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Medicine Sem 3 > Case 10 anatomy > Flashcards

Case 10 anatomy Flashcards

1
Q

what can be palpated in the neck and where?

A
  • Hyoid bone = C3
  • Thyroid cartilage – upper edge = C4
  • Cricoid cartilage = C6
  • Thyroid gland – isthmus = C7
  • Suprasternal notch = T2/3

and trachea

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2
Q

why is the cricoid cartilage an important bony landmark?

A
  • Junction between the larynx and trachea
  • Junction between the pharynx and oesophagus
  • Level where the recurrent laryngeal nerve enters the larynx
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3
Q

what is the liagmentum nuchae?

A

broad, strong, fibroelastic ligament that merges with the supraspinous ligament

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4
Q

how is the hyoid bone suspended while being attached to no other bones?

A
  • suspended from the styloid process by the stylohyoid ligament
  • attached to thyroid cartilage by thyrohyoid membrane
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5
Q

what is the role of the hyoid bone?

A

plays a roll in:

  • swallowing
  • mastication
  • attachment for tongue
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6
Q

describe the hyoid bone

A
  • Body
  • Lesser horn
  • Greater horn (just the end not the whole thing i think)
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7
Q

where does the sternocleidomastoid originate and insert?

A
  • origin: (two heads) - manubrium and medial third of clavicle
  • insertion: mastoid process of temporal bone and superior nuchal line of occipital bone
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8
Q

what forms the floor of the triangles?

A
  • scalene muscles

- prevertebral fascia

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9
Q

what’s in the anterior triangle?

A
  • Suprahyoid muscles
  • Infrahyoid muscles
  • Thyroid gland
  • Parathyroid glands
  • Submandibular gland
  • External carotid artery
  • Internal carotid artery
  • Common carotid artery
  • Internal jugular vein
  • Phrenic nerve
  • Vagus nerve
  • Trachea
  • Oesophagus
  • 2 sets of muscles
  • 3 glands
  • 3/4 vessels
  • 2 nerves
  • 2 tubes
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10
Q

what’s in the posterior triangle?

A
  • Inferior belly of omohyoid
  • Subclavian artery
  • Suprascapular vessels
  • Transverse cervical vessels
  • External jugular vein
  • Accessory nerve
  • Branches of cervical plexus
  • Trunks of the brachial plexus
  • 1 muscle
  • 4 vessels
  • 3 nerves
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11
Q

what are the boundaries of the subdivisions of the triangles?

A
  • Submandibular – bounded by the inferior border of the mandible and the anterior and posterior bellies of the digastric
  • Submental – bounded by the midline, anterior belly of digastric and the hyoid bone
  • Carotid – bounded by posterior belly of digastric, superior belly of omohyoid and sternocleidomastoid
  • Muscular – bounded by superior belly of omohyoid, sternocleidomastoid and midline
  • Occipital – bounded by trapezius, inferior belly of omohyoid and sternocleidomastoid
  • Supraclavicular – bounded by clavicle, inferior belly of omohyoid and sternocleidomastoid
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12
Q

what’s superior and muscular or carotid triangle?

A

carotid (and more lateral)

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13
Q

what are structures of the neck compartmentalised by?

A

the cervical fascia - deep fascia

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14
Q

what does the superficial fascia do? where is ti?

A

underlies the skin – it consists of loose connective tissue and contains the thin platysma muscle

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15
Q

what are the different CERVICAL fascia?

A
  • investing layer
  • pretracheal layer
  • prevertebral layer
  • carotid sheath
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16
Q

where’s the investing layer? what does it include?

A
  • lies deep to the superficial fascia and surrounds the whole neck
  • it splits ??? to enclose the SCM, trapezius and infrahyoid muscles, and the submandibular and parotid glands
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17
Q

pretracheal layer

  • what does it enclose?
  • what is it continuous with?
  • where does it thicken to form what?
A
  • encloses the thyroid gland, oesophagus, trachea and larynx
  • posteriorly it is continuous with the buccopharyngeal fascia of the pharynx
  • it is thickened near the hyoid bone to form a pulley through which the intermediate tendon of the digastric passes
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18
Q

what does the prevertebral layer surround?

A

the vertebrae and the deep cervical muscles of the neck

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19
Q

carotid sheath

  • what does it fuse with?
  • what does it contain?
A
  • is fused anteriorly with the investing and pretracheal fascia and posteriorly with the prevertebral fascia
  • contains the common and internal carotid arteries, the internal jugular vein and the vagus nerve
20
Q

what do the suprahyoid muscles do when they contract?

A
  • Contraction of the suprahyoid muscles will then cause the mandible to be depressed
  • However, if the mandible is fixed and the infrahyoid muscles are relaxed the hyoid will be elevated when the suprahyoid muscles are contracted
21
Q

what are the origins and insertions of the suprahyoid muscles?

A
  • Anterior belly of digastric (digastric fossa of mandible)
  • Posterior belly of digastric (mastoid process)
  • Stylohyoid (styloid process to lateral aspect of hyoid bone)
  • Geniohyoid (inferior mental spine of mandible to hyoid bone)
  • Mylohyoid (from mylohyoid line of mandible to hyoid bone)
22
Q

what are the origins of the sternohyoid and sternothyroid muscles?

A
  • sternohyoid - sternum and sternoclavicular joint
  • sternothyroid - manubrium

(sternohyoid is more lateral)

23
Q

where do the common carotid arteries arise?

A
  • right - brachiocephalic trunk

- left - arch of aorta

24
Q

where does the bifurcation of the common carotid arteries occur?

A

most commonly at the upper border of the thyroid cartilage

25
Q

does the internal carotid artery give off any branches as it ascends through the neck?

A

NO

26
Q

where does the external carotid artery travel to after passed through the neck?

A

parotid gland

27
Q

how many branches does the external carotid artery give off as it courses the neck? what and where are they?

A

6:

  • three anterior = superior thyroid, lingual & facial
  • one medial = ascending pharyngeal ?
  • two posterior = posterior auricular & occipital
28
Q

which foramen transversarium do the vertebral arteries travel through? where does it go then? how do they enter the skull? then where does it go?

A
  • those of the upper 6 cervical vertebrae
  • passes medially over the posterior arch of the atlas
  • enters skull through foramen magnum
  • passes to anterior surface of medulla
  • then unites with vertebral artery from other side to form the basilar artery
29
Q

describe the path of the internal jugular vein

A
  • Begins as a continuation of the sigmoid sinus
  • Exits the skull through the jugular foramen
  • Descends through the neck within the carotid sheath
  • Receives the common facial vein
  • Unites with the subclavian vein to form the brachiocephalic vein
30
Q

external jugular vein

  • where’s it formed
  • by what
  • where does it lie and travel
  • where does it drain into
A
  • Formed behind the angle of the mandible
  • Formed by the union of the posterior division of the retromandibular vein and the posterior auricular vein
  • The external jugular vein lies superficial to the sternocleidomastoid muscle before traversing the posterior triangle
  • It drains into the subclavian vein
31
Q

is there a common jugular vein? where are they two veins in relation to each other?

A
  • no common jugular vein
  • both insert separately into the subclavian vein
  • internal jugular is more anterior than external
  • internal jugular and internal carotid artery run along side each other in neck (in carotid sheath)
32
Q

lymphatic drainage of the head and neck

  • what chain lies where
  • receive lymph from where
  • names
  • where drain
A
  • A chain of deep cervical lymph nodes lies along the length of the internal jugular vein
  • These nodes receive lymph from the numerous regional lymph nodes of the head and neck as well as directly from surrounding tissues
  • Two named nodes of this deep group are the jugulodigastric and the jugulo-omohyoid nodes
  • The former drains lymph from the tonsils and the tongue and the latter from the tongue
  • Efferent vessels from the deep cervical nodes unite to form the right and left jugular trunks which in turn drain into the right lymphatic duct and the thoracic duct respectively

deep group:

  • jugulodigastric - tonsils and tongue
  • jugulo-omohyoid - tongue
33
Q

what are the different lymph nodes of the head and neck?

A
  • cervical (those of the neck) lymph nodes = superficial and deep (jugulodigastric and jugulo-omohyoid)
  • occipital
  • mastoid
  • parotid
  • buccal
  • submental
  • submandibular
34
Q

what are the nerves of the neck?

A
  • Vagus
  • Phrenic
  • Cervical sympathetic chain
  • Hypoglossal (CN XII)
  • Glossopharyngeal (IX)
  • Internal laryngeal
  • External laryngeal
  • Ansa cervicalis (loop of nerves that are part of the cervical plexus)

(where recurrent laryngeal nerve) - just don’t have to identify it?

35
Q

which cranial nerve is associated with the ansa cervicalis?

A

hypoglossal

36
Q

which nerve gives rise to the internal and external laryngeal nerves? and sensory or motor for these nerves?

A

superior laryngeal nerve

  • internal = sensory
  • external = motor
37
Q

is recurrent laryngeal nerve sensory or motor?

A

both

38
Q

what is the aryepiglottis?

A

muscle which narrows the laryngeal inlet

39
Q

what is the only muscle with abducts the vocal cords?

A

posterior cricoarytenoid

40
Q

what’s the aryepiglottic fold?

A

free upper border of the QUADRANGULAR membrane

41
Q

which cartilage is the epiglottis attached to?

A

thyroid

42
Q

what is the vestibule of larynx?

A

supraglottic cavity

43
Q

which muscle tenses the vocal cords?

A

cricothyroid

44
Q

what is the ventricle?

A

area between the vestibular fold (false cord) and vocal fold (true cord)

45
Q

what is the glottis?

A

gap between the two vocal cords (vocal folds)

46
Q

what does the recurrent laryngeal nerve supply sensory innervation to?

A

larynx below the vocal cords

47
Q

what does the external laryngeal nerve supply?

A

the cricothyroid muscle

Medicine Sem 3 (23 decks)

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