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Head and Neck Anatomy > Anatomy of Anterior and Posterior Neck > Flashcards

Anatomy of Anterior and Posterior Neck Flashcards

1
Q

What is the neck?

A

Region of the body lying between:
- the lower margin of mandible and superior nuchal line of the occipital bone above
- and the suprasternal notch and upper border of clavicles below

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2
Q

Describe the innervation of the skin of the neck?

A

At the back – supplied segmentally by posterior rami of c2-c5
At front and sides – supplied by anterior rami of c2-c4

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3
Q

Describe the superficial fascia of the neck?

A

forms a thin layer that encloses the platysma muscle.
> embeds cutaneous nerves, superficial vessels & lymphatics

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4
Q

Describe the deep fascia of the neck?

A

consists of areolar tissue that supports muscles, vessels and viscera

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5
Q

What are the fibrous sheets of the deep fascia?

A
  1. Investing layer - surrounds all structures in the neck
  2. pre-tracheal layer
  3. prevertebral layer
  4. carotid sheath
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6
Q

Name the 3 compartments of the neck and their contents?

A
  1. Visceral Compartment
    - Digestive and respiratory systems + several endocrine glands
  2. Vertebral Compartment
    - Cervical vertebrae, spinal cords, cervical nerves, associated muscles
  3. Vascular Compartments
    - Major blood vessels and vagus nerve [X]
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7
Q

What divides the neck into anterior and posterior triangles?

A

sternocleidomastoid

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8
Q

What are the boundaries of the anterior triangle?

A
  1. Anterior border: Imaginary midline of the neck
  2. Posterior Border: Anterior border of SCM
  3. Superiorly (Base): inferior margin of mandible
    > The roof is formed by skin, superficial fascia, platysma and investing layer of deep fascia
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9
Q

What are the 4 divisions of the anterior triangles?

A
  1. submandibular (digastric)
  2. submental
  3. carotid
  4. muscular
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10
Q

Which muscles form the 4 divisions of the anterior triangle?

A
  1. digastric muscles
  2. superior belly of Omohyoid
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11
Q

What are the contents of the submental division of the anterior triangle?

A
  • submental lymph nodes
  • beginning of anterior jugular vein
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12
Q

What are the contents of the submandibular division of the anterior triangle?

A
  • submandibular salivary gland
  • lymph nodes
  • facial artery & vein
  • carotid sheath
  • hypoglossal nerve
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13
Q

What are the contents of the carotid division of the anterior triangle?

A
  • carotid sheath
  • branches of external carotid artery
  • internal jugular vein
  • hypoglossal
  • accessory and vagus nerves
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14
Q

What are the contents of the muscular division of the anterior triangle?

A

sternohyoid and sternothyroid form the floor beneath which lies the:
- thyroid gland
- larynx
- trachea
- oesophagus

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15
Q

Name the supra-hyoid muscles of the anterior triangle and their action?

A

Stylohyoid
digastric
mylohyoid
geniohyoid
> Raise hyoid bone or depress mandible (mylohyoid and digastric)

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16
Q

What is the innervation of the supra-hyoid muscles?

A
  1. Facial nerve
    > posterior belly of digastric and stylohyoid
  2. Mandibular division of trigeminal CNV3
    > anterior belly of digastric and mylohyoid
  3. branches from anterior ramus of C1 carried along the Hypoglossal nerve [XII]
    > geniohyoid
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17
Q

What are the infrahyoid muscles and what is their action?

A

Omohyoid
sternohyoid
thyrohyoid
Sternothyroid
- depress hyoid bone
Note: Names indicate sites of attachment

18
Q

What is the innervation of the infrahyoid muscles?

A

Ansa cervicalis
> except thyrohyoid = C1 via hypoglossal CN XII

19
Q

Describe the cervical plexus?

A
  • Anterior rami C1-4
  • Joined into loops that lie anterior to levator scapulae and scalenus medius
  • Covered by pre-vertebral layer of deep cervical fascia
  • Somatic motor and sensory (plus sympathetic)
20
Q

Describe the course of the vagus nerve?

A

Descends in carotid sheath
Recurrent laryngeal branches to muscles of larynx = L around arch of aorta, R around subclavian artery
Internal and external laryngeal branches
Through thoracic inlet into superior mediastinum – parasympathetic to thorax and abdomen

21
Q

Describe the course of the common carotid artery?

A

LCA from arch of aorta
RCA from brachiocephalic
No branches but terminal 2 = internal and external
Internal carotid to brain
External carotid to head, face, neck
Within carotid sheath with internal jugular vein and vagus nerve

22
Q

Describe the thyroid gland in the anterior triangle?

A

Endocrine – regulates metabolic rate
2 lobes, isthmus and capsule
From lamina of thyroid cartilage down to 6th tracheal ring
Isthmus over tracheal ring 2 or 3
Parathyroid glands embedded into posterior surface

23
Q

Describe the arterial supply of the thyroid gland?

A
24
Q

Describe the venous drainage of the thyroid gland?

A
25
Q

Describe the course of the submandibular salivary gland?

A

Inferior to mylohyoid, plus part in floor of mouth superior to mylohyoid
One duct each side opens between the first and second lower incisor (either side of frenelum)

26
Q

What are the borers of the posterior triangle?

A
  1. anterior - posterior border of SCM
  2. posterior - anterior border of trapezius
  3. base - clavicle
  4. Floor - splenius capitis, levator scapulae, posterior, middle and anterior scalene muscles
    > The floor is formed by prevertebral layer of deep fascia
    > The triangle is covered by skin, sup fascia, platysma, and investing layer of deep fascia (roof)
27
Q

What are the contents of the posterior triangle?

A

external jugular vein
roots of brachial plexus
accessory nerve
cervical and supra-clavicular lymph nodes
Occipital artery
3rd part of subclavian
Lateral branches of thyrocervical trunk

28
Q

Describe the floor of the posterior triangle?

A
  1. Omohyoid
    • Superior border of scapula - inferior border of hyoid bone
    • Depress hyoid bone
  2. Ansa cervicalis
  3. Splenius capitis
    • Nuchal ligament, spinous process of C7-T4 to mastoid process
    • Extend the neck, rotate
  4. Dorsal rami middle cervical
29
Q

Cutaneous branches of cervical plexus running across the posterior triangle?

A
  1. lesser occipital (C2)
  2. great auricular (C2,3)
  3. lateral supraclavicular (C3,4)
  4. intermediate supraclavicular (C3,4)
  5. medial supraclavicular (C3,4)
  6. transverse cervical (C2,3)
30
Q

Locations of nerves of the posterior triangle?

A
  1. CN XI crosses obliquely on surface of L. scapulae
  2. phrenic nerve - crosses obliquely over anterior scalene
  3. brachial plexus - passing between middle and anterior scalene
31
Q

What are the divisions of the posterior triangle and what separates these divisions?

A
  1. Occipital triangle (larger – above)
  2. Supraclavicular triangle (smaller – below)
    > subdivided by inferior belly of omohyoid
32
Q

Describe the action of the sternocleidomastoid muscle?

A
  1. unilateral = lateral flexion of neck to same side (face opposite)
  2. bilateral = flexion of neck
33
Q

Describe the innervation of the sternocleidomastoid muscle?

A

motor = spinal accessory nerve (CN XI)
pain and proprioception = cervical plexus C2, C3

34
Q

Describe the action of the trapezius muscle?

A
  1. ascending part (inferior) = depress scapula
  2. transverse part (middle) = retracts scapula
    2 descending part (superior) = elevate scapula, rotate glenoid cavity
    > holds scapula in position - weightlifting
35
Q

Describe the innervation of the trapezius muscle?

A

spinal accessory nerve (CN XI), cervical plexus C3,C4 (proprioception)

36
Q

Describe the action of the levator scapulae muscle?

A

Help control scapular position, elevate shoulder (with trapezius), shoulder fixed can laterally flex neck to the same side

37
Q

Location of levator scapulae?

A

Transverse processes of atlas and axis, 3rd and 4th C vertebrae to medial scapular border between superior angle and medial end of scapular spine

38
Q

Location of scalene muscles?

A

Origin:
From transverse processes of:
1. C3-6 (anterior),
2. C2-7 (middle)
3. C4-6 (posterior)
Insertion:
1. To ribs 1 (scalene tubercle m) = anterior
2. Upper surface of rib 1 = middle
- Artery lies between it and tubercle
3. Upper surface of rib 2 (posterior)

39
Q

Innervation of scalene muscles?

A
  1. anterior - ant. rami C4-7
  2. middle - ant. rami C3-7
  3. posterior - ant. rami C5-7
40
Q

Action of scalene muscles?

A

flex neck (bilateral)
tilt head to same side (unilateral)
elevate upper ribs

41
Q

What is an emergency cricothyroidotomy?

A

an incision made through the skin and cricotyroid membrane to establish a patent airway during certain life-threatening situations
e.g. airway obstruction by foreign body, angioedema or massive facial trauma

Head and Neck Anatomy (37 decks)

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