Anterior Triangle (Lecture) Flashcards
1
Q
What muscle is contained in the superficial fascia of the neck?
A
Platysma
2
Q
What is the innervation of the platysma?
A
Cervical Branch of the Fascial Nerve
3
Q
What are the boundaries of the carotid ∆?
- Anterior
- Posterior
- Superior
- Floor
A
Anterior:
Superior Belly of the Omohyoid
Posterior:
Anterior border of Sternocleidomastoid
Superior:
Posterior Belly of Digastric
Floor:
Thyrohyoid, Middle Pharyngeal constrictor, Inferior Pharyngeal constrictor
4
Q
What are the contents of the carotid ∆?
A
- Carotid Sheath (w/ Carotid a.)
- Internal Jugular v.
- Vagus n.
- Ansa Cervicalis
5
Q
What are the boudaries of the Submandibular ∆?
- Anterior
- Posterior
- Superior
- Floor
A
Anterior:
Anterior belly of the digastric
Posterior:
Posterior Belly of the digastric
Superior:
Inferior Border of Mandible
Floor:
Mylohyoid, Hyoglossus, Middle Pharyngeal Constrictor
6
Q
What are the contents of the submandibular ∆?
A
- Submandibular gland
- Hypoglossal nerve (CN XII)
- Nerve to Mylohyoid
- Facial Artery and Vein
7
Q
What are the borders of the submental triangle?
***UNPAIRED; Suprahyoid Region
- Lateral
- Inferior
- Apex
- Floor
A
Lateral:
R and L anterior Bellies of the Digastrics
Inferior:
Body of the hyoid
Apex:
Symphysis Menti
Floor:
Both Mylohyoids
8
Q
What are the contents of the submental ∆?
A
- Anterior Jugular v.
- Lymph Nodes
9
Q
What are the boundaries of the muscular ∆?
A
Anterior:
Median Plane of the neck
Inferior:
Anterior Border of the Sternocleidomastoid muscle
Superior:
Superior Belly of the OmoHyoid
Floor:
- Thyroid and Cricoid Cartilages
- Middle Pharyngeal Constrictor
- Inferior Pharyngeal Constrictor
10
Q
What are to contents of the anterior ∆?
A
- Thyroid and Parathyroid Glands
- Infrahyoid Muscles
- Termination of Ansa Cervicalis
- Superior Thyroid Artery
- Superior Laryngeal Artery
- Internal and external Laryngeal NN.
- Recurrent Laryngeal n.
11
Q
The mastoid process is a feature of what bone?
A
Temporal
12
Q
What muscle arises from the medial side of the mastoid process and inserts on the hyoid?
A
Posterior Belly of the Digastric Muscle
13
Q
What muscle arises from the digastric fossa on the lower inside of the mandible?
A
Anterior Belly of Digastric
14
Q
What is the action of the digastric muscle when the mandible is fixed?
A
Raises the hyoid bone
15
Q
What is the action of the digastric muscle when they hyoid is fixed?
A
It lowers the mandible
16
Q
What is the innervation of the posterior belly of the digastric?
A
Facial n. (VII)
17
Q
What is the innervation of the anterior belly of the digastric?
A
V3 (madibular division) or Trigeminal Nerve
18
Q
What two muscles are completely invested in investing fascia at as result of the fascia splitting?
A
- Trapezius
- Sternocleidomastoid
19
Q
What structures pierce the investing fascia?
A
- External and Anterior Jugular v.
- Lesser occipital n.
- Great auricular n.
- Transverse cervical n.
- Serpraclavicular nn.
- All Branches of Cervical Plexus
20
Q
What is the investing fascia attached to superiorly?
A
- External Occipital Protuberance
- Superior Nuchal Line
21
Q
What is the investing fascia attached to laterally?
A
- Mastoid Process
- Zygomatic Arch
22
Q
What is the investing fascia attached to inferiorly?
A
- Manubrium
- Clavicle
- Arcomion
- Scapular Spine
23
Q
What muscles are surrounded by the prevertebral layer?
A
- Prevertebral Muscles
- Anterior, Middle, Posterior Scalene Muscles
- Deep muscles of the back
24
Q
How does the prevertebral fascia attach to the skull superiorly?
A
- Ligamentum nuchae
- Continuous circular line at the base of the skull (around jugular foramen, carotid canal, mastoid process, nuchal line, external occipital protuberance)
25
What are the anterior attachments of the prevertebral fascia?
- Anterior surface of transverse processes CI-CVII
26
What muscles lie just anterior to the pretracheal layer of fascia?
Infrahyoid muscles
27
What fascial layer separates the Thyroid gland from the infrahyoid muscles?
Pretracheal fascia
28
Where does the pretracheal fascia begin superiorly?
| - inferior extent?
At the hyoid bone
- Extends all the way down into the Upper Thoracic Cavity
29
What is the pretracheal layer called on its posterior side?
Buccopharyngeal Fascia
30
Where does the Buccopharyngeal fascia begin superiorly?
| - Inferior extent?
At the base of the skull.
- Ends inferiorly in the thoracic cavity
**think about spread of infection
31
What fascial layers enclose the pretracheal space?
- anterior
- Posterior
- Superior
- Inferior
Anterior:
- Investing Fascia (posterior surface of infrahyoids)
Posterior:
- Pretracheal Fascia (covers trachea and thyroid)
Superior:
neck
Inferior:
ANTERIOR part of SUPERIOR mediastinum
32
What fascial layers enclose the pretracheal space?
- Anterior
- Posterior
- LATERALLY
- Superior
- Inferior
Anterior:
- Buccopharyngeal Fascia (on posterior surface of pharynx and esophagus)
Posterior:
- Prevertebral Fascia (on anterior surface of transverse processes and bodies of cervical vertebrae)
LATERALLY:
CAROTID SHEATH - think about infection
Superior:
- Base of the Skull
Inferior:
Upper Part of POSTERIOR Mediastinum
33
What space exists to permit movement of of pharynx, larynx, trachea, and esophagus during swallowing?
Retropharyngeal Space
34
Pretracheal space where could it spread?
- Superior Mediastinum, anterior to the pericardium
35
Which of the infrahyoid muscles is NOT innervated by Ansa Cervicalis?
Thyrohyoid
36
What ∆ are the infrahyoid muscles located in?
Muscular ∆
37
Where does the superior belly of the omohyoid begin?
At the intermediate Tendon
38
What inserts more laterally on the hyoid bone, the superior belly of omohyoid or sternohyoid?
Omohyoid inserts more laterally
39
What attaches the intermediate tendon connecting the bellies of the omohyoid muscles to the clavicle?
a Fascial Sling
40
What inserts on the greater horn of the hyoid bone?
Thyrohyoid
41
What muscle would raise the larynx when singing a high note?
Thryohyoid
42
What nerve roots make up the cervical plexus?
C2-C4 (possible contribution from C1)
43
What fascial layer is the cervical nerve plexus associated with?
Prevertebral Layer
44
What triangle is the cervical nerve plexus associated with?
Posterior ∆
45
Where do the cutaneous branches of the cervical plexus first emerge from the muscles of the posterior ∆?
Posterior border of Sternocleidomastoid
46
T or F: the phrenic n. arrises from the cervical plexus
True
47
What fascial layer does the phenic nerve travel within?
Prevertbral layer (This is where branches of the cervical plexus are formed)
48
What nerve ascends along the posterior border of sterocleidomastoid?
- Lesser Occipital n.
49
What spinal nerve root contributes to the Lesser occipital n.?
C2
50
What are the 4 cutaneous branches of the cervical plexus?
- Lesser Occipital N.
- Great Auricular N.
- Transverse Cervical N.
- Supraclavicular N.
51
What is the distribution of the lesser occipital nerve?
- neck and scalp posterior to the ear
52
What area is innervated by the great auricular n.?
| - Nerve Roots
- Nerve Roots = C2 and C3
Distribution:
- Lower ear
- Parotid Region
- Mastoid area
53
What area is innervated by the transverse cervical n.?
| - Nerve Roots
- Nerve Roots = C2 and C3
Distribution:
- Lateral and Anterior parts of the neck
54
What nerve emerges and crosses sternocleidomastoid superiorly and perpendicularly on its way to the anterior neck?
Transverse cervical n.
55
What nerve supplies cutaneous innervation to the area over the clavicle and shoulder down to rib 2?
- Nerve roots
Supraclavicular nerves (C3 and C4)
56
Where is the nerve point of the neck located?
Midway up the sternocliedomastoid on the posterior border.
57
What 4 nerves emerge at the nerve point of the neck?
1. Lesser Occipital
2. Great Auricular
3. Transverse Cervical
4. Supraclavicular
58
T or F: C1 has a dermatome
False
59
What nerve structure is located deep and slightly inferior to the nerve point of the neck?
Upper Truck of the Brachial Plexus
60
What do the Ventral Rami of the Cervical Plexus coalesce to form?
Ansa Cervicalis
61
T or F: the internal carotid gives off branches in the neck.
FALSE
62
Which carotid artery goes through the carotid canal?
Internal Carotid
63
What 8 branches are given off of the external carotid?
Anterior:
1. Superior Thyroid
2. Lingual
3. Fascial
Posterior:
4. Occipital
5. Posterior Auricular
Medial/Terminal:
6. Maxillary
7. Superficial Temporal
8. Ascending Pharyngeal is Variable as to were it comes off
64
T or F: superior thyroid artery is deep to the infrahyoid muscles
True
65
What branch does the superior thyroid give off?
Superior Layngeal
66
What arteries are located directly above and below the posterior belly of the digastrics?
Above:
- Facial a.
Below:
- Lingual a.
67
What artery emerges directly from under the mandible at its midpoint?
Fascial a.
68
What artery arises between the internal and external carotid?
Ascending Pharyngeal a.
69
What branch of the external carotid travels on the medial side of the mastoid?
Occipital a.
70
What branch of the external carotid travels between the external auditory meatus and the mastoid?
Posterior Auricular
71
What branch of the external carotid travels between the mandible and external auditory meatus?
Superficial Temporal
72
What branch of the external carotid braches to travel under the posterior aspect of the mandible?
maxillary a.
73
T or F: the posterior auricular a. travels superior to the posterior digastric whie the occipital travels under.
True
74
What two veins join to form the EXTernal jugular vein?
| - where does this happen?
- Posterior Auricular Vein
- Retromandibular Vein (POSTERIOR DIVISION)
**Join posterior to the angle of the mandible
75
What vein drains the scalp behind and above the ear?
- Posterior Auricular Vein
76
What veins join to form the retromandibular vein and where does this happen?
Formed by:
- Superficial Temporal and Maxillary Veins
**Join IN the parotid gland
77
How does the Retromandibular link the internal and external JUGULAR veins?
- Posterior portion joins posterior auricular to MAKE the EXternal jugular vein
- Anterior portion drain into the Facial Vein which then drains to the INternal Jugular vein
78
What vein courses on top of SCM throughout its course?
EXternal Jugular Vein
79
Where does the External Jugular Vein piece the investing fascia?
- what does it drain into?
- Immediately posterior to SCM
| - drains into Subclavian Vein
80
What vein drains the anterior aspect of the neck?
Anterior Jugular Vein
81
Where are the Anterior jugular veins formed and what is their path following formation?
Formed at or just superior to the Hyoid
| - Descends on either side of the midline of the neck
82
What joins the R and L anterior jugular veins?
| - where is this located
Jugular Venous Arch
- Near Suprasternal Notch
83
Where does the External Jugular Cross the SCM?
- Near the Nerve Point of the Neck
84
T or F: the great vessels of the heart are at risk if an infection gets into the carotid sheath.
TRUE, the Carotid Sheath is continous with the CT surrounding the Great Vessels of Heart
85
Where does the carotid sheath sit in relation to the clavicular head of SCM and the junction of the superior and inferior omohyoid?
- Posterior to both
86
What veins drain to the Internal Jugular Vein?
1. Lingual
2. Facial
3. Superior Thyroid
4. Middle Thyroid
87
What is the location of the vagus nerve (X) to internal jugular and Common carotid?
Posterior to:
Internal Jugular
Anterior to:
Common Carotid
88
What nerve are artery run together to pierce the thyroid membrane?
- Superior Laryngeal n.
| - Superior Thyroid a.
89
What do recurrent laryngeal nerves become as they ascend towards the neck?
- Inferior laryngeal nerves
90
What is the relationship of sympathetic trunk ganglia to carotid sheath and prevertebral fascia?
- POSTERIOR: to carotid sheath
| - ANTERIOR: to prevertebral Fascia
91
Where does the dual blood supply to the thyroid come from?
| - do these sources anastomose
- Superior Thyroid artery => External Carotid
| - Inferior Thyroid artery => Thyrocervical Trunk
92
What is the lymphatic drainage of the thyroid gland?
- Paratracheal nodes
| - Deep Cervical Notes (INFERIOR to OMOHYOID)
93
What type of receptor is the carotid body?
Chemoreceptor (bO2dy)
Monitors:
- pH
- pCO2
- pO2
94
T or F: the carotid body modulates cardiovascular and respiratory function primarily through parasympathetic tone
FALSE, it does it by modulating sympathetic tone
Firing Causes:
- Increased blood pressure, heart rate, respiratory rate
95
What CRANIAL nerve montiors the Carotid BODY?
- Glossopharyngeal (CN IX) via Hering's nerve (carotid body nerve)
96
What type of receptor is the is the Carotid SINUS, what cranial nerve?
- Baroreceptor- monitors BLOOD PRESSURE
| - Glossopharyngeal (CN IX) via Hering's nerve (carotid sinus nerve)
97
What are ways the carotid SINUS can be affected causing DECREASED blood pressure?
- Tumor
| - Pressing on it
