Flashcards in Session 3: Neck and Face Deck (29)
What are the three main functions of the neck?
Structural – support and move the head
Conduit for blood vessels and nerves
How are the components of these functions divided structurally in the neck?
Structural – inside prevertebral fascia
Visceral – inside or associated with pretracheal fascia
Blood vessels and nerves – carotid sheaths
What are the two large muscles that are found on the anterior and posterior sides of the neck?
Anterior – sternocleidomastoid
Posterior – trapezius
What are the contents of the carotid sheath?
Internal jugular vein
Common carotid artery
What are the contents of the visceral fascia?
What is the name given to the fascia between the posterior aspect of the oesophagus and the anterior part of the prevertebral fascia?
Which fascia splits in two around the sternocleidomastoid and trapezius?
What important structures are at each of the following levels:
Superior cervical ganglion
Body of hyoid
Birfurcation of common carotid
Upper border of thyroid cartilage
Middle cervical ganglion
Inferior cervical ganglion
What are the two triangles of the neck? State their borders.
Anterior triangle – mandible, anterior border of sternocleidomastoid and midline
Posterior triangle – posterior border of sternocleidomastoid, anterior border of trapezius and clavicle
What are the main muscles in the anterior triangle and which nerves innervate them?
What are the four infrahyoid muscles and where are they attached?
Platysma – facial
Mylohyoid – mandibular division of trigeminal
Digastric muscle – anterior belly (mandibular division of trigeminal) + posterior belly (facial)
Infrahyoid muscles (strap muscles)
Omohyoid – superior border of scapula near scapular notch --> hyoid
Sternohyoid – sternum --> hyoid
Sternothyroid – sternum --> thyroid cartilage
Thyrohyoid – thyroid cartilage --> hyoid
Which nerves innervate each of the four infrahyoid muscles?
Omohyoid – ansa cervicalis
Sternohyoid – ansa cervicalis
Sternothyroid – ansa cervicalis
THYROHYOID – C1 fibres via the hypoglossal nerve
The posterior triangle consists mainly of blood vessels and nerves. Which blood vessels and nerves are in the posterior triangle?
External jugular vein
Trunks of brachial plexus
Spinal accessory nerve
Which other smaller nerves are found in this area?
Lesser occipital nerve
Greater auricular nerve
Transverse cervical nerve
Where do the trunks of the brachial plexus emerge?
Posterior to scalenus anterior
Where are the subclavian artery and vein relative to the scalene muscles?
Subclavian artery = posterior to scalenus anterior
Subclavian vein = anterior to scalenus anterior
Where is the phrenic nerve relative to the scalene muscles?
Phrenic nerve lies on the anterior surface of scalene anterior
Which spinal nerves contribute to the superior, middle and inferior trunks of the brachial plexus?
Superior = C5 + C6
Middle = C7
Inferior = C8 + T1
Which spinal nerves contribute to the phrenic nerve and what isits main function?
C3, C4 and C5
Motor supply of the diaphragm
Sensory innervation to the diaphragmatic pleura and peritoneum
What is platysma innervated by?
Facial nerve (cervical branch)
What is mylohyoid innervated by?
Mandibular division of trigeminal nerve
What are the anterior and posterior bellies of the digastric muscle innervated by?
Anterior – mandibular division of trigeminal nerve
Posterior – facial nerve
What are the infrahyoid muscles innervated by?
Ansa cervicalis = omohyoid + sternothyroid + sternohyoid C1 fibres via hypoglossal nerve = thyrohyoid
What are the clinical applications of a carotid pulse?
Measuring pulse rate
List the main sites of access for central venous lines.
Internal jugular (most common)
What are the uses of central venous lines?
Long-term access e.g. for chemotherapy drugs
Administering drugs that can cause phlebitis
Monitoring blood pressure
What are the complications of insertion of central venous lines?
Accidental arterial puncture
Pneumothorax or haemothorax
Where does the accessory nerve exit the skull?
The accessory nerve begins in the upper spinal cord and ascends to enter the skull through the foramen magnum
The accessory nerve then leaves via the jugular foramen
What does the accessory nerve innervate?