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Anatomy BDS3 > Anterior Traingle > Flashcards

Anterior Traingle Flashcards

1
Q

What are the borders of the anterior triangle of the neck

A

Superiorly - inferior border of the mandible
Postioerly - anterior border of SCM
Anteriorly - midline of neck

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2
Q

What are the 4 subdivisions of the anterior triangle

A

Submental, Submandibular, carotid and muscular

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3
Q

What does the submandibular division of the anterior neck consist of

A

Submandibular gland, lymph nodes, parts of hypoglossal nerve, mylohyoid nerve and parts of facial artery and vein

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4
Q

What does the submental region of the anterior triangle contain

A

Submental lymph nodes and some small veins

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5
Q

What does the carotid part of the anterior triangle contain

A

Thyroid gland, larynx, pharnyx ; carotid sheath ( and its components), branches of the cervical plexuses, super root of asna cervical is and parts of CN11 and 12

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6
Q

What does the muscular region of the anterior triangle contain

A

Sternohyoid and sternothryoid muscles and thyroid and para thyroid glands

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7
Q

Name the 4 suprahyoid muscles
( connect to skull or mandible and hyoid )

A

Mylohyoid, Diagastric( anterior and posterior ) , stylohyoid and geniohyoid.

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8
Q

Name the 4 infrahyoid muscles
( connect to inferior structure and the hyoid bone - with one exempt)

A

Sternothyroid, omohyoid, sternohyoid and thryohyoid

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9
Q

What is the function of the suprahyoid muscles

A

They function to elevate the hyoid during swallowing and the larynx for tone production.

They constitute substance of the floor of mouth

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10
Q

Mylohyoid muscle origin

A

Originates at the mylohyoid line on the mandible

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11
Q

Where does the mylohyoid muscle insert

A

Into the body of the hyoid and the fibres of the opposite mylohyoid

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12
Q

Action of mylohyoid

A

Elevates the hyoid and the floor of the mouth and reinforces the floor of the oral cavity

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13
Q

Where are the origins of the anterior and posterior diagastric belly

A

Anterior - diagastric fossa on medial surface of the mandible
Posterior -mastoid notch on medial side of mastoid process

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14
Q

Where is the insertion of both the diagastric muscles

A

The intermediate tendon at the hyoid

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15
Q

What other function does the anterior belly have that the other suprahyoid muscles do not

A

Anterior belly functions to open the mouth by lowering the mandible

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16
Q

What is the innervation of the mylohyoid muscle

A

The nerve to mylohyoid which is a branch of IAN which is a branch of CNV3

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17
Q

Diagastric Muscles innervation

A

Anterior belly =nerve to mylohyoid

Posterior belly = diagastric branch of CN7

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18
Q

Origin, insertion, Action and innervation of stylohyoid

A

Originates at styloid process

Inserts - body of hyoid.

Action - pulls hyoid upwards

Innervation - CN7

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19
Q

Origin, insertion, action, innervation Geniohyoid

A

Origin - from mandible

Inserts - body of hyoid

Action - fixed mandible= elevates and pulls hyoid forward
- fixed hyoid =. Pulls mandible downwards and inwards

Innervation = via anterior ramus of C1 which travels with Hypoglossal Nerve

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20
Q

Origin, insertion and action of sternohyoid muscle

A

Origin - posterior surface of the sternoclavivular joint and manubrium

Inserts - into body of hyoid

Action- depresses hyoid after elevation during swallowing

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21
Q

What is the group function of the infra-hyoid muscles

A

They function as a group to depress the hyoid and larynx during swallowing and speech

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22
Q

Discuss the two planes of the infrahyoid muscles

A

Superficial = sternohyoid and omohyoid

Deep = thyrohyoid and sternothyroid

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23
Q

What are the two bellies of omohyoid connected by

A

The superior and inferior bellies of the omohyoid are connected by an intermediate tendon

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24
Q

Origins, instertion and action of omohyoid muscle

A

Origins; Superior belly -immediate tendon
inferior belly -superior border of the scapula

Inserts ; Superior belly - Hyoid bone
Inferior belly - intermidaite tendon in posterior triangle
Action - depresses and fixes the hyoid

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25
Q

How is the omohyoid anchored to its immediate tendon at the Clavicle

A

By a facial sling

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26
Q

Thyrohyoid orgin insertion and action

A

Origin- oblique line on thyroid cartilage

Inserts - greater horn and adjacent Body of hyoid

Action - depresses hyoid ; can raise larynx when hyoid is fixed

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27
Q

Sternothyroid origin, action and insertion

A

Origin - at posterior surface of manubrium

Inserts - into oblique line on thyroid cartilage

Action - draws Larnyx downward

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28
Q

What is the innvervation of sternohyoid, omohyoid and sternothyroid

A

Anterior rami of C1-C3 ( through the ansa cerviaclis )

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29
Q

Thryrohyoid innervation

A

Anterior rami of C1 but the fibres run with CN12

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30
Q

The two lateral lobes of the thyroid gland extend from?

A

Thyroid cartilage to 5th tracheal ring

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31
Q

What is the level of the isthmus

A

Level of 3rd tracheal ring

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32
Q

The pyramidal lobe is on the thyroid gland is present in 80% of people - what is this the remenants of ?

A

Thyroglossal duct

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33
Q

What is the arterial supply of the thyroid gland

A

Superior thyroid artery ( 1st branch of external carotid)

Inferior thyroid artery ( branch of thyrocervical trunk from subclavian )

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34
Q

Discuss venous drainage of the thyroid gland

A

Drained through the thyroid Venous plexus ;

Superior thyroid and middle thyroid vein into the internal jugular vein

The inferior thyroid vein into the brachiocephalic

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35
Q

In 10% of people there is an additional artery which supplies the thyroid , apart from the superior and inferior thyroid arteries, what is this

A

The thyroid IMA artery

Unpaired artery which usually arises from brachiocephalic trunk but can come from elsewhere

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36
Q

Why must the thyroid IMA artery be considered clinically

A

In midline neck procedures like an insertion of a surgical airway ( tracheostomy) as it is a potential bleeding risk

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37
Q

Where are the two pairs of parathyroid glands MOST COMMONLY present ( position can vary)

A

On posterior surface of the thyroid

38
Q

What is the arterial supply of the parathyroid arteries

A

Inferior thyroid arteries

39
Q

What is the nerve innervation of both the thyroid and parathyroid glands?

A

They are both innervated by the thyroid branches from the cervical ( sympathetic) ganglia

Vasomotor fibres - cause blood vessel constriction

40
Q

What are some implications of neck surgery surrounding the recurrent laryngeal nerves

A

The right reccrurent laryngeal nerve has a close relationship to the inferior thyroid artery and therefore during surgery there is a risk of damage

Left one carries less risk

41
Q

If there has been injury to the recurrent laryngeal nerve or potential post surgical blood/exudate accumulation , how would this present

A

Hoarseness, temporary aphonia ( disturbance of voice production)

42
Q

What are the two types of emergency and surgical airway procedures

A

Cricothyrotomy and Tracheostomy

43
Q

What is a cricothryotomy

A

It is an emergency procedure, when a large bore needle is passsed through the cricothyroid ligament; this may be replaced by a small tracheostomy tube

44
Q

What is a tracheostomy

A

More complex of surgical airway procedures

Involves retraction of infrahyoid muslces and incision of isthmus of thyroid to insert tube between second and first or second and fourth tracheal rings to insert tracheostomy tube

45
Q

Why is there more of a risk in children and neonates when carry out surgical airway procedures

A

In these groups the trachea is very soft and surgical procedures may carry a risk of damage to oesphagous which lies deep to trachea

46
Q

What does the carotid sheath contain

A

The vagus nerve, the carotid arteries ( internal and part of external ) and the internal. Jugular vein

The Ansa cervicalis usually lies on ( or is embedded in) the anterolateral aspect of the sheath

47
Q

Where does the carotid sheath run from

A

From foramen of carotid Canal to the aortic arch

48
Q

Where do the left and right Common carotid arteries come from?

A

Right common carotid artery is a branch of the brachiocephalic trunk

Left common carotid artery is a DIRECT branch from the arch of the aorta

49
Q

At what level do the Common carotid arteries branch

A

Branch at the level of C3/C4 into internal and external carotid

50
Q

The internal carotid artery supplies what

A

THE BRAIN

The internal carotid artery has no branches in the neck and ascends to carotid canal to supply the brain

51
Q

What is the carotid sinus

A

It is an enlargement at the bifurcation of the common carotid artery which contains baroreceptors and pressoreceptors in the wall of internal carotid artery

52
Q

What is the carotid sinus function?

A

It is important for monitoring blood pressure.
The baroreceptors are sensitive to stretch when the bP increases and they note it and report to CN9

CN9 then carries it to the medulla and brain stem to return BP to normal homeostatic values

53
Q

What is the carotid sinus inverted by

A

Innvervated by CN9 via carotid sinus nerve and CN10

Action potentials travel from the baroreptors through CN9 to the cardioregulatory system and vasometers in the medulla

54
Q

What is the carotid body

A

Small organ which houses chemoreceptors location at bifurcation of CCA near the carotid sinus

55
Q

What is the function of the carotid body

A

It has chemoreceptors and it is important in monitoring the blood 02,C02, ph and temperature.

Stimulated by low blood 02 levels and initiates a reflex
in emergency situations by increasing respiration, blood pressure and cardiac rate

56
Q

What is the innervation of the carotid body

A

Innverated by CN9 via the carotid sinus nerve and CN10

Afferent fibres from the carotid body travel into the cardioregulatory and vasomotor centres in the medulla

57
Q

What does the external carotid artery supply

A

Most structures external to the cranium

58
Q

Which structures are the expection to being supplied by the ECA and what instead are they supplied by

A

The orbit and part of the forehead and the scalp and supplied by the supra-orbital artery

59
Q

Where does the middle menigeal artery branch from and how does it enter the cranium

A

The middle meningeal artery is a branch of the maxillary artery which is a terminal branch of ECA

60
Q

Where does the ECA terminate and what happens there

A

The ECA terminates and it is there that it gives off its last 2 branches the terminal branches - maxillary artery and superficial temporal artery

61
Q

What are the 8 branches of the ECA

A

Some Anatomists Like Freaking Out Poor Medical Students

Superficial Thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal

62
Q

ECA - superior thyroid supply

A

Thyroid , muslces of larnyx and muscles of neck

63
Q

ECA - Ascending pharyngeal Supply

A

Pharynx, palatine tonsils, dura mater, CN12,9 and 10

64
Q

ECA - lingual artery supply

A

Tongue, salivary glands, soft palate, palatine tonsils and muslces attached to hyoid bone

65
Q

ECA. - facial artery supply

A

Muscle of the face, cervical lymph nodes, palatine tonsils, lips and part of nose

66
Q

ECA - occipital artery supply

A

Dura matter, the auricle, the SCM and deep posterior muscles of the back

67
Q

ECA - Posterior auricular artery

A

Facial nerve , tympanic membrane and external auditory measutus

68
Q

ECA - maxillary artery

A

Tympanic membrane. External ear, the mandible,the maxilla,the cal aria the dura mater, the nasal septum and many muslces of face

69
Q

ECA- superficial temporal artery

A

Muslces and skin of face and scalp

70
Q

What does the internal jugular vein drain?

A

The brain, skull and part of face and neck

71
Q

What is the internal jugular vein a continuation of?

A

Sigmoid sinus

Venous drainage in posterior cranial fossa

72
Q

How does the internal jugular vein exit the skull and where does it enter

A

Exits skull via the jugular foramen and then enters the carotid sheath

Runs lateral to CCA

73
Q

Which veins drain into the internal jugular vein?

A

Parallel to branches of ECA and thyroid vessels

74
Q

What is the superior bulb of the internal jugular vein

A

The internal jugular vein is continuous with the sigmoid sinus however its ORIGIN is demarcated by the superior bulb.

At this superior bulb the inferior pectoral sinus enters

75
Q

What is the small dilation before the internal jugular veins termination before joining subclavian vein called?

A

Inferior bulb and this bulb has bicuspid valves here to prevent backflow into the vein ( if say standing on head) whilst permitting blood flow to The heart

76
Q

Which infrahyoid muscle runs across the internal jugular vein?

A

Omohyoid

77
Q

What does the IJV vein merge with and what does this then become

A

The internal jugular vein joins with the subclavian vein to become the left and right brachiocephalic veins

78
Q

Where does the external jugular vein begin?

A

At the angle of the mandible

79
Q

How is the external jugular vein formed?

A

By the union of the posterior division of retromanidubular vein with posterior auricular vein

80
Q

What are the 5 branches of the facial nerve

A

Temporal , zygomatic, buccal mandibular and cervical.

81
Q

What nerve innervates the platysma muscle

A

Cervical branch of CN7 - facial nerve

82
Q

What are the digastric muscle innervation

A

Digastric branch of CN7

83
Q

Where does CN7 the facial nerve emerge

A

Stylomastiod foramen

84
Q

Which cranial nerves emerge through the jugular foramen

A

Cranial nerves 9, 10 and 11 all emerge via the jugular foramen and travel downward between the IJC and the ICA

85
Q

The recurrent laryngeal nerves are branches of the vagus nerve.

What arteries do the right and left loop around

A

The right recurrent laryngeal nerve loops around the subclavian artery and the left loops around the arch of the aorta and brachiocephalic trunk

86
Q

What two muscles does the accessory nerve cn11 innervate

A

The SCM and the trapezius

87
Q

Which cranial nerve gives off the superior root of ansa cervicalis

A

Hypolossal nerve CN12

88
Q

What is the main innervation to the infra hyoid muscles

A

Ansa cervicalis ( anterior rami C1-C3)

89
Q

Which nerve supplies cutaneous innervation over SCM and anterior triangle

A

Transverse cervical nerve ( anterior rami of C2 and C3)

90
Q

Where does the phrenic nerve run across?

A

The anterior scalene muscle on the right

Crosses anterior to subclavian artery on left

91
Q

What supplies the upper limb

A

Brachial plexus ( C5-T1)

Anatomy BDS3 (19 decks)

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