Anatomy of the Neck

Question 1

describe the organization of the cervical fascia of the neck

Answer 1

superficial, investing, pretracheal, prevertebral, carotid sheath), comminications between the neck and other regions

Question 2

what is fascia and what does it do?

Answer 2

is a connective tissue, surrounds and supports muscles, vessels and nerves in the body. in the neck also helps compartmentalize structures of the neck.

Question 3

what are the two fascias in the neck?

Answer 3

superficial cervical fascia and deep cervical fascia

Question 4

where does the superficial fascia lie and what does it contain?

Answer 4

between the skin and the deeper layer of the cervical fascia. containes superficial veins, (external jugular), lymph nodes, adipose tissue and platysma muscle

Question 5

what layers does the deep cervical fascia of the neck have

Answer 5

superficial - surrounds all the structures in the neck, prevertebral -surrounds the vertebral column and deep muscles of the neck, pretracheal layer - encloses the viscera of the neck ( pharynx, esophagus, thyroid gland, and trachea)

Question 6

what is the posterior part of the pretracheal layer of the deep cervical fascia referred to as?

Answer 6

buccopharyngeal fascia

Question 7

where are the carotid sheaths (4th layer of the superficial fascia of the neck)

Answer 7

surround the neurovascular bundles on either side of the neck ( common carotid artery, internal jugular vein and vagus nerve)

Question 8

what is between the fascial layers of the neck?

Answer 8

potential spaces that may provide a conduit for the spread of infections from the neck to the thorax

Question 9

three potential spaces of fascial layers of the neck

Answer 9

Pretracheal space -between investing layer of cervical fascia and pretracheal fascia, Retropharyngeal space - between the buccopharyngeal fascia and the prevertebral fascia, Third space - within the anterior part of the prevertebral fascia covering the bodies of the vertebrae

Question 10

what is the anterior triangle of the neck bounded by

Answer 10

Anterior triangle is bounded by the anterior border of the sternocleidomastoid muscle, inferior border of the mandible and midline of the neck

Question 11

what is the posterior triangle of the neck bounded by?

Answer 11

the posterior border of the sternocleidomastoid muscle, anterior border of the trapezius and clavicle

Question 12

muscles of anterior and posterior triangles can be thought of as groups of muscles with common what functions, what are the three groups?

Answer 12

suprahyoid muscles, infrahyoid muscles, scalene muscles

Question 13

what do the suprahyoid muscles (above hyoid bone) do and what are they innervated by?

Answer 13

raise the hyoid bone toward the mandible during swallowing. innervation-facial or trigeminal nerve

Question 14

what do the infrahyoid muscles (below the hyoid) do and what are they innervated by?

Answer 14

depress the hyoid bone and larynx during swallowing and vocalization. innervated by branches of the cervical spinal nerves (ansa cervicalis)

Question 15

what do the scalene muscles (ant, middle and post) located in lateral aspect of the neck in posterior triangle do and what are they innervated by?

Answer 15

scalenes act as accessory muscles of respiration and flex the neck, innervated by branches of the cervical spinal nerves.

Question 16

what is the important about scalene muscles landmark ( what passes between them?

Answer 16

subclavian artery and the brachial plexus pass between the anterior and middle scalene muscles

Question 17

describe the thyroid gland, where is it found?

Answer 17

endocrine gland, in visceral compartment of the neck, inferior to the thyroid cartilage, surrounded by pretracheal fascia.

Question 18

how many lobes does thyroid have and what are they joined by?

Answer 18

isthmus that crosses the anterior surfaces of the second and third tracheal cartilages

Question 19

what is the thyroid gland supplied by? (artery)

Answer 19

superior thyroid artery (first branch of the external carotid artery) and inferior thyroid artery (branch of the thyrocervical trunk off the subclavian artery)

Question 20

where do the rich supply of veins from the thyroid empty into?

Answer 20

either internal jugular or brachiocephalic veins

Question 21

which nerves are at risk of injury during surgical removal of or manipulation of the thyroid gland?

Answer 21

recurrent laryngeal nerves that pass deep to the lateral lobes of the gland and enter the larynx

Question 22

what are the parathyroid glands and where are they found?

Answer 22

small endocrine glands normally found on the deep surface of the lateral lobes of the thyroid gland(location can be highly variable)

Question 23

what do the parathyroid glands do?

Answer 23

they are responsible for the production of PARATHYROID HORMONE that acts to regulate calcium levels in the body

Question 24

what may be encountered during an emergency tracheotomy?

Answer 24

isthmus of the thyroid ( may have to be retracted or divided)

Question 25

what may be be present and interfere with access to airway during a cricothyrotomy?

Answer 25

pyramidal lobe ( if it is present)

Question 26

right and left common carotid arteries are contained within the carotid sheath in association with what?

Answer 26

internal jugular vein and the vagus nerve

Question 27

where are the right and left common carotid arteries found and do they give off any branches

Answer 27

neck lateral to the trachea and the espophagus

Question 28

where do the common carotid artery split into the external and internal carotid arteries?

Answer 28

at approximately the level of the thyroid cartilate

Question 29

does the internal carotid artery give off any branches in the neck and where does it go and what does it supply?

Answer 29

no branches in neck, enters skull, blood supply to brain

Question 30

how many branches does the external carotid have, what are they?

Answer 30

7 - (superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular, and maxillary) and ends as the superficial temporal artery. ( name of artery tell you which areas of the head and neck the artery supplies)

Question 31

what is the cervical plexus and what does it do?

Answer 31

network of nerve fibers, supplies motor and sensory innervation to structures in neck and trunk

Question 32

what is the cervical plexus formed from and where is it located?

Answer 32

anterior rami of C1-C4 spinal nerves and is located in the posterior triangle of the neck

Question 33

what are two important motor branches of the cervical plexus?

Answer 33

phrenic nerve (C3-C5) that provides motor supply to the diaphragm, and ansa cervicalis (C1-C3) provides motor innervation to the infrahyoid muscles of the neck

Question 34

what do the sensory branches of the cervical plexus supply?

Answer 34

skin of the neck, upper thorax, scalp and ear.

Question 35

what is Erb’s point?

Answer 35

the area where all the sensory branches of the cervical plexus enter the skin at the middle of the posterior border of the sternocleidomastoid muscle ( SITE OF CERVIAL NERVE BLOCK)

Question 36

What are the four major branches of the sensory branches of the cervical plexus (erb’s point nerves)

Answer 36

lesser occipital, greater auricular, transverse cervical and supraclavicular nerves