DR1 - Neck Flashcards
What are the 4 compartments of the neck?
Vertebral compartment:
- Cervical vertebrae & postural muscles (prevertebral & postvertebral muscles
Vascular compartments (x2):
- Carotid sheath
- CCA
- IJV
- CN X
Visceral compartment:
- Throaty stuff
- Thyroid & parathyroid
What encloses the 4 compartments of the neck?
Musculofascial collar
Identify the compartments of the neck and their contents (red) and then the fascial components (blue)
Identify the features of a cervical vertebra - what features help identify it?
Bifid spine (forked)
Foramen transversarium (vertebral arteries on their way to foramen magnum)
What kind of joint is present between the occipital condyles and the C1 (atlas)?
Condyloid joint (type of synovial)
What is the specific name is given to C1, C2 and C7
C1 - Atlas
C2 - Axis
C3 - Vertebra prominens
The neck can be divided into anterior and posterior (lateral) triangles
Label the structures of the neck below that bound the triangles of the neck
(The carotid triangle is a sub-area of the anterior triangle)
What are the boundaries of the Anterior triangle of the neck:
A) Anteriorly
B) Posteriorly
C) Superiorly
A) Median line of the neck
B) Anterior border of the SCM
C) Inferior border of mandible
What are the boundaries of the posterior (lateral) triangle of the neck:
A) Anteriorly
B) Posteriorly
C) Inferiorly
A) Posterior border of SCM
B) Anterior border of Trapezius
C) Clavicle (between SCM & Trapezius)
What are the main contents of the anterior triangle of the neck?
Arteries
- Common Carotid artery + branches
- External carotid artery + branches
- Facial artery
Veins
- IJV
- Anterior jugular vein
- Facial vein
Nerves
- CN X, CN XI, CN XII
- Ansa Cervicalis (superior root)
Lymph node groups:
- Submental
- Submandibular
- Deep cervical
Organs n shit:
- Thyroid & Parathyroid glands
- Submandibular gland
- All dem muscles
What are the main contents of the posterior (lateral) triangle of the neck?
Arteries:
- Subclavian artery (third part)
Veins:
- External jugular vein
Nerves:
- CN XI (spinal accessory)
- Posterior branches of Cervical plexus
- Trunks of Brachial plexus
Lymph:
- Cervical
- Supraclavicular
What are the attachments, innervation and action of the Sternocleidomastoid muscle?
Origin:
- Manubrium & Clavicle (superior borders)
Insertion:
- Mastoid process of Temporal bone
Innervation:
- Accessory nerve - CN XI
Action:
- Flexing the Head & neck laterally
What are the attachments of the trapezius muscle and its nerve supply?
Origin:
- External occipital protuberance
- Spinous processes of C1 - T12 (ie a fuck ton of origins)
- Couldn’t be arsed drawing them all on the diagram below but you get the idea
Insertion:
- Scapula
- Clavicle
Innervation:
- Accessory nerve - CN XI
- C3 - C4
With all this neck stuff, you’ve got to remember there’s a big fucking muscle covering the neck on top of all this stuff
What muscle is this?
Platysma
Innervated by branch of facial nerve CN VII
What is the fate of the ventral rami of the lower cervical nerves that are in the posterior triangle of the neck?
They form the brachial plexus
They emerge from between the scalene muscles that form the posterior triangle of the neck
The anterior triangle can be further subdivided into more triangles
What are these triangles and what are their boundaries?
Submental:
- Laterally - Right & left digastric muscles anterior bellies
- Inferiorly - Hyoid bone
Digastric/submandibular:
- Superiorly - mandible
- Inferiorly - digastric anterior & posterior bellies
Carotid:
- Superiorly - Stylohyoid & PB of digastric
- Anteriorly - SB of Omohyoid
- Posteriorly - SCM
Muscular (omotracheal):
- Superiorly - Hyoid
- Laterally - SB of omohyoid & SCM
- Medially - Midline of neck
What are the main contents of each sub triangle of the anterior triangle?
Submental:
- Submental lymph nodes
- Anterior jugular vein
Submandibular (digastric):
- Submandibular gland (+ tiny bit of parotid)
- Facial artery & vein
- Hypoglossal nerve CN XII
Carotid:
- Common carotid, External carotid, Internal carotid
- Internal jugular vein, common facial
- Vagus CN X, Hypoglossal CN XII
Muscular:
- Thyrohyoid, sternothyroid, sternohyoid muscles
- Thyroid & parathyroid glands + arteries n shit
- Larynx, trachea, oesophagus
From which artery does each common carotid arise from?
Right side = Brachiocephalic artery
Left side = Aorta (arch)
Describe the structure and contents of the carotid sheath?
Contents enclosed in a fibrous connective tissue sheath & lies in the deep cervical fascia
It is contained mainly within the carotid triangle funnily enough - but kinda just lies deep to the SCM for most of its time
Contents - Common carotid artery, Internal jugular vein, Vagus nerve CN X, Deep cervical lymph node
At what vertebral level does the CCA split into the external and internal CAs?
C3/4 - at the upper border of the thyroid cartilage
(In the photo the CCA divides a bit too high up than it should)
Which of the carotid arteries gives off branches in the neck?
What important branches arise from this artery?
The External carotid gives off branches in/that supply the neck…
Maxillary
Lingual
Facial
Superior thyroid
Superficial temporal
Posterior auricular, Occipital, Ascending pharyngeal
Identify the arteries in the diagram below
What are the 2 terminal branches of the external carotid artery
In what structure are these given off?
Maxillary artery
Superficial temporal artery
These are given off in the Parotid Gland
Identify the labels yes
Yes i like
Where does the Internal jugular vein arise and run?
Arises from (ie drains) jugular venous (sigmoid) sinus
Passes through the jugular foramen of the base of the skull then runs in the carotid sheath
Drains into the Subclavian vein just medially to where the EJV drains into it
What is the general purpose of the External jugular vein?
The EJV is a superficial vein that drains the scalp and face
It also drains into the subclavian veins, just laterally to where the IJV joins it
Identify the veins
Appreciate the colours and shit i drew on there
Identify the labels
Orientate the diagram - where does the Vagus nerve lie in relation to the other contents of the Carotid sheath
CN X lies posteriorly in the Carotid sheath
What actually is the cervical plexus?
a plexus of the anterior (ventral) rami of the first four cervical spinal nerves which arise from C1 to C4
Where in the neck does the phrenic nerve arise?
What is its anatomical relation to the carotid sheath?
Phrenic nerve arises from cervical plexus in the neck - supplied by ventral roots of C3, C4 & C5
Higher up the neck (near its origin) - the Phrenic nerve runs posterior to the Carotid sheath
Lower down, it moves much more laterally to the carotid sheath
Identify the parts of the Hyoid bone
Fun fact - its the only bone in the body that is not articulated with another bone
What are the 4 muscles/sets of muscles that attach to the hyoid bone
Suprahyoid muscles:
- 4 pairs of these
- Collectively act to elevate the hyoid
Infrahyoid muscles:
- 4 pairs of these
- Collectively depress the hyoid
Hyoglossus muscle
Middle pharyngeal constrictor
Identify the Suprahyoid muscles.
For each one, state its nerve supply
Mylohyoid:
- Mandibular nerve CN V3
Geniohyoid:
- C1 via Hypoglossal nerve CN XII
Digastric:
- Mandibular CN V3 & Facial CN VII
- Only one that directly depresses the mandible
Stylohyoid:
- Facial nerve CN VII
Identify the Infrahyoid muscles and state each ones nerve supply
Sternohyoid:
- C1 - C3
Sternothyroid:
- C2 - C3
Thyrohyoid:
- C1 via Hypoglossal nerve (same as Geniohyoid of Suprahyoid muscles)
Omohyoid:
- C1 - C3
Supply of Infrahyoid muscles is via the ANSA CERVICALIS
What 2 muscles are these?
Hyoglossus & Middle pharyngeal constrictor
These are the muscles that directly attach to the Hyoid bone - but are not supra/infrahyoid muscles
(hyoglossus is the one on right)
Identify the labels boyo
Identify the parts of the Thyroid gland
What vertebral levels does the thyroid gland exist?
What area of the trachea does the isthmus cover?
C5 - T1
Isthmus covers the 2/3rd tracheal rings ish
Identify the nerves and labels supplying the Thyroid n stuff
