THE NECK 1.1 (AB) Flashcards
(122 cards)
1
Q
What are the two major triangles of the neck?
A
Anterior Triangle. Posterior Triangle
2
Q
What are the subdivisions of the anterior triangle of the neck?
A
Submandibular. Submental. Carotid. Muscular
3
Q
What are the subdivisions of the posterior triangle of the neck?
A
Occipital. Supraclavicular
4
Q
Is the submental triangle paired or unpaired?
A
Unpaired
5
Q
What are the borders of the submental triangle?
A
Anterior belly of digastric. Hyoid
6
Q
What does the submental triangle contain?
A
Lymph nodes
7
Q
What are the borders of the submandibular triangle?
A
Mandible. Anterior and posterior bellies of digastric
8
Q
What are the contents of the submandibular triangle?
A
Submandibular gland. Facial artery. Facial vein
9
Q
What are the borders of the carotid triangle?
A
SCM. Omohyoid (superior belly). Posterior belly of digastric
10
Q
What are the contents of the carotid triangle?
A
Common carotid artery. Internal jugular vein. Vagus nerve. Sympathetic trunk. Hypoglossal nerve
11
Q
What are the borders of the muscular triangle?
A
SCM. Superior belly of omohyoid. Hyoid. Midline neck
12
Q
What are the contents of the muscular triangle?
A
Infrahyoid muscles. Thyroid glands. Parathyroid glands
13
Q
What are the borders of the occipital triangle?
A
Omohyoid (inferior belly). Trapezius. SCM
14
Q
What are the contents of the occipital triangle?
A
Accessory nerve. Brachial plexus. Lymph nodes
15
Q
What are the borders of the supraclavicular triangle?
A
Clavicle. Omohyoid (inferior belly). SCM
16
Q
What are the contents of the supraclavicular triangle?
A
Subclavian artery. Subclavian vein. Lymph nodes
17
Q
What are the layers of the neck from superficial to deep?
A
Skin. Subcutaneous Fat. Superficial Cervical Fascia. Platysma. Superficial Layer of Deep Cervical Fascia. SCM and Trapezius. Middle Layer of Deep Cervical Fascia. Strap muscles. Thyroid. Parathyroid. Trachea. Larynx. Esophagus. Deep Layer of Cervical Fascia
18
Q
What does the superficial cervical fascia envelop?
A
Platysma. Muscles of facial expression
19
Q
What structures does the investing layer of deep cervical fascia envelop?
A
Trapezius. SCM. Muscles of mastication. Parotid glands. Submandibular glands
20
Q
What ligament does the investing fascia form?
A
Stylomandibular ligament
21
Q
What does the muscular division of the visceral layer of deep cervical fascia surround?
A
Strap muscles
22
Q
What does the visceral division of the visceral layer of deep cervical fascia surround?
A
Buccinator. Pharyngeal constrictors. Larynx. Trachea. Esophagus. Thyroid. Parathyroid
23
Q
What fascia does the visceral division form?
A
Pretracheal fascia
24
Q
What does the prevertebral fascia envelop?
A
Paraspinous muscles. Cervical vertebrae. Scalene muscles
25
What does the prevertebral fascia form?
Floor of the posterior triangle
26
What space is between the buccopharyngeal fascia and alar fascia?
Retropharyngeal space
27
What space is between the alar fascia and prevertebral fascia?
Danger space
28
What space is behind the prevertebral fascia?
Prevertebral space
29
Why are deep neck spaces clinically important?
They are potential locations for abscess or infection. Infection can spread to the coccyx
30
What is the function of platysma?
Depresses the mandible and angle of the mouth
31
Why must the platysma be sutured in neck lacerations?
Its tone can pull scar tissue and cause a gaping scar
32
What is the origin and insertion of the sternocleidomastoid?
Sternum. Clavicle. Mastoid process
33
What happens when both SCM muscles contract?
Extension of head. Flexion of neck
34
What happens when one SCM muscle contracts?
Rotation of the head to the opposite side
35
What muscles elevate the hyoid?
Digastric. Mylohyoid. Geniohyoid. Stylohyoid
36
What muscles depress the hyoid?
Thyrohyoid. Omohyoid. Sternohyoid. Sternothyroid
37
What causes congenital torticollis?
Excessive stretching of SCM during difficult labor
38
What is the result of hemorrhage in SCM during birth?
Fibrosis and contraction of SCM
39
What is the head position in congenital torticollis?
Mastoid pulled toward sternoclavicular joint on same side. Face turns to opposite side
40
What causes spasmodic torticollis?
Chronic SCM and trapezius contractions. Idiopathic. Often psychogenic
41
What are the symptoms of spasmodic torticollis?
Dystonic neck movement. Neck pain. Head tremors
42
What is the treatment for spasmodic torticollis?
Botulinum Toxin A
43
What are the branches of the external carotid artery?
Superior thyroid. Ascending pharyngeal. Lingual. Facial. Occipital. Posterior auricular. Maxillary. Superficial temporal
44
What are the parts of the internal carotid artery?
Cervical. Petrous. Cavernous. Cerebral
45
What is the origin of the recurrent laryngeal nerve?
Branch of vagus nerve
46
Where does the right recurrent laryngeal nerve loop?
Subclavian artery
47
Where does the left recurrent laryngeal nerve loop?
Aortic arch
48
Where do the recurrent laryngeal nerves enter the larynx?
Lower border of the inferior constrictor muscle
49
Where is cervical lymph node level IA located?
Submental. Between mandible and hyoid. Between digastric bellies
50
What does cervical lymph node level IA drain?
Anterior oral cavity. Lower lip
51
Where is cervical lymph node level IB located?
Submandibular. Bounded by submandibular gland. Mandible. Digastric muscles
52
What does cervical lymph node level IB drain?
Oral cavity. Lip. Cheek. Nose. Skin of lip. Nose. Medial canthus
53
Where is cervical lymph node level III located?
Middle jugular. Deep to SCM. From hyoid to cricoid cartilage
54
What does cervical lymph node level III drain?
Oropharynx. Larynx. Hypopharynx. Thyroid
55
Where is cervical lymph node level IV located?
Inferior jugular. Deep to SCM. From cricoid to 2 cm above sternoclavicular joint
56
What does cervical lymph node level IV drain?
Larynx. Hypopharynx. Thyroid. Cervical esophagus. Trachea
57
Where is cervical lymph node level V located?
Posterior cervical triangle. Between trapezius and SCM. From hyoid to transverse cervical vessels
58
What does cervical lymph node level V drain?
Nasopharynx. Posterior neck skin. Scalp. Hypopharynx
59
Where is cervical lymph node level VI located?
Anterior neck compartment. From thyroid cartilage to manubrium
60
What does cervical lymph node level VI drain?
Larynx. Thyroid
61
What type of gland is the thyroid?
Ductless endocrine gland
62
What hormones does the thyroid gland secrete?
T3. T4. Calcitonin
63
What is the approximate weight of the thyroid gland?
20 grams
64
At what vertebral levels is the thyroid gland located?
C5 to T1
65
What structure connects the two lobes of the thyroid?
Isthmus
66
Where is the thyroid isthmus located?
Level of the 2nd to 4th tracheal ring
67
In which tracheal rings is a tracheostomy usually performed?
Between 2nd and 3rd or 3rd and 4th tracheal rings
68
What is the pyramidal lobe of the thyroid?
An upward projection from the isthmus present in about 40 percent of people
69
What fascia covers the thyroid gland?
Visceral or Pretracheal layer of deep cervical fascia
70
What is Berry's ligament?
Suspensory ligament of the thyroid gland
71
What structures does Berry's ligament attach the thyroid gland to?
Cricoid and tracheal cartilages
72
Why does the thyroid move during swallowing?
Because it is fixed by Berry's ligament to the trachea
73
What structure causes a thyroid mass to move with swallowing?
Ligament of Berry
74
Which veins drain the thyroid gland?
Superior. Middle. Inferior thyroid veins
75
Which artery is missing in the thyroid gland?
Middle thyroid artery
76
What nerve innervates the thyroid gland?
Recurrent laryngeal nerve
77
The recurrent laryngeal nerve is a branch of which cranial nerve?
Vagus nerve
78
Where does the right recurrent laryngeal nerve loop?
Subclavian artery
79
Where does the left recurrent laryngeal nerve loop?
Aortic arch
80
Where do the recurrent laryngeal nerves run?
Tracheoesophageal groove
81
Where do the recurrent laryngeal nerves enter the larynx?
Lower border of the inferior constrictor muscle
82
What happens if the recurrent laryngeal nerve is injured?
Hoarseness
83
What happens if both recurrent laryngeal nerves are injured?
Stridor and difficulty of breathing
84
What happens if the superior laryngeal nerve is injured?
Aspiration and changes in pitch
85
What color and shape are the parathyroid glands?
Caramel-colored. Ovoid bodies
86
Where are the parathyroid glands located?
Posterior border of the thyroid gland within its fascial capsule
87
What do chief cells in the parathyroid produce?
Parathyroid hormone
88
How does parathyroid hormone increase blood calcium levels?
Stimulates bone resorption. Renal reabsorption. Intestinal absorption
89
What arteries supply the parathyroid gland?
Branches of superior and inferior thyroid arteries
90
What veins drain the parathyroid gland?
Superior. Middle. Inferior thyroid veins
91
What lymph nodes drain the parathyroid gland?
Deep cervical and paratracheal lymph nodes
92
Where is the trachea located in the neck?
Midline anterior to the esophagus
93
What is the length of the trachea?
10 to 14 cm or 5 inches
94
From which vertebral levels does the trachea extend?
C6 to T4 or T5
95
How many C-shaped cartilaginous rings does the trachea have?
12 to 20
96
What type of cartilage is found in the trachea?
Hyaline cartilage
97
What muscle is found in the posterior wall of the trachea?
Trachealis muscle
98
What is the mucosal lining of the trachea composed of?
Ciliated pseudostratified columnar epithelium with goblet cells
99
What is a tracheostomy?
Operative procedure to create a surgical airway in the cervical trachea
100
Where is a tracheostomy performed?
Between tracheal rings 2 and 3 or 3 and 4
101
What position is the patient in during tracheostomy?
Rose position
102
Why is a shoulder pad used during tracheostomy?
To elevate the shoulder and hyperextend the head and neck
103
What incision is used in long-term tracheostomy?
Inverted U or Bjork flap
104
What are indications for tracheostomy?
Mechanical airway obstruction. Aspiration risk. Impending respiratory failure. Retained secretions. Prolonged intubation. Head and neck surgery
105
What is a complication of prolonged intubation?
Subglottic stenosis. Laryngeal injury
106
What is a cricothyroidotomy?
Emergency incision through skin and cricothyroid membrane to access trachea
107
When is cricothyroidotomy performed?
In emergency situations when OR transfer is not possible
108
Where is the cricothyroid membrane located?
Between thyroid and cricoid cartilage. One fingerbreadth below thyroid notch
109
What is the general approach to a patient with a neck mass?
Consider age. duration. location. associated symptoms. and risk factors. History and physical exam are key.
110
What are common causes of neck masses in children?
Congenital anomalies such as thyroglossal duct cyst or branchial cleft cyst. infectious causes like reactive lymphadenitis. and neoplastic causes like lymphoma.
111
What is a thyroglossal duct cyst?
A midline congenital neck mass that typically moves with swallowing or tongue protrusion. It results from a persistent thyroglossal duct.
112
What is a branchial cleft cyst?
A lateral congenital cyst usually located anterior to the sternocleidomastoid muscle. Most commonly due to second branchial arch anomalies.
113
What are red flags for malignancy in a neck mass?
Hard consistency. fixation to surrounding tissues. rapid growth. systemic symptoms like weight loss or night sweats. and history of tobacco or alcohol use.
114
What diagnostic steps are important for evaluating neck masses?
Begin with a detailed history and physical examination. followed by imaging like ultrasound or CT. Fine needle aspiration biopsy is crucial if the mass is suspicious.
115
When is imaging indicated for neck masses?
Imaging is indicated when the mass persists for more than two weeks. is firm or fixed. or is associated with systemic symptoms such as fever. weight loss. or night sweats.
116
What are common infectious causes of neck masses?
Viral upper respiratory infections. bacterial lymphadenitis. tuberculosis. and cat scratch disease are common infectious causes.
117
What is the most common congenital midline neck mass?
Thyroglossal duct cyst is the most common midline congenital neck mass in children.
118
What is the most common congenital lateral neck mass?
The second branchial cleft cyst is the most common lateral congenital neck mass.
119
What is the usual treatment for congenital neck masses?
Surgical excision is the treatment of choice. The Sistrunk procedure is used for thyroglossal duct cysts to prevent recurrence.
120
What are characteristics of reactive lymph nodes?
Reactive lymph nodes are typically soft. mobile. tender. and less than 2 cm in diameter. They are often bilateral and associated with infection.
121
What are signs that a neck mass may be neoplastic?
Features suggesting neoplasm include painless and progressively enlarging mass. hard consistency. fixation to deeper structures. and persistence for several weeks.
122
What is the importance of FNAB in neck mass evaluation?
Fine needle aspiration biopsy helps obtain a cytological diagnosis. distinguishing benign from malignant masses and guiding further management.
