Suprahyoid And Infrahyoid Neck Flashcards
(192 cards)
1
Q
Suprahyoid neck level
A
Skull base to hyoid bone, excluding orbit, sinuses and oral cavity
2
Q
Infrahyoid neck level
A
Below hyoid bone with some continuing into mediastinum
3
Q
Contents of suprahyoid neck
A
Parapharyngeal space Pharyngeal mucosal space Masticator space Parotid space Carotid space Buccal space Retropharyngeal space Perivertebral space
4
Q
Contents of infrahyoid neck
A
Visceral space, posterior cervical space, anterior cervical space,
CS, RPS, PVS
5
Q
From skull base to posterior mandibular space
A
Parapharyngeal space
6
Q
Contents of parapharyngeal space
A
Fat and pterygoid venous plexus
7
Q
Medial to parapharyngeal space and anterior to retropharyngeal space
A
Pharyngeal mucosal space
8
Q
Contents of pharyngeal mycosal space
A
Mucosa, minor salivary glands, PMS lymphatic ring, constrictor muscles
9
Q
PMS of nasopharynx
A
Torus tubarius, adenoids, superior constrictor, levator palatini muscles
10
Q
PMS of oropharynx
A
Anterior and posterior tonsillar pillars, palatine and lingual tonsils, soft palate
11
Q
Anterolateral to PPS
A
masticator space
12
Q
Contents of masticator space
A
Ramus and condyle of mandible
CNV3, masseter, medial and lateral pterygoid and temporalis musles, pterygoid venous plexus
13
Q
Fascia or masticator space
A
Superficial layer of deep cervical fascia
14
Q
Importance of masticator space
A
Perineural tumor on CNV3, sarcoma
15
Q
Lateral to PPS
A
Parotid space
16
Q
Contents of parotid space
A
Parotid gland, extracranial CN7, nodes, retromandibular vein, external carotid artery
17
Q
Posterior to PPS in SHN, lateral to VS and RPS
A
Carotid space
18
Q
Carotid space begins at
A
Inferior jugular foramen and carotid canal or skull base
19
Q
Carotid space extends inferiorly down to
A
Aortic arch
20
Q
Contents of carotid space
A
CN9-12, internal jugular vein, carotid artery
21
Q
Fascia or cervical space
A
All 3 layers of deep cervical fascia
22
Q
Posterior to PMS in suprahyoid neck and VS in infrahyoid neck
A
Retropharyngeal space
23
Q
Contents of retropharyngeal space
A
Nodes and fat in suprahyoid neck
24
Q
Retropharyngeal space begins at and ends at
A
Begins at clivus and ends at T3
25
Anterior fascia of RPS
Middle layer DCF
26
Lateral and posterior fascia of RPS
Deep layer DCF/alar fascia
27
Importance of retropharyngeal space
Inferior communication with danger space allows access to mediastinum
28
Posterior to RPS and continous inferiorly into mediastinum
Danger space
29
Behind RPS and around spine in SHN and IHN, defined by skull base above to clavicle below
Perivertebral space
30
Contents of perivertebral space
Prevertebral and paraspinal components
31
Fascia of perivertebral space
Deep layer DCF
32
Traverses visceral space
Trachea and esophagus
33
Contents of visceral space
Thyroid, parathyroid, paratracheal nodes, esophagus, trachea, recurrent laryngeal nerve
34
Fascia of visceral space
Middle layer
35
Posterior cervical space begins at and extends to
Begins at mastoid tip and extends to clavicle
36
Contents of posterior cervical space
Fat, CN11, spinal accessory nodes
37
Fascia of posterior cervical space
Between SL and DL
38
PMS mass displaced PPS
Laterally
39
MS mass displaces PPS
Posteriorly
40
PS mass displaces PPS
Medially
41
CS mass displaces PPS
Anteriorly
42
Lateral RPS nod mass displaces PPS
Anterolaterally
43
Foramen ovale contains what nerve
CNV3
44
Foramen spinosum contains
Middle meningeal artery
45
Stylomastoid foramen contains
CN7
46
Jugular foramen contains
Cranial nerves 9-11
47
“Elevator shaft” thru which infection and tumor from the adjacent neck spaces may travel from skull base to superior cornu of hyoid bone
Parapharyngeal space
48
Critical contents of parapharyngeal space
```
Fat
Minor salivary glands
Internal maxillary artery
Ascending pharyngeal artery
Pterygoid venous plexus
```
49
Attachment area of PMS posteriorly
Basisphenoid (sphenoid sinus floor)
50
Anterior attachment of PMS
Anterior basiocciput (anterior clivus)
51
Includes foramen lacerum
PMS
52
Cartilagenous floor of anterior horizontal petrous internal carotid artery which represent perivascular route for nasopharyngeal carcinoma to access intracranial structures
Foramen lacerum
53
Lymphatic ring of PMS
Waldeyer ring
54
Lateral wall of oropharynx in PMS
Palatine (faucial) tonsil
55
Base of tongue in oropharynx of PMS
Lingual tonsil
56
Tough aponeurosis that connecta superior constrictor muscle to skull base
Pharyngobasilar fascia
57
Levator palatini muscle and eustachian tube pass thru this notch on way from skull base to PMS
Sinus of Morgagni/ posterosuperior margin notch
58
PMS muscles
Superior, middle and inferior constrictor muscles
Salpingopharyngeus muscle
Levator palatini muscle, distal end
59
Cartilagenous end of eustachian tube found in PMS
Torus tubarius
60
Fascia of PMS
Middle layer of DCL
61
Contents of masticator space
Muscles of mastication, posterior body and ramus of mandible
| CNV3
62
Suprazygomatic MS contains
Belly of temporalis muscle
63
Infrazygomatic masticator space contains
Masseter, medial and lateral pterygoids, CNV3 and ramus/posterior body of mandible
64
Mandibular division of trigeminal nerve contains
```
Masticator nerve branch
Mylohyoid nerve branch
Inferior alveolar nerve branch
Lingual nerve
Auriculotemporal nerve
```
65
Fascia of masticator space
Superficial layer of DCL
66
Primary tumor of MS
Sarcoma
67
Contents of parotid space
Parotid glands, nodes, extracranial facial nerve branches
68
Deep lobe of the parotid gland projects into
Lateral parapharyngeal space
69
Vessel that is seen just behind the mandibular ramus in parotid space medially
External carotid artery
70
Vessel that is seen just behind the mandibular ramus in parotid space laterally
Retromandibular vein
71
Intraparotid facial nerve branches course just lateral to what vessel
Retromandibular vein
72
Widening of stylomandibular gap indicates the lesion is in what space
Parotid space
73
Parotid glands appear more fatty in adult or pedia?
Adult
74
Contents of carotid space
Carotid arteries, internal jugular veins, cranial nerves 9-12
75
Lower limit of carotid space
Aortic arch
76
Sympathetic plexus is in between
Medial CS and lateral RPS
77
Carotid sheath incomplete or less substantial
Suprahyoid carotid space
78
Carotid sheath is well-defined, tenacious fascia
Infrahyoid carotid space
79
Midline space just posterior to pharynx and cervical esophagus
Retropharyngeal space
80
RPS runs from skull base down to what vertebral level
T3
81
RPS nodes are only found in suprahyoid or infrahyoid neck?
Suprahyoid
82
Posterior to RPS
Danger space
83
Lateral to RPS
Carotid space
84
RPS empties into fascial door trap into what space inferiorly at T3 level
Danger space
85
Lateral group of RPS lymph nodes also called
Nodes of Rouviere
86
Anterior to RPS
PMS
87
Perivertebral space extends from skull base above to what vertebral level
T4 in posterior mediastinum
88
Prevertebral muscles
Longus colli and capitis
89
Brachial plexus
C5 to T1
90
Brachial plexus pass between what muscles of PVS
anterior and middle scalene
91
Called “the carpet”
Anterior deep layer of DCF
92
Prevertebral PVS contains
Proximal brachial plexus, phrenic nerve, vertebral arteries
93
Two major components of PVS
Prevertebral and paraspinal
94
Most PVS lesions originate in
Vertebral body (infection or metastasis)
95
Path of least resistance of spreading pus or tumor is deep through
Neural foramen into epidural space
96
Posterolateral fat-containing space in the neck with complex fascial boundaries
Posterior cervical space
97
Posterior cervical space extends from
Posterior mastoid tip to clavicle
98
Lesions from posterior cervical space typically arise from
Spinal accessory nodal chain
99
Appears as “tilting tent” when viewed on the side
Posterior cervical space
100
Primary component of posterior cervical space
Fat
101
Critical contents of posterior cervical space
```
Fat
Accessory nerve (CN11)
Spinal accessory lymph node chain (level 5A and 5B)
Pre-axillary brachial plexus
Dorsal scapular nerve
```
102
Region of cervical neck posterolateral to sternomastoid muscle and anteromedial to trapezius muscle
Posterior triangle
103
Posterior triangle is subdivided by
Inferior belly of omohyoid (into occipital and subclavian triangles)
104
Two triangles in posterior cervical space
Occipital triangle and subclavian triangle
105
Majority of posterior cervical space is what triangle
Occipital triangle
106
Most commonly injured during neck dissection for malignant sCCa nodes
CN11
107
Midline infrahyoid neck space enclosed by middle layer DCF
Visceral space
108
Visceral space extends from
Hyoid bone above to superior mediastinum below
109
Contents of visceral space
Larynx, trachea, hypopharynx, esophagus, thyroid and parathyroid glands
110
Largest space of infrahyoid neck
Visceral space
111
Less reliable location of parathyroid glands, superior or inferior?
Inferior
112
Inferior parathyroid glands may be normally found in
Cervicothoracic junction or superior mediastinum
113
Left recurrent laryngeal nerve recurs at
Level of arch where it passes through the aortopulmonic window
114
Right recurrent laryngeal nerve recurs in
Most inferior infrahyoid neck around right subclavian artery
115
Visceral lymph nodes is what level
Level VI
116
First order of drainage for thyroid malignancy
Paratracheal lymph nodes (level VI)
117
Also referred to as visceral fascia
Middle layer DCF
118
Mass centered between thyroid love anteriorly and longus colli muscle posteriorly
Parathyroid (tracheoesophageal groove) mass lesion
119
Caudal continuation of pharyngeal mucosal space, between oropharynx and esophagus
Hypopharynx
120
Junction of upper and lower airway
Larynx
121
Hypopharynx extends from level of glossoepiglottic and pharyngoepiglottic folds superiorly to
Inferior cricoid cartilage (cricopharyngeus muscle)
122
Hypopharynx: oropharynx above, ____________ below
Esophagus
123
Larynx: oropharynx above, ___________ below
Trachea
124
3 regions of hypopharynx
Pyriform sinus
Posterior wall
Post-cricoid region
125
Anterolateral recess of hypopharynx, between inner surface of thyrohyoid membrane above, thyroid cartilage below and lateral aryepiglottic fold
Pyriform sinus
126
Anterior wall of lower hypopharynx
Post-cricoid region
127
Provides all motor and most sensory to hypopharynx
Pharyngeal plexus (CN9-10)
128
Laryngeal cartilages
Thyroid, cricoid, arytenoid, corniculate
129
Largest laryngeal cartilage
Thyroid cartilage
130
Only complete ring in endolarynx, provides structural integrity
Cricoid cartilage
131
Paired pyramidal cartilages that sit atop posterior cricoid cartilage
Arytenoid cartilage
132
Rests on top of superior process of arytenoid cartilage, within AE folds
Corniculate cartilage
133
Extends from tip of epiglottis above to laryngeal ventricle below
Supraglottis
134
Leaf-shaped cartilage, larynx lid with free margin and fixed portion
Epiglottis
135
Free margin of epiglottis is at
Suprahyoid
136
Fixed portion of epiglottis
Infrahyoid
137
Fat-filled space between hyoid bone anteriorly and epiglottis posteriorly
Pre-epiglottic space
138
Projects from cephalad tip of arytenoid cartilages to inferolateral margin of epiglottis
Aryepiglottic fold
139
Mucosal surfaces of laryngeal vestibule of supraglottis
False vocal cords
140
Paired fatty regions beneath fals and true vical cords
Paraglottic spaces
141
Contains true vocal cords and anterior and posterior commisures
Glottis
142
Only soft tissue structures of glottic region, comprised of thyroarytenoid muscle
True vocal cord
143
Fibroelastic membrane extends from medial margin of TVC above to cricoid below
Conus elasticus
144
Fibrous membrane extends from upper arytenoid and corniculate cartilages to lateral margin epiglottis and medial margin of paraglottic space
Quadrangular membrane
145
Formed from primitice buccopharyngeal anlage and has rich lymphatics
Supraglottic larynx
146
Forms from tracheobronchial buds and has few lymphatics
Glottic and subglottic larynx
147
Pyramidal lobe of thyroid gland can be seen from
Isthmus area toward hyoid bone
148
Thyroid glands extends from C5 to
T1
149
Arterial supply to thyroid gland
Superior thyroid arteries, inferior thyroid arteries, thyroidea ima
150
1st anterior branch of external carotid artery
Superior thyroid artery
151
Arises from thyrocervical trunk, a branch of subclavian artery
Inferior thyroid artery
152
Runs superficially on anterior border of lateral thyroid lobe, with its proximal course closely associated with superior laryngeal nerve
Superior thyroid arteries
153
Most of its branches penetrate posterior aspect of lateral thyroid lobe with close association with recurrent laryngeal nerve
Inferior thyroid artery
154
Single vessel originating from aortic arch or innominate artery, which enters the thyroid gland at inferior border of isthmus
Thyroidea ima
155
Venous drainage of thyroid gland
Superior, middle and inferior thyroid veins
156
Superior and middle thyroid veins drain into
Internal jugular vein
157
Inferior thyroid vein drain into
Left brachiocephalic vein
158
Lymphatic drainage of thyroid gland
Level 6
159
Fascia or thyroid gland
Middle later DCF and true capsule
160
First endocrine gland to develop
Thyroid gland
161
Thyroid gland originates as proliferation of endodermal epithelial cells on median surface of developing pharyngeal floor termed
Foramen cecum
162
Most common location of ectopic thyroid gland
Deep to foramen cecum in tongue base= lingual thyroid
163
Posterior visceral space endocrine glands that control calcium metabolism by producing parathormone
Parathyroid gland
164
Superior parathyroid gland normal locations
Posterior border of middle 1/3 of thyroid (75%)
165
Inferior parathyroid gland normal locations
Lateral to lower pole of thyroid gland (50%)
166
Arterial supply of parathyroid gland
Superior thyroid artery and inferior thyroid artery
167
Fascia of parathyroid gland
Middle DCF
168
Superior parathyroid gland develops from
4th branchial pouch
169
Inferior parathyroid gland develops from
3rd branchial pouch
170
Most frequent ectopic site of parathyroid gland
Just below inferior thyroid pole
171
Trachea extends in midline from inferior larynx at what vertebral body level to what level
C6 to T5 (carina)
172
Tracheal length
10-13 cm
173
Length of esophagus and extent
25 cm
| From C6 to T11
174
Broadest of all tracheal cartilage
First tracheal cartilage
175
Blood supply of trachea
Inferior thyroid artery and vein
176
Upper limit of esophagus
Cricopharyngeus muscle
177
Blood supply of esophagus
Inferior thyroid artery and vein
178
Sentinel or highest node found at apex of internal jugular chain at angle of mandible
Jugulodigastric node
179
Node found at bottom of internal jugular chain in supraclaviculsr fossa
“Signal” Virchow node
180
Level IA nodes, found between anterior bellis of digastric muscles
Submental
181
Level IB nodes, found around submandibular glands in submandibular space
Submandibular nodes
182
Level 2 nodes from posterior belly of digastric muscle to hyoid bone
Upper internal jugular chain
183
Contains the jugulodigastric nodal group
Level 2A
184
Level 3 nodes from hyoid bone to inferior margin of cricoid
Mid IJC nodes
185
Level 4 nodes from inferior cricoid margin to clavicle
Lower internal jugular chain
186
Nodes of posterior cervical space or spinal accessory chain
Level 5
187
Level 5A nodes are from skull base to
Bottom of cricoid cartilage
188
Nodes of visceral space
Level 6
189
Superior mediastinal nodes
Level 7
190
Parotid nodal group drain into
Level 2
191
Retropharyngeal nodal group recieve drainage from
Posterior pharynx
192
Final commin pathway for all lymphatics of upper aerodigestive tract and neck
Internal jugular chains
