CC2 - Anatomy Flashcards
1
Q
Torticollis-Congenital
A
- a contraction or shortening of the cervical muscles → twisting of the neck and slanting of the head
- most commonly from a fibrous tissue tumor that develops in the SCM before/shortly after breath
- lesion causes head to tilt toward, and the face to turn away from, the affect side
- SCM can be injured when an infants head is pulled too much during birth → hematoma forms that entraps CN XI → denervates part of the SCM → twisting and stiffness of neck resulting from fibrosis and shortening of the SCM
2
Q
Torticollis-Spasmodic
A
cervical dystonia
- begins in adulthood
- usually affects the SCM and trapezius
- sx: sustained turning, tilting, flexing, or extending of the neck
3
Q
Spread of infections in the neck
A
- investing layer of the deep cervical fascia helps prevent the spread of abscesses
- if an infection occurs between the investing layer and the muscular part of the pretracheal fascia → infection wont spread
- if an infection occurs between the investing fasic and the visceral part of the pretracheal fascia → can spread to the thoracic cavity and pericardium
- infections in head may also spread inferiorly posterior to the esophagus and enter mediastinum or trachea
4
Q
Paralysis of Platysma
A
- results from injury to the cervical branch of the facial nerve
- causes skin to fall away from the neck in slack folds
- be careful to this area during surgery (preserve cervical branch)
- when suturing → carefully suture around the edges of the platysma
- if not done → skin will be distracted → ugly scar
5
Q
Prominence of the External Jugular Vein
A
- serves as an internal barometer
- normal venous pressure → EJV is visible above the clavicle for a short distance
- venous pressure rises → vein is prominent throughout its course along the side of the neck
6
Q
Severance of the External Jugular Vein
A
- if severed along the posterior border of the SCM (knife slash) → negative intrathoracic pressure will suck air into the vein
- causes a churning noise in the thorax
- venous air embolism can form this way → stop blood flow to right side of heart
7
Q
Subclavian Vein Puncture
A
- often the site for central line placement
- not inserted carefully → may puncture the pleura and lung → pneumothorax (air between lungs and chest wall)
- needle may also enter subclavian artery
8
Q
Right Cardiac Catherization
A
- used to make measurements of pressures in the right chambers of the heart
- puncture IJV to get catheter into superior vena cava and R side of heart
9
Q
Ligation of External Carotid Artery
A
- used to make measurements of pressures in the right chambers of the heart
- puncture IJV to get catheter into superior vena cava and R side of heart
- blood flows backwards into the artery from external carotid artery on the other side
- when ligated → descending branch of the occipital artery provides the main collateral circulation
10
Q
Carotid Occulsion and Endarterectomy
A
- atherosclerotic thickening of the internal carotid artery may obstruct blood flow
- partial occlusion →cause a transient ischemic attack (TIA) (a sudden focal loss of neurological function that disappears within 24 hours) OR cause a minor stroke (a loss of neurological function that exceeds 24 hr but disappears within 3 weeks)
- obstruction can be observed in a Doppler color study
- carotid endarterectomy- opening the artery at its origin and stripping off the atherosclerotic plaque with the intima
11
Q
Carotid Pulse
A
- easily felt by palpating the common carotid artery in the side of the neck
- lies in groove between the trachea and the infrahyoid muscle
- felt deep to the anterior border of the SCM at the level of the the superior border of the thyroid cartilage
12
Q
Carotid Sinus Hypersensitivity
A
- external pressure on the carotid artery may cause slowing of the heart rate, fall in BP and cardiac ischemia → fainting
- don’t check pulse in this area for people with cardiac or vascular disease
13
Q
Role of Carotid Bodies
A
- in an ideal position to monitor the oxygen content of the blood before it reaches the brain
- A decrease in PO2 (partial pressure of oxygen) → activates the aortic and carotid chemoreceptors → increasing alveolar ventilation
- also respond to increased CO2 tension or free H+ in the blood
- CN IX conducts info centrally → stimulation of respiratory centers → increase breathing
14
Q
Thyroid Ima Artery
A
- small, unpaired artery that arises from the brachiocephalic trunk
- in 10% of people
- must be considered when performing procedures in the midline
15
Q
Thyroglossal Duct Cysts
A
- remnants of the epithelium may remain in the thyroid gland → form cyst
- usually close to the hyoid bone and forms a swelling in the anterior part of the neck
