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FM1020 > ANATOMY - Anterior Triangle Of Neck > Flashcards

ANATOMY - Anterior Triangle Of Neck Flashcards

1
Q

When is the carotid pulse felt?

A

During cardiopulmonary resuscitation

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2
Q

What is the carotid sinus?

A

Dilation of distal CCA and proximal ICA.

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3
Q

What is contained in the carotid sinus?

A

Baroreceptors - detect changes in BP

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4
Q

Where does the CCA bifurcate?

A

Superior border of thyroid cartilage

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5
Q

What innervates the carotid sinus?

A

Glossopharyngeal nerve

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6
Q

What is sinus hypersensitivity?

A
  • a disorder
  • when pressure is put on carotid sinus it leads to an excessive decrease in HR and BP
  • leads to cerebral ischaemia
  • leads to fainting
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7
Q

Do the internal carotid arteries have branches in the neck?

A

No

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8
Q

What is internal carotid artery atherosclerosis?

A
  • Thickening and hardening of ICA
  • narrowing of ICA lumen
  • caused by atherosclerotic plaques
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9
Q

What can ICA atherosclerosis lead to ?

A
  • transient ischaemic attack ( mini stroke )
  • stroke (cerebrovascular accident)
  • these lead to visual impairment, motor paralysis, sensory loss
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10
Q

What are the branches of the external carotid artery?

A
  • superior thyroid artery
  • lingual artery
  • facial artery
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11
Q

How does the ECA terminate?

A

Divides into:
- superficial temporal artery
- maxillary artery (larger of the 2)

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12
Q

What does the maxillary artery pass through?

A

Parotid gland

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13
Q

Where does the right CCA originate from ?

A

Brachiocephalic trunk

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14
Q

Where does the left CCA originate from ?

A

Arch of aorta

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15
Q

What is in the carotid sheath?

A

-common carotid artery
- internal carotid artery
- internal jugular vein
- vagus nerve
- deep cervical chain of lymph nodes

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16
Q

Where do the IJV, CCA and vagus nerve lie in relation to each other in the carotid sheath?

A

IJV lateral to CCA
Vagus nerve posteriorly

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17
Q

What do the IJVs drain?

A
  • brain
  • face
  • parts of neck
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18
Q

How does the IJV exit the skull?

A

Through the jugular foramen

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19
Q

Does the IJV pass superficial or deep to SCM?

A

Deep

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20
Q

How does the IJV get back to the heart?

A

IJV + subclavian = brachiocephalic vein

brachiocephalic vein + brachiocephalic vein = SVC

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21
Q

Is the IJV pulse palpable ?

A

No

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22
Q

What causes the IJV pulse?

A

Changes in pressure in right atrium since there are no valves in between it and the heart

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23
Q

Where can you see the IJV pulse?

A

Behind SCM muscle , above medial end of clavicle

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24
Q

When is the IJV pulse visible behind the sternal notch?

A

When the patient is sitting at at 45 degree angle

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25
Q

Why is the jugular venous pulse important clinically?

A

Shows the the right side of the heart is working properly

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26
Q

What happens to jugular venous pulse if pressure in right atrium is raised?

A
  • Central venous pressure is raised
  • pulsations of IJV are higher in the neck and more visible
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27
Q

When is catheterisation of the IJV required?

A

In critically ill patients to get acccurate venous pressure readings

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28
Q

How do you perform catheterization of the IJV?

A
  • palpate CCA pulse
  • insert needle into IJV lateral to artery
  • insert needle through SCM or in gap between two heads to SCM
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29
Q

What are the superficial veins of the neck?

A

External jugular veins
Anterior jugular veins

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30
Q

What do the EJV drain?

A

Scalp and face

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31
Q

Where does EJV begin

A

Angle of mandible

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32
Q

Does EJV pass superficial or deep to SCM?

A

Superficial

33
Q

Where does EJV terminate?

A

Subclavian vein, after passing through posterior triangle

34
Q

When is the EJV visible? Normally (i.e in healthy people )

A
  • on the side of neck when patient is lying down
  • for a short distance above clavicle when patient is sitting up
35
Q

Where is the EJV visible when venous pressure is raised?

A

All along its course.

36
Q

What could prominence of the EJV indicate?

A

Heart failure
or
obstruction of SVC

37
Q

What do the anterior jugular veins drain?

A

Anterior part of neck

38
Q

What do AJVs drain into?

A
  • EJV or
  • subclavian vein
39
Q

What is a common complication of a cut wall of the IJV?

A

An air embolism

40
Q

Why is the IJV susceptible to air embolisms if cut?

A

The wall has little smooth muscle, so it doesn’t contract following injury
The adventitia of the vein is attached to the carotid sheath, which hinders collapse of the vein

41
Q

Why shouldn’t you clamp the IJV blindly if it is cut?

A

It is close to vagus and hypoglossal nerves

42
Q

What happens if you get an air embolism in the IJV?

A

It fills the right side of the heart with froth and nearly stops blood from flowing through the heart

43
Q

What are the boundaries of the root of the neck?

A

Anteriorly - manubrium of sternum + upper margin of clavicles

Posteriorly - T1 vertebra and upper margin of scapulae

44
Q

What are the contents of the root of the neck?

A
  • Upper lobe of lungs
  • subclavian arteries
45
Q

What is the clinical significance of the upper lobes of the lungs being located in the root of the neck?

A

The lungs could be punctured as a result of trauma to this area or an invasive procedure to the neck

46
Q

Where do you insert a needle when carrying out subclavian venous access?

A

Below midpoint of clavicle and directed towards sternoclavicular joint.

47
Q

What are the risks when carrying out subclavian venous access?

A

Injury to subclavian artery
Injury to pleura
Injury to thoracic duct (left side only)

48
Q

What are the branches of the subclavian artery?

A
  • vertebral arteries
  • internal thoracic arteries
  • suprascapular artery
  • thyrocervical trunk (giving off inferior thyroid artery)
49
Q

What is the course of the vertebral arteries?

A

Ascend in foramena of cervical vertebrae to the cranium

50
Q

What is the course of the internal thoracic arteries?

A

Enter thoracic cavity and descend on inner surface of anterior thoracic wall

51
Q

Which is anterior to anterior scalene, subclavian artery or subclavian vein?

A

Vein

52
Q

What are the three sheets formed by condensation of the deeep cervical fascia?

A
  • investing layer of deep cervical fascia
  • pretracheal fascia
  • prevertebral fascia
53
Q

Where is the investing layer of deep cervical fascia found?

A

Encircles the neck completely

54
Q

Where is the pretracheal fascia found?

A

Surrounds oesophagus, trachea and thyroid gland

55
Q

Function of pretracheal fascia?

A

Ensures that thyroid gland moves during swallowing

56
Q

Where is the prevertebral fascia found?

A

Covering vertebral column and muscles associated with it

57
Q

Why are the fascial spaces of the neck clinically important?

A

Infection can spread through them

58
Q

What are the three fascial spaces of the neck?

A
  • retropharyngeal space
  • pretracheal space
  • third space
59
Q

Where is the retropharyngeal space?

A

Between prevertebral fascia and posterior part of pretracheal fascia

60
Q

What can result from infection in retropharyngeal space?

A

Difficulty swallowing

61
Q

Where can infection in retropharyngeal space spread to ?

A

Posterior mediastinum

62
Q

Where is the pretracheal space?

A

Between pretracheal fascia and investing layer of deep cervical fascia

63
Q

Where can infection in the pretracheal space spread to ?

A

Superior mediastinum

64
Q

Where is the third space?

A

In prevertebral fascia Covering anterior surface of cervical vertebrae

65
Q

Where does the third space extend from ?

A

Base of skull to posterior mediastinum

66
Q

What are the 4 subdivision of the anterior triangle of neck?

A
  • submental
  • submandibular
  • muscular
  • carotid
67
Q

What are the boundaries of the anterior triangle of neck? +APEX

A

Anterior = anterior midline of neck
Posterior = anterior border of SCM
Superior = mandible
Apex= where SCM and midline meet

68
Q

What are the boundaries of the submental triangle ?

A

ONLY UNPAIRED TRIANGLE
- base = hyoid bone
- side = anterior bellies of digastric muscles
- apex = mandibular symphysis

69
Q

Boundaries of submandibular triangle?

A

Superior = mandible
Sides = anterior and posterior bellies of digastric m

70
Q

What is in the submandibular triangle?

A

Salivary glands

71
Q

Boundaries of carotid triangle?

A

Superior = post belly of digastric
Sides = SCM and sup belly of omohyiod

72
Q

Contents of carotid triangle?

A

Carotid sheath

73
Q

Boundaries of muscular triangle?

A

Superior belly omohyoid
Midline
Ant border SCM

74
Q

Contents of muscular triangle ?

A

infrahyoid muscles
(thyrohyoid, sternothyroid, sternohyoid)

75
Q

Where does the External carotid artery terminate?

A

Posterior to the neck of the mandible

76
Q

What is the surface landmark of the beginning of the external jugular vein?

A

Posterior to angle of mandible

77
Q

What do the anterior jugular veins drain into?

A

EJV / Subclavian

78
Q

The external jugular vein is prominent on the side of the neck of your
patient who is sitting up. What may this be a sign of?

A

Increased venous pressure
Due to heart failure or obstruction of SVC

FM1020 (11 decks)

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