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Neuroscience And Behaviour > [002] The Superficial Structures In Neck > Flashcards

[002] The Superficial Structures In Neck Flashcards

1
Q

Where can you find the phrenic nerve

A

Travelling on scalenus anterior towards thorax

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2
Q

What does the anterior compartment of the neck contain

A

Digestive
Upper respiratory tract
Neuro vasculature

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3
Q

What does the posterior compartment of the neck contain

A

Vertebral column and associated musculature

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4
Q

Which fascia encloses all neck compartments

A

Deep cervical fascia

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5
Q

Where is the deep cervical fascia located

A

Below the superficial cervical fascia and platysma

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6
Q

What are the 3 main layers of the deep cervical fascia

A
  1. Investing layer
  2. Pretracheal layer
  3. Prevertebral layer
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7
Q

What muscles do the investing (/superficial/ anterior) layer enclose?
What structure/ compartment is associated with it

A

Encloses trapezius and sternocleidomastoid

Associated with carotid sheath

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8
Q

Which muscle is contained in the superficial cervical fascia

A

Platysma

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9
Q

What does the Pretracheal (/middle) layer enclose?

A

Encloses infrahyoid muscles, thyroid gland, trachea and oesophagus

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10
Q

What does the prevertebral (/deep/ posterior) layer enclose?

A

Encloses erector spinae, prevertebral muscles and scaleni muscles

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11
Q

What is C1 vertebrae called

A

Atlas

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12
Q

What is C2 cervical vertebrae called

A

Axis

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13
Q

Properties of cervical vertebrae

A
  • transverse foramen between rib angle and transverse processes
  • commonly bifurcated spinous processes
  • specific shapes of C1 and C2
  • cranial orientated joint facets (joint facets visible in axial plane)
  • large vertebral canal
  • additional joints (= uncinate joints) formed between uncinate processes of neighbouring vertebral bodies
  • large range of movements possible (eg flexion, extension, lateral bending, rotation)
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14
Q

What is the scaleni muscle composed of

A

Anterior, middle and posterior scalenus

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15
Q

Function of scaleni

A

(Enclosed in prevertebral layer of deep cervical fascia)

Laterally bend neck
Lift ribs 1 and 2 (breathing mechanics)

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16
Q

Which muscle is the phrenic nerve anatomically related to in the neck

A

Scaleni
Phrenic nerve runs vertically down the anterior scalene

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17
Q

What innervates the scaleni muscle

A

Cervical and brachial plexi

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18
Q

What encloses the infrahyoid / “strap” muscles

A

Pretracheal layer of deep cervical fascia

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19
Q

Function of infrahyoid muscles

A

Lower hyoid and larynx in relation to mandible

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20
Q

What are the 4 infrahyoid muscles and its innervation

A

Thyrohyoid (C1)
Omohyoid (C1,2,3 via ansa cervicalis)
Sternohyoid (C1,2,3 via ansa cervicalis)
Sternothyroid (C1,2,3 via ansa cervicalis)

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21
Q

Innervation of sternocleidomastoid

A

Motor: Spinal accessory nerve cranial nerve XI
Sensory: cervical plexus

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22
Q

Innervation of trapezius

A

Motor:
spinal accessory nerve cranial nerve XI
C3, C4 spinal nerves

Sensory: cervical plexus

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23
Q

Action of upper fibres of trapezius

A

Elevate and upwardly rotate scapula and extend neck

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24
Q

Action of sternocleidomastoid

A

One muscle will produce side flexion of head to same side

One muscle will rotate head to opposite side

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25
Q

Action of trapezius and sternocleidomastoid muscle combined

A

Unilateral:
Lateral bending to same side, rotation to opposite side

Bilateral:
neck flexion and head extension, assists breathing mechanics (sternal lift)

26
Q

What is the main head and neck arterial supply

A

Stems directly from aorta — carotid arteries (internal and external)

27
Q

What is the main venous drainage of head and neck into

A

To superior vena cava, via jugular veins (internal and external)

(Internal jugular vein is larger than external)

28
Q

Where does the common carotid divide at
And what does the common carotid artery divide into

A

Common carotid divides into internal and external carotid arteries

Near superior border of thyroid cartilage

29
Q

Internal carotid artery route of travel
What does it supply

A

Continues upwards and enters skull through carotid canal
Without releasing any branches

Supplies cerebrum and meninges

30
Q

External carotid artery
What does it supply?

A

Supplies larynx, pharynx, mouth, nose and
Scalp, skull, meninges

And shares the supply to thyroid gland

31
Q

Where is the carotid sinus located at?

A

Carotid sinus is a dilation of the start of the internal carotid artery
Situated behind bifurcation of common carotid artery

32
Q

What is the carotid sinus sensitive to

A

Sensitive to arterial blood pressure changes
Due to many baroreceptors

33
Q

Where is the carotid body found

A

In close vicinity to carotid sinus

34
Q

Function of carotid body

A

Contains chemoreceptors,
Monitoring
- O2/ CO2 levels
- pH levels
- temperature of arterial blood

35
Q

Innervation to carotid body and sinus

A

Main innervation to carotid body and sinus is derived from: carotid branches of glossopharyngeal nerve (IX)

Also receives contribution from
- cervical sympathetic trunk
- vagus nerve (X)

36
Q

Overview of head and neck arterial supply

A

In addition to carotids, head and neck receive blood from:
branches of subclavian arteries — vertebral arteries (supplying cerebrum and meninges)

37
Q

What muscle is internal jugular vein related with

A

Sternocleidomastoid muscle is a clinically important relation of internal jugular vein

Internal jugular vein is found in a line between tragus of ear and between the heads of SCM

38
Q

External jugular vein surface relations with which muscle/

A

Sternocleidomastoid
Runs across sternocleidomastoid superficially

39
Q

What is the general direction of lymphatic drainage for the head and neck

A

Superficial lymph vessels of both head and neck drain to —> superficial cervical nodes —> deep cervical nodes

*some superficial structures drain directly to deep cervical nodes

Deep cervical nodes —> lymphatic duct (right), thoracic duct (left)

40
Q

What are the 5 superficial lymph nodes of the head and neck (from posterior to anterior)

A
  1. Occipital nodes (near occipital artery)
  2. Mastoid nodes, including posterior auricular nodes (near auricular artery)
  3. Parotid and/or pre auricular nodes (near superficial temporal artery)
  4. Submandibular nodes (near facial artery)
  5. Submental nodes (near facial artery)
41
Q

What is the general drainage direction of the 5 superficial lymph nodes?

A

Posterior-most two groups (occipital and mastoid lymph nodes): drain to superficial cervical lymph node

Other three groups ( parotid, submandibular, submental lymph nodes): drain to deep cervical lymph node directly

42
Q

What are the deep chains of cervical lymph nodes associated with

A

Associated with internal jugular vein and carotid sheath

Beneath sternocleidomastoid

43
Q

Where does jugulodigastric node receive lymph from?

A

( jugulodigastric node is a large lymph node)

Receives lymph from tonsils and tonsillar beds (back of nose and mouth)

44
Q

What is the uppermost deep cervical node

A

Jugulodigastric lymph node

45
Q

Where does jugulo-omohyoid node receive lymph from?

A

From tongue

(Jugulo-omohyoid node is large)

46
Q

Where else can supraclavicular node (deep cervical node) receive lymph from?

A

Supraclavicular nodes just below jugulo-Omohyoid nodes

Can receive lymph from upper limbs and trunk ( on the left)
- can be involved in cancers of chest and abdomen

47
Q

What forms the cervical plexus

A

Anterior spinal nerve roots of C1- C4

48
Q

How is the ansa cervicalis formed
(Which cervical spinal nerve roots are involved)

A

C1-C3

Inferior ansa root (C2,C3) form ansa cervicalis with superior root (C1)

49
Q

What is the direction of travel of ansa cervicalis of cervical plexus

A

Towards infrahyoid muscles (Omohyoid, Sternothyroid, Sternohyoid)

50
Q

Direction of travel of phrenic nerve (C3-C5)?

A

Travels on anterior scalene muscle towards thorax

51
Q

Does C1 contribute to body surface SENSORY innervation?

A

NO

52
Q

What are the branches of cervical plexus
Cervical plexus sensory distribution

A

Lesser occipital nerve
Greater auricular nerve
Transverse cervical nerve
Supraclavicular nerve

These branches can be located in the posterior neck triangle when following posterior border of the sternocleidomastoid

53
Q

Talk about the “origin” of accessory nerve (XI)

A

Accessory nerve has a cranial and spinal portion.
Spinal portion enters skull via foramen magnum

54
Q

How does vagus (X) and accessory nerve (XI) leave the skull

A

Via jugular foramen

55
Q

What is the course of travel for
A. Accessory nerve (XI)
B. Vagus nerve (X)

A

A.
Cranial portion of accessory nerve travels with vagus nerve to pharyngeal plexus and laryngeal nerves (their course is deep to neck)
Spinal portion of accessory nerve reaches sternocleidomastoid and trapezius (motor) muscles

B.
Vagus nerve travels in carotid sheath on its way to thorax

56
Q

Where does glossopharyngeal nerve (IX) leave the skull

A

Jugular foramen

57
Q

What is glossopharyngeal nerve (IX ) route of travel

A

Leaves skull via jugular foramen, crosses over internal carotid but below external one

58
Q

Hypoglossal nerve (XII) route of travel?

A

Follows stylopharyngeus muscle,
Crossing underneath accessory and over vagus nerve in neck to reach back of tongue

(Supplies carotid body and other stuff)

59
Q

Location of sympathetic trunk in neck

A

Located alongside carotid sheaths, anterior to transverse processes of cervical vertebrae

60
Q

Sympathetic trunk in neck contain 3 ganglia.
What are the 3 ganglia

A
  1. Superior/ upper cervical ganglion (C1-C4)
  2. Middle cervical ganglion (C5-C6)
  3. Inferior/ lower/ thoraco-cervical/ stellate ganglion (C7-T1)
61
Q

Effects of head sympathetic innervation

A

Dilated pupil, relaxed ciliary muscle
Reduced secretion of salivary gland
Reduced secretion of lacrimal glands
Increased secretion from sweat glands
Constricted blood vessels

Neuroscience And Behaviour (11 decks)

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