Neck G48 Flashcards
(138 cards)
1
Q
Organizing the neck into UNITS
A
Boundaries defined by fascia
2
Q
Organizing the neck into TRIANGLES
A
Boundaries defined by muscles and bones
3
Q
Layers of cervical fascia
A
Superficial cervical fascia and deep cervical fascia
4
Q
Functions of fascia
A
fascial planes determine direction of infection and form natural cleavage planes that give slipperiness for structures to move passed another, limit spread of abscesses
5
Q
Superficial Cervical Fascia
A
Between dermis and investing layer of deep cervical fascia, contains: cutaneous nerves, blood and lymph vessels, superficial lymph nodes, FAT, and platysma m. anterolaterally
6
Q
Deep Cervical Fascia layers
A
Investing layer, pretracheal layer, prevertebral layer, and carotid sheath
7
Q
Investing layer of deep cervical fascia
A
Most superficial, surrounds entire neck, ENCLOSES TRAPEZIUS, STERNOCLEIDOMASTOID, PAROTID and SUBMANDIBULAR GLANDS
8
Q
Muscular unit is surrounded by
A
investing layer of deep cervical fascia
9
Q
Stylomandibular ligament
A
thickened modification of the investing deep cervical fascia
10
Q
Pretracheal layer of deep cervical fascia
A
Anterior portion of neck, thin, ENCLOSES THYROID GLAND, TRACHEA, and ESOPHAGUS (INFRAHYOID M.)
11
Q
Visceral unit is surrounded by…
A
pretracheal layer of deep cervical fascia
12
Q
What layer forms the fascial slings for the digastric and omohyoid muscles?
A
pretracheal fascia
13
Q
Prevertebral layer of deep cervical fascia
A
tubular sheath for the vertebral column and associated muscles, sympathetic trunks are embedded in this layer
14
Q
Sympathetic trunks are embedded in what fascial layer of the neck
A
prevertebral layer of deep cervical fascia
15
Q
Vertebral unit is surrounded by
A
prevertebral layer of deep cervical fascia
16
Q
Carotid sheath of deep cervical fascia
A
tubular from base of skull to root of neck, containing: common and internal carotid arteries, internal jugular vein, vagus n, deep cervical lymph nodes, carotid sinus n, sympathetic fibers
17
Q
Carotid unit is surrounded by
A
carotid sheath of deep cervical fascia
18
Q
Which fascial layer is a potential pathway for spread of infection because it allows communication with the mediastinum and cranial cavity?
A
Carotid sheath
19
Q
What muscle divides each side of the neck into two large triangles?
A
sternocleidomastoid
20
Q
Anterior boundary of the posterior triangle
A
Sternocleidomastoid
21
Q
Posterior boundary of the posterior triangle
A
Trapezius muscle
22
Q
Inferior boundary of the posterior triangle
A
middle 1/3 of the clavicle
23
Q
Apex of the posterior triangle
A
behind the ear at the level of the superior nuchal line of occipital bone
24
Q
Roof of the posterior triangle
A
investing fascia, platysma, and skin
25
Floor of the posterior triangle
Prevertebral fascia and Splenius Capitis, Levator Scapulae, Middle scalene, Anterior scalene, and Posterior scalene
26
Posterior triangle can be divided into two smaller triangles... by the...
Occipital triangle and subclavian triangle... inferior belly of omohyoid m.
27
Occipital triangle
Accesory n. (CN XI) crosses this triangle within the investing layer of deep cervical fascia
28
Posterior border of anterior triangle
Sternocleidomastoid
29
Anterior border of anterior triangle
Median line of neck
30
Superior border of anterior triangle
inferior margin of mandible
31
Apex of anterior triangle
jugular (suprasternal) notch
32
Roof of anterior triangle
investing fascia, platysma, and skin
33
Floor of anterior triangle
pharynx, larynx, and thyroid gland (covered by pretracheal fascia)
34
The anterior triangle can be subdivided into 4 triangles...
Submental, submandibular (digastric), carotid, and muscular triangle
35
Location of anterior scalene
deep to sternocleidomastoid, anterior to middle scalene (in posterior triangle)
36
Origin of anterior scalene
C4-C6 transverse processes
37
Insertion of anterior scalene
1st rib
38
Action of anterior scalene
Elevates 1st rib, laterally flexes and rotates neck
39
Innervation of anterior scalene
C4, C5, C6 spinal nerves
40
Origin of middle scalene
C2-C7 transverse processes
41
Insertion of middle scalene
1st rib
42
Action of middle scalene
Elevates 1st rib during forced inspiration, laterally flexes neck
43
Innervation of middle scalene
Ventral rami of C3-C7
44
Location of posterior scalene
posterior to middle scalene and anterior to levator scapulae (in posterior triangle)
45
Origin of posterior scalene
C5-C7 transverse processes
46
Insertion of posterior scalene
superior border of 2nd rib
47
Action of posterior scalene
Elevates 2nd rib during forced inspiration, laterally flexes neck
48
Innervation of posterior scalene
ventral rami of C7-C8
49
Omohyoid
two muscle bellies united by a tendon
50
The inferior belly of the omohyoid passes through
the posterior triangle posterior to the sternocleidomstoid
51
Omohyoid inferior belly Insertion
intermediate tendon (held to clavicle by CT pretracheal fascia loop)
52
Omohyoid inferior belly origin
superior border of scapula
53
Omohyoid superior belly origin
intermediate tendon
54
Omohyoid superior belly insertion
inferior border of hyoid bone
55
Innervation to both bellies of omohyoid
Ansa Cervicalis (C1-C3)
56
Action of Omohyoid
depresses, retracts, and steadies hyoid bone
57
What muscles are found in the anterior triangle superior to the hyoid (supra hyoid)?
Digastric, stylohyoid, mylohyoid, geniohyoid, hyoglossus
58
Digastric M Action
Has two belles that work to raise the hyoid bone; steady it during speaking and swallowing, acting posteriorly - open mouth, depresses mandible
59
Posterior Belly of digastric m insertion
intermediate tendon (loop of CT connected to the hyoid bone)
60
Posterior Belly of digastric m origin
mastoid notch of temporal bone
61
Posterior Belly of digastric m innervation
Facial n (CN VII)
62
Anterior Belly of Digastric m origin
digastric fossa of mandible
63
Anterior Belly of Digastric m insertion
intermediate tendon
64
Anterior Belly of Digastric m innervation
mylohyoid n. (CN V-3)
65
Stylohyoid origin
styloid process of the temporal bone
66
Stylohyoid insertion
body of hyoid bone; surrounds the tendon of digastric m
67
Stylohyoid action
elevates and retracts hyoid bone
68
Stylohyoid innervation
Facial n (CN VII)
69
Infrahyoid muscles "strap muscles" of the anterior triangle
Omohyoid, Sternohyoid, Thyrohyoid, sternothyroid, sternocleidomastoid, and platysma
70
Which part of the Omohyoid crosses the anterior triangle?
Superior belly
71
Sternohyoid origin
Manubrium sterni and medial end of clavicle
72
Sternohyoid insertion
Body of hyoid
73
Sternohyoid action
Depressed hyoid bone and larynx
74
Sternohyoid innervation
Ansa Cervicalis C1-C3
75
Thyrohyoid is deep to
sternohyoid
76
Thyrohyoid origin
oblique line of thyroid cartilage
77
Thyrohyoid insertion
body and greater horn of hyoid bone
78
Thyrohyoid action
depresses hyoid bone; elevates thyroid cartilage
79
Thyrohyoid innervation
C1 via hypoglossal n (contributes to ansa cervicalis)
80
Sternothyroid origin
manubrium sterni and 1st costal cartilage
81
Sternothyroid insertion
oblique line of thyroid cartilage
82
Sternothyroid action
depresses hyoid bone and larynx
83
Sternothyroid innervation
Ansa Cervicalis C1-C3
84
Sternocleidomastoid origin
Sternal head - manubrium sterni, clavicular head - medial 1/3 of clavicle
85
Sternocleidomastoid insertion
mastoid process of temporal bone, occipital bone
86
Sternocleidomastoid actions
unilaterally - laterally flexes neck, rotates head to opposite side, bilaterally - flexes neck
87
Sternocleidomastoid innervation
Accessory n. (CN XI) and sensory fibers from C2/C3 ventral rami
88
Platysma origin
fascia and skin over pectoralis major and deltoid muscles
89
Platysma insertion
inferior border of mandible and skin of lower face
90
Platysma action
tenses skin of neck, draws corners of mouth inferior
91
Platysma innervation
cervical branch of FACIAL N (CN VII)
92
Branches of cervical plexus seen in posterior triangle (C1-C4)
Cutaneous nerves: lesser occipital n., great auricular n., transverse cervical n., and supraclavicular n.
93
Phrenic n. is a branch of the cervical plexus
motor innervation to diaphragm C3-C5 over anterior surface of anterior scalene m.
94
Brachial plexus C5-T1
Neck: roots and trunks and dorsal scapular n and suprascapular n.
95
Dorsal scapular n.
C5 in posterior triangle penetrating the middle scalene
96
Suprascapular n.
upper trunk of brachial plexus and courses across triangle to innervate supraspinatus and infraspinatus
97
Spinal accessory n.
exits via jugular foramen, innervates trap and sternocleidomastoid, within investing fascia
98
Vagus n.
jugular foramen, in carotid sheath posterior to jugular and carotid, gives off superior laryngeal n. (to thyroid), recurrent laryngeal nerve (branches after carotid meets subclavian and loops around and back up), and cardiac nerves
99
Cardiac nerves of vagus n.
PREGANGLIONIC PARASYMPATHETIC terminate near heart wall
100
Hypoglossal n.
hypoglossal canal, innervates tongue musculature, on superficial surface of hyoglossus muscle (carries superior root of ansa cervicalis)
101
Ansa Cervicalis
C1-C3 (C1 superior root ride along hypoglossal n, joins C2-C3 to form a loop) superficial surface of carotid sheath, supply strap muscles (thyrohyoid, omohyoid, stylohyoid, sternohyoid)
102
Sympathetic trunk
preganglionic fibers run in prevertebral fascia along longus colli, synapse in three cervical ganglia
103
Inferior cervical ganglion
posterior to vertebral a. as it branches from subclavian
104
Stellate ganglion
cervicothoracic ganglion: fusion of inferior cervical ganglion and first thoracic ganglion
105
Middle cervical ganglion
anterior aspect of inferior thyroid a. near level of cricoid cartilage
106
Superior cervical ganglion
large - 2-3cm in length, level of the atlas/axis
107
Cardiac branches of the sympathetic trunk
carry POSTGANGLIONIC fibers to the heart
108
Horner's Syndrome
interruption of sympathetics (injury to Upper plexus, facial n.) pupil constriction, ptosis, warm and dry to touch, loss of sympathetics
109
Subclavian a. branches
vertebral a., internal thoracic a., thyrocervical trunk, and the costocervical trunk
110
Vertebral a.
enters transverse foramen of C6 and enters foramen magnum
111
Internal thoracic a.
descends posterior to ribs
112
Thyrocervical trunk branches
inferior thyroid a.(superiorly, anterior to anterior scalene, posterior to carotid sheath, to thyroid), suprascapular a. (posterior and lateral, deep to sterno and trap), and the transverse cervical a. (extends laterally)
113
Common carotid a.
within the carotid sheath, at level of thyroid cartilage it bifurcate into internal and external carotid
114
Carotid body
at carotid bifurcation, small brownish mass of tissue that is a blood chemoreceptor (CO2, O2) innervated by CN9 and CN10
115
Carotid sinus
dilated area of the proximal part of the internal carotid artery, BP regulatory area, innervated by the sinus n. of Hering (CN9)
116
External Carotid branches
Superior thyroid a., ascending pharyngeal a., lingual a, facial a, occipital a, posterior auricular a, maxillary a, and superficial temporal a.
SALFOPMS
117
Terminal branches of the external carotid?
superficial temporal a and maxillary a
118
Thyroid gland
bilobed endocrine gland, isthmus crosses 2nd-4th tracheal ring
119
Blood supply to the thyroid gland
superior (external carotid) and inferior thyroid a. (subclavian - thyrocervical trunk)
120
Veins from thyroid gland
Superior and middle thyroid veins (internal jugular v), and inferior thyroid vein (brachiocephalic v)
121
Parathyroid gland
small paired endocrine glands embedded in the posterior surface of the thyroid gland, essential for life
122
Superior thoracic apertyre
T1 vertebra, first ribs, and manubrium
123
Compression of inlet syndrome
Compression of nerves - irritation, arteries - ischemia or necrosis, vein - dilation, cyanosis, edema
124
What structures pass through the interscalene triangle?
brachial plexus trunks and subclavian a.
125
Costocervical trunk
last branch of subclavian, passes posteriorly to supply 1st ICS and deep back muscles
126
Superior Thyroid a.
(external carotid branch) courses inferior to supply thyroid, sternocleidomastoid, strap muscles, and larynx
127
Ascending pharyngeal a.
(external carotid branch) arises at bifurcation and ascends to supply pharynx, pre vertebral m. and inner ear
128
Lingual a
(external carotid branch) courses superiorly and anteriorly deep to hyoglossus to supply the tongue
129
Facial a.
(external carotid branch) over inferior border of mandible (anterior to masseter) supplies face, tonsil, palate, and submandibular gland
130
Occipital a.
(external carotid branch) posterior side of carotid courses posterior to supply posterior scalp
131
Posterior auricular a.
(external carotid branch) courses posteriorly to external auditory meatus and supply ear area
132
Maxillary a
terminal branch to infratemporal fossa
133
Superficial temporal a.
terminal branch to scalp and temporalis
134
Internal jugular v is found where in the carotid sheath
LATERAL to the internal carotid artery
135
External jugular v.
arises from a branch of the retromandibular v. beginning at the angle of the mandible, empties into subclavian
136
Subclavian veins orientation in respect to anterior scalene
anterior to anterior scalene
137
Pyramidal lobe of thyroid
extension upward from the isthmus to the hyoid bone, representing a persistent thyroglossal duct (opening into back of tongue in embyo and descends to become the thyroid)
138
Blood supply to parathyroid glands
superior and inferior thyroid artery
