Root of the Neck and Thoracic Outlet Flashcards Preview

Head And Neck Anatomy > Root of the Neck and Thoracic Outlet > Flashcards

Flashcards in Root of the Neck and Thoracic Outlet Deck (20)
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1
Q

Root of the neck

A
  • junction of the thorax and neck
  • superior thoracic aperture (STA)
    • AKA thoracic inlet (anatomical)
    • AKA thoracic outlet (clinical)
2
Q

Structures Passing Through STA

A
  • GI/Respiratory
    • trachea, espophagus
    • apices of lungs

Terry eats all lemons

  • Cardiovascular
    • subclavian aa., vv.
    • comon carotid aa.
    • internal jugular vv.

How sic to mispell sick?

  • Nerves
    • vagus nn. (CN X)
    • reccurrent laryngeal nn.
    • phrenic nn.
    • brachial plexus (passes over, not through STA)

Van rental prices break the bank

  • thoracic duct (lymph)

This Donny

3
Q

Apex of the Lungs

A
  • apices of lungs extend above sternal end of the first rib
  • affected by centrilobar emphysema (smoker’s emphysema), the breakdown of alveolar lung tissue
  • apical lung tumors=pancoast tumors
4
Q

Subclavian Artery (Artery of Root of Neck)

Left and right branch from?

A
  • left branches from aortic arch
  • right branches from the brachiocephalic a.
  • passes over first rib and becomes axillary artery
  • axillary artery passes the teres major muscle and becomes the brachial artery to upper extremity

subclavian–>axillary–>brachial artery

5
Q

Branches of Subclavian Artery

A
  • internal thoracic a.
  • vertebral a.; supplies posterior brain
  • thyrocervical trunk
    • inferior thyroid a.
    • ascending cervical a.
    • suprascapular a.
    • transverse cervical a.
      • superfiscial branch to trapezius
      • deep branch=dorsal scapular a.
  • costocervical trunk
    • located behind the anterior scalene m.
    • deep cervical a.
    • superior intercostal a.

VIT C, I took a class that could suck, DS–>dental student costs

6
Q

Nerves in the STA

A
  • vagus n. (CN X): visceral motor (GVE) and sensory (GVA) to throax and abdomen
  • recurrent laryngeal n.: motor (SVE) to larynx (speech)
  • phrenic n.: motor (GSE) to diaphragm m., sensory to pericardial sac
  • brachial plexus: motor (GSE) and sensory (GSA) to upper extremity and pectoral girdle
  • sympathetic chain: visceral motor (GVE) to head, neck, and heart
7
Q

Vagus nerve (CN X) Function

A
  • motor function of swallowing, speech (SVE)
  • taste of epiglottis (SVA)
  • monitors BP in aortic arch (GVA)
  • controls heart and respiratory rates (PN, GVE)
  • controls digestion in foregut, midgut (PN, GVE)
8
Q

Recurrent Laryngeal Nerve (Right and Left)

A
  • branch of CN X in thorax
  • motor fxn (SVE) to intrinsic mm. of larynx (speech)
  • may be affected by thoracic/neck surgery, lymph node biopsy, or tumors
  • Right RLN wraps around r. subclavian artery
  • Left RLN wraps around aortic arch
9
Q

Cervical Spinal Nerves

A
  • phrenic n. (C3-C5)
    • GSE to diaphragm m.
    • passes over anterior scalene m.
  • brachial plexus (C5-T1)
    • GSE and GSA to upper limb and pectoral girdle
    • passes between anterior and middle scalene mm.

BP

10
Q

Scalene Muscle Functions

A
  • flex the neck
  • elevate first and second ribs
  • accessory muscle of respiration
11
Q

Causes of Thoracic Outlet Syndrome

A
  • compression on the neurovasculature of the STA by:
    • scalene muscle spasms or tension
    • clavical fracture or congenital defects
    • cervical ribs (long cervical transverse processes)
    • pancoaste (apical) lung tumor
  • repetitive strain injury (RSI) from non ergo keyboard use, neck posture, etc.
12
Q

Signs of Thoracic Outlet Syndrome

A
  • numbness, pain (nerve compression)
  • discoloration, temp. abnormalities (CV vessels)
13
Q

Brachial Plexus Innervation

A
  • VPR’s from spinal levels C5-T1
    • (ventral primary rami)
  • GSA and GSE innervation
  • upper limb and pectoral girdle
14
Q

Major Terminal Branches of Brachial Plexus

A
  • axillary nerve: to shoulder muscles
  • radial nerve: to posterior arm and forearm; extensor muscles
  • musculocutaneous nerve: to anterior arm; flexor muscles of shoulder and elbow
  • median nerve; to anterior forearm (flexors of wrist and fingers) and 1st digit (thumb)
  • ulnar nerve: to anterior forearm (flexors of wrist and fingers) and fifth digit (pinky)

Under My ARM

15
Q

Brachial Plexus Neuropathies

A
  • Affect motor (GSE) and sensory (GSA) fxn between target tissue and lesion
  • Can be transient palsies due to compression or inflammation
16
Q

Signs of Brachial Plexus Neuropathies

A

muscle paralysis or paresis (weakness)

paresthesia

pain

17
Q

Radial Nerve Travels Through…

A
  • the axilla
    • crutch palsy from poorly fitted axillary crutches
    • affects extensor muscles of the elbow and wrist
  • travels on surface of posterior humerus (in spinal groove)
    • saturday night palsy from compressing nerve against humerus, affects wrist extensors (wrist drop)
    • mid-humeral fractures can also damage the nerve in the spinal groove
18
Q

Median Nerve

A
  • travels with the brachial artery in arm
  • crosses the cubital fossa (elbow pit)
  • travels through the carpal tunnel with digital flexor tendons (carpal tunnel syndrome)
  • innervates the lateral (thumb) side of hand
19
Q

Ulnar Nerve

A
  • travels posterior to the medial epicondyle of humerus
    • medial side of elbow joint
    • “funny bone”
  • innervates the medial (pinky finger) side of hand
20
Q

Hand–> Sensory Skin Dermatomes

A
  • Digit 1 (thumb): C6
  • Digit 3 (middle): C7
  • Digit 5 (pinky): C8