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SF2 - Test 1 > 1 - Zill - Neck > Flashcards

1 - Zill - Neck Flashcards

1
Q

Compartments of the Neck

A
  1. Posterior Compartment - Vertebrae and Muscles
    1. Support and move head/neck
  2. Anterior Compartment - Viscera
    1. ​Rostral continuiation of GI and Respiratory Systems (trachea/esophogus)
    2. Pharynx/ Larynx
  3. Lateral Compartment
    1. Blood vessels and nerve (+ carotid pulse)
    2. Carotid Sheath
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2
Q

Posterior Compartment - Muscles that Move Head and Neck

Posterior Side?

Lateral Side?

Anterior Side?

A
  • Posterior Side:
    • Deep Muscles: EXTEND
      • Suboccipital Mucles
  • Lateral Side:
    • Scalene Muscles - flex laterally
  • Anterior Side:
    • Prevertebral Muscles - Direct ant. to vert, FLEX head and neck
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3
Q

Anterior Compartment - Viscera

Main Contents?

A

Larynx and Esophagus open into Pharynx

Pharynx opens to oral and nasal cavities

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4
Q

Sensation ant/pos to Paloglossal Arch?

A

Posterior - Vague

Anterior - Precise

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5
Q

***Contents of Carotid Sheath***

A
  1. Common and Internal Carotid Arteries
  2. Internal Jugular Vein
  3. Vagus Nerve
    - - -

NOT IN CAROTID SHEATH: Sympathetic Chain (posterior to sheath)

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6
Q

Muscles of Neck (Action/Innervation):

Sternocleidomastoid

Attached to Hyoid? (Y/N)

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Sternocleidomastoid

Attached to Hyoid?: No

Action: Flex Neck (bilateral), Rotate head so face is directed opposite to (unilateral)

Nerve: Accessory Nerve (CN XI)

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7
Q

Muscles of Neck (Action/Innervation):

Scalenus Anterior and Scalenus Medius

Attached to Hyoid? (Y/N)

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Scalenus Anterior and Scalenus Medius

Attached to Hyoid: No

Action: Flex neck and elevate rib 1

Nerve: Branches of ventral rami of cervical spinal nerves

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8
Q

Muscles of Neck (Action/Innervation):

Omohyoid (two bellies)

Attached to Hyoid? (Y/N)

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Omohyoid (two bellies)

Attached to Hyoid? Yes

Action: Depresses Hyoid Bone

Nerve: Ansa Cervicalis

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9
Q

Muscles of Neck (Action/Innervation):

Sternohyoid

Attached to Hyoid? (Y/N)

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Sternohyoid

Attached to Hyoid? Yes

Action: Depresses Hyoid Bone

Nerve: Ansa Cervicalis

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10
Q

Muscles of Neck (Action/Innervation):

Sternothyroid

Attached to Hyoid? (Y/N)

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Sternothyroid

Attached to Hyoid? Yes

Action: Depresses Thyroid Cartilage, Indirectly depresses hyoid bone and larynx

Nerve: Ansa Cervicalis

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11
Q

Muscles of Neck (Action/Innervation):

Thryohyoid

Attached to Hyoid? (Y/N)

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Thryohyoid

Attached to Hyoid? Yes

Action: Depresses hyoid bone, elevate larynx

Nerve: C1 via branch hitch-hiking with Hypoglossal Nerve (CN XII)

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12
Q

Sternocleidomastoid

Head Attachment(s)?

Clinical Dysfunction?

Action?

Procedure Landmark?

A

Two Heads: Clavicle, Sternum

Clinical: Torticollis - Contracture of Sternocleidomastoid (congenital or acquired); face “locked” in opposite direction

Action: Pulls mastoid toward sternum

Procedure Landmark: Central Line - Internal Jugular V. accessed and catherterized between Sternal and Clavicular heads

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13
Q

Palpation of Thyroid Gland

A

Palpated in Anterior Triangle below Cricoid Cartilated, medial to Sternocleidomastoid

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14
Q

Masses in Neck Diagnosis

Branchial Cyst or Fistula (Channel)

Thyroglossal Duct Cyst

A

Use Sternocleidomastoid as Landmark

Branchial Cyst or Fistula = Anterior to Sterno. M.

Throglossal Duct Cyst = Midline mass

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15
Q

Muscles of Neck Not Attached to Hyoid as Landmark:

Scalenus Anterior and Scalenus Medius

Clinical?

A

Landmark for

Branchial Plexus - Between Heads

PHRENIC NERVE - Top of Scalenus Anterior; goes to Diaphragm

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16
Q

Phrenic Nerve Clinical Issues

A

Nerve courses on top of Scalenus Anterior

“(C345), Keep Alive!”

Have to worry about respiratory issues with neck injuries that could affect Phrenic Nerve

17
Q

Hyoid Bone

Parts?

Major two functions?

A

Free floating bone, held by muscles and ligaments

Parts: Body, Greater and Lesser Horns

Functions: Speech, Swallowling (life on land!)

18
Q

Gills and Embryology

A

Gills became unnecessary as we developed lungs

Structures used to eventually form middle ear structures for detecting sounds

19
Q

What forms an attachment for the mobile nature of the tongue?

A

Hyoid Bone

20
Q

Infrahyoid Mucles

A

All depress hyoid

Omohyoid (long, from shoulder area to hyoid)

Sternohyoid (sternum to hyoid)

Sternothyroid (sternum to thyroid)

Thyrohyoid (thyroid to hyoid)

21
Q

Muscles of Neck (Action/Innervation):

Digastric

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Digastric

Action: Elevate hyoid bone, depress mandible

Nerve:

Posterior Belly: Facial Nerve (CN 7)

Anterior Belly: Trigeminal Nerve (V3)

22
Q

Muscles of Neck (Action/Innervation):

Stylohyoid

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Stylohyoid

Action: Elevate Hyoid

Nerve: Facial Nerve (CN VII)

23
Q

Muscles of Neck (Action/Innervation):

Mylohyoid

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Mylohyoid

Action: Elevate hyoid, raise floor of mouth during swallowing

Nerve: Trigeminal Nerve (V3)

24
Q

Muscles of Neck (Action/Innervation):

Geniohyoid

Action:

Nerve:

A

Muscles of Neck (Action/Innervation):

Geniohyoid

Action: Elevate hyoid, draws hyoid forward

Nerve: C1 branch hitch-hiking with Hypoglossal Nerve (CN XII)

Swallowing!

25
Q

**Digastric** (practical)

Two Heads - Innervation?

Embryology Origin?

Major Action?

A

Two bellies and two cranial nerves

insert to hyoid via intermediate tendon

Posterior Belly: Cranial Nerve VII

Anterior Belly: Cranial Nerve V3

From First and Second Branchial Arch

Major Act: Open Mouth

26
Q

Cervical Plexus

Branching?

Cutaneous Nerves?

Where do these emerge from, and what is clinical relevance?

A

From C2-C4

Branching not that important, it’s deep and protected

- - -

Cutaneous:

  1. Lesser Occipital - Behind Ear
  2. Great Auricular - Beneath Ear
  3. Transverse Cervical - Anterior Neck
  4. Supraclavicular - Lower Neck / Shoulder
    - - -

Emerge from post. border of sternocleidomastoid, important for anesthesia for suturing neck

27
Q

Ansa Cervicalis

A

Fibers from C1 join Hypoglossal Nerve (XII); some leave and join C2 / C3 to form Ansa (Loop) Cervicalis

C1 - C3 Innervated Neck Muscles, some just travel with XII

***Just remember this name for the practical, and write it down if you see any loop like nerves in neck!!!***

28
Q

Arteries of Head and Neck:

Subclavian and its Parts

*** Develop Mnemonic ***

A

Subclavian - At root of neck, goes to arm becomes Axillary A.; divided into three parts at Scalenus Anterior

  • Part 1: Medial to Scalenus Anterior
    • Vertebral A.
    • Internal Thoracic A.
    • Thyrocervical Trunk: Branches:
      • Inferior Thyroid
      • Transverse Cervical
      • Suprascapular
  • Part 2: Posterior to Scalenus Anterior
    • Costocervical Trunk: Branches:
      • Superior Intercostal A.
      • Deep Cervical A. (deep neck)
  • Part 3: Lateral to Scalenus Anterior
    • No Branches
29
Q

External Carotid Artery

Anterior Branches

Posterior Branches

A

Anterior Branches:

  • Superior Thyroid A.
    • Descends to Thyroid
  • Ascending Pharyngeal A.
    • Ascends to Pharynx
  • Lingual A.
    • Tongue
  • Facial A. ***
    • ​Below then on surface of mandible (heavy bleeding to cuts to lips)

Posterior Branches:

  • Occipital A.
    • Post. Scalp
  • Post. Auricular A.
    • Post. to Ear
30
Q

Carotid Bifurication

A

Location of pulse taken in neck, and level of C4

31
Q
A
32
Q

Ischemic vs Hemorrhagic Stroke

A

Ischemic - Occlusion (blockage); insufficient blood supply to brain

Hemorrhagic - Rupture of weakened/diseased blood vessel

33
Q

Venous Sinuses of Brain

A

Superior Sagittal - Top Middle of Falx Cerebri

Straight Sinus - Top of Tentorium Cerebelli, connects to–

Inferior Sagittal Sinus - Bottom Middle of Falx Cerebri

Transverse Sinus - Beneath Tentorium Cerebelli, connects to–

Sigmoid Sinus - Connects transverse sinus to internal Jugular Vein

Cavernous Sinus - Clinically important ear by Turrica Sellica; location of Carotid Siphon

34
Q

Platysma

A

Connective, Superficial fascia of neck

35
Q

Deep Fascia of Neck Compartments?

A

Investing Layer of Deep Cervical Fascia - Neck, splits around muscles of neck

Prevertebral Layer - Surronds vert. column, muscles of neck

Pretracheal Layer - Surround respiratory/GI structures

Carotid Sheath - Surrouns Common/Int. Carotid, Int. Jugular, and Vagus (CN X) NOT Symp Chain

36
Q

Retropharyngeal Space

Clinical Significance (2x)?

(***probably on practical/exam***)

A

Space between Pretracheal Layer and Prevertebral Layers

Infection from head (tonsillitis) can spread to mediastinum (Thorax)

- - -

***Retropharyngeal Abscess - Can be difficult to diagnose, no external swelling, LIFE-THREATENING, can block airway***

37
Q

Lymphatics of Neck

Three Groups

Main Drainage Port

A

Groups:

  1. Superficial Ring
  2. Deep Ring - Pretracheal, Retropharyngeal nodes
  3. Deep Cervical Chain - Along Int. Jugular Vein, receive from above nodes

Main Drainage Port:

Jugular Lymph Trunk - To right lymphatic duct or Thoracic Duct

Drains to venous system

38
Q
A

SF2 - Test 1 (20 decks)

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