Lecture 2 - Fascial Layers, Deep Neck Spaces And Cross Section Anatomy

Question 1

Describe where the hyoid bone is

Answer 1

At level of C3 directly under chin

Question 2

Where is the thyroid cartilage and the cricoid cartilage?

Answer 2

Under hyoid bone (adams apple)
Then the cricoid is like 1 cm under the thyroid cartilage

Question 3

What is it called when the thyroid gland is enlarged and palpable?

Answer 3

Goitre

Question 4

What nerve innervates platysma?

Answer 4

Facial nerve (cervical branch)

Question 5

What is the origin and insertion of Sternocleidomastoid?

Answer 5

Origin = clavicle and sternum

Inserts = mastoid process (bony part behind ear)

Question 6

What is the action of Sternocleidomastoid?

Answer 6

Rotates head so chin can turn to opposite side

Question 7

What nerve innervates Sternocleidomastoid?

Answer 7

Accessory nerve

Question 8

How can you test the strength of the right Sternocleidomastoid muscle?

Answer 8

Put hand on persons LHS of their face and push across to their right and they try and resist

Question 9

What is the condition called where there is involuntary contraction of Sternocleidomastoid causing an asymmetrical neck position?

Answer 9

Torticollis

Question 10

What is Torticollis?

Answer 10

Involuntary contraction of SCM

Question 11

What nerve innervates trapezius?

Answer 11

Accessory nerve

Question 12

What is the origin of trapezius?

Answer 12

Occipital bone and nuchal ligament

Question 13

What can lead to trapezius muscle wastage?

Answer 13

Accessory nerve injury

Question 14

What are the 3 borders of the anterior triangle?

Answer 14

Mid Sagittal line of neck

Inferior margin of mandible = superior margin

Anterior border of SCM = lateral border

Question 15

What other part of the body is th anterior triangle of the neck connected to?

Answer 15

Thorax

Question 16

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

Answer 16

Posterior border of SCM
Anterior border of trapezius
Clavicle
Scalene muscles = floor

Question 17

What other part of the body is the posterior triangle of the neck connected to?

Answer 17

Upper limb

Question 18

What do the suprahyoids do?

Answer 18

Elevate hyoid and depress mandible

Question 19

What does the infrahyoid muscles do?

Answer 19

Depress hyoid

Question 20

What is contained in the neurovascular bundle in the neck?

Answer 20

Common carotid artery
Internal jugular vein
Vagus nerve

Question 21

What muscle is the neurovascualr bundle in the neck deep to?

Answer 21

Sternocleidomastoid

Question 22

At what vertebral level does the common carotid artery bifurcate into the internal and external carotid arteries?

Answer 22

C4

Question 23

What is more medial in the neurovascular bundle in the neck the Common Carotid Artery or the internal jugular vein?

Answer 23

CCA (think it needs to be protected more)

Internal jugular vein is more lateral

Question 24

What is the PNUEMONIC for the contents of the posterior triangle?

Answer 24

Some
Pretty
Brave
Students
Invented Ony ( Not P should be I)
An
Envelope

Question 25

Using the PNUEMONIC what are the contents of the posterior triangle? Deepest —> most superficial

Answer 25

Some (scalene muscles is floor) Pretty = Phrenic nerve Brave = brachial plexus Students = subclavian vessels Invented Only =Inferior belly of Omohyoid An = accessory nerve Envelope = external jugular vein

Question 26

How many superficial cervical layers of fascia are there and how any deep cervical fascia layers are there?

Answer 26

1 superficial 4 deep fascial layers

Question 27

What des the superficial cervical fascial layer surround in the neck?

Answer 27

All of it

Question 28

What are the 4 deep cervical fascial layers?

Answer 28

Investing layer Pre vertebral fascia Carotid sheath Pretracheal fascia/buccopharyngeal fascia

Question 29

What does the pre tracheal fascia/buccopharangeal fascia surround? Why are there separate names for the same layer?

Answer 29

Infrahyoid muscles TTO Thyroid cartilage Trachea Oesophagus Pre tracheal fascia anteriorly and then becomes buccophargeal fascia posteriorly

Question 30

What does the carotid sheath dep. fascial layer surround?

Answer 30

Neurovascular bundle (Commmon carotid artery, internal jugular vein and vagus nerve)

Question 31

What does the pre-vertebral fascia layer surround?

Answer 31

The vertebra and the muscles

Question 32

What does the investing deep fascial layer surround?

Answer 32

All compartments and also circling trapezius and Sternocleidomastoid

Question 33

What muscle is found in the superficial cervical fascial layer?

Answer 33

Platysma

Question 34

What is the Retropharyngeal space?

Answer 34

Deep neck space located between the buccopharyngeal fascia nd the prevertebral fascia

Question 35

Why do kids more commonly get retropharyngeal abcesses secondary to infection tan adults?

Answer 35

Kids have lymph nodes in retropharyngeal space which drain fro the upper respiratory tract

Question 36

What are the clinical features of a deep neck space infection like a retropharyngeal abscess?

Answer 36

Unwell Sore throat Difficultly swallowing Drooling Painful neck movements

Question 37

Why is it dangerous if the retropharyngeal abscess descends?

Answer 37

The retropharyngeal space extends down into the thorax/mediastinum which can cause mediastinitis if infection spreads Airway could also get compromised

Question 38

What are the contents of the anterior triangle of the neck?

Answer 38

Suprahyoid muscles Infrahyoid muscles Glossopharyngeal nerve Vagus nerve Accessory nerve Hypoglossal nerve Common carotid (bifurcates in here too forming internal and external carotids) Internal jugular vein

Question 39

What is an important subdivided area in the anterior triangle?

Answer 39

Carotid triangle

Question 40

What are the borders of the carotid triangle in the anterior triangle?

Answer 40

Superior border = post belly of Digastric Lateral border = medial border of SCM Inferior border = sup belly of Omohyoid

Question 41

What are the main contents of the carotid triangle in the anterior triangle of the neck?

Answer 41

Common carotid + when it bifurcates Internal jugular vein Vagus nerve Hypoglossal nerve