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COM Neuroendocrine > Triangles of the Neck and Larynx > Flashcards

Triangles of the Neck and Larynx Flashcards

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1
Q

Vertebral level C3-4 marked by

A

Body of hyoid bone
Upper margin of thyroid cartilage
Bifurcation of common carotid artery

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2
Q

Vertebral level C5-6 marked by

A

Arch of cricoid cartilage
Superior end of esophagus
Superior end of trachea

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3
Q

Posterior triangle borders

A

Anterior- posterior sternocleidomastoid
Posterior- anterior trapezius
Inferior- clavicle

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4
Q

Anterior triangle borders

A

Midline of neck
Sternocleidomastoid
Lower border of mandible

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5
Q

Submandibular division of anterior triangle borders, floor, contents

A

Anterior belly of digastric muscle
Posterior belly of digastric
Inferior border of mandible
Floor- Mylohyoid, hypoglossus, middle pharyngeal constrictor
Contents- submandibular gland & lymph nodes, hypoglossal N, nerve to mylohyoid, parts of facial A/V

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6
Q

Submental division of anterior triangle borders, floor, contents

A 
Midline of neck
Anterior belly of digastric
Body of hyoid
Floor- Mylohyoid muscles
Contents- submental lymph nodes and small veins that unite to form anterior jugular vein
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7
Q

Carotid division of anterior triangle borders, floor

A

Posterior belly of digastric
Superior belly of omohyoid
Sternocleidomastoid
Floor- thyrohyoid, hyoglossus, middle/inferior constrictor muscles of pharynx

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8
Q

Muscular division of anterior triangle borders, muscles

A

Body of hyoid
Superior belly of omohyoid
Sternocleidomastoid
Muscles- sternohyoid, sternothyroid, thyrohyoid

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9
Q

Posterior triangle roof and floor

A

Floor- semispinalis capitis, splenius capitis, levator scapula, posterior/middle/anterior scalene
Roof- skin, superficial fascia, platysma, investing layer of deep fascia

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10
Q

Arteries in posterior triangle

A 
Subclavian
Thyrocervical trunk
Transverse cervical
Dorsal scapular
Suprascapular
Part of occipital artery
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11
Q

Transverse cervical artery path

A

Runs superficially and laterally across the phrenic nerve and anterior scalene muscle

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12
Q

Suprascapular artery path

A

Branch of the thyrocervical trunk, passes inferiolaterally across the anterior scalene muscle and phrenic nerve. Travels with suprascapular nerve

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13
Q

Veins of posterior triangle

A

External jugular and subclavian
EJV begins inferior to angle of mandible by union of posterior retromandibular vein with posterior auricular vein anterior to SCM. Drains into subclavian vein
Subclavian is anterior to anterior scalene muscle and joins with internal jugular vein to form brachiocephalic vein.

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14
Q

Nerves of the posterior triangle

A

Spinal accessory, roots and trunks of brachial plexus, phrenic
Lessor occipital- skin of neck and scalp posterior to auricle
Great auricular- skin and sheath over parotid gland, mastoid process, auricle and angle of mandible
Transverse cervical- skin of anterior cervical region
Supraclavicular- skin over the clavicle and shoulder

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15
Q

Spinal accessory nerve path

A

Deep to SCM, lies in deep fascia, enters trapezius

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16
Q

Phrenic nerve path

A

Anterior to anterior scalene muscle, supplies diaphragm

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17
Q

Torticollis

A

Contraction or shortening of SCM that causes the head to tilt towards and the face to turn away from the affected side

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18
Q

Suprahyoid muscles

A 
Located in anterior triangle, elevate hyoid and larynx
Mylohyoid
Stylohyoid
Digastric anterior/posterior bellies
Geniohyoid
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19
Q

Infrahyoid muscles

A 
Located in anterior triangle, depress hyoid and larynx
Sternohyoid
Omohyoid
Sternothyroid
Thyrohyoid
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20
Q

Arteries of the anterior triangle

A

Common carotid- bifurcates into internal and external carotid at C3-4
Internal carotid does not branch in neck, contains carotid sinus (baroreceptor) in proximal portion and carotid body (chemoreceptor) in cleft between ICA/ECA

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21
Q

External carotid artery branches and description

A

Superior thyroid- gives rise to superior laryngeal, supplies thyroid
Lingual- anterior to middle pharyngeal constrictor, deep to hypoglossal nerve, posterior belly of digastric and stylohyoid muscle. Disappears deep to hyoglossus
Facial- gives rise to ascending palatine and tonsillar arteries, found deep to submandibular gland/angle of mandible (pulse point)
Ascending pharyngeal- only medial branch, medial to ICA
Occipital- passes superficial to ICA and hypoglossal N.
Posterior auricular- ascends b/w external acoustic meatus and mastoid process, terminates into maxillary and superficial temporal arteries in the face

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22
Q

Contents of the muscular division of anterior triangle

A

Viscera- thyroid/parathyroid glands, larynx, trachea and esophagus
Arteries- common carotid, superior/inferior thyroid
Veins- anterior jugular, superior/middle/inferior thyroid
Nerves- ansa cervicalis, external laryngeal, recurrent laryngeal

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23
Q

Contents of carotid division of anterior triangle

A

Carotid sheath- contains common/internal carotid arteries, internal jugular vein, vagus nerve, deep cervical lymph nodes, carotid sinus, sympathetic fibers
Arteries- branches of external carotid
Nerves- internal/external laryngeal, hypoglossal, spinal accessory, ansa cervicalis

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24
Q

Carotid sheath contents

Study These Flashcards
A

Carotid arteries- medial
Internal jugular vein- lateral
Vagus n- posterior
Ansa cervicalis- anterior or embedded in sheath

25
Vagus nerve branches
Pharyngeal branch Superior laryngeal- internal/external branches Carotid body branch
26
Thoracic inlet/outlet contents
``` Apex of lung Subclavian artery and vein Brachial plexus Vagus nerve Phrenic nerve Thoracic duct Right lymphatic duct Sympathetic chain Trachea/esophagus ```
27
Subclavian steal syndrome/vertebrobasilar insufficiency
Subclavian artery occlusion or hemodynamically significant stenosis proximal to the origin of the vertebral artery results in lower pressure in the distal subclavian artery. As a result, blood is "stolen" from the cerebral circulation to perfuse the arm. Blood flows up the contralateral vertebral artery to the basilar artery, and retrograde down the ipsilateral vertebral artery away from the brainstem
28
Phrenic nerve importance
Phrenic nerve is the sole motor supply to the diaphragm, so it must be identified and preserved during surgery Because the phrenic nerve arises from the neck, patients who suffer spinal cord injuries below the neck are still able to breath effectively despite paralysis of lower limbs
29
Sympathetic trunk
Extends superiorly to C1 or base of skull Superior cervical ganglion- C1-2 Middle cervical ganglion- located at C6 at the level of cricoid cartilage, smallest of the 3, may be absent Inferior cervical ganglion- in 80% of people the inferior cervical ganglion fuses with the 1st thoracic ganglion and is termed the stellate ganglion Located anterior to transverse process of C7
30
Contents of superficial cervical fascia
``` Cutaneous nerves Blood/lymph vessels Superficial lymph nodes Fat Platysma muscle- muscle of facial expression, innervated by fascial nerve CN VII ```
31
Investing layer of deep cervical fascia
Most superficial layer of deep, surrounds entire neck Encloses SCM and trapezius Encloses parotid and submandibular glands Attaches to occipital/temporal bones, zygomatic arches, inferior border of mandible, hyoid bone and spinous processes of cervical vertebrae Extends to manubrium, clavicles, acromion and spines of scapula
32
Pretracheal layer of deep cervical fascia
Located only in anterior region of neck Blends with fibrous pericardium of heart Muscular layer with infrahyoid muscles, buccopharyngeal fascia and a visceral layer
33
Prevertebral layer of deep cervical fascia
Encloses vertebral column and associated muscles Extends laterally as the axillary sheath into the arm Extends from cranial base to mediastinum
34
Retropharyngeal space
Posterior to the pharynx, bound by buccopharyngeal fascia anteriorly, prevertebral fascia posteriorly and the carotid sheaths laterally Extends superiorly to base of skull and inferiorly to mediastinum
35
Retropharyngeal abscess
Develops secondary to lymphatic drainage or contiguous spread of upper respiratory/oral infections Swelling can cause difficulty swallowing and speaking and can be life threatening
36
Thyroid location, arteries, veins
C5-T1 Superior thyroid artery supplies anterior/superior Inferior thyroid supplies posterior/inferior Thyroid ima artery- found in 10%, anterior to trachea Veins- superior/middle/inferior thyroid veins form thyroid plexus of veins
37
Relationships- recurrent laryngeal nerves and ligaments of thyroid
RLN ascend in groove b/w trachea and esophagus, they pass deep to the posteromedial surface of the lateral lobes of the thyroid gland Ligaments bind thyroid gland to trachea and cricoid cartilage of larynx
38
Larynx
Vertebral levels C3-6 Connected to pharynx and trachea Functions in phonation and patent airway
39
Thyroid cartilage
Located at C4 Laryngeal prominence- adams apple Superior thyroid notch Superior/inferior thyroid horn
40
Cricoid cartilage
Located at C6 | Signet ring shaped
41
Thyrohyoid membrane
Aperture for internal branch of superior laryngeal nerve and superior laryngeal artery
42
Laryngeal cavity
Extends from laryngeal inlet, through which it communicates with the laryngopharynx, to the inferior border of the cricoid cartilage. It is continuous with the trachea
43
Laryngeal vestibule
Between the laryngeal inlet and the vestibular folds
44
Laryngeal ventricle
Between the vestibular and vocal folds
45
Infraglottic cavity
B/w vocal folds and the inferior border of the cricoid cartilage
46
Rima glottidis
Space between the vocal folds
47
Cricothyroid muscle innervation/action
External laryngeal nerve from CN X | Stretches and tenses vocal ligament
48
Thyro-arytenoid innervation and action
Inferior laryngeal nerve (terminal portion of recurrent laryngeal nerve from CN X) Relaxes vocal ligament
49
Posterior crico-arytenoid innervation/action
Inferior laryngeal nerve | Abducts vocal folds
50
Lateral crico-arytenoid innervation/action
Inferior laryngeal nerve | Adducts vocal folds (interligamentous portion)
51
Transverse and oblique arytenoids innervation/action
Inferior laryngeal nerve | Adduct arytenoid cartilages- adducting intercartilagenous portion of vocal folds, closing posterior rima glottidis
52
Vocalis innervation/action
Inferior laryngeal nerve | Relaxes posterior vocal ligament while maintaining (or increasing) tension of anterior part
53
Superior/inferior laryngeal arteries
Superior- accompanies internal branch of superior laryngeal nerve. Supplies superior larynx above vocal folds Inferior- accompanies inferior laryngeal nerve. Supplies inferior larynx below vocal folds
54
Superior laryngeal nerve
Branches into internal and external branches Internal innervates sensory above the vocal folds External innervates the cricothyroid muscle
55
Internal laryngeal nerve
Terminal branch of the recurrent laryngeal nerve Innervates all intrinsic muscles of larynx except cricothyroid Provides sensory below vocal cords
56
Superficial lymph nodes
Drain face and scalp Occipital- drain posterior scalp and neck Mastoid- drain posterolateral scalp Pre-auricular/parotid- drain ainterior auricle, anterolateral scalp, upper half of face Submandibular- follow facial artery, drain gingivae, teeth, tongue, upper lip and lateral lower lip Submental- drain center lower lip, chin, floor of mouth, tip of tongue and lower incisor teeth
57
Superficial cervical nodes receives drainage from what nodes
Occipital, mastoid nodes along external jugular vein | Eventually drain into deep cervical nodes
58
Deep cervical nodes receive drainage from what nodes
Pre-auricular/parotid, submandibular and submental Located along internal jugular vein Jugulodigastric is most superior node at C3-4 Jugulo-omohyoid is associated with lower deep cervical nodes at C6

COM Neuroendocrine (46 decks)

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