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NE Exam 1 > Triangles Of The Neck > Flashcards

Triangles Of The Neck Flashcards

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1
Q

What is the subcutaneous layer of the superficial fascia of the neck?

A

Thin CT lying between the dermis and investing layer of deep cervical fascia

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2
Q

What are the contents of the subcutaneous layer of superficial fascia of the neck?

A

Sensory nerves, blood and lymph vessels, superficial LNs, fat, and playsma muscle

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3
Q

Describe the playsma muscle

A

Muscle of facial expression

Innervation: facial nerve

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4
Q

What are some landmarks in the neck?

A 
Vertebra prominens (C7) 
Hyoid bone 
Thyroid and cricoid cartilages (level of C6) 
Clavicle and sternum 
Mandible
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5
Q

Describe the hyoid bone

A

Body at C3-4 axial level
Suspended by muscles
Body plus greater and lesser horns

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6
Q

What is the retromandibular vein?

A

Junction of superficial temporal vein and maxillary vein (runs deep within parotid gland)

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7
Q

What is the external jugular vein?

A

Crosses over upper 2/3 SCM muscle

May even be absent

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8
Q

What is the anterior jugular vein?

A

Runs just off the midline to the root of the neck and connects with subclavian

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9
Q

The superficial veins of the neck overly what?

A

The surface of investing fascia

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10
Q

The superficial cutaneous nerves of the neck all originate from what?

A

The cervical plexus and emerge from posterior margin of mid-sternocleidomastoid muscle

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11
Q

What are the superficial cutaneous nerves of the neck?

A

Lesser occipital, transverse cervical, greater auricular and supraclavicular nerves

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12
Q

What is the lesser occipital nerve?

A

C2-3

Runs along border of SCM relaying scalp sensory information

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13
Q

What is the transverse cervical nerve?

A

C2-3
Supplies skin overlying anterior triangle of neck
Crosses SCM

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14
Q

What is the greater auricular nerve?

A

C2-3 anterior rami from cervical plexus
Runs with EJV on surface of SCM muscle
Supplies posterior auricle and area extending from mandibular angle to mastoid process

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15
Q

What is the supraclavicular nerve?

A

C3-4

Supplies root of neck in the area of clavicle, acromion and sternum

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16
Q

What is the nerve point of the neck?

A

Site of application of anesthetic (mid-SCM)

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17
Q

What is investing fascia?

A

Most superficial

Surround entire neck and encloses SCM and trapezius muscles and parotid and submandibular glands

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18
Q

What is the pretarcheal fascia?

A

Located in anterior of neck and blends with pericardium

Contains infrahyoid muscles and buccopharyngeal fascia

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19
Q

What is prevertebral fascia?

A

Encloses vertebral column and associated muscles

Extends laterally as axillary sheath into arm

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20
Q

What is the carotid sheath?

A

Fascia covering the carotids, IJV and vagus nerve
Runs along and then under the anterior border of SCM
IJV most lateral
Vagus nerve most posterior

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21
Q

What is the retrhopharyngeal space?

A

Posterior to pharynx and esophagus
Bounded by buccopharyngeal and prevertebral fascia and carotid sheath
Extends from base of skull to mediastinum
Permits movement of pharynx, larynx and esophagus during swallowing
Easy route for upper respiratory or oral infections to spread

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22
Q

What are the different fascia of the neck?

A

Investing fascia, pretracheal fascia, prevertebral fascia, carotid sheath, retropharyngeal space

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23
Q

What is torticollis?

A

Pathology of the SCM causing head to turn to side and the face to turn away from affected side

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24
Q

What is congenital torticollis?

A

Fibrous tissue tumor within SCM that develops in utero

Causes head to turn to side and the face to turn away from affected side - shortens SCM

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25
What is muscular torticollis?
Occasionally SCM may be injured during difficult childbirth, tearing its fibers leading to hematoma that develops into fibrotic mass that entraps part of CN 11 effectively denervating it Stiffness of neck then results from fibrosis and shortening of SCM May require surgical detaching of SCM
26
Describe the innervation of the sternocleidomastoid
Innervated by spinal accessory nerve (CN 11) and with propiosensory information returning via C2-4 CN 11 exits via jugular foramen and lies posterior to the SCM Then emerges about 1/3 does along posterior margins of SCM to cross the posterior triangle to innervate the trapezius
27
What is the cervical plexus?
From ventral rami of C1-4 Each divides into ascending and descending branches (except C1) that forms a loop with the next one Loops like anterolateral to levator scapulae and middle scalene muscles Forms cutaneous nerves of posterior triangle but also supplies adjacent prevertebral muscles, phrenic nerve and strap muscles (Ansa cervicalis)
28
What is the course of the phrenic nerve in the neck?
Runs anterior to the surface of the anterior scalene muscle Descends obliquely with IJV deep to prevertebral fascia and posterior to suprascapular and transverse cervical artery off the thyrocervical trunk Runs posterior to the subclavian vein but anterior to internal thoracic artery as it enters the thorax
29
What forms the phrenic nerve?
Roots of C3 and C4 of cervical plexus + ventral rami of C5
30
What occurs with severance of the phrenic or phrenic nerve block?
Paralysis of that side of the diaphragm
31
Describe the first part of the subclavian artery
Lies medial to anterior scalene and at apex of lung and cervical pleura Branches include internal thoracic and vertebral arteries and thyrocervical trunk (inferior thyroid, transverse scapular, suprascapular)
32
Describe the second part of the subclavian artery
Behind anterior scalene gives off costocervical trunk (superior intercostal and deep cervical arteries)
33
Describe the third part of the subclavian artery
Lateral to the anterior scalene lying anterior to brachial plexus within the posterior triangle In contact with the first rib Dorsal scapular artery often off this segment
34
Compression of the subclavian artery against the rib can control what?
Bleeding in upper limb
35
What is the Ansa cervicalis?
Consists of anterior branches off ventral rami of cervical plexus forming a loop innervating infrahyoid muscles and geniohyoid muscles Loops vary in length
36
Branches off the Ansa cervicalis supply which muscles?
Sternohyoid, sternothyroid, thyrohyoid and omohyoid muscles
37
Describe the superior part of the loop of Ansa cervicalis
Originates from C1 of the cervical plexus that soon joins hypoglossal nerve Fibers run with hypoglossal nerve and then leave to descend in front of internal carotid arteries are superior limb/loop This loop/limb gives off a nerve to thyrohyoid (C1) and geniohyoid muscle (c1) Then swings down to meet the inferior limb giving off a branch to superior omohyoid belly
38
Describe the inferior part of the loop of Ansa cervicalis
Formed by branches of C2 and C3 Descends behind carotid sheath and then winds lateralward and emerges from behind carotid sheath to joint the superior limb
39
What is the carotid sheath?
Fascia covering surrounding IJV, carotid artery and vagus nerve ?????
40
What are the arteries of the anterior triangle?
Carotid sinus, internal carotid and external carotid
41
Describe the carotid sinus
Located at the site of bifurcation of common carotid | Contains chemoreceptors and baroreceptors for monitory O2 and BP levels
42
Does the internal carotid artery have any branches in the neck?
No
43
Describe the external carotid artery
Terminates by dividing into maxillary and superficial temporal arteries Branches include ascending pharyngeal, superior thyroid, lingual, facial, occipital, and posterior auricular
44
Describe the thyroid gland
Lies deep to sternothyroid and sternohyoid muscles from levels C5-T1 Consists of two lobes that are anteriolateral to larynx and trachea Has isthmus uniting lobes overlying trachea at 2nd/3rd tracheal rings
45
What are the unpaired laryngeal cartilages?
Thyroid (thyroid prominence and superior thyroid notch), epiglottis (elastic cartilage), cricoid (located at C6)
46
What are the paired laryngeal cartilages?
Arytenoid (vocal cords attached), comiculate and cuneiform
47
What are the ligaments/membranes of the laryngeal cartilages?
Vocal ligament (lies under vocal cord), thyrohyoid membrane and cricothyroid membrane
48
What are the vocal folds?
Contain elastic vocal ligaments running between the thyroid and arytenoid cartilages Generates sound by vibrating air passing by Force of air control the volume; tension of folds determines pitch
49
Describe the laryngeal innervation
Superior laryngeal nerve (internal/sensory and external/motor to cricothyroid muscle) Inferior laryngeal nerve which is the terminal branch of recurrent laryngeal nerve and provides motor innervation to intrinsic laryngeal muscles
50
Describe the thyroid blood supply
Superior to thyroid from external carotid Inferior thyroid from thyrocervical trunk Parallel veins May have thyroid ima artery—branch directly off brachiocephalic trunk to inferior thyroid gland
51
Describe the laryngeal blood supply
Superior laryngeal artery off superior thyroid artery | Inferior laryngeal artery off inferior thyroid artery
52
Injury to what nerve causes loss of vocalization?
Recurrent laryngeal nerve
53
Describe the cervical sympathetic chain
No white rami in neck (presynaptic fibers from superior thoracic spinal nerves) Fibers pass to cervical spinal nerves via gray rami or leave as visceral branches (splanchnic) into thorax Branches to head run via vascular plexus
54
What are the three cervical ganglia of the cervical sympathetic chain?
Superior ganglia, middle ganglia, and inferior ganglion
55
Describe the superior ganglia
Level C1/2 Post synaptic fibers form an internal carotid periarterial plexus that enters cranium Also sends fibers to cervical plexus as well as cardiopulmonary branches
56
Describe the middle ganglia
May be absent Lies over inferior thyroid artery at level of cricoid cartilage and transverse processes of C6 Distributed via periarterial plexes and cardiopulmonary splanchnic nerves
57
Describe the inferior ganglion
Lies anterior transverse process of C7 just superior to neck of 1st rib Some post-ganglionic fibers enter the brachial plexus, run to heart (inferior cervical cardiac nerve) Others go to periarterial plexus of vertebral artery
58
Describe the superficial cervical LNs
Located along EJV draining superficial tissues of neck
59
Describe the inferior deep cervical LNs
Drain lateral cervical area and run along path of CN XI
60
Describe the lymphatics of the neck
All drain into nodes and lymphatics running along IJV Lymphatics join to form lymphatic trunks that then join to form lymphatic ducts that empty into subclavian vein near its junction with IJV
61
The prevertebral muscles are all posterior to what?
Retropharyngeal space and innervated by cervical plexus and/or brachial plexus
62
Describe the structures of the thyroid gland
Dense CT attaches it to cricoid cartilage and superior tracheal rings Parathyroid glands lie on posterior aspect of thyroid gland in own capsule
63
What regulates tension in the vocal folds?
Intrinsic muscles innervated y the vagus nerve (CN X)
64
What are ventricular folds?
False cords Brought together when holding your breath while straining Do not contain vocal ligaments
65
What is dysphonia?
Disorder of the voice Hoarseness-inflammation of the vocal cords Laryngitis-inflammation of vocal cords where they no longer vibrate

NE Exam 1 (20 decks)

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