Anterior Neck Flashcards
Which cartilages inferior to the hyoid bone are “true rings” and which are “V-shaped”?
- Thyroid cartilage: V-shaped
- Cricoid cartilage: True ring
What are the borders of the anterior triangle of the neck?
- Anterior: anterior median line
- Posterior: SCM
- Superior: inferior border of mandible
- Apex: jugular notch
- Roof: Sub-Q fascia & platysma
- Floor: pharynx, larynx, thyroid gland (covered by pretrachial fascia)
Mylohyoid m: OIIA?
Suprahyoid
Origin: mylohyoid line of mandible
Insertion: Medial raphe and body of mandible
Innervation: Nerve to the mylyhyoid of V3 (also innervates ant belly of digastric)
Action: Elevates hyoid bone, base of tongue, floor of mouth; depresses mandible
Digastric m: OIIA?
Suprahyoid
Origin: Ant-digastric fossa of mandible; post-mastoid notch of temporal bone
Insertion: Intermediate tendon attached to body of hyoid
Innervation: Ant-nerve to mylohyoid (CN V3); post-Facial n. (CN VII)
Action: Stablizes, raises, anterior movement (ant belly) and posterior movement (post belly) of the hyoid
Geniohyoid m: OIIA?
Suprahyoid
Origin: Genial tubercle of mandible
Insertion: Hyoid bone (deep to mylohyoid)
Innervation: Nerve to geniohyoid (C1, runs w/hypoglossal CN XII)
Action: Raises hyoid bone, depresses mandible
Stylohyoid m: OIIA?
Suprahyoid
Origin: Styloid process
Insertion: Hyoid bone
Innervation: Facial n. (CN VII)
Action: Elevates hyoid b. and base of tongue
Sternohyoid m: OIIA?
Infrahyoid
Origin: Posterior aspect of manubrium (of sternum)
Insertion: Hyoid
Innervation: Ansa cervicalis (C1-C3)
Action: Depresses larynx and hyoid bone, steadies hyoid bone (during vocalization & depression of mandible)
Sternothyroid m: OIIA?
Infrahyoid
Origin: Manubrium (posterior to sternohyoid)
Insertion: Thyroid cartilage (oblique line)
Innervation: Ansa cervicalis (C1-C3)
Action: Depresses larynx and thyroid cartilage (stabilizes it during vocalization and depression of mandible)
Thyrohyoid m: OIIA?
Infrahyoid
Origin: Thyroid cartilage (oblique line)
Insertion: Hyoid bone
Innervation: Nerve to the thyrohyoid (C1, travels w/hypoglossal CN XII)
Action: Depresses larynx and hyoid bone, elevates thyroid cartilage (stabilizes both during vocalization)
Omohyoid m: OIIA? (sup and inf bellies)
Infrahyoid
Origin: Superior border of scapula (near scapular notch)
Insertion: Hyoid bone (jcn of body and greater horn)
Innervation: Innervation: Ansa cervicalis (C1-C3)
Action: Depresses hyoid bone and may stabilize it from below
What 2 mm. appear as 1 going from the manubrium to the hyoid b. but actually start and stop at the thyroid cartilage?
Sternothyroid m. –> Thyrohyoid m.
different innervations
The hyoid bone aids mainly in what 3 actions?
Tongue movement, vocalization, swallowing
During swallowing, infrahyoid mm. ___________ while suprahyoid mm. ___________.
Relax (infrahyoids); Contract (suprahyoids)
What are the 5 major contents of the submandibular triangle?
Submandibular gland Submandibular lymph nodes Mylohyoid n. (V3) Facial a. Lingual n. (can't see it) Hypoglossal n. (CN XII)
What are the 3 branches of the aortic arch?
BCS
- Brachiocephalic Trunk
- Left Common Carotid a.
- Left Subclavian a.
What does the brachiocephalic trunk branch into?
Right common carotid a. and right subclavian a.
The common carotid a. divides into:
Internal and external carotid aa. (enters skull via carotid foramen)
Which major a. is responsible for supplying the face and neck, both superficial and deep?
External carotid a.
Recall: what 3 things are in the carotid sheath?
Vagus n.
IJV
Common carotid a.
Name the branches of the external carotid a:
SALFOP Super-T Max
- Superior thyroid a.
- Ascending pharyngeal a.
- Lingual a.
- Facial a.
- Occipital a.
- Posterior auricular a.
- Superficial temporal a. (gives off transverse facial a.)
- Maxillary a.
(not sure about this image)
What runs next to the vagus n. to provide a type of innervation about the external carotid a.?
Sympathetic trunk (from cervical ganglia)
What m. divides the subclavian a. into 3 sections?
Anterior scalene m.
Vertebral a. runs through what part of the vertebrae?
Foramen transversarium
Subclavian v. runs behind __________ and in front of the ___________.
Clavicle; anterior scalene
Subclavian a. and brachial plexus run b/w _______ & ________.
Anterior scalene and middle scalene.
Important structures near the superior thoracic apertures include: (Don’t memorize)
- Thoracic duct
- Vagus n.
- Phrenic n.
- Sympathetic chain
- Recurrent laryngeal n.
- Subclavian aa. and vv. (and their branches)
- Common carotid aa.
- Apices of lt and rt lungs (and their pleura)
What 5 branches does the vagus n. give off in the neck? (Which 2 are most important?)
- Pharyngeal branch (motor)
- Superior laryngeal n.
- N. to the carotid body (sensory)
- Cardiac nerves (parasympathetic)
- Recurrent laryngeal n.
(2 & 5 most important)
What are the 2 branches of the superior laryngeal n (branch of vagus n)?
- Internal laryngeal n.–*pierces thyrohyid membrane; sensory to larnyx above true vocal folds
- External laryngeal n.–supplies cricothyroid m. (motor)
What are the 2 branches of the recurrent laryngeal n (branch of vagus n)?
- Right recurrent laryngeal n.–loops around the subclavian a. (ant –> post), runs in tracho-esophageal groove, provides motor to all vocalization mm. except cricothyroid (external laryngeal n. does that)
- Left recurrent laryngeal n.–wraps around aortic arch
What are the usual 3 cervical sympathetic ganglion in the T and L spinal cord? (numbers may vary)
- *Superior (C1-C4)
- Middle (C5-C6)-may be absent
- Inferior (C7-C8)
What is important about the superior cervical sympathetic ganglion?
- C1-C4; Very large
- Supplies structures of the head via internal carotid plexus and also supplies the superior cardiac nerves (which participates in the cardiac plexus of nerves)
Interruption in the sympathetic ganglion chain in the neck can result in what syndrome?
Horner’s syndrome
What is the name for a possible branch of the middle cervical sympathetic ganglion that passes around the subclavian a. and runs to the inferior ganglion?
Ansa subclavia
The inferior cervical sympathetic ganglion frequently fuses with the first thoracic ganglion to form what?
Stellate (Cervicothoracic) ganglion
The right arm, right upper thorax, and right head drain to what duct?
Right lymphatic duct
All of the body except the right arm, right upper thorax, and right head (all of the left side and lower right) drain to what duct?
Thoracic duct
The pleura of the lung where it extends about an inch above the clavicle is called the cervical pleura or ________?
Cupula
The area b/w the 2 lobes of the thyroid gland is called the ____________.
Isthmus
The lobes of the thyroid gland are called _________ ______.
Pyramidal lobes
Parathyroid glands regulate ____. How many glands are typically found? What side of thyroid?
Ca2+
4 glands
Posterior side of thyroid gland
What 4 mm. located deep to the prevertebral layer of cervical fascia assist in flexion of the head/neck?
(Anterior group)
Longus coli
Longus capitis
Rectus capitis anterior
Anterior scalene
What 4 mm. located deep to the prevertebral layer of cervical fascia assist in flexion of the head/neck?
(Lateral group)
Rectus capitis lateralis
Splenius capitis
Levator scapulae
Middle & posterior scalenes
From this lecture, which mm. have their own n. that runs specifically to them?
Mylohyoid (off V3, also to ant digastric), geniohyoid (off C1, running w/XII), thyrohyoid (off C1, running w/XII)
What innervates splenius capitis m.? Action?
- C3/C4
- Extends, rotates cervical spine
