1 - Triangles and Root of the Neck

Question 1

What are the bones of the neck?

Answer 1

The temporal bone (mastoid process and styloid process), mandible, hyoid, clavicle, and sternum.

Question 2

What are the attachments of the sternocleidomastod muscle? What is it’s innervation?

Answer 2

Mastoid process and the sternum and clavicle.

Innervation: Accessory nerve - CN XI motor and C2, C3 nerves proprioception (sensory) and pain

Question 3

What is the action of the sternocleidomastoid muscle unilaterally and bilaterally?

Answer 3

Unilaterally: lateral flexion to the same side and rotation to opposite side

Bilaterally: cervical flexion

Question 4

What are the attachments of the scalene muscles? What is their innervation and action?

Answer 4

Transverse processes of cervical vertebrae and first two ribs.

Bilaterally assist in neck flexion and raise the first t ribs.

Innervation: ventral rami of cervical nerves.

Question 5

What are some important landmarks near the scalene muscles?

Answer 5

Subclavian gap between anterior and middle scalene: subclavian ARTERY goes through this ( not the vein).

Phrenic nerve comes out between the middle and anterior scalene and sits on top of anterior scalene.

Question 6

What are the suprahyoid muscles?

Answer 6

Mylohyoid, digastric (anterior and posterior), stylohyoid, and geniohyoid.

Question 7

What are the infrahyoid muscles?

Answer 7

Omohyoid, sternohyoid, sternothyroid, thyrohyoid.

Question 8

What is the superficial cervical fascia between? What does it contain?

Answer 8

The dermis of the skin and the investing layer of deep cervical fascia.

Cuteaneous nerves, blood, and lymphatic vessels.

Anteriorly contains the platysma muscle.

Question 9

What are the layers of the deep cervical fascia?

Answer 9

1. Superficial investing fascia
2. Pretracheal fascia
3. Prevertebral fascia

Question 10

Describe the superficial investing fascia (part of the deep cervical fascia). What is it’s function?

Answer 10

Surrounds entire neck deep to skin and superficial fascia.

Splits into superficial and deep layers to invest the traps and sternocleidomastoid muscles.

Protects head from getting bacteria from skin.

Question 11

Where is the thin pretracheal layer of deep cervical fascia located? What are it’s layers?

Answer 11

Anterior part of neck.

This muscular layer that encloses the infrahyoid muscles and a visceral layer that encloses the thyroid gland, trachea, and esophagus.

Question 12

What is the visceral layer of the pretracheal layer of deep fascia continuous with?

Answer 12

The buccopharyngeal fascia, which separates the esophagus from the prevertebral fascia.

Question 13

As the prevertebral fascia approaches the anterior tubercles of the vertebrae where it attaches, it contributes to the posterior portion of the ______ ______?

Answer 13

Carotid sheath.

Question 14

The prevertebral fascia splits into two laminae , ______ and ______.

Answer 14

Alar fascia (anterior)

Prevertebral fascia (posterior)

Question 15

What are the contents of the carotid sheath?

Answer 15

IC 10 CC’s in the IV

Internal carotid artery, cranial nerve 10 (vagus), Common carotid artery, and the internal jugular vein.

Question 16

Why is the prevertebral space called “danger space 4”?

Answer 16

Beccause here the pretracheal fascia extends inferiorly from the hyoid bone into the thorax where it blends with the fibrous pericardium around the heart.

1/2 of people with infection here will die because infection spreads to heart and lungs.

Question 17

What does the thyocervical trunk arise from and what does it give off?

Answer 17

Arises from subclavian.

Gives off: suprascapular artery, transverse cervical artery, inferior thyroid artery, and the ascending cervical artery.

Question 18

What are the branches of the external carotid artery?

Answer 18

Some Angry Ladies Fight Off PMS!

1. Superior thyroid
2. Ascending pharyngeal
3. Lingual
4. Facial
5. Occipital
6. Posterior auricular
7. Superficial temporal
8. Maxillary

Question 19

What are the contents of the submandibular triangle?

Answer 19

Submandibular gland, submandibular lymph nodes, hypoglossal nerve (CN XII), merve to mylohyoid, facial artery, and facial vein.

Question 20

What are the contents of the Submental triangle?

Answer 20

Submental lymph nodes, tributaries of the anterior jugular vein, and geniohyoid muscle (deep).

Question 21

What are the contents of the muscular triangle?

Answer 21

Sternohyoid, sternothyroid, thyrohyoid, and omohyoid muscles as well as the thyroid and parathyroid glands.

Question 22

What does the carotid triangle contain?

Answer 22

Common carotid a, internal carotid a, external carotid a; the internal jugular vein and vagus nerve (CN X), spinal accessory nerve (CN XI), and hypoglossal nerve (CN XII); the ansa cervicalis and the transverse cervical nerve; and cervical branch of the facial nerve.

Question 23

What are the two subdivisions of the posterior triangle?

Answer 23

The occipital triangle and the omoclavicular triangle.

Question 24

What are the contents of the occipital triangle?

Answer 24

Ex. jugular vein, branches of cervical plexus, accessory nerve, trunks of brachial plexus, transverse cervical artery, and cervical lymph nodes.

Question 25

What are the contents of the omoclavicular triangle?

Answer 25

Subclavian artery, subclavian vein, suprascapular artery, and supraclavicular lymph nodes.

Question 26

When is a neck wound considered a penetrating neck wound?

Answer 26

If it penetrates the platysma.

Question 27

What is zone III of the neck? What is located here?

Answer 27

Between the angle of the mandible and the base of the skull.

Distal carotid and vertebral arteries; some segments of jugular veins.

Question 28

What is zone II of the neck? What is located here?

Answer 28

Between the cricoid cartilage and the angle of the mandible.

Carotid and vertebral arteries, jugular veins, pharynx, larynx, esophagus, and trachea.

Question 29

What is zone I of the neck? What is located here?

Answer 29

Inferior to the cricoid cartilage.

Trachea, great vessels, upper mediastinum. lung apices, thoracic duct.

Mortality in zone I is the highest of all three zones!!!