11: Cervical Viscera and Root of the Neck

Question 1

root of the neck borders

Answer 1

top - manubrium
front - first rib
back - T1

Question 2

how to divide the subclavian artery

Answer 2

part 1 - medial to anterior scalene m.
part 2 - behind anterior scalene m.
part 3 - after anterior scalene m. to first rib

Question 3

part 1 of subclavian a.

Answer 3

vertebral a.
internal thoracic a.
TCT - thyrocervical trunk: inferior thyroid with ascending cervical a., transverse cervical (*DS), suprascapular

Question 4

vertebral a. details

Answer 4

heads up in to the brain (circle of willis) via the foramen magnum
travels via transverse foramina of C1-6

Question 5

internal thoracic artery details

Answer 5

passes down into the thoracic cavity, lines the inside of the ribs

Question 6

suprascapular artery

Answer 6

from the TCT

supplies muscles on the posterior scapula

Question 7

transverse cervical artery

Answer 7

from TCT
*DS can branch
supplies muscles of posterior triangle and trapezius

Question 8

inferior thyroid artery

Answer 8

from TCT

supplies thyroid

Question 9

ascending cervical artery

Answer 9

branches from inferior thyroid (from TCT)

supplies lateral muscles of the upper neck

Question 10

branches of 2nd part of subclavian a.

Answer 10

CCT - costocervical trunk
superior intercostal
deep cervical

Question 11

superior intercostal a.

Answer 11

supplies first two intercostal spaces

Question 12

deep cervical a.

Answer 12

supplies posterior deep cervical muscles

Question 13

branches of 3rd part of subclavian a.

Answer 13

dorsal scapular a, sometimes

supplies levator scapulae and rhomboid muscles

Question 14

blood supply to thyroid

Answer 14

inferior thyroid a. - from TCT (runs behind carotid sheath)

superior thyroid a. - first branch of external carotid

Question 15

brachiocephalic vein

Answer 15

internal jugular + subclavian v

referred to as “venous angle” - where lymph is returned to the venous system

Question 16

veinous drainage of the root of the neck

Answer 16

brachiocephalic
internal jugular
anterior jugular
subclavian
thyroid veins

Question 17

thyroid veins

Answer 17

superior - to internal jugular v.
middle - to internal jugular v.
inferior - to brachiocephalic v.

two pairs of arteries, three pairs of veins to the thyroid.

Question 18

thyroid gland

Answer 18

two lobes, isthmus in middle
sometimes pyramidal lobe leftover - remnant of thyroglossal duct
origin: foramen cecum in tongue
sits on top of the trachea

Question 19

parathyroid glands

Answer 19

4 little hard knots on the posterior side of the thyroid, exterior to the fibrous thyroid capsule
parthyroid hormone increases blood calcium levels

Question 20

thoracic duct

Answer 20

delivers lymph into the venous system at the left venous angle (union of internal jugular and subclavian v); drains 3/4 of the body’s lymph

Question 21

right lymphatic duct

Answer 21

drains right half of head, right half of torso, and right arm

Question 22

nerves of the root of the neck

Answer 22

phrenic, vagus (recurrent laryngeal), brachial plexus, sympathetic trunks

Question 23

cervical sympathetic ganglia location

Answer 23

lies on the anterior scalene muscle

Question 24

cervical sympathetic trunk locations

Answer 24

lie on prevertebral muscles
superior - C2, lateral to vagus
middle - C6, near inferior thyroid artery
stellate - C7, behind subclavian a. near vertebral a.

Question 25

periarterial plexi

Answer 25

sympathetic trunk running with the carotid and vertebral arteries
vagus also runs with them

Question 26

structures that are anterior to the anterior scalene m.

Answer 26

subclavian v.
suprascapular, transverse cervical, ascending cervical aa. (maybe inferior thyroid a. too??)
phrenic n.

Question 27

structures that are posterior to the anterior scalene m.

Answer 27

i.e. in interscalene triangle
ventral rami of brachial plexus
subclavian a.
costocervical branch of subclavian a.

Question 28

divisions of subclavian artery relative to anterior scalene m.

Answer 28

1st - medial
2nd - posterior
3rd - lateral