Lecture 2-Anterior Cervical Triangle, Viscera, Root of Neck Flashcards
1
Q
The anterior cervical triangle can be broken down into 4 smaller triangles:
A
- submental
- submandibular
- muscular
- carotid
2
Q
The anterior cervical triangle borders are:
Lateral:
Superior:
Medial:
A
Lateral: anterior border of SCM
Superior: inferior border of mandible
Medial: Midline of necl
3
Q
The “roof” of the anterior cervical triangle is formed by the… and … m.
A
skin and platysma muscle
4
Q
What nerve innervates Platysma?
A
CNVII (cervical branch of facial)
5
Q
Muscles of the anterior triangle can be grouped based upon their position relative to the…. bone. So the 2 groups are…
A
- hyoid
- suprahyoid and infrahyoid
6
Q
The suprahyoid muscles are comprised of these 4 muscles ans their function is to… the hyoid bone which happens when you swallow for example
A
- Stylohyoid
- Digastric
- Mylohyoid
- Geniohyoid
- elevate
7
Q
The action of the stylohyoid muscle is that it pulls…
A
the hyoid bone upward in posterosuperior direction
8
Q
The stylohyoid muscle is innervated by
A
CNVII (facial n.)
9
Q
The digastric muscle has 2 actions. When the mandible is fixed it….
and when the hyoid is fixed it…
A
- raises hyoid bone
- lowers mandible(opens mouth)
10
Q
The anterior belly of digastric is innervated by….
The posterior belly of digastric is innervated by…
A
anterior- CNV, mandibular vision of trigeminal (V3) also called mylohyoid branch
posterior- CNVII (facial n)
11
Q
What is the action of the mylohyoid muscle?
A
supports and elevates floor of mouth and elevates the hyoid
12
Q
Innervation of the mylohyoid muscle?
A
Mandibular branch of Trigeminal. CNV (V3) also called mylohyoid branch
13
Q
The geniohyoid has 2 functions. When the mandible is fixed it…
When the hyoid is fixed it…
A
- elevates and pulls hyoid forward
- pulls mandible downward and inward
14
Q
Innervation of geniohyoid muscle
A
branch from anterior ramus of C1 carried via hypoglossal n. (CNXII)
15
Q
The infrahyoid muscles are also called the “strap” muscles and they all function to… the hyoid
A
depress
16
Q
4 infrahyoid muscles
A
- omohyoid
- sternohyoid
- thyrohyoid
- sternothyroid
17
Q
The action of the sternohyoid muscle is to…. after swallowing
A
depress hyoid bone
18
Q
Innervation of sternohyoid muscle
A
anterior rami of C1-C3 via ans cervicalis
19
Q
3 infrahyoid muscles, sternohyoid, omohyoid and sternothyroid are all innervated by…..
Only one infrahyoid muscle, Thyrohyoid is not
A
anterior rami of C1-C3 via ansa cervicalis
20
Q
Thyrohyoid muscle is innervated by the fibers from…
A
anterior ramus of C1 carried via hypoglossal n. (CNXII)
-called nerve to thyrohyoid m.
21
Q
The omohyoid muscle … and… the hyoid bone
A
depresses and fixes
22
Q
The thyrohyoid muscle has 2 different actions: it … the hyoid bone and when the hyoid is fixed, it…
A
- depresses
- raises the larynx
23
Q
The sternohyoid m. draws the…. downward
A
larynx (thyroid cartilage)
24
Q
There are 2 anterior… veins that drain anterior neck and are located in midline. They empty into subclavian v. or EJV
A
-Jugular
25
The communicating branch veins connect the... with the...
- common facial vein
| - anterior jugular vein
26
The retromandibular vein is formed by... and ... and then divides into...
1. superficial temporal vein
2. maxillary vein
- anterior and posterior divisions
27
The anterior divison of the retromandibular vein connects with the.... to form.. which drains into the internal jugular vein
- facial vein
| - common facial vein
28
The posterior division of the retromandibular vein connects with the .... vein to form the...
- posterior auricular vein
| - external jugular vein
29
The facial vein originates at the... and receives tributaries from veins... and drains into...
- angle of the eye
- draining face
- internal jugular vein
30
The internal jugular vein drains blood from the skull, brain...
superficial face and cervical viscera
31
The internal jugular vein transverses neck within... and then joins with the.... to form the...
- carotid sheath
- subclavian vein
- brachiocephalic vein
32
The common carotid aa. are not symmetrical. The right common carotid comes off the... and the left common carotid comes off the...
- brachiocephalic trunk
| - aortic arch
33
The internal carotid artery does not give off any branches in the neck. It goes up into skull and contributes to...
circle of willis
34
The external carotid artery gives off branches immediately after ..
bifurcation of common carotid
35
The 3 anterior branches of the ECA
1. Superior thyroid a.
2. Lingual a.
3. Facial a.
36
The 3 posterior branches of the ECA
1. Ascending pharyngeal a.
2. Occipital a.
3. Posterior auricular a.
37
The ECA terminates as ... and...
superficial temporal a. and maxillary a.
38
The Superior thyroid artery is the 1st anterior branch of the... it gives off the... which pierces the...together with the....
- ECA
- Superior laryngeal a.
- thyrohyoid membrane
- internal branch of superior laryngeal nerve
39
The superior thyroid artery supplies the...
superior portion of the thyroid gland
40
The Lingual artery is the 2nd anterior branch from the.... and arises just above the superior thyroid a. at the level of the.... and it passes deeply into the...
- ECA
- greater horn of the hyoid bone
- muscles of the tongue
41
The Facial artery is the 3rd anterior branch of the...and rises superior to the.... and crosses the inferior border of... to supply the face
- ECA
- lingual a.
- mandible
42
The ascending pharyngeal a. is the 1st posterior branch of the....and arises close to the bifurcation of the... and ascends to supply the ... and ...
- ECA
- common carotid a.
- pharynx and tonsils
43
The Occipital a. is the 2nd posterior branch of the... arises near level of the... passes deep to the... and ascends to supply ...
- ECA
- facial a.
- posterior belly of digastric
- neck and scalp
44
The occipital a. sends off muscular branch to... which hooks over...
- SCM
| - CNXII
45
The Posterior Auricular a. is the 3rd posterior branch of the ... and arises superior to origin of... artery and superior to... it then passes upward and posteriorly to supply...
- ECA
- occipital
- posterior belly of digastric
- scalp to posterior ear
46
The carotid sinus is a dilatation of... near bifurcation of common carotid a. and contains receptors that monitor...
- internal carotid a.
| - BP changes (baroreceptors)
47
The carotid sheath contains..
1. carotid a. (common/internal/carotid sinus)
2. Internal jugular v.
3. Vagus n. (CNX)
48
2 spinal nerves associated with the anterior cervical triangle
1. Transverse cervical n. (C2-3)
| 2. Ansa cervicalis (C1-3)
49
5 CN's associated with the anterior cervical triangle
7,9,10,11,12
50
The transverse cervical nerve which arises from cord levels... emerges from deep to posterior border of... and tranvels...
- C2-C3
- SCM
- transversley across middle of SCM
51
The transverse cervical nerve provides cutaneous innervation to skin...
overlying anterior cervical triangle
52
The Ansa Cervicalis is a nerve loop formed from the... and innervates...
- anterior rami of cervical nerves C1-3
| - infrahyoid mm. (not thyrohyoid)
53
The ansa cervicalis has a superior root which is mainly... from... and an inferior root which is...
- C1 fibers from anterior rami
| - anterior rami of C2 and C3
54
The borders of the submental triangle:
Inferior:
Lateral (R):
Lateral (L):
Inferior: Hyoid bone
Lateral (R): anterior belly of digastric
Lateral (L): anterior belly of digastric
55
The contents of the submental triangle (3)
- mylohyoid m.
- submental lymph nodes
- some small veins
56
The borders of the submandibular triangle
Superior:
Anterior/Inf:
Posterior/Inf:
Superior: Inferior border of mandible
Ant/Inf: ant belly of digastric
Post/Inf: post belly of digastric
57
6 contents of submandibular triangle
1. submandibular gland
2. submandibular lymph nodes
3. marginal mandibular branch of CNVII
4. CNXII
5. Mylohyoid n. (of CNV3)
6. Facial a. and v.
58
Borders of muscular triangle
Superior:
Lateral:
Medial:
Superior: Hyoid bone
Lateral: superior belly of omohyoid m. and anterior border of SCM m.
Medial: midline of neck
59
4 muscles of muscular triangle
1. omohyoid (border)
2. Sternohyoid
3. Sternothyroid
4. Thyrohyoid
60
6 viscera components of muscular triangle
1. thyroid gland
2. parathyroid glands
3. trachea
4. esophagus
5. common carotid a.
6. Internal jugular v.
61
Borders of carotid triangle
Superior:
Posterior:
Anteroinferior:
Superior: Stylohyoid m. and posterior belly of digastric
Posterior: Anterior border of SCM
Anteroinferior: Superior belly of omohyoid m.
62
Nerves of carotid triangle
- CNX, XI, XII
- ansa cervicalis (C1-3)
- laryngeal nn. (branches of CNX)
63
Arteries of carotid triangle
- common a.
- internal carotid a.
- external carotid a. and 6 branches
64
The larynx continues inferiorly as the... and the pharynx continues inferiorly as the... Both of these transitions happen at vertebral level....
- trachea
- esophagus
- C6
65
The adam's apple is called the.... and is superior to the.... cartilage and inferior to the... membrane.
- laryngeal prominence
- thyroid cartilage
- thyrohypid membrane
66
Inferior to the thyroid cartilage is the... membrance and inferior to that is the .... cartilage
- cricothyroid
| - cricoid
67
What is a cricothyrotomy?
| Where is this performed?
- emergency procedure to establish airway.
| - Cricothyroid membrane (between thyroid and cricoid cartilage)
68
What is a tracheotomy (tracheostomy-more permanent)?
When is it performed?
Where is the opening made?
- creation of midline incision in trachea and insertion of tube to enable ventilation
- airway obstruction
- between infrahyoid mm.
69
A high tracheotomy is superior to...
isthmus of thyroid
70
A low tracheotomy is inferior to...
isthmus of thyroid
71
Isthmus of thyroid may be... during a tracheotomy
divided surgically
72
The.... gland is a large, unpaired endocrine gland located inferior and lateral to thyroid cartilage. It's R and L lobes are connected by
- thyroid gland
| - isthmus (covers 2-4 tracheal rings)
73
In the thyroid gland, the... lobe is frequently present and extends superior from isthmus
pyramidal
74
The Superior thyroid a. (1st branch of ant ECA) supplies the....
superior pole of lateral lobe of thyroid gland
75
The Inferior thyroid a. is a branch of the ... and supplies the...
- thyrocervical trunk (from subclavian a.)
| - inferior pole of lateral lobe of thyroid gland
76
The.... is a small artery ocassionally found arising from either brachiocephalic trunk or arch of aorta and ascends anterior surface of trachea to supply thyroid gland
Thyroid ima a.
77
There are 3 veins of the thyroid gland. The... and ... drain into the IJV and the... drain into the....
- Superior and middle thyroid vv.
- Inferior thyroid v.
- brachiocephalic vv.
78
The parathyroid gland which is involved in calcium metabolism is usually comprised of 4 glands within the posterior surface of the...
thyroid
79
The parathyroid glands are ..., ..., ... structures on deep surface of r/l lobes of thyroid. they are called superior and inferior but position is variable
small (5mm), ovoid, yellowish
80
A thyroidectomy is the excision of part of/most of... and can cause damage to... or these 2 nerves
- thyroid gland
- parathyroid glands
- external laryngeal n.
- recurrent laryngeal n.
81
If there is damage to the external laryngeal nerve in a thyroidectomy, it could cause paralysis of ... membrane and to inferior ....muscle
- cricothyroid membrane
| - pharyngeal constrictor muscle
82
If there is damage to the recurrent laryngeal nerve in a thyroidectomy, there would be paralysis of most...
laryngeal mm.
83
The root of the neck is the junction between the... and .... It lies superior to...
- thorax and neck
| - superior thoracic aperature
84
Th extension of the thoracic cavity projects into neck; consists of upward projection of pleural cavity and includes....
- cervical part of parietal pleura (cupula)
| - apical part of superior lobe of each lung
85
At the root of the neck, the subclavian artery gives off there 3 arteries
1. vertebral
2. thyrocervical trunk
3. internal thoracic
86
The thyrocervical trunk arises from the... artery and medial to... muscle
- subclavian artery
| - anterior scalene muscle
87
The 3 branches of the thyrocervical
1. inferior thyroid a.
2. transverse cervical a.
3. Suprascapular a.
88
The inferior thyroid a. (branch of thyrocervical) gives off.... artery and runs posterior to... and...
- ascending cervical artery
| - carotid sheath and thyroid gland
89
The transverse cervical artery and the suprascapular a. cross over the anterior surface of the.... muscle and .... nerve
- anterior scalene muscle
| - phrenic nerve
90
The vertebral artery enters the transverse foramen of... and passes up to...
- C6
| - C1
91
The vertebral vein drains into.... vein and travels in transverse foramen of.... to...
- brachiocephalic vein
| - C1-C6
92
The phrenic nn. from cord levels... are of the .... plexus
- C3-C5
| - cervical
93
The phrenic n. passes inferiorly across anterior surface of.... muscle
anterior scalene muscle
94
The phrenic nerve passes between the.... v. and a. and enters the thorax and continues to the...
- subclavian
| - diaphragm
95
The vagus nerve descends through neck in... and provides all... innervation to the neck and the R and L side both have a .... nerve
- carotid sheath
- parasympathetic
- recurrent laryngeal nerve
96
The recurrent laryngeal nn. are branches of the.... nerve and they ascend in groove between the... and... and enter the... They innervate all intrinsic laryngeal mm. except...
- vagus
- trachea and esophagus
- larynx
- cricothyroid muscle
97
The right recurrent laryngeal nerve (from R. vagus) loops around right.... and upward toward larynx
-subclavian artery
98
The left recurrent laryngeal nerve (from L. vagus nerve) loops around below and behind... and upward to larynx
-arch of aorta
99
The Sympathetic trunk (chain) extends from base of skull to... and is punctuated by ganglia along extent of trunk/chain
-coccyx
100
The cervical part of symathetic trunk is.... to prevertebral mm. and ...to cervical viscera
- anterior
| - posterior
101
The sympathetic trunk is connected to each spinal nerve by a....
gray ramus comminicans
| **no white rami communicans in cervical region**
102
There are...sympathetic ganglia found in the cervical region. They are called...
- 3
| - superior, middle and inferior cervical ganglion
103
The superior cervical ganglion is found high in neck near level of..... of temporal bone
-mastoid process
| on R and L
104
The middle cervical ganglion is found posterior to the...
thyroid gland
| on R and L
105
The inferior cervical ganglion is found at the.... end of the cervical part of the sympathetic trunk. It combines with the first thoracic ganglion and forms the...
- lower
| - cervicothoracic (stellate) ganglion
106
The thoracic duct is the major lymphatic channel that drains lymph from the..... UL, head, neck, thorax, abdomen and LL
left
107
The thoracic duct lies posterior to.... between... and...
- esophagus
| - azygos vein and thoracic aorta
108
The thoracic duct drains into ... which is the junction between .... and....
- left venous angle
| - Left IJV and Left subclavian vein
109
The R. lymphatic duct drains R. UL, head, neck and thorax and drains into the.... which is the junction between the.... and...
- right venous angle
| - Right IJV and Right subclavian vein
