13-A Deep Neck

Question 1

What arteries supply the head?

Answer 1

internal carotid (brain), external carotid (external head) and vertebral artery (spinal cord and brain)

Question 2

What arteries supply the neck?

Answer 2

branches of the subclavian arteries (ie. thyrocervical artery) and some branches of the external carotid

Question 3

Describe the pathway of the vertebral arteries?

Answer 3

ascend in the transverse foramina before entering into the foramen magnum where they join the circle of Willis

Question 4

Name the branches of the external carotid.

Answer 4

SALFOPMS: superior thyroid a., ascending pharyngeal artery, lingual a. facial a. occipital a. posterior auricular a. mandibular and superior temporal a.

Question 5

What is the position of the external carotid in relation to the digastric muscle?

Answer 5

the external carotid lays deep to the superior belly of the digastric muscle.

Question 6

Name 3 branches of the subclavian artery.

Answer 6

thyrocervical trunk, vertebral artery and the internal thoracic artery

Question 7

Name the 4 branches of the thyrocervical trunk

Answer 7

as they branch: supra scapular, transfers cervical artery, ascending cervical artery, inferior thyroid artery (much variation with the inferior thyroid artery most consistent)

Question 8

Where do the inferior and superior thyroid arteries branch from?

Answer 8

thryocervical trunk (inferior) and external carotid artery (superior)

Question 9

What is most important thing to remember about surrounding anatomy when attempting a venipuncture?

Answer 9

the entry point is very near to the apex of the parietal pleura

Question 10

Inferior (recurrent) and superior laryngeal arteries are branches of what nerve?

Answer 10

vagus

Question 11

What serves the major venous return from the head?

Answer 11

internal jugular veins which drain into the subclavians

Question 12

Where do left and right sided lymph nodes drain into as they descend?

Answer 12

the thoracic duct on the left side and the right lymphatic duct on the right side

Question 13

Where does the thoracic duct empty into the venous system?

Answer 13

at the junction of the internal jugular vein and the subclavian artery

Question 14

Three small muscles attach to the styloid process of the temporal bone, name them and what innervates them.

Answer 14

styloglossus (hypoglossus), stylohyoid (facial) and stylopharyngeus (glossopharyngeal)—all derived from branchial arches/ post otic somite

Question 15

The glosopharyngeal nerve innervates structures in branchial arch 3, what structures does that include generally?

Answer 15

tongue and pharynx BONUS this nerve carries branchiomotor, visceromotor (PNS), general somatosensory, special sensory and viscerosensory

Question 16

What is a handy way to find the glossopharyngeal nerve? (what muscle does it wrap around?)

Answer 16

wraps around a branch of the stylopharyngeus muscle

Question 17

What is the pathway for parasympathetic vibes of the glossopharyngeal n?

Answer 17

parasympathetic exit the jugular foramen, pass through plexus and form the lesser petrosal nerve and enter the middle cranial fossa, lesser petrosal nerve exits the skull through foramen ovale to synapse in the otic ganglion which continue on to the parotid via the auriculotemporal branch of CNV

Question 18

What types of fibers make up the vagus nerve?

Answer 18

branchiomotor (m. of larynx, pharynx and soft palate), general sensory of (larynx, pharynx and ear), visceral sensory (of tongue and epiglottis and sensory of the thoracic and abdominal organs) and parasympathetic fibers to the thoracic and abdominal organs

Question 19

The sympathetic trunk extends to the base of the skull and terminates in the ____ _____ ___

Answer 19

superior cervical ganglion

Question 20

How do sympathetic reach targets in the head?

Answer 20

post ganglionic sympathetic fibers travel with major arteries into the head and follow these fibers until they can jump on to cranial nerves (internal carotid nerve is composed of postganglionic sympathetic fibers from the superior cervical ganglion)

Question 21

What embryonic structures form the external auditory meatus and auditory tube?

Answer 21

the first pharyngeal pouch and the first pharyngeal cleft

Question 22

What are the targets of the internal and external carotid plexi?

Answer 22

vessels in the brain and superficial vessels and sweat glands

Question 23

What structures are derived from the second pharyngeal pouch?

Answer 23

palatine tonsils

Question 24

What structures are derived from the third pharyngeal pouch?

Answer 24

inferior parathyroid and thyroid glands as well as the thymus*

Question 25

What structures are derived from the fourth pharyngeal pouch?

Answer 25

superior parathyroid glands

Question 26

The thyroid gland develops from a bud on the tongue whose location in the adult is the ____ ____

Answer 26

foramen cecum

Question 27

Which structures descend to their adult positions in the neck?

Answer 27

the thyroid, thymus, parathyroid and others

Question 28

What embryonic tissues come together to form the tongue?

Answer 28

portions of branchial arches 1-4, and some post otic somite resulting in innervation by 5 cranial nerves

Question 29

What are the 5 nerves that innervate the tongue?

Answer 29

lingual (CN V) somatosensory anterior 2/3, chroda tympani (CNVII) taste anterior 2/3, glossopharyngeal (IX) taste and general sensory posterior ⅓ , vagus nerve (CNX) taste and sensory of epiglottis, and hypoglossal (CNXI) somatomotor