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Anatomy 2 Unit 2 > 1 - Neck: Fascial layers and compartments > Flashcards

1 - Neck: Fascial layers and compartments Flashcards

1
Q

Superficial fascia

A

Immediately deep to skin
Subcutaneous tissue
Comprised of loose connective tissue & fat

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2
Q

Deep fascia

A

Deep to superficial fascia
Dense, organized connective tissue layer
Devoid of fat
Envelops most body structures deep to skin & subcutaneous tissue

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3
Q

fascia

A

band of connective tissue that surrounds structures (such as enveloping muscles), giving rise to potential tissue spaces and pathways that allow infection to spread.

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4
Q

In the superficial neck fascia we find the

A

thin platysma m.

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5
Q

The deep fascia aids in

A

muscle movements, provides passageways for nn. & vessels, and provides attachment for some mm.

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6
Q

The neck is a tube, within this tube,

A

there are 4 longitudinal compartments:
1 visceral component (anterior) – contains digestive & respiratory systems as well as some endocrine glands
1 vertebral component (posterior) – contains cervical vertebrae, spinal cord, cervical nn., & mm. associated with vertebral column
2 vascular components (one on each side; lateral) – contains major vessels & vagus n. (CN X)

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7
Q

Investing fascia (deep)

A

Surrounds trapezius & SCM mm. & infrahyoid mm.

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8
Q

Pretracheal fascia

A

Surrounds the thyroid, trachea & esophagus & post. surface of infrahyoid mm.

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9
Q

Buccopharyngeal fascia

A

Surrounds pharynx posteriorly

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10
Q

Alar fascia

A

Ant. layer of prevertebral fascia & runs behind buccopharyngeal fascia

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11
Q

Prevertebral fascia

A

Surrounds prevertebral & deep back mm.

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12
Q

Carotid sheath

A

Column of fascia that surrounds the CCA, ICA, IJV, & Vagus n.

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13
Q

Muscular pretracheal f.

A

surrounds infrahyoid mm.

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14
Q

Visceral pretracheal f.

A

sur. thyroid, trachea & esophagus

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15
Q

Prevertebral Layer:

A

in the anterolateral position extends from the anterior and middle scalene muscles to surround the brachial plexus and subclavian artery as these structures pass into the axilla. Thus it is forming the axillary sheath.

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16
Q

Prevertebral Layer:

A

in the anterolateral position extends from the anterior and middle scalene muscles to surround the brachial plexus and subclavian artery as these structures pass into the axilla. Thus it is forming the axillary sheath.

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17
Q

Understand that in the sagittal view the

A

carotid space is not visible yet it is an important potential space associated with the neck and inferior access to the thorax.

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18
Q

Fascial Layers

A 
Investing fascia
Pretracheal fascia
Prevertebral fascia
Alar fascia
Buccophary-ngeal fascia
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19
Q

Please also note that the carotid sheath also extends from the

A

base of the skull

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20
Q

Fascial Spaces

A

Carotid sheath
Pretracheal space
Retropharyngeal space
Prevertebral “danger” space

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21
Q

Carotid Sheath

A

Between SCM & prevertebral mm.

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22
Q

carotid sheath formed by

A

condensations of deep cervical fascia

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23
Q

carotid sheath encases

A

carotid aa., IJVs & vagus nn.

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24
Q

Carotid sheath infections

A

Infections or blood may spread with sheaths from skull down into middle mediastinum

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25
Pretracheal Space
Between trachea & infrahyoid mm. | From thyroid cartilage down into anterior mediastinum
26
Pretracheal space infection
Infections here can spread between these 2 regions
27
Retropharyngeal Space
Between buccopharyngeal & alar fascia | From skull base down into superior mediastinum
28
Retropharyngeal space infection
can spread between these 2 regions skull base down into superior mediastinum
29
Prevertebral “Danger” Space (third space)
Between alar & prevertebral fascia
30
Prevertebral “Danger” Space * infections
Infections here can spread from skull base down into posterior mediastinum Notorious for inferior spread of infections here
31
Correlate - Prevertebral Emphysema
the cervical prevertebral space (arrows) connects to the mediastinum, which may permit gas or microorganisms from the oral cavity to enter the mediastinum. A 47-year-old woman with diabetes was seen in the emergency room withdifficulty swallowing, bilateral chest pain, and a foreign-body sensation in her throat. Earlier that day, she had undergone a root canal under local anesthesia. Her symptoms were initially attributed to an allergic reaction to the anesthetic. Examination showed crepitus (noise or vibration) in her neck. A radiograph of the neck showed emphysema with prevertebral air in the cervical soft tissues. The likely mechanism for the introduction of air was injection by means of a high-speed dental drill through the soft tissue adjacent to the roots of the lower molars. Surgical procedures, especially those involving the lower third molar teeth, may confer a predisposition to the development of soft-tissue emphysema and even a fatal air embolism when air-cooled dental turbines are used.
32
Horizontal Zones of the Neck
3 of them- emergency room terminology
33
Zone 1 (horizontal zone of neck)
thoracic inlet to cricoid cartilage
34
Zone 2 (horizontal zone of neck)
cricoid cartilage to angle of mandible
35
Zone 3 (horizontal zone of neck)
angle of mandible to base of skull Note: useful in clinical assessment of neck trauma
36
Triangles of the Neck
Each triangle contains key structures used as landmarks by anatomists and physicians operating in this area. The neck is a vertical conduit for structures entering or leaving the head. 
37
Posterior Cervical Triangle
SCM = anterior boundary Trapezius m. = posterior boundary Middle 1/3 of clavicle = inferior boundary
38
Posterior Cervical Triangle contents
``` Platysma m. External jugular v. Cutaneous nn. Motor nn. Transverse cervical & suprascapular aa. Deep muscles ```
39
Cutaneous Nerves
``` Lesser occipital (C2-C3) Great auricular (C2-C3) Transverse cervical (C2-C3) Supraclavicular nn. (C3-C4) ``` * All emerge deep to SCM at “Erb’s point”
40
Lesser Occipital Nerve (C2-C3)
Runs superiorly along posterior border of SCM Crosses over portion of occipital a. Supplies skin of scalp at apex of triangle
41
Great Auricular Nerve (C2-C3)
Ascends vertically on surface of SCM Runs with EJV superiorly toward ear Supplies lobe & skin posterior to auricle Also supplies angle of mandible to mastoid process
42
Transverse Cervical Nerve (C2-C3)
Runs transversely across middle of SCM Supplies skin of anterior cervical triangle & lateral neck
43
Supraclavicular Nerves (C3-C4)
Generally 3 main branches: Medial, intermediate & lateral (post.) nn. Run superficial to clavicle & deep to platysma Supply skin of clavicular region
44
Motor Nerves posterior cervical triangle
Accessory n. (CN XI) Phrenic n. (C3-C5)
45
Accessory Nerve (CN XI) emerges from
jugular foramen
46
Accessory Nerve (CN XI)
Runs diagonally thru triangle deep to investing fascia | Supplies both SCM & trapezius mm.
47
The trapezius m. also receives proprioceptive fibers
C3-C4
48
Phrenic Nerve (C3-C5) descends
vertically along anterior scalene m.
49
Phrenic nerve Crossed
anteriorly by transverse cervical a. & suprascapular a.
50
Phrenic Nerve (C3-C5)
Enters thorax between subclavian v. & a. | Travels along pericardial sac to supply diaphragm
51
Phrenic n. & supraclavicular nn. share similar
origins Phrenic n (C3-C5) VS supraclavicular nn. (C3-C4) Explains phenomenon of referred pain in pleurisy Irritation of phrenic n referred from diaphragm to supraclavicular nn. in clavicular region
52
pleurisy
Irritation of phrenic n referred from diaphragm to supraclavicular nn. in clavicular region
53
Vessels of the Posterior Triangle
External jugular vein, Transverse cervical a, Suprascapular a
54
External jugular v. (EJV
drains into subclavian v.
55
Transverse cervical a.
from thyrocervical trunk
56
Suprascapular a
from thyrocervical trunk
57
After crossing the sternocleidomastoid m., the EJV
enters the posterior triangle and continues its vertical descent.
58
In the lower part of the posterior triangle, the EJV
pierces the investing layer of cervical fascia and ends in the subclavian v.
59
After branching from the thyrocervical trunk, the transverse cervical a.
passes laterally and slightly posteriorly across the base of the posterior triangle anterior to the anterior scalene muscle and the brachial plexus.
60
The suprascapular a. passes
laterally, in a slightly downward direction across the lowest part of the posterior triangle, and ends up posterior to the clavicle
61
Deep Muscles of the Posterior Triangle
Splenius capitis m. Levator scapulae m. 3 scalene mm. Omohyoid m. (inferior belly)
62
Splenius Capitis Muscle action
Extend & laterally rotate head & neck
63
Splenius Capitis Muscle innervation
Dorsal rami of spinal nn
64
Levator Scapulae Muscle action
Elevate scapula
65
Levator Scapulae Muscle innervation
Dorsal scapular n. (C5)
66
3 Scalene Muscles
Anterior, posterior, inferior All - A: Tilt neck laterally Inn: Ventral rami C3-C8 nn.
67
Interscalene Triangle
Elongated triangle deep to posterior cervical triangle Anatomical variations can cause narrowing of triangle Extra m. slips, cervical ribs or cartilage outgrowths May compress brachial plexus or subclavian a. Leads to n. dysfunction or ischemia or UL May contribute to thoracic outlet syndrome Compromise of nn. or aa. between neck base & axilla
68
Interscalene triangle formed by
anterior scalene, middle scalene & 1st rib
69
Interscalene Triangle brachial plexus and
subclavian a. pass thru it
70
Interscalene triangle - Subclavian v. passes
ant. to anterior scalene m.
71
Lesser occipital root
C2-C3
72
Great auricular root
C2-C3
73
Transverse cervical root
C2-C3
74
Supraclavicular root
C3-C4
75
Middle mediastinum
heart. Once infection gets here, it can spread rapidly around body.
76
T4-T5
around area of superior mediastinum.
77
T12
posterior mediastinum - goes to inferior diaphragm.
78
Treatment for infections between layers is
pretty much the same. Antiobiotics, monitor. Otherwise this will become systemic.
79
Cervical plexus
where cutaneous nerves come from.
80
Transverse cervical artery
runs opposite (posteriorly) than the transverse cervical nerve. Lateral posterior, other runs lateral anterior
81
Anterior and middle scalene have
slit between them for brachial plexus. Forms interscalene triangle.
82
Excess tissue in interscalene triangle can lead to
pain or loss of sensation.

Anatomy 2 Unit 2 (15 decks)

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