Anterior Neck Flashcards

1
Q

What is Fascia?

A

Grossly visible connective tissue or sheaths deep to the skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different layers of fascia?

A

Epidermis > Dermis > Superficial Fascia > Deep Fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are 2 terms synonymous with Superficial Fascia?

A

Subcutaneous tissue and Hypodermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What muscle is contained within the hypodermis of the anterior neck?

A

Platysma m.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What nerve innervates the platysma m?

A

Facial n. (CN VII) - cervical br.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What movements is the platysma responsible for?

A

Facial expression, but mainly neck tension. It also has some role in “weak” lower lip and mandible depression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What system is the platysma m. a part of?

A

the Superficial-Musculo-Aponeurotic-System (SMAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 3 main Deep Cervical Fascia layers?

A

Investing Middle Deep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the “Investing” division of Deep Cervical Fascia responsible for?

A

It is the most superficial part of the Deep Cervical Fascia layers and covers the entire neck beneath the superficial fascia layers. (“deep to the skin and superficial cervical fascia”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the two divisions of the Middle Deep Cervical Fascia layer?

A

Muscular - Covers the infrahyoid mm. and is placed more toward the front. (anterior) Visceral - Invests the majority of the organs (viscera) of the neck. (thyroid gland, trachea, esophagus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the name for the subdivision of the visceral layer of the DCF?

A

Buccopharyngeal Fascia Surround muscles of Cheek and Pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 2 divisions of the Deep layer of the DCF?

A

Alar Fascia Prevertebral Fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the space between the Buccopharyngeal fascia and the Prevertebral Fascia?

A

The Retropharyngeal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where is the “danger space” located, and why is it referred to as such?

A

It is the space between the alar fascia and the preverterbral space. It is a potential space for infection to spread from the pharynx to the mediastinum (heart, trachea…).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the boundaries of the anterior cervical triangle?

A

Medial: Midline Lateral: Anterior border of the sternocleidomastoid mm. Superior: Base of the mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 4 subdivided triangles within the anterior cervical triangle?

A

Submandibular triangle Submental Triangle Carotid Triangle Muscular Triangle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the boundaries of the Submandibular Triangle?

A

Inferior: Anterior and posterior of digastric m. Superior: Mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is contained within the Submandibular Triangle?

A

the Submandibular Gland and facial a. and v.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the boundaries of the Submental Triangle?

A

Medial: Midline Lateral: Anterior belly of digastric m. Inferior: Hyoid bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the boundaries of the Carotid triangle?

A

Superior: Posterior belly of digastric m. Lateral: Sternocleidomastoid m. Medial: Superior belly of omohyoid m.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the boundaries of the Muscular Triangle?

A

Medial: midline Inferolateral: SCM Superolateral: Superior belly of omohyoid m.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is contained in the Carotid Triangle?

A

the Carotid sheath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is contained in the Muscular Triangle?

A

the infrahyoid mm., the thyroid gland, and the larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the two major superficial veins of the neck?

A

Anterior jugular vein (AJV) External jugular vein (EJV) - Typically the most obvious superficial vein in neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The EJV Drains into the______.

A

subclavian v.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How is the EJV formed?

A

The external jugular vein is formed when the posterior division of the retromandibular v. joins with the posterior auricular v.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is the AJV formed?

A

By the junction of the superficial submandibular vv.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The AJV drains into the _________ or the __________ often after nestling under the __________.

A

EJV subclavian v. SCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What characteristic does the AJV have that is not common in many veins?

A

it is valveless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Where is the superior attachment of the SCM?

A

Mastoid process and superior nuchal line (pic of mastoid process)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the inferior attachment of the SCM?

A

Sternal attachment (manubrium)

Clavicular attachment (medial third of clavicle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What nerve innervates the SCM?

A

Accessory n. (CN XI)

33
Q

What artery supplies the SCM?

A

the SCM branch of the occipital a.

34
Q

What are the actions of the SCM?

A

it flexes the cervical vertebrae (Bilateral)

and it laterally flexes the neck and tuns the face in the opposite direction

35
Q

The SCM and the trapezius mm. are both ___________ innervated by the ____________ n..

A

Efferently

Accessory n. (CN XI)

36
Q

Where does the afferent supply come from for the SCM and Trapezius mm?

A

Ventral Primary Rami of cervical nerves C2-C4

37
Q

Which cervical nerves afferently innervate the SCM? the Trapezius m.?

A

C2-C3

C3-C4

38
Q

Where is the nerve point typically found on the neck?

A

“Erb’s point” is typically found just superior to the midpoint of the posterior margin of the SCM.

39
Q

What 4 nerve points radiate from the nerve point of the neck?

A

Lesser occipital n. (C2-C3 area)

Great auricular n. (C2-C3 area)

Transverse cervical n. (C2-C3 area)

Supraclavicular n. (C3-C4 area)

40
Q

What 2 groups can the infrahyroid mm. be classified into? What is included in each?

A

Superficial (sternohyoid mm. & omohyoid mm.)

Deep (sternothyroid mm. & thyrohyoid mm.)

41
Q

Give the Sternohyoid’s Origen, Insertion, Innervation, and Action

A

Origen: Manubrium, Medial clavical, and posterior sternoclavicular ligament

Insertion: Inferior body of hyoid

Innervation: Ansa cervicalis

Action: Stabilizes hyoid; may depress an elevated hyoid.

42
Q

Give the omohyoid’s Origen, Insertion, Innervation, and Action

A

Origen: Upper border of scapula

Insertion: Inferior body of hyoid

Innervation: Ansa cervicalis

Action: Stabilizes hyoid; may depress an elevated hyoid

43
Q

What is the inferior belly of the omohyoid connected to?

A

The upper border of the scapula

44
Q

What anchors the intermediate tendon of the omohyoid to the medial clavical?

A

a fascial sling

45
Q

Give the Sternothyroid’s Origen, Insertion, Innervation, and Action

A

Origen: Manubrium

Insertion: oblique line of the thyroid cartilage

Innervation: Ansa cervicalis

Action: Pulls an elevated larynx inferiorly

46
Q

Give the thyrohyoid’s Origen, Insertion, Innervation, and Action

A

Origen: Oblique line of thyroid cartilage

Insertion: Inferior border of hyoid bone

Innervention: C1

Action: pulls the hyoid down; elevates the larynx

47
Q

What is the Ansa Cervicalis? What nerve is located proximally to it?

A

A nerve that innervates the Sternohyoid m., Omohyoid m., and Sternothyroid m.

The Hypoglossal n. is located proximally.

48
Q

REMINDER: Nerves are collections of axons. These axons may use different nevers to get to or from their target site. This is why the fibers of the VPR are able to “hitchhike” along the hypoglossal n. before rejoining the Ansa Cervicalis

A
49
Q

Where do the limbs of the ansa cervicalis lie within?

A

Within the carotid sheath

50
Q

What vertebra do the thyroid glands lie between?

A

C5-T1

51
Q

Nearly ____ of people have an accessory (pyramidal) lobe of the thyroid gland, which varies in size and typically connects the _____________________ to the ________.

A

50% : isthmus of the thyroid gland : hyoid bone

52
Q

The Thyroid gland is what kind of gland?

A

Endocrine (secretes hormones - is ductless)

53
Q

What hormones does the Thyroid gland secrete, and what are they responsible for?

A

Thyroid hormones - they are responsible for metabolism rate; and Calcintonin - important for metabolizing calcium

54
Q

What arteries supply the thyroid glands?

A

the Superior and Inferior thyroid aa.

55
Q

The ___________ is the first branch of the carotid a.

A

Superior thyroid a.

56
Q

Name one of the branches of the superior thyroid a.

A

the superior laryngeal a.

57
Q

The Inferior Thyroid a. is a branch of the _______________ which is a branch of the first part of the _________________.

A

thyrocervical trunk : subclavian a.

58
Q

The thyroid glands typically drain in to 3 sets of veins. They are:

A

the superior thyroid vv. : the middle thyroid vv. : the inferior thyroid vv.

59
Q

the superior thyroid vv. and the middle thyroid vv. drain into the _________.

A

internal jugular vv.

60
Q

the inferior thyroid vv. drain into the _________________.

A

L. brachiocelphalic vv.

61
Q

How many parathyroid glands are there? (typically)

A

4 - a superior and inferior pair (may be more or fewer)

62
Q

The parathyroid glands are typically supplied by the _______________, but may be supplied by _________________.

A

inferior thyroid aa. : either set of thyroid aa.

63
Q

The parathyroid glands are ____________ glands and produce ____________.

A

endocrine ; parathyroid hormone (PTH)

64
Q

What structures pass through the jugular foramen?

A

IJV, Glossopharyngeal n. (CN IX), Vagus n. (CN X), Accessory n. (CN XI)

65
Q

What is invested by the Visceral layer of the Middle DCF?

A

The thyroid gland, trachea, and esophagus

66
Q

What is on the anterior and posterior borders of the alar fascia?

A

Anterior: Buccopharyngeal fascia

Posterior: Prevertebral fascia

67
Q

Are cutaneous nerves afferent or efferent?

A

Afferent (cutaneous – skin)

68
Q

What cervical branch contribute to these nerves: Lesser occipital, great auricular, transverse cervical, supraclavicular?

A

C2 .

C2 C3 .

C2 C3 .

C3 C4 .

69
Q

What cervical nerves serve the superior root of the ansa cervicalis? Inferior root?

A

C1 (not both even though says on slide)

C2 C3

70
Q

What innervates the thyrohyoid?

A

C1

71
Q

What is invested by the carotid sheath?

A

Common and internal carotid aa.

IJV

Vagus n (CN X)

Deep cervical lymph nodes

72
Q

What is the first branch of the exterior carotid artery?

A

Superior thyroid a.

73
Q

What a. does the superior thyroid a. have as a branch?

A

Superior laryngeal a.

74
Q

What is the recurrent laryngeal n. a branch of?

A

Vagus (CN X)

75
Q

Is the recurrent laryngeal afferent or efferent?

A

Both

76
Q

What divides the superior and inferior deep cervical lymph nodes?

A

Omohyoid

77
Q

What artery does 10% of the population have laying overtop of their trachea?

A

Thyroid ima a.

78
Q

What is an enlargement of the thyroid glands referred to as?

A

A goiter