Flashcards in Posterior Triangle of the Neck Deck (39):
Which muscle attaches to the posterior skull in between the inferior and superior nuchal lines?
What is the posterior skull bone called?
How does the mastoid process form?
After birth from the sternocleidomastoid pulling on it.
The hyoid bone is located inferior to the _______ and has a greater and lesser horn. What muscles attach to it?
Located inferior to the mandible. Suprahyoid muscles and the infrahyoid muscles attach to it.
Name the five axial planes of the cervical region.
Occlusal plane at C1 - a plane between the upper and lower teeth.
Angle of the mandible at C2.
Hyoid bone at C3.
Thyroid cartilage at C4/C5.
Cricoid cartilage at C6.
What is the thing called that attaches the inferior hyoid bone to the thyroid cartilage?
The thyrohyoid membrane.
How many cervical vertebrae are there? How many cervical nerves are there? How does that work?
7 cervical vertebrae, 8 cervical nerves. C1 nerve passes above the C1 vertebra, C8 nerve passes below the C7 vertebrae. All the thoracic nerves pass below their corresponding thoracic verbetrae.
Which vertebrae has a bifid spinous process?
What are the transverse foramina of the cervical vertebrae for?
The vertebral arteries run through them - beginning with C6 usually.
What part of the skull articulates with atlas? What is this joint called?
Occipital condyles. Joint is called the atlanto-occipital joint.
What are the primary motions of the atlanto-occipital joint? What motion is restricted?
Flexion, extension, and some lateral bending. Rotation does not happen.
Rotation at the head primarily occurs at which joint?
The atlanto-axial joint.
What is the superior protuberance of axis (C2) called? What is its function?
Dens. It is the pivot point around which the skull can rotate.
What ligaments attach dens to atlas? What do they do?
The transverse ligament wraps around dens posteriorly and prevents anterior displacement of the atlas and skull on C2.
The alar ligaments are on the anterolateral portion of dens and prevent excessive side-to-side motion.
What does the anterior longitudinal ligament do? What about the posterior longitudinal ligament?
Anterior prevents hyperextension.
Posterior prevents hyperflexion.
What is a hangman's fracture?
Bilateral fracture of the posterior arch of C2 with anterior subluxation of C2 on C3 from hyperextension/distraction.
What is a Clay Shoveler's fracture?
When the tips of the spinous processes of C6-T1 avulse from constant flexion and extension of the neck.
What is a Jefferson fracture?
Compression fracture of C1 anterior and/or posterior arches – lateral masses split and the transverse ligament tears.
What is a mental process?
What are the three compartments of the neck?
1. Visceral compartment (anterior to the vertebrae)
2. Bony-muscular compartment posteriorly
3. 2 neurovascular compartments laterally (carotids, IJV, vagus nerve)
Name the five fascial layers found in the neck.
1. Investing fascia
2. Prevertebral fascia
3. Carotid sheath (2 of them)
4. Pretracheal fascia
5. Alar fascia (anterior part of the prevertebral fascia)
What structures are found within the pretracheal fascia?
Esophagus, trachea, thyroid gland.
What is the pretracheal space?
What is the retropharyngeal space?
What is the danger space?
Pretracheal space is between the pretracheal fascia and the trachea.
Retropharyngeal space is between the retropharyngeal fascia and the alar fascia.
Danger space is between the alar and prevertebral fascia and infection in this space can get down to the posterior mediastinum.
Which two veins join to form the external jugular vein?
The posterior auricular vein and the retromandibular vein
What do the two branches of the retromandibular vein do?
The posterior one joins with the posterior auricular vein to form the external jugular vein, the anterior branch joins with the facial vein.
What does a distended external jugular vein tell you?
Elevated central venous pressure (at the IVC just before the right heart) - indicative of right heart failure
From what does the platysma muscle originate from inferiorly?
The deep fascia surrounding the deltoid and pectoralis muscles.
What is torticollis aka wry neck?
When a SCM on one side is shorter than the opposite side, pulling the head towards that side and rotating the face to the opposite side. Can be congenital or acquired.
What are the two triangles of the neck and what are their borders?
Anterior triangle: posterior border is the posterior edge of the SCM, inferior edge of the mandible, and the superior clavicle and manubrium.
Posterior triangle: anterior border is the posterior edge of the SCM, posterior border is the anterior border of the trapezius. Inferior border is the middle third of the clavicle. The roof is the skin, superficial fascia, platysma, and investing deep layer of fascia. The floor is the muscles covered by prevertebral fascia (scalenes and some others).
What are the two triangles of the posterior neck triangle?
Occipital triangle is within the borders of the trapezius, SCM, and omohyoid mucle inferiorly. The supraclavicular triangle is within the omohyoid, clavicle, and SCM.
What is the "nerve point" of the neck?
A spot on the posterior edge of the SCM about halfway up where a bunch of cutaneous nerves from the cervical plexus and the spinal accessory nerve comes out.
What makes up the cervical plexus?
Connections between ventral primary rami of C1-C4
What nerve provides cutaneous sensation for the anterior head and face?
Trigeminal nerve (CN V)
Cutaneous innervation for the posterior head and neck is supplied by the _____ _____ of cervical spinal nerves.
What are the three parts of the trigeminal nerve and what do they do?
V1 is the opthalmic division and supplies cutaneous sensation for the anterior head down to the nose.
V3 is the mandibular division and supplies cutaneous sensation for the lower lip, chin and up the side of the face to the temples.
V2 supplies cutaneous sensation in between V1 and V3.
Which scalene muscles attach to the first rib and which attach to the 2nd?
Anterior and middle attach to rib 1 and posterior attaches to rib 2.
What two important structures run between the anterior and middle scalene muscles? What structure does NOT?
Brachial plexus and subclavian artery run between the scalenes. The subclavian vein does NOT (it runs anterior to the anterior scalene).
What is scalene compression syndrome?
A type of thoracic outlet syndrome - compression of the brachial plexus and subclavian artery due to hypertrophy or fibrosis of the anterior and middle scalene muscles, causing pain, muscle weakness and low BP in the upper limb.