Root of The Neck

Question 1

What is the anterior border of the root of the neck?

Answer 1

Top of manubrium and superior border of clavicle

Question 2

What is the posterior border of the root of the neck?

Answer 2

Body of T1 and superior margin of scapula to coracoid process

Question 3

What is the lateral border of the root of the neck?

Answer 3

First pair of ribs and costal cartilages

Question 4

What is the inferior border of the root of the neck?

Answer 4

Superior thoracic aperture (thoracic inlet) and axiliary inlets

Question 5

When do the subclavian vessels become axillary vessels?

Answer 5

Lateral border of the 1st rib

Question 6

What is the brachial plexus formed from?

Answer 6

5 anterior rami - C5,6,7,8 and T1

Question 7

What are the divisions of the brachial plexus?

Answer 7

3 trunks - superior, middle and inferior
3 anterior divisions - superior, middle, inferior
3 posterior divisions - lateral, posterior, medial

Question 8

What is the superior thoracic aperture?

Answer 8

All structures going from the thorax to head/upper limb pass through it

Question 9

Where is the apex of the lungs?

Answer 9

About 2.5cm above middle 1/3 of the clavicle - above first rib into root of neck

Question 10

What is the cervical pleura?

Answer 10

The superior continuation of the costal and mediastinal parts of the parietal pleura

Question 11

What is the pleural cupola?

Answer 11

A cup-like dome formed superiorly to the pleura

Question 12

What is important about the cervical pleura in children?

Answer 12

More susceptible to injury since it extends higher due to the relatively short length of the neck

Question 13

What is Sibson’s fascia?

Answer 13

The suprapleural membrane that reinforces the cervical pleura
A strong fibrous connective tissue that is an extension of the endothoracic fascia

Question 14

Where does Sibson’s fascia attach?

Answer 14

To the internal surface of rib 1 and the transverse processes of C7

Question 15

What is the purpose of Sibson’s fascia?

Answer 15

Acts as a barrier to prevent changes in intrathoracic pressure drawing upon contents in the neck

Question 16

What are the branches of the aortic arch?

Answer 16

Brachiocephalic trunk
Left common carotid artery
Left subclavian artery

Question 17

What does the brachiocephalic trunk divide into?

Answer 17

Right common carotid artery
Right subclavian artery

Question 18

What are the parts of the subclavian artery?

Answer 18

1st part - Medial to anterior scalene muscle (from origin to muscle)
2nd part - Posterior to anterior scalene
3rd part - Lateral to anterior scalene (from muscle until lateral border of 1st rib)

Question 19

What are the branches of the 1st part of the subclavian artery?

Answer 19

Vertebral artery
Thyrocervical trunk
Internal thoracic artery

Question 20

What are the branches of the 2nd part of the subclavian artery?

Answer 20

Costocervical trunk

Question 21

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

Answer 21

Dorsal scapular artery

Question 22

Describe the path of the vertebral artery

Answer 22

Ascends in neck as cervical part to enter foramen transversarium of C6 and ascends through C1 to C6 as vertebral part
Exits foramen transversarium crossing over posterior tubercle of C1 and travels medially to foramen magnum to eventually become basilar artery

Question 23

What are the branches of the thyrocervical trunk?

Answer 23

Inferior thyroid artery
Transverse cervical artery
Suprascapular artery

Question 24

Describe the inferior thyroid artery

Answer 24

Largest branch of thyrocervical trunk
Supplies thyroid
Gives off ascending cervical artery to prevertebral muscles and spinal cord

Question 25

Describe the transverse cervical artery

Answer 25

Second branch of thyrocervical artery Anterior to anterior scalene Gives superficial branch to trapezius and deep branch to rhomboids and scapula

Question 26

Describe the suprascapular artery

Answer 26

3rd branch of thyrocervical artery Anterior to anterior scalene Supplies supraspinatus fossa

Question 27

What are the terminal branches of the thyrocervical artery?

Answer 27

Inferior thyroid artery Ascending cervical artery

Question 28

Describe the path of the internal thoracic artery

Answer 28

Descends inferomedially posterior to the clavicle into the thoracic cavity to the 6th intercostal space and gives rise to anterior intercostal arteries that supply the intercostal spaces

Question 29

What are the divisions of the costocervical trunk?

Answer 29

Supreme intercostal artery Deep cervical artery

Question 30

Describe the path of the supreme intercostal artery

Answer 30

To 1st rib as posterior intercostal arteries to 1st and 2nd intercostal spaces

Question 31

Describe the path of the dorsal scapular artery

Answer 31

Highly variable origin Part of subclavian artery or can arise from a common trunk with the transverse cervical artery

Question 32

Describe the subclavian vein

Answer 32

Continuation of axillary vein beginning at lateral border of 1st rib Major venous drainage from upper limb Runs parallel and anterior to subclavian artery and anterior to anterior scalene EJV drains into subclavian

Question 33

What makes up the brachiocephalic vein?

Answer 33

Internal jugular vein Subclavian vein

Question 34

Where does the inferior thyroid vein drain?

Answer 34

Directly into the brachiocephalic vein

Question 35

What is the thoracic duct

Answer 35

A major lymphatic drainage channel that begins in the abdomen ascending through the thoracic cavity

Question 36

Describe the path of the thoracic duct

Answer 36

Begins in abdomen and ascends through thoracic cavity into the neck where it enters the venous system between the left IJV and left subclavian vein On the right side, there is a right lymphatic trunk/duct entering the same venous areas

Question 37

What are the anterior prevertebral muscles?

Answer 37

Longus coli Longus capitis Rectus capitis anterior Anterior scalene

Question 38

What are the lateral vertebral muscles?

Answer 38

Rectus capitis lateralis Splenius capitis Levator scapulae Middle and posterior scalenes

Question 39

What are the actions of the anterior vertebral muscles?

Answer 39

Longus colli - flexes neck with rotation to opposite side (unilaterally) Longus capitis, rectus capitis anterior, anterior scalene - flex head

Question 40

What is the action of the splenius capitis?

Answer 40

Laterally flexes and rotates head and neck to same side Bilaterally - extends head and neck

Question 41

What is the action of the middle and posterior scalenes?

Answer 41

Flex neck laterally Middle scalene elevated 1st rib Posteriors elevates 2nd rib during forced inspiration

Question 42

What is the action of the levator scapulae?

Answer 42

Elevates scapula and rotates it