Neck Lecture

Question 1

What are the 2 boundrys of the neck?

Answer 1

Superior and the Inferior boundry

Question 2

What are the borders of the superior boundry?

Answer 2

Starts anterior at the mandible then posterior across lateral edge of the mandible to the base of the skull.

Bilaterally.

Question 3

What are the borders of the inferior boundry?

Answer 3

Starts in the front at the manubrium, move laterally across the clavical to the acromium, (tip) of the scapula and then posterior to the line btwn spinous process of C7

Similar ot thoracic aperature

Question 4

What are the 4 comparments of the neck?

Encapsulated by fascia!

Answer 4

1. Vertebral
2. Visceral
3. Vascular
4. Musculofacial

Question 5

What does the vertebral compartment contain? Where?

Answer 5

Located posteriorly in neck
* Verterbal Bodys
* Spinal Cord
* Spinous/Transverse processes
* All posture/deep back & neck muscles

Question 6

What does the Visceral compartment contain? Where?

Answer 6

Located anteriorly and centered.
* Trachea
* Esophagus
* Thyroid gland
* On Posterior side of TG is the parathyroid gland
* The superior extension of the thymus (potentially)

Question 7

What does the vascular compartment contain? Where?

Answer 7

Located bilaterally to the visceral comparment (anterior) VAN
* Internal Jugular Vein
* Common Carotid A. then branches Int/Ext
* Vagus Nerve (C10)

Question 8

What is the Musculofascial collar?

Myo-Facial collar

Answer 8

A deep facia that forms a collar around the neck, deep investing facia.

Question 9

Explain this funny thing

Answer 9

Anterior superior:
1. Nasal Cavity
2. Oral Cavity

Anterior Inferior:
1. Larygeal Inlet
2. Larynx
3. Trachea

Posterior Superior to inferior= Pharynx -> Esophagus
1. Nasopharynx
2. Ornopharynx
3. Larygopharynx
4. Esophagus

Question 10

What are the 3 components of the pharynx?

Answer 10

1. Nasopharynx
2. Ornopharynx
3. Larygopharynx

All continuous!

Question 11

What divides the largyngealpharyx (to esophagus) and the Larynx (to trachea) ?

Answer 11

Eppiglottis!

Question 12

WHat is the large prominant cartilage that you can feel on your neck? What vertebrae?

Answer 12

Thyroid Cartilage on the trachea.
C3-C4

In larynx

Question 13

What is below the thyroid cartilage after gap? What Vertebrae?

Answer 13

Cricoid Cartilage
C5-C6

In larynx

Question 14

Explain the landmark on neck at C3-C4

Answer 14

Line from Spinous process C3-C4 level going anteriorly to the superior boarder of the thyroid cartilage

Where bifrucation of the common carotid artery occurs.

Question 15

If you want to place a stethascope and listen for plaques in the common carotid artery, where do you place it?

Answer 15

Look for larygeal prominance (anterior neck adams apple), move posteior laterally= bifrucation of common carotid artery.

Bifurcation= where plaques commonly buildup

Question 16

Explain the landmark on the neck at C5-C6

Answer 16

Line from Spinous process C5-C6 level going anteriorly to the arch of the cricoid cartilage

Posterior this is where the boundry from pharynx to superior esophagus occurs.

Anterior this is the transition from Larynx to trachea.

Question 17

Where does the transition from Pharynx to esophagus and larynx to trachea occur?

Answer 17

C5-C6 level

Question 18

Semicircular bone, superior to the thyroid notch, important for muscle attachment. When you swallow it goes up and down.

Answer 18

Hyloid Bone

Question 19

Explain the Larygeal Prominance

Answer 19

It is the protrusion on the thyroid cartilage, a distinguishing characteristic between men and women.

Question 20

Inferior to the laryngeal prominance, is is a ligmanet that runs from thethyroid cartilage to the cricoid cartilage.

Answer 20

Median crycothyroid ligament

Question 21

What is immediatley inferior to median crycothyroid ligamnet then explain thickness anterior and posterior.

Answer 21

Cricoid cartilage; anteriorly it is called the Arch of th Cricoid and is is thinner, posterior thicker (like a class ring)

Question 22

What sits below the arch of the cricoid? On either side?

Answer 22

Thyroid Gland.

Question 23

Explain parts of thyroid gland and ocasional abnormality that can occur

Answer 23

Left lobe, isthmus (center), Right lobe

Occasionally you can have a Pyramidal (4th lobe) that comes off the isthmus and extends superiorly over the median cricoidthyroid ligament.

Question 24

What issue can the pyramidal lobe of the thyroid gland cause when preforming a tracheotomy?

Answer 24

It blocks the acess point, can puncture it, lots of blood loss.

Question 25

All of the laryngeal structures are poterior to what 2 muscles?

Answer 25

1. Omohyoid 2. Sternohyoid

Question 26

WHat are the two triangles of the neck?

Answer 26

Anterior and posterior triangles

Question 27

What are the boarders of the anterior triangle of the neck?

Answer 27

Starts at the **chin** and funs posteior laterally to the anterior boarder the **sternocleidomastoid muscles** and comes down along it to its attachment at the **manubrium of the sternum**

Question 28

What structures are found in the **anterior triangle** of the neck?

Answer 28

**Things that go into the thorax** * esophagus * Trachea * R/L Common Carotid artery * R/L Internal Jugular veins * Vagus N (C10), Phrenic N.

Question 29

What are the boarders of the posterior triangle of the neck?

Answer 29

Starts at the **superior posterior** boarder of the **sternocleidomastoid** muscle, running inferior along it to the **middle 1/3rd of the clavical** and the laterally to the **trapezius** and the back up its anterior boarder.

Question 30

What structures are found in the **posterior triangle** of the neck?

Answer 30

**Things that go into the Arms** * Brachial plexus * Subclavian artery & Vein

Question 31

Most superficial musle in the neck, behind layer of fatty tissue, thin, comes down from jaw across clavical and to the deltoid.

Answer 31

Platysma

Question 32

What are the function of the platysma?

Answer 32

Frowing and neck definition. Too much fat= saggy neck. Neck lift!

Question 33

What are the 4 fasica of the neck?

Answer 33

1. Pre-tracheal 2. Deep investing Fasica 3. Prevertebral fasica 4. Carotid Sheath

Question 34

Explain the Investing Fasica Layer | Muscolofacial collar

Answer 34

A **deep facia** , continues all the way around, attaches to posterior **spinous process** * *Splits and ecases* the **trapezius muscles ** * Then comes anterior and split/encase **Sternocleidomastoid muscles + Infrahyoid muscles**

Question 35

Explaint Prevertebral layer of fascia

Answer 35

Fascia **wrapping around vertebral compartment** * On the anterior space the **layer splits** into an anteiror and posterior layer in front of vertebral body

Question 36

Explaint the pre-tracheal fascia of the neck

Answer 36

**Facia that wraps around visceral compartment.** * The posterior aspect of it from carotid sheath to another it is **buccoharygeal fasica.**

Question 37

What is the posterior aspect of the pretracheal layer of fascia called?

Answer 37

Buccopharyngeal Fascia Rus posterior to the esophagus (longitudinaly from base of skull to neck

Question 38

Explaint the carotid sheath

Answer 38

Bilaterally, derived from all 3 fasica (connect) forming the caroitd sheath. Holds VAN.

Question 39

# What layer of fascia? Anteriorly, running from the **manudrium up to the hyoid** bone is what? Posteriorly runs **superfical to the vertebral layer **

Answer 39

Investing layer

Question 40

# What layer of fascia? What facia runs **anterior to trachea** and goes down and runs **posterior to the esophagus**

Answer 40

Pre-tracheal fascia

Question 41

What is the space between the investing layer (anterior) and pretracheal fasica (anterior to the trachea) called? Where is it located?

Answer 41

**Pre-tracheal space** Anterior-superior mediastinal; *Inferior to the neck* , and *superior to the heart* and its large blood vessels.

Question 42

What happens if you get an infection in the pre-tracheal space?

Answer 42

Infection can descend to the heart.

Question 43

What is the importance of fascia?

Answer 43

Prevents movment of fluid, and infection.

Question 44

# What layer of fascia? Runs anteior to the vetebrae, **splits into two layers= 2** spaces( retropharyngeal space + prevertebral space)

Answer 44

Pre-vertebral fasica

Question 45

What **anterior** space is posterior to the buccopharyngeal fasica and anterior to the prevertebral layer (ant.)

Answer 45

Retropharyngeal Space

Question 46

What posterior space is between the 2 prevertebral layers?

Answer 46

Fasical Space

Question 47

____ can transverse all the way from the base of the skull to the thorax. Posterior mediastinum.

Answer 47

Infection

Question 48

What joint on the Atlas C1 is where you go in to uncover the head.. and view all fasia.

Answer 48

Atlanto Occipital Joint

Question 49

# What superfical Vein? What veins runs down the **centerline of the neck**, *next to thyroid cartilage and trachea*?

Answer 49

Anterior Jugular veins

Question 50

# What superfical Vein? What veins run over sternocleidomastoid muscles?

Answer 50

External Jugular Vein

Question 51

Where does the external jugular vein empty into?

Answer 51

Emptys into the internal jugular/subclavian vein junction.

Question 52

What vein come off the external jugular vein on the head?

Answer 52

1. Posterior auricular vein

Question 53

# What superfical Vein? Comes of the external jugular, runs behind ear.

Answer 53

Posterior auricular vein

Question 54

What vein **runs under and behind the madible**, joins with post. division to form **internal jugular vein**

Answer 54

Retromandibular vein

Question 55

# What superfical Vein? **Comes off face, runs anteriorly**, descends under the madible funses with retromandibular vein and goes into the **internal jugular.**

Answer 55

Facial Vein

Question 56

Arch between the anterior jungular veins, connecttion btwn R/L side. Variable location.

Answer 56

Jugular Venous Arch

Question 57

What are the **2 superfical nodes** in the neck that **drain superficially**?

Answer 57

1. Occipital Nodes 2. Mastoid Nodes | Posteiror nodes

Question 58

WHat are the **4 superfical nodes** that **drain deep?**

Answer 58

1. Pre-auricular / Parotid nodes 2. Sub parotid nodes 3. Sub mandibular nodes 4. Submental nodes

Question 59

Explain the occipital node

Answer 59

**Posterior node**, drains the posterior **scalp superficially.** Goes to the *external jugular nodes* | Superficial cervical Node

Question 60

Explain the Mastoid nodes

Answer 60

Located next to the **auditory meatus on the mastoid bone.** Drains the ***posterior** lateral side of the head superficially.* Goes to the *external jugular nodes* | Superficial cervical Node

Question 61

Explain the Pre-auricular/Parotid Node

Answer 61

Sits anteriorly next to the auditory meatus on the parotid glad. Drain the * anterior lateral side of the gland * Parotid glad * Lateral inferior portion of the face. Drains into **deep cervical node; jugulodigastric node.**

Question 62

What are the 2 deep cervical nodes located on the internal jugular vein?

Answer 62

1. Jugulodigastric node 2. Jugulo-omohyloid Node

Question 63

Explain the submandibular nodes

Answer 63

**Across the lateral bottom of the mandible** Drains the: * Rest of inferor portionof the face, *same location as facial artery* * gingiva, * some teeth (posterior) * some part of tongue. **Drains into the deep cervical nodes on the internal jugular vein.**

Question 64

Explain the submental nodes

Answer 64

**Across the anteiror portion of the madible** Drains the: * Lower lip * Incisors * Tip of tongue **Drains into the deep cervical nodes on the internal jugular vein.**

Question 65

The vertical group of nodes along the external jugular vein are?

Answer 65

Superficial cervical nodes

Question 66

Explain the jugulodigastric node

Answer 66

Deep cervical node on the internal jugular vein * Large; can be palpated if infected * Superior * Digastric musle passes next to it.

Question 67

Explain the Juglo-omohyloid node

Answer 67

Located next to the **crossing of the omohyloid muscle, on the internal jugular vein**. Inferior.

Question 68

Where do all nodes eventually drain?

Answer 68

Superficial nodes eventrually drain deep, and then all deep cervical nodes empty at the **jugular/subclavian venous angel (thoracic duct) and back to blood supply.**

Question 69

Where is the **brachial plexus** located and where does it innervate?

Answer 69

**C5-T1** Upper limb

Question 70

Where is the **Cervical plexus** located and where does it innervate?

Answer 70

**C1-C4 ** Innervate Superficial **cutaneuous (sensory)** and a **motor component** as well.

Question 71

Explain the **cutaneous nerves** of the cervical plexus

Answer 71

**Dermatomes C2,C3,C4** * Posterior Rami * Superfical Sensory **Innervaton:** * Back of the head C2 * Neck C3 * Top of shoulder and back of neck C4

Question 72

Where do the **rami of C2** go?

Answer 72

**Posterior**= back of head **Anterior**= Ear, come down into neck

Question 73

What does the **rest of the face, anteriorly, innervated by**?

Answer 73

**Trigeminal Nerve C5;** 1. Opthamalic n. 2. Maxillary n. 3. Mandibular n.

Question 74

Where do the **rami of C3** go?

Answer 74

**Posterior**= back of neck **Anterior**= front of neck

Question 75

Where do **rami of C4** go?

Answer 75

**Posterior**= back of shoulders **Anterior**= superior thoraci aperature, across the clavicle.

Question 76

Middle cervical ganglia

Answer 76

* Spinal nerves C5 to C6 * Heart (Middle cardiac nerves)