Surface anatomy of the neck

Question 1

Name the columns of the neck with their fascia

Answer 1

1 - Neuro-muscular skeletal column with prevertebral fascia.
2- Visceral column with pretracheal and buccopharyngeal fascia.
3 - Carotid neurovascular bundle with carotid sheath

Question 2

what is the most superficial of the deep fascia?

Answer 2

investing fascia

Question 3

what does the pretrachael fascia become?

Answer 3

buccopharyngeal fascia

Question 4

Name the fascial layers

Answer 4

1. Investing/superficial fascia.
2. Pretracheal fascia.
3. Carotid sheath.
4. Prevertebral fascia

Question 5

What potential space allows for the movement of pharynx, larynx, trachea and oesophagus? Where does it extend too?

Answer 5

Retropharyngeal space, this permits movement for swallowing. It extends from the base of the skull to the diaphragm via the posterior mediastinum.
it allows the columns to move against each other.

Question 6

What fascia further divides the retropharyngeal space and what is this space called and its clinical significance?

Answer 6

The alar fascia, forming the Danger space which is a major pathway for spread of infection (extends between the carotid sweats) creating a danger space and a true retropharyngeal space.

Question 7

What is the clinical significance of dental abscesses?

Answer 7

It can spread mediastinum

Question 8

where are potential spaces for infection in the neck?

Answer 8

• true retropharyngeal space (permits movement during swelling of the pharynx, oesophagus, trachea and larynx)
• danger space (major pathway for the spread of infection tot eh mediastinum)

Question 9

Name the boarders of the anterior triangle?

Answer 9

Superiorly - inferior boarder of mandible,
Laterally - anterior boarder of sternocleidomastoid,
Medially - Sagittal line down the midline of the neck

Question 10

Name the boarders of the Posterior triangle

Answer 10

Anterior - posterior boarder of sternocleidomastoid,
Posterior - anterior boarder of trapezius muscle,
Inferior - Middle 1/3 of clavicle

Question 11

What is the clinical relevance of the triangles of the neck?

Answer 11

It can help give clues for the reasons of neck lumps, along with other signs like; Tenderness, heat, size, pulsatile, solitary/multiple and is they move when swallowing or sticking out tounge.

Question 12

Where is the mastoid landmark?

Answer 12

It is the boney prominence directly behind the ear.

Question 13

what are the bony landmarks of the skull?

Answer 13

• transverse process of C1
• angle of mandible
• mastoid process
• styloid process

Question 14

Where can you palpate the position of the transverse process of Atlas?

Answer 14

It is midway between the mastoid and angel of the mandible

Question 15

Where is the Hyoid bone?

Answer 15

Superior to thyroid cartilage, it is suspended in the muscles of the neck.

Question 16

What does the thyroid cartilage articulate with?

Answer 16

The cricoid cartilage, this allows for rotation and gliding of thyroid cartilage and change in length of vocal cords.

Question 17

Anteriorly, what is the brachiocephalic trunk covered by?

Answer 17

Sternohyoid and sternothryroid muscles.

Question 18

where will the brachiocephalic trunk pass superolaterallly too?

Answer 18

• to the right and divides into the right common carotid and right subclavian
• posterior to the strenoclavicular joint

Question 19

Name the three parts of the subclavian artery and its branches

Answer 19

1st part has 3 branches (vertebral artery, thyrocervical trunk and internal thoracic artery).
2nd part has 1 branch (costocervical trunk) and the 3rd part has 1 branch (dorsal scapular artery)

Question 20

Where does the common carotid artery bifurcate and what does it turn into?

Answer 20

Bifurcation at the level of the superior thyroid cartilage and turns into the internal and external carotid artery. C3

Question 21

Where is the location of the carotid body and sinus and what is its nerve innervation

Answer 21

Found at bifurcation of common carotid artery. Innervated by afferent glossopharyngeal and its branch carotid sinus nerve
- efferent vagus nerve

Question 22

WHAT is the common carotid artery covered by?

Answer 22

• proximmaly= muscles
• distally exposed allowing palpitation for pulse
• normally internal carotid artery

Question 23

What are the functions of the carotid sinus and carotid body?

Answer 23

Sinus - Has baroreceptors which react to changes in arterial blood pressure. Carotid body has chemoreceptors that monitor the partial pressure of CO2

Question 24

What does the internal carotid artery supply?

Answer 24

Intercrainal structures

Question 25

1- where does the carotid artery bifurcate? 2- into what 3- why is it never palpable bilaterally?

Answer 25

1 - level of the superior border of the thyroid gland into: 2 - external carotid artery - internal carotid artery 3- it is never palpable laterally because there are baroreceptors which detect changes in blood pressure artificially increasing the blood pressure = bad because the body will decrease heart rate and therefore blood pressure.

Question 26

What does the carotid sheath surround?

Answer 26

Internal jugular vein internal carotid artery vagus nerve

Question 27

What are the branches of the external carotid artery

Answer 27

(Some Anatomist Like Freaking Out Poor Medical Students) - Superior Thyroid a. - Ascending pharyngeal a. - Lingual a. - Facial a. - Occipital a. - Posterior auricular a. - Maxillary a. - Superficial temporal a.

Question 28

What are the facial veins?

Answer 28

Superficial and deep veins

Question 29

What are the cranial veins?

Answer 29

Cerebral veins Dural venous sinuses Diplopic veins Emissary veins

Question 30

What are the cervical veins?

Answer 30

External jugular veins anterior jugular veins vertebral veins

Question 31

What are the cranial veins drained by?

Answer 31

Dural venous sinus

Question 32

What is the most common vein use for Central Venous Catheterisation? and what are the complications of CVC?

Answer 32

Most commonly used is IJV. Some of the complications are pneumothorax, puncture the subclavian artery and nerve injury

Question 33

What is the EJV route?

Answer 33

Crosses SCM, deep to platysma and enters the anterio-inferior part of posterior triangle. Finally it terminates as subclavian vein

Question 34

Where does the anterior jugular vein drain into? What will it join with?

Answer 34

It drains into external jugular or subclavian veins. Both anterior jugular veins join at the jugular venous arch.

Question 35

What is Erb's point, the nerves here and the clinical relevance

Answer 35

This is the point at which the -Lesser occipital nerve - the Great auricular nerve - transverse cervical nerve - supraclavicular nerve become superficial. Local anaesthetics can be injected here to numb a large area.

Question 36

what does the internal jugular vein drain?

Answer 36

drains the intracranial structure, superficial parts of the face and neck.

Question 37

what is within the carotid sheath

Answer 37

vagus and internal carotid artery

Question 38

where is the jugular venous pulse wave visible?

Answer 38

along the trajectory of the internal jugular vein.

Question 39

where does the internal jugular vein lie?

Answer 39

initially posterior to the internal carotid artery, moves laterally then anterior to the common carotid.

Question 40

for central venous asess, where do you want to stab?

Answer 40

internal jugular vein measuring the venous pressure

Question 41

what is a normal central venous pressure?

Answer 41

<8cm H20

Question 42

WHAT ARE COMPLICATIONS OF THE CENTRAL Venus access?

Answer 42

- pneumothorax - puncture of subclavian artery - nerve injury

Question 43

describe the position of the external jugular vein and what is it formed by?

Answer 43

- descends the angle of the mandible to the middle of the clavicle - formed by posterior division of the retromandibular vein and posterior auricular vein

Question 44

describe the position and drainage of the anterior jugular vein?

Answer 44

- inferior to the hyoid bone - drains into external jugular or subclavian veins. - anterior jugular veins of both sides join to become the jugular venous arch.

Question 45

describe the nerves in the neck?

Answer 45

- there are cuteness branches of the cervical plexus - erbs points (4 cutaneous branches) - accessory nerve

Question 46

describe the accessory nerve in the neck?

Answer 46

- motor control of trapezius and SCM - passes across the posterior triangle

Question 47

what is the lymphatic system like in face and scalp?

Answer 47

there's no lymph nodes in the face and scalp. - the lymph drains into the superficial cerviacal (alongside external jugular) and deep cervical (alongside the internal jugular)

Question 48

what is the dural venous sinus made from?

Answer 48

- superior sagital sinus - inferior sagital sinus - sinus rectus - sigmoid sinus THEY WILL ALL BECOME THE INTERNAL JUGULAR VEIN.

Question 49

at what level does the common carotid bifurcate?

Answer 49

- C3 - level of the superior border of the thyroid cartilage