Anatomy of the neck

Question 1

What are the borders of the posterior triangle?

Answer 1

Posterior border of sternocleidomastoid
Anterior border of trapezius
Middle 1/3 of the clavicle

Question 2

How can the posterior triangle be further divided?

Answer 2

Occipital and supraclavicular

Question 3

4 neuronal structures contained in posterior triangle?

Answer 3

Brachial plexus, cervical plexus, phrenic nerve and spinal accessory nerve

Question 4

Which vein is found in posterior triangle?

Answer 4

External jugular vein

Question 5

What causes external jugular vein to be visible through its entire course?

Answer 5

Raised venous pressure (could be caused by heart failture, SVC obstruction, raised intra-thoracic pressure)

Question 6

What does the spinal accessory nerve supply?

Answer 6

Somatic supply to trapezius and SCM

Question 7

Which cranial nerves do the rootlets of spinal accessory travel up the neck with?

Answer 7

IX and X

Question 8

How do rootlets of XI enter and leave cranial cavity

Answer 8

enter through foramen magnum, exit through jugular foramen

Question 9

What are the signs of a XI nerve injury?

Answer 9

weakened shoulder shrugging
atrophy of trapezius
drooping of shoulder

Question 10

What roots make up cervical plexus?

Answer 10

C1-C4

Question 11

Where do the branches of the cervical plexus emerge?

Answer 11

Middle of the posterior border of the sternocleidomastoid

Question 12

How does the phrenic nerve descend the body?

Answer 12

Obliquely with the internal jugular vein across scalene and into thorax

Question 13

What muscles is cervical plexus motor into?

Answer 13

Infrahyoid

Question 14

What roots make up ansa cervicalis?

Answer 14

C1-C3

Question 15

What are the borders of the anterior triangle?

Answer 15

midline of neck (chin- jugular notch)
anterior border of sternocleidomastoid
lower border of mandible (mastoid process)

Question 16

3 divisions of the anterior triangle?

Answer 16

Carotid, submandibular, submental

Question 17

Which division of the anterior triangle takes up the most room?

Answer 17

Submandibular

Question 18

What are the borders of the carotid triangle?

Answer 18

Posterior diagastric
Superior omohyoid
Anterior sternocleidomastoid

Question 19

2 main vascular structures found in carotid triangle?

Answer 19

Internal juguar vein

Common carotid and bifurcation

Question 20

Where does the carotid artery bifurcate within the carotid triangle?

Answer 20

Superior border of thyroid cartilage

Question 21

What type of receptors does carotid sinus contain?

Answer 21

Baroceptors which measure stretch

Question 22

Does the internal carotid branch within the carotid triangle?

Answer 22

No- only branches when it enters skull

Question 23

Name the 8 branches of the external carotid (some anatomists like frollicking others prefer scaring medics)

Answer 23

Superior thyroid artery
Ascending pharyngeal
Lingual
Facial 
Occipital
Posterior auricular
Superior temporal 
Maxillary

Question 24

7 main structures found in the carotid sheath

Answer 24

Common carotid
Internal carotid
Internal jugular
vagus
Ansa cervicalis
Lymph node
Cervical part of sympathetic trunk

Question 25

What syndrome arises due to lesion of sympathetic trunk in neck?

Answer 25

Horner's syndrome

Question 26

Symptoms of Horner's syndrome?

Answer 26

``` pupil contraction (miosis) drooping of superior eyelid sinking of eye vasodilation and absence of sweating all ipsilateral ```

Question 27

Which vein does IVJ puncture use (right or left)

Answer 27

right

Question 28

Where does the thoracic duct drain

Answer 28

at venous angle on left

Question 29

Name 3 things that a raised IVJ pulse can indicate

Answer 29

mitral valve disease increased pulmonary pressure right sided heart failure

Question 30

What is unique about the hyoid bone?

Answer 30

doesn't articulate with other bones- support for tongue

Question 31

what are the suprahyoid muscles?

Answer 31

mylohyoid, diagastric, stylohyoid

Question 32

function of suprahyoid muscles?

Answer 32

swallowing and tone production

Question 33

what are the infrahyoid muscles?

Answer 33

sternohyoid, thyrohyoid, sternthroid, omohyoid

Question 34

function of infrahyoid muscles?

Answer 34

depress hyoid and larynx during speaking and swallowing

Question 35

Name the 6 muscles of the pharynx

Answer 35

``` Superior constrictor Middle constrictor Inferior constrictor Palatopharyngeus Salipigophayngeus Stylopharyngeus ```

Question 36

What is the innervation of pharynx muscles?

Answer 36

All vagys except from stylopharyngeus which is IX

Question 37

What are the extrinsic muscles of the larynx?

Answer 37

Suprahyodi and infrahyoid muscles

Question 38

What is the rima glottidis?

Answer 38

aperture between vocal folds

Question 39

Function of intrinsic muscles of the larynx?

Answer 39

Alter the length and tension of vocal cords, and the size/ shape of the rima glottidis

Question 40

How does larynx appear during normal respiration?

Answer 40

laryngeal muscles relaxed | rima glottidsis is narrow slit but wide enough to let air into lungs

Question 41

How does larynx appear during deep respiration

Answer 41

Vocal ligaments abducted by contraction of posterior cricoartenoid muscles Rima glottidis opens widely

Question 42

How does larynx appear during phonation?

Answer 42

Arytenoid muscle adduct arytenoid cartilage Cricoarytenoids adduct vocal ligaments Air forced between vocal ligaments giving sounds

Question 43

How does larynx appear during whispering?

Answer 43

Vocal ligaments strongly adducted, but arytenoids relaxed so can't get same levels of vibration/ amplitude

Question 44

What does the superior laryngeal innervate?

Answer 44

Sensory to larynx above vocal cords | Motor to cricothyroid

Question 45

What does the recurrent laryngeal innervate?

Answer 45

Motor to all intrinsic apart from cricothyroid | Sensory to area below vocal cords

Question 46

Result of superior layngeal paralysis?

Answer 46

Loss of cough reflex | Monotonous voice as paralysed cricothryoid can't vary in length or tension

Question 47

Result of injury to recurrent laryngeal?

Answer 47

Dysphonia/ hoarse voice | Can't get same tension on vocal cords