- Origin External Occipital Protuberance (EOP) Superior Nuchal Line Ligamentum Nuchae CV7-TV12 SPs - Insertion = Lateral 1/3 of clavicle, acromion process, and scapular spine - Function Upper Fibers = Elevate Scapula Middle Fibers = Retract Scapula Lower Fibers = Depress Scapula Upper + Lower = Rotate scapula - abduction - Innervation = Spinal accessory nerve (CN 11) - Blood Supply Superficial branch of transverse cervical artery OR Superficial cervical artery ( If there is a dorsal scapular artery)

- Origin = CV1-CV4 TPs - Insertion = Vertebral border of scapula, above scapular spine - Function = Elevates scapula - Innervation Dorsal scapular nerve (C5) C3-C4 VPRs of cervical plexus

3 Parts - Inferior belly (posterior triangle) - Intermediate tendon = Connects inferior belly and superior belly - Superior belly (anterior triangle) - Origin = Medial to scapular notch - Insertion = Hyoid bone - Lower board - Function = Depresses scapula bone - Innervation = Ansa Cervicalis (C1-C3)

Gross Anatomy 5010 - Unit 09: Posterior Triangle and Root of the Neck Flashcards by KC Clemmons

Where is the platysma muscle located?

Superficial cervical fascia

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Platysma Muscle

Origin = Skin below the clavicle

Insertion
- Mandible
- Lower lip muscles

Function
- Main Function = Tenses skin of the neck
- Moves lower lip down
Moves corners of the mouth down

Innervation = Cervical branch of facial nerve

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What makes up the cervical plexus?

C1-C4 VPRs

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What branches do the cervical plexus divide into? What do these branches include?

Cutaneous (Superficial) Branches = Strictly Sensory
- C2 = Lesser Occipital nerve
- C2-C3 = Greater Auricular Nerve
- C2-C3 = Transverse Cervical Nerve
- C3-C4 = Supraclavicular Nerve

Muscular (Deep) Branches
- Ansa Cervicalis (C1-C3) = Motor
- Phrenic Nerve (C3-C5) = Mixed
- Muscular Branches
- Rectus Capitis anterior muscle
- Rectus Capitis Lateralis muscle
- Longus Capitis muscle
- Longus colli muscle

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What do the ansa cervicalis nerve innervate? What do the phrenic nerve innervate?

Ansa Cervicalis (C1-C3) = Supplies motor innervation to the 3 of the 4 infrahyoid muscles

Phrenic Nerve (C3-C5, Mixed) = Supplies motor innervation to the diaphragm
- C3, C4, C5 keep the diaphragm alive

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What does the lesser occipital nerve (C2) do?

Climbs up the sternocleidomastoid muscle’s posterior border
Supplies the skin of the neck and scalp, behind the ear

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What does the auricular nerve (C2-C3) do?

Climbs up and over the sternocleidomastoid
Supplies skin of the angle of the mandible and ear
Travels with external jugular vein (EJV)

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What does the cervical (C2-C3) do?

Courses horizontally over sternocleidomastoid
Supplies skin on the neck - anterior and lateral sides

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What does the supraclavicular nerves (C3-C4) do?

Climbs diagonally down across the posterior triangle of the neck
Supplies the skin over the clavicle and superior region of the chest

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What forms the external jugular vein? Where does the external jugular vein drain into?

Posterior branch of retromandibular vein + Posterior Auricular Vein = External Jugular vein
Drains into subclavian vein

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What are the boundaries of the posterior triangle of the neck?

Anteriorly = Sternocleidomastoid muscle’s posterior border
Posteriorly = Trapezius’ anterior border
Inferiorly = Middle third of clavicle

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What makes up the roof, floor, and carpet of the posterior triangle of the neck?

Roof = Investing (anterior) layer of deep cervical fascia
Floor
- Splenius muscles (Splenius Capitis & Splenius Cervicis)
- Levator Scapulae
- Scalene Muscles (Anterior Scalene, Middle Scalene, & Posterior Scalene)
Carpet = Prevertebral (Posterior) fascia of deep cervical fascia

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Sternocleidomastoid (SCM) Muscle

Origin
- Manubrium
- Medial end of clavicle
Insertion = Mastoid process
Function
- Unilateral = Tilts head to same side, rotate head to opposite side
- Bilateral = Flex head
- As an accessory muscle of respiration
Innervation = Spinal accessory muscle

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Trapezius

Origin
- External Occipital Protuberance (EOP)
- Superior Nuchal Line
- Ligamentum Nuchae
- CV7-TV12 SPs
Insertion = Lateral 1/3 of clavicle, acromion process, and scapular spine
Function
- Upper Fibers = Elevate Scapula
- Middle Fibers = Retract Scapula
- Lower Fibers = Depress Scapula
- Upper + Lower = Rotate scapula - abduction
Innervation = Spinal accessory nerve (CN 11)
Blood Supply
- Superficial branch of transverse cervical artery OR Superficial cervical artery (* If there is a dorsal scapular artery)

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True or False: Does the trapezius act on the shoulder joint?

False - Trapezius acts only on the scapula

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Splenius Muscles

Splenius Capitis
- Origin
* CV7-TV3 SPs
* Ligamentum Nuchae
- Insertion
* Superior nuchal line
* Mastoid process
- Function
* Unilateral = Flexes and rotates face to same side
* Bilateral = Extend head
- Innervation = Middle cervical nerves dorsal rami

Splenius Cervicis
- Origin
* TV3-TV6 SPs
- Insertion = CV1-CV3 TPs
- Function
* Unilateral = Flexes and rotates neck to same side
* Bilateral = Extend neck
Innervation = Lower and middle cervical spinal nerves dorsal rami

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Levator Scapulae

Origin = CV1-CV4 TPs
Insertion = Vertebral border of scapula, above scapular spine
Function = Elevates scapula
Innervation
- Dorsal scapular nerve (C5)
- C3-C4 VPRs of cervical plexus

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Scalene Muscles

Anterior Scalene Muscle
- Origin = CV3-CV6 TPs anterior tubercle
- Insertion = 1st rib scalene tubercle
- Innervation = C4-C7 ventral rami

Middle Scalene Muscle
- Origin = CV2-CV7 TPs posterior tubercle
- Insertion = 1st rib
- Innervation = C3-C7 ventral rami

Posterior Scalene Muscle
- Origin = CV4-CV6 TPs posterior tubercle
- Insertion = 2nd rib
- Innervation = C5-C7 ventral rami

ALL SCALENE MUSLCES *
Function
- Elevates ribs (inspiration)
- Flex neck

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Omohyoid Muscle

3 Parts
- Inferior belly (posterior triangle)
- Intermediate tendon = Connects inferior belly and superior belly
- Superior belly (anterior triangle)

Origin = Medial to scapular notch
Insertion = Hyoid bone - Lower board
Function = Depresses scapula bone
Innervation = Ansa Cervicalis (C1-C3)

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True or False: The omohyoid muscle cross both triangles?

True

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True or False: The omohyoid muscle is part of the posterior triangle?

False

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What 2 structures lie between the anterior and middle scalene muscles?

1) Anteriorly = Subclavian Artery
2) Posteriorly = Brachial Plexus (C5-T1 Roots)

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What 6 structures lie superficial to the anterior scalene muscle?

1) Phrenic nerve
2) Prevertebral fascia
3) Suprascapular artery
4) Transverse cervical artery
5) Subclavian vein
6) Omohyoid muscle

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What structures lie immediately above 1st rib (from anterior to posterior)?

Study These Flashcards

1) Subclavian vein
2) Anterior scalene
3) Subclavian artery
4) Brachial Plexus - Lower Portion
5) Middle Scalene

What are the 3 branches of the aortic arch?

1) Brachiocephalic trunk (artery) 2) Left common carotid artery 3) Left subclavian artery

Where is the aortic arch and its branches located?

Superior mediastinum

What is included in the brachiocephalic trunk (artery)?

Brachiocephalic trunk includes or branches off into the right common carotid artery and right subclavian artery

What portions of the brachial plexus can be seen within the posterior triangle?

* C5-T1 Roots * Trunks (Lower, middle, & Upper trunks)

What nerves pierces the middle scalene muscle?

1) Dorsal scapular nerve 2) Long thoracic nerve

What does the investing (anterior) layer of deep cervical fascia surround? And what does it form?

- Surrounds sternocleidomastoid and trapezius - Forms roof of posterior triangle

What does the prevertebral (posterior) layer of deep cervical fascia continue as?

Axillary fascia

What does the carotid sheath surround/What are the contents of the carotid sheath?

Surrounds the carotid vessels, internal jugular vein, and vagus nerve - Carotid vessels are medial - Internal Jugular Vein is lateral - Vagus nerve is deep

What are the contents of the superficial cervical fascia?

1) Platysma muscle 2) Cervical branch of facial nerve (CN 7) 3) Cutaneous Nerves (Branch of cervical plexus) 4) External Jugular vein 5) Anterior jugular vein

At what location does the thoracic duct empty its contents into the venous system?

Left venous angle (junction of left subclavian vein and left internal jugular vein)

Where does the subclavian artery end at?

Lateral border of the 1st rib

How many parts are there of the subclavian artery? What is the landmark?

- Landmark = Anterior scalene - 3 Parts * 1st part is medial to anterior scalene * 2nd part is posterior to anterior scalene * 3rd part is lateral to anterior scalene

What are the 3 branches of the first part of the subclavian artery?

1) Vertebral artery 2) Internal thoracic artery 3) Thyrocervical trunk (gives off 3 branches)

Where does the vertebral artery enter?

CV6 transverse foramen and foramen mangum supplying the brainstem

What are the 3 branches that thyrocervical trunk (one of the branches of the 1st part of the subclavian artery)

1) Suprascapular Artery 2) Transverse Cervical Artery 3) Inferior Thyroid Artery

Where is the suprascapular artery located? What nerve does it travel with?

- Located above superior transverse scapular ligament - Travels with suprascapular nerve which is below superior transverse scapular ligament

Describe the branches of the transverse cervical artery

Branches off into 2 - Superficial Branch = Travels with spinal accessory nerve - Deep Branch = Travels with dorsal scapular nerve

What does the ascending cervical artery travel with?

Phrenic nerve

What does the inferior laryngeal artery (terminal branch) travel with?

Recurrent laryngeal nerve

How many branches are there in the second part of the subclavian artery? Describe them.

1 branch - Costocervical Trunk * Deep Cervical Artery = Supplies deep muscles of the neck and upper back * Spinal cord (cervical part) - Highest Intercostal Artery = gives off 1st and 2nd posterior intercostal artery

How many branches are there in the third part of the subclavian artery? Describe them.

1 Branch - Dorsal Scapular Artery (IF YOU SEE) * Found between upper and middle trunks of brachial plexus * This artery replaces the deep branch of transverse cervical artery

What does the transverse cervical artery change its name to?

Superficial cervical artery

Where does the subclavian vein begin at?

Begins at the lateral border of the 1st rib from axillary vein

what forms the internal jugular vein? Where does it exit? Where does it collect blood from?

- Sigmoid sinus and inferior petrosal sinus forms IJV - Exits jugular foramen - Collects blood from brain, face, and neck

What passes through the scalene (interscalene) triangle?

Roots of brachial plexus and the 3rd part of subclavian artery

What makes up the boundaries of the scalene (interscalene) triangle?

- 1st rib - Anterior Scalene - Middle Scalene

Where does the jugular venous arch usually enter?

External jugular vein

Describe the vagus nerve and its branches

- Sits anterior to subclavian artery - Right Side = Gives off right recurrent laryngeal nerve and is related to right subclavian artery - Left Side = Gives off left recurrent laryngeal nerve and is related to the aortic arch and is lateral to ligamentum of arteriosum - Superior cardiac branch = Preganglionic parasympathetic fibers

Describe the phrenic nerves (mixed) and its relationships

- Spinal Cord = C3-C5 - Sits on anterior scalene - Between subclavian artery and vein - Right side = Related to superior vena cava and inferior vena cava - Left Side= Related to aortic arch - Anterior to root of the lung that serves as the last connection to mediastinum

What is the importance of the scalene (interscalene) triangle?

A region of the neck that provides function to the upper limb

What is a cervical rib?

- An extra rib that grows from the cervical spine - A small percentage of people develop thoracic outlet syndrome (TOS) from cervical rib

What is thoracic outlet syndrome (TOS)?

Occurs when nerves or blood vessels are compressed by the rib, clavicle or neck muscles at the top of the outlet

What are the 3 types of TOS?

1) Neurogenic TOS = Occurs when the nerves leading from the neck to the arm (brachial plexus) is compressed - More than 90% of cases are neurogenic 2) Venous TOS = Occurs when a vein is compressed, leading to upper body thrombosis - 5% of cases 3) Arterial TOS = Occurs when an artery is compressed - 1% of cases

What is vascular thoracic outlet syndrome?

Venous + Arterial Syndromes = Vascular Thoracic Outlet Syndrome

Gross Anatomy 5010 - Unit 09: Posterior Triangle and Root of the Neck Flashcards

(58 cards)