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Block 5 Week 3 Dani > Anatomy-Superficial and Deep Neck > Flashcards

Anatomy-Superficial and Deep Neck Flashcards

1
Q

All the muscles of the neck are encircled by cervical investing fascia except for the (blank)

A

platsyma

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2
Q

How many compartments are there in the cervical cross section?

A

four

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3
Q

What is the most superficial muscle relative to the cervical compartments? Describe its position more thoroughly

A

the platysma

on top of the investing fascia and deep to and within the superficial fascia

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4
Q

What is the origin and insertion of the investing fascia of the cervical area?

A

Starts at clavical and inserts at zygomatic arch and attaches to superior temporal line above the attachment of the temporalis muscle.

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5
Q

What are the 2 ridges on the temporal bone for?

A

One for attachment of the temporalis (lower one) and one for the cervical investing fascia (higher one)

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6
Q

What is inside of the carotid sheath?

A

common carotid, internal carotid, internal jugular vein, vagus, branches of CN 9, deep nodes

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7
Q

What is right outside of the carotid sheath in the retropharyneal space (danger space)?

A

the sympathic trunk

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8
Q

What is the SCM surrounded by on both sides?

A

superifical cervical investing fascia

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9
Q

What does the prevertebral fascia surround?

A

all the muscles associated with vertebral muscles (intrinisic back muscles)

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10
Q

When the prevertebral fascia reaches anterior border of veterbral body it splits off and forms 2 layers. What are these 2 layers? What do these make?

A

alar layer and vertebral layer

the retropharyngeal space

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11
Q

What fascia is in between the esophagus and the alar layer of the prevertebral fascia?

A

the buccopharyngeal fascia

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12
Q

What fascia surrounds the larynx, esophagus, trachea, thyroid gland and STRAP muscles?

A

the pretracheal fascia

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13
Q

What are the 2 layers of the deep cervical fascia?

A

the superficial investing layer and the prevertebral layer

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14
Q

What is the visceral compartment?

A

the compartment covered by pretracheal fascia

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15
Q

Why is the retropharyngeal space dangerous?

A

Can conduct infection from base of skul to the thorax (superior mediastinum)

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16
Q

What does the retropharyngeal space allow you to do?

A

move your esophagus and larynx during swallowing

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17
Q

What are the four superficial veins of the neck?

A 
Facial
External Jugular
Anterior Jugular
Internal Jugular
F A E I
There are Four..... then start naming vowels. A E I.
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18
Q

Where does the facial vein drain into?

A

the internal jugular

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19
Q

What is super scary about superficial veins?

A

they can be easily cut which will result in air getting into them and causing an air embolis which will cause immediate block to blood flow in the heart!!

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20
Q

If someone has an air embolism due to a cut of a superficial vein what should you do?

A

choke em out and pin em on the floor (cuts off air flow and reduces neg pressure)

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21
Q

anterior jugular and external jugular drain into the (blank)

A

subclavian

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22
Q

What is the main drainage of the superficial veins?

A

the internal jugular

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23
Q

What are the boundaries of the posterior triangle of the neck?

A

SCM (medially)
trapezius (laterally)
and the clavicle (inferiorly)

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24
Q

What structures are found in the posterior triangle of the neck?

A 
11 CB (play with) Scales and Sets
Nerves:
Cn 11
cervical plexus, 
roots of brachial plexus
Arteries and Veins:
suprascapular artery
external jugular vein
transverse cervical artery
subclavian artery

Muscles:
scalene muscles
myohyoid

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25
Q

The roots of the brachial plexus are between what two muscles?

A

the medial and anterior scalene muscles

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26
Q

What are the boundaries of the anterior triangle?

A

mandible
anterior midline
SCM

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27
Q

What are the important structures within the anterior triangle of the neck?

A

carotid sheath and contents
ansa cervicalis
thyroid gland
many muscles and viscera

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28
Q

What is the most important anterior triangle?

A

carotid triangle

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29
Q

Where will you find the cervical plexus nerves, behind or in front of the sternoclidomastoid?

A

behind

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30
Q

What are the four triangles of the anterior triangles of the neck?

A

carotid
submandibular
submental
muscular

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31
Q

What makes up the muscular floor of the the posterior triangle?

A
  • brachial plexus b/w anterior and middle scalenes
  • levator scapulae
  • scalene muscles (3)
  • inferior belly of omohyoid

BLIS :)

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32
Q

What’s the difference between thoracic outlet syndrome and scalenus anticus syndrome?

A

thoracic outlet syndrome is a problem bone to bone or tendon to bone (i.e you get squished because your clavicle squeezes against your first rib)
Scalenus anticus syndrome is when you anterior and middle scalene squeezes your brachial plexus or subclavian artery

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33
Q

What does scalenus anticus syndrome cause?

A

causes numbness and ischemia due to compression of subclavian artery and the brachial plexus nerves

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34
Q

What are the cutaneous branches of the cervical plexus?

A

lesser occipital
great auricular
transverse cervical
supraclavicular

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35
Q

The cutaneous branches of the cervical plexus are embedded where?

A

in the investing fascia

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36
Q

Where does the lesser occipital nerve run? Is this a ventral or a dorsal ramus?

A

runs up to the posteriorlateral side of head
ventral ramus
**remember the greater occipital is a dorsal ramus*

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37
Q

Where does the great auricular nerve run?

A

comes up behind SCM and up towards the ear (supplies similiar to lesser occipital but does more of the ear)

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38
Q

Where does the transverse cervical nerve run?

A

goes straight across the neck and innervates the anterior lateral surface of the neck

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39
Q

What does the supraclavicular nerve branch into? What does it do?

A

it goes down and branches into intermediate, medial and lateral.
It gives sensory innervation to clavicle and onto shoulder

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40
Q

What will C1-C4 gives branches to? Which are the major contributors to this?

A

the cervical plexus

C2,3,4

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41
Q

C2 and C3 will combine and go up to form what 2 nerves?

A

great auricular nerve

lesser occipital nerve

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42
Q

What nerves will come off of C2 and head and connect with C1 to make a large loop?

A

the anca cervicalis

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43
Q

What come off of C1 and travels with the hypoglossal nerve (CN 12)?

A

geniohyoid and thyrohyoid

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44
Q

Which nerves of the cervical plexus make up the phrenic?

A

345 keep the diaphragm alive

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45
Q

What does the phrenic lie on top of? What does the phrenic nerve lie behind? Why is this signif?

A

the anterior scalene
SCM
Because when trying to anesthatize the cervical plexus you need to watch out for that pesky phrenic :)

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46
Q

Is the phrenic nerve in a triangle?

A

nope

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47
Q

What all does the C1 of the cervical plexus give off?

A

the descending branch of the ansa cervicalis (which connects to the ascending branch from C2) and a nerve to the geniohyoid muscle and thryohyoid muscle

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48
Q

What does the ansa cervicalis supply?

A

all other infrahyoid muscles

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49
Q

What do you find running between the common cartoid and internal jugular vein?

A

the vagus

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50
Q

What do you find on top of the internal jugular vein?

A

the ansa cervicalis

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51
Q

What do you find lateral to the internal jugular vein?

A

the phrenic

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52
Q

Which is more lateral, the common carotid or internal jugular vein?

A

internal jugular vein

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53
Q

What does C3 and C4 combine to create that goes inferior?

A

supraclaviculars nerve and the phrenic nerve

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54
Q

What does C2 and C3 combine to create that goes horizontal?

A

transverse cervical

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55
Q

What nerve runs with C1?

A

hypoglossal

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56
Q

Inflamed gallbladder can irritate peritoneum on undersurface of the (blank)

A

diaphragm

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57
Q

(blank) provides somatosensory innervation to the diaphragm, including the periotneum

A

phrenic

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58
Q

Pain from the diaphragm enters dorsal horns of cervical nerves (blank, blank, blank)

A

C3,C4,C5

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59
Q

The (blank) nerve arises from C3 and C4 and innervates skin over the shoulder

A

Supraclavicular nerve

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60
Q

Any pain close to the diaphragm will refer to the (blank) because of the cervical plexus

A

shoulder

i.e diaphram, gall bladder, liver can refer to shoulder due to overlap of fibers onto the same dorsal horn area

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61
Q

Tell me where the hypoglossal nerve comes from, what it goes through and what it gives

A

from hypoglossal nucleus-> through hypoglossal canal-> gives motor to tongue muscles and all muscles with glossus in the name except for palatoglossus

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62
Q

If you damage your hypoglossal nerve you wont be able to (blank)

A

talk

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63
Q

What do you call a lower motor neuron issue that doesnt allow you to speak?

A

dysarthria

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64
Q

What do you call a upper motor neuron issue that doesnt allow you to speak?

A

aphasia

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65
Q

ALl the muscles that control the palate are innervated by CN (blank) except for the tensorpalantine.

A

10

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66
Q

Anything that starts with a T or sounds like it starts with a T (like pterygoid) is innerated by (Blank)

A

CN 5

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67
Q

The wide variety of muscles attaching to the hyoid bone allow it to (blank) and (blank) in vocalization and swallowing.

A

elevate and depress

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68
Q

What bone does the hyoid bone articulate with?

A

IT DOESNT it is just a floating bone

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69
Q

How can you palpate the hyoid bone?

A

you hole one side steady and then you can palpate the greater horn on the opposing side

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70
Q

If you pull down on the hyoid bone then the hyoid muscles will be accessory (blank)

A

jaw openers

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71
Q

What muscles makes up the floor of the mouth?

A

mylohyoid

72
Q

What muscle extends from the styloid process of the mandible to the hyoid?

A

stylohyoid

73
Q

What lays superficial to the mylohyoid and meets at the chin?

A

the anterior belly of the diagastric

74
Q

What innervates the posterior belly of the digastric?

A

CN 7

75
Q

What innervates the anterior belly of the digastric?

A

CN 5

76
Q

What innervates the mylohyoid?

A

CN V3

77
Q

What muscles is deep to the mylohyoid?

A

the genohyoid

78
Q

What are the deep muscles that are below they hyoid bone?

A

The strap muscles (infrahyoid muscles)

79
Q

What makes up the infrahyoid/ Strap muscles?

A

The four infrahyoid muscles are; the sternohyoid, sternothyroid, thyrohyoid and omohyoid muscles.

80
Q

What muscle extends from the omohyoid tubercle on the scapula all the way to the hyoid bone with a superior and inferior belly that is held down by a fascial sling?

A

omohyoid

81
Q

What muscle is on top of the thyrohyoid and the sternothyroid?

A

the sternohyoid

82
Q

THe supra hyoids are for the most part innervated by (blank) except for the geniohyoid (done by C1)

A

CN

83
Q

The infrahyoids, aka strap muscles, are innervated by the (blank)

A

cervical plexus

84
Q

What muscle splits around the digastric muscle?

A

stylohyoid

85
Q

Where does the stylohyoid come from and what is it innervated by?

A

comes from the second brachial arch and is innervated by CN 7

86
Q

Where does the styloglossus muscle coem from and what innervates it?

A

derived from postotic somites and is innervated by CN 12

87
Q

Where does the stylopharyngeus come from and what innervates it?

A

derived from branchial arch 3 and is innervated by CN 9

88
Q

What are the muscles of the styloid process?

A

stylohyoid
styloglossus
stylopharyngeus

89
Q

What are the four suprahyoid muscles?

A

mylohyoid
geniohyoid
stylohyoid
digastric (anterior and posterior bellies)

90
Q

What muscles pierces right through the submanibular gland?

A

the mylohyoid

91
Q

What nerve passes superior to the submanidular gland?

A

lingual nerve

92
Q

What is the origina and insertion of the geniohyoid muscle?

A

the hyoid bone and the genial tubercle of the mandible

93
Q

What is the mylohyoid muscle innervated by?

A

V3

94
Q

What are the boundaries of the anterior triangle?

A

anterior border of SCM
anterior midline of neck
Mandible

95
Q

What are the borders of the muscular triangle?

A

midline of neck
anterior margin of sternocleidomastoid
superior belly of omohyoid

96
Q

What is on TOP of the carotid sheath?

A

ansa cerivicalis

97
Q

What does the carotid sheath contain?

A

common carotid artery
internal jugular vein
vagus nerve

98
Q

Which part of the carotid DOESNT have branches until it enters the cranial cavity?

A

Internal carotid artery

99
Q

What does the external carotid artery have branches to?

A

the face and neck

100
Q

Are there anastomotic connections between the external and internal carotid?

A

yes!

101
Q

What part of the carotid goes to the cranial cavity?

A

internal carotid

102
Q

Describe the path of the internal carotid

A

runs up to carotid canal makes sharp bend in cavernous sinus and ends in circle of willis.

103
Q

Describe the path of the vertebral artery

A

Comes off of subclavian and goes up from C6 to C1 through transverse foramen and then courses over lamina of C1 and goes into foramen magnum and then goes to basilar then to circle of willis

104
Q

Foramen spinosum and formane ovale are in what bone?

A

sphenoid

105
Q

The foramen of the cartoid canal and jugular foramen come out of what bone?

A

temporal

106
Q

Where does the carotid canal lead to?

A

middle cranial fossa

107
Q

Where does the jugular foramen lead to?

A

posterior cranial fossa

108
Q

The carotid and jugular are very close but (blank) very quickly

A

diverge

109
Q

What passses over the top of the foramen lucerum?

A

the internal carotid artery

110
Q

What is a swelling at the origin of the internal cartoid artery?

A

carotid sinus

111
Q

What is the carotid sinus innervated by?

A

CN 9

112
Q

What is the carotid sinus?

A

a baroreceptor

113
Q

What is a mass of tissue at the bifurcation of the common carotid artery?

A

carotid body

114
Q

What is the carotid body innervated by?

A

CN 9

115
Q

The external carotid has these structure that the internal doesnt.

A

branches

116
Q

Where does all viscerent afferent innervation go in the brainstem?

A

to the caudal part of the solitarious where they ascend to cranial avity

117
Q

If you have carotid sinus and body to detect changes in pressure how come you don’t always have normal pressure?

A

because they adapt and only respond to transience.

118
Q

What is right next to the nucleus solitariuos?

A

DMX

119
Q

What CN does the baroreceptors (carotid sinus) use?

A

In on 9, out on 10

120
Q

The carotid body and sinus utilize reflexes so what nerve and nucleus might they use?

A

vagus via dorsal motor nucleus and some sympathetics and parasympathetics

121
Q

What foramen does the lesser petrosal go through?

A

the foramen ovale

122
Q

The sensory fibers from carotid body and sinus are going into the general visceral efferent nuclei (solitarius) and out on either 10 or (blank)

A

sympathetics

123
Q

What are the branches of the external carotid?

A 
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial Temporal
124
Q

What is interesting about the lingual and facial artery?

A

they sometimes come off the external carotid as a combined lingual facial trunk

125
Q

What is the very first branch off the vagus?

A

the pharyngeal branch

126
Q

What is the second branch off the vagus? WHat does it do?

A

superior laryngeal nerve

gives a branch to the internal portion of the larynx and an external branch going to muscle

127
Q

What should you be worried about during thyroid surgery?

A

recurrent laryngeal of the vagus

128
Q

What are the 2 branches off the superior laryngeal nerve of the vagus?

A

internal branch and external branch

129
Q

What does the internal branch of the superior laryngeal nerve (comes off vagus) do?

A

sensory above the vocal cords

130
Q

What does the external branch of the superior laryngeal nerve (comes off vagus) do?

A

motor to cricothyroid (part of larynx)

131
Q

What does the recurrent laryngeal do?

A

sensory below vocal cords

motor to all other muscles of the larynx (cricothyroid is part of larynx)

132
Q

Where does the recurrent laryngeal recur?

A

around either the subclavian artery or the aortic arch

133
Q

What is worrisome about the course of the recurrent laryngeal?

A

On the left side it has a long course down into the thorax and onto the ligamentum arteriosum which means lung cancer can spread here :(

134
Q

What cranial nerves does the cough reflex use?

A

in on 9, out on 10

135
Q

What cranial nerves does the gag reflex use?

A

in on 9 out on 10

136
Q

What kinds of fibers does vagus have?

A

general sensory, viscerosensory, visceromotor, branchiomotor

137
Q

Where do you find DMX and what does it contain?

A

in mid medulla and contains GVE :)

138
Q

Where do you find the nucleus solitarius?

A

in the medulla next to DMX

139
Q

What does the inferior ganlion of X provide?

A

taste to the epiglottis and motor to the thorax and abdomen

140
Q

What does the superior ganglion of X provide?

A

Sensory to the ear and lower pharynx

141
Q

What do the pregang. parasympathetics go from CN X?

A

to ganglia in heart, thorax, and abdomen

142
Q

What does the nucleus ambiguus do for CN X?

A

it provides motor innervation to the striated muscle of soft palate, pharynx, larynx and upper esophagus

143
Q

Where do they superior thyroid arteries originate from?

Where do they inferior thyroid arteries originate from?

A

external carotid artery

subclavian arteries via the thyrocervical trunk

144
Q

The brachiocephalic artery branches into what 2 things?

A

the right subclavian artery and the common carotid

145
Q

How is the right subclavian artery connected to the carotid?

A

via the thryocervical trunk

146
Q

Where does the vertebral and the inferior thyroid artery come off of?

A

the subclavian artery

147
Q

There is an (blank) between thesuperior and inferior thyroid arteries.

A

anastomoses

148
Q

the superior thyroid vein drains into the (blank)

A

internal juguar vein

149
Q

the middle thyroid vein drains into the (blank)

A

internal jugular vein

150
Q

The inferior thyroid vein drains into the (blank)

A

brachiocephalic vein

151
Q

What is the pyramidal lobe?

A

the weird tongue like projection on the thyroid gland that strangly enough is a remnant of the descent from the tongue

152
Q

A (blank) is an incision made through the skin and cricothyroid membrane to establish a patent airway during certain life-threatening situations, such as airway obstruction by a foreign body, angioedema, or massive facial trauma.

A

cricothyrotomy (coniotomy)

153
Q

(blank) is an incision in the windpipe made to relieve an obstruction to breathing

A

tracheostomy

154
Q

The thyroid gland develops at the base of the (blanK) and can leave remnants in many places.

A

tongue

155
Q

Where are places to find aberrant thyroid tissue?

A 
lingual
intralingual
thyroglossal tract
sublingual
thyroglossal cyst
prelaryngeal
intratracheal
substernal
156
Q

Preganglionic fibers from the sympathetic trunk ascend from the (blank)

A

thorax

157
Q

Where do sympathetics to the head synpase?

A

T1, T2, T3

158
Q

Where do postganglionic sympathetics go?

A

join cervical spinal nerves and travel on blood vessels to the head (like the internal carotid)

159
Q

The preganglionic parasympathetics can synapse in the superior middle and inferior, however depending on where they synapse determines where they go… tell me where they go please

A

superior goes to head

middle and inferior can go to head or neck

160
Q

What does disruption of the sympathetic chain cause (horners syndrome)?

A

ptosis
flushed face
dry face
constricted pupil

161
Q

How can you get horner’s syndrome?

A

cutting sympathetic chain above T1
damage to T1-T3 preganglionic neurons in the lateral horn
damaging outflow to the head that is traveling on internal carotid
damage to input on sympathetic preganglioncs (inside spinal corn)
(i.e can get it in chain, spinal cord, carotid atery, brainstem)

162
Q

What are the branches of the subclavian artery??

A 
Vertebral 
Internal Thoracic
Thyrocervical Trunk
-Inferior thyroid
-Transverse cervical
-Suprascapular
Costocervical

VIT C
T=> ITS

163
Q

What is more anterior, the subclavian vein or artery?

A

subclavian vein (vein is ventral)

164
Q

Where do you find the deepest nodes of the neck and what is especially important about them?

A

find them on the internal jugular and all the superficial nodes will go to the deep nodes before going to the thoracic duct or right lymphatic duct

165
Q

What nodes are within the pericervical collar?

A

occipital, retro-auricular, parotid, buccal, submental, dubmandibular

166
Q

The superifical cervical (post. and ant) nodes drain where?

A

to the internal jugular vein

167
Q

What node is capable of going across the midline and allows for collaterals and thus lymph can travel from one side to the other?

A

submental node

168
Q

Lymph from median part of tongue drains to (blank) and (blank) sides

A

right and left

169
Q

Which are more medial, the submental lymph nodes or the submandibular lymph nodes?

A

the submental lymph nodes

170
Q

WHere doe the deep cervical lymphatics lie?

A

along the course of the internal jugular

171
Q

What are the most clinically significant lymph nodes in the neck?
Why?

A

the supraclavicular

because they can indicate pathology in the head, neck or thoracic cage

172
Q

What are the deep cervical nodes?

A

jugulodigastric node
jugulo-omohyoid node
inferior deep cervical node
transver cervical nodes or supraclavicular nodes

173
Q

What junction does the thoracic duct enter? How does the thoracic duct course in relation to this junction?

A

the junction of the subclavian and internal jugular veins

posterior to it

174
Q

What does the thoracic duct drain into?

A

the left subclavian vein

175
Q

What does the thoracic duct arch over?

A

the arch of the aorta (medial to the branches) around C8

Block 5 Week 3 Dani (12 decks)

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