Anterior triangle of the neck Flashcards

1
Q

what divides the anterior from the posterior triangle

A

sternocleidomastoid (SCM) - anterior boundary of posterior triangle and vice versa

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2
Q

what is the cranial boundary of the anterior cervical region

A

mandible

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3
Q

what is the caudal border of the anterior triangle

A

sternum, jugular notch

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4
Q

what is the lateral border of the anterior cervical region

A

SMC

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5
Q

what are the 4 divisions of the anterior triangle

A

submental
submandibular
cartoid
muscular/omotracheal

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6
Q

what is found in the submental division of the anterior triangle

A

submental lymph nodes (drain the anterior part of tongue)
submental arteries and veins
mylohyoid nerve
beginning of anterior jugular vein?

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7
Q

what is the in submandibular division of the anterior triangle

A

lingual nerve, submandibular ganglion
submandibular salivary gland, lymph nodes
facial artery and vein
lingual artery and vein
hypoglassal nerve

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8
Q

what is in the carotid division of the anterior triangle

A

inside carotid sheath:
-common carotid artery (medially), continues as internal carotid artery from c4 upward)
-internal jugular vein (laterally)
-superior toot of deep ansa cervicalis
-vagus nerve

outside carotid sheath:
-branches of external carotid artery: superior thyroid (runs caudally to omotracheal triangle, lingual (runs cranially to submandibular triangle), facial (runs cranially to submandibular triangle)
-arch of hypoglossal nerve, sympathetic trunk and superior cervial ganglion, accessory nerve
- veins: facial, retromandibular, lingual, superior thyroid
-lateral group of deep cervial lymph nodes

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9
Q

what is the muscular division of the anterior triangle

A

sternohyoid and sternothyroid form the floor beneath which lies the thyroid gland, layrnx, trachea and oesophagus

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10
Q

what are the divisions of the fascial layers of the neck

A

superficial cervical fascia - lies close to skin
deep fascia (investing layer, pretracheal layer, prevertebral layer, alar fascia and carotid sheath)

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11
Q

what is the first structure that is revealed when you remove the skin of the neck

A

platysma

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12
Q

what are the attachments of platysma

A

from fascia above pectoralis major and clavicle to the lateral neck and onto mandible

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13
Q

what is the innervation of platysma

A

facial nerve CN VII

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14
Q

platysma forms a thin layer than covers what surfaces of the neck

A

anterior and lateral

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15
Q

what is the function of platysma

A

considered a muscle of facial expression even though it functions to tighten the skin of the neck

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16
Q

all the muscles of facial expression are innervated by what

A

facial nerve CN VII

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17
Q

how does platysma vary

A

varies in its exact attachment areas on the face and neck

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18
Q

what superficial vein of the neck crosses the anterior surface of sternocleidomastoid

A

external jugular vein

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19
Q

some individuals have what superficial vein of the neck

A

anterior jugular vein in the midline, may be absent

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20
Q

what usually joins with the external jugular vein

A

posterior division of the retromandibular vein

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21
Q

the posterior division of the retromandibular vein usually joints the external jugualr vein which carries blood where

A

down the neck into the subclavian vein

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22
Q

what vein is found posterior to sternocleidomastoid

A

internal jugular vein

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23
Q

the internal jugular vein is part of what triangle of the neck

A

anterior triangle

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24
Q

the external jugular vein is in what triangle of the neck

A

posterior triangle

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25
Q

what vein joins with the anterior division of the retromandibular vein

A

facial vein

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26
Q

the facial vein joins with the anterior division of the retromandibular vein and this usually drains where

A

internal jugular vein

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27
Q

where does the internal jugular vein lie in the neck

A

deeper in the neck within the carotid sheath

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28
Q

the internal jugular vein drains where

A

subclavian vein to form brachiocephalic vein

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29
Q

the anterior jugular veins can drain where

A

external or internal veins depending on the individual

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30
Q

what other venous structure may be seen in the neck

A

communicating vein between the facial and anterior jugular veins

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31
Q

the cervical plexus forms from what

A

anterior rami of C1-C4

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32
Q

the cervical plexus is joined into loops that lie anterior to what

A

levator scapulae and scalenus medius

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33
Q

what fascial layer covers the cervical plexus

A

covered by pre-vertebral layer of deep cervical fascia

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34
Q

what innervation does the cervical plexus carry

A

somatic motor and sensory (plus sympathetic)

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35
Q

what are the sensory branches of the cervical plexus

A

lesser occipital
greater auricular
transverse cervical
supraclavicular

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36
Q

what is the general direction of the lesser occipital sensory branch

A

behind the ear

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37
Q

what is the general direction of the greater auricular sensory branch

A

infront of the ear

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38
Q

what is the general direction of the transverse cervical branch

A

under the chin

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39
Q

what is the general direction of the supraclavicular sensory branch

A

down the neck/over clavicle

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40
Q

what is the name of the loop of nerves created by the cervical plexus

A

the ansa cervicalis

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41
Q

what fibres does the ansa cervicalis contain

A

C1 to C3

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42
Q

the ansa cervicalis sits where

A

anterior surface of the carotid sheath

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43
Q

what are the motor nerves coming from the cervical plexus

A

ansa cervicalis
to sternohyoid, sternothyroid and omohyoid
to thyrohyoid
to glenohyoid
to trapezius C3, 4 (proprioception)
to levator scapulae C3 4
to SCM C2 3 (proprioception)
Phrenic (C3 4 5)

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44
Q

what is meant by the term suprahyoid

A

between the hyoid bone and the skull or mandible

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45
Q

what is meant by the term infrahyoid

A

between the hyoid bone and the sternum or thyroid cartilage

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46
Q

the hyoid bone lies between what

A

mandible and larynx

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47
Q

what is the function of the supra-hyoid muscles

A

raise hyoid bone

mylohyoid and digastric also depress mandible

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48
Q

what are the suprahyoid muscles

A

mylohyoid digastric (anterior and posterior belly)
geniohyoid
stylohyoid

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49
Q

what nerve innervates the posterior belly of the digastric and stylohyoid

A

facial nerve

50
Q

what nerve innervates the anterior belly of digastric and the mylohyoid

A

mandibular division of the trigeminal nerve CNV3

51
Q

what is geniohyoid found

A

deep to mylohyoid

52
Q

what innervates geniohyoid

A

C1 via hypoglossal nerve CN XII

53
Q

where does the anterior belly of digastric attach

A

mandible and hyoid bone

54
Q

where does the posterior belly of the digastric attach

A

mastoid process of temporal bone and hyoid bone

55
Q

what does stylohyoid attach to

A

styloid process of temporal bone and hyoid

56
Q

what does mylohyoid attach to

A

mylohyoid line of the mandible and to the hyoid bone

57
Q

what muscle forms a diaphragm in the floor of the oral cavity

A

mylohyoid

58
Q

what does geniohyoid attach to

A

inferior genial tubercle of the mandible and the hyoid bone

59
Q

the facial nerve exits the skull via … so passes close to what

A

stylomastoid foramen
posterior belly of digastric and to stylohyoid

60
Q

what supplies the muscles of mastication

A

mandibular division of the trigeminal nerve

61
Q

what is another name for the infrahyoid muscles

A

strap muscles

62
Q

what is the function of the infrahyoid/strap muscles

A

depress the hyoid bone and thyroid cartilage

63
Q

what are the superficial infrahyoid/strap muscles

A

omohyoid
sternohyoid

64
Q

what are the deeper infrahyoid/strap muscles

A

sternothyroid
thyrohyoid

65
Q

what does thyroid hyoid of the infrahyoid/strap muscles attach to

A

thyroid cartilage and hyoid bone

(name indicates attachment)

66
Q

what gives omohyoid its name

A

shape - superior and inferior belly passing through a sling

67
Q

describe omohyoid

A

superior belly that attaches to the hyoid - this becomes tendinous near the clavicle and passes through a small fascial sling that is attached to the clavicle
inferior belly attaches to the scapula

68
Q

what is the attachment of the superior belly of omohyoid

A

hyoid

69
Q

what is the attachment of the inferior belly of omohyoid

A

clavicle

70
Q

what is the innervation of the infrahyoid/strap muscles

A

ansa cervicalis
except thyrohyoid which is innervated by C1 via hypoglossal nerve

71
Q

what nerves so far have been innervated by C1 via the hypoglossal nerve

A

thyrohyoid
geniohyoid

72
Q

on the left, the common carotid artery is a branch of what

A

arch of aorta

73
Q

on the right the common carotid artery is a branch of what

A

brachiocephalic artery

74
Q

what is the standard pattern of branching of the common carotid artery

A

2 terminal branches - internal and external carotid

75
Q

where does the common carotid artery branch

A

between the thyroid cartilage and the hyoid bone, between C3 and C4

76
Q

at the bifurcation, the internal carotid lies _____ to the external carotid

A

at the bifurcation, the internal carotid lies external to the external carotid but comes internal as it passes into the skull whereas the external carotid remains on the external surface of the head to supply the face and neck

77
Q

the internal carotid goes where

A

passes into the skull to supply brain

78
Q

the common carotid artery is in the carotid sheath with what

A

internal jugular vein and vagus nerve
also lymph nodes near vessels

79
Q

describe the structures of the carotid sheath

A

internal jugular vein and common carotid artery and between them the vagus nerve

80
Q

how many branches of the external carotid artery lie in the anterior triangle of the neck

A

3

81
Q

what are the 3 anterior branches of the external carotid artery in the anterior triangle of the neck

A

facial artery, lingual artery and superior thyroid artery

82
Q

describe the course of the superior thyroid artery

A

first anterior branch of the external carotid artery. Passes down the neck to the thyroid gland

83
Q

what is the second anterior branch of the external carotid artery

A

lingual artery

84
Q

what is the path of the lingual artery

A

passes into floor of the oral cavity to supply the tongue

85
Q

what is the third anterior branch of the external carotid artery

A

facial artery

86
Q

what is the path of the facial artery

A

crosses the anterior surface of the mandible to supply the face

87
Q

the lingual artery passes close to what nerve

A

hypoglossal nerve

88
Q

what branch of the subclavian artery supply the thoracic wall

A

internal thoracic

89
Q

what branch of the subclavian artery supplies the brain

A

vertebral branch

90
Q

what branch of the subclavian artery supplies structures in the neck

A

thyrocervical trunk

91
Q

where are branches of the first part of the subclavian found in the neck

A

deep in the triangles of the neck

92
Q

what is cranial nerve CNX

A

vagus nerve

93
Q

the vagus nerve will supply structures in the neck via what branch

A

laryngeal branches

94
Q

what is the course of the recurrent laryngeal nerve on the left

A

descends into thorax and wraps around arch of aorta before ascending the neck lying between the oesophagus and the trachea

95
Q

what is the course of the recurrent laryngeal nerve on the right

A

wraps around the subclavian artery before ascending the neck lying between the oesophagus and the trachea

96
Q

what are the laryngeal branches of the vagus nerve

A

recurrent, external and internal

97
Q

the vagus goes through the thoracic inlet to the superior mediastinum and carries what kind of innervation to the thorax and abdomen

A

parasympathetic

98
Q

what kind of gland is the thyroid gland

A

endocrine

99
Q

what is the function of the thyroid gland

A

regulates metabolic rate

100
Q

describe the structure of the thyroid gland

A

2 lobes connected by an isthmus and a capsule

101
Q

where is the thyroid gland found in the neck

A

deep in the anterior triangle

102
Q

what covers the thyroid

A

infrahyoid muscles

103
Q

where is the isthmus of the thyroid

A

over tracheal ring 2 or 3

104
Q

where are the parathyroid glands found

A

embedded into posterior surface

105
Q

what is the arterial supply of the thyroid gland

A

one superior and one inferior thyroid artery on each side

106
Q

the superior thyroid is a branch of what

A

first anterior branch of the external carotid

107
Q

the inferior thyroid artery is a branch of what

A

branch of the thyrocervical trunk of subclavian artery

108
Q

what is the venous drainage of the thyroid gland

A

superior middle and inferior thyroid vein on each side

109
Q

where do the superior and middle thyroid veins drain

A

internal jugular veins

110
Q

where do the inferior thyroid veins drain

A

both into left brachiocephalic vein

111
Q

where does the right inferior thyroid vein drain

A

left brachiocephalic vein

112
Q

what are the 3 sets of salivary glands

A

parotid
submandibular
sublingual

113
Q

what salivary gland lies in the anterior triangle

A

submandibular

114
Q

what vein crosses the submandibular salivary gland

A

facial vein

115
Q

what part of the submandibular salivary gland lies in the anterior triangle and where does the rest of it lie

A

small outer part in anterior triangle - rest is in the floor of the mouth superior to mylohyoid

116
Q

the submandibular gland passes saliva into the mouth via a duct located where

A

between the 1st and 2nd lower incisor teeth each side
(either sde of frenelum)

117
Q

what supplies parasympathetic secretomotor to the submandibular gland

A

facial nerve CN VII

118
Q

part of the submandibular gland lies in the anterior triangle of the neck inferior to

A

mylohyoid

119
Q

the part of the submandibular gland in the floor of the mouth lies superior to what

A

mylohyoid

120
Q

where does the thoracic duct empty lymph

A

junction of the internal jugular and subclavian veins as they form the brachiocephalic vein