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9.23.16 Posterior Triangle Flashcards

1
Q

What are the fascial layers of the neck?

A
  1. Investing (superficial) layer of dense connective tissue
  2. Infrahyoid fascia
  3. Pretracheal fascia
  4. Carotid sheath
  5. Prevertebral (deep cervical) fascia
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2
Q

What is the sleeve that binds all structures to the neck?

A

Investing layer of dense connective tissue

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3
Q

What is the investing fascia of the neck attached to?

A

Ligamentum nuchae and spinous process of C7 vertebrae

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4
Q

What covers the supra and infra-hyoid muscles (strap muscles)?

A

Infrahyoid fascia

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5
Q

What is the viscera surrounded with a layer of fascia including the thyroid and parathyroid glands, larynx, trachea, and esophagus?

A

Pretracheal fascia

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6
Q

What covers the carotid artery, internal jugular vein, and vagus nerve?

A

Carotid sheath

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7
Q

What covers the vertebral musculature?

A

Prevertebral (deep cervical) fascia

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8
Q

What are the boundaries of the posterior triangle (anterior, posterior, inferior)?

A

Anterior: sternocleidomastoid muscle
Posterior: trapezius
Inferior (base): Clavicle

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9
Q

What is the origin and insertion of sternocleidomastoid?

A

Sternal head origin: anterior surface of manubrium
Clavicular head origin: upper surface of medial 1/3 of clavicle
Insertion: lateral usrface of matoid process; lateral half of superior nuchal line of occipital bone

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10
Q

What innervates sternocleidomastoid?

A

Accessory nerve (CN XI)

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11
Q

What is the function of sternocleidomastoid?

A

Bilaterally - flex head, raise thorax

Unilaterally - turns face toward opposite side

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12
Q

What supplies sternocleidomastoid?

A

Sternocleidomastoid branch of superior thyroid and occipital arteries, muscular branch of suprascapular artery, occipital branch of posterior auricular artery

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13
Q

What are the three scalene muscles?

A

Anterior scalene, middle scalene, posterior scalene

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14
Q

What is the origin and insertion of anterior scalene?

A

Origin: anterior tubercles of transverse processes of C3-C6
Insertion: Scalene tubercle on 1st rib

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15
Q

What is the origin and insertion of middle scalene?

A

Origin: posterior tubercles of transverse processes of C2-C7
Insertion: Upper surface of 1st rib (behind subclavian groove)

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16
Q

What is the origin and insertion of posterior scalene?

A

Origin: posterior tubercles of transverse processes of C4-C6
Insertion: Outer surface of 2nd rib (behind attachment of serratus anterior)

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17
Q

What innervates anterior scalene?

A

Anterior rami of cervical nerves (C5-C8)

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18
Q

What innervates middle scalene?

A

Anterior rami of cervical nerves (C3-C7)

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19
Q

What innervates posterior scalene?

A

Anterior rami of lower four cervical nerves

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20
Q

What is the function of anterior scalene?

A

Elevates 1st rib, bends neck

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21
Q

What is the function of middle scalene?

A

Elevates 1st rib, bends neck

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22
Q

What is the function of posterior scalene?

A

Elevates 2nd rib, bends neck

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23
Q

What is the largest and longest of the 3 scalenes?

A

Middle scalene

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24
Q

What makes up the occipital triangle?

A

Cervical plexus (cutaneous branches and motor branches), CN XI (accessory), phrenic nerve, and transverse cervical artery

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25
___ divides the posterior triangle of the neck into two smaller triangles.
The inferior belly of the omohyoid muscle
26
Where is the occipital triangle found?
Above the omohyoid muscle
27
Where is the omoclavicular triangle found?
Below the omohyoid muscle
28
What are the two subtriangles of the posterior triangle?
Occipital triangle and omoclavicular triangle
29
What is Erb's point?
An area halfway along the posterior border of the sternocleidomastoid muscle that the cutaneous branches of the cervical plexus emerge from; the accessory nerve is also just deep to the investing fascia at this point.
30
What are the cutaneous branches of the cervical plexus?
1. Transverse cervical nerve 2. Great auricular nerve 3. Lesser occipital nerve 4. Supraclavicular nerve
31
The transverse cervical nerve branches from the ventral rami of ___ and is the cutaneous nerve to the ___.
C2-C3; throat
32
The greater auricular nerve branches from the ventral rami of ___ and is the cutaneous nerve to the area around the ___.
C2-C3; ear
33
The lesser occipital nerve branches from the ventral rami of ___ and is cutaneous to the skin near the ___.
C2 (and sometimes C3); mastoid process
34
The supraclavicular nerve branches from the ventral rami of ___ and then splits into three branches named ___, ___, and ____. This is cutaneous to the area over the ___.
C3-C4; Anterior; middle; posterior; clavicle
35
The motor portion of the cervical plexus lies ___ to the sensory portion and much of it can found in the ___ triangle.
Deep; carotid
36
What are the three parts of the motor portion of the cervical plexus?
1. Phrenic nerve 2. Ansa cervicalis 3. Ventral rami
37
What are the roots of the phrenic nerve and what do they do?
C3-C4-C5; innervate the diaphragm (3-4-5 keeps the diaphragm alive)
38
The phrenic nerve sits on top of the ___ muscle.
Anterior scalene
39
What are the roots of ansa cervicalis?
C1-C2-C3
40
What are the two limbs (roots) of the ansa cervicalis?
1. C1 ventral ramus | 2. C2 and C3 rami
41
What does the C1 ventral ramus do?
Provides separate motor innervation to the thyrohyoid and geniohyoid muscles
42
What forms the superior root of the ansa cervicalis?
C1 ventral ramus
43
What do C2 and C3 rami do?
Innervates sternohyoid, sternothyroid, and omohyoid muscles
44
What forms the inferior root of the ansa cervicalis?
C2 and C3 rami
45
What does the ventral rami do?
Innervates the rectus capitis lateralis, rectus capitis anterior, longus capitis, longus colli, levator scapulae, and scalene muscles
46
What are the contents of the supraclavicular triangle?
1. Lower portion of brachial plexus 2. Subclavian artery and vein 3. Branches of the subclavian artery 4. Termination of external jugular vein
47
What are the branches of the subclavian artery?
V: veterbral artery I: internal thoracic artery T: thyrocervical trunk (inferior thyroid artery, transverse cervical artery, suprascapular artery, ascending cervical artery) C: costocervical trunk (supreme intercostal artery, deep cervical artery) D: dorsal scapular artery
48
Where does the vertebral artery go to?
Brain via transverse foramina and foramen magnum
49
Where does the internal thoracic artery go to?
Posterior aspect of anterior chest wall
50
What are the 4 parts of the thyrocervical trunk?
1. Inferior thyroid artery 2. Transverse cervical artery 3. Suprascapular artery 4. Ascending cervical artery
51
Where does the inferior thyroid artery go to?
Thyroid and larynx
52
Where does the transverse cervical artery go to?
Scalene and posterior triangle muscles, brachial plexus
53
Where does the suprascapular artery go to?
Area above the scapula and rhomboids
54
Where does the ascending cervical artery go?
Area around scalenes and anterior tubercles; spinal cord (?)
55
What are the two parts of the costocervical trunk?
1. Supreme intercostal artery | 2. Deep cervical artery
56
Where does the supreme intercostal artery go to?
First and second intercostal spaces
57
Where does the deep cervical artery go to?
Prevertebral and deep next structures
58
Branches off of the third segment are aberrant forms of the ___ (which normally arises elsewhere) and the ___ (which is frequently absent)
Suprascapular; dorsal scapular artery
59
What runs behind the clavicle and in front of the anterior scalene?
Subclavian vein
60
What runs between the anterior and middle scalene muscles?
Subclavian artery and brachial plexus
61
What runs in front of (on top of) anterior scalene?
Phrenic nerve
62
What run in front of the anterior scalene?
Transverse cervical artery and suprascapular artery
63
What (if it exists) normally runs behind (deep to) the anterior scalene?
Dorsal scapular artery
64
Draw the cervical plexus.
See Powerpoint
65
What is the origin and insertion of subclavius?
Origin: upper border of 1st rib and its cartilage Insertion: inferior surface of middle third of clavicle
66
What innervates subclavius?
Nerve to subclavius
67
What is the function of subclavius?
Anchors and depresses clavicle
68
What supplies subsclavius?
Clavicular branch of thoraco-acromial artery
69
What is the origin and insertion of longus capitis?
Origin: anterior tubercles of transverse processes of C3-C6 Insertion: inferior surface of basilar part of occipital bone
70
What innervates longus capitisi?
Ventral rami of cervical nerves (C1-C4)
71
What is the function of longus capitis?
Flexes and assists in rotating cervical vertebrae and head
72
What supplies longus capitis?
Ascending cervical branch of inferior thyroid artery, ascending pharyngeal artery, muscular branches of vertebral artery
73
What is the origin and insertion of splenius cervicis?
Origin: spinous process of T3-T6 Insertion: transverse processes (C1-C3)
74
What innervates splenius cervicis?
Dorsal rami of lower cervical nerves
75
What is the function of splenius cervicis?
Bilaterally: extend neck Unilaterally: laterally bends (flexes) and rotates neck toward same side
76
What supplies splenius cervicus?
Descending branch of occipital artery, deep cervical artery
77
What is the origin and insertion of omohyoid?
Origin of inferior belly: from upper border of scapula and suprascapular ligament, ending in tendon under sternocleidomastoid bone Origin of superior belly: from this tendon Insertion of inferior belly: to intermediate tendon Insertion fo superior belly: to body of hyoid bone
78
What innervates omohyoid?
Ansa cervicalis
79
What is the function of omohyoid?
Steadies hyoid bone and depresses hyoid
80
What supplies omohyoid?
Hyoid branch of lingual artery, sternocleidomastoid branch of superior thyroid artery

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