Anterior Triangle (Lecture) Flashcards

1
Q

What muscle is contained in the superficial fascia of the neck?

A

Platysma

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2
Q

What is the innervation of the platysma?

A

Cervical Branch of the Fascial Nerve

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3
Q

What are the boundaries of the carotid ∆?

  • Anterior
  • Posterior
  • Superior
  • Floor
A

Anterior:
Superior Belly of the Omohyoid

Posterior:
Anterior border of Sternocleidomastoid

Superior:
Posterior Belly of Digastric

Floor:
Thyrohyoid, Middle Pharyngeal constrictor, Inferior Pharyngeal constrictor

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4
Q

What are the contents of the carotid ∆?

A
  • Carotid Sheath (w/ Carotid a.)
  • Internal Jugular v.
  • Vagus n.
  • Ansa Cervicalis
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5
Q

What are the boudaries of the Submandibular ∆?

  • Anterior
  • Posterior
  • Superior
  • Floor
A

Anterior:
Anterior belly of the digastric

Posterior:
Posterior Belly of the digastric

Superior:
Inferior Border of Mandible

Floor:
Mylohyoid, Hyoglossus, Middle Pharyngeal Constrictor

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6
Q

What are the contents of the submandibular ∆?

A
  1. Submandibular gland
  2. Hypoglossal nerve (CN XII)
  3. Nerve to Mylohyoid
  4. Facial Artery and Vein
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7
Q

What are the borders of the submental triangle?

***UNPAIRED; Suprahyoid Region

  • Lateral
  • Inferior
  • Apex
  • Floor
A

Lateral:
R and L anterior Bellies of the Digastrics

Inferior:
Body of the hyoid

Apex:
Symphysis Menti

Floor:
Both Mylohyoids

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8
Q

What are the contents of the submental ∆?

A
  • Anterior Jugular v.

- Lymph Nodes

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9
Q

What are the boundaries of the muscular ∆?

A

Anterior:
Median Plane of the neck

Inferior:
Anterior Border of the Sternocleidomastoid muscle

Superior:
Superior Belly of the OmoHyoid

Floor:

  • Thyroid and Cricoid Cartilages
  • Middle Pharyngeal Constrictor
  • Inferior Pharyngeal Constrictor
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10
Q

What are to contents of the anterior ∆?

A
  • Thyroid and Parathyroid Glands
  • Infrahyoid Muscles
  • Termination of Ansa Cervicalis
  • Superior Thyroid Artery
  • Superior Laryngeal Artery
  • Internal and external Laryngeal NN.
  • Recurrent Laryngeal n.
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11
Q

The mastoid process is a feature of what bone?

A

Temporal

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12
Q

What muscle arises from the medial side of the mastoid process and inserts on the hyoid?

A

Posterior Belly of the Digastric Muscle

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13
Q

What muscle arises from the digastric fossa on the lower inside of the mandible?

A

Anterior Belly of Digastric

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14
Q

What is the action of the digastric muscle when the mandible is fixed?

A

Raises the hyoid bone

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15
Q

What is the action of the digastric muscle when they hyoid is fixed?

A

It lowers the mandible

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16
Q

What is the innervation of the posterior belly of the digastric?

A

Facial n. (VII)

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17
Q

What is the innervation of the anterior belly of the digastric?

A

V3 (madibular division) or Trigeminal Nerve

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18
Q

What two muscles are completely invested in investing fascia at as result of the fascia splitting?

A
  • Trapezius

- Sternocleidomastoid

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19
Q

What structures pierce the investing fascia?

A
  • External and Anterior Jugular v.
  • Lesser occipital n.
  • Great auricular n.
  • Transverse cervical n.
  • Serpraclavicular nn.
  • All Branches of Cervical Plexus
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20
Q

What is the investing fascia attached to superiorly?

A
  • External Occipital Protuberance

- Superior Nuchal Line

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21
Q

What is the investing fascia attached to laterally?

A
  • Mastoid Process

- Zygomatic Arch

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22
Q

What is the investing fascia attached to inferiorly?

A
  • Manubrium
  • Clavicle
  • Arcomion
  • Scapular Spine
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23
Q

What muscles are surrounded by the prevertebral layer?

A
  • Prevertebral Muscles
  • Anterior, Middle, Posterior Scalene Muscles
  • Deep muscles of the back
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24
Q

How does the prevertebral fascia attach to the skull superiorly?

A
  • Ligamentum nuchae
  • Continuous circular line at the base of the skull (around jugular foramen, carotid canal, mastoid process, nuchal line, external occipital protuberance)
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25
Q

What are the anterior attachments of the prevertebral fascia?

A
  • Anterior surface of transverse processes CI-CVII
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26
Q

What muscles lie just anterior to the pretracheal layer of fascia?

A

Infrahyoid muscles

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27
Q

What fascial layer separates the Thyroid gland from the infrahyoid muscles?

A

Pretracheal fascia

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28
Q

Where does the pretracheal fascia begin superiorly?

- inferior extent?

A

At the hyoid bone

  • Extends all the way down into the Upper Thoracic Cavity
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29
Q

What is the pretracheal layer called on its posterior side?

A

Buccopharyngeal Fascia

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30
Q

Where does the Buccopharyngeal fascia begin superiorly?

- Inferior extent?

A

At the base of the skull.
- Ends inferiorly in the thoracic cavity

**think about spread of infection

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31
Q

What fascial layers enclose the pretracheal space?

  • anterior
  • Posterior
  • Superior
  • Inferior
A

Anterior:
- Investing Fascia (posterior surface of infrahyoids)

Posterior:
- Pretracheal Fascia (covers trachea and thyroid)

Superior:
neck

Inferior:
ANTERIOR part of SUPERIOR mediastinum

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32
Q

What fascial layers enclose the pretracheal space?

  • Anterior
  • Posterior
  • LATERALLY
  • Superior
  • Inferior
A

Anterior:
- Buccopharyngeal Fascia (on posterior surface of pharynx and esophagus)

Posterior:
- Prevertebral Fascia (on anterior surface of transverse processes and bodies of cervical vertebrae)

LATERALLY:
CAROTID SHEATH - think about infection

Superior:
- Base of the Skull

Inferior:
Upper Part of POSTERIOR Mediastinum

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33
Q

What space exists to permit movement of of pharynx, larynx, trachea, and esophagus during swallowing?

A

Retropharyngeal Space

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34
Q

Pretracheal space where could it spread?

A
  • Superior Mediastinum, anterior to the pericardium
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35
Q

Which of the infrahyoid muscles is NOT innervated by Ansa Cervicalis?

A

Thyrohyoid

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36
Q

What ∆ are the infrahyoid muscles located in?

A

Muscular ∆

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37
Q

Where does the superior belly of the omohyoid begin?

A

At the intermediate Tendon

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38
Q

What inserts more laterally on the hyoid bone, the superior belly of omohyoid or sternohyoid?

A

Omohyoid inserts more laterally

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39
Q

What attaches the intermediate tendon connecting the bellies of the omohyoid muscles to the clavicle?

A

a Fascial Sling

40
Q

What inserts on the greater horn of the hyoid bone?

A

Thyrohyoid

41
Q

What muscle would raise the larynx when singing a high note?

A

Thryohyoid

42
Q

What nerve roots make up the cervical plexus?

A

C2-C4 (possible contribution from C1)

43
Q

What fascial layer is the cervical nerve plexus associated with?

A

Prevertebral Layer

44
Q

What triangle is the cervical nerve plexus associated with?

A

Posterior ∆

45
Q

Where do the cutaneous branches of the cervical plexus first emerge from the muscles of the posterior ∆?

A

Posterior border of Sternocleidomastoid

46
Q

T or F: the phrenic n. arrises from the cervical plexus

A

True

47
Q

What fascial layer does the phenic nerve travel within?

A

Prevertbral layer (This is where branches of the cervical plexus are formed)

48
Q

What nerve ascends along the posterior border of sterocleidomastoid?

A
  • Lesser Occipital n.
49
Q

What spinal nerve root contributes to the Lesser occipital n.?

A

C2

50
Q

What are the 4 cutaneous branches of the cervical plexus?

A
  • Lesser Occipital N.
  • Great Auricular N.
  • Transverse Cervical N.
  • Supraclavicular N.
51
Q

What is the distribution of the lesser occipital nerve?

A
  • neck and scalp posterior to the ear
52
Q

What area is innervated by the great auricular n.?

- Nerve Roots

A
  • Nerve Roots = C2 and C3

Distribution:

  • Lower ear
  • Parotid Region
  • Mastoid area
53
Q

What area is innervated by the transverse cervical n.?

- Nerve Roots

A
  • Nerve Roots = C2 and C3

Distribution:
- Lateral and Anterior parts of the neck

54
Q

What nerve emerges and crosses sternocleidomastoid superiorly and perpendicularly on its way to the anterior neck?

A

Transverse cervical n.

55
Q

What nerve supplies cutaneous innervation to the area over the clavicle and shoulder down to rib 2?
- Nerve roots

A

Supraclavicular nerves (C3 and C4)

56
Q

Where is the nerve point of the neck located?

A

Midway up the sternocliedomastoid on the posterior border.

57
Q

What 4 nerves emerge at the nerve point of the neck?

A
  1. Lesser Occipital
  2. Great Auricular
  3. Transverse Cervical
  4. Supraclavicular
58
Q

T or F: C1 has a dermatome

A

False

59
Q

What nerve structure is located deep and slightly inferior to the nerve point of the neck?

A

Upper Truck of the Brachial Plexus

60
Q

What do the Ventral Rami of the Cervical Plexus coalesce to form?

A

Ansa Cervicalis

61
Q

T or F: the internal carotid gives off branches in the neck.

A

FALSE

62
Q

Which carotid artery goes through the carotid canal?

A

Internal Carotid

63
Q

What 8 branches are given off of the external carotid?

A

Anterior:

  1. Superior Thyroid
  2. Lingual
  3. Fascial

Posterior:

  1. Occipital
  2. Posterior Auricular

Medial/Terminal:

  1. Maxillary
  2. Superficial Temporal
  3. Ascending Pharyngeal is Variable as to were it comes off
64
Q

T or F: superior thyroid artery is deep to the infrahyoid muscles

A

True

65
Q

What branch does the superior thyroid give off?

A

Superior Layngeal

66
Q

What arteries are located directly above and below the posterior belly of the digastrics?

A

Above:
- Facial a.

Below:
- Lingual a.

67
Q

What artery emerges directly from under the mandible at its midpoint?

A

Fascial a.

68
Q

What artery arises between the internal and external carotid?

A

Ascending Pharyngeal a.

69
Q

What branch of the external carotid travels on the medial side of the mastoid?

A

Occipital a.

70
Q

What branch of the external carotid travels between the external auditory meatus and the mastoid?

A

Posterior Auricular

71
Q

What branch of the external carotid travels between the mandible and external auditory meatus?

A

Superficial Temporal

72
Q

What branch of the external carotid braches to travel under the posterior aspect of the mandible?

A

maxillary a.

73
Q

T or F: the posterior auricular a. travels superior to the posterior digastric whie the occipital travels under.

A

True

74
Q

What two veins join to form the EXTernal jugular vein?

- where does this happen?

A
  • Posterior Auricular Vein
  • Retromandibular Vein (POSTERIOR DIVISION)

**Join posterior to the angle of the mandible

75
Q

What vein drains the scalp behind and above the ear?

A
  • Posterior Auricular Vein
76
Q

What veins join to form the retromandibular vein and where does this happen?

A

Formed by:
- Superficial Temporal and Maxillary Veins

**Join IN the parotid gland

77
Q

How does the Retromandibular link the internal and external JUGULAR veins?

A
  • Posterior portion joins posterior auricular to MAKE the EXternal jugular vein
  • Anterior portion drain into the Facial Vein which then drains to the INternal Jugular vein
78
Q

What vein courses on top of SCM throughout its course?

A

EXternal Jugular Vein

79
Q

Where does the External Jugular Vein piece the investing fascia?
- what does it drain into?

A
  • Immediately posterior to SCM

- drains into Subclavian Vein

80
Q

What vein drains the anterior aspect of the neck?

A

Anterior Jugular Vein

81
Q

Where are the Anterior jugular veins formed and what is their path following formation?

A

Formed at or just superior to the Hyoid

- Descends on either side of the midline of the neck

82
Q

What joins the R and L anterior jugular veins?

- where is this located

A

Jugular Venous Arch

  • Near Suprasternal Notch
83
Q

Where does the External Jugular Cross the SCM?

A
  • Near the Nerve Point of the Neck
84
Q

T or F: the great vessels of the heart are at risk if an infection gets into the carotid sheath.

A

TRUE, the Carotid Sheath is continous with the CT surrounding the Great Vessels of Heart

85
Q

Where does the carotid sheath sit in relation to the clavicular head of SCM and the junction of the superior and inferior omohyoid?

A
  • Posterior to both
86
Q

What veins drain to the Internal Jugular Vein?

A
  1. Lingual
  2. Facial
  3. Superior Thyroid
  4. Middle Thyroid
87
Q

What is the location of the vagus nerve (X) to internal jugular and Common carotid?

A

Posterior to:
Internal Jugular

Anterior to:
Common Carotid

88
Q

What nerve are artery run together to pierce the thyroid membrane?

A
  • Superior Laryngeal n.

- Superior Thyroid a.

89
Q

What do recurrent laryngeal nerves become as they ascend towards the neck?

A
  • Inferior laryngeal nerves
90
Q

What is the relationship of sympathetic trunk ganglia to carotid sheath and prevertebral fascia?

A
  • POSTERIOR: to carotid sheath

- ANTERIOR: to prevertebral Fascia

91
Q

Where does the dual blood supply to the thyroid come from?

- do these sources anastomose

A
  • Superior Thyroid artery => External Carotid

- Inferior Thyroid artery => Thyrocervical Trunk

92
Q

What is the lymphatic drainage of the thyroid gland?

A
  • Paratracheal nodes

- Deep Cervical Notes (INFERIOR to OMOHYOID)

93
Q

What type of receptor is the carotid body?

A

Chemoreceptor (bO2dy)

Monitors:

  • pH
  • pCO2
  • pO2
94
Q

T or F: the carotid body modulates cardiovascular and respiratory function primarily through parasympathetic tone

A

FALSE, it does it by modulating sympathetic tone

Firing Causes:
- Increased blood pressure, heart rate, respiratory rate

95
Q

What CRANIAL nerve montiors the Carotid BODY?

A
  • Glossopharyngeal (CN IX) via Hering’s nerve (carotid body nerve)
96
Q

What type of receptor is the is the Carotid SINUS, what cranial nerve?

A
  • Baroreceptor- monitors BLOOD PRESSURE

- Glossopharyngeal (CN IX) via Hering’s nerve (carotid sinus nerve)

97
Q

What are ways the carotid SINUS can be affected causing DECREASED blood pressure?

A
  • Tumor

- Pressing on it