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Head And Neck > The Neck > Flashcards

The Neck Flashcards

Learn about the anatomy of the neck

1
Q

The neck is divided into two aspects, an anterior and a posterior. T/F

A

T

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2
Q

The posterior aspect of the neck consists of posterior neck muscles, the spinal cord and vertebral column and prevertebral muscles. T/F

A

F

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2
Q

The sternocleidomastoid separates between the anterior and posterior triangles of the neck. T/F

A

T

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3
Q

The investing layer of deep cervical fascia is the most superficial of all its layers. T/F

A

T

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4
Q

The external jugular vein pierces the investing layer of deep cervical fascia where?

A

It pierces this fascia close to its attachment to the clavicle between the attachments of the trapezius and sternocleidomastoid to the clavicle.

I.e in the lower part of the posterior triangle.

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5
Q

The hyoid lies at what level?

A

Above the larynx at C3 vertebra level.

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6
Q

The attachment of the investing layer of deep cervical fascia to the hyoid along its anterior part is to the?

A

Front of the hyoid body and the lateral aspect of the greater horns of the hyoid.

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7
Q

List at least two activities that occur at the level of the lower border of the C6 vertebral bone.

A
  1. The laryngotracheal junction
  2. The pharyngoesophageal junction
  3. The lower border of the cricoid cartilage
  4. The entry of the vertebral artery into the transverse foramen of the 6th cervical vertebra
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8
Q
  1. The contents of the carotid sheath are internal and common carotid arteries, internal jugular vein and vagus nerve as well as deep cervical lymph nodes.T/F
  2. The carotid sheath runs from its commencement at _____ along with its content to blend with the _____ most inferiorly.
  3. What nervous system structure lies posteromedially behind the carotid sheath within areolar tissue?
A
  1. T
  2. …the base of the skull around d margins of the carotid canal and jugular fossa. … adventitia of aortic arch
  3. Cervical sympathetic trunk
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9
Q

The platysma is superficial to the investing layer of the deep fascia of the neck.

A

T

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10
Q

What is the origin of the platysma?

A

It originates from the deep fascia over the upper part of the pectoralis major and deltoid muscles.

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11
Q

What is the platysma’s insertion?

A

It continues upward from its inferior origin to attach to the lower border of the mandible after fusing with its contralateral counterpart in the midline above the hyoid bone. Some fibres continue superiorly to the face to blend with face muscles.

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12
Q

Action of platysma

A

Facial expression and opening of mouth.

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13
Q

Describe the course of the anterior jugular veins.

A

They commence on either side of the midline beneath the chin and pass inferiorly deep to the platysma. They then pierce the anterior layer of investing fascia above the jugular notch to enter the suprasternal space, where they pass laterally btw d sternocleidomastoid and strap muscles to drain into the terminal part of external jugular veins.

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14
Q

What is the suprasternal space and what are its contents?

A

It is a space above the jugular notch formed by the investing fascia btw layers which attach respectively to the anterior and posterior borders of the jugular notch.

The space contains; the terminal part of the anterior jugular veins and the anastomosing arch btw them, the sternal heads of the sternocleidomastoids and sometimes a lymph node.

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15
Q

The lower belly of the omohyiod is held low in the neck by a fascial sling from the lower part of the deep surface of the investing fascia over the posterior triangle of the neck.T/F

A

T

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16
Q

The prevertebral fascia extends over the prevertebral muscles from the base of the skull to the blend with the anterior longitudinal ligament on the body of T4 vertebra. T/F

A

T

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17
Q

What fascia covers the surface of the muscles that form the floor of the posterior triangle of the neck?

A

The prevertebral fascia by its lateral extension.

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18
Q

The prevertebral fascia covers the cervical nerve roots (thus the cervical plexus and trunks of the brachial plexus), the third part of the subclavian artery and the subclavian vein. T/F

A

F

The subclavian vein is not included and thus the axillary vein, it’s predecessor, is outside(anterior to) the axillary sheath.

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19
Q

The accessory nerve (CN XI) lies superficial to the prevertebral fascia as well as lymph nodes in the posterior triangle of the neck.T/F

A

T

20
Q
  1. Prevertebral fascia is pierced by 5 cutaneous branches of the cervical plexus. T/F
  2. This nerves go on to pierce the roof of the posterior triangle of the neck l, emerging along the posterior border of which muscle?
A

1.F

Just 4; lesser occipital nerve, great auricular nerve, transverse cervical nerves and supraclavicular nerves

  1. Sternocleidomastoid
21
Q

Pretracheal fascia lies deep to the strap muscles. T/F

A

T

22
Q

1 The pretracheal fascia fuses with the carotid sheath laterally. T/F

  1. It encloses the thyroid gland. T/F
  2. It continues inferiorly to blend into the adventitia of the brachiocephalic vein, arch of aorta and fibrous pericardium. T/F
A
  1. T
  2. T
  3. F this is because it passes behind the brachiocephalic vein and does not blend with it.
23
Q

Pretracheal fascia could be regarded as a cervical visceral fascia. T/F

A

T

24
Q

The prevertebral fascia is posterior to the cervical sympathetic chain. T/F

A

T

25
Q
  1. What is the relationship btw the carotid sheath and the pretracheal fascia?
  2. What is the c. sheath’s relationship with the layer of fascia over the deep surface of the sternocleidomastoid?
A
  1. They fuse at the posterolateral aspect of the pretracheal fascia.
  2. The lower part of the sheath fuses with it.
26
Q

Tissue around veins usually allow for their expansion in case of increased venous return. T/F

A

T

27
Q

What is the innervation of the platysma?

A

Cervical branch of the facial nerve, afferent fibres (proprioceptive) run with the transverse cervical nerve.

28
Q

The retropharyngeal space extends from the base of the skull to the diaphragm in front of the prevertebral fascia. T/F

A

F

It is only the upper part of this space

29
Q

Retropharyngeal space communicates laterally with the parapharyngeal spaces. T/F

A

T

30
Q

In what structure is the upper part of the parapharyngeal space?

A

It is in the infratemporal fossa

31
Q

The submandibular space is?

A

Below the mylohyoid muscle and above the investing layer of deep cervical fascia.

32
Q

Submental lymph nodes are all superficial to the investing fascia below the chin. T/F

A

F

Some are superficial while others are deep to it.

33
Q

How many submental lymph nodes are there?

A

3-4 small lymph nodes

34
Q

The submental lymph nodes drain ______

A

They drain the four lower incisors teeth, gum, a wedge of tissue in the floor of the mouth across the midline, tip of the tongue and lips along the same wedge. It drains into submandibular glands.

35
Q

Describe the drainage around the submandibular lymph nodes _________

A

It drains the submental nodes, lateral parts of the lower lip, the entire upper lip, the external nose, the anterior part of the tongue, the anterior half of the nasal walls and paranasal sinuses that drain there. It drains from all the teeth except lower incisors.

36
Q

How many submandibular nodes are there?

A

6

37
Q

Submandibular lymph nodes are found on the surface of the submandibular gland and may also be embedded in it.T/F

A

T

38
Q

The apex of the posterior triangle of the neck lies on which bone marking?

A

On the superior nuchal line of the occipital bone.

39
Q

Describe the origin of the sternocleidomastoid.

A

It originates from two heads; the sternal head from front of the sternum below the jugular notch via a round tendon and the clavicular head via a flat fleshy origin along the medial third of the superior surface of the clavicle.

40
Q

What special structure is made accessible by the triangular space btw the two heads of the sternocleidomastoid for catheters or needles?

A

The lower part of the internal jugular vein.

41
Q

Describe the insertion of the sternocleidomastoid.

A

On the lateral surface of the mastoid process and the lateral half of the superior nuchal line. Since the clavicular fibres spiral behind the sternal fibres to fuse with the sternal part on its deep surface, most of the fibres inserting into the mastoid are from the clavicular head while that from the sternal head is mostly into the superior nuchal line.

42
Q

Sternocleidomastoid nerve supply?

A

Spinal part of accessory nerve(C2 & 3), proprioceptive fibres from C2 and C3.

43
Q

What is the action of sternocleidomastoid?

A

Individually, it tilts the head in the ipsilateral direction and rotates the head and face to the opposite side.

Both muscles muscles acting together flex the head. It also acts as an accessory muscle in inspiration.

44
Q

The base of the posterior triangle of the neck.

A

The middle 3rd of the clavicle

45
Q

Contents of the posterior triangle of the neck.

A

Branches of the cervical plexus, the trunks of the brachial plexus, the subclavian artery, lymph nodes, accessory nerve, transverse cervical and suprascapular vessels, lower belly of omohyoid muscle.

46
Q

The floor of the posterior triangle?

A

Covered by prevertebral fascia it usually includes; splenius, levator scapula and scalenus medius from superior to inferior.

Semispinalis capitis may be noticed in the upper part of the triangle if the splenius is low enough and the anterior scalene and 1st digitation of serratus anterior may also be seen depending on the size of the sternocleidomastoid or level of depression of the shoulder.

47
Q

Describe the relationship between the accessory nerve, sternocleidomastoid and trapezius.

A

The accessory nerve emerges from 1/3rd the way down the posterior border of the sternocleidomastoid, it then passes downwards and backwards towards the anterior border of the trapezius while adherent to the deep surface of the investing fascia over the posterior triangle. It disappears under d anterior border of the trapezius at a 1/3rd the way up this border.

48
Q

Blood supply of sternocleidomastoid

A

Occipital and superior thyroid arteries

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