4 - Anterior triangle, thyroid and parathyroid Flashcards
What are the borders of the anterior triangle?
- inferior border of mandible
- anterior border of SCM
- midline of neck
What forms the roof of the anterior triangle?
Deep investing cervical fascia around the muscles
What forms the floor of the anterior triangle?
Pretracheal fascia and carotid sheath
What are the subdivisions of the anterior triangle?
- submandibular
- submental
- carotid
- muscular (omotracheal)
What is contained in the submandibular triangle?
- digastric
- submandibular gland
- lymph nodes
- parts of CN XII (hypoglossal)
- mylohyoid nerve
- parts of facial artery and vein
What is contained in the submental triangle?
- submental lymph nodes
- small veins (unite to form anterior jugular)
What is contained in the carotid triangle?
- thyroid gland
- larynx
- pharynx
- carotid sheath
- branches of the cervical plexus
- superior root of the ansa cervicalis
- parts of CN XI and XII
- deep cervical lymph nodes
What is contained in the muscular triangle?
- sternohyoid
- sternothyroid
- thyroid
- parathyroid glands
What are the suprahyoid muscles?
- mylohyoid
- diagastric
- stylohyoid
- geniohyoid
What are the infrahyoid muscles?
- sternohyoid
- sternothyroid
- omohyoid
- thyrohyoid
What is the origin of mylohoid?
Mylohyoid line on mandible
What is the insertion of mylohyoid?
- body of the hyoid
- fibres of the opposite mylohyoid
What is the insertion of digastric?
Both bellies insert at the attachment of their intermediate tendon at hyoid (fascial sling)
What is the action of mylohyoid?
- elevate hyoid and the floor of the mouth
- reinforces floor of oral cavity
What is the action of the suprahyoid muscles?
- elevate the hyoid (swallowing)
- elevate the larynx (tone production)
- form floor the mouth
What is the origin of the digastric?
Anterior belly - digastric fossa on lower medial aspect of mandible
Posterior belly - mastoid notch of medial side of mastoid process
What is the action of the digastric?
Anterior belly - raises hyoid and opens mouth by lowering mandible
Posterior belly - elevates and retracts hyoid
What is innervation of mylohyoid?
CN V3, via inferior alveolar branch, “nerve to mylohyoid”
What is the innervation of digastric?
Anterior belly - nerve to mylohyoid (CN V3)
Posterior belly - digastric branch of CN VII
What is the origin of stylohyoid?
Styloid process
What is the insertion of stylohyoid?
Body of hyoid (laterally)
What is the innervation of stylohyoid?
CN VII
What is action of stylohyoid?
Pulls hyoid bone upwards (posterosuperior)
What is the origin of geniohyoid?
Inferior mental spine of mandible
What is the insertion of geniohyoid?
- body of hyoid
- located superior to mylohyoid
What is the action of geniohyoid?
- when mandible is fixed = elevates and pulls hyoid forward
- when hyoid is fixed = pulls mandible down and inward
What is the innervation of geniohyoid?
Anterior ramus of C1 (travels with CN XII)
What is the insertion of omohyoid?
Superior belly - body of hyoid laterally
Inferior belly - intermediate tendon in posterior triangle
What is the origin of omohyoid?
Superior belly - intermediate tendon
Inferior belly - superior border of scapula
What is the action of omohyoid?
Depresses and fixes hyoid
What is the action of infrahyoid muscles?
- depress or fix hyoid
- provide attachment for suprahyoid muscles
What is the origin of thyrohyoid?
Oblique line on thyroid cartilage
What is the insertion of thyrohyoid?
Great horn and adjacent body of hyoid
What is the action of thryohyoid?
- depress hyoid
- can raise larynx when hyoid is fixed
What is the insertion of sternothyroid?
Oblique line on thyroid cartilage
What is the origin of sternothryoid?
Posterior surface of manubrium
What is the action of sternothyroid?
Draw larynx down
What is the innervation of sternohyoid?
Anterior rami of C1 to C3 (through ansa cervicalis)
What is the innervation of sternothyroid?
Anterior rami of C1 to C3 (through ansa cervicalis)
What is the innervation of omohyoid?
Anterior rami of C1 to C3 (through ansa cervicalis)
What is the innervation of thyrohyoid?
Anterior rami of C1, fibres run with CN XII
Describe the thyroid gland.
- within visceral compartment of neck
- made up of 2 lateral lobes (L/R)
- midline isthmus (level of the 3rd tracheal ring)
- midline pyramidal lobe (variably present)
What is the arterial supply of the thyroid?
- superior thyroid artery (1st branch of ECA)
- inferior thyroid artery (branch of TCT of subclavian)
What is the venous drainage of the thyroid?
- superior and middle thyroid vein (to IJV)
- inferior thyroid vein (to brachiocephalic)
What are the parathyroid glands?
- two pairs of glands usually found on the posterior surface of the thyroid (superior and inferior pairs)
- exact position vary
What is the arterial supply of the parathyroid glands?
Inferior thyroid arteries (branch of TCT of subclavian)
What is the venous drainage of the parathyroid glands?
- superior and middle thyroid vein (to IJV)
- inferior thyroid vein (to brachiocephalic)
What is the innervation of the thyroid and parathyroid?
Thyroid branches of the cervical (sympathetic) ganglia