Anatomy of the Neck Flashcards

1
Q

What fascia covers the thyroid, trachea and esophagus (visceral compartment)?

A

Pretracheal fascia

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2
Q

What are the fascia of the neck?

A
  • Superficial fascia
  • Investing fascia
  • Pretracheal fascia
  • Prevertebral fascia
  • Carotid sheath
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3
Q

What is the anterior triangle bound by?

A
  • Inferior border of the mandible
  • Anterior border of the sternocleidomastoid (SCM)
  • Midline of neck
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4
Q

What is on the roof of the anterior triangle?

A

Deep investing fascia around muscles

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5
Q

What is on the floor of the anterior triangle?

A
  • Pretracheal fascia

- Carotid sheath (posterolaterally)

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6
Q

What are the 4 sub-triangles in the anterior triangle of the neck?

A
  • Submandibular (digastric) triangle
  • Submental triangle
  • Carotid triangle
  • Muscular (omotracheal) triangle
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7
Q

What are the 2 sub-triangles in the posterior triangle of the neck?

A
  • Omoclavicular (supraclavicular) triangle

- Occipital triangle

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8
Q

What is the submandibular triangle bound by?

A
  • Anterior and posterior bellies of digastric

- Body of mandible

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9
Q

What is located within the submandibular triangle?

A
  • Submandibular gland
  • Submandibular lymph nodes
  • Facial artery (pulse) and vein
  • (part of) CN XII
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10
Q

What is the submental triangle bound by?

A
  • Anterior belly of diagastric
  • Hyoid
  • Midline
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11
Q

What is found within the submental triangle?

A

Submental lymph nodes

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12
Q

Where can you feel the pulse of the facial artery?

A

Anteroinferior angle of the masseter muscle against inferior surface of mandible

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13
Q

What are the 2 bellies of the digastric muscle?

A
  • Anterior belly

- Posterior belly

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14
Q

Where does the anterior belly of the digastric muscle originate?

A

Digastric / Submandibular fossa on lower medial aspect of mandible

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15
Q

Where does the posterior belly of the digastric muscle originate?

A

Mastoid notch on medial side of mastoid process

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16
Q

Where do both bellies of the digastric muscle insert?

A

Attachement of their intermediate tendon at hyoid

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17
Q

What are the actions of the digastric muscle?

A
  • Anterior belly raises hyoid and opens mouth by lowering mandible
  • Posterior belly elevates and retracts hyoid bone
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18
Q

What is the anterior belly of the digastric innervated by?

A

Nerve to mylohyoid (V3)

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19
Q

What is the posterior belly of the digastric innervated by?

A

Digastric branch of VII

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20
Q

What is the mylohyoid derived from?

A
  • Anterior = 1st pharyngeal arch

- Posterior = 2nd pharyngeal arch

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21
Q

What borders the carotid triangle?

A
  • Posterior belly of digastric

- Superior belly of omohyoid and sternocleidomastoid

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22
Q

What are found in the carotid triangle?

A
  • Thyroid gland
  • Larynx
  • Pharynx
  • Carotid sheath (and contents)
  • Branches of cervical plexus
  • Ansa cervicalis
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23
Q

What is the ansa cervicalis?

A
  • Loop between branches of cervical plexus and hypoglossal nerve
  • Superficial to IJV
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24
Q

What are the borders of the omotracheal / muscular triangle?

A

Superior - hyoid bone
Lateral - superior belly of omohyoid and anterior border of sternocleidomastoid
Medial - midline of neck

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25
Q

What are the borders of the omotracheal / muscular triangle?

A
  • Superior: Hyoid bone
  • Lateral: Superior belly of omohyoid and anterior border of SCM
  • Medial: Midline of neck
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26
Q

What is contained within the omotracheal triangle?

A

“Muscular triangle”

  • Sternohyoid muscle
  • Sternothyroid muscle
  • Thyroid gland (part of)
  • 1 parathyroid gland
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27
Q

What is the only bone in the body that does not articulate with another bone?

A

Hyoid

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28
Q

Where are the suprahyoid muscles located?

A
  • Above hyoid

- Connect to skull or mandible

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29
Q

Where are the infrahyoid muscles located?

A
  • Below hyoid

- Connect to inferior structures (sternum, scapula, thyroid cartilage)

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30
Q

When does the hyoid bone move up and own?

A

Swallowing

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31
Q

Name the suprahyoid muscles

A
  • Mylohyoid
  • Digastric
  • Stylohyoid
  • Geniohyoid
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32
Q

Name the infrahyoid muscles

A
  • Sternohyoid
  • Omohyoid
  • Thyrohyoid
  • Sternothyroid
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33
Q

What is the action of the infrahyoid (strap) muscles?

A

Depress the hyoid (in actuallity this is mostly done by gravity)

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34
Q

What is the innervation of the infrahyoid (strap) muscles?

A
  • Sternohyoid, omohyoid, sternothyroid by anterior rami of C1-3 (branches of cervical plexus)
  • Thyrohyoid by C1, hitchhiking hypoglossal nerve
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35
Q

What is the purpose of the thyroid gland?

A
  • Endocrine gland
  • Required for metabolism and growth/development
  • Thyroid hormones: T3 (triiodothyronine) and T4 (thyroxine)
  • Calcitonin
36
Q

WHat does the hypothalamus secrete when the thyroid hormone levels become too low?

A

Thyrotropin-releasing hormone (TRH)

37
Q

What does TRH cause the production of?

A

Thyroid stimulating hormone (TSH) from pituitary

38
Q

What is T3?

A

Triiodothyronine

39
Q

What is T4?

A

Thyroxine

40
Q

What is more potent T3 or T4?

A

T4

41
Q

What thyroid hormone is produced more?

A

T3 (Triiodothyronine) (80%)

42
Q

What is characteristic of patients with an overactive thyroid?

A
  • Anxious
  • Irritable
  • High HR
  • Loss of weight
  • Hot
43
Q

What produce calcitonin?

A

Parafollicular C cells of the thyroid

44
Q

What is calcitonin involved in?

A

Regulation of blood calcium levels

- Lowers blood calcium - causes deposit of calcium to bone from blood

45
Q

Where does the thyroid gland lie?

A
  • Within visceral compartment of the neck
  • Extends from thyroid cartilage to 5th tracheal ring
  • Isthmus at level of 3rd tracheal ring
46
Q

What is the pyramidal lobe?

A
  • Lies in midline, continuation of isthmus superiorly

- Remnant of thyroglossal duct

47
Q

What is the arterial supply of the thyroid gland?

A
  • Superior thyroid artery (1st branch of external carotid artery)
  • Inferior thyroid artery (branch of thyrocervical trunk from subclavian)
48
Q

What is the venous drainage of the thyroid gland?

A

Thyroid venous plexus

  • Superior thyroid vein (into IJV)
  • Middle thyroid vein (into IJV)
  • Inferior thyroid vein (into brachiocephalic)
49
Q

What is the arterial supply to the parathyroid glands?

A

Inferior thyroid arteries (branch of thyrocervical trunk from subclavian)

50
Q

What is the venous drainage of the parathyroid glands?

A

Same as thyroid gland

  • Superior thyroid vein (into IJV)
  • Middle thyroid vein (into IJV)
  • Inferior thyroid vein (into brachiocephalic)
51
Q

What do parathyroid glands regulate?

A
  • Phosphorus / phosphate metabolism

- Calcium metabolism

52
Q

What does the parathyroid gland secrete?

A

Parathyroid hormone (PTH)

53
Q

How does parathyroid hormone affect the blood calcium levels?

A

Elevates (opposite to calcitonin)

54
Q

What is the nervous innervation of the thyroid and parathyroid glands?

A

Thyroid branches from the cervical (sympathetic) ganglia

55
Q

What is the posterior triangle bound by?

A
  • Posterior border of the sternocleidomastoid
  • Anterior border of trapezius
  • Middle 3rd of clavicle
  • Occipital bone
56
Q

What is the roof of the posterior triangle?

A
  • Deep investing fascia

- Sternocleidomastoid and trapezius

57
Q

What is the floor of the posterior triangle?

A
  • Prevertebral fascia

- Splenius capitis, levator scapulae, and scalene muscles

58
Q

What are the 2 minor triangls located within the posterior triangle?

A
  • Occipital triangle (larger)

- Ommoclavicular (major supraclavicular) triangle

59
Q

What is located inside the occipital triangle?

A
  • Accessory nerve

- Brachial plexus

60
Q

What is the occipital triangle bound by?

A

Anterior: Posterior margin of sternocleidomastoid
Posterior: Anterior margin of trapezius
Inferior: Inferior belly of omohyoid

61
Q

WHat is the name of the minor triangle which is not located within the posterior or anterior triangle?

A

Minor supraclavicular triangle (located within 2 heads of SCM)

62
Q

What is located deep to the minor supraclavicular triangle?

A

Inferior bulb of the IJV

63
Q

Where is the retromandibular fossa located?

A

Posterior to the ramus of the mandible

64
Q

What is contained within the retromandibular fossa?

A
  • Parotid gland
  • Styloglossus, stylohyoid, stylopharyngeal muscles
  • Stylomandibular and stylohyoid ligaments
  • Retromandibular vein, maxillart and superficial temporal vessels
65
Q

What is the cervical plexus formed by?

A

Anterior rami of C1-4, deep to sternocleidomastoid

66
Q

What are the muscular branches of the cervical plexus?

A
  • Phrenic nerve (C3-5) to the diaphragm

- Ansa cervicalis (C1-3) to the infrahyoid muscles

67
Q

Where do the cutaneous branches of the cervical plexus become superficial?

A

Erb’s point

- Halfway on the posterior border of the SCM

68
Q

What are the cutaneous branches of the cervical plexus?

A
  • Lesser occipital nerve (C2)
  • Great auricular nerve (C2-3)
  • Transverse cervical nerve (C2-3)
  • Supraclavicular nerve (C3-4)
69
Q

Where does the common carotid artery bifuricate?

A
  • C3/4

- Upper margin of thyroid cartilage

70
Q

How many branches does the internal carotid artery have in the neck?

A

0

71
Q

What are the common carotid arteries branches of?

A
  • Right: Brachiocephalic trunk

- Left: Aortic arch

72
Q

Where does the common carotid ascend in the neck?

A

Either side of larynx and trachea within carotid sheath

73
Q

What is the name of the slighlty dilated area of the internal carotid artery?

A

Carotid sinus

74
Q

What does the carotid sinus contain and what is its function?

A

Baroreceptors - sensitive to bloop pressure

  • If BP too high signals are activated and carried by glossopharyngeal nerve to nucleus of tractus solitarius
  • This is connected to dorsal nucleus of vagus and vasomotor receptors in medulla
  • Vagus will dilate snmooth muscle of blood vessels
75
Q

What is the carotid body?

A
  • Small organ which houses chemoreceptors located at posterior wall bifurication of CCA
  • Monitors blood O2, CO2, pH and temperature
  • Responds in emergency situations by increasing respiration, BP, HR
  • Inervated by CN IX
  • Nucleus to tractus solitarius to cardioregulatory and vasomotor centres in the medulla then to dorsal nucleus of vagus
76
Q

What are the primary superficial veins of the neck?

A

Internal, anterior and external jugular veins

77
Q

What is the internal jugular vein a continuation of?

A

Sigmoid sinus

78
Q

What does the IJV exit the skull via?

A

Jugular foramen

79
Q

Where does the IJV lie in relation to the common carotid artery?

A

Lateral

80
Q

Where does the external jugular vein begin?

What is it formed by?

A

At angle of the mandible

- Joining of retromandibular and posterior auricular veins

81
Q

What does the external jugular vein pierce through, what is significant about this?

A

Investing fascia to enter and drain into subclavian
- Investing fascia holds wall of external jugular vein and suspends it (pressure within external jugular is negative), danger of air embolism

82
Q

What does the anterior jugular vein arise near?

A

Hyoid bone and run either side of midline

83
Q

What does the anterior jugular vein drain into?

A

External jugular

84
Q

What muscle do the external jugular veins cross over?

A

Sternocleidomastoid

85
Q

What do the left and right anterior jugular veins connect and form?

A

Jugular venous arch