Deep Neck & Root of the Neck

Question 1

what is the root of the neck?

Answer 1

area immediately superior to the superior thoracic aperture and axillary inlet

Question 2

anterior boundary of the root of the neck

Answer 2

superior margin of manubrium, sternum, & clavicle

Question 3

posterior boundary of the root of the neck

Answer 3

body of T1

Question 4

lateral boundary of the root of the neck

Answer 4

superior margins & costal cartilages of ribs 1 & 2

Question 5

name the prevertebral muscles seen posterior to retropharyngeal space & medial to neurovascular plane in the root of the neck

Answer 5

• longus coli
• longus capitus
• rectus capitus anterior
• anterior scalene

Question 6

name the muscles seen posterior to the neurovascular plane in the root of the neck

Answer 6

• rectus capitus lateralis
• splenius capitus
• levator scapulae
• middle scalene
• posterior scalene

Question 7

the right subclavian artery branches from the ____

Answer 7

brachiocephalic trunk

Question 8

the left subclavian artery branches from the ____

Answer 8

arch of aorta

Question 9

location of the first part of the subclavian artery

Answer 9

medial to anterior scalene

Question 10

location of the second part of the subclavian artery

Answer 10

deep to anterior scalene

Question 11

location of the third part of the subclavian artery

Answer 11

lateral to anterior scalene

Question 12

name the branches of the first part of the subclavian artery

Answer 12

• vertebral a
• internal thoracic a
• thyrocervical trunk

Question 13

the costocervical trunk is a branch of the ____

Answer 13

second part of the subclavian artery

Question 14

name the branches of the costocervical trunk

Answer 14

superior intercostal a
deep cervical a

Question 15

the dorsal scapular artery is a branch of the ____

Answer 15

third part of the subclavian artery
(Variation: may be off of transverse cervical a)

Question 16

name the 4 parts of the vertebral artery

Answer 16

• cervical
• vertebral
• suboccipital
• cranial

Question 17

location of cervical part of vertebral artery

Answer 17

ascends between scalenes & longus coli mm

Question 18

location of vertebral part of vertebral artery

Answer 18

passes through transverse foramen of C6-C1

Question 19

location of suboccipital part of vertebral artery

Answer 19

passes over groove for vertebral a on C1 posterior arch to enter foramen magnum

Question 20

location of cranial part of vertebral artery

Answer 20

right and left join in foramen magnum to form basilar a

Question 21

the vertebral artery will enter the transverse foramen at what level?

Answer 21

C6

Question 22

name the 4 branches of the thyrocervical trunk

Answer 22

• inferior thyroid a
• ascending cervical a
• suprascapular a*
• transverse cervical a*

Question 23

name 2 veins of the root of the neck

Answer 23

• external jugular v
• anterior jugular v

Question 24

location of internal jugular vein

Answer 24

• deep to SCM
• terminates at T1

Question 25

what forms the brachiocephalic vein?

Answer 25

internal jugular v + subclavian v

Question 26

where is the brachiocephalic vein formed?

Answer 26

venous angle

Question 27

describe the course of the subclavian vein in the root of the neck

Answer 27

travels over 1st rib ant. to subclavian a (separated from a by ant. scalene)

Question 28

describe the lymphatic structures on either side of the venous angle

Answer 28

- thoracic duct empties on left - right lymphatic duct empties on right

Question 29

in the carotid triangle, the internal jugular vein lies lateral to the ____ artery

Answer 29

common carotid

Question 30

the bifurcation of the common carotid artery into the internal and external carotid arteries occurs at what spinal level?

Answer 30

C3-C4

Question 31

the external carotid artery lies ____ to the posterior belly of the digastric

Answer 31

deep

Question 32

the internal jugular vein unites with the ____ superior to the clavicle on each side to form the ____

Answer 32

subclavian v brachiocephalic v

Question 33

in the carotid sheath, the vagus nerve lies between ____ and ____

Answer 33

internal jugular v & common carotid a

Question 34

vagus nerve is located in what part of the carotid sheath?

Answer 34

posterior

Question 35

describe the path of the **right** vagus nerve

Answer 35

- passes anterior to 1st part of subclavian a to enter thorax - gives off right recurrent laryngeal n which loops around *R subclavian a*

Question 36

describe the path of the **left** vagus nerve

Answer 36

- passes between left common carotid and left subclavian to enter thorax - gives off left recurrent laryngeal n which loops around *arch of aorta*

Question 37

describe the path of both recurrent laryngeal nerves

Answer 37

ascend in tracheo-esophageal groove to supply trachea, esophagus and larynx

Question 38

what is the sensory ganglion of the vagus nerve, and where is it located?

Answer 38

- inferior nodose ganglion - at jugular foramen

Question 39

location of superior cervical ganglion

Answer 39

level of C1-C2

Question 40

location of middle cervical ganglion

Answer 40

level of cricoid cartilage and TP of C6

Question 41

location of inferior cervical ganglion

Answer 41

anterior TP of C7 and posterior to vertebral a

Question 42

superior cervical ganglion innervates...

Answer 42

- postgang. fibers for internal carotid plexus - arterial branches to external carotid artery branches - gray rami to C1-C4 spinal nn - superior cervical cardiac n

Question 43

which white rami communicates does the cervical sympathetic trunk receive?

Answer 43

NONE

Question 44

middle cervical ganglion innervates...

Answer 44

- postgang. fibers for gray rami of C5-C6 spinal nn - middle cervical cardiac n - arterial plexus to thyroid gland

Question 45

which cervical ganglion is the smallest and may be absent?

Answer 45

middle

Question 46

what forms the stellate (cervicothoracic) ganglion in 80% of individuals?

Answer 46

inferior cervical ganglion fuses with T1 ganglion

Question 47

the inferior cervical ganglion innervates...

Answer 47

- postgang. fibers for gray rami of C7-C8 spinal nn - inf. cervical cardiac n - arterial branches to vertebral a

Question 48

what is ansa subclavia (subclavian loop)?

Answer 48

bilateral nerve loop that connects middle & inferior cervical ganglia and loops around the subclavian a

Question 49

name the 3 visceral layers of the neck

Answer 49

- endocrine - respiratory - alimentary

Question 50

name the components of the endocrine layer of the neck

Answer 50

thyroid & parathyroid glands

Question 51

name the components of the respiratory layer of the neck

Answer 51

larynx & trachea

Question 52

name the components of the alimentary layer of the neck

Answer 52

pharynx & esophagus

Question 53

what is the largest endocrine gland?

Answer 53

thyroid gland

Question 54

describe the location of the thyroid gland

Answer 54

at level of C5-T1 anterolateral to larynx & trachea

Question 55

right and left lobes of the thyroid gland are connected by the ____ at the level of the ____

Answer 55

- isthmus - 2nd-3rd tracheal rings

Question 56

what arteries supply the thyroid gland?

Answer 56

superior thyroid a inferior thyroid a

Question 57

name 3 thyroid anomalies

Answer 57

- pyramidal lobe (50%) - levator glandulae thyroideae m - thyroidea ima a (10%)

Question 58

describe the location of the parathyroid glands

Answer 58

bilateral pairs (sup & inf) external to thyroid capsule on posterior surface of thyroid gland

Question 59

what is the function of parathyroid hormone secretion?

Answer 59

serum calcium regulation

Question 60

blood supply of parathyroid glands

Answer 60

inferior thyroid a

Question 61

the thyroid gland lies superficial to what nerves?

Answer 61

recurrent laryngeal nn