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MD4001 Week 4 > 1. Structure of the Neck and Cervical Spine > Flashcards

1. Structure of the Neck and Cervical Spine Flashcards

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1
Q

Neck anterior and inferior boundaries?

Importance?

A

Superior boundary: Base of skull & inferior border of mandible
Inferior boundary: Top of sternum, clavicle, acromion (anterior) & C7 (posterior)

Houses critical structures:
Serves as conduit for structures passing between head/thorax & head/upper limb

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2
Q

Boundaries of the anterior triangle of the neck?

A

Bounded by inferior border of mandible, anterior border of SCM & midline of neck (head-thorax connection; superior thoracic aperture [thoracic inlet])

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3
Q

Boundaries of the posterior triangle of the neck?

A

Posterior triangles: Bounded by posterior border of SCM, middle 3rd of clavicle & anterior border of trapezius (head/neck-upper limb connection; axillary inlet at base)

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4
Q

2 triangles of neck?

A

Anterior and posterior

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5
Q

2 region of the neck and their contents?

A

cervical region
Sternocleidomastoid region: SCM, nerves (great auricular, transverse cervical), external jugular vein (superior part)
Posterior cervical region: Trapezius, nerves (cutaneous branches of posterior rami of cervical spinal nerves)

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6
Q

What are the neck compartments?

A

Visceral
Vertebral
2 x vascular

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7
Q

Viceral compartment of neck, contents?

A

Contains parts of respiratory system, digestive system & endocrine glands

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8
Q

Vertebral neck compartment, contents?

A

Contains cervical vertebrae, spinal cord, muscles & cervical nerves

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9
Q

2 vascular compartments of the neck, contents?

A

On either side of visceral compartment

Contains blood vessels & nerves (CN X)

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10
Q

The compartments (vertical columns) of the neck are surrounded by ______!

A

The compartments (vertical columns) of the neck are surrounded by fascia!

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11
Q

Role of fascia in neck?

A
  • Provides containment (varying rigidity) of muscles & viscera
  • Provides slipperiness that allow structures to slide over each other (expansion/contraction, up/down)
  • Serves as conduit for passage of neurovascular structures
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12
Q

Layers of the deep cervical fascia of the neck

A

1: Investing fascia (hugs muscles e..g SCM, trapezius) also called musculofascial collar
2. Pretracheal (ant to trachea)
3. Prevertebral
4. Carotid sheath (contains vascular compartment)

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13
Q

Superfical fascia layers?

A

cervical subcutaneous tissue and platysma muscle

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14
Q

Superficial neck fascia connects to..

A
  • Continuous with superficial fascia of thorax

* Connects to mandible & facial muscles

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15
Q

Role of investing fascia? (part of deep fascia)

Encloses what structures?

A
  • Surrounds neck completely except for superficial layer, same as deep fascia of limbs
  • Encloses (‘invests’) SCM, trapezius & infrahyoid muscles
  • Encloses (‘invests’) parotid & submandibular glands
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16
Q

What vessels pierces through the investing deep fascia of the neck?

A

External and anterior jugular veins and nerves

inc cervical plexus

17
Q

Attachments of the investing fascia?

A
  • Posterior: Ligamentum nuchae & C7 spinous process; surrounds trapezius
  • Anterior: Hyoid bone; surrounds infrahyoid & SCM
  • Superior: External occipital protuberance & superior nuchal line
  • Inferior: Spine of scapula, acromion, clavicle, manubrium (see suprasternal space)
  • Lateral: Mastoid process & zygomatic arch
18
Q

The pretracheal fascia (as part of the deep neck fascia:

  • Surrounds what?
  • Attachments?
  • Posteriorly called?
  • Lateral relation?
  • Anteriorly separates what?
  • Pierced by which vessels?
A
  • Surrounds viscera as visceral part (trachea, oesophagus & thyroid gland)
  • Extends from hyoid bone to upper thoracic cavity (blends with fibrous pericardium & aortic arch)
  • Posteriorly it is called buccopharyngeal fascia (runs from base of skull to thoracic cavity)
  • Laterally fuses with carotid sheath (extends to C7)
  • Anteriorly, it separates infrahyoid muscles from the trachea & thyroid glands (muscular part)
  • Pierced by thyroid vessels
19
Q

The prevertebral fascia (as part of the deep neck fascia:

  • Surrounds what?
  • Attachments?
  • Pierced by which vessels?
  • Relation to first rib?
A
  • Surrounds vertebral column (including cervical nerves), pre- & post-vertebral muscles (scalenes, longus colli, longus capitus, deep cervical muscles)
  • Pierced by cutaneous branches of cervical plexus
  • Fixed to the cranial base (superior), blends with endothoracic fascia (inferior), blends with anterior longitudinal ligament at T3/4 (posterior)
  • Prevertebral fascia extends laterally over the first rib to surround axillary vessels & brachial plexus as the axillary sheath
20
Q

Prevertebral fascia of the deep fascia of the neck, attachments?

A

• Posterior: Along superior nuchal line to external
occipital protuberance
• Anterior: Attaches to basilar part of occipital
bone, area of jugular foramen & carotid canal
• Lateral: Mastoid process

Extends: from base of skull to superior mediastinum…

21
Q

Neck deep fascia: carotid sheath-
Surrounds?
Juxtaposed to?
Runs from?

A
  • Surrounds major vasculature (CCA, int CA, part ext CA, int JV) & CN X), other nerves, some cervical lymph nodes
  • Juxtaposed to all other deep fascial types, receives contributions from each
  • Runs from foramen of carotid canal to aortic arch
22
Q

Where is the pretracheal space?

A

Between investing layer and pretracheal fascia. Area extends between neck and superior mediastrinum

23
Q

Where is ‘True’ retropharyngeal space: ?

A

Between buccopharyngeal fascia & superficial prevertebral fascia (alar fascia); area extends between base of skull & superior mediastinum

24
Q

Where is Danger (alar) space/fascial space?

A

Within prevertebral layer (alar fascia & deep prevertebral layer); covers anterior surface of transverse processes & bodies of cervical
vertebrae; area extends from base of skull through posterior mediastinum to diaphragm

25
Q

How does the danger space change between healthy and infected individuals?

A 
When healthy:
The danger (alar) space is indistinguishable for the ‘true’ retropharyngeal space

When infected:
Infections from the pharynx can spread via the ‘true’ retropharyngeal (e.g. retropharyngeal abscess) & danger (alar) spaces into the posterior mediastinum

NOTE: Fluid collection & abscesses in the danger (alar) space are visible in radiological investigations

26
Q

Hyoid bone:

  • Shape
  • Location?
  • Connections?
A

U-shaped bone

Found at C3 level in anterior neck

Suspended by muscles & ligaments with connections to mandible, styloid process, thyroid cartilage, manubrium & scapulae
Connects oral cavity with pharynx posteriorly & larynx inferiorly

27
Q

Role/attachment of ligamentum nuchae?
Continuous with which ligament?
Resists which movements?

A

Attaches external occipital protuberance & foraman magnum to spinous processes of the cervical vertebrae

Continuous with supraspinous ligament

Supports head & resists flexion, attachment point for muscles

28
Q

Cervical are only vertebrae with which feature?

A

Foramen transversarium (vertebral artery)

29
Q

Spinous process (bifid in ___-C6)

A

Spinous process (bifid in C2-C6)

30
Q

What makes the atlas atypical compared to other cervical vertebrae?

A

C1: Anterior & posterior arches, no body, spinous process = tubercle, facets articulate with occipital condyles of skull or dens)

31
Q

What makes the axis atypical compared to other cervical vertebrae?

A

C2: Have the dens!

32
Q

Movements at atlanto-occiptal joint?

Type of joint?

A

Allows flexion & extension (nodding); condyloid joint

33
Q

Movements allowed of the head by Lateral atlanto-axial joint & pivot joint of dens?
Assisted by….

A

Allows rotation of head

Assisted by transverse ligament of atlas holding dens in position

34
Q

Location and role of alar ligaments?

A

Alar ligaments prevent excessive rotation of head & neck, connect dens to occipital condyles

35
Q

Describe the IV disk between C1 and C2?

A

There isn’t one silly

36
Q

In hyperextension of the neck; major area of damage for _______ ________ ligament, but vertebrae can also become dislocated &/or fractured

A

Anterior longitudinal ligament

37
Q

3 major structures that are at C3/4 level?

A

Bifurcation of common carotid artery
Top of thyroid cartilage of larynx (palpable)
Hyoid bone

38
Q

2 major structures at C6 level?

A

C6:
Lower border of pharynx & larynx (cricoid cartilage palpable)
Upper border of oesophagus & trachea

39
Q

Apex of lung & cervical portion of parietal pleura is in the ____ not _______!

A

Apex of lung & cervical portion of parietal pleura is in the neck not thorax!

MD4001 Week 4 (9 decks)

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