1.2.1 General Organisation of the Head and Neck

Question 1

What is the superficial anatomy of the neck?

Answer 1

Thyroid Cartilage
Cricoid Cartilage
Thyroid Gland
Trachea

Question 2

What are the key muscles of the neck?

Answer 2

Platysma
Sternocleidomastoid
Trapezius
Scalene muscles
Supra and infra-hyoids

Question 3

What supplies the supra and infra-hyoids?

Answer 3

Supra-supplied by cranial nerves
Infra-supplied by cervical plexcus, C1,2,3 (ansa cervicalis)

Question 4

What is the origin and function of the Platysma?

Answer 4

Continuation of anterior thorax muscles

Tense neck, grimace face

Question 5

What is the origin, insertion and action of the SCM?

Answer 5

Origin: Clavicle and sternum
Inserts: Mastoid process

Action: rotates head, contralateral rotation, chin turns to opposite side

Nerve: Accessory nerve CNXI

Question 6

How can you test the SCM?

Answer 6

Push against the side of the face and get patient to resist

Question 7

What is Torticollis?

Answer 7

Involuntary contraction of SCM causing asymmetrical head/neck position

Question 8

What is the origin, insertion, action and nerve to supply to the trapezius?

Answer 8

Origin: occipital bone, nuchal ligament

Insertion: Lateral 1/3 clavicle& acromion of scapula

Action: Elevation of the shoulders (Shrugging), stabilises the scapula

Nerve: CNXI- Accessory

Question 9

How can you test the trapezius?

Answer 9

Shrug the shoulders
In CNXI injury there will be muscle wasting and sunken shoulder

Question 10

What are the borders of the anterior triangle?

Answer 10

Midline of the neck
Inferior margin of the mandible
Anterior SCM

Question 11

What are the borders of the posterior triangle?

Answer 11

Anterior trapezius
Posterior SCM
Middle 1/3 of Clavicle

Question 12

What is the neurovascular bundle present in the neck?

Answer 12

Runs in the Carotid Sheath
IJV-laterally
Vagus nerve-middle
Common Carotid artery- medially

Question 13

What happens to the Common Carotid Artery at C4?

Answer 13

Bifurcates into external and internal carotids

Question 14

What are the functions of the suprahyoid muscles?

Answer 14

Above hyoid bone, attach to jaw or base of skull and attach to hyoid bone

Elevates the hyoid and depresses the mandible

Question 15

What are the functions of the infrahyoid muscles?

Answer 15

Overlie the larynx and thyroid gland
Depress the hyoid and help stabilise

Question 16

What are the borders of the Carotid triangle?

Answer 16

Posterior Belly of the digastric (superior)
Lateral SCM (lateral)
Superior belly of the omohyoid (medially)

Question 17

What is useful about the carotid triangle?

Answer 17

Useful for JVP and insertion of central catheters

Question 18

Why is the carotid sheath easy to access in the carotid triangle?

Answer 18

Not covered by the SCM

Question 19

What is significant about the scalene muscles?

Answer 19

• Floor of posterior triangle
• Brachial plexus and Subclavian vessels pass between anterior and middle scalenes
• Phrenic nerve along anterior scalene before thorax

Question 20

What runs in the roof of the posterior triangle?

Answer 20

External Jugular Vein, very superficial and easily seen do not confuse with IJV

Question 21

What do neurovascular structures in the posterior triangle do?

Answer 21

Communicate with upper limb

Question 22

What are the cervical vertebrae important landmarks for?

Answer 22