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Neuro > Superficial Triangles and Cervical Viscera, Blood Vessels and Lymphatics > Flashcards

Superficial Triangles and Cervical Viscera, Blood Vessels and Lymphatics Flashcards

1
Q

Falls off ladder, fractures dens

A

Odontoid type 3 fracture

Impinges spinal cord

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2
Q

Hangman’s fracture

A

Through pars interarticularis

Impinge spinal cord above C3-5

SO, can’t breathe

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3
Q

3 landmarks in the neck

A

Greater cornu of hyoid bone

C6

Anterior scalene muscle

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4
Q

Greater cornu of hyoid bone:

Relevant to what?

A

Right above laryngeal prominence
The key landmark of the upper neck

Branches off of ECA

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5
Q

C6: relevant to what?

A

Verterbal artery enters the C6 TP first

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6
Q

Anterior scalene muscle relationships

A

Anterior - phrenic n, subclavian v, suprascapular a, transverse cervical a, EJV

Posterior - brachial plexus, subclavian a

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7
Q

Layer 1 dissection

A

Platysma(CN7), EJV

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8
Q

Layer 2 dissection

A

SCM

Spinal accessory n.

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9
Q

Layer 3 dissection

A

Ansa cervicalis

Superior and inferior omohyoid mm.

Sternohyoid, sternothyroid, thyrohyoid

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10
Q

Relate carotid sheath to SCM

A

Sheath is medial to SCM

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11
Q

3 things commonly removed in radical neck dissection

A

SCM
Spinal accessory
IJV (for lymph nodes)

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12
Q

Carotid sheath

A

IJV
Common carotid
Vagus

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13
Q

Contents of lateral region of neck

A

EJV
Spinal accessory (along floor)
Superficial cervical plexus
Thoracic duct (left side)

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14
Q

Branchial fistulas of first branchial arch

A

Eustachian tube and middle ear cavity

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15
Q

Branchial fistulas typically are where?

A

Along SCM

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16
Q

Level of thyroid gland

A

Tracheal rings 2-4

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17
Q

Pyramidal lobe of thyroid gland

A

Remnant of thyroglossal duct

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18
Q

Cysts along migration path of thyroid from floor of mouth

A

Remnants of thyroglossal duct

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19
Q

Injury to the midline of the clavicle can cause what?

Why?

A

Pneumothorax

Cupula of pleura projects 1 inch above midline of clavicle

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20
Q

Borders of submandibular triangle

A

SCM
Mandible
Sternohyoid

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21
Q

Contents of submandibular triangle (10)

A 
Digastric mm.
Facial a. and v.
Marginal br. of VII
IJV
Spinal accessory n.
Superior root of ansa
Submandibular gland
Superior omohyoid
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22
Q

Innervation of digastric mm

A

Anterior digastric = nerve to mylohyoid

Posterior digastric = facial nerve

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23
Q

In general, sympathetic post-ganglionic nerve fibers run where?

Post-ganglionic fibers for the salivary glands?

A

W/in tunica adventitia of nearby arteries

Facial plexus (facial artery)

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24
Q

2 things to look for when doing a cricothyrotomy

A

Pyramidal lobe of thyroid

Vocal folds (don’t point scissors up)

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25
Q

Remnant of thyroglossal duct on tongue

Where is it?

A

Foramen cecum

Between ant. 2/3 and post. 1/3

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26
Q

Dysphonia after surgery is evidence of what?

What surgery?

A

Cut RLN - paralyzed vocal fold

Thyroidectomy

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27
Q

Tetany after surgery is evidence of what?

What surgery?

A

Removal of PT glands

Thyroidectomy

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28
Q

If the RLN is cut, what else could potentially be cut?

Where are they seen?

A

Inferior thyroid a.

Medial to the thyroid

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29
Q

Terminal name of the RLN

When?

A

Inferior thyroid n.

After it enters the thyrohyoid membrane - under the inferior constrictor muscle

30
Q

Lymphatic drainage of thyroid

A

Deep cervical lymph nodes

31
Q

When is a hemithyroidectomy not enough?

Why?

A

With papillary carcinoma

Can spread across isthmus to other lobe, AND will still drain to deep cervical lymph nodes

32
Q

Papillary carcinoma often presents with ____

A

Palpable thyroid mass

33
Q

Vertebral aa. and basilar a. supply what parts of the brain?

A

Brainstem
Cerebellum
Occipital lobe

34
Q

First branch of subclavian a.

Second branch of subclavian a.

A

Vertebral a. (suppy 20% of brain)

Thyrocervical trunk

35
Q

ICAs supply what parts of the brain?

A

Hemispheres (except occipital lobe)

Upper brainstem

36
Q

Cerebral blood flow autoregulation

Dangers?

A

Shunting of blood flow from one region to another to try to perfuse underperfused areas

Hyperperfusion, cerebral edema

37
Q

Cerebral edema cause and effect

A

Small arterioles leak fluid into extracellular space in brain

Neuron/glial malformation

Cell death, ischemic infarct

38
Q

What must be true to avoid cerebral edema?

A

Input = output

39
Q

Subclavian steal syndrome

A

Obstruction of proximal portion of subclavian a.

Demand for blood in UE –> shunt blood OUT of vertebral a. (going down)

Causes vertebro-basilar insufficiency

40
Q

Vertebro-basilar insufficiency symptoms

A

Dizziness
Cranial n. dysfunction
Paralysis
Loss of consciousness

41
Q

Branches of Circle of Willis from ICAs (internal carotid artery)

A

ACA (ACoA)- Anterior cerebral
MCA-middle cerebral
Ant. choroidal a.

42
Q

Branches of Circle of Willis from vertebral aa.

A

Anterior spinal a.
Posterior spinal a.
PICA

43
Q

Branches of Circle of Willis from Basilar a.

A

AICA
PCA
Sup. cerebellar a.

44
Q

How often will branches of the Circle of Willis vary?

A

1/6 of the time

Off next available artery

45
Q

First branch of the ECA

Why important?

A

Superior thyroid a.

Superior laryngeal a.

46
Q

Superior laryngeal a.

A

Runs with ibSLN into thyrohyoid membrane

47
Q

Maxillary artery passes through what part of skull?

Into where?

A

Ptergomaxillary fissure

Ptergopalatine fossa

48
Q

Terminal branch of maxillary a.

Importance?

A

Sphenopalatine a.

Supplies posterior 2/3 of nasal cavity

49
Q

Locations of IJV bulbs (and valves?)

Which is clinical? Why?

A

Superior bulb - base of skull- no valve
Inferior bulb - just above SC joint (valve)

Inferior - look for lymph nodes on ultrasound

50
Q

IJV is continuous with what superiorly?

A

Dural sinuses

51
Q

IJV drains what?

A

Dural venous sinuses

Thyroid gland

Facial vein

Lingual vein

52
Q

Ways of causing cerebral edema

A

Impairing arterial OR venous sides of cerebral blood flow

53
Q

Main important vein of face

Continuous with what superiorly?

A

Retromandibular vein

Superficial temporal vein

54
Q

Pterygoid plexus

Blood ends up where?

A

Veins draining side of face between facial v. and retromandibular v.

Eventually into IJV or brachiocephalic v.

55
Q

2 groups of deep cervical LNs

A

Jugulodigastric (superior)

Jugulo-omohyoid (inferior)

56
Q

Spinal accessory Nerve (XI)-position and contributions

A

Spinal accessory Nerve (XI)
Enters above SCM, Moves diagonally across Levator scapulae
Contributions from C2-3 for SCM. C3-4 for Trapezius

57
Q

Lesser occipital nerve root and course

A

(C2-3) courses supero-posteriorly along the posterior border of the SCM, and supplies GSA fibers to the postero- lateral aspect of the head.

58
Q

Greater auricular nerve root and course

A

ascends vertically across the SCM to innervate the skin of the parotid and mastoid regions.

59
Q

Transverse cervical nerve root and course

A

(C2-3)
is also called the transverse colli nerve or the anterior cutaneous nerve of the neck. It crosses the SCM at its midpoint, and innervates the skin of the anterior neck.

60
Q

Supraclavicular nerve root and course

A

(C3-4); are divided into medial, intermediate, & lateral branches that descend in the posterior triangle, and cross superficial to the clavicle. These branches innervate the skin of the upper chest and shoulders.

61
Q

Order for NAV around ant scalene m

A

VNM ANM

Subclavian v, phrenic n, ant scalene m, subclavian a, brachial plexus, middle scalene

62
Q

superior savlivatory nucleus sends preganglionic fibers to ___

A

submandibular ganglion

63
Q

postganglionic PS axons from submandibular ganglion will innervate ___

A

submandibular and sublingual salivary glands

64
Q

Postganglionic sympathetic neurons are clustered where. These fibers radiate from ___ to ___

A

cervical sympathetic ganglion. Radiate from sympathetic ganglia to form external carotid plexus embdded in tunica adventitia.

65
Q

Facial plexus on facial arter distributes

A

postganglionic sympathetic fibers to submandibular and sublingual salivary glands.

66
Q

5 branches of thyrocervical trunk

A

Inferior thyroid-Cross ant scalene behind carotid sheath
Ascending cervical-W phrenic n
Inferior laryngeal-with recurrent laryngeal n
Suprascapular-Crosses ant scalene muscle, subclavian artery and branchial plexus
Transverse cervical-Runs parallel and superior to suprascapular artery (Often 1st branch off transverse cervical artery )

67
Q

costocervical trunk branches from

A

1st part from L subclavian

2nd part from R subclavian

68
Q

Dorsal scapular aries from___ and path

A

May arise from 2nd or 3rd part of subclavian
Runs anterior to rhomboid mm.
50% of the time will branch from transverse cervical a

69
Q

Right common carotid origin and termination

A

Origin: Bifurcation of brachiocephalic trunk, Posterior to R sternoclavicular joint
Termination: Bifurcate just below hyoid into internal and external carotid arteries

70
Q

left common carotid origin and course

A

Origin: apex of aortic arch and Passes through superior mediastinum to enter neck posterior to left sternoclavicular joint

71
Q

branches of external carotid

A

Superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular, superficial temporal, maxillary(back 2/3 of nasal cavity and infratemporal fossa)

72
Q

pericervical lymph nodes

A

P BOSS

parotid, buccal, occipital, submandibular, submental

Neuro (4 decks)

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