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MRCS A > ANATOMY - Neck p2 > Flashcards

ANATOMY - Neck p2 Flashcards

1
Q

which nn innervates the suboccipital muscles?

A

suboccipital nn (posterior ramus C1)

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2
Q

which compartment of the neck of the are the suboccipital muscles in?

A

suboccipital compartment

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3
Q

action of the suboccipital muscles

A

extend + rotate neck

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4
Q

what are the name of the 4 suboccpital muscles?

A

rectus capitis post major
rectus capitis post minor
obliquus capitis superior
obliquus capitis inferior

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5
Q

rectus capitis post major origin/insertion

A

spinous process C2 –> lateral part of inferior nuchal line occipital bone

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6
Q

action rectus capitis post major

A

extend + rotate head

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7
Q

origin/insertion rectus capitis post minor

A

posterior tubercle C1 –> medial part inferior nuchal line occipital bone

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8
Q

action rectus capitis post minor

A

extends head

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9
Q

origin/insertion obliquus capitis superior

A

transverse process C1 –> occipital bone

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10
Q

action obliquus capitis superior

A

extends head

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11
Q

origin/insertion obliquus capitis inferior

A

does not attach to cranium
spinous process C2 –> transverse process C1

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12
Q

action obliquus capitis inferior

A

extends + rotates head

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13
Q

contents suboccipital triangle (3)

A

vertebral aa
suboccipital vv plexus
suboccipital nn

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14
Q

borders suboccipital triangle

A

superomed: rectus capitis post major
superolat: oblique capitis superior
inf: oblique capitis inf
floor: post atlanto-occipital membrane + posterior arch C1
roof: semispinalis capitus

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15
Q

what is the role of the scalene muscles?

A

accessory muscles of respiration
flex neck

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16
Q

origin/insertion anterior scalene

A

anterior tubercles of T processes C3-6 –> scalene tubercle 1st rib

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17
Q

action anterior scalene

A

elevates 1st rib
ipsilat: lat flexion neck
bilat: ant flexion neck

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18
Q

innervation anterior scalene

A

ant rami C5/6

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19
Q

origin/insertion middle scalene

A

post tubercle T processes C2-7 –> scalene tubercle 1st rib

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20
Q

action middle scalene

A

elevates 1st rib
ipsilat: ipsilat lat flexion neck

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21
Q

innervation middle scalene

A

ant rami C3-8

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22
Q

origin/insertion post scalene

A

post tubercles TP C5-7 –> 2nd rib

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23
Q

action post scalene

A

elevates 2nd rib
ipsilat - lat flexion neck

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24
Q

innervation post scalene

A

ant rami C6-8

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25
Q

relation of brachial plexus and SCA to scalene muscles

A

pass between anterior + middle scalene

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26
Q

relation of SCV and phrenic nn to scalene mm

A

anterior to ant scalene

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27
Q

interscalene nn block

A

block of brachial plexus at the level of the cricoid cartilage

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28
Q

action of suprahyoid muscles

A

elevate hyoid bone

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29
Q

what are the 5 suprahyoid muscles

A

geniohyoid
mylohyoid
stylohyoid
ant belly digastric
post belly digastric

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30
Q

aa supply suprahyoid mm

A

facial aa
occipital aa
lingual aa branches

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31
Q

which suprahyoid muscle forms the floor of the oral cavity?

A

mylohyoid

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32
Q

origin/insertion mylohyoid

A

mylohyoid line mandible –> hyoid bone

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33
Q

action mylohyoid

A

elevates hyoid + floor mouth

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34
Q

innervation mylohyoid

A

inf alveolar nn (V3)

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35
Q

where is the geniohyoid in relation to the mylohyoid

A

deep

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36
Q

origin/insertion geniohyoid

A

inferior mental spine of the mandible –> hyoid

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37
Q

action geniohyoid

A

depresses mandible
elevates hyoid

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38
Q

innervation geniohyoid

A

C1 nn root

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39
Q

relation of stylohyoid in relation to digastric mm

A

superior to the post belly of digastric

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40
Q

origin/insertion stylohyoid

A

styloid process temporal bone –> lat hyoid

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41
Q

action stylohyoid

A

initiates swallowing
pulls hyoid posterosuperiorly

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42
Q

innervation stylohyoid

A

stylohyoid branch CN VII

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43
Q

origin/insertion anterior belly digastric

A

digastric fossa mandible –> intermediate tendon attaching to hyoid

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44
Q

origin/insertion posterior belly digastric

A

mastoid process temporal bone –> intermediate tendon attaching to hyoid

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45
Q

action digastric

A

depress + elevate hyoid bone

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46
Q

innervation anterior belly digastric vs posterior belly

A

anterior - inf alveolar branch V3
post - digastric branch VII

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47
Q

how are the infrahyoid muscles split into 2 groups?

A

superficial plane - omohyoid + sternohyoid
deep plane (related to thyroid) - sternothyroid + thyrohyoid

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48
Q

aa supply infrahyoid muscles

A

inf + sup thyroid aa

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49
Q

origin/insertion omohyoid

A

sup belly - hyoid bone
inf belly - scapula
–> intermediate tendon clavicle

50
Q

action omohyoid

A

depress hyoid

51
Q

innervation omohyoid

A

anterior rami C1-3 via ansa cervicalis

52
Q

origin/insertion sternohyoid

A

sternum + SCJ –> hyoid

53
Q

action sternohyoid

A

depress hyoid

54
Q

inn sternohyoid

A

anterior rami C1-3 via ansa cervicalis

55
Q

origin/insertion sternothyroid

A

manubrium sternum –> thyroid cartilage

56
Q

action sternothyroid

A

depress hyoid (as continues as thyrohyoid)

57
Q

inn sternothyroid

A

ant rami C1-3 via ansa cervicalis

58
Q

origin/insertion thyrohyoid

A

continuation of sternothyroid
thyroid cartilage –> hyoid

59
Q

action thyrohyoid

A

depress hyoid

60
Q

innervation thyrohyoid

A

ant ramus C1
via CN XII

61
Q

nn roots phrenic nerve

A

C3-5

62
Q

motor action phrenic nerve

A

diaphragm - ipsilateral side

63
Q

sensory action phrenic nn

A

central part diaphragm, pericardium, mediastinal part parietal pleura

64
Q

which cervical nerve is the main contributor to the phrenic nn

A

C4

65
Q

anatomical course phrenic nn

A

1)arise at lateral border ant scalene mm
2) progresses inferior, deep to prevertebral layer fascia
3) splits into R + L, posterior to the SCV

66
Q

right phrenic nn course after SCV

A

anterior over lateral part of R SCA
enters thorax via sup thoracic aperture
ant along R Lung root
along pericardium RA
pierces diaphragm at IVC opening opening to innervate inferior surface of diaphragm (ipsilat)

67
Q

left phrenic nn course after SCV

A

passes anterior over medial part L SCA
enters thoracic via sup thoracic aperture
descends to L lung root
along pericardium LV
pierces and inn infer surface diaphragm

68
Q

causes of phrenic nerve palsy

A

mechanical trauma
compression e.g. tumour
neuropathy (diabetic neuropathy)
paralysis

69
Q

where is the cervical plexus?

A

post triangle neck, 1/2 way up SCM
within prevertebral layer cervical fascia

70
Q

greater auricular nn roots

A

C2-3

71
Q

action greater auricular nn

A

external ear + parotid gland sensation

72
Q

lesser occipital nn roots

A

C2, sometimes C3

73
Q

route lesser occipital nn

A

curves around CN XI, close to border SCM

74
Q

lesser occipital nn action

A

cutaneous sensation to the scalp

75
Q

transverse cervical nn roots

A

C2-3

76
Q

route transverse cervical nn

A

curves around post SCM
then pierces deep cervical fascia and gives off branches

77
Q

action transverse cervical nn

A

anterolat skin of the neck and upper sternum

78
Q

supraclavicular nn roots

A

C3-4

79
Q

route supraclavicular nn

A

arises behind post border SCM

80
Q

action supraclavicular nn

A

skin around supraclavicular fossa, upper thoracic region + SCJ

81
Q

nn to geniohyoid + thyrohyoid roots

A

C1

82
Q

route nn to geniohyoid + thyrohyoid roots

A

travels with CN XII to respective mm

83
Q

rectus capitis ant + lat - cervical plexus nn roots

A

C1-2

84
Q

longus capitis - cervical plexus nn roots

A

C1-3

85
Q

prevertebral mm + SCM contribution - cervical plexus nn roots

A

C2-3

86
Q

levator scapulae, trapezius + scalene mm - cervical plexus nn roots

A

C3-4

87
Q

phrenic nn contributing nn roots cervical plexus

A

ant rami C3-5

88
Q

ansa cervicalis nn roots

A

C1-3

89
Q

what are the 4 mm branches of the ansa cervicalis

A

sup belly omohyoid
inf belly omohyoid
sternohyoid
sternothyroid

90
Q

how to do a cervical plexus block

A

midway up post border SCM
injust 3 times in fan like fashion cranially, caudally, anteriorly

91
Q

RCCA origin

A

from bifurcation brachiocephalic trunk

92
Q

LCCA origin

A

arch aorta

93
Q

how many branches do the common carotid aa give off in the neck?

A

none

94
Q

level of CCA bifurcation

A

C4 (sup margin thyroid cartilage) in carotid triangle

95
Q

where does the right ECA end + terminating branches

A

within the parotid gland to form superficial temporal + macillary

96
Q

6 other branches ECA

A

sup thyroid
lingual
facial
ascending pharyngeal
occipital
post auricular

97
Q

what is carotid sinus hypersensitivity

A

decr HR + BP secondary to hypersensitive baroceptors
–> underperfused brain –> syncope

98
Q

where do the vertebral aa arise from

A

from SCA, just medial to the anterior scalene

99
Q

what are the 3 branches of the SCA

A

1st - inf thyroid aa (post prevertebral vv )
2nd - transverse cervical aa (trapezius + rhomboid)
3rd - suprascapular aa (post shoulder)

100
Q

which 2 veins form the EJV

A

post auricular and retromandibular vv

101
Q

where does the EJV form

A

posterior to the angle of mandible

102
Q

route of EJV to the SCV

A

originates post to the angle of the mandible
descends down neck in superficial fascia, anterior to the SCM in a posteromedial direction
reaches root of neck
goes under clavicle –> SCV

103
Q

what are the 3 tributaries it picks up in the neck

A

post ext jugular
transverse cervical
suprascapular

104
Q

what does the Ant jugular vv drain

A

anterior aspect neck

105
Q

where does the anterior jugular vein drain into

A

SCV

106
Q

what does the IJV begin as a continuation of?

A

sigmoid sinus

107
Q

through which opening does the IJV exit the skull>

A

jugular foramen

108
Q

relation of IJV within the carotid sheath

A

deep to SCM
lateral to CCA

109
Q

which vein joins the IJV to form the BCV?

A

SCV

110
Q

which vv drain into the IJV in the neck? (4)

A

facial vv
lingual vv
occipital vv
sup/mid thyroid vv

111
Q

what do the post auricular LN drain

A

area post to ear

112
Q

what do the occpital LN drain

A

occipital areas scalp

113
Q

what do the pre-auricular LN drain

A

superficial face + temporal regions

114
Q

what do the supramandibular LN drain

A

cheeks, lateral nose, upper lips, lat lower lip, gums, ant tongue

115
Q

what do the submandibular LN drain

A

mucous membranes nose, cheek, eyelids, conjuctiva

116
Q

what do submental LN drain

A

central lower lip, floor mouth, apex + tongue

117
Q

what do the parotid LN

A

nose, nasal cavity, EAM, tympanic cavity, lateral orbit, nasal cavities + nasopharynx

118
Q

superficial cervical LN drain

A

superficial surafces ant neck, sup surface neck

119
Q

ultimately where do the LN of the neck drain into

A

deep cervical LN

120
Q

where is the vertical chain of the deep cervical LN

A

closeto the IJV within the carotid sheath

121
Q

deep cervical LN –>

A

jugular lymphatic trunks
L trunk –> thoracic duct -> vv system via L SCV
R trunk –> R lymphatic duct –> SVV system via R SCV

122
Q

Trosiers sign

A

raised Virchow’s node 2’ to gastric malignancy

MRCS A (36 decks)

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