Anterior Triangle Flashcards
borders of anterior triangle
inferior border of mandible
anterior border of SCM
midline of neck
roof and floor of anterior triangle
roof: deep investing fascia around muscles
floor: pretracheal fascia and carotid sheath (posterolaterally)
subdivisions of anterior triangle
submandibular
submental
carotid
omotracheal
what is in submandibular triangle
submandibular gland, lymph nodes, part of hypoglossal nerve (CN VII), mylohyoid nerve, parts of facial artery and vein
what is in submental triangle
submental lymph nodes, small veins that unite to form anterior jugular vein
what is in the carotid triangle
parts of thyroid gland, larynx & pharynx, common and internal carotid artery, internal jugular vein and vagus nerve
what is in omotracheal triangle
sternohyoid and sternothyroid muscles, larger part of thyroid and parathyroid glands
where are the suprahyoid muscles found
located superiorly to the hyoid bone
what do suprahyoid muscles connect to
connect to the skull / mandible as well as the hyoid
what are the suprahyoid muscles
mylohyoid
digastric (right & left)
stylohyoid
geniohyoid
where are the infrahyoid muscles found
located inferiorly to the hyoid bone
what do the infrahyoid muscles attach to
attach to sternum , scapula and thyroid cartilage also hyoid bone but there is 1 exception
what are the infrahyoid muscles
sternohyoid
omohyoid
thyrohyoid
sternothyroid
which infra / suprahyoid muscle does not attach to the hyoid
sternothyroid
group function of suprahyoid muscles
to raise the hyoid during swallowing & to elevate the pharynx during tone production
origin and insertion of mylohyoid
origin - mylohyoid line on the mandible
insertion - body of hyoid
action of mylohyoid
to elevate the hyoid & floor of the mouth
digastric muscle origin & insertion
right & left digastric each have an anterior & posterior belly
anterior - originates at lower medial aspect of mandible
posterior - originates on medial side of mastoid process
insertion of both is the hyoid bone
function of anterior belly of digastric muscle
raises the hyoid & opens mouth by lowering the mandible
function of posterior belly of digastric
elevates and retracts the hyoid bone
innervation of mylohyoid & anterior belly of digastric
CN V3 inferior alveolar branch known as nerve to mylohyoid
innervation of posterior belly of digastric
digastric branch of facial nerve (CN VII)
origin and insertion of stylohyoid
origin: styloid process of skull
insertion: body of hyoid from lateral side
function of stylohyoid
to elevate hyoid in posterosuperior direction
innervation of stylohyoid
via facial nerve CN VII
origin and insertion of geniohyoid
origin: mandible
insertion: body of hyoid superiorly to mylohyoid
innervation of geniohyoid
anterior ramus of C1 which travels with hypoglossal nerve CN XII
function of geniohyoid
if mandible is fixed - elevates + moves hyoid in a forwards direction
if hyoid is fixed - acts to pull mandible down and inwards
group function of infrahyoid muscles
depress or fix hyoid bone & provide attachment for suprahyoid muscles
what 2 planes can infrahyoid muscles be separated into
- superficial - sternohyoid & omohyoid
- deep - sternothyroid & thyrohyoid
origin and insertion of sternohyoid
origin: posterior surface of sternoclavicular joint
insertion: body of hyoid medially
action of sternohyoid
acts to depress hyoid after it has been elevated for swallowing
how are superior & inferior omohyoid bellies connected
by an intermediate tendon
origin & insertion of superior belly of omohyoid
origin: intermediate tendon
insertion: laterally into body of hyoid
innervation of superior belly of omohyoid
superior root of ansa cervicalis (C1)
action of superior belly of omohyoid
depresses and stabilises hyoid
origin & insertion of inferior belly of omohyoid
origin: superior border of the scapula
insertion: laterally into hyoid bone
innervation of inferior belly of omohyoid
the ansa cervicalis (C1-C3)
action of inferior belly of omohyoid
depresses and stabilises hyoid
origin & insertion of thyrohyoid
origin: oblique line on thyroid cartilage
insertion: greater horn + adjacent body of hyoid
action of thyrohyoid
depresses the hyoid. if hyoid is fixed it can raise the larynx
innervation of thyrohyoid
branch from anterior rami of C1
sternothyroid origin & insertion
origin: posterior surface of manubrium
insertion: oblique line of thyroid cartilage (where thyrohyoid originates)
innervation of sternothyroid
ansa cervicalis
action of sternothyroid
acts to draw larynx downwards
innervation of sternohyoid
ansa cervicalis
arterial supply of thyroid gland
superior thyroid artery - 1st branch of external CA
inferior thyroid artery - branch of thyrocervical trunk from subclavian
venous drainage of thyroid gland
superior thyroid vein (into IJV)
middle thyroid vein (into IJV)
inferior thyroid vein (into brachiocephalic vein)
venous drainage of parathyroid glands
same as thyroid i.e. superior / middle / inferior thyroid veins
arterial supply of parathyroid glands
inferior thyroid artery
endocrine regulation of thyroid is via
pituitary gland
what nerves are found on the posteromedial aspect of the thyroid
right and left recurrent laryngeal nerves
where do the RRL & LRL arise from
vagus nerve from inferior part of neck
where does RRL go
loops to the right subclavian artery at T1-T2 level
where does LRL go
loops inferior to the arch of the aorta around T4-T5 level
boundaries of carotid triangle
superior belly of omohyoid
posterior belly of digastric
anterior border of SCM
carotid sheath runs from where to where
from foramen of carotid canal to aortic arch
contents of carotid triangle
common carotid artery
internal carotid artery
part of external carotid artery
IJV
CN X
common carotid artery splits into
internal and external carotid artery
what level is bifurcation of CCA
c3 - c4
right common carotid artery branches from where
branches from brachiocephalic trunk
left common carotid artery branches from where
direct branch from aortic arch
what is the carotid sinus
dilation at bifurcation of ICA containing baroreceptors
function of carotid sinus
monitor and react to changes in blood pressure
innervation of carotid sinus
CN IX (glossopharyngeal) via carotid sinus nerve and CN X (vagus)
what is the carotid body
small reddish brown ovoid mass on medial side of bifurcation of CCA near carotid sinus
function of carotid body
monitors and responds to blood O2, CO2, pH & temperature
ECA terminates by
dividing into 2 branches:
1. maxillary artery
2. superficial temporal artery
what 6 arteries arise from ECA
superior thyroid
ascending pharyngeal
occipital
lingual
facial
posterior auricular
ECA supplies vs ICA supplies
ICA - enters cranium through carotid canals and becomes main arteries of brain
ECA - supplies structures external to cranium
IJS drains what
blood from brain, skull, face, cervical viscera and deep muscles of neck
3 things of note about IJV
- continuation of sigmoid sinus in posterior cranial fossa
- exits skull via jugular foramen and enters carotid sheath
- runs lateral to CCA
inferior bulb of IJV
has a bicuspid valve which permits blood flow to the heart while preventing back flow into the vein if one were inverted
superior bulb of IJV
dilation at origin of IJV which is where the inferior petrosal sinus enters after it has left the cranium through the jugular foramen
which infrahyoid muscle runs across the IJV
omohyoid
where does IJV exit skull and where does it go
exits at jugular foramen and enters the carotid sheath
what happens when IJV reaches the sternoclavicular joint
it merges with the subclavian vein to form the brachiocephalic trunk
what 2 veins join to form external jugular vein
- posterior auricular vein
- retromandibular vein (posterior division)
what veins drain into EJV
posterior external jugular
transverse cervical
suprascapular
anterior jugular
what muscle does EJV cross and where does it then go
crosses over SCM to pierce investing fascia and drain into subclavian vein
5 terminal branches of the facial nerve
- temporal
- zygomatic
- buccal
- marginal mandibular
- cervical
what cranial nerves exit the jugular foramen
IX, X, XI
what does CN XI innervate in the neck
SCM & trapezius
what does CN XII supply
4/5 extrinsic muscles of the tongue - there are no branches to the anterior triangle of the neck