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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
Why is the jugular venous pulse important clinically?
Shows the the right side of the heart is working properly
26
What happens to jugular venous pulse if pressure in right atrium is raised?
- Central venous pressure is raised - pulsations of IJV are higher in the neck and more visible
27
When is catheterisation of the IJV required?
In critically ill patients to get acccurate venous pressure readings
28
How do you perform catheterization of the IJV?
- palpate CCA pulse - insert needle into IJV lateral to artery - insert needle through SCM or in gap between two heads to SCM
29
What are the superficial veins of the neck?
External jugular veins Anterior jugular veins
30
What do the EJV drain?
Scalp and face
31
Where does EJV begin
Angle of mandible
32
Does EJV pass superficial or deep to SCM?
Superficial
33
Where does EJV terminate?
Subclavian vein, after passing through posterior triangle
34
When is the EJV visible? Normally (i.e in healthy people )
- on the side of neck when patient is lying down - for a short distance above clavicle when patient is sitting up
35
Where is the EJV visible when venous pressure is raised?
All along its course.
36
What could prominence of the EJV indicate?
Heart failure or obstruction of SVC
37
What do the anterior jugular veins drain?
Anterior part of neck
38
What do AJVs drain into?
- EJV or - subclavian vein
39
What is a common complication of a cut wall of the IJV?
An air embolism
40
Why is the IJV susceptible to air embolisms if cut?
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
Why shouldn’t you clamp the IJV blindly if it is cut?
It is close to vagus and hypoglossal nerves
42
What happens if you get an air embolism in the IJV?
It fills the right side of the heart with froth and nearly stops blood from flowing through the heart
43
What are the boundaries of the root of the neck?
Anteriorly - manubrium of sternum + upper margin of clavicles Posteriorly - T1 vertebra and upper margin of scapulae
44
What are the contents of the root of the neck?
- Upper lobe of lungs - subclavian arteries
45
What is the clinical significance of the upper lobes of the lungs being located in the root of the neck?
The lungs could be punctured as a result of trauma to this area or an invasive procedure to the neck
46
Where do you insert a needle when carrying out subclavian venous access?
Below midpoint of clavicle and directed towards sternoclavicular joint.
47
What are the risks when carrying out subclavian venous access?
Injury to subclavian artery Injury to pleura Injury to thoracic duct (left side only)
48
What are the branches of the subclavian artery?
- vertebral arteries - internal thoracic arteries - suprascapular artery - thyrocervical trunk (giving off inferior thyroid artery)
49
What is the course of the vertebral arteries?
Ascend in foramena of cervical vertebrae to the cranium
50
What is the course of the internal thoracic arteries?
Enter thoracic cavity and descend on inner surface of anterior thoracic wall
51
Which is anterior to anterior scalene, subclavian artery or subclavian vein?
Vein
52
What are the three sheets formed by condensation of the deeep cervical fascia?
- investing layer of deep cervical fascia - pretracheal fascia - prevertebral fascia
53
Where is the investing layer of deep cervical fascia found?
Encircles the neck completely
54
Where is the pretracheal fascia found?
Surrounds oesophagus, trachea and thyroid gland
55
Function of pretracheal fascia?
Ensures that thyroid gland moves during swallowing
56
Where is the prevertebral fascia found?
Covering vertebral column and muscles associated with it
57
Why are the fascial spaces of the neck clinically important?
Infection can spread through them
58
What are the three fascial spaces of the neck?
- retropharyngeal space - pretracheal space - third space
59
Where is the retropharyngeal space?
Between prevertebral fascia and posterior part of pretracheal fascia
60
What can result from infection in retropharyngeal space?
Difficulty swallowing
61
Where can infection in retropharyngeal space spread to ?
Posterior mediastinum
62
Where is the pretracheal space?
Between pretracheal fascia and investing layer of deep cervical fascia
63
Where can infection in the pretracheal space spread to ?
Superior mediastinum
64
Where is the third space?
In prevertebral fascia Covering anterior surface of cervical vertebrae
65
Where does the third space extend from ?
Base of skull to posterior mediastinum
66
What are the 4 subdivision of the anterior triangle of neck?
- submental - submandibular - muscular - carotid
67
What are the boundaries of the anterior triangle of neck? +APEX
Anterior = anterior midline of neck Posterior = anterior border of SCM Superior = mandible Apex= where SCM and midline meet
68
What are the boundaries of the submental triangle ?
ONLY UNPAIRED TRIANGLE - base = hyoid bone - side = anterior bellies of digastric muscles - apex = mandibular symphysis
69
Boundaries of submandibular triangle?
Superior = mandible Sides = anterior and posterior bellies of digastric m
70
What is in the submandibular triangle?
Salivary glands
71
Boundaries of carotid triangle?
Superior = post belly of digastric Sides = SCM and sup belly of omohyiod
72
Contents of carotid triangle?
Carotid sheath
73
Boundaries of muscular triangle?
Superior belly omohyoid Midline Ant border SCM
74
Contents of muscular triangle ?
infrahyoid muscles (thyrohyoid, sternothyroid, sternohyoid)
75
Where does the External carotid artery terminate?
Posterior to the neck of the mandible
76
What is the surface landmark of the beginning of the external jugular vein?
Posterior to angle of mandible
77
What do the anterior jugular veins drain into?
EJV / Subclavian
78
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?
Increased venous pressure Due to heart failure or obstruction of SVC

FM1020 (11 decks)

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