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Neuroendocrine > 1. Triangles Of Neck And Larynx > Flashcards

1. Triangles Of Neck And Larynx Flashcards

1
Q

What is at the vertebral level of C3-C4?

A
  • Body of hyoid bone
  • Upper margin of thyroid cartilage
  • Bifurcation of common carotid artery
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2
Q

What is at the vertebral level of C5-C6?

A
  • Arch of cricoid cartilage
  • Superior end of esophagus
  • Superior end of trachea
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3
Q

Boundaries of anterior triangle

A
  • Midline of neck
  • SCM
  • Lower border of mandible
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4
Q

Boundaries of posterior triangle

A
  • SCM
  • Trapezius m.
  • Clavicle
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5
Q

Submandibular triangle

A
  • Anterior belly of digastric
  • Posterior belly of digastric
  • Inferior border of mandible
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6
Q

Boundaries of submental triangle

A
  • Midline of neck
  • Anterior body of digastric m.
  • Body of hyoid
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7
Q

Boundaries of muscular triangle

A
  • Body of hyoid
  • Superior belly of omohyoid
  • SCM
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8
Q

Boundaries of carotid triangle

A
  • Posterior belly of digastric m.
  • Superior belly of omohyoid m.
  • SCM
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9
Q

Contents of the floor of the posterior triangle

A
  • Splenius capitis m.
  • Levator scapulae m.
  • Scalene mm. (posterior, middle, anterior)
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10
Q

Arteries in the posterior triangle (most important)

A
  • thyrocervical trunk
    • transverse cervical a.
      • deep cervical a. (II)/dorsal scapular a.(III)
      • superficial cervical a.
    • suprascapular a.
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11
Q

Veins in the posterior triangle

A
  • External jugular vein (EJV)
  • Subclavian vein (SV)
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12
Q

Nerves in the posterior triangle

A
  • Cervical plexus (cutaneous branches)
    • Lesser occipital n.
    • Greater auricular n.
    • Transverse cervical n.
    • Supraclavicular n.
  • Ansa cervicalis
  • Spinal accessory n.
  • Phrenic n.
  • Roots of the brachial plexus
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13
Q
  1. Contraction or shortening of SCM causes head to tilt ____ and face to tilt _____ affected side.
  2. What is this called?
A
  1. Head tilts toward; face tilts away
  2. Torticollis
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14
Q

Muscles of the anterior triangle

A
  • Suprahyoid muscles (elevate hyoid and larynx)
    • Mylohyoid m.
    • Stylohyoid m.
    • Digastric m. (anterior & posterior bellies)
    • Geniohyoid
  • Infrahyoid muscles (depress hyoid & larynx)
    • Sternohyoid
    • Omohyoid
    • Sternothryoid
    • Thyrohyoid
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15
Q

Arteries of the anterior triangle

A

From the external carotid artery:

  • superior thyroid a
  • lingual a.
  • facial a.
  • ascending pharyngeal a.
  • occipital a.
  • posterior auricular a.
  • maxillary a.
  • superifical temporal a.
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16
Q

Triangles within the anterior triangle

A
  • Submandibular
  • Submental
  • Carotid
  • Muscular (omotracheal)
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17
Q

What are the contents of the submandibular triangle?

A
  • Submandibular gland
  • Submandicular lymph nodes
  • Hypoglossal nerve (CN XII)
  • Nerve to myolohyoid m.
  • Facial artery and vein
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18
Q

What are the contents of the submental triangle?

A
  • Submental lymph nodes
  • Small veins that unite to form anterior jugular vein
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19
Q

What are the contents of the carotid triangle?

A
  • Carotid sheath: CCA, ICA, IJV, vagus n, deep cervical LN, carotid sinus n., sympathetic nerve fibers
  • Not within the carotid sheath:
    • Arteries: branches of the ECA
    • Nerves: internal and external laryngeal nerves, hypoglossal nerve, spinal accessory nerve, ansa cervicalis
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20
Q

What are the contents of the muscular triangle?

A
  • Muscles: sternohyoid m., sternothyroid m., thryohyoid m.
  • Viscera: thyroid gland, parathyroid glands, larynx, trachea, esophagus
  • Arteries: common carotid a., superior thyroid a., inferior thyroid a.
  • Veins: anterior jugular v., thyroid v. (superior, middle, inferior)
  • Nerves: ansa cervicalis, external laryngeal v., recurrent laryngeal v.
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21
Q

Vasculature of the carotid triangle

A

External carotid a.

  • Ascending pharyngeal a.
  • Occipital a.
  • Posterior auricular a.
  • Superior thyroid a.
  • Lingual a.
  • Facial a.
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22
Q

Which structure is an important baroreceptor (arterial BP)?

A

carotid sinus

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23
Q

What structure is an important chemoreceptor (O2 levels in blood)?

A

carotid body

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24
Q

sole motor supply to the diaphragm

A

phrenic n.

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25
Q

clinical importance of the phrenic n.

A
  • sole motor supply to diaphragm => phrenic n. must be identified during thoracic surgery and preserved
  • phrenic n. arises from neck => pt w/ spinal cord injuries below neck are still able to breathe effectively despite paralysis of lower limbs
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26
Q

Where is the phrenic n.?

A

superficial to the anterior scalene m.

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27
Q

cervical plexus

A

anterior rami of C1-C4

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28
Q

thin connective tissue layer that lies between dermis and investing layer of deep cervical fascia

A

subcutaneous layer (superficial fascia)

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29
Q

contents of the superficial fascia

A
  • cutaneous nerves
  • blood and lymphatic vessels
  • superficial lymph nodes
  • fat
  • platysma m.
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30
Q

(1) muscle of facial expression
(2) innervation of this muscle

A

(1) platysma m.
(2) Facial N. (CN VII)

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31
Q

layers of the deep cervical fascia

A
  1. investing layer
  2. pretracheal layer
  3. prevertebral layer
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32
Q
  • most superficial of the 3 deep cervical fascial layers
  • surrounds entire neck
  • encloses sternocleidomastoid and trapezius m.
  • encloses parotid and submandibular glands
  • extends to manubrium, clavicles, acromion, spines of scapula
A

deep cervical fascia

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33
Q
  • located in the anterior region of the neck
  • blends with fibrous pericardium of the heart
  • muscular layer (infrahyoid muscles), buccopharyngeal fascia, and a visceral layer
A

pre-tracheal layer

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34
Q
  • encloses the vertebral column and associate muscles
  • extends laterally as the axillary sheath into the arm
  • extends from cranial base to mediastinum
A

pre-vertebral layer

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35
Q

Where is the retropharyngeal space?

A

posterior to the pharynx

36
Q

Boundaries of the retropharyngeal space

A
  • anterior: buccopharyngeal fascia
  • posterior: pre-vertebral fascia
  • laterally: carotid sheaths
37
Q

Where does the retropharyngeal space extend to?

A
  • superiorly to the base of the skull
  • inferiorly to the mediastinum
38
Q

When would a retropharyngeal abscess develop?

A

secondary to lymphatic drainage or contiguous spread of URI or oral infections

39
Q

Retropharyngeal abscess/swelling causes?

A
  • cause difficulty in swallowing and speaking
  • can be life-threatening
40
Q

muscles of larynx

A
  • cricothyroid m.
  • thyro-arytenoid m.
  • posteriorcrico-arytenoid m.
  • lateral crico-arytenoid m.
  • transverse and oblique arytenoids m.
  • vocalis m.
41
Q

innervation of the cricothyroid m.

A

external laryngeal nerve (CN X)

42
Q

innervation of all muscles of the larynx (except cricothyroid m.)

A

inferior laryngeal nerve (terminal part of recurrent laryngeal n.)

43
Q

runs superficially and laterally across the phrenic n. and anterior scalene m.

A

transverse cervical a.

44
Q
  • branch of the thyrocervical trunk
  • passes inferolaterally across the anterior scalene m. and phrenic n.
  • travels with the suprascapular n.
A

suprascapular artery

45
Q

route of external jugular vein (EJV)

A
  • begins inferior to the angle of the mandible by the union of posterior retromadibular v. & posterior auricular v.
  • anterior to the SCM
  • drains into the subclavian v.
46
Q

route of subclavian vein

A
  • anterior to the anterior scalene m.
  • joins with internal jugular v. to form the brachiocephalic v.
47
Q

Occipital triangle (posterior)

  1. Boundaries
  2. Contents
A
  1. Boundaries
    • SCM
    • trapezius m.
    • inferior belly of the omohyoid
  2. Contents
    • part of EJV
    • posterior branches of cervical plexus of n.
    • spinal accessory nerve (CN XI)
    • trunks of brachial plexus
    • cervicodorsal trunk
    • cervical lymph node
48
Q

Omoclavicuar/subclavian triangle (posterior)

  1. Boundaries
  2. Contents
A
  1. Boundaries
    • SCM
    • inferior belly of the omohyoid
    • clavicle
  2. Contents
    • subclavian a.
    • part of subclavian v.
    • suprascapular a.
    • supraclavicular lymph nodes
49
Q

Floor of the submandicular triangle

A
  • Myolohyoid m.
  • Hypoglossus m.
  • Middle pharyngeal constrictor
50
Q

Floor of the submental triangle

A

myolohyoid m.

51
Q

Contents of the carotid sheath

A
  • Medial: carotid arteries
  • Lateral: internal jugular vein
  • Posterior: vagus n.
  • Anterior/embedded: ansa cervicalis
52
Q

Branches of the vagus nerve

A
  • Pharyngeal branch
  • Superior laryngeal
    • Internal branch of the superior laryngeal n.
    • External branch of the superior laryneal n.
  • Carotid body branch
53
Q

anatomist reference to superior thoracic aperture where food and air may enter

A

thoracic inlet

54
Q

clinician reference to superior thoracic aperture where arteries and nerves emerge

A

thoracic outlet

55
Q

contents of the thoracic inlet/outlet

A
  • lung apex
  • subclavian a. and v.
  • brachial plexus
  • vagus n.
  • phrenic n.
  • thoracic duct
  • right lymphatic duct
  • sympathetic chain
  • trachea
  • esophagus
56
Q

Which branches of the cervical plexus provide sensory innervation: superficial or deep?

A

superficial branches

57
Q

Which branches of the cervical plexus provide motor innervation: sueprficial or deep?

A

deep branches

58
Q

Location of superior cervical ganglion

59
Q

Location of middle cervical ganglion

A

C6 (level of cricoid cartilage)

60
Q

Location of inferior cervical ganglion

A

anterior to TP of C7

61
Q

when inferior cervical ganglion fuses with 1st thoracic ganglion in 80% population

A

stellate (cervicothoracic) ganglion

62
Q

What bones attach to the investing layer of the deep cervical fascia?

A
  1. occipital and temporal bones
  2. zygomatic arches
  3. inferior border of mandible
  4. hyoid bone
  5. SP of cervical vertebrae

*extends to manubrium, acromion/spine of scapula, and clavicles

63
Q

location of the thyroid

A
  • deep to sternothyroid and sternohyoid m.
  • vertebral levels C5-T1
  • isthmus anterior to 2nd/3rd tracheal rings
64
Q

arteries of the thyroid

A
  • superior thyroid a. (anterior-superior aspects)
  • inferior thyroid a. (posterior-inferior aspects)
  • thyroid ima a. (anterior to trachea, 10% pop)
65
Q

veins of the thyroid

A

superior, middle, and inferior thyroid veins form thyroid plexus of veins

66
Q

route of recurrent laryngeal nerves

A
  • ascend in a groove between trachea and esophagus
  • pass deep to posteromedial surface of lateral lobes of thyroid gland
67
Q

What binds thyroid gland to the trachea and cricoid cartilage of the larynx?

68
Q

location of the larynx

A

vertebral levels C3-C6; connected to pharynx and trachea

69
Q

functions of the larynx

A

phonation and patent airway

70
Q
  • located at C4
  • contain: laminae, laryngeal prominence, superior thyroid notch, superior and inferior thyroid horn
A

thyroid cartilage

71
Q
  • located at C6
  • signet ring shaped
  • laminae
  • arch
A

cricoid cartilage

72
Q

cartilage of the laryngeal skeleton and membranes

A
  • thyroid
  • cricoid
  • epiglottic
  • arytenoid
  • corniculate
  • cuneiform
73
Q

aperture for internal branch of superior laryngeal n. and superior laryngeal a.

A

thyroihyoid membrane

74
Q

location of cricothyrotomy

A

cricothyroid membrane

75
Q

Identify:

  • epiglottic ligament
  • vocal ligament
  • cricothyroid joint
76
Q

extends from laryngeal inlet, through which it communicates with laryngopharynx, to the inferior border of the cricoid cartilage; continuous with trachea

A

laryngeal cavity

77
Q

between laryngeal inlet and vestibular folds

A

laryngeal vestibule

78
Q

between vestibular and vocal folds

A

laryngeal ventricle

79
Q

between vocal folds and inferior border of cricoid cartilage

A

infraglottic cavity

80
Q

space between vocal folds

A

rima glottidis

81
Q
  • accompanies internal branch of superior laryngeal n.
  • supplies superior larynx above vocal folds
A

superior laryngeal a.

82
Q
  • accompanies inferior laryneal n.
  • supplies inferior larynx below vocal folds
A

inferior laryngeal a.

83
Q

innervates sensory above vocal folds

A

internal branch of superior laryngeal n.

84
Q

innervates cricothyroid muscle (motor)

A

external branch of superior laryngeal n.

85
Q
  • terminal branch of recurrent laryngeal n.
  • sensory below vocal folds
  • motor of all muscles of larynx except cricothyroid
A

internal laryngeal n.

Neuroendocrine (30 decks)

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