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Anatomy 2 Unit 2 > 2 - Ant cervical triangle > Flashcards

2 - Ant cervical triangle Flashcards

1
Q

Posterior Cervical Triangle:

A

Anterior boundary = SCM
Posterior boundary = Trapezius m.
Inferior boundary = middle 1/3 of clavicle

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2
Q

Anterior Cervical Triangle Boundaries:

A

Lateral: anterior border of SCM m.
Superior: inferior border of mandible
Medial: midline of neck

Roof – Skin & platysma m. (contained within the skin)
Floor – formed by muscles
Viscera – considered “contents”

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3
Q

Roof” of anterior cervical triangle:

A

formed by skin & platysma m.

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4
Q

Platysma m. innervation

A

Cervical Branch of Facial n. (CN VII)

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5
Q

Anterior Cervical Triangle can be subdivided into 4 smaller triangles:

A

Submental triangle
Submandibular triangle
Muscular triangle
Carotid triangle

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6
Q

Anterior cervical triangle contents:

A 
Muscles
Veins
Arteries 
Nerves 
Cervical viscera
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7
Q

Muscles of anterior cervical triangle can be grouped based upon their

A

position relative to the hyoid bone

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8
Q

Suprahyoid muscles

A

Located superior to hyoid bone
Elevate hyoid bone

4 muscles: 
Stylohyoid m. 
Digastric m. 
Mylohyoid m. 
Geniohyoid m.
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9
Q

Stylohyoid m. Action

A

Pulls hyoid bone upward in posterosuperior direction

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10
Q

Stylohyoid m. Innervation

A

Facial n. (CN VII)

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11
Q

Digastric m. Action

A

Mandible fixed – raises hyoid bone

Hyoid bone fixed – opens mouth (by lowering mandible)

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12
Q

Digastric m. Innervation

A

Ant. belly – Mandibular division of trigeminal n. (V3) (mylohyoid branch)
Post. belly – Facial n. (CN VII)

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13
Q

Mylohyoid m. Action

A

Supports & elevates floor of mouth; elevates hyoid

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14
Q

Mylohyoid m Innervation

A

Mandibular division of trigeminal n. (V3) (mylohyoid branch)

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15
Q

Geniohyoid m. Action

A

Mandible fixed – elevates & pulls hyoid forward

Hyoid fixed – pulls mandible downward & inward

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16
Q

Geniohyoid m. Innervation

A

branch from anterior ramus of C1 carried via hypoglossal n. (CN XII)

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17
Q

Infrahyoid mm.

A

Located inferior to the hyoid bone
Depress the hyoid bone

4 muscles: 
Omohyoid m. 
Sternohyoid m. 
Thyrohyoid m. 
Sternothyroid m.
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18
Q

Sternohyoid m. action (infrahyoid group)

A

Depresses hyoid bone after swallowing

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19
Q

Sternohyoid m. Innervation (infrahyoid group)

A

anterior rami of C1-C3 via ansa cervicalis

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20
Q

Omohyoid m. (infrahyoid group)

A

two bellies (superior & inferior) connected by an intermediate tendon

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21
Q

Omohyoid m. innervation (infrahyoid group)

A

anterior rami of C1-C3 via ansa cervicalis

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22
Q

Omohyoid m. action (infrahyoid group)

A

depresses & fixes hyoid bone

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23
Q

Thyrohyoid m. Action (infrahyoid group)

A

Depresses hyoid bone

When hyoid is fixed, it raises the larynx

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24
Q

Thyrohyoid m. innervation (infrahyoid group)

A

fibers from anterior ramus of C1 carried via the hypoglossal n. (CN XII)
Nerve to thyrohyoid m.

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25
Q

Sternothyroid m. Action (infrahyoid group)

A

Draws larynx (thyroid cartilage) downward

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26
Q

Sternothyroid m. Innervation (infrahyoid group)

A

anterior rami of C1-C3 via ansa cervicalis

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27
Q

Anterior jugular vein:

A

Drains anterior neck; located in midline

Empties into subclavian v. (most commonly) or external jugular v.

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28
Q

Communicating branch:

connects the

A

common facial v. with the anterior jugular v.

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29
Q

Common facial v.

A

formed from the joining of the anterior division of retromandibular v. with the facial v.

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30
Q

Retromandibular vein:

formed by

A

superficial temporal v. & maxillary v.

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31
Q

Retromandibular vein: divides into

A

anterior & posterior divisions

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32
Q

Retromandibular vein: Anterior div. + Facial v. =

A

Common facial v. (drains into internal jugular v.)

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33
Q

Retromandibular vein: Posterior div. + Posterior auricular v. =

A

External jugular v.

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34
Q

Facial vein:

A

Originates at angle of eye
Receives tributaries from veins draining face
Drains into internal jugular v.

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35
Q

Internal jugular vein drains

A

blood from skull, brain, superficial face, & cervical viscera

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36
Q

Internal jugular vein joins with

A

subclavian v. to form brachiocephalic v.

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37
Q

Internal jugular vein Traverses neck within

A

carotid sheath

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38
Q

Common carotid a.

A

Right and left common carotid

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39
Q

Right Common Carotid a.

A

from brachiocephalic trunk

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40
Q

Left Common Carotid a.

A

– direct branch off arch of aorta

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41
Q

Internal carotid a. –

A

gives off no branches in the neck

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42
Q

External carotid ar.

A

External carotid a. – gives off branches immediately after bifurcation of common carotid a.

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43
Q

The common carotid a. bifurcates at

A

C3-C4 vertebral level

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44
Q

The internal carotid a. does NOT give off any

A

branches within the neck! There are no branches off of the internal carotid a. outside of the skull

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45
Q

Branches of External Carotid a.

A

3 anterior, 3 posterior

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46
Q

3 anterior branches of external carotid a.

A

Superior thyroid a.
Lingual a.
Facial a.

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47
Q

3 posterior branches of external carotid ar.

A

Ascending pharyngeal a.
Occipital a.
Posterior auricular a.

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48
Q

External carotid a. terminates as

A

superficial temporal a. and maxillary a.

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49
Q

Superior Thyroid a.

A

1st anterior branch of external carotid a.

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50
Q

Superior thyroid a. Arises from

A

anterior surface near bifurcation

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51
Q

Superior thyroid a. Gives off the

A

superior laryngeal a.

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52
Q

Superior laryngeal a. pierces

A

thyrohyoid membrane together with internal branch of superior laryngeal n.

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53
Q

Superior thyroid a. supplies

A

superior portion of thyroid gland

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54
Q

Lingual a.

A

2nd anterior branch from external carotid a

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55
Q

Lingual a. arises just above

A

superior thyroid a. at level of greater horn of the hyoid bone

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56
Q

Lingual a. passes deeply into the

A

muscles of the tongue

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57
Q

Facial a.

A

3rd anterior branch of external carotid a.

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58
Q

Facial a. arises just superior

A

to lingual a.

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59
Q

Facial a. Crosses the

A

inferior border of mandible to supply the face

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60
Q

Ascending pharyngeal a.

A

1st posterior branch of external carotid a.

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61
Q

Ascending pharyngeal a. Arises close to

A

bifurcation of common carotid a

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62
Q

Ascending pharyngeal a. Ascends to supply

A

pharynx & tonsils

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63
Q

Occipital a.

A

2nd posterior branch of external carotid a.

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64
Q

Occipital a. Arises near

A

level of origin of facial a.

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65
Q

Occipital a. Passes deep to

A

posterior belly of digastric m.

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66
Q

Occipital a Ascends to supply

A

neck & scalp

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67
Q

Occipital a. Sends off

A

muscular branch to SCM (*hooks over CN XII)

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68
Q

Posterior Auricular a.

A

3rd posterior branch of external carotid a.

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69
Q

Posterior Auricular a. Arises superior to

A

origin of occipital a.

70
Q

Posterior Auricular a. Superior to

A

posterior belly of digastric m.

71
Q

Posterior Auricular a. Passes upward & posteriorly to supply

A

scalp posterior to ear

72
Q

Carotid sinus

A

dilation of internal carotid a. near bifurcation of common carotid a.; contains receptors that monitor blood pressure changes (baroreceptors)

73
Q

Carotid sheath

A 
Carotid a.
-Common carotid a.
-Internal carotid a.
*Carotid sinus
Internal jugular v.
Vagus n. (CN X)
74
Q

Nerves associated with the anterior cervical triangle:

A

Spinal nerve branches:

Transverse cervical n. (C2-C3) 
Ansa cervicalis (C1-C3)

Cranial nerves:

Facial n. (CN VII) 
Glossopharyngeal n. (CN IX) 
Vagus n. (CN X) 
Accessory n. (CN XI) 
Hypoglossal n. (CN XII)
75
Q

Transverse cervical n.

A

(C2-C3) Branch arising from cervical plexus

76
Q

Transverse cervical n. Provides cutaneous innervation to

A

skin overlying anterior cervical triangle

77
Q

Transverse cervical n. Emerges from

A

deep to posterior border of SCM & travels transversely across middle of SCM

78
Q

Ansa cervicalis

A

nerve loop formed from anterior rami of cervical nerves C1-C3

79
Q

Ansa cervicalis innervates

A

infrahyoid mm.*

*Innervates all infrahyoid mm. EXCEPT thyrohyoid m. (anterior ramus of C1 via hypoglossal n.)

80
Q

Ansa cervicalis Superior root

A

mainly of C1 fibers from anterior rami

81
Q

Ansa cervicalis Inferior root

A

anterior rami of C2 & C3

82
Q

Submental triangle Borders

A

Inferior = Hyoid bone
Lateral (right) = anterior belly of digastric m.
Lateral (left) = anterior belly of digastric

83
Q

Submental triangle contents

A

Mylohyoid m.
Submental lymph nodes
Some small veins

84
Q

Submandibular (Digastric) triangle

borders

A 
Superior = Inferior border of mandible
Anterior/inferior = Ant. belly of digastric m. 
Posterior/inferior = Post. belly of digastric m.
85
Q

Submandibular (Digastric) triangle

contents

A 
Submandibular gland 
Submandibular lymph nodes
Marginal mandibular branch of facial n. (CN VII)
Hypoglossal n. (CN XII) 
Mylohyoid n. (of CN V3)
Facial a. & v.
86
Q

Marginal mandibular branch of facial n. (CN VII

A

supplies mm. of facial expression

87
Q

Mylohyoid n. (of CN V3) –

A

supplies mylohyoid m. & anterior belly of digastric m.

88
Q

Muscular triangle Borders

A 
Superior = Hyoid bone
Lateral = Superior belly of omohyoid m. & anterior border of SCM m. 
Medial = midline of neck
89
Q

Muscular triangle Contents - muscles

A

Muscles:
*Omohyoid m. - Omohyoid m. forms part of the boundary, so technically, it’s not really a content

Sternohyoid m.
Sternthyroid m.
Thyrohyoid m.

90
Q

Muscular triangle Contents - Viscera

A 
Thyroid gland
Parathryroid glands 
Trachea 
Esophagus
Common carotid a. 
Internal Jugular v.
91
Q

Carotid triangle Borders

A 
Superior = Stylohyoid m. & posterior belly of digastric m. 
Posterior = Anterior border of SCM m. 
Anteroinferior = Superior belly of omohyoid m.
92
Q

Carotid triangle Content:

A

Nerves
Vagus (CN X), Laryngeal nn. (CN X branches), Accessory (CN XI), Hypoglossal (CNXII), Ansa cervicalis (C1-C3)

Arteries
Common, Internal & External carotid aa., 6 branches of ext. carotid a. (3 ant. & 3 post.)

Veins
All branches have accompanying vv. draining into IJV

93
Q

Cervical viscera

A 
Larynx & Trachea 
Pharynx & Esophagus
Thyroid Cartilage
-Thyrohyoid membrane
-Cricothyroid membrane
Cricoid cartilage
Thyroid & Parathyroid glands
Carotid Sheath
Common carotid a., IJV,  Vagus n.
94
Q

Larynx & Trachea

A

Larynx continuous with trachea inferiorly (vertebral level C6)

95
Q

Pharynx & Esophagus

A

Pharynx continuous with esophagus inferiorly (vertebral level C6)

96
Q

Trachea

A

begins at vertebral level C6; continuous with larynx superiorly; trachea lies directly anterior to the esophagus

97
Q

Pharynx

A

common pathway for air and food; pharynx ends at C6 where it is continuous with the esophagus inferiorly

98
Q

Thyroid Cartilage

A 
Laryngeal Prominence (“Adam’s apple”) 
Thyrohyoid membrane
99
Q

Cricoid cartilage

A

Cricothyroid membrane

100
Q

Cricothyrotomy

A

emergency procedure to establish airway

when airway is blocked above level of vocal folds.
There are few structures present to be damaged, except for small vessels and pyramidal lobe of thyroid gland (which is only sometimes present).

101
Q

Cricothyroid membrane

A

between thyroid cartilage and cricoid cartilage

102
Q

Tracheotomy (tracheostomy)

A

creation of midline incision in trachea & insertion of tube to enable ventilation
Performed in cases of airway obstruction
Opening made in midline between the infrahyoid mm.

Typically performed when there is an obstruction to the larynx due to inhalation of a foreign body, severe edema (i.e. due to anaphylaxis), or severe head and neck trauma; it is generally performed in an operating room.

103
Q

High tracheotomy =

A

superior to isthmus of thyroid

104
Q

Low tracheotomy =

A

inferior to isthmus of thyroid

105
Q

Isthmus of thyroid may also be

A

divided surgically

106
Q

Thyroid gland

A

large, unpaired endocrine gland located inferior (and lateral) to thyroid cartilage

107
Q

Thyroid gland right and left lobes connected by

A

isthmus

108
Q

Thyroid gland Isthmus usually covers

A

2nd to 4th tracheal rings

109
Q

Thyroid gland Pyramidal lobe frequently present;

A

extends superiorly from isthmus

110
Q

Arteries of the Thyroid Gland

A

Superior thyroid a.
Inferior thyroid a.
Thyroid ima a.

111
Q

Superior thyroid a.

A

1st branch off external carotid a.

112
Q

Superior thyroid a. supplies

A

superior pole of lateral lobe of thyroid gland

113
Q

Inferior thyroid a.

A

Branch off thyrocervical trunk (from subclavian a.)

114
Q

Inferior thyroid a. supplies

A

inferior pole of lateral lobe of thryoid gland

115
Q

Thyroid ima a.

A

Small artery occasionally found arising from either brachiocephalic trunk or arch of aorta

116
Q

Thyroid ima a. ascends

A

anterior surface of trachea to supply thyroid gland

117
Q

Veins of the Thyroid Gland

A

Superior, middle, inferior thyroid v.

118
Q

Superior thyroid v.

A

Drains into internal jugular v.

119
Q

Middle thyroid v.

A

Drains into internal jugular v.

120
Q

Inferior thyroid v.

A

Drains into brachiocephalic vv.

121
Q

Parathyroid glands

A

usually 4 glands within the posterior surface of the thyroid
Small (~5mm diameter), ovoid, yellowish structures on deep surface of right/left lobes of thyroid
Denoted as superior & inferior, but position is variable – can be anywhere (from carotid bifurcation superiorly to mediastinum inferiorly)

122
Q

The parathyroid glands may be

A

darker in color and harder in texture than thyroid gland.

123
Q

There are usually 2 parathyroid glands

A

on each side of the thyroid gland, but the number can vary from 1 to 3.

124
Q

Thyroidectomy

A

excision of part of/most of thyroid gland

125
Q

Parathyroid glands

A

May be damaged/removed

126
Q

External laryngeal n. damage leads to

A

paralysis of cricothyryoid m. & damage to inferior pharyngeal constrictor m.

127
Q

Recurrent laryngeal .

damage leads to

A

paralysis of most laryngeal mm.

128
Q

Parathyroid glands play an important role in the regulation of

A

calcium metabolism. During thryoidectomy, parathyroid glands are in danger of being damaged or removed. In order to maintain proper serum calcium levels without medication, at least 1 parathyoid gland must be retained.

129
Q

External laryngeal n. innervates

A

cricothryoid m. (action: pulls thyroid cartilage forward and rotates it down  lengthening/tensing vocal folds) and inferior pharyngeal constrictor m.

130
Q

The recurrent laryngeal n. innervates all of the

A

intrinsic laryngeal mm. except for cricothyroid (innervated by external laryngeal n.). Paralysis of laryngeal mm. leads to hoarseness of the voice.

131
Q

Root of neck

A

junction between thorax and neck; lies superior to superior thoracic aperture
Contains structures passing between the neck, thorax, & upper limb
Extension of thoracic cavity projects into neck; consists of upward projection of pleural cavity & includes:
Cervical part of parietal pleura (cupula) & apical part of superior lobe of each lung

132
Q

Arteries

A

Subclavian a.

  • Vertebral a.
  • Thyrocervical trunk
  • Internal thoracic a.
133
Q

Thyrocervical trunk

A

arises from subclavian a., medial to anterior scalene m.

134
Q

Thyrocervical trunk 3 branches

A

Inferior thyroid a.
Transverse cervical a.
Suprascapular a.

135
Q

Inferior thyroid a.

A

Gives off ascending cervical a.

Runs posterior to carotid sheath & thyroid gland

136
Q

Suprascapular a.

A

Transverse cervical a. & suprascapular a. cross over ant. surface of ant. scalene m. & phrenic n.

137
Q

the transverse cervical artery and transverse cervical nerve run in

A

OPPOSITE directions

138
Q

Vertebral a.

A

First branch off subclavian a.
Medial to anterior scalene m.
Enters transverse foramen of C6, passes up to C1

139
Q

vertebral a. Enters

A

transverse foramen of C6, passes up to C1

140
Q

Vertebral v.

A

Drains into brachiocephalic v.
Travels in transverse foramen of C1-C6

Remember: like the vertebral a., the vertebral v. also travels in the transverse foramina of the cervical vertebrae (C1-C6).

141
Q

Nerves of Root of Neck:

A

Phrenic n. (C3-C5)
Vagus n. (CN X)
-Recurrent laryngeal n.
Sympathetics

142
Q

Phrenic n. (C3-C5)

A

Phrenic nn. are branches of cervical plexus

143
Q

Phrenic n. passes

A

inferiorly across ant. surface of anterior scalene m.

144
Q

Phrenic n. Passes between

A

subclavian v. & a.; enters thorax & continues to diaphragm

145
Q

Vagus n. (CN X)

A

Descends through neck in carotid sheath

Provides all parasympathetic innervation to neck

146
Q

Recurrent laryngeal n. (right & left) –

A

branch of vagus n.

147
Q

Recurrent laryngeal n ascends in

A

groove between trachea & esophagus; enters larynx

148
Q

recurrent laryngeal n. Innervates all

A

intrinsic laryngeal mm. (*except cricothryoid m.)

149
Q

Right recurrent laryngeal n. loops

A

around right subclavian a., & upward to larynx

150
Q

Left recurrent laryngeal n.

loops

A

below & behind arch of aorta, & upward to larynx

151
Q

Cricothryoid m. innervated by external branch of

A

superior laryngeal n.

152
Q

Sympathetic trunk (chain)

A

extends from base of skull to coccyx; punctuated by ganglia along extent of trunk/chain

153
Q

Cervical part of sympathetic trunk is

A

anterior to prevertebral mm. & posterior to cervical viscera

154
Q

Sympathetic trunk (chain) is connected to each

A

spinal nerve by a gray ramus communicans

No white rami communicantes in cervical region

155
Q

3 sympathetic ganglia found in cervical region:

A

Superior, middle, inferior cervical ganglion

156
Q

Superior cervical ganglion

A

High in neck, near level of mastoid process of temporal bone

157
Q

Middle cervical ganglion

A

posterior to thyroid gland

158
Q

Inferior cervical ganglion

A

At lower end of cervical part of symp. trunk

Combines with first thoracic ganglion & forms the cervicothoracic (stellate) ganglion

159
Q

All lymphatic vessels coalesce to form larger trunks or ducts, which drain into the venous system at the

A

venous angle

160
Q

Thoracic duct

A

Major lymphatic channel that drains lymph from left upper limb, head, neck, thorax, abdomen, & lower limbs
Lies posterior to esophagus, between azygos v. & thoracic aorta

161
Q

Thoracic duct drains into

A

left venus angle

162
Q

Left venous angle

A

Junction between left internal jugular v. & left subclavian v.

163
Q

Right lymphatic duct

A

Lymphatic duct draining right upper limb, head, neck, & thorax

164
Q

Righty lymphatic duct drains into

A

right venous angle:

165
Q

Right venous angle

A

Junction between right internal jugular v. & right subclavian v.

166
Q

Digastric - 2 heads converge to

A

tendon which connects to hyoid

167
Q

digstric anterior belly

A

pharyngeal arch 1

168
Q

digastric posterior belly

A

pharyngeal arch 2

169
Q

Cricoid cart

A

only cartilage to completely encircle airway

170
Q

During thyroidectomy, you need to maintain at least

A

1 parathyroid gland, otherwise you will have issues with maintaining serum calcium levels.

Anatomy 2 Unit 2 (15 decks)

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