue. Therefore it aims for the wall of the pharynx.

92
Q

What does the vagus nerve follow through the neck?

A

It closely follows the path of the internal and common carotid arteries downwards through the neck.

93
Q

How does the vagus nerve leave the neck?

A

The vagus nerve runs in front of the subclavian artery and leaves the neck through the superior aperture of the thorax.

94
Q

Why are there 2 particularly important branches of the vagus nerve?

A

These are particularly important in the neck because they supply the larynx.

95
Q

What do the 2 laryngeal branches of the vagus nerve aim for?

A

They aim for the upper and lower boundaries of the larynx.

96
Q

Which 2 muscles does the accessory nerve supply?

A
  • sternocleidomastoid
  • trapezius
97
Q

What does the hypoglossal nerve supply?

A

Supplies the musculature of the tongue and therefore passes deep the muscles of the floor of the mouth.

98
Q

What is the path of the glossopharyngeal nerve after leaving the skull through the jugular foramen?

A
  • passes between internal and external carotid arteries
  • arrives at the upper border of the middle constrictor muscle of the pharynx
    • here it contributes to the sensory nerve supply of the pharynx
  • runs lateral to palatine tonsil in the wall of the oropharynx
  • supplies the posterior 1/3 of the tongue
  • fine filamentous branch runs to the bifurcation of the carotids
    • supplies specialised tissue in the carotid sinus and the carotid body
99
Q

What do the carotid sinus and carotid body supply?

A

They help to monitor and regulate blood pressure and blood gas concentrations.

100
Q

How does the vagus nerve enter the neck?

A

Enters the neck through the jugular foramen.

101
Q
A

Head and Neck Anatomy (36 decks)

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