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MD4001 Week 4 > 4. Anterior triangle - neurovascular bundle > Flashcards

4. Anterior triangle - neurovascular bundle Flashcards

1
Q

Contents of carotid triangle (subdivision of anterior triangle)?

A

Carotid triangle: Contains thyroid gland, larynx, pharynx, carotid sheath (& contents), branches of cervical plexus, superior root of the ansa cervicalis, deep cervical lymph nodes, & (parts of) CN XI & XII

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2
Q

Vascular compartment contents?

A

Medially
• Common carotid artery
• Internal carotid artery
• External carotid artery (part)

Laterally
• Internal jugular vein

Posteriorly
• CNX

bifurcates at C3/4

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3
Q

Difference between origin of R and L CCA?

A

Right CCA
• Branch of the brachiocephalic trunk

Left CCA
• Direct branch from the arch of the aorta

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4
Q

When does CCC bifurcate?

A

ICA & ECA: Branches of CCA at C3/C4

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5
Q

When does ICA branch?

A

ICA has no branches in the neck & ascends to enter carotid canal to supply the brain

Provides the Anterior circulation of the brain

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6
Q

What is carotid sinus? Importance?

A 
Carotid sinus: Enlargement/dilation at bifurcation of common carotid artery containing baroreceptors/pressoreceptors in wall of ICA
• Important in monitoring blood pressure
• Baroreceptors are sensitive to stretch
(baroreceptor reflex)
• Helps keep blood pressure within
homeostatic values
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7
Q

Innervation fo the carotid sinus?

A

Innervated by CN IX via carotid sinus nerve & CN X (back to the tractus solitarius)
Action potentials travel from the baroreceptors through CN IX to the cardioregulatory & vasomotor centres in the medulla (vital centres…)

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8
Q

What are fibres that surround solitary nucleus?

A

tractus solitarius

or “Solitary tract”

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9
Q

What is the carotid body?

Function

A

Carotid body: Small organ (~2-5mm) which houses chemoreceptors located at bifurcation of CCA near the carotid sinus

Function:
• Important in monitoring blood O2, CO2, & pH (& temperature)
• Responds in emergency situations by increasing respiration, blood pressure & cardiac rate (not as much at rest)

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10
Q

Innervation of the carotid body?

A

Innervated by CN IX via carotid sinus nerve & CN X (back to the
tractus solitarius)
• Afferent fibres from the carotid body travel to the cardioregulatory & vasomotor centres in the medulla (vital centres…)

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11
Q 
Branches of the ECA?
S t
A p
L
F
O
P a
S t
M
A
  • Superior thyroid
  • Ascending pharyngeal
  • Lingual
  • Facial
  • Occipital
  • Posterior auricular
  • Superficial temporal (terminal branch)
  • Maxillary (terminal branch)
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12
Q

Majority of scalp & facial blood supply is from the _________ carotid artery with some from the internal carotid

A

Majority of scalp & facial blood supply is from the external carotid artery with some from the internal carotid

ICA gives off the supratrochlear and supra-orbital artery (at the forehead)

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13
Q

Middle meningeal artery is a branch of…

A

the maxillary branch of ECA

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14
Q

Course of IJV?

A 
• Continuation of sigmoid sinus
• Exits skull via the jugular
foramen & enters carotid
sheath
• Runs lateral to CCA
• Omohyoid muscle runs
across
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15
Q

Veins draining into IJV?

A
  • Inferior petrosal sinus
  • Pharyngeal
  • Occipital
  • Facial
  • Lingual
  • Superior thyroid
  • Middle thyroid
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16
Q

IJV joins _______ vein to become brachiocephalic vein (left & right)

A

IJV joins subclavian vein to become brachiocephalic vein (left & right)

17
Q

IJV has what which helps prevent infection spread?

A

Valve system (one found at inferior bulb)

18
Q

How is the EJV formed? Which vessels?

A

EJV begins at angle of mandible, joining RETROMANDIBULAR & POSTERIOR AURICULAR veins
• Post auricular – from scalp behind ear
• Retromandibular (posterior division) – from superficial temporal & maxillary veins

19
Q

Veins draining into EJV?

A

Veins draining into EJV:
• Posterior external jugular
• Transverse cervical
• Suprascapular

20
Q

Anterior jugular vein, course and drainage?

A

Anterior jugular veins arise near the hyoid bone and run on either side of midline through subcutaneous tissue communicating across the midline via the JUGULAR VENOUS ARCH.
Drains into EJV; in some instances, will drain directly into subclavian vein

21
Q

Cervical branch of CN VII innervates ________ muscle Digastric branch of CN VII innervates ____ muscle

A

Cervical branch of CN VII innervates platysma muscle Digastric branch of CN VII innervates digastric muscle

22
Q

Stylohoid supplied by

A

CN VII

23
Q

Course of the CN IX in the neck?

Include the vascular relations

A

CN IX exits the jugular foramen & travels downward between the IJV & ICA
Much of the nerve then travels forward to oral cavity, but some branches travel downward to carotid sinus (& body), pharynx (sensory) & stylopharyngeus (motor)

24
Q

Course of the CN X in neck and the vascular relations?

A

CN X exits the jugular foramen & travels downward within carotid sheath with
IJV & CCA (ICA)
As it travels downward, a motor branch to the pharynx arises as well as a branch to the carotid body, the superior laryngeal nerve & a cardiac branch
Recurrent laryngeal nerves arise inferiorly near to the subclavian artery (R) or arch of aorta (L)

25
Q

Course of the CN XI in the neck?

Arterial relations and muscles innervated?

A

CN XI (spinal) exits the jugular foramen & travels downward between the IJV & ICA
It then crosses the lateral surface of the IJV to descend to the posterior triangle of the neck
It innervates SCM & trapezius

26
Q

Course of CN XII in the neck?

A

CN XII exits the hypoglossal canal & is between the IJV & ICA
It then crosses the ICA & ECA laterally on its way to the oral cavity There are no branches to the anterior triangle of the neck

27
Q

Supply of the transverse cervical nerve in neck?

A

supply cutaneous innervation over SCM & anterior triangle

28
Q

Cutaneous supply of the great auricular nerve from C2 and C3?

A

Angle of the mandible

NOT THE TRIGEMINAL

29
Q

What nerve innervates the ansa cervicalis?

A

Ansa cervicalis (anterior rami of C1-C3) innervates infrahyoid muscles

30
Q

Two plexus’s of the neck?

A 
Cervical plexus (anterior rami of C1, C2-4)
Branchial plexus from C5 to T1
31
Q

Which motor and cutaneous supply is from the cervical plexus C1-C4?

A

Infrahyoid
Diaphragm (via phrenic)
Skin of anterior/lateral neck
Skin of inferior neck

32
Q

Which branches of the brachial plexus are seen in the neck?

A

Dorsal scapular nerve
C5 branch to the phrenic nerve
Suprascapular nerve

33
Q

Which sympathetic truck ganglia are found in the neck?

A

Cervical part of sympathetic trunk gives of superior, middle and inferior cervical ganglia

34
Q

What is the ansa cervicalis? What is it’s function?

A

The ansa cervicalis is a loop of nerves, formed by nerve roots C1-C3. It gives off four muscular branches:
-Superior belly of the omohyoid muscle
-Inferior belly of omohyoid muscle
- Sternohyoid
- Sternothyroid
These muscles (the infrahyoids) act to DEPRESS the HYOID bone; an important function for swallowing and speech.

MD4001 Week 4 (9 decks)

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