Posterior Triangle

Question 1

What are the borders of the posterior triangle?

Answer 1

Anterior border of the trapezius, posterior border of the SCM, and the middle 1/3rd of the clavicle

Question 2

What muscles comprise the floor of the posterior triangle?

Answer 2

Anterior, middle, and posterior scalene muscles; levator scapulae, and splenius capitis

Question 3

What cutaneous nerves turn around the posterior border of the SCM then exit from the posterior triangle?

Answer 3

Lesser Occipital, Great Auricular, and Transverse Cervical Nerves

Question 4

Where do the anterior, middle, and posterior scalene muscles originate and insert*?

Answer 4

Originate: Cervical Transverse Processes

Insert*: 1st Rib; posterior scalene inserts on 2nd rib

Question 5

What is the relationship of the roots and trunks of the brachial plexus versus the vertebral artery at the transverse processes of the cervical vertebrae?

Answer 5

The nerves will run posterior to the vertebral artery.

Question 6

Between what two muscles will the ventral ramus of the brachial plexus nerves run through going toward the vertebra?

Answer 6

Middle scalene and Anterior scalene muscles.

Question 7

Within what structure does the vertebral artery pass?

Answer 7

Within in the transverse foramen

Question 8

(T/F) The subclavian vein passes through the scalene triangle?

Answer 8

False. It passes anterior to the anterior scalene muscle.

Question 9

What spinal nerve segments (cervical) contribute to the phrenic nerve?

Answer 9

C3-C5; C4 is most of contribution

Question 10

On what surface does the phrenic nerve pass?

Answer 10

Anterior surface of the anterior scalene muscle

Question 11

(T/F) The Phrenic nerve does not lie within the scalene triangle.

Answer 11

True.

Question 12

What are the clinical presentations of thoracic outlet syndrome (TOS)?

Answer 12

Cold hands from arterial compression, numb fingers from nerve compression, or swelling and blueish colorations from vein compression

Question 13

What redundant structure developed in a small percentage of the population can cause TOS?

Answer 13

Cervical Rib

Question 14

What and where is compressed in neurogenic TOS?

Answer 14

Brachial plexus nerves; between scalene muscles and first rib

Question 15

What and where is compressed in venous TOS?

Answer 15

Subclavian vein; between clavicle and first rib

Question 16

What causes arterial TOS?

Answer 16

Occlusion or aneurysm of the subclavian artery in the neck associated with an extra “cervical” rib

Question 17

Where does the subclavian vein join the internal jugular vein?

Answer 17

Posterior to the sternoclavicular joint

Question 18

What arteries divide posterior to the sternoclavicular joint?

Answer 18

Brachiocephalic trunk divides into right subclavian and right common carotid artery

Question 19

What structures are between the dividing brachiocephalic trunk and the subclavian vein?

Answer 19

Phrenic Nerve, Vagus Nerve, and Anterior Scalene Muscle

Question 20

(T/F) The common carotid arteries have branches.

Answer 20

False.

Question 21

“At the ______ edge of the 1st rib, the subclavian artery becomes the _______ artery”

Answer 21

lateral; axillary

Question 22

What are the three initial branches off the subclavian artery?

Answer 22

Internal thoracic artery, vertebral artery, and thyrocervical trunk

Question 23

What is the path of the internal thoracic artery?

Answer 23

Passes posterior to the subclavian vein and first rib into the thorax

Question 24

What is the origin of the vertebral artery surrounded by?

Answer 24

Sympathetic branches of cervicothoracic ganglion

Question 25

What vertebral transverse processes does the vertebral artery skip over and which one does it dive into?

Answer 25

Skips 8th and 7th; dives into 6th cervical vertebrae

Question 26

What foramen does the vertebral artery pass through?

Answer 26

Costotransverse foramen

Question 27

(T/F) The vertebral artery ascends through the remaining costotransverse foramina anterior to emerging cervical spinal nerves.

Answer 27

True.

Question 28

Where does the vertebral artery pierce the dura mater to enter the brain?

Answer 28

Foramen Magnum

Question 29

What does the vertebral artery supply?

Answer 29

Brain, spinal cord, and deep neck muscles

Question 30

What is the other artery that supplies the brain?

Answer 30

Internal Carotid Artery

Question 31

What artery forms when the left and right vertebral arteries anastomose?

Answer 31

Basilar Artery

Question 32

What parts of the body does the thyrocervical trunk supply?

Answer 32

Thyroid Gland and Shoulder

Question 33

The thyrocervical trunk runs ________ (direction) on the ______ (relation) of the anterior scalene muscle.

Answer 33

superiorly; medial

Question 34

What structure does the inferior thyroid gland pass to reach the thyroid gland?

Answer 34

Passes deep to the carotid sheath

Question 35

The inferior thyroid artery passes (anterior/posterior) to the sympathetic trunk, but (anterior/posterior) to the recurrent laryngeal nerve.

Answer 35

posterior; anterior

Question 36

What branch off the thyrocervical trunk ascends along the anterior scalene to supply muscles in the neck?

Answer 36

Ascending Cervical Artery

Question 37

What branch of the thyrocervical trunk pins the phrenic nerve down to the anterior scalene?

Answer 37

Suprascapular Artery

Question 38

What branch of the thyrocervical trunk joins CN 11?

Answer 38

Transverse Cervical Artery

Question 39

If the costocervical trunk branches posterior to the anterior scalene, what part of the subclavian does it branch from?

Answer 39

2nd part of the subclavian artery

Question 40

What are the divisions of the costocervical trunk?

Answer 40

Highest intercostal artery and deep cervical artery

Question 41

What artery branches off the 3rd part of the subclavian?

Answer 41

Dorsal Scapular Artery

Question 42

What structure parallels the subclavian vein?

Answer 42

Subclavian artery

Question 43

The subclavian vein passes (anterior/posterior) to the anterior scalene (before/after) joining the internal jugular vein to form the _________ vein.

Answer 43

anterior; before; brachiocephalic vein

Question 44

What is the only veinous tributary of the subclavian vein?

Answer 44

External jugular vein

Question 45

At what point do the thoracic duct and right lymphatic duct empty their contents into a vessel?

Answer 45

At the junction of subclavian and internal jugular veins at the most medial aspect of the subclavian vein

Question 46

What muscles does CN 11 innervate?

Answer 46

SCM and trapezius

Question 47

Name 3 reasons why CN 11 is not regarded as a spinal nerve.

Answer 47

1. Cell bodies of GSE fibers are not located in same region of spinal cord as spinal nerve GSE fibers. 2. CN 11 collects from 4-6 different spinal segments to go into a single nerve- unlike spinal nerves. 3. Goes up through foramen magnum and exits jugular foramen

Question 48

What segments join CN 11 to innervate SCM?

Answer 48

C2 and C3

Question 49

C3 and C4 join CN 11 to innervate what muscle?

Answer 49

Trapezius

Question 50

To affect all function of CN 11, where would there have to be a lesion?

Answer 50

Medial to the SCM

Question 51

To affect solely the trapezius, where would CN 11 have to be lesioned?

Answer 51

Lateral to SCM

Question 52

What is the clinical presentation of a lesion of CN 11 affecting SCM?

Answer 52

Difficulty elevating chin and turning head

Question 53

What is the clinical presentation of a lesion affecting only the trapezius?

Answer 53

Affected shoulder would droop lower than the other, difficulty elevating shoulder, raising arm above horizontal plane, and squaring shoulders

Question 54

Where does the sympathetic trunk extend in the neck?

Answer 54

In the space posterior to the carotid sheath along the surface of pre vertebral muscles

Question 55

Ascending Preganglionic Axons forming the sympathetic trunk primarily enter from what spinal cord segments?

Answer 55

T1 and T2

Question 56

(T/F) The cervical part of the sympathetic chain receives white rami.

Answer 56

False.

Question 57

What spinal segments form the superior cervical ganglion?

Answer 57

C1-C4

Question 58

The fusion of C5 and C6 form what ganglion?

Answer 58

Middle Cervical Ganglion

Question 59

The cervicothoracic ganglion is a fusion of what spinal segments?

Answer 59

C7, C8, and T1

Question 60

Many large nodes of the lymphatic chain in the neck lie along what common structure?

Answer 60

Internal Jugular Vein

Question 61

The lymphatic chain is divided into superior and inferior nodes based on the position of what structure?

Answer 61

Omohyoid Muscle

Question 62

Superior nodes receive drainage from what space?

Answer 62

Retropharyngeal Space

Question 63

What is a major node in the superior group of nodes and what structures does it drain?

Answer 63

Jugulodigastric Node; tongue and palatine tonsil

Question 64

What are inferior deep cervical nodes also called and where do they drain?

Answer 64

Supraclavicular nodes; thoracic duct and right lymphatic duct