ANATOMY - Neck p1 Flashcards
1
Q
anterior triangle of neck - superior border
A
inferior border mandible
2
Q
anterior triangle of neck - lateral border
A
anterior border SCM
3
Q
anterior triangle of neck - medial border
A
sagittal line midline neck
4
Q
anterior triangle of neck - roof
A
investing fascia
5
Q
anterior triangle of neck - floor
A
visceral fascia
6
Q
contents of anterior triangle neck
A
CCA (ICA + ECA)
IJV
CN VII, IX, X, XI, XII
Suprahyoid mm
infrahyoid mm
7
Q
what are the subdivisions of the anterior triangle
A
Carotid triangle
submental triangle
submandibular triangle
muscular triangle
8
Q
contents carotid triangle (5)
A
CCA
IJV
CN X
CN XII
Carotid sinus
9
Q
superior border carotid triangle
A
posterior belly digastric
10
Q
lateral border carotid triangle
A
medial border SCM
11
Q
inferior border carotid triangle
A
superior belly omohyoid
12
Q
contents submental triangle
A
submental LN
13
Q
inferior border submental triangle
A
hyoid bone
14
Q
medial border submental triangle
A
midline neck
15
Q
lateral border submental triangle
A
anterior belly digastric
16
Q
floor submental triangle
A
mylohyoid
17
Q
submandibular triangle contents (4)
A
SM gland
SM LN
facial aa
Facial vv
18
Q
superior border submandibular triangle
A
body of mandible
19
Q
anterior border submandibular triangle
A
anterior belly digastric
20
Q
posterior border submandibular triangle
A
posterior belly digastric
21
Q
contents muscular triangle anterior triangle (4)
A
infrahyoid muscles
pharynx
thyroid
parathyroid
22
Q
superior border muscular triangle
A
hyoid
23
Q
medial border muscular triangle
A
midline neck
24
Q
superolateral border of the muscular triangle
A
sup belly omohyoid
25
inferolateral border muscular triangle
inferior portion SCM
26
anterior border of posterior triangle
posterior border SCM
27
posterior border of posterior triangle
anterior border trapezius
28
inferior border posterior triangle
middle 1/3 clavicle
29
floor of posterior triangle
pre-vertebral fascia
30
roof of posterior triangle
investing fascia
31
contents posterior triangle (12)
inf belly omohyoid
splenius capitis
levator scapulae
scalenes
EJV (+ retromandibular + post auricular draining into)
SCV
SCA
Tranverse cervical + subscapular vv
CN XI
Cervical plexus
Trunks brachial plexus
32
What are the 2 subdivisions of the posterior triangle of the neck
omohyoid triangle = sup to omohyoid
subclavian triangle = cont SCA
33
how many cervical vertebrae
7
34
Name for C1
ATLAS
35
Name for C2
Axis
36
what travels through the transverse foramina of the C spines
vertebral aa
vertebral vv
sympathetic nn
37
what 2 things does the atlas not have in comparison to the rest of the C spine vertebra
no vertebral body
no spinous processes (has lateral masses instead)
38
function of medial atlanto-axial joint?
rotation of head independent from torso
39
what are the 2 joints present throughout the whole of the vertebral column in the C spine?
betw vertebral bodies - IVD
betw vertebral arches - sup + inf processes
40
what type of joint is the IVD joint between vertebral bodies?
symphysis joint
41
what type of joint is the sup + inf processes joints between vertebral arches?
synovial joint
42
What are the 3 joints unique to the C spine?
lateral A-A joints x2
medial A-A joint
Atlanto-occipital joint
43
what are the lateral A-A joints + what type of joint are they?
betw inf facet of lateral mass C1 and sup facets C2
plane synovial joint
44
what is the medial A-A joint + what type of joint is it?
dens of C2 to articular facet C1
pivot synovial joint
45
what is the Atlanto-occipital joint and what type of joint is it
sup facet lat mass C1 to occpital condyles
condyloid synovial joint
46
6 ligaments of the C spine
Ant longitudinal
Post longitudinal
longitudinal ligaments cover VB + IVD
Nuchal ligament - tips of process C1-7 for mm attachment
Interspinal ligament - connects spinous processes
Ligamentum flavum - lamina of adjacent vertebra
transverse ligament axis - - connects lat masses of atlas to anchor dens
47
how many C spine nerves?
8
48
Jefferson fracture
C1
fall on extended neck
ant or post arch fracture
49
Hangmans fracture
C2
fracture pars interarticularis
high velocity hyperextension
50
Dens fracture
40%
C2 fracture
high risk AVN
51
Hyoid bone level
C3
52
3 ligaments which attach to hyoid bone
stylohyoid
thyrohyoid
hyoepiglottic
53
stylohyoid ligament
styloid process temporal bone --> lesser horn hyoid
54
thyrohyoid ligament
sup thyroid cartilage to posterior hyoid and greater horns
55
hyoepiglottic
hyoid to anterior epiglottis
56
where does the pharynx run between?
base of skull --> inf border cricoid cartilage C6
57
what are the 3 parts of the pharynx
nasopharynx
oropharynx
laryngopharynx
58
where does nasopharynx run between?
base of skull to soft palate
59
cell lining nasopharynx
ciliated pseudostratified columnar ep + goblet cells
60
contents nasopharynx
adenoid tonsils
61
where does the oropharynx run between?
soft palate to sup border epiglottis
62
contents oropharynx (4)
posterior 1/3 tongue
superior constructor muscles
lingual tonsils
palatine tonsils
63
what is Waldeyers ring
ring of lymphoid tissue formed by the palatine, adenoid and lingual tonsils
64
where does the laryngopharynx run between?
sup border of epiglottis to inf border cricoid cartilage C6
65
contents laryngopharynx (2)
inf + middle constrictors
66
what are the 2 muscles groups of the pharynx?
3 circulator muscles
3 longitudinal muscles
67
which CN are the muscles of the pharynx innervated by except stylopharyngeus?
CN X
Stylopharyngeus = CN IX
68
superior pharyngeal constrictor origin/insertion
pterygomandibular ligament, alveolar process mandible, medial pterygoid plate --> pharyngeal tubercle occiput + pharyngeal raphe
69
middle pharyngeal constrictor origin/insertion
stylohyoid ligament + horns hyoid
70
inferior pharyngeal constrictor origin/insertion
thyropharyngeal fibres from thyroid cartilage + cricopharyngeal fibres from cricoid cartilage --> pharygneal raphe
71
role of longitudinal muscles in pharynx
shorten + widen pharynx
elevate larynx during swallowing
72
palatopharyngeus origin/insertion
hard palate --> pharyngeal wall
73
stylopharyngeus origin/insertion
styloid process temporal bone --> pharyngeal wall
74
salpingopharyngeus origin/insertion
eustachian tube --> pharyngeal wall
75
what does the majority of motor and sensory inn to the pharynx come from?
pharyngeal plexus
(also CN IX)
76
where is the pharyngeael plexus
middle constrictor
77
which nerves make up the pharyngeal plexus (4)
pharyngeal branch CN IX
pharyngeal branch CN X
branches ext laryngeal branch
sympathetic fibres sup cervical ganglion
78
aa supply pharynx
3 branches ECA - ascending pharyngeal aa, branches facial aa, branches maxillary/lingual aa
79
vv supply pharynx
pharyngeal vv plexus
80
where does the pharyngeal vv plexus drain into
IJV
81
larynx spans over
C3-6
82
what muscles are anterior to the larynx?
infrahyoid muscles
83
what structure is lateral to the larynx?
thyroid gland
84
what structure is posterior to the larynx?
oesophagus
85
what are the 3 sections of the larynx?
supraglottis
glottis
infraglottis
86
supraglottis
inferior surface of the epiglottis to the false VC
87
glottis
VC to 1cm below
88
infraglottis
inferior border of the glottis --> inferior border of the cricoid cartilage
89
cell lining of the larynx
pseudostratified ciliated columnar epithelium
90
cell lining of the VC
stratified squamous ep
91
aa supply to the larynx
superior and inferior laryngeal aa
92
superior laryngeal aa is a branch of
superior thyroid aa (^ECA)
93
inferior laryngeal aa is a branch of
inferior thyroid aa (^thyrocervical trunk)
94
what nn does the superior laryngeal aa follow
internal branch of the superior laryngeal nn
95
what nn does the inferior laryngeal aa follow
recurrent laryngeal nn
96
recurrent laryngeal nn - sensory inn
infraglottis
97
recurrent laryngeal nn - motor inn
all internal mm of the larynx EXCEPT CRICOTHYROID
98
inn - internal branch of the superior laryngeal nn
sensory info to the surpaglottis
99
inn - external branch of the superior laryngeal nn
motor inn to the cricothyroid
100
unilateral VC paralysis PS:
hoarseness of voice
101
bilateral VC paralysis PS
impaired breathing -stridor
cannot phonate
102
what are the 3 unpaired cartilages of the larynx?
thyroid cartilage
cricoid cartilage
epiglottis
103
what joins the 2 sheets of the thyroid cartilage at the front
laryngeal prominence
aka Adams apple
104
what is attached to the superior horns of the thyroid cartilage
lateral thyroihyoid ligaments (to hyoid)
105
what is attached to the inferior horns of the thyroid cartilage
cricothyroid ligaments (to cricoid)
106
what type of cartilage is the cricoid
complete ring of hyaline cartilage
107
shape of cricoid cartilage
signet ring shape
108
what spinal level is the cricoid cartilage
C6
109
shape of epiglottis
leaf shape
110
what type of cartilage is the epiglottis
elastic cartilage
111
what happens to the epiglottis during swallowing
flattens and moves posteriorly to close off the larynx
112
what are the 3 paired cartilages of the larynx?
arytenoid
corniculate
cuneiform
113
shape of arytenoid cartilage
pyramidal
114
what cartilage do the arytenoids sit on
cricoid
115
what does the apex of the arytenoid cartilages articulate with?
corniculate cartilages
116
what does the base of the arytenoid cartilages articulate with
superior facet of the cricoid cartilages
117
what attaches to the vocal process of the arytenoid
vocal ligament
118
what attaches to the muscle process of the arytenoid
posterior and lateral cricoarytenoid muscles
119
what do the corniculates articulate with
apices of the arytenoid
120
where are the cuneiform cartilages
within the aryepiglottic folds
121
how many extrinsic ligaments of the larynx are there?
5
122
what are the names of the extrinsic ligaments of the larynx
thyrohyoid membrane aka medial and lateral thryohyoid ligaments
hyoepiglottic ligament
cricotracheal ligament
medial criciothyroid ligament
123
how many intrinsic ligaments of the larynx are there
2
124
what are the intrinsic ligaments of the larynx
cricothyroid ligament
quadrangular membrane
125
which intrinsic ligament of the larynx forms the vocal ligament?
cricothyroid ligament
126
where does the cricothyroid ligament extend between?
cricoid cartilage to upper margin of thyroid + arytenoid
127
what does the lower margin of the quandrangular membrane of the larynx thicken to become?
vestibular ligament
128
where does the quadrangular membrane of the larynx extend between?
anterolateral arytenoid + lateral epiglottis
129
what are the 2 laryngeal folds
vocal folds aka true vocal folds
vestibular folds aka false VC
130
what are the 4 movements of the vocal folds
abduction
adduction
relaxed
tensed
131
what are the 4 layers of the vocal folds from superficial to deep
Non-keratinised stratified squamous ep
Reinke's space
vocal ligament
vocalis mm
132
what is the space between the true and false VC called?
Rima glottidis (white)
133
are the false vocal cords superior or inferior to the true vocal cords?
superior
134
colour of false vocal cords
pink
135
function of false vocal cords
provide protection to larynx
136
which 2 extrinsic laryngeal muscle groups elevate the larynx
suprahyoid mm
stylopharyngeus
137
role of intrinsic muscles of the larynx
control shape of rima glottidis
138
innervation of intrinsic mm of the larynx (except cricothyroid)
inferior laryngeal branch of rec laryngeal nn (CNX)
139
innervation of cricothyroid muscle
external branch of sup laryngeal nn
140
what are the 5 intrinsic mm of the larynx
transverse arytenoid
post cricoarytenoid
lat cricoarytenoid
thyroarytenoid
cricothyroid
141
transverse arytenoid origin/insertion
arytenoid to the other arytenoid
142
action transverse arytenoid
adduction arytenoid
143
origin/insertion post cricoarytenoid
post cricoid to mm process arytenoid
144
action post cricoarytenoid
abductors of VC (widen rima glottidis)
145
origin/insertion thyroartenoid
inferopost thyroid to anterolat arytenoid
146
action thyroarytenoid
relaxes vocal ligament
147
origin/insertion lat cricoarytenoid
arch cricoid cartilage to mm process arytenoid
148
action lat cricoarytenoid
main adductors vocal cord
149
origin/insertion cricothyroid
ant cricoid cartilage --> inf horns thyroid
150
action cricothyroid
stretches + tenses vocal ligament
151
length of oesophagus
25cm
152
where does the oesophagus extend between?
inferior border cricoid cartilage C6 --> cardia orifice stomach T11
153
where is the oesophagus in the superior mediastinum?
between the trachea + VB T1-4
154
structure oesophagus from external to inner layer
adventitia (outer layer connective tissue)
mm layer
submucosa
mucosa
155
instead of adventitia in the distal portion of the oesophagus, what layer is there instead?
serosa
156
mm layer sup 1/3 oesophagus
voluntary striated mm
157
mm layer middle 1/3 oesophagus
voluntary striated + smooth mm
158
mm layer distal 1/3 oesophagus
smooth m
159
what cell type make up the mucosa of the oesophagus
non-keratinised stratified squamous ep
160
which muscle forms the upper oesophageal sphincter?
cricopharyngeus
161
what level is the lower oesophageal sphincter at?
T11
162
what 4 factors maintain the physiological LOS?
oesophagus entering stomach at an acute angle
walls of oesophagus being compressed with increased IAP
prominent mucosal folds at GOJ
R crus diaphragm pinch cork effect
163
structures anterior to the thoracic oespohagus
trachea
L recurrent laryngeal nn
pericardium
164
structures posterior to the thoracic oesophagus
VB
thoracic duct
azygous vv
descending aorta
165
structures to the left to thoracic oesophagus
pleura
terminal part azygous vv
166
structures to the LEFT of the thoracic oesophagus
SCA
aortic arch
thoracic duct
pleura
167
structures anterior to the abdominal oesophagus
L CNX
posterior surface heart
168
Structures posterior to the abdominal oesophagus
R CNX
L crus diaphragm
169
aa supply thoracic oesophgagus
branches thoracic aorta + inf thyroid aa
170
vv drainage thoracic oesophagus
branch azygous vv + inf thyroid vv
171
aa supply abdominal oesophagus
L gastric aa + L phrenic aa
172
vv drainage abdominal oesophagus
gastric vv (portal circ)
azygous vv (systemic circ)
173
inn oespohagus
oesophageal plexus
174
parasympathetic aspect oesophageal plexus
vagal trunks - upper = nucleus ambigulus, lower = dorsal motor nucleus
175
sympathetic aspect oesophageal plexus
cervical/thoracic trunks
176
LN drainage superior 1/3 oepsphagus
deep cervical LN
177
LN drainage middle 1/3 oesophagus
sup + post mediastinal LN
178
LN drainage lower 1/3 oesophagus
L gastric + coeliac LN
179
where vertebra does the thyroid gland span between?
C5-T1
180
embryological origin thyroid gland
foramen cecum (near base of tongue)
reaches anterior neck by week 7
descends --> thyroglossal duct --> usually regresses by week 6
181
structures anterior to the thyroid
infrahyoid muscles
182
structures lateral to the thyroid
carotid sheath (cont common carotid artery, internal jugular vein and vagus nerve)
183
structures medial to the thyroid
Organs – larynx, pharynx, trachea and oesophagus
Nerves – external laryngeal and recurrent laryngeal
184
what are the 2 main aa supplying the thyroid gland?
sup + inf thyroid aa
185
origin sup thyroid aa
1st branch ECA
186
origin inf thyroid aa
thyrocergical trunk
187
which nn is the sup thyroid aa in close proximity to?
external sup laryngeal nn
188
which nn is the inf thyroid aa in close proximity to?
rec laryngeal nn
189
what % of the population also have the thyroid ima aa?
10%
190
origin of thyroid ima aa?
brachiocephalic trunk
191
what part of the thyroid does the thyroid ima supply
ant surface
isthmus
192
vv drainage thyroid
sup, mid and inf thyroid vv form venous plexus
193
sup and mid thyroid vv drain into
IJV
194
inferior thyroid vv drains into
brachiocephalic vv
195
inn thyroid gland
sympathetic trunk - SENSATION ONLY
196
LN drainage thyroid gland
paratracheal + deep cervical LN
197
where are the parathyroid glands?
posterior aspect of thyroid gland
198
within which fascia would you find the parathyroid glands?
pretracheal fascia
199
embryological origin sup parathyroid glands
4th pharyngeal pouch
200
embryological origin inf paraythyroid glands
3rd pharyngeal pouch
201
relation of sup parathyroid glands to inf thyroid aa
1cm superior to the entry of inf thyroid aa into glands
202
aa supply parathyroids
inf thyroid aa chiefly
collat from other 2 thyroid aa
203
vv drainage parathyroids
sup, mid + inf thyroid vv
204
LN drainage parathyroids
paratracheal + deep cervical LN
205
nn supply parathyroids
thyroid branches cervical ganglion (vasomotor)
