Anatomy 2- Neck and mediastinum

Question 1

location and fn of phrenic nerve

Answer 1

b/w parietal pleura and pericardium, comes from C3,4, and 5

innervates diaphragm, sensory signals from all three of these things

Question 2

principal and accessory muscles of inspiration

Answer 2

principal: diaphragm and ext intercostals
accessory: SCM, scalenes

Question 3

muscles of expiration

Answer 3

passive process during quiet breathing, int intercostals and abs during active breathing

Question 4

differentiate the pleural layers

Answer 4

parietal pleura assoc w/ walls of pleural cavity, visceral pleura w/ surface of the lung

pleural cavity is potential space b/w the two

Question 5

4 divisions of the parietal pleura

Answer 5

costal, diaphragmatic, mediastinal, cervical (aka sibson’s fascia)

Question 6

define hilum and root of lung

Answer 6

hilum is the bare location where mediastinal pleura reflects, makes way for the root which contains vessels and airways

Question 7

pleural recesses

Answer 7

2 regions where lungs are not present except for forced inspiration: costomediastinal recess and costodiaphragmatic

Question 8

patho of pneumothorax

Answer 8

trauma or damage allows air into pleural cavity, lung collapses due to its inherent elasticity (normally prevented by surface tension b/w parietal layers)

Question 9

Sx and Tx of pneumothorax

Answer 9

Sx: diminished breath sounds, distended neck veins

Tx: needle decompression, allow air to escap

Question 10

structure of right lung

Answer 10

3 lobes: superior, middle and inferior,
10 bronchopulmonary segments

oblique fissure divides inferior and superior, horizontal fissure divides superior and middle

Question 11

left lung structure

Answer 11

superior lobe w/ lingula, inferior lobe and they are divided by oblique fissure

8 bronchopulmonary segments

Question 12

components of bronchopulmonary segemtns

Answer 12

each gets its own tertiary branch of a pulm artery and bronchus, veins run b/w segments

Question 13

source of bronchial arteries

Answer 13

from branches of aorta, run along with bronchi

Question 14

bronchial veins drainage site

Answer 14

drain into azygos system

Question 15

diff b/w pulmonary and bronchial arteries

Answer 15

pulm bring deoxy blood to alveoli, bronchial bring oxy blood to lung tissues

Question 16

lymphatic drainage of the lungs

Answer 16

drain into tracheobronchial lymph nodes which send efferent vessels into bronchomediastinal trunks

Question 17

autonomic innervation

Answer 17

pulmonary plexus has both SNS and PSNS, located at bifurcation of trachea

SNS dilates brochioles and PSNS constricts

Question 18

differentiate azygos, hemiazygos and accessory hemiazygos

Answer 18

azygos: right side, receives blood from right intercostals and empties into SVC

Hemiazygos: left side, lower 4 intercostals

accessory hemiazygos: middle left 4 posterior intercostals

Question 19

location and fn of thoracic duct

Answer 19

located b/w aorta and azygos vein, begins in abdomen and empties lymph from RLQ, LLQ, LUQ in junction of left internal jugular and subclavian veins

RUQ drains right lymphatic duct

Question 20

location and fn of splanchnic nerves

Answer 20

sympathetic nerves from throax to abdomen, innervate organs in this region

Question 21

3 different layers of deep cervical fascia, why they are useful

Answer 21

investing layer: outer layer around deeper structures

prevertebral layer: around vertebral column and associate muscles

pretracheal layer: around thyroid, trachea, esophagus

can determine spread of infection

Question 22

carotid sheath

Answer 22

tubular fascial sheath with fascia from other layers, contains common carotid, IJV, and vagus nerve

Question 23

large veins in order as they empty into the heart

Answer 23

on both sides, internal jugular veins means subclavians to form brachiocephalic, then empty into SVC

Question 24

venous angle

Answer 24

juntion of IJV and subclavian vein, location where many lymphatic vessels join circulation (thoracic duct in left venous angle)

Question 25

major branches from aortic arch

Answer 25

brachiocephalic trunk on the right (gives rise to right common carotid and right subclavian), left subclavian, left common carotid

Question 26

first branch of the external carotid

Answer 26

superior thyroid artery

Question 27

receptors at the carotid bifurcation

Answer 27

carotid body: chemoreceptor monitoring O2 levels carotid sinus: dilation near base of internal carotid that acts as baroreceptor

Question 28

innervation of carotid receptors

Answer 28

glossopharyngeal nerve CN IX

Question 29

3 parts of subclavian artery

Answer 29

1st is medial to anterior scalene, 2nd is posterior, 3rd is lateral to the muscle- after this is is the axillary artery

Question 30

4 main branches of subclavian artery

Answer 30

VITamin C: | vertebral artery, Internal thoracic, thyrocervical trunk, costocervical

Question 31

vertebral artery

Answer 31

ascends w/i transverse foramina to supply brain and spinal cord

Question 32

main branch of thyrocervical trunk

Answer 32

inferior thyroid artery

Question 33

development of thyroid gland

Answer 33

forms at base of tongue and descends thru thyroglossal duct in the neck

Question 34

structure of thyroid

Answer 34

two lobes connected by isthmus, can sometimes have pyramidal lobe as superior projection

Question 35

blood supply of thyroid

Answer 35

superior thyroid from external carotid, inferior thyroid from thyrocervical trunk off of subclavian in some ppl thyroid ima artery from brachiocephalic trunk

Question 36

blood supply of parathyroids

Answer 36

inferior thyroid arteries (branch of thyocervial trunk, itself a branch of the subclavian)

Question 37

what else to find near anterior scalene

Answer 37

brachial plexus and subclavian artery b/w anterior and middle scalene, subclavian vein is anterior to anterior scalene, phrenic nerve lies on the anterior surface of anterior scalene

Question 38

3 suprahyoid muscles

Answer 38

mylohyoid, digastric muscle (anterior and posterior bellies), stylohyoid

Question 39

4 infrahyoid muscles

Answer 39

sternohyoid, sternothyroid, omohyoid, thyrohyoid | names based on first part=origin, second=attachment

Question 40

innervation of infrahyoid muscles

Answer 40

cervical plexus, specifically the ansa cervicalis

Question 41

cervical plexus

Answer 41

ventral rami of C1-4, motor branches form loop called ansa cervicalis

Question 42

sensory branches of the cervical plexus (4)

Answer 42

cutaneous nerves, exit the posterior border of the SCM at Erbs point lesser occipital, greater auricular, transverse cervical, supraclavicular

Question 43

anterior triangle

Answer 43

inferior border of mandible, neck midline, anterior SCM

Question 44

posterior triangle

Answer 44

posterior SCM, clavicle, anterior trapezius

Question 45

carotid triangle

Answer 45

bordered by the superior belly of omohyoid, anterior SCM, posterior belly of digastric contains: carotid sheath (IJV, vagus, common carotid), ansa cervicalis, hypoglossal nerve

Question 46

contents of posterior triangle

Answer 46

spinal accessory nerve (trapezius and SCM), brachial plexus, anterior and middle scalene, phrenic nerve, EJV

Question 47

EJV clinical use

Answer 47

in right sided heart failure, blood is backed up in EJV and is visible on the neck, amount of distortion is proportional to extent of heart failure