Anterior Neck And Visceral Organs Flashcards
Neck boundaries
Superior: inferior border of the mandible and C1
Inferior: transverse plane from manubrium to C7 spinous process, laterally to acromium
*weakest part of the body
Hyoid parts
Body, greater, and lesser horn
Thyroid cartilage
Shape: half ring
Landmarks:
1. Sup/inf notch
2. Oblique line
3. Sup/inf horn
4. Lamina: 90~120°
5. Laryngeal prominence (Adam’s Apple)
Cricoid cartilage
Shape: ring
- posterior wall is higher than the anterior wall
Landmarks:
- superior facet for the arytenoid
- inferior facet for the thyroid cartilage inferior horn
Arytenoid
Shape: pyramid
Apex and vocal process
Base articulates with superior facet on cricoid
Corniculate
Hat for arytenoid cartilage
Cuneiform
Found in the fold of epiglottis
Epiglottis
Elastic cartilage “leaf-like” structure
Depression: swallowing reflex
Elevation: breathing and speaking
Larynx
Function: speaking
Assembly:
- inferior articular facets of the thyroid attach to cricoid cartilage
- arytenoid articulates with cricoid
Facial compartments
Superficial fascia: platysma
Investing fascia
Visceral fascia
Carotid sheath
Vertebral fascia
Facial function
Protects structures and contains infection
Allows free motion of the neck during swallowing and turning
Fascia fusion
Neighboring fascia merge to form ligaments
M
Cervical plexus
All ventral rami of the spinal nerves
C1 to geniohyoid and there hyoid muscles through hypoglossal nerve (cn 12)
Anna cervicalis
Motor
Cervical plexus: cutaneous division
Lesser occipital nerve(C2)
Greater auricular nerve (C2-C3)
Transverse cervical nerve (C2-C3)
Supraclavicular nerve (C3 - C4)
Nerve point: cervical plexus
Exiting ~ 1/3 - 1/2
Subclavian artery branches
Thyrocervical trunk → inferior thyroid artery
Costocervical trunk → posterior intercostal arteries 1 and 2
External carotid artery branches: posterior
Ascending
External carotid artery branches: anterior
Superior
Terminal
Anterior neck veins
*Huge variations, not symmetric along the neck
1. Superficial vein → Internal jugular vein
2. External jugular vein →
Lymph drainage
25% to the r subclavian vein and Internal jugular vein “angle”
75% to the L subclavian vein and Internal jugular vein “angle”
Platysma muscle
P: inferior mandible border skin and subcutaneous tissue of the face
D: pectoralis major
Sternocleidomastoid (SCM)
P: manubrium and proximal clavicle
D: mastoid process and superior nuchal line
I: CN XI
B: occipital and superior thyroid arteries
A: FLX (B), ipsilateral sb/ contralateral Rot., ELE Thorax and shoulder
** unilateral impairment results to torticollis: tightness of the some side or weakness of contralateral side
Suprahyoid muscles
Stylohyoid, digastric, mylohyoid, and geniohyoid
Stylohyoid
P: styled process
D: hyoid body
I: CN VII
B: superior thyroid artery and lingual artery
A: hyoid elevation
Digastric
P: posterior belly-
anterior belly
Mylohyoid muscle
P: mylohyoid line of Hu mandible
D: hyoid body and median raphe
Geniohyoid
P: mandibular inferior mental spire
D: anterior hyoid body
I: C1 hiking through the CN 12
Infrahyoid muscles
Sternohyoid, sternothyroid, omohyoid, and thyrohyoid
Sternohyoid muscle
P: posterior menubrium clavicle, and sternoclavicular ligament
Sternothyroid muscle
Omohyoid
P: inferior border of the hyoid body
D: suprascapular notch
I: Anna cericalis
B: Lingual artery
Thyrohyoid muscle
P: oblique line of the thyroid cartilage
D:
Anterior scalene
- Same direction as SCM
P: anterior tubers of tu transverse process of C3 - C6
D: scalene tubercle of the 1st rib
Middle scalene
P: Posterior tubercle of transverse process of C2-C7
D:
Posterior scalene
P: posterior tubercle of transverse process C5 -C7
Thoracic outlet syndrome
Vertebral fascia compartment
Longus capitis
Carotid sheath boundary
Base of skull to 1st rib/sternum
Carotid sheath contents
Different at different levels
Important for
Carotid sheath contents
Different at different levels
Important for
Cervical sympathetic ganglia
Thyroid
Left and right lobes, occasional pyramidal lobe
Endocrine organ: thyroid hormone - regulating metabolism
Hyperthyroidism and hypothyroidism
Hyper - thin and hot
Hypo - fat and cold
Parathyroid glands
Sup/int glands in each lobe of thyroid gland
Function: regulating calcium levels in blood.
Thyroid/parathyroid blood support
Arteries
1. Inferior thyroid artery
Thyroid/parathyroid visceral innervation
Sensory: superior laryngeal nerve (CN x, myelinated)
Motor: unmyelinated, postganglianic axons
- sympathetic: middle
- parasympathetic:
Larynx functions
Respiration and speech
Larynx muscles: extrinsic
Supra- and infra- hyoid/ thyroid muscles : C1 and ansa cervicalis branches
Larynx muscles: intrinsic
Muscles are covered by a mucosal surface to create the vocal folds
All innervated by the recurrent laryngeal nerve (CN X)
Open and close quickly; lengthening and changing the tension of the vocal folds
Folding epiglottis to close larynx when swallowing
Trachea
Larynx and trachea neurovascular
Arteries: inf/ sup thyroid artery
Vein: inf/ sup laryngeal vein
Innervation:
Pharynx. Boundaries
Base of skull to inferior border of the cricoid, surround
Pharynx: extrinsic muscles
Pharyngeal raphe: merge of i
Pharynx: intrinsic muscles
Palatopharyngeus (cnx)
Salpingopharyngeus
Stylopharyngeus (CN IX)
Pharynx innervation
Motor:
- somatic
- visceral
Sensory:
- somatic
- visceral
Gag reflex
Vomiting
Esophagus
Continuous to pharynx: infe
