Flashcards in Triangles of the Neck 3 Deck (58):
The anterior boundary of the root of the neck is the superior border of (____ + ____).
manubrium + clavicle
The posterior boundary of the root of the neck is the superior border of (____ + ____) to the ___ process
T1 + scapula; coracoid
Subclavian vessels, vertebral artery, thyrocervical turnk, internal thoracic artery, and costocervical trunk are all vessels found in the root of the neck. True or false?
Irritation of the parietal pleura or parietal peritoneum covering diaphragm causes pain that is carried by the ____ nerve to the area supplied by the ____ nerves (shoulder_
The ___ subclavian artery arises from the brachiocephalic artery behind the sternoclavicular joint
The ___ subclavian artery arises from the arch of the aorta
The subclavian artery is divided by the anterior scalene into 3 parts. Describe the course of the 1st part.
from its origin till anterior scalene
The subclavian artery is divided by the anterior scalene into 3 parts. Describe the course of the 2nd part.
posterior to anterior scalene
The subclavian artery is divided by the anterior scalene into 3 parts. Describe the course of the 3rd part.
lateral to anterior scalene till its end at the lateral border of 1st rib
In regards to the subclavian artery on the right side, there are 2 nerves, 2 veins, and 2 muscles that are anterior to the 1st and 2nd parts of the artery. Name them.
2 nerves: vagus and ansa subclavia
2 veins: internal jugular vein and vertebral vein
2 muscles: sternohyoid and sternothyroid muscles
note: anterior scalene + right phrenic nerve are anterior only to the 2nd part
In regards to the subclavian artery on the left side, there are two structures that are anterior to the 1st part of the artery. Name them.
thoracic duct; left phrenic nerve
In regards to both subclavian arteries (right and left), what two structures are posterior to the 1st part of the arteries?
apex of lung and cervical pleura
In regards to both subclavian arteries (right and left), what two structures are posterior to the 2nd part of the arteries?
lower trunk of brachial plexus and suprapleural membrane
The suprapleural membrane extends from the tip of TS process of ___ to the inner border of the ___ rib
note: separates the artery from pleura and lung
In regards to both subclavian arteries (right and left), what structure lies above the 2nd part of the arteries?
upper and middle trunks of the brachial plexus
In regards to both subclavian arteries (right and left), what structures lie anterior to the 3rd part of the arteries?
external jugular vein, suprascapular vessels, nerve to subclavius, insertion of anterior scalene
This is the first branch of the 1st part of the subclavian artery in the root of the neck. It ascends medially to anterior scalene muscles
This artery is anterior to the vertebral artery.
hint: it is covered in the carotid sheath
common carotid artery
This artery crosses the vertebral artery anteriorly.
inferior thyroid artery
The transverse process of C7, along with the ventral rami from C7-C8 and the inferior cervical sympathetic ganglion are located ____ to the vertebral artery
The 1st part of the vertebral artery is between the ___ ___ and ___ ___ muscles
anterior scalene; longus coli
The 2nd part of the vertebral artery is located in the ___ ____ from the 6th vertebra below to the 1st above
The 3rd part of the vertebral artery is in the ____ triangle behind the lateral mass of the atlas
The 4th part of the vertebral artery is inside the ___ cavity
The vertebral artery ends by joining its fellow of the opposite side to form the ___ artery
This is another branch off of the 1st part of the subclavian artery. It arises close to the medial border of the anterior scalene
This is the lowest branch of the thyrocervical trunk
The suprascapular artery passes laterally, crossing anterior to the ___ ___ muscle, ___ nerve, and __ part of subclavian artery
anterior scalene; phrenic; 3rd
At the superior border of the scapula, the suprascapular artery crosses over the ___ ___ ligament to enter the supraspinous fossa
This is the middle branch of the thyrocervical trunk
transverse cervical artery
The transverse cervical artery enters and crosses the base of the ___ triangle and then courses deep to the ___ muscle
note: divides into superficial branch (trapezius) and deep branch (rhomboids)
This is the superior continuation of the thyrocervical trunk. It ascends anterior to the anterior scalene muscle
inferior thyroid artery
The inferior thyroid curves medially between the ___ artery (posterior) and the _____ sheath (anterior)
The inferior thyroid artery reaches the ___ surface of the thyroid gland to supply it
note: as it curves medially to reach thyroid, it gives ascending cervical artery which supplies prevertebral muscles and spinal cord
This is the 3rd branch of the 1st part of the subclavian artery in the root of the neck. It arises from its lower border of subclavian artery and descends to the thoracic cavity on both sides of the sternum.
internal thoracic artery
The internal thoracic artery ends by dividing into what 2 arteries?
musculophrenic artery and superior epigastric artery
On the left subclavian artery, the ___ ___ trunk arises form the 1st part at the medial border of the anterior scalene (instead of the 2nd part)
This is the only branch from the 2nd part of the subclavian artery on the RIGHT side. (arises from the 1st part on the left side)
On both sides, the costocervical trunk arches posteriorly above the apex of the ___ and ____ to reach the neck of 1st rib
The costocervical trunk (right side) ends by dividing into what two arteries?
deep cervical artery and supreme intercostal artery
note: deep cervical artery ascends to back of neck to anastomose with descending branch of occipital artery
Are there any branches from the 3rd part of the subclavian artery?
Dorsal scapular artery (30% arises form transverse cervical artery of the 1st part)
The phrenic nerve arises from the ventral rami of ___-___
This nerve arises in the root of the neck and is a branch of the right vagus nerve as it reaches the lower edge of the 1st part of the subclavian artery, passing around it to ascend in groove between trachea and esophagus
right recurrent laryngeal
This nerve passes in the root of the neck. It is a branch of the left vagus nerve as it crosses the arch of aorta in the superior mediastinum
left recurrent laryngeal
note: it passes below arch of aorta to ascend beside trachea to larynx
The cervical sympathetic chain lies in front of the ___ ___ of cervical vertebrae and behind the ___ sheath
transverse processes; carotid
note: consists of 3 ganglia ( superior, middle and inferior )
Name the vascular branches to the superior ganglia (C1-C2) in the cervical sympathetic chain
internal and external carotid artery
Name the vascular branch to the middle ganglia (C5-C6) in the cervical sympathetic chain
inferior thyroid artery
Name the vascular branches to the inferior ganglia (C7-C8) in the cervical sympathetic chain
subclavian artery and vertebral artery
The visceral branch to the superior ganglia is the superior cardiac nerve and supplies the ___, ___, and ___
larynx; pharynx; heart
The visceral branch to the middle ganglia is the middle cardiac nerve and supplies the ___, ___, and ___
trachea; esophagus; and heart
The visceral branch to the inferior ganglia is the inferior cardiac nerve and only supplies the heart. True or false?
The ___ ganglia of the cervical sympathetic chain is connected to the inferior ganglia by a loop called nasa subclavia
The inferior ganglia of the cervical sympathetic chain fuses with T1 ganglion to form the ___ ganglion
cells of origin of sympathetic fibers in the head and neck are ___ horn cells in upper 2-3 thoracic segments of spinal cord
This syndrome is due to 2nd order neurons. Most of the preganglionic fibers to superior cervical ganglion are derived from the T1 segment. Thus, destruction of these fibers as they pass through the trunk of the T1 nerve occurs
preganglionic Horner's syndrome
What are the symptoms of preganglionic Horner's syndrome? (5)
1. ptosis: drooping of upper eye lid
2. Miosis: constricted pupil
3. enopthalmos: sunken eyes
4. anhydrosis: loss of sweating
5. vasodilator skin arterioles
What causes central Horner's sydrome?
1st order neuron defect (lesion in the reticulospinal fibers in brain stem or spinal cord)