Root of Neck, Fascia, and Spaces of Neck Region Flashcards

(54 cards)

1
Q

Boundaries of Root of Neck

A

Anterior - manubrium of sternum
Lateral - 1st ribs, which slope upwards as they pass posterioly to articulate with vertebra T1
Posterior - vertebra T1

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2
Q

Plueral Cavity of Root of Neck?

A

Plueral cavities and apex of lungs extend into root of neck

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3
Q

cervical pleura

A

part of pleura on lungs that extend up into the root of the neck
lie POSTERIOR to the FIRST PART OF THE SUBCLAVIAN ARTERIES

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4
Q

cervical pleura, apices of the lung, and sympathetic trunk all..

A

lie POSTERIOR to the FIRST PART OF THE SUBCLAVIAN ARTERIES in root of neck

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5
Q

vessels in root of neck

A

subclavian artery and vein

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6
Q

Nerves in root of neck

A

Phrenic
Vagus
Recurrent laryngeal
Components of teh sympathetic nervous system

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7
Q

Right Subclavian artery -general

A

Terminal Branch of brachiocephalic trunk

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8
Q

Left Subclavian artery -general

A

direct branch off of the aortic arch

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9
Q

Pathway of R and L subclavian arteries

A

Anterior to pleural cavity in root
Posterior to anterior scalene muscle (Divides each into three parts)
Become AXILLARY ARTERIES as they cross the lateral border of the first rib

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10
Q

Subclavian artery reference to anterior scalene

A

first part is medial to the muscle
second part is POSTERIOR to muscle
third part is LATERAL to muscle

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11
Q

what comes off the right subclavian artery?

A

Vertebral artery, internal thoracic artery, and thyrocervical trunk off of FIRST PART
Costocervical trunk arises from SECOND PART
dorsal scapular artery arises from THIRD PART

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12
Q

vertebral artery and where it travels

A

comes off FIRST part of the subclavian artery and travels in the TRANSVERSE FOREMEN of the cervical vertebrae as it enters the foramen magnum

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13
Q

internal thoracic artery

A

comes off first portion of the subclavian artery and we saw this in lab - goes inferiorly on posterior aspect of the thoracic cage

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14
Q

thyrocervical trunk

A

off of the FIRST aspect of the subclavian artery

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15
Q

coming off of the thyrocervical trunk

A

suprascapular artery
transverse cervical artery
inferior thyroid artery–> gives off the ascending cervical artery

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16
Q

suprascapular artery

A

crosses anterior scalene muscle, enters into posterior triangle and passes posteriorly to suprascapular region of the back

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17
Q

transverse cervical artery

A

crosses the scalenus anterior muscle to enter the posterior triangle to supply the lateral structures of the neck

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18
Q

inferior thyroid artery

A

ascend in the neck and arches MEDIALLY and DOWNWARD to enter and supply the inferior portion of the thyroid gland
large musclular branch from the inferior thyroid artery –> ASCENDING CERVICAL ARTERY travels STRAIGHT UPWARD

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19
Q

anastemosis in the shoulder

A

dorsal scapular artery and the suprascapular artery

IMPORTANT THAT A HIGHLY MOBILE JOINT HAS GOOD BLOOD SUPPLY

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20
Q

costocervical trunk gives rise to…

A

deep cervical artery and the supreme intercostal artery

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21
Q

dorsal scapular artery passage if branch of the subclavian artery

A

from the third part of the subclavian artery and passes LATERALLY through the trunks of the brachial plexus, anterior to the middle scalene –> then is runs DEEP to the levator scapulae and rhomboid muscles, supplying both and participating in the arterial ANASTEMOSES around the scapuls

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22
Q

subclavian vein

A

axillary vein –> into root of neck now at the LEVEL OF THE LATERAL BORDER OF THE FIRST RIB is the subclavian vein
will cross the first rib anterior to the insertion of the anterior scalene muscle

ANTERIOR to the subclavian artery becuase need to remove to see the arteries

23
Q

subclavian vein receives blood from?

A
  1. external jugular vein
  2. vertebral vein
  3. internal thoracic vein
24
Q

phrenic nerve

A

descends obliquely with internal jugular vein across the anterior scalene
deep to the transverse cervical and suprascapular arteries

both sides it runs POSTERIOR to the subclavian vein and ANTERIOR to the internal thoracic artery

25
left phrenic course vs. right phrenic course
left phrenic lies on the anterior scalene muscle and crosses to the FIRST PART of the subclavian artery the right phrenic also lies anterior to the anterior scalene muscle but it crosses anterior to the SECOND part of the subclavian artery
26
right vagus
crosses anterior to the right subclavian artery and gives off the right recurrent laryngeal nerve which passes MEDIALLY to reach the trachea and esophagus
27
inferior cervical ganglion
FOUND JUST ABOVE THE SUBCLAVIAN ARTERY | usually fused with ganglion of T1 and forms the stellate ganglion
28
sympathetic trunk
passes upward from the superior mediastinum through the thoracic inlet and continues up the neck outside and POSTERIOR TO THE CAROTID ARTERY
29
Eight sympathetic ganglia in cervical region?
coalesce as THREE MAJOR SWELLINGS : 1. inferior cervical ganglion 2. middle cervical ganglion 3. superior cervical ganglion
30
middle cervical ganglion
found at vertebral level C6 opposite the cricoid cartilage
31
superior cervical ganglion
long, fusiform ganglion about 2-3 cm long, stretching from vertebral level C1 to C2/C3
32
superficial cervical fascia
thin layer of subcutaneous connective tissue that lies between the dermis of the skin and the investing layer of deep cervical fascia it contains cutaneous nerves, blood and lymphatic vessels, superficial lymph nodes, and variable amounts of fat - anterolaterally = the platysma muscle
33
platsyma muscle
anteriorlaterally of the subcutanous/ superficial cervical fascia muscle of facial expression
34
three layers of deep cervical fascia
investing pretracheal prevertebral
35
investing layer of fascia
superficial layer of the deep cervical fascia surrounds the entire neck deep to the skin and superficial fascia splits into superficial and deep layers to ENCLOSE/INVEST the trapezius and sternocleidomastois (SCM) muscles
36
suprasternal space
created by the investing layer of the deep cervical fascia one layer attaches to the anterior part of the manubrium and the other to the posterior which creates this suprasternal space
37
pretracheal layer of fascia
limited to anterior part of the neck extends inferiorly from hyoid bone into thorax where it BLENDS IN WITH THE FIBROUS PERICARDIUM OF THE HEART DIVIDED INTO TWO DIVISIONS - MUSCULAR AND VISCERAL
38
muscular layer of the pretracheal fascia
encloses the infrahyoid muscle
39
visceral layer of the pretracheal fascia
encloses the thyroid gland and trachea
40
buccopharyngeal fascia
basically an extension of the visceral portion of the pretracheal fascia that extends posterior separating the esophagus from the prevertebral fascia
41
prevertebral fascia
encloses the scalenes, deep back muscles, vertebrae
42
anterior portion of the prevertebral fascia
attaches to the ANTERIOR TUBERCLE of the vertebrae
43
alar fascia
ANTERIOR lamina of the split of the prevertebral fascia when it crosses midline immediately deep to the buccopharyngeal fascia of the posterior visceral wall
44
location of carotid sheath
tubular fascial investment from base of skull to the root of the neck
45
carotid sheath blends with?
anteriorly with the investing layer and the pretracheal fascia and posteriorly with the prevertebral fascia
46
what is inside the carotid sheath?
``` common and internal carotid arteries the internal jugular vein the vagus nerve (CN X) some deep cervical lymph nodes carotid sinus nerve sympathetic nerve fibers known as the carotid periarterial plexuses ```
47
potential spread of infection and blood?
communications - the carotid sheath and the pretracheal fascia communicate freely with the mediastinum of the thorax inferiorly and the cranial cavity superiorly
48
fascial spaces
the loose areolar connective tissue fills spaces BETWEEN the various layers of deep cervical fascia they are POTENTIAL spaces only when invaded and displaces by infective material (pus) or occasionally by air (surgical emphysema)
49
retropharyngeal space
located posterior to the pharynx, larynx, and trachea
50
boundaries of the retropharyngeal space
``` anterior: buccopharyngeal fascia (visceral) posterior : alar (prevertebral fascia) lateral: carotid sheath superior: base of skull inferior : mediastinum ```
51
parapharyngeal space
DOES NOT INCLUDE THE CAROTID SHEATH BUT THE AREAS AROUND IT AKA : lateral pharyngeal space superior: skull Inferior: hyoid bone lateral border - medial pterygoid muscle (in the head) or sternocleidomastoid (in the neck) medial and anterior borders - superior contrictor (head) and buccophayrngeal fascia posterior border - alar fascia and carotid sheath
52
infections in the paraphayrngeal space..?
are often and primarily spread to the retropharyngeal space
53
prevertebral space AKA
Danger space number 4 associated with immeditaley behind the alar fascia and anterior to the prevertebral space it is continuous to the base of the skull through the neck and into the thorax to end at the diaphragm since it extends into the thorax region - it is a large potential space and thus a big risk for infection
54
cervicofacial emphysema
link to dentistry - emphysema of the head and neck can occur when air gains entry into facial spaces and becomes trapped - as these are POTENTIAL spaces inappropriate use of the air turbine or high speed handpiece use AIR UNDER PRESSURE ENTERS THE TISSUES AND INFLATES THE POTENTIAL SPACE