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Board Part 1 > The Neck > Flashcards

The Neck Flashcards

1
Q

Submandibular/Digastric Triangle Borders

A

Anterior Digastric
Posterior Digastric
Inferior border of mandible

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2
Q

Submandibular/Digastric Triangle Floor

A

Mylohyoid
Hyoglossus
Middle Constrictor

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3
Q

Submandibular/Digastric Triangle Roof

A

Skin
Superficial fascia with platysma
Deep cervical fascia

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4
Q

Submandibular/Digastric Triangle

Arteries

A

Facial Artery
Submental Artery
Lingual Artery (small portion)

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5
Q

Submandibular/Digastric Triangle

Veins

A

Facial Vein
Submental Vein
Lingual Vein (small portion)

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6
Q

Submandibular/Digastric Triangle

Nerves

A

Mylohyoid n.

CN XII Hypoglossal

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7
Q

Submandibular/Digastric Triangle

Structures

A

***Submandibular salivary gland (occupies most of triangle)
Submandibular lymph nodes
Inferior portion of Parotid salivary gland

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8
Q 
Submental Triangle (there's only 1)
Borders
A

Left anterior digastric
Right anterior digastric
Body of Hyoid bone

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9
Q

Submental Triangle

Floor

A

Mylohyoid

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10
Q

Submental Triangle

Roof

A

Skin
Superficial fascia w/ Platysma
Superficial/Investing layer of deep fascia

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11
Q

Submental Triangle

Major contents

A

no MAJOR contents

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12
Q

Submental Triangle

Veins

A 
Anterior jugular
  (has poor drainage, little vasculature, infections here do not heal well)
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13
Q

Submental Triangle

Structures

A

Submental lymph nodes

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14
Q

Muscular Triangle

Borders

A

Anterior border of Sternocleidomastoid
Superior belly of omohyoid muscle
Midline

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15
Q

Muscular Triangle

Floor

A

Sternohyoid

Sternothyroid

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16
Q

Muscular Triangle

Roof

A

Skin
Superficial fascia w/ Platysma
Superficial/Investing layer of deep fascia

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17
Q

Muscular Triangle

Arteries

A

Superior Thyroid artery

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18
Q

What’s in the carotid space?

A 
IC 10 CC's in the IJ (I see 10 cc's in the IV)
Internal carotid artery (superior)
Common carotid artery (inferior)
CN 10 Vagus
Internal Jugular vein
Cervical lymph nodes
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19
Q

Define Fascial Planes

A

Bands of connective tissue (dense irregular) that surrounds and protects structures.
The solid, colored lines in the cross-section

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20
Q

Define Tissue Spaces

A

Spaces & Pathways that allow infection to spread (from head and neck down to your heart)

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21
Q

The most superficial muscle on the back of the neck?

A

Trapezius

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22
Q

When you cut past the skin layer, what’s the first thing you’ll see?

A

Superficial fascia (aka subcutaneous tissue)
Surrounds our entire body
If being asked about fascia etc, it’s called superficial fascia.
If being asked about skin stuff, it’s called subcutaneous tissue.

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23
Q

What does superficial fascia contain?

A

Fat & the
Platysma is embedded in this layer
Contains sensory branches to the neck

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24
Q

Deep to the Superficial fascia

A

The layers of Deep fascia which also surround the whole body….Deep to this are the actual muscles (other than the platysma) and organs.

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25
Q

Is there any deep fascia in the face?

A

No deep fascia in face

This allows for free spread of fluid and therefore infections around there

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26
Q

Purpose of deep fascia?

A

Protects muscles and organs
Reduces friction of muscle movements
Passageways for nerves and vessels
Provides attachment for some muscles

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27
Q

BD*Which 2 muscles are surrounded by the investing/superficial layer of deep cervical fascia?

A

SCM

Trapezius

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28
Q

Layers of Deep Cervical Fascia & what kind of fascia does each contain?

A 
Superficial/Investing layer
Middle layer (pretracheal fascia: muscular & visceral, buccopharyngeal fascia)
Deep layer (prevertebral fascia, alar fascia)
Carotid sheath (=superficial,middle,deep combined)
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29
Q

Superficial/Investing Layer

A

Surrounds entire neck
Encloses SCM & Trapezius
*not so important…Surrounds: Clavicle, Manubrium, Acromion, Zygomatic Arch to Scapular Spine, Mastoid Process, Occipital Bone

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30
Q

in the Middle Layer the Muscular Pretracheal Fascia encloses what?

A

the 4 infrahyoid muscles:
omohyoid
sternohyoid,

sternothyroid,
thyrohyoid

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31
Q

in the Middle Layer the Visceral Pretracheal Fascia surrounds….like a horseshoe…

A

Pharynx
Larynx
Thyroid + Trachea + Esophagus

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32
Q

in the Middle Layer the Buccopharyngeal Fascia lies where?

A

in the back of the esophagus where you can see it

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33
Q

in the Deep fascia’s deep layer, the Prevertebral Fascia
Surrounds what?
Envelopes what?
*And what does it have to do with innervation?

A

Cervical vertebral column
Deep neck muscles, including prevertebral scalenes & deep back muscles
*CN XI travels along it to the SCM and Trapezius

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34
Q

in the Deep Cervical Fascia, the Carotid Sheath is made of

A

Contributions of the superficial/investing, middle, and deep layers of fascia

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35
Q

the carotid sheath travels from where to where?

A

aortic arch up to the base of the skull

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36
Q

what is the space called that’s within the carotid sheath?

and what

A

carotid space

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37
Q

what is embedded in the wall of the carotid sheath?

A

ansa cervicalis.
It is not “inside the sheath” nor in the “carotid space”
It IS embedded inside “the wall” of the sheath

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38
Q

Buccopharyngeal fascia will be asked on bds in

  1. it’s relationship to the oropharynx
  2. in regards to the spaces infections spread through….
A
  1. you’ll see it when your patient opens his/her mouth…it’s the back of th oropharynx
  2. it serves as a border to the spaces infections can spread through….right behind it is the danger space
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39
Q

What fascia lies btwn the buccopharyngeal & prevertebral fascias, and why is this fascia important?

A

the alar fascia.

It divides 2 spaces where infections spread…which 2?

40
Q

What are the 3 Fascial Spaces

A

Spaces in between the individual fascial layers where disease can spread.
Different from the Cervical Triangles

41
Q

What are the Fascial Spaces that will be on the boards

A

Retropharyngeal space
Danger space
Carotid space

42
Q

Boundaries of the Retropharyngeal space

A

Located btwn buccopharyngeal fascia and alar fascia
Lateral boundaries are the carotid sheaths
Extends from Clivus down to T2

43
Q

Retropharyngeal space’s inferior portion is sometimes also called what?

A

Retrovisceral space

44
Q

Why is Retropharyngeal space so significant re infections?

What is the significant infection here called?

A

An absess tooth infection can travel down it, down into our entire neck.
It’s called a
A RETRO-PHARYNGEAL ABSESS

45
Q

Describe the danger space

A

Btwn Alar Fascia and Pre-vertebral Fascia
From clivus to diaphragm
*An infection can travel from Pharynx down to the mediastinum where the heart is.

46
Q

When an infection builds up in the fascial spaces it will push what?

A

it will push tongue forward and upward***

Can also lead to edema of vocal cords and airway obstruction

47
Q

How many cervical triangles are there and what are their names

A

3: Anterior and Posterior and Suboccipital triangles (2 of each
Divided into 11 divisions (5 paired, 1 single)

Posterior:
Occipital & Subclavian/Supraclavicular/Omoclavicular

Anterior:
Submandibular, Submental (single)
Carotid, Muscular

48
Q

Anterior Triangle borders

A

Anterior border of SCM
Inferior border of mandible
Midline of the neck

49
Q

T/F: The roof is the same for all the cervical triangles

A

True!

50
Q

Muscular Triangle

Veins

A

Inferior thyroid v.

Anterior jugular v.

51
Q

*Muscular Triangle

Nerves

A

*Ansa cervicalis

52
Q

Muscular Triangle

(Major) Structures

A

Pharynx, Larynx, Trachea (top), Esophagus (top)
Thyroid, Parathyroid
Sternothyroid, Sternohyoid, Thyrohyoid

53
Q

Carotid Triangle

Borders

A

Ant border of SCM
Post Digastric
Superior border of omohyoid m.

54
Q

Carotid Triangle

Floor

A

Hyoglossus
Thyrohyoid
Middle constrictor (of pharynx)
Inferior constrictor (of pharynx)

55
Q

Carotid Triangle

Roof

A

Skin
Superficial fascia w/ Platysma
Superficial/Investing layer of deep fascia

56
Q

Carotid Triangle

Arteries

A 
Common Carotid a. w/ Carotid Body
Internal Carotid a. w/ Carotid Sinus
External Carotid a. w/ its following branches:
               Superior thyroid a.
               Lingual a.
               Facial a.
               Ascending pharyngeal a
               Occipital a.
57
Q

Carotid Triangle

Veins

A 
Internal Jugular v. w/ its following branches:
                Common facial v.
                Lingual v.
                Superior thyroid v.
                Middle thyroid v.
58
Q

Carotid Triangle

Nerves

A 
Vagus CN X
                 External laryngeal n.
                 Internal laryngeal n.
Accessory CN XI
Hypoglossal CN XII
Ansa Cervicalis' superior limb
Superior cervical ganglion of sympathetic trunk
59
Q

Carotid Triangle

Structures

A

Carotid sheath

60
Q

Which triangle has 3 different names and what are they

A

Supraclavicular
Omoclavicular
Subclavian

61
Q

Posterior Triangle

Borders

A

Posterior border of SCM
Anterior border of Trapezius
Clavicle

62
Q

Posterior Triangle

Roof

A

Skin
Superficial fascia w/ Platysma
Superficial/Investing layer of deep fascia

63
Q

Posterior Triangle

Floor

A 
Splenius capitis
Semispinalis capitis
Scalenes
Levator scapulae
Omohyoid
Prevertebral fascia
                        SSSLOP
64
Q

What divides the Posterior Triangle into 2 smaller triangles, and what are those 2 sub-triangles?

A

Inferior belly of the Omohyoid muscle divides it up.

  1. Occipital Triangle (on top)
  2. Omoclavicular/Supraclavicular/Subclavian Triangle (on bottom)
65
Q

Occipital Triangle

Borders

A
  1. Superior to the
    omohyoid’s inferior belly
  2. Posterior to SCM
  3. Anterior to Trapezius m.
66
Q

Occipital Triangle

Arteries

A

Thyrocervical trunk
and a branch off it:
Transverse cervical n.

67
Q

Occipital Triangle

Nerves

A
  1. Cervical Plexus: All portions of cervical plexus have a component there
  2. Accessory CN XI, which travels along fascia to innrvte the SCM and Trapezius
68
Q

Subclavian/Omoclavicular/Supraclavicular triangle

Borders

A

Inferior to the Omohyoid’s inferior belly
Posterior to the SCM
Superior to the Clavicle

69
Q

Subclavian/Omoclavicular/Supraclavicular triangle

Arteries

A

Subclavian a.

Thyrocervical trunk & it’s branch: Suprascapular a.

70
Q

Subclavian/Omoclavicular/Supraclavicular triangle

Veins

A

External jugular

71
Q

Subclavian/Omoclavicular/Supraclavicular triangle

*Nerves

A

Bd *Brachial plexus

72
Q

Subclavian/Omoclavicular/Supraclavicular triangle

Roof

A

Skin
Superficial fascia w/ Platysma
Superficial/Investing layer of deep fascia

73
Q

Suboccipital triangle

Borders

A

Obliquus capitis superior
Obliquus capitis inferior
Rectus capitis posterior major

74
Q

Suboccipital triangle

Roof

A

Skin
Superficial fascia w/ Platysma
Superficial/Investing layer of deep fascia
(All roofs are Dense Connective Tissue, fyi :)

75
Q

Suboccipital triangle

Floor

A

Posterior arch of atlas (C1)

76
Q

Suboccipital triangle

Artery

A

Vertebral

77
Q

Suboccipital triangle

Vein

A

Vertebral

78
Q

Suboccipital triangle

Nerves

A

Greater occipital

Suboccipital

79
Q

Suboccipital triangle

Muscles

A

Obliquus capitis superior
Obliquus capitis inferior
Rectus capitis posterior major
Rectus capitis posterior minor

80
Q

In what triangle are the visceral structures of the neck found?

A

Muscular triangle (of the anterior triangle)

81
Q

List the visceral structures of the neck

A 
Pharynx
Larynx
Trachea + Esophagus
Thyroid
Parathyroid
82
Q

How many parathyroid glands are there and where are they located?
What do they make?

A

Several (usually 4)
They’re embedded in the back of the Thyroid gland.
They make parathyroid hormone

83
Q

What does the thyroid make?

A 
Calcitonin
T3   (Triiodothyronine)
T4   (Tetraiodothyronine or Thyroxine)
84
Q

Name the lobes of the thyroid

A

Left and Right lobes

Sometimes a Pyramidal lobe

85
Q

What connects the left and right lobes,

and where is it in relation to the trachea

A

the Isthmus of the thyroid

It crosses anterior to the 2nd and 3rd tracheal rings, lies right up against them

86
Q

Is the Thyroid highly vascular or not?

A

Yes highly vascular

which is why cancer grows well in that area

87
Q

Where is the Thyroid located relative to the vertebrae

A

Btwn
C6 and
T1

88
Q

What vessels bring blood to the Thyroid?

Which ones take blood away from Thyroid?

A

To:
Superior Thyroid a.
Inferior Thyroid a.

From:
Superior thyroid v.
Middle thyroid v.
Inferior thyroid v.

So thyroid gland is highly vascular!

89
Q

Where’s the “root of the neck”?
And what does it consist of?
What is the Superior thoracic aperture?
What are this aperture’s borders
and what does it contain sometimes?

A 
where neck attaches to thorax
It's where the Superior Thoracic Aperture is, this is the top opening of the thoracic cage, a circle. It's bounded by:
1st rib and cartilage, L and Right
1st thoracic vertebrae
Manubrium

During full inhalation it contains the Lung’s apex which inflates up into it

90
Q

List contents of the “root of the neck”

A 
Just think, what arteries, veins, nerves, and other structures are located in both the thoracic cage and head/neck
Rely on your basic anatomical knowledge.
Here's the list anywy:
Arteries===
  Aortic Arch
  Common carotid
  Subclavian
  Vertebral
  Transverse cervical
Veins===
  Internal jugular
  Subclavian
  Brachiocephalic
  Inferior thyroid
  Vertebral
Nerves===
  Vagus
  Recurrent laryngeal
  Phrenic
  Sympathetic trunk
  Brachial plexus
Structures===
  Trachea
  Esophagus
  Thoracic duct
  Right lymphatic duct
91
Q

List the layers of the Scalp

(superficial to deep)

A

S=kin
C=onnective tissue
Dense CT
Distributes neurovascular supply to scalp
A=poneurosis (a tough layer of dense fibrous tissue)
Consists of Occipitalis, Galea Aponeurotica, & Frontalis
L=oose CT
P=eriosteum

92
Q

What does the CT of the scalp do?

A

distributes neurovascular supply to the scalp

93
Q

*What blood sources come up and feed the scalp

Why is this a beneficial arrangement?

A

*Internal and external carotid arteries both feed the scalp. Internal primarily feeds the brain, external primarily does everything else….but the scalp is one place where they actually both work together.
Anastomosis occurs here (they’re interconnected), so if one of these blood sources gets blocked another source can still supply the same tissue/scalp. A built-in back up plan.

94
Q

Cutaneous innervation of the scalp

Which nerves do this?

A 
CN V1
CN V2 
CN V3
and Cervical plexus branches, C2 n C3
The scalp is a great meeting place for arteries, veins, and nerves.
95
Q

Why is danger space more dangerous than the neighboring retropharyngeal space?

A

danger space goes farther down, all the way to the diaphragm

Board Part 1 (3 decks)

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