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Head and Neck > Structural Anatomy of the Neck > Flashcards

Structural Anatomy of the Neck Flashcards

1
Q

Division of cervical vertebrae

A
  • Typical (C3-C6)

- Atypical (C1, 2, 7)

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2
Q

Features of typical cervical vertebrae

A
  • Small body
  • Large triangular foramen
  • Transverse process includes transverse foramina
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3
Q

Describe the Atlas

A
  • C1
  • Ring-like
  • Lacks spinous process or body
  • Consists of two lateral masses connected by arches
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4
Q

Describe the Axis

A
  • C2

- Odontoid peg projects from anterior aspect of its body

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5
Q

Describe the Vertebra Prominens

A
  • C7
  • Long spinous process (hence name)
  • Large transverse processes
  • Small transverse foramina (do not contain vertebral artery)
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6
Q

Level of the hyoid bone

A

C3

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7
Q

Parts of the hyoid bone

A
  • Body
  • Greater horn
  • Lesser horn
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8
Q

Connection between hyoid and styloid process

A

Stylohyoid ligaments

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9
Q

3 divisions of the deep cervical fascia

A
  1. Investing layer
  2. Prevertebral fascia
  3. Pretracheal fascia
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10
Q

Function of the investing fascia

A

Encloses the muscles of the neck

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11
Q

Superior attachments of the investing fascia

A
  • Superior nuchal lines
  • Mastoid process
  • Zygomatic arch
  • Inferior border of mandible
  • Hyoid bone
  • Spinous processes of cervical vertebrae
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12
Q

Inferior attachments of cervical fascia

A
  • Manubrium
  • Clavicles
  • Acromions and spines of scapulae
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13
Q

Where does the EJV pierce the investing fascia

A

Below omohyoid, just above the midpoint of the clavicle

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14
Q

What does the investing fascia enclose

A
  • Trapezius
  • SCM
  • Strap muscles
  • Parotid and submandibular glands
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15
Q

Where is the prevertebral fascia situated

A
  • Passes across vertebrae and prevertebral muscles

- Oesophagus, pharynx, and great vessels lie in front

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16
Q

Describe the lateral course of the preverterbal fascia

A
  • Covers the cervical and brachial plexuses
  • Covers the muscles in the floor of the posterior triangle
  • Becomes the axillary sheath
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17
Q

Describe the course of the pretracheal fascia

A
  • Anterior part of neck only
  • Extends from hyoid bone to fibrous pericardium
  • Blends laterally with the carotid sheaths
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18
Q

What is enclosed by the pretracheal fascia

A
  • Larynx
  • Trachea
  • Pharynx
  • Oesophagus
  • Thyroid gland
  • Infrahyoid muscles
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19
Q

Describe the course of the carotid sheath

A
  • Extends from cranial base to root of neck
  • Blends anteriorly with the investing and pretracheal layers
  • Blends posteriorly with the preverterbral fascia
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20
Q

Contents of the carotid sheath

A
  • Carotid artery
  • IJV
  • Vagus nerve
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21
Q

Where is the retropharyngeal space

A

Lies between:

  • Visceral part of prevertebral fascia
  • Buccopharyngeal fascia surrounding the pharynx
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22
Q

To where does the retropharyngeal space open inferiorly

A

Superior mediastinum

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23
Q

Bounds of the anterior triangle

A
  • Anterior = midline of neck
  • Above = ramus of mandible
  • Behind = anterior border of SCM
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24
Q

Bounds of posterior triangle

A
  • Anterior = posterior border of SCM
  • Below = middle 1/3rd of clavicle
  • Behind = anterior margin of trapezius
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25
Q

Origins and insertion of SCM

A
  • Sternal head to manubrium
  • Superior surface of middle 1/3rd of clavicle
  • Mastoid process and superior nuchal line
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26
Q

Contents of the SCM region of the neck

A
  • SCM
  • Superior part of EJV
  • Greater auricular nerve (C2/3)
  • Transverse cervical nerve
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27
Q

Contents of the posterior cervical region

A
  • Trapezius muscle

- Cutaneous branches of posterior rami of cervical spinal nerves

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28
Q

Divisions of the posterior triangle

A
  1. Occipital triangle

2. Subclavian region

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29
Q

What divides the posterior triangle into its two divisions

A

Omohyoid muscle

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30
Q

Contents of the occipital triangle

A
  • Part of EJV
  • Accessory nerve (CN 11)
  • Trunks of brachial plexus
  • Posterior branches of cervical plexus
  • Cervicodorsal trunk
  • Cervical lymph nodes
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31
Q

Contents of subclavian region

A
  • 3rd part of subclavian artery
  • Suprascapular artery
  • Supraclavicular lymph nodes
  • Subclavian vein (sometimes)
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32
Q

Divisions of the anterior triangle

A
  1. Submandibular (digastric) triangle
  2. Submental triangle
  3. Carotid triangle
  4. Muscular triangle
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33
Q

Bounds of the submandibular triangle

A
  • Superior = inferior border of mandible
  • Anterior and posterior bellies of digastric
  • Floor = mylohyoid and hyoglossus and pharyngeal constrictor
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34
Q

Bounds of the submental triangle

A
  • Inferior = body of hyoid
  • Lateral = right and left anterior bellies of digastric
  • Floor = mylohyoid muscles which meet at the median fibrous raphe
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35
Q

Bounds of the carotid triangle

A
  • Superior belly of omohyoid
  • Posterior belly of digastric
  • SCM
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36
Q

Contents of the carotid triangle

A
  1. Carotid sinus
  2. Carotid body
  3. Carotid arteries (medially)
  4. IJV (laterally)
  5. Vagus (posterior)
  6. Ansa cervicalis
  7. Deep cervical lymph nodes
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37
Q

Contents of the submandibular triangle

A
  • Submandibular gland
  • Submandibular lymph nodes
  • Hypoglossal nerve
  • Mylohyoid nerve
  • Parts of facial artery and vein
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38
Q

Contents of submental triangle

A
  • Submental lymph nodes

- Small veins that unite to form the anterior jugular vein

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39
Q

Contents of the muscular triangle

A
  • Sternothyroid and sternohyoid muscles

- Thyroid and parathyroid glands

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40
Q

What is the carotid sinus and what is it innervated by

A
  • Dilatation of the proximal part of the internal carotid artery
  • Baroreceptor
  • Innervated by CN 9 through the carotid sinus nerve (and 10)
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41
Q

What is the carotid body

A
  • Red/brown ovoid mass in the septum of the bifurcation of common carotid (C4)
  • Supplied by carotid sinus nerve and vagus
  • Chemoreceptor (sensitive to fall in PaO2)
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42
Q

Role of the carotid body

A
  • Chemoreceptor that monitors blood oxygen levels

- Can stimulate increase in the rate and depth of respiration, cardiac rate, and BP

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43
Q

Relation of ansa cervicalis to the carotid sheath

A

Lies on or is embedded in the anterolateral sheath

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44
Q

Function of the suprahyoid muscles

A

Elevate the hyoid and pull it forward during swallowing

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45
Q

What are the strap muscles

A

Infrahyoid muscles:

  • Sternohyoid
  • Omohyoid
  • Sternythyroid
  • Thyrohyoid
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46
Q

Innervation of the strap muscles

A

Ansa cervicalis (C1-3)

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47
Q

Orientation of the cervical facet joints

A

Parallel with the vertebral plane

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48
Q

Site of surgical division of the strap muscles

A

Upper half - the ansa cervicalis enters in the lower half

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49
Q

What contains haematoma post thyroidectomy

A

Pretracheal fascia

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50
Q

List the suprahyoid muscles

A
  • Mylohyoid
  • Geniohyoid
  • Stylohyoid
  • Anterior and posterior bellies of digastric
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51
Q

Mylohyoid OIIA

A 
O = Mylohyoid line of mandible 
I = Body of hyoid 
I = Nerve to mylohyoid (branch of alveolar nerve - V3)
A = Elevates hyoid, floor of mouth and tongue
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52
Q

Geniohyoid OIIA

A 
O = inferior mental spine of mandible 
I = Body of hyoid 
I = C1 via hypoglossal 
A = Pulls hyoid anterosuperiorly
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53
Q

Stylohyoid OIIA

A 
O = Styloid process of temporal bone 
I = Body of hyoid 
I = Styloid branch of facial nerve (CN 7) 
A = Elevates and retracts hyoid
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54
Q

Anterior belly of digastric OIIA

A 
O = digastric fossa of mandible 
I = Intermediate tendon
I = Nerve to mylohyoid (branch of inferior alveolar - V3)
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55
Q

Posterior belly of digastric OIIA

A 
O = Mastoid notch of temporal bone 
I = Intermediate tendon 
I = Digastric branch of facial nerve (CN 7)
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56
Q

Sternohyoid OIIA

A 
O = manubrium and medial end of clavicle 
I = Body of hyoid 
I = Ansa cervicalis 
A = depresses hyoid
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57
Q

Omohyoid OIIA

A 
O = superior border of scapula 
I = Inferior border of hyoid 
I = Ansa cervicalis 
A = depresses and retracts hyoid
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58
Q

Sternothyroid OIIA

A 
O = posterior surface of manubrium 
I = Oblique line of thyroid cartilage 
I = Ansa cervicalis 
A = Depresses hyoid and larynx
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59
Q

Thyrohyoid OIIA

A 
O = oblique line of thyroid cartilage 
I = inferior border and body of greater horn of hyoid 
I = C1 via hypoglossal 
A = depresses hyoid and elevates larynx
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60
Q

What is Berry’s ligament

A

Connects thyroid to cricoid cartilage and trachea

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61
Q

Level of common carotid bifurcation

A

Upper border of thyroid cartilage (C3/4)

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62
Q

Orientation of IJV and vagus nerve to common carotid

A
  • IJV lateral

- Vagus posterior (between artery and vein)

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63
Q

What separates internal carotid from external carotid on its ascent through the neck

A
  • Styloid process
  • Stylopharyngeus muscle
  • Glossopharyngeal nerve
  • Pharyngeal branch of vagus
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64
Q

List the 8 branches of the external carotid artery

A
  1. Superior thyroid
  2. Lingual
  3. Facial
  4. Occipital
  5. Posterior auricular
  6. Ascending pharyngeal
  7. Maxillary (terminal)
  8. Superficial temporal (terminal)
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65
Q

Describe the course of the IJV

A
  • Formed at jugular foramen as continuation of sigmoid sinus
  • Lies behind ICA at its start
  • Moves lateral to ICA and common carotid as it descends
  • Contained within carotid sheath
  • At the root of the neck lies behind the gap between the heads of the SCM
  • Joins subclavian vein to form brachiocephalic vein
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66
Q

What surrounds the IJV on its descent

A

Deep cervical chain of lymph nodes

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67
Q

Which side is IJV cannulation typically performed on

A

Right side

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68
Q

Describe the course of the superior thyroid artery

A
  • 1st branch of ECA
  • Anterior branch
  • Runs deep to infrahyoid muscles to reach thyroid
  • Gives branches to infrahyoids, SCM, superior laryngeal artery to larynx
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69
Q

Describe the course of the lingual artery

A
  • Lies on middle pharyngeal constrictor
  • Passes deep to hypoglossal nerve, stylohyoid, posterior belly of digastric
  • Supplies posterior tongue
  • Divides into deep lingual and sublingual arteries deep to hyoglossus muscle
70
Q

Describe the course of the facial artery

A
  • Arises anteriorly from ECA
  • Gives off tonsillar and ascending palatine branches
  • Supplies submandibular gland (lies between it and the mandible)
  • Gives off submental branch to floor of mouth
  • Hooks around middle of the inferior border of the mandible to enter the face
71
Q

Describe the course of the posterior auricular artery

A
  • Posterior branch of ECA
  • Ascends between acoustic meatus and mastoid process
  • Supplies adjacent muscles, parotid gland, facial nerve, structures in the temporal bone, auricle, and scalp
72
Q

What is the only medial branch of the ECA

A

Ascending pharyngeal artery

73
Q

Describe the course of the ascending pharyngeal artery

A
  • Only medial branch of ECA
  • Ascends on the pharynx deep to the ICA
  • Sends branches to: pharynx, prevertebral muscles, middle ear, cranial meninges
74
Q

Roof of the posterior triangle

A

Investing layer of deep cervical fascia

75
Q

Floor of posterior triangle (inc 4 muscles)

A

Muscles covered by the prevertebral fascia:

  • Splenius capitis
  • Levator scapulae
  • Middle scalene
  • Posterior scalene
76
Q

Features of the occipital triangle

A
  • Occipital artery at its apex

- Crossed by the accessory nerve

77
Q

Features of the subclavian triangle

A
  • Indicated on the neck by the supraclavicular fossa
  • Inferior part of the EJV crosses the triangle superficially
  • Subclavian artery is deep to it
78
Q

List the branches of the thyrocervical trunk

A
  1. Cervicodorsal trunk (a.k.a. transverse cervical artery)
  2. Suprascapular artery
  3. Inferior thyroid artery
  4. Ascending cervical artery
79
Q

Relation of the 3rd part of subclavian artery to 1st rib and anterior scalene

A

Lies on the first rib and passes POSTERIOR to the anterior scalene

80
Q

Relation of inferior trunk of brachial plexus to 3rd part of subclavian artery

A

Lies immediately posterior

81
Q

Describe the course of the EJV

A
  • Forms near the angle of the mandible by the union of the retromandibular vein and posterior auricular vein
  • Crosses the SCM deep to platysma
  • Pierces floor of the posterior triangle (investing layer)
  • Terminates at subclavian vein
82
Q

Relation of subclavian vein to anterior scalene muscle

A

Passes ANTERIOR to anterior scalene AND phrenic nerve

83
Q

Describe the course of the brachial plexus in the neck

A
  • Appear between anterior and middle scalene
  • Five rami unite to form three trunks
  • Passes between 1st rib, clavicle, and superior bordrer of scapula to enter axilla
84
Q

Describe the course and distribution of the suprascapular nerve

A
  • Arises from the superior trunk of the brachial plexus
  • Supplies supraspinatus and infraspinatus
  • Sends articular branch to GH joint
85
Q

Describe how the cervical plexus is constructed

A
  • C1-C4
  • Each ramus (except first) divides into ascending and descending branches
  • Adjacent branches unite to form loops
86
Q

Where is the cervical plexus situated

A

Anteromedial to the levator scapulae and middle scalene and deep to SCM

87
Q

List the branches of the cervical plexus

A
  • Lesser occipital nerve (C2)
  • Great auricular nerve (C2/3)
  • Transverse cervical nerve (C2/3)
  • Supraclavicular nerves (C3/4)
  • Dorsal scapular nerve
  • Long thoracic nerve
88
Q

Distribution of lesser occipital nerve

A

Skin of the neck and scalp posterosuperior to the auricle

89
Q

Distribution of the great auricular nerve

A
  • Supplies skin over and sheath of the parotid gland
  • Mastoid process
  • Surfaces of the auricle
  • Angle of the jaw
90
Q

Distribution of long thoracic nerve

A

Supplies serratus anterior

91
Q

Distribution of dorsal scapular nerve

A

Supplies rhomboids

92
Q

Origin of the phrenic nerve

A
  • Chiefly C4

- Contributions from C3 and C5

93
Q

Risk of SCM mobilisation

A

Damage to accessory nerve

94
Q

Course of the phrenic nerve

A
  • Arises from C3/4/5
  • Forms at superior part of lateral border of anterior scalene muscle at the level of the superior border of the thyroid cartilage
  • Descends obliquely with IJV deep to the prevertebral fascia
  • LEFT - crosses anterior to first part of subclavian artery
  • RIGHT - crosses anterior to second part of subclavian artery
  • Thus runs posterior to 1st rib
95
Q

Where are the prevertebral muscles located

A

Deep to the vertebral deep cervical fascia

96
Q

Where are the anterior vertebral muscles located

A

Directly posterior to the retropharyngeal space and medial to the neurovascular plane of the cervical and brachial plexuses and subclavian artery

97
Q

List the anterior vertebral muscles

A
  • Longus coli
  • Longus capitis
  • Rectus capitis anterior
  • Anterior scalene
98
Q

List the lateral vertebral muscles

A
  • Rectus capitis lateralis
  • Splenius capitis
  • Levator scapulae
  • Middle scalene
  • Posterior scalene
99
Q

Anterior scalene OIIA

A
  • O = transverse processes of C3-6
  • I = 1st rib
  • I = cervical spinal nerves C4-6
  • A = Flexes head
100
Q

Levator scapulae OIIA

A
  • O = posterior tubercles of transverse processes C2-6
  • I = superior part of medial border of scapula
  • I = dorsal scapula nerve
  • A = downward rotation of scapula and tilts glenoid cavity inferiorly
101
Q

Middle scalene OIIA

A
  • O = posterior tubercles of transverse processes of C5-7
  • I = superior surface of 1st rib (posterior to groove for subclavian artery)
  • I = anterior rami of cervical spinal nerve
  • A = flexes neck laterally, elevates 1st rib
102
Q

Posterior scalene OIIA

A
  • O = posterior tubercles of transverse processes of C5-7
  • I = External border of 2nd rib
  • I = anterior rami of cervical spinal nerves C7/8
  • A = flexes neck laterally, elevates 2nd rib
103
Q

Where is the inferior thyroid artery derived from

A

Thyrocervical trunk (branch of subclavian)

104
Q

Where is the thyroidea ima vessels derived from

A

Brachiocephalic trunk

105
Q

Innervation of latissimus dorsi

A

Thoracodorsal nerve

106
Q

Site of the odontoid peg and orientation of transverse ligament

A

Anterior half of spinal canal with transverse ligament posterior

107
Q

Describe Sibson’s fascia

A
  • Suprapleural membrane
  • Attached to inner border of 1st rib and transverse process of C6
  • Subclavian artery, vein and brachial plexus lies on the membrane
108
Q

Function of Sibson’s fascia

A

Prevents lung and pleura rising further into the neck on inspiration

109
Q

Anterior relations of brachiocephalic trunk (muscular)

A
  • Sternohyoid

- Sternothyroid

110
Q

Where can the subclavian artery pulse be felt

A

Medial 1/3rd of the clavicle near the lateral border of SCM on deep palpation against 1st rib

111
Q

Describe the 3 divisions of the subclavian artery

A

Relative to anterior scalene:
1st = medial to muscle
2nd = posterior to muscle
3rd = lateral to muscle

112
Q

List the branches of the 1st part of the subclavian artery

A
  • Vertebral artery
  • IMA
  • Thyrocervical trunk
113
Q

List the branches of the 2nd part of the subclavian artery

A
  • Costocervical trunk
114
Q

List the branches of the 3rd part of the subclavian artery

A
  • Dorsal scapular artery
115
Q

Describe the course of the vertebral arteries

A
  • Cervical part = ascends in space between scalene and longus muscles
  • Vertebral part = ascends in tranverse foramina of C1-6
  • Suboccipital part = enters cranial cavity through FORAMEN MAGNUM
116
Q

Outline the cranial distribution of the vertebral arteries

A

Supply branches to:

  • Medulla
  • Spinal cord
  • Cerebellum
  • Dura of posterior cranial fossa
117
Q

What does the inferior thyroid artery supply

A
  • Larynx
  • Trachea
  • Oesophagus
  • Thyroid and parathyroid glands
118
Q

Describe the course of the subclavian vein in the neck

A
  • Follows course of subclavian artery BUT lies anterior to anterior scalene on 1st rib
  • Unites with IJV
119
Q

Describe the venous angle

A
  • Site of unity of IJV and subclavian vein

- Site where thoracic duct (left side) and right lymphatic trunk (right side) drain lymph into venous circulation

120
Q

Outline the course of the thoracic duct

A
  1. Commences at the cysterna chyli between abdominal aorta and right crus of diaphragm
  2. Passes up through aortic hiatus in diaphragm
  3. Ascends behind oesophagus, inclining to left at T5
  4. Arches laterally at the root of the neck to lie between carotid sheath and vertebral artery
  5. Enters left venous angle
121
Q

Outline the course of the vagus nerve in the neck

A
  1. Exits jugular foramen
  2. Descends in posterior part of carotid sheath
  3. a) Right vagus passes anterior to 1st part of subclavian and posterior to brachiocephalic vein
    b) Left vagus descends between common carotid and left subclavian and posterior to SC
  4. Recurrent laryngeal nerve arises from vagus in inferior part of neck
122
Q

Difference in course between right and left recurrent laryngeal nerves

A
  • Right = loops inferior to the right subclavian artery at T1-2
  • Left = loops inferior to arch of aorta at T4-5
123
Q

Distribution of recurrent laryngeal nerves

A

All intrinsic muscles of the larynx except cricothyroid

124
Q

Level of the hyoid

A

C3

125
Q

Level of the notch of the thyroid

A

C4

126
Q

Level of the cricoid

A

C6

127
Q

List the components of the larynx

A
  • Epiglottis
  • Thyroid cartilage
  • Cricoid cartilage
  • Arytenoid cartilage
128
Q

Purpose of the larynx

A

Voice production

129
Q

How is the epiglottis connected to the arytenoids

A

By the aryepiglottic folds

130
Q

Shape and orientation of the cricoid cartilage

A

Signet ring - band part facing anteriorly

131
Q

Attachments of the cricoid cartilage

A
  • Inferior margin of thyroid via median cricothyroid ligament
  • First tracheal ring via cricotracheal ligament
  • Arytenoid cartilages
132
Q

Describe the components of the arytenoid cartilage

A
  • Corniculate cartilage (small nodule at apex of arytenoids)
  • Cuneiform cartilage (lies at the margin of the aryepiglottic folds
133
Q

What forms the vocal ligament

A

Upper edge of the cricothyroid membrane (A.K.A. Cricothyroid ligament)

134
Q

What forms the false vocal cords

A

Vestibular fold - upper fold of mucosa passing forwards from arytenoids to back of thyroid cartilage

135
Q

What forms the vocal cord

A

Lower fold of mucosa (conus elasticus) passing forwards from arytenoids to the back of the thyroid cartilage

136
Q

What is the Rima Glottidis

A

Space between the vocal cords

137
Q

Outline the 3 compartments of the larynx

A
  1. Supraglottic (vestibule) - above the false cords
  2. Glottic - between false cords and true cords
  3. Subglottic - between true cords and first tracheal ring
138
Q

What is the piriform fossa

A

A recess on either side of the larynx where foreign bodies may lodge

139
Q

What tenses the vocal cords

A

Cricothyroid

140
Q

What abducts the vocal cords

A

Posterior cricoarytenoid

141
Q

Innervation of cricothyroid

A

External laryngeal branch of the superior laryngeal nerve

142
Q

Arterial supply of the larynx and their course

A
  • Superior and inferior laryngeal arteries (branches of the superior and inferior thyroid arteries)
  • Accompany the superior laryngeal and recurrent laryngeal nerves respectively
143
Q

Clinical effect of superior laryngeal nerve injury

A

Change in the pitch of voice through loss of innervation to the cricothyroid muscle

144
Q

Innervation of all intrinsic larynx muscle (apart from cricothyroid)

A

Recurrent laryngeal nerve

145
Q

Outline the lymphatic drainage of the larynx

A
  • Above the vocal cords = upper deep cervical nodes
  • Below the vocal cords = lower deep cervical nodes

(Vocal cords separate the drainage anteriorly but there is cross-communication posteriorly)

146
Q

To what spinal level does the pharynx extend to inferiorly

A

C6

147
Q

Outline the divisions of the pharynx

A
  1. Nasopharynx - opening anteriorly into the nasal cavities
  2. Oropharynx - opening into the oral cavity
  3. Laryngopharynx - opening into the larynx and continuing down into the oesophagus
148
Q

Contents of the nasopharynx

A
  • Nasopharyngeal tonsils (adenoids)
  • Orifice of the Eustachian tubes
  • Chonae (paired opening of the nose)
149
Q

Where is the palatine tonsil situated

A

Oropharynx

150
Q

What forms the anterior pillar of the palatoglossal arch

A

Palatoglossus muscle

151
Q

What forms the posterior pillar of the palatopharyngeal arch

A

Palatopharyngeus muscle

152
Q

What forms the capsule of the palatine tonsil

A

Pharyngobasillar fascia which lines the inner surface of the constrictor

153
Q

Platysma innervation

A

Cervical branch of facial nerve

154
Q

What nerve provides sensory innervation to the larynx

A

Laryngeal branch of vagus

155
Q

What type of tissue does the palatine tonsil consist of

A

Lymphoid tissue

156
Q

What adducts (closes) the vocal cords

A

Lateral cricoarytenoids

157
Q

Arterial supply to the palatine tonsil

A

Tonsilar branch of the facial artery which enters lower pole of tonsil

158
Q

What vein can easily bleed during tonsillectomy

A

Paratonsillar vein

159
Q

Lymphatic drainage of the palatine tonsil

A

Jugular digastric lymph node situated behind the angle of the mandible

160
Q

What does tonsillectomy involve

A

Removal of the tonsil and the fascial capsule separating it from the loose areolar tissue clothing the superior constrictor

161
Q

Limits of the laryngopharynx

A
  • Tip of the epiglottis

- Oesophagus inlet at C6

162
Q

What is the piriform fossa

A

Recess anterolateral to the inlet. Rich lymphatic supply and is a silent area for tumours that spread rapidly to the deep cervical nodes.

163
Q

Outline the mucosal types in the pharynx (Nasopharynx Vs. Remainder)

A
  • Nasopharynx = pseudostratified columnar epithelium

- Remaining = stratified squamous

164
Q

Main 3 muscles of the pharynx

A
  1. Superior constrictor
  2. Middle constrictor
  3. Inferior constrictor
165
Q

Where do the eustachian tubes enter the pharynx

A

Between upper border of superior constrictor and base of skull

166
Q

What enters the pharynx between the middle and superior constrictors

A
  • Stylopharyngeus

- Glossopharyngeal nerve

167
Q

What occupies the space between the middle and inferior constrictors

A

Thyrohyoid ligament and associated structures

168
Q

What are the two parts of the inferior constrictor

A
  1. Thyropharyngeus

2. Cricopharyngeus

169
Q

Where is the weakest point in the pharyngeal wall and what is the significance of this

A

Killan’s dehiscence = gap between thyropharyngeus and cricopharyngeus in the midline posteriorly.

Common site of pharyngeal pouches

170
Q

Motor innervation of the pharynx

A
  • Stylopharyngeus = glossopharyngeal nerve

- All remaining muscles = pharyngeal branch of the vagus nerve

171
Q

At what level does the inferior thyroid artery enter the gland

A

C6

Head and Neck (7 decks)

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