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Anatomy - Neck Flashcards

0
Q

What are characteristics of typical cervical vertebrae?

A
  • transverse mass: anterior and posterior tubercles
  • transverse foraminae transmits vertebral a.
  • bifid spinous process increase surface area for muscle attachments
  • uncinate process
  • I-V foramen
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1
Q

What are the 4 layers of deep cervical fascia?

A
  • investing layer
  • pretracheal layer
  • prevertebral area
  • carotid sheath
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2
Q

What are the 3 lateral vertebral muscles?

A
  • scalenus anterior
  • scalenus medius
  • scalenus posterior
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3
Q

Which neurovascular structures run between scalenus anterior and scalenus medius?

A
  • phrenic nerve
  • brachial plexus
  • subclavian artery
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4
Q

Where do the lateral vertebral muscles attach?

A

Attach to transverse mass of cervical vertebrae (tubercles)

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5
Q

Where are the lateral vertebral muscles located?

A

Deep to prevertebral fascia

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7
Q

What are characteristics of the C1 vertebra?

A

Atlas:

  • no body
  • anterior and posterior arches
  • facet for dens
  • upper surfaces articulate with occipital condyles
  • long transverse process
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8
Q

What are characteristics of the C2 vertebra?

A

Axis:

  • dens (odontoid process)
  • surfaces on dens articulate with anterior arch of C1
  • strong spinous process gives attachment to strong stabiliser muscles
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9
Q

What is the passage of cervical nerve roots?

A

C1 and C2 pass behind facet joints

The rest pass between body and facet

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10
Q

At what spinal segment does the common carotid artery bifurcate?

A

C4

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11
Q

Through which foraminae is vertebral a. transmited?

A

Transverse foraminae C6-C1

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12
Q

Where may compression of common carotid artery occur?

A

At anterior tubercle of C6 (carotid tubercle)

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13
Q

What are the superior joints (suboccipital) of the cervical spine?

A

Atlanto-occipital (0-C1)

Atlanto-axial (C1-C2)

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14
Q

What are characteristics of intervertebral discs of the cervical spine?

A
  • thick disc with central nucleus
  • form cervical lordosis
  • relative to size of body, cervical I-V discs are largest
  • prevent forward slip and rotation
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15
Q

What is an uncovertebral joint?

A

Uncinate process articulates with superior margins of body

Non-synovial joint

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16
Q

What sort of injury occurs in hyperextension of facet joints?

A

compression injury

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17
Q

What sort of movement does the atlanto-occipital joint permit?

A

Loose fibrous capsule permits nodding movement (flexion/extension)

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18
Q

Where are the atlanto-occipital joints?

A
  • 2 lateral synovial joints

- between occipital condyles and upper surfaces of atlas

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19
Q

T/F

Superior cervical joints contain an intervertebral disc?

A

False

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20
Q

What sort of movement do the atlanto-axial joints permit?

A

Rotation

Transverse ligament allows minimal flexion/extension

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21
Q

What is the ligament between atlas and occiput?

A

Posterior atlanto-occipital membrane

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22
Q

What ligaments are between axis and occiput?

A

Membrane tectoria/posterior longitudinal ligament (PLL)

Anterior atlanto-occipital membrane

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23
Q

What movements do the ligaments of the cervical spine limit?

A

Resist movements in sagittal plane - flexion/extension

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24
Q

What is the function of the transverse ligament?

A

Stabilises dens - prevents posterior translation of dens into the vertebral canal

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25
Q

What is the function of alar ligaments?

A

Restricts range of rotation of atlas around dens

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26
Q

What are the effects of aging on the cervical spine?

A
  • Lordosis flattens when water content of I-V disc nucleus reduces
  • Osteophytes may develop from uncinate processes and facet surfaces which may irritate nerve roots and occlude vertebral artery
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27
Q

What are the margins of the posterior neck?

A

Extends from superior nuchal line of the skull to C7/T1 disc

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28
Q

What are the compartments of the neck?

A
  • Visceral compartment
  • 2 vascular compartments (carotid sheath)
  • Vertebral compartment
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29
Q

What structures are contained within the vertebral compartment?

A
  • Cervical vertebrae

- Postural muscles

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30
Q

What structures are contained within the visceral compartment?

A
  • Thyroid and parathyroid glands
  • Thymus gland if present
  • Trachea and oesophagus
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31
Q

What structures are contained within the vascular compartments?

A
  • Carotid sheath
  • Common carotid artery or ICA and ECA (if post-bifurcation)
  • Internal jugular vein
  • Vagus
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32
Q

What structures are contained within the superficial fascia?

A
  • Platysma muscle (innervated by cervical branch of facial nerve)
  • External jugular vein
  • Anterior jugular vein
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33
Q

What are the fascial layers of the neck?

A
  • Superficial fascia
  • Investing fascia
  • Prevertebral fascia
  • Pretrachial and buccopharyngeal fascias
  • Carotid sheath
34
Q

Where does EJV begin in the neck?

A

Angle of the mandible

35
Q

What is the descent of EJV?

A

Vertical descent on SCM

36
Q

What structures does the investing fascia surround?

A
  • All compartments of the neck

- Splits to surround SCM and trapezius

37
Q

What structures does the prevertebral fascia surround?

A

Surround the vertebral compartment which consists of cervical spine and postural muscles

38
Q

Which layers of fascia surround the visceral compartment?

A
  • Pretracheal fascia

- Buccopharyngeal fascia

39
Q

What structure does the pretracheal fascia extend up to?

A

Hyoid bone

40
Q

What neurovascular structures does the carotid sheath contain?

A
  • CCA/ICA and ECA
  • IJV
  • Vagus
41
Q

What are the boundaries of the anterior triangle?

A
  • In front of SCM
  • Beneath inferior border of the mandible
  • On either side of the midline of the neck
42
Q

What are the boundaries of the posterior triangle?

A
  • Behind SCM
  • In front of trapezius
  • Above middle 1/3 of clavicle
43
Q

What groups of muscles are contained in the anterior triangle and where they located?

A

Supra and infrahyoid muscles

Between investing fascia and pretracheal fascia

44
Q

What are the attachments of the suprahyoid muscles and what is their function?

A

Muscles of the floor of the mouth connect the hyoid bone to the skull
Contraction of these muscles elevates the hyoid bone and larynx

45
Q

What are the attachments of the infrahyoid muscles and what is their action?

A

Anchor hyoid bone to the clavicle, sternum and scapula (omohyoid)
Contraction of these muscles depresses the hyoid bone and larynx

46
Q

What is the innervation of anterior strap muscles?

A

Ventral rami of cervical nerves

47
Q

What are the important structures found in the anterior compartment of the neck?

A
  • Anterior strap muscles (supra and infrahyoid muscles)
  • Carotid system
  • IJV
  • CN IX, X, XI, X
48
Q

At what level does the CCA bifurcate into ECA and ICA?

A

Level of C3/4 which also corresponds to superior border of the thyroid cartilage

49
Q

T/F

ICA sends branches into the neck

50
Q

What are the 6 main branches of the ECA?

A
  • Superior thyroid artery
  • Lingual artery
  • Facial artery
  • Posterior auricular artery
  • Occipital artery
  • Ascending pharyngeal artery
51
Q

What 3 branches come off the front of ECA?

A
  • Superior thyroid a.
  • Lingual a.
  • Facial a.
52
Q

What 2 branches come off the back of ECA?

A
  • Posterior auricular a.

- Occipital a.

53
Q

What branch of ECA is deeply placed?

A

Ascending pharyngeal a.

54
Q

Where is the IJV located in relation to the arteries of the carotid sheath?

A

IVJ is lateral to the arteries

55
Q

What foraminae are associated with the anterior compartment of the neck?

A
  • Jugular foramen

- Hypoglossal foramen

56
Q

Which nerves enter the anterior compartment of the neck via jugular foramen?

A
  • Glossopharyngeal
  • Vagus
  • Spinal accessory
57
Q

What is path does glossopharyngeal follow in the neck?

A

It passes forward into the oropharynx and sends a branch to the carotid sinus

58
Q

What path does the vagus nerve follow in the neck?

A

Descending in the carotid sheath with the vascular structures

59
Q

What path does spinal accessory nerve follow in the neck?

A

Passes backwards
Pierces SCM
Enters posterior triangle of the neck

60
Q

What path does hypoglossal follow in the neck?

A

Passes forward, like glossopharyngeal but emerges from hypoglossal foramen
Passes between the arterial and venous structures:
-In front of ICA and ECA
-Behind IJV

61
Q

What are the boundaries of the thyroid gland?

A

Between upper border of thyroid cartilage and 6th tracheal ring

62
Q

Which tracheal cartilages does the isthmus run in front of?

A

Tracheal cartilages 2,3,4

63
Q

Which layer of fascia encloses the thyroid?

A

Pretracheal fascia

64
Q

What structures does the thyroid gland relate to?

A
  • Deep to strap muscles
  • Lateral to trachea and oesophagus
  • Adjacent to and overlaps carotid sheaths
65
Q

What are the clinical consequences of an enlarged thyroid gland?

A
  • Compression of the trachea may present as respiratory obstruction
  • Compression of oesophagus may present as dysphagia
  • Compression of IVJ may present as venous distension
66
Q

What is the course of right recurrent laryngeal nerve as it ascends?

A

Comes off right vagus and loops beneath right subclavian

67
Q

What is the course of left recurrent laryngeal nerve as it ascends?

A

Comes off left vagus and loops around ligamentum arteriosum beneath aortic arch

68
Q

What is the blood supply of the thyroid?

A
  • Superior thyroid arteries
  • Inferior thyroid arteries
  • Sometimes thyroid ima artery (10% of population) which ascends in front of trachea up to the isthmus
  • Superior, middle and inferior thyroid veins
69
Q

What is the embryological origin of the thyroid gland?

A

Develops as an outgrowth of the floor of the pharynx and descends ventral to the larynx

70
Q

Which structure marks the site of origin of the thyroid gland?

A

Foramen caecum

71
Q

What are the important neurovascular structures in the posterior triangle of the neck?

A
  • Subclavian system
  • Brachial plexus
  • CN XI
  • Cervical plexus
72
Q

Which neurovascular structures emerge at the bottom of the posterior triangle?

A

Roots of brachial plexus between scalenus medius and scalenus anterior
Subclavian system

73
Q

Which muscle does spinal accessory nerve run on top of?

A

Levator scapuli

74
Q

Which nerve pierces SCM?

A

Spinal accessory

75
Q

What muscles does spinal accessory innervate?

A

SCM and trapezius

76
Q

Which nerve roots from the cervical plexus?

A

Ventral rami of C1-4

77
Q

Which nerve descends on scalenus anterior in the posterior triangle?

78
Q

Which cervical roots make up the phrenic nerve?

79
Q

What plexus supplies the anterior strap muscles?

A

Ansa cervicalis

84
Q

Which muscle maintains cervical lordosis?

A

Longus colli

Neuroscience (9 decks)

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