Anterior Neck

Question 1

What is Fascia?

Answer 1

Grossly visible connective tissue or sheaths deep to the skin.

Question 2

What are the different layers of fascia?

Answer 2

Epidermis > Dermis > Superficial Fascia > Deep Fascia

Question 3

What are 2 terms synonymous with Superficial Fascia?

Answer 3

Subcutaneous tissue and Hypodermis

Question 4

What muscle is contained within the hypodermis of the anterior neck?

Answer 4

Platysma m.

Question 5

What nerve innervates the platysma m?

Answer 5

Facial n. (CN VII) - cervical br.

Question 6

What movements is the platysma responsible for?

Answer 6

Facial expression, but mainly neck tension. It also has some role in “weak” lower lip and mandible depression.

Question 7

What system is the platysma m. a part of?

Answer 7

the Superficial-Musculo-Aponeurotic-System (SMAS)

Question 8

What are the 3 main Deep Cervical Fascia layers?

Answer 8

Investing Middle Deep

Question 9

What is the “Investing” division of Deep Cervical Fascia responsible for?

Answer 9

It is the most superficial part of the Deep Cervical Fascia layers and covers the entire neck beneath the superficial fascia layers. (“deep to the skin and superficial cervical fascia”)

Question 10

What are the two divisions of the Middle Deep Cervical Fascia layer?

Answer 10

Muscular - Covers the infrahyoid mm. and is placed more toward the front. (anterior) Visceral - Invests the majority of the organs (viscera) of the neck. (thyroid gland, trachea, esophagus)

Question 11

What is the name for the subdivision of the visceral layer of the DCF?

Answer 11

Buccopharyngeal Fascia Surround muscles of Cheek and Pharynx

Question 12

What are the 2 divisions of the Deep layer of the DCF?

Answer 12

Alar Fascia Prevertebral Fascia

Question 13

What is the space between the Buccopharyngeal fascia and the Prevertebral Fascia?

Answer 13

The Retropharyngeal space

Question 14

Where is the “danger space” located, and why is it referred to as such?

Answer 14

It is the space between the alar fascia and the preverterbral space. It is a potential space for infection to spread from the pharynx to the mediastinum (heart, trachea…).

Question 15

What are the boundaries of the anterior cervical triangle?

Answer 15

Medial: Midline Lateral: Anterior border of the sternocleidomastoid mm. Superior: Base of the mandible

Question 16

What are the 4 subdivided triangles within the anterior cervical triangle?

Answer 16

Submandibular triangle Submental Triangle Carotid Triangle Muscular Triangle

Question 17

What are the boundaries of the Submandibular Triangle?

Answer 17

Inferior: Anterior and posterior of digastric m. Superior: Mandible

Question 18

What is contained within the Submandibular Triangle?

Answer 18

the Submandibular Gland and facial a. and v.

Question 19

What are the boundaries of the Submental Triangle?

Answer 19

Medial: Midline Lateral: Anterior belly of digastric m. Inferior: Hyoid bone

Question 20

What are the boundaries of the Carotid triangle?

Answer 20

Superior: Posterior belly of digastric m. Lateral: Sternocleidomastoid m. Medial: Superior belly of omohyoid m.

Question 21

What are the boundaries of the Muscular Triangle?

Answer 21

Medial: midline Inferolateral: SCM Superolateral: Superior belly of omohyoid m.

Question 22

What is contained in the Carotid Triangle?

Answer 22

the Carotid sheath

Question 23

What is contained in the Muscular Triangle?

Answer 23

the infrahyoid mm., the thyroid gland, and the larynx

Question 24

What are the two major superficial veins of the neck?

Answer 24

Anterior jugular vein (AJV) External jugular vein (EJV) - Typically the most obvious superficial vein in neck

Question 25

The EJV Drains into the\_\_\_\_\_\_.

Answer 25

subclavian v.

Question 26

How is the EJV formed?

Answer 26

The external jugular vein is formed when the posterior division of the retromandibular v. joins with the posterior auricular v.

Question 27

How is the AJV formed?

Answer 27

By the junction of the superficial submandibular vv.

Question 28

The AJV drains into the _________ or the __________ often after nestling under the \_\_\_\_\_\_\_\_\_\_.

Answer 28

EJV subclavian v. SCM

Question 29

What characteristic does the AJV have that is not common in many veins?

Answer 29

it is valveless

Question 30

Where is the superior attachment of the SCM?

Answer 30

Mastoid process and superior nuchal line (pic of mastoid process)

Question 31

What is the inferior attachment of the SCM?

Answer 31

Sternal attachment (manubrium) Clavicular attachment (medial third of clavicle)

Question 32

What nerve innervates the SCM?

Answer 32

Accessory n. (CN XI)

Question 33

What artery supplies the SCM?

Answer 33

the SCM branch of the occipital a.

Question 34

What are the actions of the SCM?

Answer 34

it flexes the cervical vertebrae (Bilateral) and it laterally flexes the neck and tuns the face in the opposite direction

Question 35

The SCM and the trapezius mm. are both ___________ innervated by the ____________ n..

Answer 35

Efferently Accessory n. (CN XI)

Question 36

Where does the afferent supply come from for the SCM and Trapezius mm?

Answer 36

Ventral Primary Rami of cervical nerves C2-C4

Question 37

Which cervical nerves afferently innervate the SCM? the Trapezius m.?

Answer 37

C2-C3 C3-C4

Question 38

Where is the nerve point typically found on the neck?

Answer 38

"Erb's point" is typically found just superior to the midpoint of the posterior margin of the SCM.

Question 39

What 4 nerve points radiate from the nerve point of the neck?

Answer 39

Lesser occipital n. (C2-C3 area) Great auricular n. (C2-C3 area) Transverse cervical n. (C2-C3 area) Supraclavicular n. (C3-C4 area)

Question 40

What 2 groups can the infrahyroid mm. be classified into? What is included in each?

Answer 40

Superficial (sternohyoid mm. & omohyoid mm.) Deep (sternothyroid mm. & thyrohyoid mm.)

Question 41

Give the Sternohyoid's Origen, Insertion, Innervation, and Action

Answer 41

Origen: Manubrium, Medial clavical, and posterior sternoclavicular ligament Insertion: Inferior body of hyoid Innervation: Ansa cervicalis Action: Stabilizes hyoid; may depress an elevated hyoid.

Question 42

Give the omohyoid's Origen, Insertion, Innervation, and Action

Answer 42

Origen: Upper border of scapula Insertion: Inferior body of hyoid Innervation: Ansa cervicalis Action: Stabilizes hyoid; may depress an elevated hyoid

Question 43

What is the inferior belly of the omohyoid connected to?

Answer 43

The upper border of the scapula

Question 44

What anchors the intermediate tendon of the omohyoid to the medial clavical?

Answer 44

a fascial sling

Question 45

Give the Sternothyroid's Origen, Insertion, Innervation, and Action

Answer 45

Origen: Manubrium Insertion: oblique line of the thyroid cartilage Innervation: Ansa cervicalis Action: Pulls an elevated larynx inferiorly

Question 46

Give the thyrohyoid's Origen, Insertion, Innervation, and Action

Answer 46

Origen: Oblique line of thyroid cartilage Insertion: Inferior border of hyoid bone Innervention: C1 Action: pulls the hyoid down; elevates the larynx

Question 47

What is the Ansa Cervicalis? What nerve is located proximally to it?

Answer 47

A nerve that innervates the Sternohyoid m., Omohyoid m., and Sternothyroid m. The Hypoglossal n. is located proximally.

Question 48

REMINDER: Nerves are collections of axons. These axons may use different nevers to get to or from their target site. This is why the fibers of the VPR are able to "hitchhike" along the hypoglossal n. before rejoining the Ansa Cervicalis

Question 49

Where do the limbs of the ansa cervicalis lie within?

Answer 49

Within the carotid sheath

Question 50

What vertebra do the thyroid glands lie between?

Answer 50

C5-T1

Question 51

Nearly ____ of people have an accessory (pyramidal) lobe of the thyroid gland, which varies in size and typically connects the _____________________ to the \_\_\_\_\_\_\_\_.

Answer 51

50% : isthmus of the thyroid gland : hyoid bone

Question 52

The Thyroid gland is what kind of gland?

Answer 52

Endocrine (secretes hormones - is ductless)

Question 53

What hormones does the Thyroid gland secrete, and what are they responsible for?

Answer 53

Thyroid hormones - they are responsible for metabolism rate; and Calcintonin - important for metabolizing calcium

Question 54

What arteries supply the thyroid glands?

Answer 54

the Superior and Inferior thyroid aa.

Question 55

The ___________ is the first branch of the carotid a.

Answer 55

Superior thyroid a.

Question 56

Name one of the branches of the superior thyroid a.

Answer 56

the superior laryngeal a.

Question 57

The Inferior Thyroid a. is a branch of the _______________ which is a branch of the first part of the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

Answer 57

thyrocervical trunk : subclavian a.

Question 58

The thyroid glands typically drain in to 3 sets of veins. They are:

Answer 58

the superior thyroid vv. : the middle thyroid vv. : the inferior thyroid vv.

Question 59

the superior thyroid vv. and the middle thyroid vv. drain into the \_\_\_\_\_\_\_\_\_.

Answer 59

internal jugular vv.

Question 60

the inferior thyroid vv. drain into the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

Answer 60

L. brachiocelphalic vv.

Question 61

How many parathyroid glands are there? (typically)

Answer 61

4 - a superior and inferior pair (may be more or fewer)

Question 62

The parathyroid glands are typically supplied by the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, but may be supplied by \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

Answer 62

inferior thyroid aa. : either set of thyroid aa.

Question 63

The parathyroid glands are ____________ glands and produce \_\_\_\_\_\_\_\_\_\_\_\_.

Answer 63

endocrine ; parathyroid hormone (PTH)

Question 64

What structures pass through the jugular foramen?

Answer 64

IJV, Glossopharyngeal n. (CN IX), Vagus n. (CN X), Accessory n. (CN XI)

Question 65

What is invested by the Visceral layer of the Middle DCF?

Answer 65

The thyroid gland, trachea, and esophagus

Question 66

What is on the anterior and posterior borders of the alar fascia?

Answer 66

Anterior: Buccopharyngeal fascia Posterior: Prevertebral fascia

Question 67

Are cutaneous nerves afferent or efferent?

Answer 67

Afferent (cutaneous – skin)

Question 68

What cervical branch contribute to these nerves: Lesser occipital, great auricular, transverse cervical, supraclavicular?

Answer 68

C2 . C2 C3 . C2 C3 . C3 C4 .

Question 69

What cervical nerves serve the superior root of the ansa cervicalis? Inferior root?

Answer 69

C1 (not both even though says on slide) C2 C3

Question 70

What innervates the thyrohyoid?

Answer 70

C1

Question 71

What is invested by the carotid sheath?

Answer 71

Common and internal carotid aa. IJV Vagus n (CN X) Deep cervical lymph nodes

Question 72

What is the first branch of the exterior carotid artery?

Answer 72

Superior thyroid a.

Question 73

What a. does the superior thyroid a. have as a branch?

Answer 73

Superior laryngeal a.

Question 74

What is the recurrent laryngeal n. a branch of?

Answer 74

Vagus (CN X)

Question 75

Is the recurrent laryngeal afferent or efferent?

Answer 75

Both

Question 76

What divides the superior and inferior deep cervical lymph nodes?

Answer 76

Omohyoid

Question 77

What artery does 10% of the population have laying overtop of their trachea?

Answer 77

Thyroid ima a.

Question 78

What is an enlargement of the thyroid glands referred to as?

Answer 78

A goiter