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M1: Anatomy and Embryology Lecture BW > Block 4: GL 28 Learning Objectives--Overview of Neck, Vasculature, Lymphatics > Flashcards

Block 4: GL 28 Learning Objectives--Overview of Neck, Vasculature, Lymphatics Flashcards

1
Q

Describe the fascial layers of the neck

A

superficial fascia: contains the platysma muscle; located deep to the dermis and superficial to the investing layer of deep fascia

deep fascia: deep to the superficial fascia and platysma muscle with 3 layers

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2
Q

What are the layers of the deep fascia of the neck

A

investing layer of fasica
pretracheal fascia
prevertebral fascia

all 3 of these fascias combine to form the carotid sheath

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3
Q

Describe the investing layer of fascia in the neck

A

the most superficial fascial layer; surrounds all structures and fascial layers in the neck

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4
Q

What is the investing layer of fascia pierced by?

A

external and internal jugular veins
lesser occipital, great auricular, cervical & supraclavicular nerves
all branches of the cervical plexus

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5
Q

Describe the pretracheal layer of fascia

A

collection of fascia surrounding the trachea, esophagus, thyroid gland & infrahyoid muscles

2 parts: visceral, muscular

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6
Q

Differentiate between the visceral and muscular parts of the pretracheal fascia

A

visceral: surrounds the esophagus, trachea, and thyroid gland
muscular: surrounds the infrahyoid muscles

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7
Q

Describe the prevertebral layer of fascia

A

surrounds the vertebral column and associated muscles

muscles: scalene’s, prevertebral & deep muscles of the back

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8
Q

Describe the carotid sheath (formation & contents)

A

formed by contributions from the pretracheal, prevertebral & investing fascial layers

contents: vagus nerve, common carotid artery, internal jugular vein, cervical lymph noes

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9
Q

Describe the clinical significance of the structure of the carotid sheath

A

it is a column that runs from the base of the skull to the thoracic mediastinum; it’s an easy path for the spread of infection

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10
Q

What are the compartments of the neck?

A

visceral compartment
vertebral compartment
vascular compartments (2)

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11
Q

Describe the visceral compartment of the neck

A

located anteriorly; contains parts of the digestive, respiratory systems & endocrine glands

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12
Q

Describe the vertebral compartment of the neck

A

located posteriorly; contains: cervical vertebrae, spinal cord, cervical nerves & muscles of the vertebral column

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13
Q

Describe the vascular compartment of the neck

A

located bilaterally, carotid spaces

contain: major vessels & vagus nerve

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14
Q

Describe the spaces of the neck and their significance

A

spaces: pretracheal (visceral space), retropharyngeal, carotid space

spaces of the neck are located b/w the fascial layers and may provide a conduit for the spread of infection from the neck to the mediastinum

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15
Q

Describe the clinical significance and location of infection spread from the retropharyngeal space to surrounding structures

A

the retropharyngeal space extends from the base of the skull to the upper part of the posterior mediastinum.

the anterior (true) and posterior (danger) retropharyngeal spaces are separated by alar fasia

the “danger space” is the posterior retropharyngeal space, meaning infections from the head and neck can spread into the retropharyngeal space and pass inferiorly to the posterior mediastinum

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16
Q

What are the subdivisions of the anterior triangle?

A

carotid triangle
submental triangle
submandibular triangle
muscular triangle

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17
Q

List the contents of the carotid triangle

A

common carotid artery
internal jugular vein
hypoglossal & vagus nerves

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18
Q

Hyoid Bone Landmark

A

C3

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19
Q

Thyroid Cartilage Landmark

A

C4-C5

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20
Q

Criothyroid Membrane Landmark

A

C6

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21
Q

Carotid Bifurcation Landmark

A

C4, near the superior edge of the thyroid cartilage

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22
Q

Thyroid Gland Landmark

A

C5-T1

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23
Q

Trachea Landmark

A

begins @ C1

24
Q

Location of Parathyroid Glands

A

deep to the lateral lobes of the thyroid glands

25
Q

List the boundaries of the anterior triangle

A

superior: inferior margin of the mandible
medial: median vertical line of neck
lateral: anterior margin of sternocleidomastoid muscle

26
Q

List the branches of the carotid artery

A

“Some anatomists like freaking out poor medical students”

Superior Thyroid 
Ascending Pharyngeal 
Lingual 
Facial 
Occipital 
Posterior Auricular 
Maxillary 
Superficial temporal
27
Q

Describe carotid insufficiency

A

carotid insufficiency: occlusion of the internal carotid artery and of the common carotid and vertebral vessels

most common site: internal carotid just above the carotid sinus

28
Q

Describe the significance of the carotid sinus

A

dilated opening of the internal carotid artery that contains receptors that monitor changes in the blood pressure, innervated by the glossopharyngeal nerve

29
Q

Describe the current (and outdated) practice of central venous line insertion and why each one was good or bad

A

current: identify major vessels using ultrasound & obtain central venous access under direct vision to avoid any complications
previous: “blind puncture: of subclavian and jugular veins was used, but subclavian vein puncture can be problematic b/c misplacement of the needle can puncture the apical pleura, leading to a pneumothora

30
Q

Describe emergency airway management

A

cricoid cartilage can help with emergency airways b/c it’s a complete ring, and it’s one of the best places for an emergency airway

31
Q

Describe the position of the thyroid glands

A

located anteriorly in the neck from C45-T1, inferolateral to the thyroid cartilage and in contact with the carotid sheath; located within the visceral sheath

32
Q

Describe the anatomy of the thyroid gland

A

2 lobes with an isthmus connecting the lateral lobes

sometimes there is a pyramidal lobe that’s a remnant of embryological development

33
Q

Describe the arterial supply to the thyroid gland

A

superior and inferior thyroid artery (however inferior is mainly to parathyroid glands)

thyroid has to be very vascular b/c it releases hormones directly into the blood stream

34
Q

Describe the lymphatic drainage of the thyroid glands

A

paratracheal nodes, then to deep cervical nodes

35
Q

What is the location of the parathyroid glands?

A

deep to the lateral lobes of the thyroid gland

inferior parathyroids are anterior to the recurrent laryngeal nerve, superior parathyroids are posterior to the recurrent laryngeal nerve

36
Q

What is the arterial supply to the parathyroid glands? Why is this significant?

A

inferior thyroid arteries

significant b/c these arteries can help you identify the recurrent laryngeal nerve

37
Q

Describe the course of the recurrent laryngeal nerve

A

runs in the tracheoesophageal groove and enters into the cricothyroid joint

38
Q

Describe the difference b/w the right and left recurrent laryngeal nerves

A

right: descends into the chest and hooks around the subclavian artery
left: descends into the chest and hooks around the arch of the aorta

39
Q

Describe the relationship b/w the recurrent laryngeal nerve and the thyroid gland

A

the laryngeal nerve passes through ligaments that bind the thyroid to the trachea. Manipulation of the thyroid or thyroidectomy needs to remember this

40
Q

Brachial plexus course (in the posterior triangle)

A

runs between the anterior and middle scalene muscles; the trunks cross the base of the posterior triangle & several branches are visible in the posterior triangle, including:

dorsal scapular nerve
long thoracic nerve
suprascapular nerave

41
Q

External Jugular Vein (in the posterior triangle)

A

enters the posterior triangle after crossing the sternocleidomastoid muscle

42
Q

Subclavian artery (in the posterior triangle)

A

passes the base of the posterior triangle

43
Q

Describe the route of the accessory nerve

A

descends posteriorly through the neck to reach the anterior border of the sternocleidomastoid muscle, then passes to reach the posterior triangle within the investing layer of fascia

superficial location of the nerve as it crosses the posterior triangle makes it susceptible to injury

44
Q

Describe the characteristics of the hyoid bone

A

U shaped, can be palpated and moved side to side since it’s located superiorly to the larynx

f(x); attachment for muscles & soft tissue structures in the neck

45
Q

Cricothyroid Ligament significance

A

artificial penetration of this membrane during emergency situations can provide access to the lower airway when the upper airway above the level of the vocal folds is blocked

46
Q

Occipital Nodes

A

lymphatic drainage from posterior scalp & neck

47
Q

Mastoid Nodes

A

drainage from posterolateral half of the scalp

48
Q

Pre-Auricular and Parotid Nodes

A

drainage from the anterior surface of the auricle, anterolateral scalp, upper half of face, eyelids and cheeks

49
Q

Submandibular Nodes

A

drainage from structures along the path of the facial artery, as well as the gingivae, teeth, and tongue

50
Q

Submental Nodes

A

drainage is from the center part of the lower lip, chin, floor of the mouth, tip of th etongue & lower incisor teeth

51
Q

Drainage from occipital nodes passes to

A

superficial cervical nodes

52
Q

Drainage from mastoid nodes passes to

A

superficial cervical nodes

53
Q

Drainage from pre-auricular nodes and parotid nodes

A

deep cervical nodes

54
Q

Drainage from submandibular nodes

A

deep cervical nodes

55
Q

Drainage from submental nodes

A

deep cervical nodes

56
Q

Deep Cervical Nodes

A

run along the internal jugular veins & eventually receive lymphatic drainage from the head and neck either directly or through regional lymph node groups

M1: Anatomy and Embryology Lecture BW (37 decks)

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