Neck: Area Under the SCM Flashcards Preview

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Flashcards in Neck: Area Under the SCM Deck (43):
1

contents of carotid sheath

common and internal carotid arteries
internal jugular vein
vagus nerve
ansa cervicalis
deep cervical lymph nodes

2

relationships in carotid sheath

artery - medial and anterior
vein - lateral and posterior
vagus - posterior groove between vessels

3

ansa cervicalis location

lateral to arteries
crosses internal jugular vein anteriorly and courses superiorly and medial on its surface

4

common carotid artery

left side longer than right
-right from brachiocephalic split
-left from arch of aorta

5

bifurcation of common carotid artery

level of CV3

6

carotid sinus

dilated distal common carotid and proximal internal carotid artery

pressure receptor

increased pressure, decreased HR

7

carotid body

at carotid bifurcation
chemoreceptor
decreased O2 - increased rate and depth of breathing

8

afferents from carotid body and sinus

carotid sinus nerve (CN IX)

9

internal carotid artery

enters carotid canal
-no branches prior to entering canal
-supplies orbit and brain

10

external carotid artery

not in sheath
branches in carotid triangle
-has lots of branches

11

surgery in carotid triangle

access to carotid bifurcation, internal jugular vein, vagus/hypoglossal nerves, sympathetic trunk

can affect voice - vagus and recurrent laryngeal nn.

12

carotid endarterectomy

often at bifurcation
access via carotid triangle

13

superior thyroid artery

1st branch external carotid artery

14

branches of superior thyroid artery

superior laryngeal artery - pierces thyrohyoid membrane with internal laryngea nerve to interior of larynx

anterior branch - to gland - anastomose with opposite counterpart

posterior branch - posterior gland - anastomose with inferior thyroid artery

15

ascending pharyngeal artery

arises medially off of external carotid artery
-close to bifurcation

courses straight to base of skull

16

lingual artery

branch of external carotid artery
deep to posterior border of hypoglossus muscle to enter tongue

17

facial artery

branch of external carotid artery - either common trunk or just above lingual artery branch

courses to deep surface of submandibular gland
goes around mandible and comes around anterior edge of masseter muscle to enter face

18

occipital artery

branch of external carotid artery

posterior to external carotid at border of posterior belly of digastric

passes between transverse process of atlas and mastoid process

pierces cervical fascia where trapezius and SCM come together

enters scalp and courses with great occipital nerve

19

mnemonic for external carotid artery branches

Sally Anne Likes Flirting On Philadelphias Main Streets

superior thyroid
ascending pharyngeal
lingual
facial
occipital
posterior auricular
maxillary
superficial temporal

20

posterior auricular artery

branch of external carotid artery
passes posteriorly
to ear and external acoustic meatus and anterior to mastoid process

21

final branches of external carotid artery

maxillary artery
superficial temporal artery

22

external carotid ligation

needed to stem flow of blood from deeper branches which are not surgically accessible without damaging their major structures

ex/ carotid endarterectomy

23

internal jugular veins

begins as dilation - superior jugular bulb
-at jugular foramen

ends at dilation - inferior bulb
-joins subclavian vein
-forms brachiocephalic vein

24

tributaries to internal jugular vein

occipital vein
pharyngeal vein
lingual vein
facial and common facial veins
superior and middle thyroid veins

25

right internal jugular access

insert needle inferiorly at apex of triangle between clavicular and sternal heads of SCM
-inserted finger width lateral to carotid pulse at 30 degree angle inferiorly toward ipsilateral nipple

26

branches of vagus and fiber type

meningeal - to dura sensory (GSA)
auricular - to pinna, auditory canal, external tympanic membrane (GSA)
pharyngeal - muscles of arch 4 (SVE)
nerve to carotid body (GVA)
superior laryngeal nerve - internal and external branches
cervical cardiac branches
recurrent laryngeal nerve

27

internal branch of superior laryngeal nerve

pierces thyrohyoid membrane
-with superior laryngeal branch of superior thyroid artery

sensory - taste and general sense
parasympathetic - to base of tongue (glands), epiglottis, internal larynx (above vocal fold)

28

fiber types of superior laryngeal nerve

SVA, GVA, GVE-P

29

external branch of superior laryngeal nerve

innervates cricothyroid muscle
SVE

30

recurrent laryngeal nerve

SVE, GVE-P, GVA
right - around subclavian artery
left - around aortic arch

both reach larynx
motor to intrinsic muscles of larynx
sensory to mucosa inferior to vocal folds

31

above vocal folds

internal branch of superior laryngeal nerve

32

below vocal folds

recurrent laryngeal nerve

33

laryngeal nerve fibers

SVA, GVA, GVE-P
for recurrent and superior laryngeal nerves

34

inferior laryngeal nerves

once recurrent passes into larynx
-becomes inferior

35

deep cervical lymph nodes

associated with carotid sheath
-superior and inferior groups
-split by omohyoid

36

superior deep cervical lymph nodes

receive from superificial of face and neck

37

inferior deep cervical lymph nodes

get lymph

38

jugular lymph trunks

left - to thoracic duct
right - to right lymphatic duct

39

radical neck dissection

remove all deep cervical lymph nodes and surrounding tissue

40

hypoglossal canal

near carotid sheath
-descends to submandibular triangle

41

cervical plexus

ventral rami of C1-4

42

branches of cervical plexus

greater auricular
lesser occipital
transverse cervical
supraclavicular
phrenic
ansa cervicalis

43

ansa cervicalis

C1 and C2 - superior root
C2 and C3 - inferior root

branches to infrahyoid muscles