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ENT Advanced > Cross-section Of The Neck > Flashcards

Cross-section Of The Neck Flashcards

1
Q

Which cervical vertebrae are typical and atypical?

A

Typical - C3-C6

Atypical - C1-2, C7

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2
Q

Features of the atypical vertebrae?

A

C1 - no spinous process or body
C2 - peg-like dens projecting superiorly from its body
C7 - long spinous process, not bifid. Large transverse processes with small transverse foramen

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3
Q

Where does the hyoid bone lie?

A

At the level of C3

Between the mandible and thyroid cartilage

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4
Q

Muscles which suspend the hyoid bone connect to where?

A 
Mandible
Styloid process
Thyroid cartilage
Manubrium of sternum
Scapulae
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5
Q

What is the purpose of the hyoid bone?

A

Attachment for anterior neck muscles

Prop to keep airway open

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6
Q

Name the suprahyoid muscles and their innervation

A

Stylohyoid: facial nerve

Digastric

  • anterior belly: trigeminal
  • posterior belly: facial

Mylohyoid
-trigeminal

Geniohyoid
-C1 roots

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7
Q

Overall action of the suprahyoid muscles?

A

Elevate the hyoid bone, which initiates swallowing

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8
Q

Which suprahyoid muscle forms the floor of the mouth?

A

Mylohyoid

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9
Q

Name the infrahyoids and their innervation

A

Sternohyoid
-anterior rami of C1-3

Omohyoid
-anterior rami of C1

Sternothyroid
-ant rami of C1-3

Thyrohyoid
-ant ramus of C1-3

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10
Q

Attachments of the sternocleidomastoid?

A

Medial head from manubrium of sternum
Lateral head from medial third of clavicle
Mastoid process of temporal bone

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11
Q

Innervation of the sternocleidomastoid?

A

Accessory nerve - C2-3

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12
Q

Attachments of the trapezius?

A

Skull and spinous process of C7-T12

Attaches to clavicle, acromion and spine of scapula

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13
Q

Actions of the trapezius?

A

Elevates scapula and rotates it during abduction
Middle fibres retract the scapula
Lower fibres pull it inferiorly

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14
Q

Borders of the anterior triangle in the neck?

A

Superior - inferior border of mandible
Lateral - medial border of SCM
Medial - sagittal line down body

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15
Q

Structures in the anterior triangle?

A 
Common carotid artery which bifurcates here
Internal jugular vein
Cranial nerves
-facial
-glossopharyngeal
-vagus
-accessory
-hypoglossal
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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

Contents of the carotid triangle?

A

Carotid artery which bifurcates
Internal jugular vein
Hypoglossal and vagus nerves

18
Q

Clinical relevance of the carotid triangle?

A

Structures in the triangle are easily accessible here for surgery as they are more superficial
Carotid sinus is here which contains baroreceptors - carotid rub

19
Q

Which nerve feeds info from the carotid triangle to the brain about blood pressure?

A

Glossopharyngeal nerve

20
Q

What does the submental triangle contain?

A

Submental lymph nodes which filter from floor of mouth and tongue

21
Q

What does the submandibular triangle contain?

A

Submandibular gland
Lymph nodes
Facial artery and vein

22
Q

What does the muscular triangle contain?

A

Infrahyoid muscles
Pharynx
Thyroid gland
Parathyroid gland

23
Q

Borders of the posterior triangle?

A 
Anterior - posterior border of SCM
Posterior - anterior border of trapezius
Inferior - Middle third of clavicle
Roof -investing layer of fascia
Floor - prevertebral fascia
24
Q

Contents of the posterior triangle?

A

Muscles

  • omohyoid
  • splenius captitis
  • levator scapulae
  • anterior, middle and posterior scalene

Vasculature

  • external jugular vein which drains into the subclavian vein here
  • transverse cervical artery
  • subclavian artery and vein

Nerves

  • accessory nerve
  • cervical plexus
  • trunks of brachial plexus
25
Q

What are the subdivisions of the posterior triangle?

A

Occipital triangle superiorly
Subclavian triangle inferiorly

Split by omohyoid muscle

26
Q

What injury can happen in the posterior triangle?

A

Severance of the external jugular vein
Fascia maintains the lumen - air is drawn in - froth in right atrium and ventricle - cyanosis
Therefore pressure needs to be applied

27
Q

What numbing thing can happen in the posterior triangle?

A

Cervical plexus nerve block - injected along posterior border of the SCM
Not carried out on patients with pulmonary or cardiac problems because it can damage the phrenic nerve

28
Q

What structures does the carotid sheath contain?

A

Internal jugular vein
Common carotid artery
Vagus nerve
Deep cervical lymph nodes

29
Q

What does the pre-vertebral fascia contain?

A

Muscles surrounding the vertebrae

Base of skull to T2/3

30
Q

What does the pre-tracheal fascia contain?

A

Thyroid
Trachea
Oesophagus

31
Q

What are the two main layers which surround the whole neck called?

A

Superficial cervical fascia

Deep investing fascia

32
Q

If there is an infection posterior to the pre-vertebral fascia, what can happen?

A

Erode through the pre-vertebrae fascia and drain into the retropharyngeal space

33
Q

Where can infection spread if it begins between the investing fascia and visceral part of the pre-tracheal fascia?

A

Can spread inferiorly into the chest and cause an infection of the anterior mediastinum

34
Q

What structures does the superficial cervical fascia contain?

A 
Neurovascular supply to the skin
Superficial veins eg external jugular vein
Superficial lymph nodes
Fat
Playtysma muscle
35
Q

Innervation of the platysma muscle?

A

Facial nerve

36
Q

Importance of fascia in the neck?

A

Allows structures to slide over one another
Puts them into compartments
Helps us to determine where infection and cancer can spread

37
Q

Name the three layers of the deep cervical fascia

A

Deep investing
Pretracheal
Prevertebral

38
Q

Function of the deep cervical fascia?

A

Supports viscera, muscles, vessels and deep lymph nodes
Limits the spread of abscesses resulting from infection
Allows structures in the neck to pass over each other during breathing and turning the head and neck

39
Q

Which structures does the investing layer of fascia enclose?

A

SCM
Trapezius
Submandibular and parotid salivary glands

40
Q

Structures in the occipital triangle?

A 
Spinal accessory nerve
Trunks of brachial plexus
Parts of external jugular vein
Posterior branches of the cervical plexus 
Cervicodorsal trunk
Cervical lymph node
41
Q

Contents of the omoclavicular/subclavian triangle?

A

Subclavian artery
Part of subclavian vein
Suprascapular artery
Supraclavicular lymph nodes

42
Q

Features of the typical cervical vertebrae?

A

Large and triangular vertebral foramen
Transverse processes have transverse foramen
Spinous processes are short and bifid

ENT Advanced (24 decks)

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