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Cranio Exam 3 > anterior cervical region of the neck > Flashcards

anterior cervical region of the neck Flashcards

1
Q

surface landmarks of the neck

A 
mandible
hyoid bone
thyroid and cricoid cartilage
suprasternal/jugular notch
clavicle and first rib
cervical vertebrae
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2
Q

4 layers of neck fascia

A
  1. investing layer–encloses superficial muscles and roof of neck triangles, extends from mandible to clavicle and sternum
  2. pretracheal layer–encloses thyroid, trachea, pharynx, esophagus
  3. prevertebral layer–encloses vertebral column and assoc muscles, also brachial plexus and axillary vessels
  4. carotid sheath–encloses common carotid and its branches, internal jugular vein, CN X, deep cervical nodes
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3
Q

what bisects the neck into anterior and posterior triangles?

A

sternocleidomastoid

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4
Q

boundaries of anterior cervical triangle

A

anterior edge of SCM
lower border of mandible body
midline of neck from chin to suprasternal notch

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5
Q

4 triangles of anterior cervical triangle

A
  1. submandibular (digastric)
  2. carotid
  3. submental
  4. muscular
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6
Q

submandibular triangle

A

body of the mandible and anterior and posterior bellies of digastric muscle (submandibular gland, CN XII, facial artery and vein, submandibular lymph nodes)

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7
Q

carotid triangle

A

upper anterior edge of SCM, posterior belly of digastric, superior belly of omohyoid (common carotid and branches, internal jugular vein, X, XI, XII)

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8
Q

submental triangle

A

unpaired, midline of neck, hyoid, anterior belly of both digastric muscles (sublingual gland, anterior jugular veins, submental lymph nodes)

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9
Q

muscular triangle

A

midline of neck, anterior edge superior belly omohyoid, anterior lower SCM (infrahyoid muscles, ansa cervicalis superficially and thyroid gland and viscera are deep)

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10
Q

function of infrahyoid muscles

A

lower the larynx and hyoid bone and fix the hyoid for stable movement of tongue

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11
Q

infrahyoid muscles

A

sternohyoid
omohyoid
sternothyroid
thyrohyoid

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12
Q

sternohyoid

A

between sternum and hyoid

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13
Q

omohyoid

A

from superior border of scapula to hyoid with superior and inferior bellies

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14
Q

sternothyroid

A

deep to the omohyoid from sternum to thyroid cartilage

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15
Q

thyrohyoid

A

deep from thyroid cartilage to hyoid

supplied by C1 via CN XII

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16
Q

which muscles are innervated by the ansa cervicalis originating from the cervical plexus?

A

sternohyoid
omohyoid
sternothryoid

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17
Q

roots of ansa cervicalis

A

anterior/superior (descendens hypoglossi)

posterior/inferior (descendens cervicalis)

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18
Q

the anterior root of the ansa cervicalis is associated with which cranial nerve?

A

CN XII by a common connective tissue sheath

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19
Q

how does the anterior root of the ansa cervicalis join the posterior?

A

it descends on the anteromedial aspect of the internal jugular and joins the posterior root forming a loop around the internal jugular

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20
Q

how do the motor branches from the ansa cervicalis enter the strap muscles?

A

caudally (surgical reflection should be done in a cranial to caudal direction)

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21
Q

suprahyoid muscles

A
  • muscles attached to hyoid bone
  • anterior and posterior bellies of digastric
  • stylohyoid
  • mylohyoid
  • geniohyoid
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22
Q

how are the suprahyoid muscles innervated?

A

by cranial nerves, not the nerves of the cervical plexus

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23
Q

anterior and posterior bellies of digastric

A

separated by a tendon that attaches to the hyoid bone.

  • origin from mastoid process to hyoid bone to mandible for insertion
  • posterior belly supplied by CN VII
  • anterior belly supplied by CN V
24
Q

stylohyoid

A

origin from styloid process splits around tendon of digastric muscle to attach to hyoid
-supplied by CN VII

25
Q

mylohyoid

A

arises from inside body of mandible

  • forms floor of the digastric triangle and attaching to hyoid
  • supplied by CN V
26
Q

geniohyoid

A

arises from inferior mental spine of mandible and inserts on body of hyoid bone supplied by C1 via CN XII

27
Q

carotid sheath

A

neurovascular envelope that extends from base of skull to root of neck

28
Q

common carotid artery

A

-bifurcates into internal and external at angle of mandible

29
Q

carotid sinus

A

small dilation at bifurcation of internal carotid

-baroreceptor area

30
Q

carotid body

A

area of common carotid that has chemoreceptors to monitor O2/CO2 levels in blood

31
Q

carotid sinus and body are innervated by?

A

Hering’s nerve, a branch of the glossopharyngeal nerve

32
Q

branches of external carotid

A 
superior thyroid
ascending pharyngeal
lingual 
facial 
occipital
posterior auricular
33
Q

superior thyroid

A
  • descends toward the thyroid gland and gives off the superior laryngeal artery that pierces the thyrohyoid membrane to supply the vestibular part of the larynx (with internal laryngeal nerve of superior laryngeal nerve of X)
  • parent superior thyroid artery descends further to thyroid gland with external laryngeal nerve of superior laryngeal nerve of X
34
Q

ascending pharyngeal

A
  • small

- arises from deep surface of external carotid and courses cranially on posterolateral wall of pharynx

35
Q

lingual artery

A

arises anteriorly at level of hyoid
ascends and courses partly with hypoglossal nerve
-at lateral border of hyoglossus muscle the artery passes deep and the XII nerve superficial to hyoglossus muscle

36
Q

facial artery

A

may arise from common trunk with lingual
ascends deep to stylohyoid and digastric muscle and submandibular gland to inferior border of mandible to the face (terminates as the angular artery)

37
Q

occipital artery

A
  • arises posteriorly opposite of facial artery
  • ascends deep to posterior belly of digastric
  • gives branch to SCM and then reaches posterior aspect of scalp with greater occipital nerve (DPR of C2)
38
Q

posterior auricular artery

A

small branch arising posteriorly to distribute behind ear

39
Q

two terminal branches of external carotid

A

superficial temporal

maxillary arteries

40
Q

internal jugular vein

A

-continuation of sigmoid sinus
-exits skull via jugular foramen
-most superficial structure of carotid sheath
-

41
Q

what drains into the internal jugular?

A

facial and anterior division of retromandibular vein

42
Q

there is no _____ artery but there is a ____ vein

A

middle thyroid

43
Q

brachiocephalic vein is made by?

A

at base of neck the internal jugular and subclavian unite to form it

44
Q

vagus nerve

A

-exits skull thru jugular foramen to come behind and between internal carotid and internal jugular

45
Q

what arises from vagus and divides into internal and external branches?

A

superior laryngeal branch

46
Q

internal branch of vagus

A

sensory to larynx above vocal folds

47
Q

external branch of vagus

A

motor to cricothyroid and circopharyngeus muscles

48
Q

what supplies all the intrinsic muscles of the larynx except the cricothyroid and cricopharyngeus?

A

vagus

49
Q

location of cervical sympathetic trunk

A

lie deep and medial to carotid sheath on prevertebral fascia related to the anterior surfaces of the bodies of cervical vertebrae

50
Q

superior cervical ganglion

A
  • large
  • associated with first 2 vertebrae
  • gray rami communicate with upper four cervical nerves
  • many branches to internal and external carotids for distribution to various structures in the head
51
Q

middle cervical ganglion

A
  • at level of CV 6
  • gray rami communicate with VPR C5, 6
  • communicates with inferior ganglion by fibers that pass behind the subclavian artery and fibers that pass in front and loop below the artery (ansa subclavia)
52
Q

inferior cervical ganglion

A
  • fused to the first thoracic ganglion forming the stellate ganglion
  • lies on neck of the first rib near the origin of the vertebral artery
  • sends gray rami to VPR’s C7, 8
  • sends white rami to VPR T1
  • gives rise to thoracic visceral nerve to cardiac plexus
53
Q

thyroid gland

A
  • butterfly
  • visceral neck
  • 2 lobes connected by an isthmus just below the cricoid cartilage
  • isthmus may demonstrate a pyramidal lobe extending cranially
54
Q

thyroglossal duct

A

extension of pyramidal lobe with embryologic origin

-seen at foramen cecum at midline of tongue

55
Q

parathyroid glands

A
  • deeper surface of thyroid
  • darker
  • small bean size
56
Q

anatomical differences between two sides of neck

A
  • left recurrent laryngeal hooks about the aortic arch and arises in thorax and right around the right subclav
  • right subclav and common carotid arise from brochiocephalic and on the left they arise from aortic arch
57
Q

clinical correlations

A
  • torticollis
  • subclavian vein puncture
  • corotid pulse and endarterectomy
  • role of carotid sinus and body
  • cricothyroidotomy and tracheostomy
  • thyroglossal cyst

Cranio Exam 3 (9 decks)

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