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Cranio Exam 3 > deep structures (root of neck) > Flashcards

deep structures (root of neck) Flashcards

1
Q

vertebral artery

A
  • arises from first part of subclavian artery
  • ascends medially behind the carotid sheath to reach the foramen transversarium of C6
  • ascends thru foramina transverseria of C6-C1
  • enters foramen magnum
  • joins its fellow at lower border of pons to form the basilar artery
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2
Q

course of vertebral artery

A
  1. scalenovertebral triangle
  2. foramina transcersaria
  3. posterior arch of atlas
  4. cranial cavity
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3
Q

branches of vertebral artery

A
  1. anterior spinal artery
  2. posterior spinal artery
  3. posterior superior cerebellar artery
  4. medullary branches
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4
Q

branches of thyrocervical trunk

A
  1. inferior thyroid artery
  2. transverse cervical
  3. suprascapular
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5
Q

what forms an anastomosis around the scapula?

A
  1. subclavian artery
  2. axillary artery
  3. descending thoracic aorta (posterior intercostal arteries
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6
Q

clinical importance of scapular anastomosis

A
  • provides collateral circulation
  • allows for blood to continue circulating if the subclavian is obstructed
  • securing blood supply to upper limb in case of obstruction of the artery
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7
Q

what does the inferior thyroid artery supply?

A
  • thyroid
  • parathyroid glands
  • cervical part of trachea and esophagus
  • close to recurrent laryngeal nerve close to the posterior surface of thyroid gland
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8
Q

veins in the lateral cervical region

A
  • retromandibular vein
  • facial vein
  • external jugular vein
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9
Q

jugular veins

A
  • retromandibular
  • facial vein
  • posterior auricular vein
  • external jugular vein
  • trans cervical vein
  • suprascapular vein
  • subclavian vein
  • common facial vein
  • submental plexus
  • internal jugular vein
  • anterior jugular vein
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10
Q

clinical significance of external jugular vein

A
  1. venous line
  2. central venous pressure
  3. transvenous pacemaker and pulmonary wedge catheter
    - may cause fatal bleeding and air embolism
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11
Q

beginning, termination, and tributaries of external jugular vein

A
  • begin: union of posterior auricular with posterior division of retromandibular vein
  • term: into subclavian vein
  • tributaries: post. auricular vein, post. retro, anterior jugular vein, transverse cervical suprascapular
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12
Q

beginning, termination, and tributaries of internal jugular vein

A
  • begin: continuation of segmoid sinus
  • term: ends by joining subclavian to form brachiocephalic vein
  • tributaries: inferior petrosal sinus, common facial vein, lingual vein, superior and middle thyroid veins, pharyngeal veins
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13
Q

anterior jugular vein beginning, termination, tributaries

A
  • begin: submental plexus of veins
  • termination: into external jug vein
  • tributaries: submental vein
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14
Q

the subclavian vein is a continuation of the _____

A

axillary vein

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15
Q

where does the subclavian vein run?

A

from outer border of the first rib to the medial border of anterior scalene muscle

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16
Q

how is the innominate vein formed?

A

subclavian vein joins the internal jugular vein to form the brachiocephalic vein

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17
Q

where do the subclavian vein and artery lie?

A

subclavian vein lies anterior to the anterior scalene

-subclavian artery lies posterior to the anterior scalene (and anterior to the middle scalene)

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18
Q

what is the subclavian vein puncture used for?

A

right cardiac catheterization and IV line (chemo)

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19
Q

origin of sternocleidomastoid muscle

A
  • sternal head from front of manibrium sterni

- clavicular head from superior surface of medial third of clavicle

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20
Q

insertion of sternocleidomastoid muscle

A

mastoid process and superior nuchal line

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21
Q

nerve supply of sternocleidomastoid

A

spinal accessory nerve (motor)

C2 and C3 (proprioception)

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22
Q

action of sternocleidomastoid

A

turns face to opposite side and neck to same side

23
Q

origin of trapezius

A

from superior nuchal line, external occipital protuberance, ligamentum nuchae, and thoracic spines

24
Q

insertion of trapezius

A

into lateral third of clavicle and into acromion and spine of scapula

25
Q

nerve supply of trapezius

A

spinal accessory nerve (motor)

C3 and C4 (proprioception)

26
Q

action of trapezius

A
  • retracts and elevates the scapula
  • extension of neck (bilateral contraction with shoulder fixed)
  • lateral flexion of neck (unilateral contraction)
27
Q

scalene anterior

A
  • origin: anterior tubercles of transverse processes of C3-C6
  • insertion: scalene tubercle of first rib anterior to subclavian atery
  • nerve supply: C5-C7
  • action: elevates first rib and flexion of neck anteriorly and laterally
28
Q

scalene medius

A
  • origin: posterior tubercle of C2-C7
  • insertion: upper surface of 1st rib behind subclavian artery
  • C3-C8
  • elevates first rib and flexion of neck anteriorly and laterally
29
Q

scalene posterior

A
  • origin: posterior tubercles of C5-C7
  • insertion: upper surface of 2nd rib
  • nerve supply: C7-C8
  • elevates 2nd rib and flexion of neck anteriorly and laterally
30
Q

important relations of scalenus anterior

A
  • phrenic nerve
  • carotid sheath
  • subclavian artery and its branches
  • subclavian vein
  • brachial plexus
  • sympathetic trunk
31
Q

symptoms of thoracic outlet syndrome (TOS)

A

pain, numbness, tingling, weakness in arm and hand due to pressure against nerves or blood vessels that supply the arm

32
Q

causes of thoracic outlet syndrome

A

hyperextension neck injuries

auto accidents and repetitive stress

33
Q

people born with what makes that 10 times more likely to develop symptoms of TOS

A

cervical rib

34
Q

an extra rib in the neck occurs in less than ____ of the population

A

1%

35
Q

what compresses the subclavian artery?

A

cervical rib

36
Q

what nerve would be injured in posterior neck triangle operations?

A

spinal accessory nerve – would cause paralysis of trapezius muscle
*test by asking patient to shrug their shoulder

37
Q

what other structures should be considered when operating in the posterior neck triangle?

A
  • upper and middle trunks of the brachial plexus
  • third part of subclavian artery
  • subscapular nerve and artery
  • branches of cervical plexus
  • in left side thoracic duct
38
Q

what innervates smooth and cardiac muscle, uses a two neuron system, and has ganglia between neurons?

A

autonomic nervous system

39
Q

each sympathetic pathway from the cord to the stimulated tissue is composed of ______

A

two neurons, a preganglionic neuron and a postganglionic neuron

40
Q

where is the source of all preganglionic sympathetic fibers ?

A

in the lateral horn of the spinal cord between T1 and L2 and leave the spinal cord via the ventral rootlet

41
Q

cervical sympathetic trunk

A

some of the higher thoracic preganglionic fibers ascend into the neck without synapsing to form the cervical sympathetic trunk

42
Q

cervical sympathetic chain ganglia

A

superior
middle
inferior

43
Q

superior cervical ganglion

A
  • C1-C4
  • arteries involved: common, external, internal carotid
  • organs: eye, face, nasal, pharynx, palate and nasal cavity, saliva, heart, etc
44
Q

middle cervical ganglion

A
  • C6
  • inferior thyroid artery
  • organs: larynx, trachea, pharynx, upper esoph, heart
45
Q

inferior cervical ganglion

A
  • C7
  • vertebral and subclavian arteries
  • heart, artery smooth muscle
46
Q

all sympathetics to the head are derived from the?

A

superior cervical ganglion

47
Q

where are preganglionic sympathetics located?

A

in the lateral gray horn (interomedial gray columns) of the upper thoracic spinal cord (T1 and T2)

48
Q

most fibers synapse in the _______ and send fibers along the external and internal carotid arteries

A

superior cervical ganglion

49
Q

what supplies all areas of distribution of the external carotid arteries including sweat glands of the face and neck and salivary glands?

A

external carotid (external and common carotid plexus)

50
Q

what two main groups leave the internal carotid plexus in the cavernous sinus?

A

sympathetic root of the ciliary ganglion

deep petrosal nerve

51
Q

sympathetic root of the ciliary ganglion

A

part of internal carotid plexus that runs through the ganglion without synapsing and enters the short ciliary nerves and is distributed to the dilator and vasculature of the eye

52
Q

deep petrosal nerve

A
  • of internal carotid plexus
  • joins the greater petrosal to form the nerve of the pterygoid canal
  • postganglionic sympathetic fibers pass thru the pterygopalatine ganglion and are distributed with the branches of the maxillary division of the trigeminal nerve
53
Q

stimulation of sympathetic in head leads to

A
  • dilation of pupil
  • elevation of eyelid
  • vasoconstriction of the blood vessels
  • sweating of the face
54
Q

interruption of sympathetic chain leads to

A 
horner syndrome
(lung tumor at apex can compress the chain---> unilateral dry skin, pupillary constriction, hotness, blushing of the face (ptosis, myosis, anhydrosis)

Cranio Exam 3 (9 decks)

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