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MD4001 > Anatomy of the neck > Flashcards

Anatomy of the neck Flashcards

1
Q

what and where is the neck

A

transitional area
sup = base of cranium
inf = clavicles

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2
Q

What is fascia?

A

thin sheath of connective tissue enclosing muscle or other organ

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3
Q

What are the 4 fascial layers of the neck and what do they contain

A

investing fascia - round the whole neck
pretracheal layer - trachea, oesophagus, thyroid gland and infrahyoid muscles
Prevertebral layer - vertebral column and its assoc. muscles
carotid sheath - paired structure containing IJV, CCA and vagus nerve

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4
Q

What are the boundaries of the anterior triangle?

A
  • inf border fo mandible
  • ant border fo SCM
  • midline of the neck
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5
Q

What is the fascia of the ant triangle

A 
roof = investing fascia around muscles 
floor = pretracheal + carotid sheath
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6
Q

what are the subdivisions of the ant triangle

A
  • submandibular (digastric) division
  • submental
  • carotid
  • muscular (omotracheal)
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7
Q

What does the submandibular division contain and what are its boundaries

A

angle of mandible to pos+and digastric muscles

Contains:

  • submandibular gland
  • lymph nodes
  • part of CN XII
  • Mylohyoid nerve
  • part of facial artery and vein
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8
Q

What does the submental division contain and what are its boundaries

A

ant belly of digastric
midline of neck between AoM and hyoid bone
body of hyoid bone

Contains:

  • submental lymph nodes
  • small veins
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9
Q

What does the carotid division contain and what are its boundaries

A

ant border of SCM
sup belly of omohyoid
pos belly of digastric

Contains:

  • thyroid gland
  • deep cervical lymph nodes
  • larynx
  • pharynx
  • carotid sheath and its contents
  • br’s of cervical plexus
  • superior root of ansa cervicallis
  • part of Cn XI and XII
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10
Q

What does the muscular division contain?

A
  • sternohyoid muscle
  • sternothyroid muscle
  • thyroid gland
  • parathyroid glands
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11
Q

Name the suprahyoid and infrahyoid muscles (muscles of the ant triangle)

A

Suprahyoid

  • mylohoid
  • digastric
  • stylohyoid
  • geniohyoid

Infrahyoid

  • sternohyoid
  • sternothyroid
  • omohyoid
  • thyrohyoid
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12
Q

what is the function of the suprahyoid muscles

A

raise the hyoid bone as required during swallowing

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13
Q

what is origin, insertion, innervation and function of the mylohyoid?

A 
origin = mylohyoid line on mandible 
insertion = body of hyoid and fibres fo opp mylohoid
action = raises hyoid and floor of mouth & support floor of the mouth 
innervation = nerve to mylohoid (inf alveolar br of V3)
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14
Q

what is origin, insertion, innervation and function of the digastric?

A

ant belly

  • origin = digastric fossa on lower medial aspect of mandible
  • insertion = attachment of their intermediate tendon at hyoid
  • function = raises hyoid + opens mouth by lowering mandible
  • innervation = V3 (nerve to mylohoid)

Pos belly

  • origin = mastoid notch on medial aspect of mastoid process
  • insertion = attachment of their intermediate tendon at hyoid
  • function = raises and retracts the hyoid
  • innervation = VII (digastric branch)
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15
Q

what is origin, insertion, innervation and function of the Stylohyoid?

A 
origin = styloid process 
insertion = hyoid (laterally) 
Function = raises hyoid bone (posterosuperiorly)
innervation = VII
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16
Q

what is origin, insertion, innervation and function of the geniohyoid?

A 
origin = mental spine of mandible 
insertion = body of hyoid 
function =
  - if fixed mandible = elevates and pulls hyoid forward 
  - if fixed hyoid = lowers and moves mandible inwards
innervation = ant ramus of C1 (travels with CN XII)
17
Q

What is the role of infrahyoid (strap) muscles?

A

depress hyoid after elevation during swallowing

18
Q

what is origin, insertion, innervation and function of the sternohyoid?

A 
origin = pos surface of sternoclavicular joint and manubrium 
insertion = medial body of hyoid 
action = depress hyoid after elevation during swallowing
innervation = ant rami of C1 - C3
19
Q

what is origin, insertion, innervation and function of the omohyoid?

A

ant belly

  • origin = intermediate tendon
  • insertion = hyoid bone laterally

pos belly

  • origin = sup border of scapula
  • insertion = intermediate tendon in pos triangle

action of both = depresses and fixes hyoid
innervation = ant rami of C1-C3

20
Q

what is origin, insertion, innervation and function of the thyrohyoid?

A 
origin = oblique line on thyroid cartilage 
insertion = greater horn and adjacent body of hyoid 
action = depress hyoid, if hyoid fixed = raises larynx 
innervation = ant rami of C1 (runs with CN XII)
21
Q

what is origin, insertion, innervation and function of the sternothyroid?

A 
origin = pos surface of manubrium 
insertion = oblique line on thyroid cartilage 
action = draws the larynx downwards 
innervation = ant rami of C1 -C3
22
Q

Describe the thyroid gland anatomy

A

2 lateral lobes
- extends from thyroid cartilage to 5th tracheal ring

midline isthmus
- level of 3rd tracheal ring

midline pyramidal lobe (variably preset, remnant of thyroglossal duct)

23
Q

what is the arterial supply of the thyroid gland

A

sup thyroid ar - 1st br of ECA

inf thyroid ar - branch of thyrocervical trunk from subclavian

24
Q

describe the venous drainage of the thyroid gland

A

thyroid venous plexus

  • sup thyroid vein = into IJV
  • middle thyroid vein = into IJV
  • inf thyroid vein = into brachiocephalic
25
Q

describe the location, arterial supply and venous drainage of the parathyroid glands

A

two pairs (sup + inf) of small glands, usually on the pos surface of the thyroid gland

art supply = inf thyroid ar
venous drainage = same as thyroid

26
Q

what is the innervation of the thyroid and parathyroid glands

A

both are supplied by thyroid br’s from the cervical (symp) ganglia

27
Q

Why is it important to consider the recurrent laryngeal nerve’s relationship to the thyroid and parathyroid glands?

A

concern during neck surgery - symptoms of injury:

  • hoarsness
  • aphonia (cant speak)
28
Q

What are the boundaries of the pos triangle

A 
ant = pos border of SCM 
pos = ant border of trapezius 
inf = middle 3rd of clavicle 
sup = occipital bone
29
Q

What is the fascia of the pos triangle

A 
roof = investing fascia around muscles (SCM and trap)
floor = prevertebral fascia
30
Q

Name the muscles of the pos triangle

A
  • SCM (roof)
  • ant scalene
  • middle scalene
  • inf body of omohyoid
  • trapezius (roof)
  • levator scapulae
31
Q

what is origin, insertion, innervation and function of the SCM?

A

sternal head

  • origin = manubrium
  • insertion = lateral half of sup nuchal line

Clavicular head

  • origin = medial 1/3 clavicle
  • insertion = lateral surface fo mastoid process

Action =

  • draws head forward (both SCMs)
  • tilts head to ipsilater shoulder while turning face contralaterally (both SCMs)

Innervation = CN XI

32
Q

what is origin, insertion, innervation and function of the trapezius?

A

origin

  • sup nuchal line
  • external occipital protuberance
  • ligamentum nuchae
  • spinous process fo C7-T12

insertion

  • lateral 1/3 of clavicle
  • acromion
  • spine of scapula
action 
-  Assists rotating scapula during abduction of
humerus
- Upper fibres elevate scapula
- Middle fibres adduct scapula
- Lower fibres depress scapula

innervation = CN XI

33
Q

what is origin, insertion, innervation and function of the levator scapulae?

A 
origin = transverse process of C1-4
insertion = scapula (upper medial border) 
action = elevates the scapula
innervation = cervical nerve (C3,4) + dorsal scapular nerve (C4,5)
34
Q

what is origin, insertion, innervation and function of the ant and middle scalene?

A

ant scalene

  • origin = ant tubercle of TP of C3-6
  • insertion = 1st rib and scalene tubercle

middle scalene

  • origin = TP of C4-7
  • insertion = 1st rib and pos to groove for SCA

Action = elevates 1st rib

Innervation

  • ant rami of C4-7 = both
  • C3 = also for ant
35
Q

What is the cervical plexus composed of and name the muscular and cutaneous branches

A

ant rami of C1, C2-4

muscular br’s

  • phrenic nerve (C3,4,5)
  • ansa cervicallis (C1,2,3)

cutaneous br’s

  • lesser occipital nerve (C2)
  • great auricular and transverse cervical nerves (C2,3)
  • supraclavicular nerve (C3,4)
36
Q

what are the contents of the pos triangle?

A
  • inf belly of omohyoid
  • CN XI
  • br of cervical plx
  • br of brachial plx
  • subclavian ar and vein
37
Q

describe the superficial venous drainage of the neck

A
  • EJV drains into subclavian vein

- ant JV drains into EJV

MD4001 (5 decks)

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