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