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Area under SCM Flashcards

1
Q

What are the general contents of the carotid sheath

A 
common and internal carotid aa
internal jugular v
vagus n
ansa cervicalis (superior root is in the sheath) inferior on its lateral surface
deep cervical lymph nodes
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2
Q

within the carotid sheath where do the a and v and n lay respectively

A

a lies medial and anterior
v lies lateral and posterior
n between vessels

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3
Q

Where do the common carotids branch from

A

left from arch of aorta

right from brachiocephalic trunk

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4
Q

what fascias of the neck contribute to carotid sheath

A

investing, pre-tracheal, pre-vertebral and cervical fascias

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5
Q

where is the carotid sinus found

A

dilated distal common carotid and proximal internal carotid

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6
Q

what does the carotid sinus sense

A

Pressure changes, HR

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7
Q

where is the carotid body located

A

at carotid bifurcation

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8
Q

what does the carotid body sense

A

changes in O2 tension, increase in rate and depth of respiration

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9
Q

what n carries afferents from carotid body

A

IX

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10
Q

Where does the internal carotid a enter skull

A

carotid canal

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11
Q

what are the branches of the external carotid a

A 
superior thyroid
ascending paryngeal
lingual
facial
occipital
posterior auricular
terminates as maxillary and superficial temporal aa
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12
Q

what are the boundaries of the carotid triangle

A

anterior border SCM, posterior border of superior belly omohyoid, inferior border of posterior belly digastric

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13
Q

What can be found in the carotid triangle

A

carotid bifurcation, internal jug v, vagus and hypoglossal nn and sympathetic trunk

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14
Q

if patient has voice changes after manipulation to carotid triangle area what nn are responsible

A

vagus and recurrent laryngeal because innervate mm of larynx

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15
Q

Why do atherosclerotic plaques form at carotid bifurcation?? which side is most common

A

turbulence

internal carotid area is usually more occluded

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16
Q

what is a carotid endarterectomy

A

removal of plaque from carotid bifurcation

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17
Q

What are the major branches of the superior thyroid a

A

superior laryngeal a
anterior branch
posterior branch

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18
Q

What are the branches of the ascending pharyngeal a

A

pharyngeal
palatine
inferior tympanic
meningeal

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19
Q

what are the branches of lingual a

A

dorsal lingual
deep lingual
sublingual

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20
Q

what is a “wet stroke”

A

hemorrhagic stroke, inside or around brain tissue

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21
Q

what is a “dry stroke”

A

ischemic stroke, occluded artery supplying brain tissue

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22
Q

where does facial a arise from off external carotid

A

either as trunk with lingual or right after it

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23
Q

what are the submandibular branches of the facial a

A

tonsillar, ascending palatine, glandular, muscular, submental

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24
Q

where does the occipital a run

A

passes in groove between transverse process of atlas and mastoid process
pierces fascia where trapezius and SCM come together
parallels greater occipital n

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25
what are the main branches of occipital a
``` sternocleidomastoid meningeal a auricular mastoid descending branch ```
26
what structure crosses over the occipital a where it branches of external a
hypoglossal n
27
what are the branches of the posterior auricular a
``` muscular branches parotid branches stylomastoid auricular occipital ```
28
How does the internal jugular v receive blood
from dural venous sinuses
29
where does the internal jugular v begin
at jugular foramen as superior jugular bulb
30
where does the internal jugular vein end
as inferior bulb posteiror to sternoclavicular joint where it joins subclavian v to form brachiocephalic v
31
what are some tributaries to internal jugular veins
``` occipital vv pharyngeal vv lingual v facial v as common facial v superior and middle thyroid v ```
32
where can the right internal jugular v be accessed for Dx purposes
apex of triangle between clavicular and sternal heads of SCM with needle inserted lateral to common carotid pulse at 30 angle inferiorly to ipsilateral nipple
33
What type of fibers are in vagus CN X
SVE, SVA, GVA, GSA and GVE-P
34
what mm are inn by the SVE portion of vagus
pharynx, palate and laryngeal mm also proximal 1/3 esophagus
35
What are the general afferents from vagus
GVA carotid body, epiglottis, larynx, respiratory system, GI to terminal colon GSA to external ear, external auditory meatus, tympanic membrane, posterior cranial fossa dura mater
36
What is the SVA portion of vagus
taste for epiglottic portion of tongue
37
what is the GVE-P of vagus
PAN to heart, lungs and GI system
38
where does vagus n exit brainstem
at medulla
39
where does the vagus n exit skull
jugular foramen
40
where does the vagus n eneter the thorax
R- between subclavian a and right brachiocephalic v | L- between junction of L common carotid with L subclavian and L brachiocephalic v
41
What other nn does the vagus communicate with
IX, XI XII superior cervical ganglion and spinal nn C1 and C2
42
What are the branches of vagus n in the neck
``` meningeal auricular pharyngeal nerve to carotid body superior laryngeal cervical cardiac branches recurrent laryngeal n ```
43
describe meningeal branch of vagus n
GSA to dura of posterior cranial fossa
44
describe auricular branch of vagus n
GSA posterior surface of pinna, auditory canal and external surface of tympanic membrane
45
describe pharyngeal branch of vagus n
SVE branches to mm of pharynx and soft palate
46
describe nerve to cartoid body off vagus
from pharyngeal, afferent limb from O2 chemoR in bifurcation | GVA
47
where does superior laryngeal n course in regards to the carotid sheath
medial
48
What are the branches of superior laryngeal n
internal SVA GVA GVE-P | external SVE
49
what does the internal branch of superior laryngeal n provide
taste and general sensation and PAN to base of tongue (mucous glands), also to epiglottis, aryepiglottic folds and internal portion of larynx above true vocal fold
50
What a does the external branch of superior laryngeal run with
superior thyroid a
51
what type of fibers are in external branch superior laryngeal n and inn what?
SVE | circothyroid m and inferior constrictor m
52
what are the cervical cardiac branches of vagus and type of fiber information
GVE-P GVA | superior and inferior cardiac nn
53
where are the superior cardiac nn found
near origin of superior laryngeal n and descend medial to carotid sheath
54
where are the inferior cardiac nn from vagus found
in root of neck near 1st rib
55
what nn form deep cardiac plexus | superficial cardiac plexus?
deep: superior cardiac nn and right inferior cardiac nn superficial: left inferior cardiac n
56
What type of fibers are within the recurrent laryngeal n
SVE GVE-P and GVA
57
what structures are inn by recurrent laryngeal
mm of larynx, secretory to mucous | sensory to mucosa inferior to true vocal folds
58
where are the recurrent laryngeals found
R n recurs around subclavian a | L n recurs around aortic arch at ligamentum arteriosum
59
Once the recurrent laryngeal nn are in the larynx what are they called
inferior laryngeal nn
60
what are the branches off recurrent laryngeal nn
cardiac branches to deep cardiac plexus branches to mm and glands of trachea and esophagus pharyngeal branches to inferior constrictor laryngeal branches to all m of larynx EXCEPT cricothyroid
61
What divides the deep cervical lymph nodes into superior and inferior
omohyoid m
62
what lymph nodes are found in superior carotid triangle
superior deep cervical | retropharyngeal, deep parotid, jugulodigastric and jugulo-omohyoid
63
where do the superior deep nodes drain to
inferior nodes
64
where do the inferior deep cervical nodes receive lymph from
``` superficial cervical superior deep accessory chain of posterior triangle transverse cervical nodes juxtavisceral nodes of anterior triangle: infrahyoid, pre-laryngeal, pre-tracheal and paratracheal ```
65
what are the jugular lymph trunks
on L: thoracic duct R: subclavian and right bronchi-mediastinal trunks join to make right lymphatic duct that enters where internal jug meets subclavian
66
in radical neck dissection ofr metastatic cancer in supraclavicular nodes what lymph is taken out
all of the deep cervical lymph and cutaneous branches of cervical plexus
67
Where does CN XII leave skull
hypoglossal canal medial to internal jugular v and internal carotid a
68
What spinal nn make up cervical plexus
C1-C4 ventral rami
69
what is inn by cervical plexus
motor: deep cervical mm, infra hyoids and diaphragm sensory: lateral head, neck, superolateral shoulder and upper anterior thorax carries all postganglionic sympathetics for C1-4
70
What are the sensory nn off cervical plexus and contributing levels
lesser occipital C2-3 great auricular C2-3 transverse cervical n C2-3 supraclavicular nn C3-4 phrenic C345 sensory fibers C1C2 join hypoglossal to post dura proprioceptive C2-4 in spinal accessory: 2-3 to SCM 3-4 to trapezius
71
What are the motor nn off cervical plexus
ansa cervicalis C1 in hypoglossal muscular branches to longus capitis, longus coli and middle scalene phrenic
72
What levels give rise to superior root of ansa cervicalis and inn what
C1-C2
73
what levels give rise to inferior root of ansa cervicalis
C2-C3
74
what mm are inn by the ansa cervicalis individual branches
infrahyoid mm | sternothyroid sternohyoid and omohyoid
75
what cord level inn the geniohyoid and thyrohyoid mm
C1- run in hypoglossal
76
where does accessory phrenic n most commonly arise from
C5 spinal n

Neuro I (9 decks)

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