Lecture 9: Neck

Question 0

Suprahyoid muscles- nerve Innervation

Answer 0

Stylohyoid- facial
Digastric- anterior belly:mylohyoid nerve of mandibular
Posterior belly: facial nerve
Mylohyoid:- mylohyoid nerve of mandibular
Geniohyoid- c1 of cervical nerves

Question 1

Suprahyoid muscles

Answer 1

Stylohyoid
Digastric
Mylohyoid
Geniohyoid

Question 2

Digastric Attachments

Answer 2

Superior:
anterior belly- digastric fossa of mandible
Posterior belly- mastoid notch

Inferior:
Hyoid bone

Question 3

Mylohyoid attachment

Answer 3

Superior:
Mylohyoid line of the mandible

Inferior attachment:
Hyoid bone

Question 4

Larynx

Answer 4

modifies exit of air for vocalisation 
Innervation
Sensory- internal laryngeal nerve
Motor- recurrent laryngeal nerve
Except cricothryoid muscle which is Innervation by external laryngeal nerve

Question 5

The hyoid bone is at what level?

Answer 5

C3

Question 6

The larynx is at what level?

Answer 6

C4-C6

Question 7

The thyroid gland is at what level?

Answer 7

C5-T1

Question 8

What makes up the anterior triangle of the neck?

Answer 8

Anterior border of SCM, Inferior border of mandible, Midline of neck

Question 9

What makes up the posterior triangle of the neck?

Answer 9

Posterior border of SCM
Anterior border of trapezius
Middle 1/3 of clavicle

Question 10

SCM and trapezius innervated by?

Answer 10

spinal accessory nerve CN XI

Question 11

Submental triangle of the neck

Answer 11

apex: mandibular Symphysis , base: hyoid bone

Question 12

Submandibular triangle of the neck

Answer 12

between mandible & digastric muscle, filled by submandibular
gland

Question 13

Carotid triangle of the neck

Answer 13

anterior border SCM, posterior belly digastric

Question 14

What is the purpose of the fascia of the neck?

Answer 14

Support viscera and provide “slipperiness” that allows structures to move and pass over one another without difficulty, as when you turn your head.

Question 15

What are the three cervical fascia of the neck?

Answer 15

• Cervical subcutaneous tissue and platysma 
• Deep cervical fascia 
=> investing layer 
=> pre-tracheal layer 
=>pre-vertebral layer
• Retropharyngeal space

Question 16

Investing layer of deep cervical fascia does what?

Answer 16

“invests” SCM and trapezius

Question 17

Pre-tracheal layer of deep cervical fascia does what?

Answer 17

only anterior neck. Encloses infra-hyoid muscles, thyroid gland, trachea and oesophagus. From hyoid to fibrous pericardium.

Question 18

What is inside the common carotid sheath?

Answer 18

encloses common & internal carotid arteries, IJV, CN X, deep cervical lymph nodes, carotid sinus nerve, sympathetic nerve fibres. Extends from cranial base to thorax.

Question 19

Retropharyngeal space permits what movement?

Answer 19

movement of pharynx, oesophagus, larynx & trachea relative to
vertebral column during swallowing

Question 20

What is the platysma innervated by?

Answer 20

Innervated by cervical branch of facial nerve CN VII

Question 21

Sternocleidomastoid muscle origin insertion action Innervation?

Answer 21

• Superior attachment: mastoid process
• Inferior attachment: sternum and clavicle
• innervation: XI Spinal accessory nerve, Branches of the anterior rami of C2-3

Question 22

What are the four infrahyoid muscles and their Innervation?

Answer 22

• Thyrohyoid (C1)
• Sternohyoid (C1-C3 through ansa cervicalis)
• Omohyoid (C1-C3 through ansa cervicalis)
• Sternothyroid (C1-C3 through ansa cervicalis)

Question 23

Sternothyroid superior and inferior attachment and action ?

Answer 23

• Superior attachment: lamina of thyroid cartilage
• Inferior attachment: manubrium of sternum
• Actions: Depresses thyroid cartilage (larynx)

Question 24

Sternohyoid superior and inferior attachment and action?

Answer 24

* Superior attachment: manubrium * Inferior attachment: hyoid bone * Actions: Depresses hyoid bone at the end of swallowing

Question 25

Thyrohyoid superior attachment, Inferior attachment and actions?

Answer 25

* Superior attachment: thyroid cartilage * Inferior attachment: hyoid bone * Actions: Depresses hyoid bone or raises larynx if hyoid bone is fixed

Question 26

Trapezius superior attachment, inferior attachment, action and Innervation?

Answer 26

Superior attachment: superior nuchal line, external occipital protuberance, nuchal ligament, spinous processes of C7 to T12 Inferior attachment: lateral 1/3 of clavicle, acromion, spine of the scapula Actions: Upper trapezius: elevate the scapula Middle trapezius: adduction of the scapula Lower trapezius: depresses the scapula Rotates the scapula in abduction of humerus above >90 degrees Innervation: Spinal accessory nerve and Branches of the anterior rami of C2-3

Question 27

Ansa cervicalis supplies

Answer 27

* STERNOTHYROID * STERNOHYOID * OMOHYOID

Question 28

Hypoglossal nerve supplies

Answer 28

``` Intrinsic muscles of tongue •GENIOGLOSSUS •HYOGLOSSUS •GENIOHYOID •THYROHYOID •STYOLGLOSSUS ```

Question 29

Structures passing between thorax & head?

Answer 29

* Sympathetic trunk & cervical ganglia (x3) * Vagus (CN X) + recurrent laryngeal nerve * Phrenic (C3, C4, C5)

Question 30

Brachial plexus emerges between?

Answer 30

anterior and middle scalene muscles

Question 31

Cervical plexus

Answer 31

* Anterior rami C1-C4 * Deep to SCM * Anteromedial to levator scapulae and middle scalene. * Superficial branches = cutaneous sensory * Deep branches = motor (phrenic nerve, ansa cervicalis)

Question 32

Cervical plexus nerves

Answer 32

* Lesser occipital (C2) * Great auricular (C2 and C3) * Transverse cervical (C2 and C3) * Supraclavicular (C3 and C4)

Question 33

What is ansa cervicalis?

Answer 33

Loop of nerve fibres from C1-C3 that provides motor innervation to infra-hyoid muscles (sternohyoid, omohyoid, sternothyroid)

Question 34

What is the course of the right recurrent laryngeal nerve?

Answer 34

nerve hooks around right subclavian and heads superiorly to | innervate laryngeal muscles.

Question 35

What is the course of the left recurrent laryngeal nerve?

Answer 35

nerve hooks around 6th aortic arch which becomes ductus arteriosus or ligamentum arteriosum and heads superiorly to innervate laryngeal muscles.

Question 36

Cervical ganglia of sympathetic trunk levels?

Answer 36

* Superior: level C1/C2; large; sends post-synaptic sympathetic fibres into cranial cavity & C1-C4 spinal nerves. * Middle: level TP of C6; small; post-synaptic sympathetic fibres to C5-C6 spinal nerves. * Inferior: level of TP of C7; star-shaped (“stellate”) when fused with first thoracic ganglion; post-synaptic sympathetic fibres to C7-C8 spinal nerves.

Question 37

Name two endocrine organs?

Answer 37

=> thyroid and | => parathyroid glands

Question 38

Positioning if the thyroid gland?

Answer 38

Deep to sternothyroid & sternohyoid muscles | Extends C5-T1

Question 39

Blood supply to the thyroid glands?

Answer 39

inferior thyroid artery

Question 40

Parathyroid gland secretes what?

Answer 40

• Secrete parathyroid hormone, most important hormone for Ca2+ balance

Question 41

Sympathetic Innervation of parathyroid gland?

Answer 41

Cervical ganglia

Question 42

What is the purpose of the larynx?

Answer 42

communicates with oropharynx and trachea, modifies exit of air for vocalisation

Question 43

Purpose of the trachea?

Answer 43

provides a patent airway, conducts air to lungs