Lecture 8: Neck

Question 1

Boundaries of neck

Answer 1

External occipital protuberance

Tip of mastoid process

Spinous process of C7 vertebra

Acromion

Clavicle

Suprasternal notch

Inferior border of mandible

Question 2

Function fo cervical vertebral column

Answer 2

Mobile rod of cervical vertebrae

Attachment points for muscles and fascia

Casing for vertebral artery and spinal cord

Question 3

Movements of cervical vertebra

Answer 3

Retroflexion

Anteflexion

Sideflexion

See figure

Question 4

What bones for the antlanto-occipital and the atlanta-axial joints?

Answer 4

AO joint: occipital bone and atlas

AA joint: Atlas and axis

See figure

Question 5

Anterior pre vertebral muscles

Answer 5

Longus colli: Flexes neck (anterior or lateral)

Longus capitis: Flexion of head on neck (anterior or lateral)

Rectus capitis (ant,,lat.): Anterior flexes neck laterally, Lateral flexes head and stabilizes it

Question 6

Lateral pre vertebral muscles

Answer 6

Anterior scalenus: Flexes neck laterally

Med scalenus: Flexes neck laterally

Post scalenus: Flexes neck laterally

See figure

Question 7

Plastyma

Answer 7

Mimetic muscle of neck

Question 8

Which nerve innervates the plastyma?

Answer 8

CN VII

Question 9

Fascial layers of neck

Answer 9

Pretracheal layer (muscular portion)

Investing layer

Carotid sheath

Prevertebral layer

Pretracheal layer (Visceral portion)

Question 10

What structures are inside the carotid sheath?

Answer 10

Internal carotid artery

Internal jugular vein

Vagus nerve

See figure

Question 11

Anterior triangle borders

Answer 11

Anterior edge of sternocleidomastoid

Midline of neck

Mandible

Question 12

Posterior triangle borders

Answer 12

Posterior border of sternocleidomastoid

Clavicle

Trapezius

See figure

Question 13

Content of posterior triangle of neck

Answer 13

Brachial plexus

Vagal nerve

Sympathetic trunk

Question 14

What muscles do the brachial plexus pass through?

Answer 14

The scalene muscles

Question 15

Roots of brachial plexus

Answer 15

C5-T1

See figure

Question 16

What do the brachial plexus innervate?

Answer 16

Shoulder and upper extremity

Question 17

Succession of branches of brachial plexus

Answer 17

Roots -> Trunks -> Divisions -> Cords

Question 18

Branches of brachial plexus

Answer 18

Median nerve

Ulnar nerve

Radial nerve

Question 19

Biggest cranial nerve

Answer 19

Vagus

Question 20

What does the vagus nerve innervate?

Answer 20

Muscles in neck

ANS system of heart, lungs, GI, liver, kidney, colon, small intestine

Question 21

Ganglion of cervical sympathetic trunk

Answer 21

Superior, middle and inferior sympathetic ganglion

Question 22

Location of cervical sympathetic trunk

Answer 22

On top of the anterior scalene

Question 23

What does cervical sympathetic trunk innervate?

Answer 23

Upper extremities, head, neck, heart

Question 24

Function of cervical sympathetic system

Answer 24

Antagonizes the parasympathetic system

Question 25

Content of the anterior triangle

Answer 25

Hyoid bone with supra- and infra-hyoid muscles Larynx Thyroid gland and parathyroid glands

Question 26

Suprahyoid muscles

Answer 26

Diastric Stylohyoid Genohyoid Mylohyoid See figure

Question 27

Infrahyoid muscles

Answer 27

Sternohyoid Omohyoid Sternothyroid Thyrohyoid See figure

Question 28

Innervation of suprahyoid

Answer 28

Anterior digastric: CN V3 Posterior digastric, stylohyoid: CN VII Mylohyoid: CN V3 Genohyoid: C1

Question 29

Composition of larynx

Answer 29

Cartilage Ligaments Membranes Muscles

Question 30

What are the cartilaginous laryngeal structures?

Answer 30

Epiglottis Thyroid cartilage Cricoid cartilage 2x Arytenoid cartilages See figure

Question 31

Innervation of infrahyoid muscles

Answer 31

Ansa cervicalis

Question 32

Vestibular fold function

Answer 32

No role in sound production Play protective function

Question 33

Composition of vocal folds

Answer 33

Vocal ligament, consisting of thickened elastic tissue that is the medial free edge of the conus elasticus Vocalis muscle, composed of exceptionally fine muscle fibers immediately lateral to and terminating at intervals relative to the length of the vocal ligaments

Question 34

Glottic spaces of larynx

Answer 34

Supraglottic space Transglottic space Subglottic space See figure

Question 35

Vocal and vestibular ligaments

Answer 35

See figure

Question 36

Which laryngeal muscles abduct the vocal cords?

Answer 36

Paired posterior cricoarytenoid muscles Open the airways All other laryngeal muscles adduct the vocal cords and close the airways

Question 37

Muscles that move laryngeal cartilage

Answer 37

Cricothyroid muscles (lengthen vocal cords) Posterior cricoarytenoid muscles (abduction of vocal cords) Lateral cricoarytenoid (adduction of vocal cords) Transverse arytenoid muscle (adduction of vocal cords) Vocalis (shortening/ (relaxation of vocal folds) Thyroarytenoid muscles (shortening/ relaxation of vocal folds)

Question 38

Indirect laryngoscopy and positions of vocal folds

Answer 38

See figure

Question 39

Swallowing stages and larynx

Answer 39

See figure a) Food enters oral cavity, mastication and bolus formation b) Tongue elevates and propels bolus to pharynx, soft palate elevates to seal nasopharynx c) Larynx and hyoid bone move anterior and upward, epiglottis moves posteriorly and downwards (closes), respiration stops d) Pharynx shortens, upper esophageal sphincter relaxes, bolus passes to esophagus e-f) Esophageal sphincter relaxes Bolus reaches stomach

Question 40

Thyroid and parathyroid glands

Answer 40

See figure

Question 41

Main arterial branches of thyrocervical trunk

Answer 41

Inferior thyroid artery Transverse cervical artery Suprascapular artery

Question 42

Arterial blood supply of thyroid

Answer 42

Superior thyroid artery Inferior thyroid artery See figure

Question 43

Venous blood supply of thyroid gland

Answer 43

Superior thyroid vein Middle thyroid vein Inferior thyroid vein See figure

Question 44

What nerve innervates all intrinsic laryngeal muscles?

Answer 44

Recurrent laryngeal nerve Branch of vagus nerve EXCEPTION: does not innervate cricothyroid muscle

Question 45

What can be injured during operations of thyroid gland?

Answer 45

Recurrent laryngeal nerve See figure

Question 46

Blood supply of head and neck

Answer 46

Carotid artery Internal jugular vein