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ANATOMY SEM 3 > A10 - the neck > Flashcards

A10 - the neck Flashcards

1
Q

what vertebral level is they hyoid bone?

A

C3

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2
Q

what vertebral level is the thyroid cartilage?

A

C4-C5

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3
Q

what vertebral level is the cricoid cartilage?

A

C6-C7

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4
Q

what vertebral level is the trachea?

A

C6-T5

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5
Q

what vertebral level is the isthmus of the thyroid gland?

A

C7

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6
Q

what vertebral level is the suprasternal notch?

A

T2/T3

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7
Q

what does the cricoid cartilage indicate the level of?

A
  • junction between the larynx and trachea
  • junction between the pharynx and oesophagus
  • level where the recurrent laryngeal nerve enters the larynx

(C6-C7)

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8
Q

what does the superior articular facet of the atlas articulate with? what movement does it allow?

A

occipital condyles allowing nodding and lateral flexion

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9
Q

what passes through the foramen transversarum?

A

vertebral vessels

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10
Q

what does the dens of the axis articular with? what holds it in position?

A

anterior arch of atlas — held in position against the posterior aspect of ther anterior arch of ther atlas by the transverse ligament of the atlas

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11
Q

what ligaments are involved in the dens articulation with the atlas?

A

apical, alar and cruciate

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12
Q

what features distinguish the cervical vertebra from other vertebra?

A

short, bifid process, foramen transversarum, triangular shaped vertebral foramen, small body

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13
Q

describe C7

A
  • vertebra prominens
  • long spinous process, and non-bifid
  • small transverse foramina — transmits vertebral vein not artery
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14
Q

what suspends the hyoid bone from the styloid process?

A

stylohyoid ligament

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15
Q

how is the hyoid bone attached to the thyroid cartilage?

A

thyrohyoid membrane

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16
Q

describe the lesser horn of the hyoid bone

A
  • projects superoposteriorly (towards styloid process of temporal bone)
  • where the stylohyoid ligament attaches
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17
Q

what are the 3 main ligaments that attach to the hyoid bone, and act to support the position of the hyoid in the neck?

A
  • Stylohyoid ligament – extends from the styloid process of the temporal bone to the lesser horn of the hyoid bone.
  • Thyrohyoid membrane – originates fromthe superior border of the thyroid cartilage and attaches to the posterior surface of the hyoid bone and the greater horns.
  • Hyoepiglottic ligament – connects the hyoid bone to the anterior aspect of the epiglottis.
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18
Q

what are the 4 suprahyoid muscles?

A
  • stylohyoid
  • mylohyoid
  • digastric (anterior and posterior bellies)
  • geniohyoid
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19
Q

O, I and A of stylohyoid

A

O = styloid process of temporal bone
I = lateral aspect of hyoid bone
A = initiates a swallowing action by pulling the hyoid bone in an superoposterior direction

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20
Q

innervation of stylohyoid. where does this nerve arise?

A
  • stylohyoid branch of CNVII
  • arises proximally to the parotid gland
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21
Q

O, I and A of digastric

A

O : anterior belly from digastric fossa of mandible. posterior belly from mastoid process of temporal bone
I : 2 bellies connected by an intermediate tendon which attaches to the hyoid bone by a fibrous sling
A : depresses the mandible and elevates the hyoid

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22
Q

innervation of digastric

A

anterior belly = inferior alveolar nerve (branch of V3)
posterior belly = digastric branch of CN VII

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23
Q

O, I and A of geniohyoid

A

O : inferior mental spine of mandible
I : travels inferiorly and posteriorly to attach to hyoid bone
A : depresses mandible and elevates hypoid bone

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24
Q

innervation of geniohyoid

A

C1 nerve roots that run in the hypoglossal nerve

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25
Q

what muscle forms the floor of the oral cavity and supports the floor of the mouth?

A

mylohyoid

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26
Q

O, I and A of mylohyoid

A

O = mylohyoid line of mandible
I = hyoid bone
A = elevates the hyoid bine and the floor of the mouth

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27
Q

innervation of mylohyoid

A

inferior alveolar nerve (V3 branch) branch = nerve to mylohyoid

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28
Q
A
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29
Q

what are the infrahyoid muscles? which are deep plane and which are superficial plane?

A
  • omohyoid = superficial
  • sternohyoid = superficial
  • sternothyroid = deep
  • thyrohyoid = deep
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30
Q

what infrahyoid muscle is comprised of 2 muscular bellies connected by a muscular tendon?

A

omohyoid

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31
Q

O, I and A of omohyoid

A

O : inferior belly from scapula - runs superomedially under the sternocleidomastoid, superior belly from hyoid bone
I : intermediate tendon (anchored to clavicle by deep cervical fascia)
A : depresses hyoid bone

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32
Q

O, I and A of sternohyoid

A

O : sternum amd sternoclavicular joint
I : hyoid bone
A : depresses hyoid bone

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33
Q

O, I and A of sternothyroid

A

O : manubrium of sternum
I : thryoid cartilage
A : depresses thyroid cartilage

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34
Q

O, I and A of thyrohyoid

A

thought to be a continuation of the sternothyroid

O : thyroid cartilage of larynx
I : hyoid bone
A : depresses hyoid. if the hyoid is fixed it can elevate the larynx

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35
Q

innervation of the infrahyoid muscles

A

omohyoid, sternohyoid and sternothyroid = anterior rami of C1-C3, carried by a branch of the ansa cervicalis

thyrohyoid = anterior ramus of C1, carried with the hypoglossal nerve

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36
Q

what divides the neck into anterior and posterior triangles?

A

sternocleidomastoid (SCM)

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37
Q

O, I, A and innervation of SCM

A

O : sternal head from anterior surface of manubrium of sternum, calvicualr head from medial 1/3 of clavicle
I : mastoid process of temporal bone and superior nuchal line of occipital bone
A : flexes and laterally flexes neck, rotates head
innervation : accessory nerve CNXI

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38
Q

what are the boundaries of the anterior triangle?

A

midline, SCM, mandible

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39
Q

what covers the floor and roof of the anterior triangle?

A

investing fascia covers the roof
visceral fascia covers the floor

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40
Q

what are the subtriangles of the anterior triangle?

A

carotid, submental, submandibular, muscular

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41
Q

what is the anterior triangle subdivided by?

A

superior belly of omohyoid, and the anterior and posterior bellies of the digastric

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42
Q

what does the submental triangle contain?

A

submental lymph nodes

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43
Q

what does the submandibular triangle contain?

A

submandibular glands, submandibular lymph nodes

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44
Q

what does the carotid triangle contain?

A

carotid sheath containing common carotid artery (bifurcates in triangle into external and internal), IJV, vagus and hypoglossal nerves, deep cervical lymph nodes, larynx

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45
Q

what does the muscular triangle contain?

A

infrahyoid muscles = omohyoid, sternohyoid, sternothyroid, thyrohyoid

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46
Q

what does the posterior triangle contain?

A

muscles = omohyoid (inferior belly)

nerves = CNXI (spinal part), branches of cervical plexus, trunks of the brachial plexus

arteries/veins = transverse cervical artery, suprascapular artery, EJV, subclavian artery and vein, occipital artery

lymph nodes

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47
Q

what are the boundaries of the posterior triangle?

A

SCM, trapezius, clavicle

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48
Q

what are the sub triangles of the posterior triangle?

A

occipital and supraclavicular

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49
Q

what is the posterior triangle divided by?

A

the inferior belly of the omohyoid muscle

50
Q

what is the floor of the (posterior?? ) triangles formed by?

A

scalene muscles and prevertebral fascia

51
Q

what does the superficial cervical fascia lie between?

A

the dermis and deep cervical fascia

52
Q

what does the superficial cervical fascia contain?

A
  • neurovascular supply to the skin
  • superfical veins (eg. external jugular)
  • superfical lymph nodes
  • fat
  • platysma muscle
53
Q

what triangles are the IVJ and EJV in?

A

IVJ = anterior
EJV = posterior

54
Q

platysma:

it has 2 heads, which originate from the fascia of the ______ and ____. the fibres from the 2 heads cross the _____ and meet in the midline, fusing with the muscles of the face. superiorly, the platysma inserts into the inferior border of the _____

innervation is via the _____ branch of the _____ nerve

A

it has 2 heads, which originate from the fascia of the pectoralis major and deltoid. the fibres from the 2 heads cross the clavicle and meet in the midline, fusing with the muscles of the face. superiorly, the platysma inserts into the inferior border of the mandible

innervation is via the cervical branch of the facial nerve

55
Q

what are the deep cervical fascia layers from superfical to deep?

A
  • investing layer
  • pretracheal layer
  • prevertebral layer
  • carotid sheath
56
Q

describe the investing layer

A
  • most superficial of the deep cervical fascia
  • surrounds all structures in the neck
  • where it meets the trapezius and SCM it splits into 2, completely surrounding them
57
Q

what are the superior, inferior, anterior and posterior attachments of the investing layer?

A
  • superior — external occipital protuberance and the superior nuchal line of the skull
  • anterior — hyoid bone
  • inferior — spine and acromion of scapula, the clavicle and the manubrium of the sternum
  • posterior — nuchal ligament of the vertebral column
58
Q

what layer fuses with the fibrous pericardium?

A

pretracheal layer

59
Q

what does the pretracheal layer enclose?

A

muscular part — encloses infrahyoid muscles
visceral part — encloses thyroid gland, trachea and oesophagus

60
Q

what does the pretracheal layer span between?

A

hyoid bone superiorly and the thorax inferiorly

61
Q

the posterior part of the visceral fascia of the pretracheal layer is formed by contributions from what?

A

the buccopharyngeal fascia (a fascial covering of the pharynx)

62
Q
A
63
Q

what layer surrounds the vertebral column and its associated muscles (scalenes, prevertebral muscles and deep muscles of the back)?

A

prevertebral layer

64
Q

what are the superior, anterior, posterior and inferior attachments of the prevertebral layer?

A

> superior — base of skull
anterior — transverse processes and vertebral bodies of the vertebral column
posterior — nuchal ligament of vertebral column
inferior — fusion with the endothoracic fascia of rib cage

65
Q

what does the anterolateral portion of prevertebral fascia form the floor of?

A

posterior triangle of the neck

66
Q

what does the prevertebral layer extend laterally as and what does it surround?

A

axillary sheaths — surrounds axillary vessels and brachial plexus

67
Q
A
68
Q

what are the contents of the carotid sheath?

A
  • common and internal carotid arteries
  • IJVs
  • vagus nerve
  • deep cervical nodes
69
Q

what bifurcates in the carotid sheath?

A

the carotid artery into its external and internal parts

70
Q

clinical importance of carotid sheath?

A

pathway for spread of infection

71
Q

the carotid fascia is organised into a column which runs between what?

A

the base of the skull to the thoracic mediastinum

72
Q

where are the parathyroid glands located?

A

posterior aspect of the thyroid gland within the pretracheal fascia

73
Q

what are the 2 superior parathyroid glands derived from?

A

fourth pharyngeal pouch

74
Q

what are the 2 inferior parathyroid glands derived from?

A

third pharyngeal pouch

75
Q

arterial supply of parathyroid glands?

A
  • mainly inferior thyroid artery
  • also superior thyroid and thyroid ima arteries
76
Q

venous drainage of parathyroid glands

A

superior, middle and inferior thyroid veins

77
Q

nerve supply of parathyroid glands

A
  • sympathetic from thyroid branches of cervical ganglia
78
Q

what do the parathyroid glands do?

A

responsible for production of parathyroid hormone — acts to increase the serum Ca++ level

79
Q

what vertebra does the thyroid gland span?

A

C5-T1 vertebrae

80
Q

where is the thyroid gland located?

A
  • anterior neck
  • lobes wrapped around cricoid cartilage and superior rings of trachea
  • in the visceral co parent of the neck (along with trachea, oesophagus and pharynx) — this compartment is bounded by the pretracheal fascia
81
Q

arterial supply of thyroid gland

A
  • superior thyroid artery
  • inferior thyroid artery
  • thyroid ima artery present in 10% of people (arises from the brachiocephalic trunk and supplies the anterior surface and isthmus of the thyroid gland)
82
Q

what is the first branch of the ECA?

A

superior thryoid artery

83
Q

what does the inferior thyroid artery arise from?

A

thyrocervical trunk (a branch of the subclavian artery)

84
Q

what do the superior and inferior thyroid arteries lie in close proximity with?

A

superior — external branch of superior laryngeal nerve

inferior — recurrent laryngeal nerve

85
Q

at what level does the common carotid bifurcate into the internal and external arteries?

A

C3/4

86
Q

what do the left and right common carotids arise from?

A

left — aortic arch

right — brachiocephalic trunk

87
Q

the internal carotid artery passes beneath the _____ , being crossed by what?

A
  • parotid gland

crossed by: hypoglossal nerve, digastric muscle and stylohyoid muscle, the occipital artery and posterior auricular

88
Q

what arteyr has no branches in the neck?

A

internal carotid

89
Q

the internal carotid enters the skull via ______ , emerging at the ______ and passes to the petrolingual ligament.

A
  • carotid canal
  • foramen lacerum
90
Q

the internal carotid travels throguh what sinus before entering the subarachnoid space?

A

cavernous

91
Q

what does the external carotid enter and bifurcate into its 2 terminal brancehs?

A

parotid gland

92
Q

what are the branches of the external carotid artery?

A

SOME ANATOMISTS LIKE FREAKING OUT POOR MEDICAL STUDENTS

93
Q

vertebral artery
- arise from ______ arteries
- enter deep to the transverse process on either side of the __ vertebrae
- then proceed superiorly in the transverse foramen of each cervical vertebra
- after passing through the transverse process of C1, they travel across the ______ arch of C1 and through the suboccipital triangle before entering the ____________
- inside the skull the 2 unite to form the ___________

A
  • subclavian
  • C6
  • posterior
  • foramen magnum
  • basilar artery
94
Q

the IJV begins as a continuation of what?

A

sigmoid sinus

95
Q

what does the IJV exit the skull throguh?

A

jugular foramen

96
Q

what does the IJV descend throguh the neck in?

A

carotid sheath

97
Q

the IJV unties with ____ to form the brachiocephalic vein

A

subclavian vein

98
Q

where is the EJV formed?

A

behind the anlge of the mandible

99
Q

the EJV is formed by the union of what?

A

posterior retromandibular vein with posterior auricular

100
Q

what do the superfical temproal and maxillary veins unite to form?

A

retromandibular vein

101
Q

what unites to form the common facial nvein?

A

anterior retromandibular and facial veins

102
Q

what does the common facial vein join?

A

IJV

103
Q

where does the retromandibular vein divide into the anterior and posterior parts?

A

parotid gland

104
Q

what bifurcates at the level of the upper border of thyroid cartilage?

A

common carotid artery

105
Q

what vessel lies superficial to the SCM before transversing the posterior triangle?

A

external jugular

106
Q

what nerve lies on the anterior surface of the anterior scalene muscle?

A

phrenic

107
Q

what nerve descends in the carotid sheath posterolateral to internal and common carotid arteries and medial to the IJV?

A

vagus nerve

108
Q

identify A-H

A

A = trachea
B = left brachiocephalic vein
C = right internal jugular vein
D = left common carotid artery
E = brachial plexus
F = anterior scalene muscle
G = phrenic nerve
H = vagus nerve

109
Q
A

A = cricoid
B = arytenoid
C = thyroid

D = aryepiglottic/quadrangular

upper = aryepiglottic fold
lower = false vocal fold/cord (vestibular fold)

E = cricovocal/conus elasticus

true vocal cord/fold

110
Q
A

A = cricothyroid

  1. increases the length of the vocal cords and therefore raises the pitch of the voice
  2. external branch of superior laryngeal nerve
111
Q
A

A = posterior cricoarytenoid
- abducts the vocal cords

B = interarytenoid (transverse arytenoid)
- adducts the vocal cords

C = aryepiglottic
- narrows the laryngeal inlet

recurrent laryngeal

112
Q

label 1-18

A
  1. carotid sheath
  2. IJV
  3. common carotid artery
  4. sternohyoid
  5. sternothyroid
  6. SCM
  7. omohyoid
  8. carotid sheath (red)
  9. prevertebral fascia (orange)
  10. investing fascia (green)
  11. trapezius
  12. C7
  13. platysma
  14. vagus nerve
  15. pretracheal fascia (purple)
  16. oesophagus
  17. trachea
  18. thyroid gland
113
Q

cervical sympathetic chain

it ascends anterior to the _______ but posterior to the ________ , and laterally is the ipsilateral ______ artery

A
  • prevertebral fascia
  • carotid sheath
  • vertebral
114
Q

what supplies sensation to the mucosa from the epiglottis to just above the level of the vocal cords and pierces the thyrohyoid membrane above the superior laryngeal artery?

A

internal aryngeal

115
Q

what is a branch of the vagus nerve that innervates the cricothyroid?

A

external laryngeal

116
Q

what is formed at the lateral borders of the anterior scalene muslces, mainly from C4 but with some contribution from C3 and C5?

A

phrenic nerve

117
Q

what nerve exits from the jugular foramen and arises within the carotid sheath?

A

vagus nerve

118
Q

what enters the submandibular triangle deep to the posterior belly of the digastric muscle and gives off a branch to thyrohyoid?

A

hypoglossal

119
Q

what provides parasympathetic innervation to the parotid gland?

A

glossopharyngeal

120
Q
A
121
Q

carotid sheath contents

A

IC 10CC’s in the IV

  • internal carotid
  • vagus nerve
  • common carotid
  • internal jugular vein

ANATOMY SEM 3 (22 decks)

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