area under SCM Flashcards

1
Q

contents of carotid sheath

A
common and internal carotid aa
internal jugular v
vagus
ansa cervicalis, superior root inside sheath, inferior root on its lateral surface 
deep cervical lymph nodes
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2
Q

relationships of carotid sheath

A

deep to SCM following its ant border
a anteromedial and v posterolateral
X descends in post groove btwn vessels

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3
Q

ansa cervisalis

A

lat to common and internal carotid aa (sup root)

crosses the internal jugular v ant adn courses sup, lat, and post on its surface (inf root)

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4
Q

common carotid a

A

left side longer then right

extends to sup horn of thyroid cartilage opposite CV3 to terminate as internal and external carotids

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5
Q

carotid sinus

A

dilated distal common and proximal carotids

pressure receptor

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6
Q

carotid body

A

at carotid bifurcation

chemoreceptor

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7
Q

internal carotid a

A

ascends w/in sheath to base of skull to enter carotid canal to supply orbit and brain

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8
Q

external carotids

A

originates in carotid triangle near sup horn of thyroid cartilage
gives off 4 brr
crossed lat by post belly of diagastric and stylohyoid mm to give off 5th and 6th brr
crossed lat by XII
terminates near neck of mandible by bifurcating into maxillary and superficial temporal aa

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9
Q

brr of external carotids

A
superior thyroid (sometimes comes from common)
ascending pharyngeal
lingual 
facial
occipital
posterior auricular
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10
Q

carotid triangle boundaries

A

SCM
sup belly omohyoid
post diagastic

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11
Q

contents of carotid triangle

A
carotid bifurcation
internal jugular v
X
XI
sympathetic trunk
all at risk during surgery
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12
Q

superior thyroid a

A
1st br external carotid
courses along sup medial margin of thyroid
brr:
-sup laryngeal
-ant br
-post br
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13
Q

superior laryngeal a

A

pierces thyrohyoid membrane w/internal laryngeal n (X) to provide brr to interior larynx

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14
Q

ant br of superior thyroid a

A

brr to ant portion of thyroid and anastomoses w/contralateral counterpart

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15
Q

post brr of superior thyroid a

A

brr to posterior portion of gland and anastomoses brr of inferior thyroid a

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16
Q

ascending pharyngeal a

A

arises from medial aspect of the external carotid near bifurcation
travels in CT lateral to pharyngeal wall medial to internal carotid a and courses straight to base of skull

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17
Q

brr of ascending pharyngeal a

A

pharyngeal a
palatine a
inferior tympanic a
meningeal a

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18
Q

lingual a

A

may arise from common trunk w/facial a usually opposite greater horn of hyoid
passes deep to hypoglossus m to enter tongue

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19
Q

brr of lingual a

A

dorsal lingual
deep lingual
sublingual

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20
Q

facial a

A

may arise from common trunk w/lingual or above it
courses obliquely ant deep to posterior diagastric and stylohyoid crosses submandibular gland
leaves submadibular region by coursing around sharp inf border mandible at ant edge of masseter and enter face

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21
Q

brr of facial a

A
tonsillar 
ascending palatine
galndular
muscular
submental
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22
Q

occipital a

A

passes post from external carotid at inf border of post belly of diagastric to pass btwn the transverse process of atlas and mastoid
superficial at superior extent of post triangle to pierce cervical fascia where SCM and Trap come together then parallels greater occipital n
XI crosses it at origin

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23
Q

occipital a brr

A
SCM br
menigeal a
auricular a
mastoid a
descending br
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24
Q

internal jugular v

A

largest vv of head and neck
receives blood from face, neck, and brain via dural sinuses
begins as dilation (sup jugular bulb) at jugular foramen
ends as inferior bulb post to SC joint to join subclavian forming brachiocephalic v

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25
Q

internal jugular v relation to carotid aa

A

sup- posterolateral
mid- lateral
iinf-anterolateral

26
Q

tributaries of internal jugular v

A
occipital vv
pharyngeal vv
lingual v
common facial v
sup and middle thryoid vv
27
Q

X- SVE

A

motor to striated mm of pharynx, palate, larynx, and proximal esophagus

28
Q

X- SVA

A

taste to epiglottic portion of tongue

29
Q

X- GVE

A

para to heart, lungs, fore and mid gut

30
Q

X-GVA

A

Cartotid body, epiglottis, larynx, resp system, GI

31
Q

X-GSA

A

external ear, external auditory meatus, tympanic membrane, post cranial fossa dura

32
Q

X origin and sheath

A

exits brainstem at medulla
exits skull via jugular foramen
courses in carotid sheath post btwn carotids and internal jugular v
enters thorax on R btwn subclavian a and right brachiocephalic c
on left btwn jnx of left common carotid w/left subclavian a and left brachiocehpalic

33
Q

brr of X

A
menigeal- GSA
auricular- GSA
pharyngeal- SVE
n to carotid body- GVA
superior laryngeal n
cervical cardiac brr
recurrent laryngeal n
34
Q

superior laryngeal n brr

A

internal and external

35
Q

internal br of superior laryngeal n

A

SVA, GVA, GVE, pierces thyrohyoid membrane w/superior laryngeal br of superior thyorid a to provide sensory fibers and parasympathetics to base of tongue, epiglottis, aryepiglottic folds and internal portion of larynx ABOVE true vocal fold

36
Q

external brr of superior laryngeal n

A

SVE
courses lat to pharynx and larynx on inf constrictor m accompanied by superior thyroid a
innervates cricothyroid m and inf constictor m

37
Q

cervical cardiac brr

A

GVE, GVA
superior cardiac nn
inf cardiac nn

38
Q

deep cardiac plexus

A

superior cardiac n and r inf cardiac n

39
Q

superficial cardiac plexus

A

L ing cardiac n

40
Q

recurrent laryngeal n

A

SVE, SVE, GVA
R wraps under subclavian
L around aortic arch at ligamentum arteriosum
both reach larynx by coursing btwn trachea and esophagus
motor to intrinsic mm of larynx, secretory to mucous glands, and sensory to mucosa BELOW to true vocal cords
once in larynx called inf laryngeal n

41
Q

brr of recurrent laryngeal

A

cardiac brr to deep cardiac plexus
brr to mm and glands of trachea and esophagus
pharygeal brr to inf constrictor m
laryngeal brr to all mm of larynx except cricothryroid

42
Q

deep cervical lymph nodes

A

associated w/carotid sheath along course of internal jugular v
divided into 2 grps by passage of omohyoid m sup and inf

43
Q

superior deep cervical nodes

A

located in carotid triangle sup to superior belly of omohyoid
composed of retropharyngeal, deep parotid, jugulodigastric and jugulo-omohyoid

44
Q

superior deep cervical nodes receive lymph from and drains to

A

sup lymph nodes of face and neck
drainage from deeper areas of head
drains to inferior deep nodes

45
Q

inferior deep cervical nodes

A

inf to sup belly omohyoid m

only a few nodes located in supraclavicular may extend into omo-clavicular triangle

46
Q

inferior deep cervical nodes receive lymph from

A

superficial cervical and superior deep nodes, accessory chain of post triangle,
transverse cervical nodes
juxtavisceral nodes of ant triangle

47
Q

jugular lymph trunks

A

from sup and inf deep cervical nodes
left drain to thoracic duct
right joins w/subclaivan and right broncho-mediastinal trunks to form RIGHT LYMPHATIC DUCT

48
Q

XII

A

exits skull via hypoglossal canal medial to internal jugular v and internal carotid a invested in carotid sheath
descends post to X and passes lat to trransverse process of atlas btwn internal jugular v and external carotid a
at origin of occipital a enters submandibular triangle deep to post belly diagastric aboce hyoid
passes btwn mylohyoid and hypoglossal mm to tongue

49
Q

XII communicates with

A

X, sup cervical ganglion, and ventrla rami C1-2

50
Q

cervical plexus

A

ventral rami C1-4
innervates deep cervical mm of VC, infrahyoid mm and diaphragm
sensory dermatomes of lateral head, neck, superolateral shoulder and upper ant thorax
distributes postganglionic symp

51
Q

lesser occipital n

A

C2,3

scalp above and behind ear, upper portion of dorsum of ear

52
Q

great auricular n

A

C2,3

cutaneous innervation over superior portion of SCM, angle of mandible, and parotid region

53
Q

transverse cervical n

A

C2,3

skin over ant triangle neck

54
Q

supraclavicular nn

A

C3,4
medial, intermediate, and lat
skin at base of neck, ant upper thorax, lat and sup shoulder
sternoclavicular and acromioclavicular joints

55
Q

phrenic n- sensory

A

C3,4,5,

sensory innervation to pericardium, central portion of inf diaphragm, sup liver and gallbladder

56
Q

Sensory from C1,2

A

follow XII and X retrograde to innervate dura of posterior cranial fossa

57
Q

proprioceptive from C2-4

A

travel w/XI and leave again as they pass thru SCM and trap

58
Q

ansa cervisalis- sup root

A

C1,2
provides fibers which travel w/XII
to parallels carotid sheath internally btwn a and v

59
Q

ansa cervisalis inf root

A

C2,3 pass from behind carotid sheath wraps around internal jugular v and joins superior root to form ansa which sends brr to innervate infrahyoids

60
Q

C1

A

travel w/XII and diverge to innervate geniohyoid and thyrohyoid mm

61
Q

C1-4

A

pre-vertebral mm

62
Q

phrenic n- motor

A

diaphragm