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neck Flashcards

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1
Q

what muscle separates the anterior and posterior triangles of the neck

A

sternocleidomastoid

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2
Q

boundaries of the anterior triangle:
anterior border
posterior border
base

A

midline of neck
anterior border of sternocleidomastoid
mandible

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3
Q

name the divisions of the anterior triangle

A

submandibular
submental
carotid
muscular

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4
Q

what is within the submandibular division of the anterior triangle

A 
submandibular salivary gland
lymph nodes
facial artery and vein
carotid sheath
hypoglossal nerve
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5
Q

what is within the submental division of the anterior triangle

A

submental lymph nodes

beginning of the anterior jugular vein

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6
Q

what is within the carotid division of the anterior triangle

A 
carotid sheath
branches of external carotid artery
internal jugular vein
hypoglossal nerve
accessory nerve
vagus nerve
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7
Q

what is within the muscular division of the anterior triangle

A

sternohyoid + sternothyroid form floor

beneath thyroid gland, larynx, trachea and oesophagus

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8
Q

what are the different layers of fascia in the anterior neck

A

pre-tracheal layer (visceral) - covers trachea
pre-tracheal layer (muscular) - covers muscles surrounding the trachea
pre-vertebral layer
carotid sheath

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9
Q

what is the layer of fascia extending above the pectoral is major and clavicle to lateral neck onto the mandible

A

platysma

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10
Q

what innervates the platysma

A

facial nerve (CN VII)

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11
Q

location of the external jugular vein

A

anterior to the SCM in the posterior triangle

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12
Q

location of the internal jugular vein

A

posterior to the SCM in the anterior triangle

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13
Q

if the anterior jugular vein is present where is it located

A

midline

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14
Q

muscles of the anterior triangle of the neck

A

supra hyoid and infra hyoid muscles

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15
Q

role of supra hyoid muscles

A

raise hyoid bone and depress mandible

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16
Q

name the supra hyoid muscles (chin area)

A

mylohyoid
anterior and posterior digastric belly
stylohyoid
geniohyoid

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17
Q

name the infra hyoid muscles (neck area) and classify superficial and deep

A

superficial:
superior and inferior omohyoid belly
sternohyoid

deep:
thyrohyoid
sternothyroid

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18
Q

what nerves supply the supra hyoid muscles

A

mylohyoid + anterior digastric belly - mandibular division of trigeminal (CN V3)
stylohyoid + posterior digastric belly - facial nerve (CN VII)
geniohyoid - C1 (via hypoglossal CN XII)

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19
Q

role of the infra hyoid muscles

A

depress hyoid body

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20
Q

what nerves supply the infra hyoid muscles

A 
ansa cervicalis(C1-C3)
thyrohyoid - C1 (via hypoglossal CN XII)
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21
Q

root value of the cervical plexus and type of innervation

A

anterior rami C1-C4

somatic motor and sensory (plus sympathetic)

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22
Q

position of the cervical plexus

A

joined into loops anterior to levator scapulae and scalenus medius
covered by pre-vertebral layer of deep cervical fascia

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23
Q

what does internal carotid supply

A

brain

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24
Q

contents of carotid sheath

A

internal jugular vein
common carotid artery
vagus nerve

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25
what branches off the external carotid artery
superior thyroid artery lingual artery facial artery
26
branches of the subclavian artery
internal thoracic vertebral artery thyrocervical trunk
27
what branches off the thyrocervical trunk
supra scapular transverse cervical inferior thyroid
28
what cranial nerve is the vagus
CN X
29
location of the recurrent laryngeal branches (internal and external) of the vagus and what they supply
left around arch of aorta right around subclavian muscles of the larynx
30
vagus nerve supplies
parasympathetic innervation to thorax and abdomen
31
type of gland and role of thyroid gland
endocrine | regulates metabolic rate
32
features of the thyroid gland
2 lobes isthmus capsule
33
location of thyroid gland
lamina of thyroid cartilage down to 6th tracheal ring | isthmus over tracheal ring 2 or 3
34
arterial supply to the thyroid gland
inferior thyroid artery from the thyrocervical trunk on the subclavian superior thyroid from the external carotid
35
nerve supply to the thyroid gland
recurrent laryngeal nerve of the vagus
36
venous drainage of the thyroid gland
superior thyroid and middle thyroid to the internal jugular and inferior thyroid to left brachiocephalic vein
37
location of submandibular gland
inferior to mylohyoid | part in floor of mouth (superior to mylohyoid)
38
features of submandibular gland
one duct opening between first and secondlower incisor
39
nerve supply to the submandibular gland
facial nerve (CN VII)
40
where does the thoracic duct drain into
near the origin of the internal jugular vein from the subclavian vein
41
boundaries of the posterior triangle anterior posterior base
posterior sternocleidomastoid anterior trapezius clavicle
42
contents of the posterior triangle
external jugular vein roots of the brachial plexus accessory nerve (CN XI) cervical and supraclavicular nodes
43
superficial nerves that emerge from the posterior triangle
``` lesser occipital (C2) greater auricular C2-C3) lateral supraclavicular (C3-C4) medial supraclavicular (C3-C4) transverse cervical (C2-C3) intermediate supraclavicular (C3-C4) ```
44
veins that can be seen in the posterior triangle
superficial cervical | external jugular vein
45
cutaneous innervation to the head/lateral neck: neck posterior to anterior behind ear to below nose top oh head posterior to anterior
posterior rami (C3-C5) supraclavicular (C3-C4) transverse cutaneous of neck (C2-C3) lesser occipital greater auricular buccal mental infra-orbital greater occipital supra-trochlear and supra-orbital
46
what branches off the external jugular vein
posterior auricular | retromandibular
47
what branches of the internal jugular vein
middle and superior thyroid lingual facial vein pharyngeal plexus
48
what arteries cross the posterior triangle
thyrocervical trunk (at very anterior edge) with branches - transverse cervical suprascapular artery (runs with nerve)
49
what nerve crosses obliquely over the anterior scalene muscle
phrenic nerve
50
what travels between the anterior and middle scalene muscles
brachial plexus
51
attachments of the sternocleidomastoid
mastoid process and superior nuchal line to clavicular head - clavicle sternal head - sternum
52
innervation of the sternocleidomastoid and trapezius: motor pain and proriception
``` spinal accessory nerve (CN XI) cervical plexus (C2-C3) ```
53
actions of the sternocleidomastoid
lateral flexion and rotation extension at atlanto-occipital joints flexion of cervical vertebra (from supine)
54
attachments of the trapezius
superior nuchal line to scapular spine and to T12
55
actions of the trapezius: ascending bit transverse bit descending bit
depress scapula retract scapula elevate scapula and rotate glenoid cavity
56
floor of the posterior triangle
omohyoid splenius wapitis levator scapula scalenes
57
action and innervation of the splenius capitis
extend and rotate the neck | dorsal rami middle cervical
58
attachment of the levator scapulae
transverse process of atlas and axis and 3rd-4th cervical vertebrae to medial scapular border (superior angle and medial end of scapular spine)
59
innervation and action of elevator scapulae
direct C3-C5 via dorsal scapular nerve
60
scalenes innervation and action: middle anterior posterior
``` C3-C7 C4-C7 C5-C7 flex neck (bilateral) tilt head (unilateral) elevate upper ribs ```
61
attachment of the scalenes
``` transverse process of: C2-C7 (anterior) C3-C6 (middle) C4-C6 (posterior) to: rib 1 behind subclavian artery (middle) rib 1's scalene tubercle (anterior) rib 2 (posterior) ```
62
order of posterior triangle neck muscles from superior to inferior
``` trapezius splenius wapitis levator scapulae anterior scalene middle scalene posterior scalene omohyoid ```
63
superficial and intermediate muscles of the sub occipital region and innervation
splenius cervicis splenius capitis semispinalis capitis longissimus capitis posterior rami C1-C6
64
attachment of splenius capitis
ligamentum nuchae and C7-T3 spinous process to occipital bone (superior nuchal) and mastoid process
65
attachments of splenius cervicis
T3-T6 spinous processes to C1-C2 transverse processes
66
action of the splenius capitis and cervicis
extend neck and head (bilateral) | flexes and rotates (unilateral)
67
attachments of semispinalis capitis
C4-T7 transverse processes to occipital bone (between nuchal lines)
68
attachments of longissimus capitis
T1-T3 plus C4-C7 transverse process to mastoid process
69
action of semispinalis capitis
extend cervical spine bends to same side rotates to other
70
action of longissimus capitis
extends head (both) flexes to same side rotates to same side
71
the suboccipital muscles of the region and innervation
rectus capitis posterior minor rectus capitis posterior major obliquus capitis superior obliquus capitis inferior suboccipital nerve (posterior rami of C1)
72
attachment of rectus capitis posterior minor and major
C1 posterior tubercle to inferior nuchal line | C2 spinous process to inferior nuchal line
73
attachment of obliquus capitis superior and inferior
C1 transverse process to occipital bone (above inferior nuchal line) C2 spinous process to C1 transverse process
74
action of rectus capitis posterior minor and major
extend head and rotate to same side
75
actions of obliquus capitis superior and inferior
superior - extend head, tilt head to same side, rotate to opposite inferior - extend head, rotate to same side
76
dorsal rami of the suboccipital region
subocciptial nerve (C1) greater occipital nerve (C2) third occipital nerve (C3)
77
what arteries do the subclavian and external carotid give rise to in the sub occipital region
vertebral -> basilar | occipital
78
what branches of the deep cervical vein and what does it drain into
occipital vein runs off it with the sub occipital nerve | drains into vertebral vein at transverse process of C7
79
what are the vertebral veins
small vein s of internal vertebral plexuses which form vessel through foramen transversarsium (atlas) to C6 here it leaves foramen to join braciocephalic vein
80
what actions occur a the base of the skull
extension flexion lateral flexion axial rotation
81
what type of joint is between the atlas and axis
synovial pivot
82
type of joint between intervertebral discs
2o cartilagenous
83
type of joints at IV discs articular surface
plane synovial
84
at what point does the pharynx join the oesophagus
C6
85
linings of the pharynx
mucous membrane (nasal, mouth, larynx, tympanic cavity) ciliated columnar epithelium (superiorly) stratified squamous epithelium (inferiorly) fibrous layer under (base of skull to submucous coat oesophagus muscular layer under fibrous layer - inner circular and outer longitudinal muscle
86
divisions of the pharynx and location
nasopharynx - behind nasal cavity oropharynx - soft palate of epiglottis laryngopharynx - behind larynx and laryngeal opening
87
``` boundaries of the nasopharynx: roof floor anterior posterior lateral ```
roof - sphenoid, occipital and pharyngeal tonsil floor - soft palate - pharyngeal isthmus anterior - nasal passages posterior - roof and CI level lateral - auditory tube and salpingopharyngeal fold
88
``` boundaries of the oropharynx: roof floor anterior posterior lateral ```
roof - soft palate floor - posterior 1/3 tongue, lingual tonsil, glossoepiglottic folds anterior - mouth posterior - C2-C3 level lateral - platoglossal and palatopharyngeal folds with palatine tonsil
89
boundaries of laryngopharynx: anterior posterior lateral
anterior - larynx posterior - C3-C6 vertebrae lateral - thyroid cartilage, aryepiglottic fold and thyrohyoid membrane
90
attachment of superior constrictor
posterior medial pterygoid plate, hamulus, pterygomandibular ligament, mandible, side of tongue to pharyngeal tubercle of occipital bone, fibrous raphe and middle constrictor
91
action of constrictors
superior - (upper fibres - pull posterior pharyngeal wall anteriorly to close off nasopharynx) and propel food to middle constrictor middle - propel food towards inferior constrictor inferior - propel food towards oesophagus
92
attachment of middle constrictor
lower stylohyoid ligament to greater and lesser horn of hyoid bone to fibrous raphe (superior and inferior constrictor)
93
attachment of inferior constrictor
lamina of thyroid cartilage to fibrous raphe, middle constrictor and oesophagus
94
innervation of constrictors | *inferior constrictor
``` pharyngeal plexus (vagus) inferior constrictor circopharyngeus supplied by external laryngeal nerve (sphincter like) ```
95
longitudinal muscles of pharynx and action
salpingopharyngeus palatopharyngeus stylopharyngeus elevate pharynx *stylopharyngeus also elevates larynx
96
attachment of salpingopharyngeus
cartilage of auditory tube to blend with palatopharyngeus
97
attachment of palatopharyngeus
hard palate and palatine aponeurosis to lamina of thyroid cartilage
98
attachment of stylopharyngeus
base of styloid process of temporal bone to posterior border of thyroid cartilage
99
innervation of longitudinal muscles of pharynx
``` pharyngeal plexus (vagus CN X) *stylopharyngeus is only innervated by glossopharyngeal nerve (CN IX) ```
100
name the pre-vertebral anterior muscles
rectus capitis anterior rectus capitis lateralis longus capitis longus colli
101
innervation of the rectus capitis anterior and rectus capitis lateralis
ventral rami of cervical nerves C1-C2
102
attachment of rectus capitis anterior and rectus capitis lateralis
transverse process of atlas (anterior surface and root) to occipital bone transverse process of atlas to occipital bone (crossed by internal jugular vein)
103
action of rectus capitis anterior
flex atlanto-occipital joint
104
action of rectus capitis lateralis
lateral flexion of head
105
attachment of longus capitis
transverse process of cervical vertebrae C3-C6 (anterior tubercles) to occipital bone
106
attachment of longus coli: inferior oblique superior oblique vertical
general - atlas to T3 inferior oblique - T2/T3 to anterior tubercle of cervical transverse processes C5-C6 superior oblique - anterior tubercle of C3-C5 to atlantal anterior tubercle vertical - anterior T1-T3 to C4-C6
107
action of longus capitis and longus coli
flex head | flex neck *inferior oblique - rotation to opposite side via inferior oblique
108
innervation of longus capitis and longus coli
ventral rami of cervical spinal nerves: C1-C3 C2-C6
109
fascia surrounding auditory tube
pharyngobasilar fascia
110
nerve running alongside stylopharyngeus
glossopharyngeal nerve
111
pierces through the fascia between hyoid bone and thyroid cartilage
superior laryngeal VAN
112
passes under the constrictor muscles
recurrent laryngeal nerve
113
what supplies the pharyngeal muscles
pharyngeal branches of the inferior thyroid
114
branches of the external carotid artery
superior thyroid artery lingual artery facial artery ascending pharyngeal superficial temporal maxillary artery
115
branches of the internal jugular vein
facial retromandibular superficial temporal anastomose as pterygoid plexus
116
lymph nodes and drainage of the neck (superior to inferior)
retropharyngeal nodes jugulogastric node infra hyoid nodes (jugular drunk reaches to here and inserts at the base of the external jugular vein) paratracheal nodes
117
pharyngeal plexus includes which nerves
glossopharyngeal CN IX vagus CN X sympathetic
118
vagus nerve branches in pharyngeal plexus (superior to inferior)
inferior ganglion pharyngeal branch superior laryngeal branch -> external laryngeal branch
119
what division of the trigeminal nerve has a pharyngeal branch
mandibular division (CN V2) has pharyngeal branch
120
expansion of the sympathetic ganglia
from base of skull to join thoracic chain forms behind internal and common carotid arteries medial to vagus nerve
121
fascia covering the sympathetic ganglia
deep fascia between carotid sheath and fascia over surface of longus capitis and longus colli
122
superior cervical ganglia gives which branches
internal carotid nerve -> internal carotid plexus (in carotid canal) plexus of common and external carotid arteries cranial nerve branches CN IX, X, XII superior cardiac plexus in thorax
123
superior cervical ganglia location and has grey rami communicantes to which ventral rami
immediately below skull | C1-C4
124
middle cervical ganglia gives which branches to where
thyroid branches to gland middle cardiac branch to cardiac plexus from middle to inferior cervical ganglia there are usually 2 or more nerve bundles: anterior bundle in front of 1st part subclavian and then behind = ansa subclavia
125
middle cervical ganglia location and has grey rami communicantes to which ventral rami
at level of thyroid cartilage - related to loop of inferior thyroid artery C5-C6
126
inferior cervical ganglia gives which branches to where
arterial branches to subclavian and vertebral arteries | inferior cardiac braches to cardiac plexus
127
middle cervical ganglia location and has grey rami communicantes to which ventral rami
sometimes fused with 1st thoracic ganglion to form stellate ganglion behind vertebral artery between transverse process of C7 and head of 1st rib
128
function and location of the larynx
voice production | between thyroid and cricoid cartilage
129
formed of what and what joints connect the larynx
hyaline cartilage | plane synovial joints
130
what attaches at the oblique line of the thyroid cartilage
sternothyroid thyrohyoid inferior constrictor
131
what articulates with the facet on the inferior horn of the thyroid cartilage
cricoid
132
what facets are present on the cricoid cartilage
facet for arytenoid cartilage | facet for inferior horn of thyroid
133
what are the processes of the arytenoid cartilages associated with: muscular process vocal process
muscular - posterior and lateral cricoarytenoid | vocal - vocal fold
134
composition of the epiglottis and attachments: anterior connections lateral connections
elastic cartilage anteriorly - body of hyoid bone and post laryngeal prominence of thyroid cartilage laterally - arytenoid cartilages via pharyngoepiglottic folds
135
what does the mucous membrane covering on the interior epiglottis form
median glossoepiglottic fold | lateral pharyngoepiglottic fold
136
purpose of the corniculates and cuneiforms
corniculates attach aryepiglottic folds to arytenoid cartilage cuneiforms are within the aryepiglottic fold to support them
137
ligament from hyoid bone to superior thyroid horn
lateral thyroid ligament
138
ligament from hyoid bone to laryngeal prominence
median thyroid ligament
139
ligament from base of thyroid cartilage to arch of cricoid
median cricothyroid ligament
140
ligament from base of arch of cricoid to tracheal cartilage ring
cricotracheal ligament
141
quadrangular membrane attachments
arytenoid cartilages to epiglottis
142
what is the vestibular ligament/ fold
free edge of the quadrangular membrane (false vocal fold)
143
attachments of the cricothyroid membrane
cricoid thyroid and arytenoid
144
what forms the vocal ligament/ fold
free upper border of cricothyroid membrane
145
role of vocal folds and movement
change air flow through the larynx to produce sound only - phonation (individual sounds and words via lips, cheeks and tongue) partially open - quite respiration wide open - forced inspiration slit in middle - phonation
146
extrinsic muscles of the larynx and purpose
supra and infra-hyoid muscles | attach to hyoid or thyroid cartilage and move larynx - swallowing
147
extrinsic muscles involved in elevation of the larynx
``` digastric stylohyoid mylohyoid geniohyoid (stylopharyngeus, salpingopharyngeus, plataopharyngeus) ```
148
extrinsic muscles involved in depression of the larynx
sternothyroid sternohyoid omohyoid (elastic recoil of trachea)
149
intrinsic muscles of the larynx and purpose
``` pass between elements of the larynx and move cartilages / vocal folds cricothyroid thyroarytenoid posterior cricoarytenoid lateral cricoarytenoid oblique arytenoid transverse arytenoid ```
150
innervation of the intrinsic muscles of the larynx
recurrent laryngeal vagus (CN X) | *cricothyroid supplied by the external laryngeal branch of the vagus
151
attachment of the cricothyroid
cricoid cartilage to lamina and inferior horn of the thyroid cartilage
152
action of the cricothyroid
tense and elongate vocal folds - move thyroid forward and cricoid tilted backward
153
attachments the thyroarytenoid
inner surface of angle of thyroid to anterolateral surface of arytenoid cartilages *upper fibres - run along vocal folds
154
action of the thyroarytenoid
pull arytenoids forward to thyroid cartilage - shorten and relax vocal folds
155
posterior cricoarytenoid attachment
posterior of lamina of cricoid to muscular process of arytenoid cartilage
156
action of posterior cricoarytenoid
pulls muscular process of the arytenoid backward - abduction of the vocal cords
157
attachment of lateral cricoarytenoid
upper ridge of arch cricoid cartilage to muscular process of arytenoid cartilage
158
action of lateral cricoarytenoid
pulls muscular process of arytenoid forward - adduction of vocal folds
159
attachment of oblique arytenoid
muscular process of arytenoid to apex of opposite cartilage
160
action of oblique arytenoid
fibres form aryepiglottic muscles in aryepiglottic fold - sphincter of laryngeal inlet
161
attachment of transverse arytenoid
posterior and medial surfaces of arytenoid cartilages to opposite arytenoid cartilage
162
action of transverse arytenoid
closes posterior part of prima glottidis (space between the vocal folds)
163
what branches does the vagus nerve give that supply the larynx and pharynx (superior to inferior)
``` inferior vagal ganglion gives: pharyngeal branch superior laryngeal nerve internal laryngeal branch external laryngeal branch ``` recurrent laryngeal
164
what do the superior and inferior laryngeal veins drain into
the superior thyroid vein and inferior thyroid vein (both drain into internal jugular)

Gross Anatomy (6 decks)

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