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Neuro Exam 1 > Neck: Fascias, Spaces, Triangles, Superficial Structures > Flashcards

Neck: Fascias, Spaces, Triangles, Superficial Structures Flashcards

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1
Q

occiput

A

external occipital protuberance and superior nuchal lines

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2
Q

mastoid process

A

of temoral bone

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3
Q

mandible

A

ramus, angle, inferior margin to midline

midline - symphysis menti

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4
Q

hyoid bone

A

superior to thyroid cartilage

opposite CV3

greater horn - palpable laterally

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5
Q

thyroid cartilage

A

opposite CV4 CV5

palpable superior thyroid notch and laryngeal prominence

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6
Q

cricoid cartilage

A

anterior to CV6

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7
Q

thyroid isthmus

A

usually palpable across level of 2,3,4 tracheal rings

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8
Q

platysma

A

neck cutaneous muscles seen anterior and lateral when straining

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9
Q

superficial fascia

A

CT and fat between skin and deep fascia

contains platysma

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10
Q

attachments of platysma

A

O: superficial fascia covering pec major and deltoid
I: inferior margin of mandible, skin and subQ of lower portion of face and corner of mouth

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11
Q

action of platysma

A

draws corners of mouth down
depresses mandlble
elevates skin of chest

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12
Q

innervation of platysma

A

cervical branch of CN VII (facial)

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13
Q

investing fascia

A

first layer of deep fascia
around entire neck

invests SCM and trapezius

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14
Q

attachments of investing fascia

A

superior - external occipital protuberance, superior nuchal line, mastoid process, inferior margin of mandible

posterior - external occipital protuberance, spinous processes of CV1-7 via nuchal ligament

inferior - scapula, acromion, clavicle, manubrium

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15
Q

suprasternal space

A

where the laminae of investing fascia from both surfaces of SCM fail to fuse anteriorly and inferiorly

contains fat and a vein

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16
Q

infrahyoid fascia

A

begins at hyoid bone and thyroid cartilage

forms two layers - superficial and deep

invest infrahyoid muscles

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17
Q

superficial layer of infrahyoid fascia

A

invests sternohyoid and omohyoid
attaches posterior to manubrium
lateral fusion with periosteum of clavicle and first rib

forms sling for intermediate tendon of omohyoid muscle

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18
Q

deep layer of infrahyoid fascia

A

invests sternohyoid and thyrohyoid

inferior to posterior surface of manubrium

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19
Q

inferior lamina of infrahyoid fascia

A

both layers fuse with adventitia of brachiocephalic veins and fibrous pericardium
-via superior sternopericardial ligament

laterally with carotid sheath

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20
Q

cervical visceral fascias

A

enclose viscera of neck

pre-tracheal and buccopharyngeal

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21
Q

pre-tracheal fascia

A

anterior to larynx and trachea
attached to hyoid bone superiorly

blends laterally with buccopharyngeal fascia

splits to enclose thyroid gland

inferiorly - attaches with adventitia of aortic arch
-fuses with fibrous pericardium

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22
Q

buccopharyngeal fascia

A

attaches superior to base of skull
-covers buccinator and pharyngeal constrictor muscles

fuses laterally with the pre-tracheal fascia at muscle attachment sites of pharyngeal constrictor and at posteromedial border of thyroid gland

inferior - fuse with adventitia of esophagus

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23
Q

pre-vertebral fascia

A

encircles vertebral column

bifurcates anteriorly alar fascia

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24
Q

alar fascia

A

attaches to midline of buccopharyngeal fascia

from bifurcation of pre-vertebral fascia

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25
floor of posterior cervical triangle
pre-vertebral fascia attaches to cervical transverse processes covers scalenes, levator scapulae, splenius and semispinalis muscles
26
sibsons fascia
prevertebral fascia continues on underside of scalene muscles
27
axillary sheath
prevertebral fascia reflected from scalene muscles latearally along subclavian and axillary veins and brachial plexus as they pass through scalene triangles
28
carotid sheath
surrounds common and internal carotid arteries, internal jugular vein, and vagus nerve superior - attaches to margins of jugular foramen inferiorly - fuses with adventitia of great vessels form from all deep fascias fusing
29
infections in pretracheal, retrovisceral, and danger space
can go to carotid sheath | -and go inferiorly to involve aorta (aortitis)
30
pretracheal space
between deep layer of infrahyoid fascia and pre-tracheal fascia extends from level of attachment of infrahyoid muscles to thyroid cartilage above to attachment of pericardium to roots of major vessels in superior mediastinum below
31
retropharyngeal spaces
2x between buccopharyngeal, pre-vertebral, and alar fascias extend from base of skull to posterior mediastinum closed laterally - carotid sheath
32
retrovisceral space
between buccopharyngeal and alar fascias more anterior base of skull to where alar blends with esophagus
33
danger space
bewteen pre-vertebral and alar/buccopharyngeal fascias - base of skull to diaphragm - between vertebral column and esophagus
34
infection of pre-tracheal space
to superior mediastinum | -inflammation of brachiocephalic veins, aorta, pericardium
35
infection in danger space
retropharyngeal abscess - dysphagia/dysarthria - can dissect into posterior aspect of superior and posterior mediastinum
36
chronic tonsillitis
mediastinal abscess | inflammation of esophagus as far inferior as the diaphragm
37
attachments of SCM
O: sternal head - manubrium clavicular head - proximal 1/3 clavicle I: mastoid process, superior nuchal line
38
action of SCM
unilateral - rotates head opposite while elevating chin bilateral - flexes head and limits extension of AO joint**
39
innervation of SCM
spinal accesory nerve CN XI | cervical spinal nerves C2 and C3
40
torticollis
wry neck congenital or acquired shortening of SCM patients head sidebent to same side and rotated opposite of muscle**
41
posterior triangle
bounded by trap, SCM, and clavicle
42
subdivision of posterior triangle
by omohyoid division occipital - larger superior omoclavicular - smaller inferior
43
anterior triangle
bounded by SCM, angle of mandible, imaginary midline
44
subdivision of anterior triangle
by omohyoid and digastric muscles digastric (submandibular) triangle submental triangle carotid triangle - posterior lower muscular triangle - anterior lower
45
formation of external jugular vein
posterior division of retromandibular v. posterior auricular vv. extends SUPERIOR to SCM -then pierces investing fascia terminates in the subclavian vein
46
tributaries to external jugular vein
posterior external jugular vein transverse cervical vein suprascapular vein anterior jugular vein
47
prominence of external jugular vein
heart failure, SVC obstruction, enlarged supraclavicular lymph nodes, or increased intrathoracic pressure
48
laceration of external jugular vein
air embolism negative intrathoracic pressure sucks air in reduced blood through right atrium -accumulated air/dyspnea
49
anterior jugular vein formation
from small veins in submental and submandibular regions that coalesce at hyoid bone area has jugulovenous arch and then joins external jugular vein
50
jugulovenous arch
communication of right and left anterior jugular veins
51
common facial vein formation
facial veins join with anterior division of retromandibular vein pierces carotid sheath to join internal jugular vein also might get communicating vein -to communicate with anterior jugular veins
52
blockage of internal jugular vein?
emissary veins and opthalmic vein drain blood to retromandibular and facial veins anastomose with posterior auricular v to form external jugular vein common facial vein from anastomosis facial vein with anterior division of retromandibular vein returns blood to internal jugular vein distal to blockage
53
dorsal rami of cervical nerves?
C1 - rare C2 - greater occipital nerve C3-6 - pierce uscle - cutaneous over trapezius
54
greater occipital nerve
C2 dorsal rami pierce semispinalis capitis and trapezius and ascends to innervate skin over vertex and posterolateral skull
55
ventral rami of cervical nerves?
C1-4 cervical plexus | C2-4 of cervical plexus - to pinna of ear and in front of and behind ear
56
lesser occipital nerve
ventral rami C2,3
57
greater auricular nerve
ventral rami C2,3
58
transverse cervical nerve
ventral rami C 2,3
59
supraclavicular nerve
ventral rami C 3, 4
60
branches of supraclavicular nerve
medial, intermediate, and lateral supraclavicular nerve
61
medial supraclavicular nerve
crosses SCM to skin at base of neck, upper sternum, and SC joint
62
intermediate supraclavicular nerve
cross clavicle to innervate skin over pectoralis major as far inferior as third rib
63
lateral supraclavicular nerve
cross clavicle at AC joint and cutaneous to prominence of shoulder
64
cervical nerve block
anesthetize the cutaneous nerves during surgical approach to neck ex. radical neck dissection of cancerous lymph nodes phrenic nerve - shares SC levels of innervation -will get ipsilateral hemidiaphragm paralysis don't do this procedure on patient with respiratory or cardiac disease
65
superficial cervical lymph nodes
submental, submandibular, external jugular, anterior jugular drain to deep cervical lymph nodes that parallel internal jugular
66
lymph drainage of head and neck
superficial - superficial cervical to deep cervical | deep and visceral - to deep cervical

Neuro Exam 1 (17 decks)

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