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Anatomy > L7: Anterior Cervical Triangle > Flashcards

L7: Anterior Cervical Triangle Flashcards

1
Q

What is the pharyngeal apparatus? When does it start to develop? What are its contents?

A
  • Early embryological structure that contributes to the formation of the head and neck, including face. - 4 week old embryo - Contents: pharyngeal arches, pharyngeal pouches, pharyngeal grooves, pharyngeal membranes
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2
Q

Describe embryological development of the pharyngeal arches. Explain what each arch gives rise: CN, muscle, bone.

A
  • Pharyngeal arches develop at lateral wall of cranial end of foregut - Stomodeum = anterior end of foregut and site of future mouth - Widening at stomodeum, narrowing inferiorly to form espophagus - Oropharyngeal membrane separates primordial pharynx and foregut from amniotic cavity, ruptures at 26th day to allow communication - End 4th week, 4 pairs of arches present. 5th / 6th never develop completely, not visible exteriorly - External arches separated by pharyngeal grooves = ectoderm - Internal arches separated by pharyngeal pouches = endoderm - Arches composed of mesenchyme also, result of neural crest cells - Each arch contains: blood vessel, cartilage (precursor to skeletal/bony components), muscular component (precursor to muscles of head and neck), nerve - First arch = mandibular arch. Bones: maxilla and mandible from prominences named after them. Muscles: mastication, mylohyoid, ant. Belly of digastric, tensory tympani, tensor veli palatini. Nerve: CN V. - Second arch = hyoid arch. Bones: major contribution to hyoid bone. Muscles: facial expression, stapedius, stylohyoid, post. belly of digastric. Nerve: CN VII. - Third arch. Bone: minor contribution to hyoid bone. Muscles: stylopharyngeus muscle. Nerve: CN IX. - Fourth arch. Bone / muscles: muscles and cartilages of larynx. Nerve: CN X.
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3
Q

What are pharyngeal membranes?

A
  • Ectoderm of grooves on outside of pharyngeal wall make contact with endoderm of pouches to form these membranes. First membrane gives rise to tympanic membrane of ear. All other membranes disappear.
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4
Q

What are the derivatives of the first pharyngeal arch?

A
  • First arch = mandibular arch. Bones: maxilla and mandible from prominences named after them. Muscles: mastication, mylohyoid, ant. Belly of digastric, tensory tympani, tensor veli palatini. Nerve: CN V.
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5
Q

What are the derivatives of the second pharyngeal arch?

A
  • Second arch = hyoid arch. Bones: major contribution to hyoid bone. Muscles: facial expression, stapedius, stylohyoid, post. belly of digastric. Nerve: CN VII.
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6
Q

What are the derivatives of the third pharyngeal arch?

A
  • Third arch. Bone: minor contribution to hyoid bone. Muscles: stylopharyngeus muscle. Nerve: CN IX.
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7
Q

What are the derivatives of the fourth pharyngeal arch?

A
  • Fourth arch. Bone / muscles: muscles and cartilages of larynx. Nerve: CN X.
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8
Q

From what does the tympanic membrane of the ear form?

A
  • First pharyngeal membrane gives rise to this.
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9
Q

From what do CN X, IX, VII and V arise?

A
  • Pharyngeal arches. - CN X from 4th arch - CN IX from 3rd arch - CN VII from 2nd arch - CN V from 1st arch
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10
Q

What are the boundaries of the anterior cervical triangle?

A
  • Anterior midline of neck - Inferior border of mandible - Anterior border of SCM
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11
Q

What forms the base, apex, floor, roof of the triangle?

A
  • Apex is at the jugular notch - Base is inferior border of mandible - Roof = superficial fascia, platysma and skin - Floor = mylohyoid and hyoglossal muscles
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12
Q

Subdivisions of anterior cervical triangle. Draw and indicate boundaries.

A
  • Submandibular triangle - Submental triangle - Carotid triangle - Muscular triangle
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13
Q

What are the contents of each of the subtriangles of the anterior triangle, besides muscles?

A
  • Submandibular: submandibular gland, salivary gland, submandidublar ganglion (PSNS ganglion next to submandibular gland), submandibular lymph nodes, hypoglossal CN XII, facial a and v - Submental: submental lymph nodes, beginning of ant jugular veins - Carotid: carotid sheath: vagus nerve (CN X), common carotid and internal carotid and internal jugular v; external carotid and branches - Muscular triangle: thyroid and parathyroid glands (C6 level)
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14
Q

What are the contents of the carotid sheath? Explain with directionality.

A
  • CN X (posteriorly), common carotid (medially), internal jugular vein (laterally), internal carotid (medially superior branch)
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15
Q

What cervical level do the thyroid/parathyroid glands correspond to?

A
  • C6
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16
Q

From where does the right and left common carotids branch?

A
  • Left: branch of the aorta - Right: branch of brachiocephalic trunk
17
Q

Where does common carotid terminate, ie. at what identifiable structure/level)? What does it terminate into?

A
  • Terminates at superior border of thyroid cartilage at upper level of C5. - Terminates into internal and external carotid arteries
18
Q

Where is carotid pulse checked? Describe anatomically.

A
  • Level of thyroid cartilage deep to anterior border of SCM
19
Q

What is carotid occlusion, what does it lead to?

A
  • Atherosclerotic thickening of tunica intima obstructs blood flow to brain and leads to stroke or TIA. ~80% of blood flow to brain is via internal carotid.
20
Q

Entry point of internal carotid into skull?

A
  • Carotid canal of temporal
21
Q

What is the carotid sinus?

A
  • Dilated segment of internal carotid artery at proximal end that is innervated by CN IX and X. Acts as chemo and baroreceptor to monitor both blood gas composition and pressure.
22
Q

Branches of external carotid artery. Where does it begin, where does it terminate.

A
  • Begins at superior border of thyroid cartilage and supplies structures outside skull - Terminates in parotid gland by bifurcating into superficial temporal and maxillary arteries - Branches - Some anatomists like fornicating on plush soft mattresses: Superior thyroid Ascending pharyngeal Lingual Facial Occipital Posterior auricular Superficial temporal Maxillary
23
Q

Branches of subclavian artery.

A
  • Right subclavian branches from brachiocephalic artery - Left subclavian branches directly from aorta - Each divides into three parts (VIT = 1st, C = 2nd, D = 3rd) - Branches – VITamen C & D (without accounting form branches of thyrocervical) Vertebral Internal thoracic Thyrocervical trunk (inferior thyroid, suprascapular, transverse cervical) Costocervical trunk Dorsal scapular
24
Q

Veins of anterior triangle.

A
  • Jugular bulb from jugular foramen forms internal jugular vein descends inferior in carotid sheath. Terminates by joining subclavian and forming brachiocephalic vein. - Anterior jugular begins in submental triangle descends along anterior midline of neck and drains into external jugular vein. - Subclavian vein drains medially and joins with external and internal jugular veins to form brachiocephalic vein.
25
Q

Course and branches of CN X in neck?

A
  • Exits skull from brainstem through jugular foramen and enters carotid sheath. - Branches in neck: Recurrent laryngeal Contribution of pharyngeal plexus Cardiac branches Superior laryngeal
26
Q

Cervical sympathetic trunk. Where is it located? Where does it course? What are its components?

A
  • Begins at level of C1 - Courses inferiorly through neck anterior to vertebral column and deep to carotid sheath - Components: Superior cervical ganglion (C1, C2), middle cervical ganglion (C6 at cricoid cartilage) and inferior cervical ganglion (C7, sup border of 1st rib)
27
Q

Damage to which of the following muscles would result in skin of the neck to sag and form folds? A. SCM B. Platysma C. Sternohyoid D. Trapezius

A
  • B. SCM
28
Q

Which of the following is not a branch of the external carotid? A. Lingual B. Facial C. Vertebral D. Superior thyroid C. Vertebral

A
  • E. occipital
29
Q

The internal laryngeal nerve is a branch of the ______? A. Recurrent laryngeal B. Superior laryngeal C. Sympathetic trunk D. External laryngeal

A
  • B. Superior laryngeal
30
Q

The number of pharyngeal arches that start to develop in the embryo are: A. 2 B. 3 C. 5 D. 6

A
  • D. 6
31
Q

What are 3 muscles in head/neck that have intermediate tendons?

A
  • Omohyoid - Digastric - Occipitofrontalis
32
Q

What cranial nerve(s) innervate carotid sinus?

A
  • CN IX and X
33
Q

What structures lie close to anterior scalene?

A
  • Phrenic nerve - Subclavian artery - Brachial plexus
34
Q

What structure(s) overlies levator scapulae?

A
  • CN IX
35
Q

Over what structure(s) does the ansa cervicalis lie?

A
  • Internal jugular v, carotid a

Anatomy (19 decks)

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