Anterior Triangle of the Neck

Question 1

At what vertebral levels are the following structures:

1. Mandible
2. Hyoid Bone
3. Thyroid Cartilage
4. Cricoid Cartilage
5. Jugular Notch

Answer 1

1. Mandible - C2
2. Hyoid Bone - C3
3. Thyroid Cartilage - C4
4. Cricoid Cartilage - C6
5. Jugular Notch - T2

Question 2

What are the boundaries of the carotid triangle?

Answer 2

1. ant. border of SCM
2. Omohyoid M.
3. Post. belly of Digastric Muscle

Question 3

What are the boundaries of the Anterior triangle?

Answer 3

1. SCM
2. Midline of Neck
3. Mandible

Question 4

What are the boundaries of the submandibular triangle?

Answer 4

1. Pos. Belly of Digastric
2. Ant. Belly of Digastric
3. lower border of Mandible

Question 5

What is the most superficial fascia? What muscles does it enclose?

Answer 5

ENVELOPING/ INVESTING FASCIA

• divides to envelope Trapezius and SCM

Question 6

What is the space between the Pre-Vertebral Fascia and the Buccopharangeal fascia?

Answer 6

Retropharangeal Space

Question 7

What fascia contains most of the viscera?

Answer 7

Pre-tracheal fascia

contains:
1. thyroid gland
2. trachea
3. larynx
4. esophogus

Question 8

What fascia extends over the scalene muscles, legator scapulae, and splenius muscles?

Answer 8

Pre-vertebral fascia

Question 9

What four structures are within the Carotid Sheath?

Answer 9

1. Common Carotid A.
2. Internal Carotid A.
3. Internal Jugular Vein
4. VAGUS NERVE

Question 10

What innervates the two bellies of the digastric muscles?

Answer 10

Ant - CN V

Pos - CN VII

Question 11

What are the strap muscles? What are they innervated by?

Answer 11

1. Omohyoid
2. Sternohyoid
3. Sternothyroid
4. Thyroid

All innervated by Ansa Cervicalis (C1-C3) except for Thyroid which is innervated by a diff branch of C1

Question 12

What muscles are innervated by the Trigeminal Nerve CN V?

Answer 12

Mylohyoid and Ant. Belly of Digastric M.

Question 13

What muscles are innervated by the Fascial Nerve CN VII?

Answer 13

Stylohyoid and Pos. Belly of Digastric M.

Question 14

What muscles are innervated by the Vagus Nerve CNX?

Answer 14

Cricothyroid - tightens the vocal chords to speak

& intrinsic muscles of the larynx –> Superior Larangeal and Recurrent

** Palatoglossus

Question 15

What three muscles are innervated by Hypolglossal nerve CN XII?

Answer 15

1. Genioglossus
2. hyoglossus
3. Styloglossus

Question 16

What are the scalene muscles innervated by?

Answer 16

Cervical Nerves –> Ventral Rami

Question 17

Levator scapula is innervated by what?

Answer 17

Cr-C5 and Dorsal Scapulary Nerve

Question 18

Splenius and other back muscles are innervated by:

Answer 18

Cervical nerves –> Dorsal Rami

Question 19

What is the blood supply to the inferior part of the neck?

Answer 19

Subclavian

Question 20

What is the blood supply to the SUPERIOR part of the neck?

Answer 20

External Carotid Artery

SALFORMS

Question 21

What are the different parts of the External Carotid Artery?

Answer 21

SALFORMS

1 = (S) Superior thyroid artery 
2 = (A) Ascending pharyngeal 
3 = (L) Lingual - tongue
4 = (F) Facial. 
5 = (O) Occipital – to back
6 = (R) Posterior AuRicular – back of ear
7 = (M) Maxillary – terminal branch
8 = (S) Superficial temporal – terminal branch

Question 22

What nerve is found between the Common Carotid A. and the Internal Jugular Vein?

Answer 22

Vagus Nerve

Question 23

What are the SUPRAHYOID muscles?

Answer 23

1. Digastric (V, VII)
2. mylohyoid (V)
3. geniohyoid (C1)
4. stylohyoid (VII)
5. hyoglossus (XII)

Question 24

What are the the four INFRAHYOID muscles? What is their function?

Answer 24

STRAP MUSCLES

fx: move the HYOID BONE
1. Omohyoid
2. Sternohyoid
3. Sternothyroid
4. Thyrohyoid –> C1 innervates!!!

First three : C1-3, ansa cervicales

Question 25

The ascending pharyngeal artery is a branch of which artery?

Answer 25

External Carotid Artery

Question 26

On CT your patient shoes a large spur on the C3 pedicle that is compressing the nerve between C3 and C4. Which muscle would you suspect would have some weakeness?

Answer 26

Diaphragm

Question 27

Which cranial nerves innervate structures in the neck?

Answer 27

CNV - anterior belly of the digastric m. + mylohyoid) CNVII – posterior belly of digastric +stylohoid CNX – cricothyroid muscle of the larynx CNXI – spinal accessory  SCM + trap CNXII – hyoglossus

Question 28

Your patient comes to the ER with an arrow piercing the crycoid cartilage. Which vertebra is most likely to be in the CT when viewed in the transverse plane?

Answer 28

C6

Question 29

What Cranial Nerve(s) are responsible for: 1. Swallowing 2. Talking 3. Chewing

Answer 29

1. IX and X (9 and 10) 2. X 3. V3 (MASTICATION)

Question 30

If you were to sever the sympathetic chain ganglia what would be the result?

Answer 30

Horner's Syndrome 1. Miosis (constriction of pupils) 2. Ptosis (droopy eyelid) 3. Anhydrosis (lack of sweating of the face)

Question 31

What is the exception to the rule for the Autonomic System and is it Parasympathetic or Sympathetic?

Answer 31

SPLANCHNICS - SYMPATHETIC -. don't synapse at the chain ganglia but instead synapse in near the target organ (acting like parasympathetics)

Question 32

Does the sympathetic or parasympathetic system follow the carotid artery?

Answer 32

SYMPATHETIC (follows Carotid to the head)

Question 33

What are the innervations of 1. Styloglossus 2. Stylohyoid 3. Stylopharyngeus

Answer 33

1. 12 2. 7 (stylohyoid is pierced by the posterior belly of the digastric muscle) 3. 9

Question 34

What nerve pierces the superficial temporal artery (usually splits)

Answer 34

Auriculotemporal Nerve

Question 35

Which Cranial Nerve moves the tongue to one side?

Answer 35

12