Neck: bones, fascia, posterior triangle Flashcards by Jacqui Joseph

3rd part of the subclavian artery lies ____ and ____ to the subclavian vein, emerging between what two muscles?

posterior and superior.

emerging between anterior and middle scalenes

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3rd part of the subclavian artery: crosses over ___ ____ to become axillary, and usually gives rise to what?

crosses over 1st rib

dorsal scapular artery

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the neck is relatively slender and flexible to allow for what?

efficient use of sensory organs

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the hyoid bone is at what C level? what is it suspended between?

Suspended between styloid process & thyroid cartilage

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C__ has a carotid tubercle. while C__ has longer spinous processes that is NOT bifid (aka ____ _____)

C7- vertebrae prominens

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what is clinically important about facet joints of cervical vertebrae?

facet joints are zygopophysial (in transverese plane- slope inferior-laterally- (not truly horizontal) ) - permits flexion, extension, lateral flexion.

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which is the widest cervical vertebrae with no body or spinous process?

C1- atlas

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which cervical vertebrae? … Ring-shaped with large lateral masses (support occipital condyles of cranium). Transverse ligament between

C1- atlas

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Strongest cervical vertebrae

C2- axis

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which cervical vertebrae has the Dens (odontoid process)-superior projection from body?

C2- axis

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vertebral arteries begin ascent at level C__

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hyoid bone is in the angle between ____ and _____ _______.

Angle between mandible & thyroid cartilage

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hyoid bone is suspended by the _____ _______. connected by muscles to what 4 things?

Suspended by stylohyoid ligament

Connected by muscles to skull, thyroid cartilage, manubrium, & pectoral girdle

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the hyoid bone has what 3 parts? what is are its two purposes?

Body, lesser horns, greater horns

Adds rigidity to airway & attachments for anterior cervical muscles

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what are the 4 layers of cervical fascia?

Superficial layer

3 separate deep columns: Investing, Pretracheal, Prevertebral

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what are the 3 functions of cervical fascia?

Compartmentalize muscles & viscera
Conduit for neurovascular structures
Allows gliding of structures

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what cervical fascia is just Deep to dermis, very thin? what two structures are within this layer?

superficial layer (aka hypodermis, aka subcutaneous)

platysma muscle (highly variable)
external jugular vein (anterolaterally)

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what is the platsyma muscle used for? what is it innervated by?

Facial expression

Cervical branch of facial nerve (CN VII)

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how wide and how thick is the platysma? where is it located?

about 1mm thick, about 1 hands width on either side.

-starts at body of mandible and fans down to clavicles. does NOT meet in the midline.

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investing deep cervical fascia, splits to invest what two muscles? invests what two glands?

muscles: sternocleidomastoid & trapezius
glands: submandibular & parotid

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origins, insertions and innervations of SCM and trapezius muscle ?

Nearly continuous origins at base of skull
Nearly continuous insertions to scapular spine, acromion, clavicle, & manubrium
Both muscles innervated by spinal accessory nerve (CN XI)

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pretrachial deep cervical fascia invests what two types of structures? extends from _____ to ______.

Invests muscles & viscera in anterior neck

Extends from hyoid to pericardium of heart

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the pretrachial deep cervical fascia forms pulleys for what two things?

Forms pulleys for intermediate tendons of digastric & omohyoid

Continuous superiorly as buccopharyngeal fascia of pharynx

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muscular vs visceral portion of pretrachial deep cervical fascia? ( thin vs thick, what does each surround? )

Muscular portion-thin, surrounds infrahyoid muscles

Visceral portion-thick, surrounds thyroid, trachea, & esophagus

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what fascia layer is Continuous superiorly as buccopharyngeal fascia of pharynx?

pretracheal deep cervical fascia

what is the clinical significance of the buccopharyngeal fascia?

buccopharyngeal fascia that invests posterior wall of pharynx. BEHIND that is potential space: where pharyngeal infections can rapidly spread superior or inferiorly “retropharyngeal space”

prevertebral deep cervical fascia surrounds what structures?

Surrounds vertebral column & associated muscles

the carotid sheath is formed by which layers of the cervical fascia? from where to where does it extend?

Formed from all 3 deep sheaths | Extends from cranial base to root of neck

what does the carotid sheath contain? (5)

Common, external, & internal carotids Internal jugular Vagus (CN X) Nerve to carotid sinus Carotid arterial plexuses (postganglionic sympathetic neurons) "CN IVS"

what is the Potential space between pretracheal & prevertebral sheaths? what is this subdivided by?

retropharyngeal space- subdivided by alar fascia

retropharyngeal space: which end is opened and which is closed?

Closed at cranial base superiorly & carotid sheath laterally Open to superior mediastinum inferiorly

retropharyngeal space- pretracheal (visceral portion) and carotid sheaths are continuous with ______superiorly and _______ inferiorly ?

with cranial cavity superiorly & mediastinum inferiorly

superficial neck is deep to what fascia(s)? superficial to what fascia(s)?

Deep to superficial fascia | Superficial to prevertebral & visceral pretracheal fascias

superficial neck: ___ regions based on ___ muscles ?

4, 2

four regions of the superficial neck

Sternocleidomastoid Posterior Lateral (posterior triangle) Anterior (anterior triangle)

SCM: O, I, A, In

O-mastoid process I-manubrium (sternal head); medial 1/3 of clavicle (clavicular head) A- Extension of head, flexion of cervical spine, laterally flexes (ipsi) & rotates head (contra) In- Spinal accessory nerve (CN XI)

what fossa is between the heads of the SCM? what structure is within here?

lesser superclavicular fossa - inferior IJV

the internal jugular vein is near the (superior/inferior) 1/2 of SCM while the external jugular vein is near the (superior/inferior) 1/2.

internal JV- inferior SCM | external JV - superior SCM

what two nerves cross the SCM?

greater auricular transverse cervical (both C2 and C3)

cervical portion trapezius: O, I, A, In

O-superior nuchal line, nuchal ligament, spinous processes C7-T12 I-lateral third of clavicle, acromion, spine of scapula A- Superior fibers elevate scapula In -Spinal accessory nerve (CN XI)

dorsal rami of cervical spinal nerves supply what type of innervation?

cutaneous innervation C2 (Greater occipital) C3 (Least occipital) C4

what are the borders of the posterior triangle?

Anterior-posterior border of SCM Posterior-anterior border of trapezius Inferior-middle third of clavicle Superior-union of SCM & trapezius at mastoid process

what makes up the floor of the posterior triangle?

Floor-prevertebral fascia & muscles: - Middle & posterior scalene - Levator scapulae - Splenius capitis

Inferior belly of omohyoid divides posterior triangle into what two triangles?

occipital & omoclavicular (subclavian) triangles

what artery is a Branch of external carotid at the | Apex of occipital triangle?

occipital artery

what arteries are branches of thyrocervical trunk at the Base of occipital triangle?

suprascapular artery | and transverse cervical artery

suprascapular artery is superficial to what nerve(s)? and supplies what muscles?

Superficial to phrenic nerve & trunks of brachial plexus | Supplies muscles of posterior shoulder (“army over”)

what two arteries are superficial to phrenic nerve and trunks of brachial plexus?

suprascapular artery and trans. cervical artery

transverse cervical artery may divide into what two branches? what does each supply?

May divide into superficial & deep (dorsal scapular) branches Superficial-trapezius Dorsal scapular-levator scapulae, rhomboids, scapula

the external jugular vein is formed by the merging of what two veins (superiorly)? where does it enter the occipital triangle? what does it empty into?

Merging of retromandibular & posterior auricular Enters occipital triangle at posterior border of SCM Empties into subclavian vein

the subclavian vein is a continuation of what? what triangle does it cross?

Continuation of axillary vein | Crosses omoclavicular triangle anterior to anterior scalene

primary loops of the cervical plexus form between what?

Primary loops form between adjacent ventral rami | C1-C2, C2-C3, C3-C4, C4-C5

branches emerging from the loops: sensory course _____ while motor course ____.

sensory: posteriorly motor: anteriorly

what forms the superior and inferior roots of ansa cervicalis?

superior: C1 only (motor from C1-C2 loop) inferior: C2 & C3 (motor)

the motor branch of C1-C2 loop runs with what nerve initially?

hypoglossal (CN XII)

Nerves to ________ & _____leave hypoglossal separate from superior root ( C_ fibers only)

Nerves to thyrohyoid & geniohyoid leave hypoglossal separate from superior root C1 fibers only

the inferior root of ansa cervicalis supplies what muscles?

Supply 3/4 infrahyoid muscles Omohyoid Sternohyoid Sternothyroid

C2-C3 loop: sensory- what are the three branches?

lesser occipital, greater auricular, transverse cervical

lesser occipital nerve: what does it course along? what does it supply?

Parallels posterior SCM | Supplies posterolateral neck & scalp

greater auricular nerve: what does it course along? what does it supply?

Courses with EJV | Supplies posterior auricle & parotid region (between mastoid process & angle of mandible)

transverse cervical nerve: what does it cross? what does it supply?

Crosses SCM | Supplies anterior cervical region

C3-C4 loop: sensory - what is the branch? what does it supply?

Supraclavicular | Supplies clavicular skin & shoulder

C3-C4 loop: motor- what is the branch? what does it supply?

phrenic (Contribution from C5) Motor to diaphragm Visceral afferents from pericardium, pleura, etc.

C4-C5 loop: contributes motor fibers what two nerves of the brachial plexus?

motor fibers to dorsal scapular (C4, C5) & long thoracic (C5) nerves of brachial plexus

spinal accessory nerve (CN XI): enters occipital triangle where? what does it supply?

Enters occipital triangle at mid-SCM Crosses triangle inferolaterally Innervates SCM & trapezius

Only motor nerve superficial to prevertebral fascia

spinal accessory CN XI

posterior (cutaneous) branches of cervical plexus (C1-C4) emerge where in relation to the SCM?

at posterior midpoint of SCM

what are the 4 posterior (cutaneous) branches of the cervical plexus ?

Lesser occipital Great auricular Transverse cervical Supraclavicular

roots/trunks of brachial plexus emerge between what two muscles? descend ______ to enter the axilla. what is this called?

Emerge between anterior & middle scalenes Descend inferolaterally to enter axilla "Cervico-axillary canal"

suprascapular nerve is a branch of ____ trunk of the brachial plexus. where does it cross? what does it supply?

superior trunk Crosses occipital triangle laterally Innervates muscles of posterior scapula (“navy under”)

Neck: bones, fascia, posterior triangle Flashcards

(70 cards)