book FC on neck Flashcards
what is the layer of fatty connective tissue that lies between the dermis of the skin and the investing layer of deep cervical fascia
cervical subcutaneous tissue
what fascial layer is the stylomandibular ligament a thickened modification of
investing layer of deep cervical fascia
what space is located between the 2 layers that enclose the SCM
suprasternal space
what does the suprasternal space enclose
inferior ends of the anterior jugular veins, jugular venous arch, fat and a few deep lymph nodes
what does the pre tracheal layer of deep fascia blend laterally with
carotid sheaths
what does the pre vertebral layer of the deep cervical fascia blend with inferiorly
endothoracic fascia peripherally and anterior longitudinal ligament centrally
what does the pre vertebral fascia extend laterally as
axillary sheath
what is the potential space that consists of loose CT between the visceral part of the pre vertebral layer and the buccopharyngeal fascia
retropharyngeal space
what region is the trunks of the brachial plexus and the spinal accessory nerve within
occipital triangle (within lateral cervical region)
what is the anterior border of the lateral cervical region
posterior border of the SCM
what is the posterior border of the lateral cervical region
anterior border of traps
what is the inferior border of the lateral cervical region
middle third of the clavicle between the traps and the SCM
what 4 muscles form the floor of the lateral cervical region
splenius wapitis, levator scapulae, middle scalene and posterior scalene
what artery lies deep to the omoclavicular triangle
subclavian artery
what is the thyrocervical trunk a branch of
subclavian artery
what does the cervicodorsal trunk further bifurcate into
superficial cervical artery and dorsal scapular artery
what 2 veins join in order to form the EJV
posterior division of retromandibular and posterior auricular veins
what 2 veins join in order to form the brachiocephalic vein
subclavian and IJV
where doe the 2 veins join to form the brachiocephalic vein
at the anterior border of the anterior scalene
describe the position of the cervical plexus
anteromedial to the levator scapulae and middle scalene muscles and deep to the SCM
where do the cutaneous branches of the cervical plexus emerge
around the middle of the posterior border of the SCM (sometimes called the nerve point of the neck)
compare the crossing of the phrenic nerve on then left and right
on the right it crosses anterior to the first part of the subclavian artery; on the left it lies on the anterior scalene muscle and crosses anterior to the second part of the subclavian artery. on both sides, it runs posterior to the subclavian vein and anterior to the internal thoracic artery as it enters the thorax
what disorder causes the head to tilt toward and and the face to turn away from the affected side, due to a fibrous tumor that develops in the SCM
torticollis (L. fibromatosis colli)
what is the most commonly iatrogenic nerve injury
CN XI (located in lateral cervical region)
where is the anesthetic injected for a cervical plexus block
several points along the posterior border of the SCM
what is the main injection site for a supraclavicular brachial plexus flock
superior to the midpoint of the clavicle
what does injury to the supra scapular nerve result in
loss of lateral rotation of the humerus at the glenohumeral joint (causing the relaxed limb to rotate medially into the waiter’s tip position)
where can the carotid pulse most easily be felt
where it lies in a groove between the trachea and the infra hyoid muscles
what muscles cover the brachiocephalic trunk anteriorly
right sternohyoid and sternothyroid muscles
what are the branches of the first part of the subclavian artery
vertebral, internal thoracic and thyrocervical trunk
what is the branch of the 2nd part of the subclavian artery
costocervical trunk
what often arises from the 3rd part of the subclavian artery
dorsal scapular artery
where does the AJV typically arise
near the hyoid from the confluence of superficial submandibular veins
what union is typically referred to as the venous angle
where the IJV ends posterior to the medial end of the clavicle by uniting with the subclavian vein to for the brachiocephalic angle
where does the vagus nerve exit the cranium
through the jugular foramen
what is the course of the right vagus nerve to enter the thorax
passes anterior to the first part of the subclavian artery and posterior to the brachiocephalic vein and SC joint to enter the thorax
describe the course of the left vagus nerve to enter the thorax
descends between the left common carotid and left subclavian arteries and posterior to the SC joint to enter the thorax
describe the loop of the right recurrent laryngeal nerve
loops inferior to the right subclavian artery at T1-T2 vertebral level
describe the loop of the left recurrent laryngeal nerve
loops inferior to the arch of the aorta at T4-T5 vertebral level
where are the phrenic nerves formed
at the lateral borders of the anterior scalene muscles
where does the stellate ganglion typically lie
anterior to the transverse process of C7
what level is the middle cricoid ganglion typically found
at the level of the cricoid cartilage and the transverse process of C6 vertebra, just anterior to the vertebral artery
what level is the superior cervical ganglion typically found
C1 and C2 vertebrae
what is horner’s syndrome characterized by
contraction of pupil, drooping of the superior eyelid, sinking of the eye, vasodilation and absence of sweating on face and neck
what lesion occurs with horner’s syndrome
lesion of a cervical sympathetic trunk
what vertebral body level is the larynx located at
level of vertebral bodies of C3-C6 vertebrae
what is the most vital function of the larynx
guarding the air passages
what are the 3 single cartilages of the laryngeal skeleton
thyroid, cricoid and epiglottic
what are the 3 paired cartilages of the laryngeal skeleton
arytenoid, corniculate and cuneiform
what vertebral level is the thyroid cartilage found opposite of
C4 vertebra
what is the official name for the opening between the vocal folds
rima glottidis
what is the thin, submucosal sheet of connective tissue that extends between the lateral aspects of the arytenoid and epiglottic cartilages
quadrangular membrane
what supplies all of the intrinsic laryngeal muscles except the cricothyroid
the recurrent laryngeal nerve
what innervates the cricothyroid
Extrinsic laryngeal nerve
what are the principle adductors of the larynx
lateral crico-arytenoid muscles
what muscles pull the arytenoid cartilages together
transverse and oblique arytenoid muscles
what is the main action of the cricothyroid
stretches and tenses the vocal ligament
what is the main action of the thyro-arytenoid
relaxes vocal ligament
what is the main action of the posterior crico-arytenoid muscle
Abducts vocal folds
what is the main action of the lateral crico-arytenoid
adducts vocal folds
what is the main action of the vocalis
relaxes posterior vocal ligament while maintaining (or increasing) tension of the anterior part
what are the principle tensors of the larynx
crick-thyroid muscles
where does lymph superior to the vocal folds typically drain
superior deep cervical lymph nodes
where do the lymphatics inferior to the vocal folds drain
pre tracheal or paratracheal lymph nodes, which drain into the inferior deep cervical lymph nodes
what ganglion do the superior laryngeal nerves arise from
inferior vagal ganglion at the superior end of the carotid triangle
what nerve is the continuation of the recurrent laryngeal nerve
inferior laryngeal nerve
what does the thyroid ima artery, when present, arise from (typically)
brachiocephalic trunk
where do accessory thyroid glands typically occur
on the thyrohyoid muscle
what does goiter result from
lack of iodine
what is the usual sign of unilateral recurrent laryngeal nerve injury
hoarseness
what typically occurs as a result of laryngeal fractures
sub mucous hemorrhage and edema, respiratory obstruction, hoarseness, and sometimes temporary inability to speak
what happens to the voice when there is an injury to the external branch of the superior laryngeal nerve
it becomes monotonous due to the paralyzed cricothyroid muscle (it is unable to vary the length and tension of the vocal fold)
where is the need inserted for a superior laryngeal nerve block in a conscious person
midway between the thyroid cartilage and the hyoid
what tonsils are removed with a typical tonsillectomy
palatine tonsils
what is another name for the pharyngeal tonsils
Adenoids
what is an abnormal canal that opens internally into the tonsillar sinus and externally on the side of the neck
branchial fistula
what is the most common birth defect of the esophagus
tracheo-esohpageal fistula
what lymph nodes are commonly enlarged with esophageal cancer
inferior deep cervical lymph nodes
where is the lymph from most of the superficial tissues of the neck drained
superficial cervical lymph nodes
where does lymph from the superior cervical lymph nodes drain
inferior deep cervical lymph nodes
where does the thoracic duct enter the left brachiocephalic vein
at the junction of the subclavian and IJVs (left venous angle)
