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Head and Neck (Semester 5) > 1.1 Regions and compartments of the neck > Flashcards

1.1 Regions and compartments of the neck Flashcards

1
Q

Where does the neck start and end both anteriorly and posteriorly?

A

Anteriorly: extends from the lower border of mandible to the upper surface of manubrium of sternum

Posteriorly: from superior nuchal line on occipital bone to the IV Disc between C7-T1

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2
Q

What are the 4 major compartments of the neck and what is contained within each?

A

visceral compartment: contains viscera, trachea, oesophagus and thyroid gland

2 vascular compartments: contains vessels, carotid arteries, internal jugular vein and vagus vein

vertebral compartment: muscles of the spinal cord and the cervical spine

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3
Q

Layers through the neck (4)

A

1) Skin
2) Subcutaneous fat
3) Superficial fascial layer: 1 Layer where Platysma muscle sits (only in anterior neck)
4) Deep cervical fascia: 4 Layers

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4
Q

What are the 5 major fascial layers?

What is contained in each?

A

1) Superficial Fascial Layer: contains a thin sheet of muscle, Platysma
2) Investing Fascial Layer: surrounds all neck structures
3) Prevertebral Fascial Layer: surrounds vertebral column and deep muscles associated with the back
4) Pretracheal Fascial Layer:encloses the viscera of the neck
5) Carotid Sheaths: receive contributions from the layers above (excl superficial layer)

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5
Q

Which fascial layers make up the Deep cervical fascia?

A

Investing, Prevertebral, Pretracheal, Carotid sheaths

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6
Q

What is the thin sheet of muscle in the superficial fascial layer and what muscle group is it part of?

Where does this muscle begin and end and what is its innervation?

A

Platysma, part of the muscles of facial expression

Begins in the superficial fascia of the thorax and runs upward to attach to the mandible and blends with the muscles on the face

Innervation: CN VII: Facial n.

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7
Q

What are the attachments of the Investing fascial layer?

Describes its pathway (how it splits and regions)

A

Attaches posteriorly to the ligamentum nuchae and spinous process of the cervical vertebrae

  • Splits as it passes forward to enclose the trapezius muscle
  • Reunites into a single layer as it forms the roof of the posterior triangle
  • Splits again to surround the sternocleidomastoid and infrahyoid muscles
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8
Q

What is the name of the flat, triangular muscle situated along the vertebral column (base) and pointing towards the shoulder (apex)

What does this muscle contribute to in the neck?

A

Trapezius, helps to form posterior triangle of the neck

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9
Q

What 2 important muscles are innervated by the accessory nerve?

What CN is this and how can its function be tested?

A

Trapaezius and Sternocleidomastoid are both innervated by the cccessory nerve, CN XI (11)

Test function: ask patient to shrug shoulder (this tests both SCM and Traps)

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10
Q

What muscle divides the neck into the anterior and posterior triangle?

A

Sternocleidomastoid

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11
Q

What bone is shown in the image below?

Is this part of the axial or appendicular skeleton?

Where is this bone derived from and what spinal level does it correlate to?

A

Hyoid bone, part of axial skeleton (has no articulations)

Derived from second and third pharyngeal arch and correlates to C3 level

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12
Q

How is the Hyoid bone suspended from the styloid process?

What structure is suspended from it?

What does it function as?

A

Suspended from styloid process by stylohyoid muscle

Larynx is suspended from it

Attachment for hyoid muscles (highly mobile)

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13
Q

Muscles located superior to the Hyoid are known as what?

List these 4 muscles?

A

Suprahyoid muscles

Stylohyoid, Digastric, Mylohyoid, Geniohyoid

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14
Q

Muscles located inferior to the Hyoid are known as what?

List these 4 muscles?

A

Infrahyoid muscles

Thyrohyoid, Sternothyroid, Sternohyoid, Omohyoid

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15
Q

Label the image below

A
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16
Q

List 4 muscles associated with the Prevertebral Fascial Layer

Describe the unique attachement of this fascial layer

A

Anterior/Middle/Posterior Scalene m. + Deep muscles of the back

Attachment points on the transverse processes splits into two layers, creating a longitudinal fascial space containing loose CT that extends from the base of the skull through the thorax

This fascial extension creates the axillary sheath which exits into upper limb

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17
Q

Describe the where the Pretracheal fascial layer begins and ends

Describe its anterior, lateral and posterior relations?

A

Begins superiorly at the hyoid bone and ends inferiorly in the upper thoracic cavity

Anteriorly: crosses the neck posterior to infrahyoid muscles, covers trachea and thyroid gland

Laterally: fascia continues and covers the thyroid gland and oesophagus

Posteriorly: referred to as buccopharyngeal fascia

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18
Q

What structure separates the oesophagus from the prevertebral layer?

A

Buccopharyngeal fascia (this is the posterior portion of the pretracheal fascial layer)

19
Q

What 4 structures are contained within the 2 Carotid Sheaths?

A

1) common carotid artery (inferiorly)
2) Internal carotid artery (superiorly)
3) Internal jugular vein
4) vagus nerve

20
Q

What forms the Carotid Sheath?

A

Contributions from Investing, Prevertebral, and Pretracheal layers (all deep fascial layers)

21
Q

List the 3 fascial spaces?

A

1) Pretracheal Space
2) Retropharyngeal Space
3) Fascial Space within Prevertebral Layer

22
Q

The fascial spaces provide a conduit for the spread of infections from neck to mediastinum.

State two potential spreads

A

Pretracheal Space: Infection can spread inferiorly into superior mediastinum, anterior to pericardium

Retropharyngeal Space: Infection can spread inferiorly into superior mediastinum, posterior to pericardium

23
Q

Describe the borders of the anterior triangle of the neck

A

Posterior border: Anterior border of the sternocleidomastoid muscle

Superior border: The inferior border of the mandible

Anterior: midline of the neck

24
Q

Describe the borders of the posterior triangle of the neck

A

Anterior border: Posterior border of the sternocleidomastoid muscle

Posterior border: anterior border of the trapezius muscle

Inferior border: middle one-third of the clavicle

25
Q

The anterior triangle can be be furthur divided, list the 4 subdivisions

A

1) submandibular triangle
2) submental triangle
3) muscular triangle
4) carotid triangle

26
Q

Label the Image below?

A
27
Q

The posterior triangle can be be furthur divided, list the 2 subdivisions

A

1) occipital triangle
2) supraclavicular triangle

28
Q

What is the musculoligamentous structure with a cartilaginous framework that is continuous with the trachea below?

What does this structure open to superiorly?

What is its function?

A

The larynx

Opens into the pharynx immediately superior/posterior

Functions as a valve (sphincter) to close respiratory tract and an instrument to produce sound

29
Q

How is the larynx suspended from the hyoid and attached to the trachea?

How does it function to close respiratory tract?

A

By membranes and ligaments (highly mobile in the neck)

During swallowing, the dramatic upward and forward movements of the larynx facilitate closing the laryngeal inlet and opening the oesophagus

30
Q

What is the nervous innervation to the Larynx?

A

Motor and sensory innervation of the larynx is from the vagus nerve, CN X

31
Q

What are the 2 major arteries that supply all structures in the head and neck?

How do these branch?

Describe the exact pathway of this

A

R and L common carotid arteries which branch into:

  • External Carotid artery
  • Internal Carotid artery

CCAs ascend through the neck, just lateral to the trachea and oesophagus, within the carotid sheath (no branches as they pass through neck)

Near superior edge of thyroid cartilage each CCA divides into external and internal carotid arteries

32
Q

What are the 2 main superficial veins that drain the head and neck?

A

External Jugular Vein

Anterior Jugular Vein

33
Q

Which superficial vein crosses the Sternocleidomastoid muscle as it decends neck?

A

External Jugular vein

34
Q

What is the main deep vein that drains the head and neck?

Describe its pathway?

A

Internal Jugular vein (drains skull, brain, superficial face, and neck)

1) Travels inside the carotid sheath (DEEP to SCM).
2) Joins the subclavian veins posterior to the sternal end of the clavicle to form the brachiocephalic veins
3) This has multiple tributaries

35
Q

The Cranium can be divided into 2 parts, what are these?

A

1) Neurocranium (calvaria and skull base)
2) Viscerocranium (facial skeleton)

36
Q

The layers of the Head can be remembered by the pneumonic SCALP, what does this stand for?

What can be said about the first 3 layers?

A

Skin, Connective tissue(dense), Aponeurotic layer, Loose CT, Pericranium

First 3 layers tightly bound together

37
Q

Describe the muscular components and neural innervation of the Aponeurotic Layer

A

Firmly attached to the above layer of skin

Consists of the Occipitofrontalis muscle supplied by VII

Has 2 muscle bellies connected by the galea aponeurotica (epicranial aponeurosis)

38
Q

What separates the aponeurotic layers from the pericranium?

What is the function of this?

A

Loose CT: facilitates movement of the scalp over the calvaria

Infections tend to localize and spread through this layer

39
Q

The deepest layer of the scalp is Pericranium, what is this?

A

The Pericranium is the ‘periosteum on outer surface of calvaria’

40
Q

Label the layers of the heald (SCALP)

A
41
Q

What are the 2 major sources of nerves which innervate the scalp?

A

Cranial nerves and Cervical nerves

42
Q

What are the 4 major muscle groups in head?

What is the innervation of each?

A

1) muscles of facial expression VII
2) muscle of the cheek (Buccinators) VII
3) muscles of the scalp (occipitofrontalis) VII
4) muscles of mastication V3

43
Q

List the 4 muscles of mastication and their innervation

A

Innervated by CN V (V3 branch):

  • Masseter
  • Temporalis
  • Buccinator (CN VII)
  • Medial & Lateral Pterygoid
44
Q

What are the divisions of CN VII, facial nerve (5)

A

1) Temporal
2) Zygomatic
3) Buccal
4) Mandibular
5) Cervical

Head and Neck (Semester 5) (22 decks)

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