Block 4: Lab 23--Neck, Thyroid & Parathyroid Glands

Question 1

Describe the characteristics of the cervical vertebrae

Answer 1

small bodies
large vertebral foramina
bifid spinous processes
transverse process w/a transverse foramen

Question 2

What are the boundaries of the posterior triangle of the neck?

Answer 2

anterior: posterior border of SCM
posterior: superior boundary of trapezius
inferior: middle 1/3 of clavicle

Question 3

What make up the roof and the floor of the posterior triangle?

Answer 3

roof: investing layer of deep cervical fascia
floor: muscles of the neck covered by prevertebral facia

Question 4

List the suprahyoid muscles

Answer 4

digastric muscle (2 muscle bellies)
mylohyoid
stylohyoid
geniohyoid

Question 5

List the infrahyoid muscles

Answer 5

sternohyoid
thyrohyoid
sternothyroid
omohyoid

Question 6

Describe the innervation of the infrahyoid muscles

Answer 6

ansa cervicalis (C1-C3) : sternohyoid, omohyoid, sternothyroid 
C1 via hypoglossal nerve: thyrohyoid

Question 7

Describe the innervation of the suprahyoid muscles

Answer 7

digastric: nerve to mylohyoid (anterior belly); facial nerve (posterior belly)

Question 8

Innervation of the stylohyoid muscle

Answer 8

Facial N (CN VII)

Question 9

What nerves are located in the anterior triangle?

Answer 9

cranial nerves (some pass through, some give rise to branches, some innervate structures within the triangle)

facial nerve (VII)
glossopharyngeal (IX) 
vagus (X) 
accessory (XI) 
hypoglossal (XII) 
transverse cervical (C2, C3) 
ansa cervicalis

Question 10

What are the subdivisions of the anterior triangle of the neck?

Answer 10

carotid triangle
submental triangle
submandibular triangle

Question 11

What are the boundaries of the carotid triangle

Answer 11

superior: posterior belly of digastric muscle
lateral: medial border of SCM
inferior: superior belly of omohyoid muscle

Question 12

Contents of the carotid triangle

Answer 12

common carotid artery
internal jugular vein
hypoglossal & vagus nerves

Question 13

Describe the carotid sinus

Answer 13

a dilated portion of the common & internal carotid arteries that contains baroreceptors that detect stretch as a measure of blood pressure

the glossopharyngeal nerve feeds this information to the brain to regulate blood pressure

Question 14

Contents of the submental triangle

Answer 14

submental lymph nodes

Question 15

Borders of the submental triangle

Answer 15

inferior: hyoid bone
medial: midline of neck
lateral: anterior belly of digastric

Question 16

Contents of the submandibular triangle

Answer 16

submandibular (salivary) glands, lymph nodes, facial artery & vein

Question 17

Borders of the submandibular triangle

Answer 17

superior: body of mandible
anterior: anterior belly of digastric muscle
posterior: posterior belly of digastric muscle

Question 18

Describe the location and structure of the thyroid gland

Answer 18

location: C5-T1
structure: 2 lobes connected by an isthmus; sometimes there is a 3rd lobe thats a remnant of embryological development

Question 19

Describe the arterial supply of the thyroid gland

Answer 19

superior thyroid artery, inferior thyroid artery (mostly supplies posterioinferior portions & the parathyroid glands)
thyroid IMA artery (only in 2-12% of population but clinically significant)

Question 20

Describe the venous drainage of the thyroid gland

Answer 20

superior and middle thyroid veins

Question 21

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

Answer 21

recurrent laryngeal nerve is near/within the tissues associated w/ the thyroid gland
damage to this nerve during thyroidectomy or compression by a tumor can lead to paralysis of the laryngeal muscles

Question 22

Difference b/w right and left recurrent laryngeal nerves

Answer 22

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

Question 23

Describe the lymphatic drainage of the thyroid glands

Answer 23

goes from perithyroid nodes to prelaryngeal nodes, then to pre or paratracheal nodes

Question 24

F(x) of the parathyroid glands

Answer 24

production of parathyroid hormone, which is responsible for maintaining calcium levels in the body

Question 25

What is the location of the parathyroid glands?

Answer 25

posterior aspect of the lateral lobes of the thyroid gland

Question 26

Arterial supply to the parathyroid glands

Answer 26

inferior thyroid arteries

Question 27

What nerves pass through the posterior triangle?

Answer 27

branches of the cervical plexus accessory nerve some brachial plexus components

Question 28

``` Cervical Plexus what is it? anterior rami formed in branches ```

Answer 28

what: network of nerve fibers that supply innervation to the structures of the neck and trunk anterior rami: C1-C4 formed in: muscles making up the floor of the posterior triangle, within the prevertebral fascia branches: superficial (cutaneous); deep (muscular)

Question 29

F(x) of the muscular branches of the cervical plexus

Answer 29

supply muscles of the neck, back, & diaphragm

Question 30

What are the muscular branches of the cervical plexus?

Answer 30

phrenic nerve nerves to geniohyoid & thyrohyiod ansa cervicalis

Question 31

Phrenic Nerve anterior rami course innervation

Answer 31

anterior rami: C3-C5 course: travels down surface of the anterior scalene muscle and enters the diaphragm f(x); innervates the diaphragm

Question 32

Nerves to Geniohyoid & Thyrohyoid anterior rami course

Answer 32

anterior rami: C1 | course: travels w/ hypoglossal nerve

Question 33

Ansa Cervicalis anterior rami course

Answer 33

anterior rami: C1-C3 | course: gives off 4 muscular branches that innervate the infrahyoid muscles

Question 34

Function of the superficial branches of the cervical plexus

Answer 34

supply the skin of the neck, upper thorax, scalp, and ear

Question 35

Where do the superficial branches of the cervical plexus enter the skin?

Answer 35

at erb's point

Question 36

Erb's Point where is it? significance

Answer 36

where: middle of posterior border of SCM significance: utilized during a cervical plexus block

Question 37

What are the deep branches of the cervical plexus?

Answer 37

lesser occipital nerve great auricular nerve transverse cervical nerve supraclavicular nerve

Question 38

Lesser Occipital Nerve anterior rami f(x) course

Answer 38

anterior rami: C2 w/ contribution from C1 f(x): cutaneous sensation to the posterosuperior scalp course: curves around the accessory nerve

Question 39

Great Auricular Nerve anterior rami f(x)

Answer 39

anterior rami: C2 & C3 roots | f(x): provide sensation to the external ear & skin over the parotid gland

Question 40

Transverse Cervical Nerve anterior rami f(x)

Answer 40

anterior rami: C3 to C4 | F(x): innervation to skin overlying the supraclavicular fossa & upper thoracic region

Question 41

Accessory Nerve f(x)

Answer 41

innervates trapezius & sternocleidomastoid

Question 42

Facial Nerve f(x)

Answer 42

INN: platysma muscle; gives off branches that innervate the posterior belly of the digastric muscle

Question 43

Glossopharyngeal Nerve sensory innervation special sensory

Answer 43

sensory: pharynx, carotid body & sinus, posterior 1/3 tongue special: taste sensation to posterior 1/3 of tongue

Question 44

Vagus Nerve course branches

Answer 44

enters the carotid sheath and descends medially to the internal jugular vein, internal carotid and common carotid arteries

Question 45

Hypoglossal nerve | f(x)

Answer 45

innervates the tongue

Question 46

Transverse Cervical Nerve anterior rami innervates

Answer 46

anterior rami: C2-C3 | innervates: cutaneous innervation to the neck

Question 47

Ansa Cervicalis anterior rami: innervates

Answer 47

anterior rami: C1 to C3 | innervation: strap muscles of the neck

Question 48

external jugular vein formed by supplies course

Answer 48

posterior auricular + retromandibular vein union supplies: majority of face course: anterior to sternocleidomastoid, extremely superficial

Question 49

Signifiance of the extremely superficial nature of the course of the external jugular vein

Answer 49

makes it vulnerable to damage;

Question 50

Origin of the R vs L carotid artery

Answer 50

R: originates from brachiocephalic trunk L: branches directly from the arch of aorta