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MRCS A > ANATOMY - Neck p1 > Flashcards

ANATOMY - Neck p1 Flashcards

1
Q

anterior triangle of neck - superior border

A

inferior border mandible

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2
Q

anterior triangle of neck - lateral border

A

anterior border SCM

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3
Q

anterior triangle of neck - medial border

A

sagittal line midline neck

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4
Q

anterior triangle of neck - roof

A

investing fascia

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5
Q

anterior triangle of neck - floor

A

visceral fascia

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6
Q

contents of anterior triangle neck

A

CCA (ICA + ECA)
IJV
CN VII, IX, X, XI, XII
Suprahyoid mm
infrahyoid mm

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7
Q

what are the subdivisions of the anterior triangle

A

Carotid triangle
submental triangle
submandibular triangle
muscular triangle

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8
Q

contents carotid triangle (5)

A

CCA
IJV
CN X
CN XII
Carotid sinus

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9
Q

superior border carotid triangle

A

posterior belly digastric

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10
Q

lateral border carotid triangle

A

medial border SCM

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11
Q

inferior border carotid triangle

A

superior belly omohyoid

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12
Q

contents submental triangle

A

submental LN

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13
Q

inferior border submental triangle

A

hyoid bone

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14
Q

medial border submental triangle

A

midline neck

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15
Q

lateral border submental triangle

A

anterior belly digastric

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16
Q

floor submental triangle

A

mylohyoid

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17
Q

submandibular triangle contents (4)

A

SM gland
SM LN
facial aa
Facial vv

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18
Q

superior border submandibular triangle

A

body of mandible

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19
Q

anterior border submandibular triangle

A

anterior belly digastric

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20
Q

posterior border submandibular triangle

A

posterior belly digastric

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21
Q

contents muscular triangle anterior triangle (4)

A

infrahyoid muscles
pharynx
thyroid
parathyroid

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22
Q

superior border muscular triangle

A

hyoid

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23
Q

medial border muscular triangle

A

midline neck

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24
Q

superolateral border of the muscular triangle

A

sup belly omohyoid

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25
Q

inferolateral border muscular triangle

A

inferior portion SCM

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26
Q

anterior border of posterior triangle

A

posterior border SCM

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27
Q

posterior border of posterior triangle

A

anterior border trapezius

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28
Q

inferior border posterior triangle

A

middle 1/3 clavicle

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29
Q

floor of posterior triangle

A

pre-vertebral fascia

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30
Q

roof of posterior triangle

A

investing fascia

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31
Q

contents posterior triangle (12)

A

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

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32
Q

What are the 2 subdivisions of the posterior triangle of the neck

A

omohyoid triangle = sup to omohyoid
subclavian triangle = cont SCA

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33
Q

how many cervical vertebrae

A

7

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34
Q

Name for C1

A

ATLAS

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35
Q

Name for C2

A

Axis

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36
Q

what travels through the transverse foramina of the C spines

A

vertebral aa
vertebral vv
sympathetic nn

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37
Q

what 2 things does the atlas not have in comparison to the rest of the C spine vertebra

A

no vertebral body
no spinous processes (has lateral masses instead)

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38
Q

function of medial atlanto-axial joint?

A

rotation of head independent from torso

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39
Q

what are the 2 joints present throughout the whole of the vertebral column in the C spine?

A

betw vertebral bodies - IVD
betw vertebral arches - sup + inf processes

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40
Q

what type of joint is the IVD joint between vertebral bodies?

A

symphysis joint

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41
Q

what type of joint is the sup + inf processes joints between vertebral arches?

A

synovial joint

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42
Q

What are the 3 joints unique to the C spine?

A

lateral A-A joints x2
medial A-A joint
Atlanto-occipital joint

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43
Q

what are the lateral A-A joints + what type of joint are they?

A

betw inf facet of lateral mass C1 and sup facets C2
plane synovial joint

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44
Q

what is the medial A-A joint + what type of joint is it?

A

dens of C2 to articular facet C1
pivot synovial joint

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45
Q

what is the Atlanto-occipital joint and what type of joint is it

A

sup facet lat mass C1 to occpital condyles
condyloid synovial joint

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46
Q

6 ligaments of the C spine

A

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

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47
Q

how many C spine nerves?

A

8

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48
Q

Jefferson fracture

A

C1
fall on extended neck
ant or post arch fracture

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49
Q

Hangmans fracture

A

C2
fracture pars interarticularis
high velocity hyperextension

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50
Q

Dens fracture

A

40%
C2 fracture
high risk AVN

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51
Q

Hyoid bone level

A

C3

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52
Q

3 ligaments which attach to hyoid bone

A

stylohyoid
thyrohyoid
hyoepiglottic

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53
Q

stylohyoid ligament

A

styloid process temporal bone –> lesser horn hyoid

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54
Q

thyrohyoid ligament

A

sup thyroid cartilage to posterior hyoid and greater horns

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55
Q

hyoepiglottic

A

hyoid to anterior epiglottis

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56
Q

where does the pharynx run between?

A

base of skull –> inf border cricoid cartilage C6

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57
Q

what are the 3 parts of the pharynx

A

nasopharynx
oropharynx
laryngopharynx

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58
Q

where does nasopharynx run between?

A

base of skull to soft palate

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59
Q

cell lining nasopharynx

A

ciliated pseudostratified columnar ep + goblet cells

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60
Q

contents nasopharynx

A

adenoid tonsils

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61
Q

where does the oropharynx run between?

A

soft palate to sup border epiglottis

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62
Q

contents oropharynx (4)

A

posterior 1/3 tongue
superior constructor muscles
lingual tonsils
palatine tonsils

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63
Q

what is Waldeyers ring

A

ring of lymphoid tissue formed by the palatine, adenoid and lingual tonsils

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64
Q

where does the laryngopharynx run between?

A

sup border of epiglottis to inf border cricoid cartilage C6

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65
Q

contents laryngopharynx (2)

A

inf + middle constrictors

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66
Q

what are the 2 muscles groups of the pharynx?

A

3 circulator muscles
3 longitudinal muscles

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67
Q

which CN are the muscles of the pharynx innervated by except stylopharyngeus?

A

CN X

Stylopharyngeus = CN IX

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68
Q

superior pharyngeal constrictor origin/insertion

A

pterygomandibular ligament, alveolar process mandible, medial pterygoid plate –> pharyngeal tubercle occiput + pharyngeal raphe

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69
Q

middle pharyngeal constrictor origin/insertion

A

stylohyoid ligament + horns hyoid

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70
Q

inferior pharyngeal constrictor origin/insertion

A

thyropharyngeal fibres from thyroid cartilage + cricopharyngeal fibres from cricoid cartilage –> pharygneal raphe

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71
Q

role of longitudinal muscles in pharynx

A

shorten + widen pharynx
elevate larynx during swallowing

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72
Q

palatopharyngeus origin/insertion

A

hard palate –> pharyngeal wall

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73
Q

stylopharyngeus origin/insertion

A

styloid process temporal bone –> pharyngeal wall

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74
Q

salpingopharyngeus origin/insertion

A

eustachian tube –> pharyngeal wall

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75
Q

what does the majority of motor and sensory inn to the pharynx come from?

A

pharyngeal plexus
(also CN IX)

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76
Q

where is the pharyngeael plexus

A

middle constrictor

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77
Q

which nerves make up the pharyngeal plexus (4)

A

pharyngeal branch CN IX
pharyngeal branch CN X
branches ext laryngeal branch
sympathetic fibres sup cervical ganglion

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78
Q

aa supply pharynx

A

3 branches ECA - ascending pharyngeal aa, branches facial aa, branches maxillary/lingual aa

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79
Q

vv supply pharynx

A

pharyngeal vv plexus

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80
Q

where does the pharyngeal vv plexus drain into

A

IJV

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81
Q

larynx spans over

A

C3-6

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82
Q

what muscles are anterior to the larynx?

A

infrahyoid muscles

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83
Q

what structure is lateral to the larynx?

A

thyroid gland

84
Q

what structure is posterior to the larynx?

A

oesophagus

85
Q

what are the 3 sections of the larynx?

A

supraglottis
glottis
infraglottis

86
Q

supraglottis

A

inferior surface of the epiglottis to the false VC

87
Q

glottis

A

VC to 1cm below

88
Q

infraglottis

A

inferior border of the glottis –> inferior border of the cricoid cartilage

89
Q

cell lining of the larynx

A

pseudostratified ciliated columnar epithelium

90
Q

cell lining of the VC

A

stratified squamous ep

91
Q

aa supply to the larynx

A

superior and inferior laryngeal aa

92
Q

superior laryngeal aa is a branch of

A

superior thyroid aa (^ECA)

93
Q

inferior laryngeal aa is a branch of

A

inferior thyroid aa (^thyrocervical trunk)

94
Q

what nn does the superior laryngeal aa follow

A

internal branch of the superior laryngeal nn

95
Q

what nn does the inferior laryngeal aa follow

A

recurrent laryngeal nn

96
Q

recurrent laryngeal nn - sensory inn

A

infraglottis

97
Q

recurrent laryngeal nn - motor inn

A

all internal mm of the larynx EXCEPT CRICOTHYROID

98
Q

inn - internal branch of the superior laryngeal nn

A

sensory info to the surpaglottis

99
Q

inn - external branch of the superior laryngeal nn

A

motor inn to the cricothyroid

100
Q

unilateral VC paralysis PS:

A

hoarseness of voice

101
Q

bilateral VC paralysis PS

A

impaired breathing -stridor
cannot phonate

102
Q

what are the 3 unpaired cartilages of the larynx?

A

thyroid cartilage
cricoid cartilage
epiglottis

103
Q

what joins the 2 sheets of the thyroid cartilage at the front

A

laryngeal prominence
aka Adams apple

104
Q

what is attached to the superior horns of the thyroid cartilage

A

lateral thyroihyoid ligaments (to hyoid)

105
Q

what is attached to the inferior horns of the thyroid cartilage

A

cricothyroid ligaments (to cricoid)

106
Q

what type of cartilage is the cricoid

A

complete ring of hyaline cartilage

107
Q

shape of cricoid cartilage

A

signet ring shape

108
Q

what spinal level is the cricoid cartilage

A

C6

109
Q

shape of epiglottis

A

leaf shape

110
Q

what type of cartilage is the epiglottis

A

elastic cartilage

111
Q

what happens to the epiglottis during swallowing

A

flattens and moves posteriorly to close off the larynx

112
Q

what are the 3 paired cartilages of the larynx?

A

arytenoid
corniculate
cuneiform

113
Q

shape of arytenoid cartilage

A

pyramidal

114
Q

what cartilage do the arytenoids sit on

A

cricoid

115
Q

what does the apex of the arytenoid cartilages articulate with?

A

corniculate cartilages

116
Q

what does the base of the arytenoid cartilages articulate with

A

superior facet of the cricoid cartilages

117
Q

what attaches to the vocal process of the arytenoid

A

vocal ligament

118
Q

what attaches to the muscle process of the arytenoid

A

posterior and lateral cricoarytenoid muscles

119
Q

what do the corniculates articulate with

A

apices of the arytenoid

120
Q

where are the cuneiform cartilages

A

within the aryepiglottic folds

121
Q

how many extrinsic ligaments of the larynx are there?

A

5

122
Q

what are the names of the extrinsic ligaments of the larynx

A

thyrohyoid membrane aka medial and lateral thryohyoid ligaments
hyoepiglottic ligament
cricotracheal ligament
medial criciothyroid ligament

123
Q

how many intrinsic ligaments of the larynx are there

A

2

124
Q

what are the intrinsic ligaments of the larynx

A

cricothyroid ligament
quadrangular membrane

125
Q

which intrinsic ligament of the larynx forms the vocal ligament?

A

cricothyroid ligament

126
Q

where does the cricothyroid ligament extend between?

A

cricoid cartilage to upper margin of thyroid + arytenoid

127
Q

what does the lower margin of the quandrangular membrane of the larynx thicken to become?

A

vestibular ligament

128
Q

where does the quadrangular membrane of the larynx extend between?

A

anterolateral arytenoid + lateral epiglottis

129
Q

what are the 2 laryngeal folds

A

vocal folds aka true vocal folds
vestibular folds aka false VC

130
Q

what are the 4 movements of the vocal folds

A

abduction
adduction
relaxed
tensed

131
Q

what are the 4 layers of the vocal folds from superficial to deep

A

Non-keratinised stratified squamous ep
Reinke’s space
vocal ligament
vocalis mm

132
Q

what is the space between the true and false VC called?

A

Rima glottidis (white)

133
Q

are the false vocal cords superior or inferior to the true vocal cords?

A

superior

134
Q

colour of false vocal cords

A

pink

135
Q

function of false vocal cords

A

provide protection to larynx

136
Q

which 2 extrinsic laryngeal muscle groups elevate the larynx

A

suprahyoid mm
stylopharyngeus

137
Q

role of intrinsic muscles of the larynx

A

control shape of rima glottidis

138
Q

innervation of intrinsic mm of the larynx (except cricothyroid)

A

inferior laryngeal branch of rec laryngeal nn (CNX)

139
Q

innervation of cricothyroid muscle

A

external branch of sup laryngeal nn

140
Q

what are the 5 intrinsic mm of the larynx

A

transverse arytenoid
post cricoarytenoid
lat cricoarytenoid
thyroarytenoid
cricothyroid

141
Q

transverse arytenoid origin/insertion

A

arytenoid to the other arytenoid

142
Q

action transverse arytenoid

A

adduction arytenoid

143
Q

origin/insertion post cricoarytenoid

A

post cricoid to mm process arytenoid

144
Q

action post cricoarytenoid

A

abductors of VC (widen rima glottidis)

145
Q

origin/insertion thyroartenoid

A

inferopost thyroid to anterolat arytenoid

146
Q

action thyroarytenoid

A

relaxes vocal ligament

147
Q

origin/insertion lat cricoarytenoid

A

arch cricoid cartilage to mm process arytenoid

148
Q

action lat cricoarytenoid

A

main adductors vocal cord

149
Q

origin/insertion cricothyroid

A

ant cricoid cartilage –> inf horns thyroid

150
Q

action cricothyroid

A

stretches + tenses vocal ligament

151
Q

length of oesophagus

A

25cm

152
Q

where does the oesophagus extend between?

A

inferior border cricoid cartilage C6 –> cardia orifice stomach T11

153
Q

where is the oesophagus in the superior mediastinum?

A

between the trachea + VB T1-4

154
Q

structure oesophagus from external to inner layer

A

adventitia (outer layer connective tissue)
mm layer
submucosa
mucosa

155
Q

instead of adventitia in the distal portion of the oesophagus, what layer is there instead?

A

serosa

156
Q

mm layer sup 1/3 oesophagus

A

voluntary striated mm

157
Q

mm layer middle 1/3 oesophagus

A

voluntary striated + smooth mm

158
Q

mm layer distal 1/3 oesophagus

A

smooth m

159
Q

what cell type make up the mucosa of the oesophagus

A

non-keratinised stratified squamous ep

160
Q

which muscle forms the upper oesophageal sphincter?

A

cricopharyngeus

161
Q

what level is the lower oesophageal sphincter at?

A

T11

162
Q

what 4 factors maintain the physiological LOS?

A

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
Q

structures anterior to the thoracic oespohagus

A

trachea
L recurrent laryngeal nn
pericardium

164
Q

structures posterior to the thoracic oesophagus

A

VB
thoracic duct
azygous vv
descending aorta

165
Q

structures to the left to thoracic oesophagus

A

pleura
terminal part azygous vv

166
Q

structures to the LEFT of the thoracic oesophagus

A

SCA
aortic arch
thoracic duct
pleura

167
Q

structures anterior to the abdominal oesophagus

A

L CNX
posterior surface heart

168
Q

Structures posterior to the abdominal oesophagus

A

R CNX
L crus diaphragm

169
Q

aa supply thoracic oesophgagus

A

branches thoracic aorta + inf thyroid aa

170
Q

vv drainage thoracic oesophagus

A

branch azygous vv + inf thyroid vv

171
Q

aa supply abdominal oesophagus

A

L gastric aa + L phrenic aa

172
Q

vv drainage abdominal oesophagus

A

gastric vv (portal circ)
azygous vv (systemic circ)

173
Q

inn oespohagus

A

oesophageal plexus

174
Q

parasympathetic aspect oesophageal plexus

A

vagal trunks - upper = nucleus ambigulus, lower = dorsal motor nucleus

175
Q

sympathetic aspect oesophageal plexus

A

cervical/thoracic trunks

176
Q

LN drainage superior 1/3 oepsphagus

A

deep cervical LN

177
Q

LN drainage middle 1/3 oesophagus

A

sup + post mediastinal LN

178
Q

LN drainage lower 1/3 oesophagus

A

L gastric + coeliac LN

179
Q

where vertebra does the thyroid gland span between?

A

C5-T1

180
Q

embryological origin thyroid gland

A

foramen cecum (near base of tongue)
reaches anterior neck by week 7
descends –> thyroglossal duct –> usually regresses by week 6

181
Q

structures anterior to the thyroid

A

infrahyoid muscles

182
Q

structures lateral to the thyroid

A

carotid sheath (cont common carotid artery, internal jugular vein and vagus nerve)

183
Q

structures medial to the thyroid

A

Organs – larynx, pharynx, trachea and oesophagus
Nerves – external laryngeal and recurrent laryngeal

184
Q

what are the 2 main aa supplying the thyroid gland?

A

sup + inf thyroid aa

185
Q

origin sup thyroid aa

A

1st branch ECA

186
Q

origin inf thyroid aa

A

thyrocergical trunk

187
Q

which nn is the sup thyroid aa in close proximity to?

A

external sup laryngeal nn

188
Q

which nn is the inf thyroid aa in close proximity to?

A

rec laryngeal nn

189
Q

what % of the population also have the thyroid ima aa?

A

10%

190
Q

origin of thyroid ima aa?

A

brachiocephalic trunk

191
Q

what part of the thyroid does the thyroid ima supply

A

ant surface
isthmus

192
Q

vv drainage thyroid

A

sup, mid and inf thyroid vv form venous plexus

193
Q

sup and mid thyroid vv drain into

A

IJV

194
Q

inferior thyroid vv drains into

A

brachiocephalic vv

195
Q

inn thyroid gland

A

sympathetic trunk - SENSATION ONLY

196
Q

LN drainage thyroid gland

A

paratracheal + deep cervical LN

197
Q

where are the parathyroid glands?

A

posterior aspect of thyroid gland

198
Q

within which fascia would you find the parathyroid glands?

A

pretracheal fascia

199
Q

embryological origin sup parathyroid glands

A

4th pharyngeal pouch

200
Q

embryological origin inf paraythyroid glands

A

3rd pharyngeal pouch

201
Q

relation of sup parathyroid glands to inf thyroid aa

A

1cm superior to the entry of inf thyroid aa into glands

202
Q

aa supply parathyroids

A

inf thyroid aa chiefly
collat from other 2 thyroid aa

203
Q

vv drainage parathyroids

A

sup, mid + inf thyroid vv

204
Q

LN drainage parathyroids

A

paratracheal + deep cervical LN

205
Q

nn supply parathyroids

A

thyroid branches cervical ganglion (vasomotor)

MRCS A (36 decks)

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