Exam 1 Flashcards
What is the chiropractic landmark for the hyoid?
Test q
C3
What is the chiropractic landmark for the thyroid cartilage of the larynx (laryngeal prominence)?
Test q
C4
What is the chiropractic landmark for the bifurcation of the common carotid artery (CCA)?
Test q
C4
What is the chiropractic landmark for the carotid pulse?
Test q
C5
What is the chiropractic landmark for the cricoid cartilage?
Test q
C6
What is the chiropractic landmark for the union of the internal jugular vein (IJV) and subclavian vein?
Test q
T1
The thyroid spans from ________ with the isthmus of the thyroid located on the first and second tracheal cartilages (level between C6 and C7)
C5-T1
What are the 4 regions of the neck?
Test q
1) SCM region
2) posterior cervical region
3) lateral cervical region
4) anterior cervical region
What muscle + region divides the anterior and posterior portion of the neck?
Test q
SCM region / SCM
What fossa is within the SCM region?
Test q
Lesser supraclavicular fossa
What muscle makes up the posterior cervical region of the neck?
Test q
Traps
What triangle makes up the lateral cervical region of the neck?
Test q
Posterior triangle
What 2 triangles divide the posterior triangle?
Test q
1) occipital triangle
2) supraclavicular triangle
What 4 triangles divide the anterior cervical region?
Test q
1) submandibular triangle
2) submental triangle
3) carotid triangle
4) muscular triangle
What is the origin of the platysma?
Pectoralis and deltoid fascia
What is the insertion of the platysma?
Inferior mandible and fascia
What innervates the platysma?
CN VII
What is known as the muscle of facial expression?
Platysma
What are the actions of the platysma?
Widen and draw corners of the mouth inferiorly (when sad or frightened)
What is the origin of the SCM?
Sternum and clavicle
What is the insertion of the SCM?
Lateral 1/2 of superior nuchal line and mastoids
What innervates the SCM?
CN XI (motor) and C2/C3 spinal nerves (sensory)
What are the actions of the SCM?
LF of the neck, rotate face opposite and superior
What is the origin of the traps?
-superior nuchal line
-EOP
-nuchal ligament
-C7 SP
What are the insertions of the traps?
Lateral 1/3 of clavicle (acromion, lateral 1/3 scapular spine)
What innervates the traps?
CN XI (motor) and C3/C4 spinal nerves (sensory proprioception)
What are the actions of the traps?
Elevate shoulders/scapulae
What are the 4 muscles of the posterior triangle of the neck?
1) splenius capitis
2) levator scapulae
3) posterior scalene
4) middle scalene
What is the origin of the splenius capitis?
-inferior 1/2 of nuchal ligament
-T1/T2 SP
What is the insertion of the splenius capitis?
Lateral 1/3 superior nuchal line and mastoids
What are the actions of the splenius capitis?
-Unilateral LF and rotation same side
-Bilateral extension
What is the origin of the levator scapulae?
C1-C4 TPs
What is the insertion of the levator scapulae?
Medial/superior scapula
What are the actions of the levator scapulae?
Rotate scapula (glenoid down)
What contributes to the floor of the posterior triangle along with splenius capitis and levator scapulae?
Posterior and middle scalene muscles
Which scalene muscle lies under the SCM?
Anterior scalene
What is the superior attachment of the posterior AND middle scalene?
Test q
C5-C7 TPs
What is the inferior attachment of the posterior scalene?
2nd rib
What is the inferior attachment of the middle AND anterior scalene?
Test q
1st rib
What is the superior attachment of the anterior scalene?
Test q
C3-C6 TPs
What are the actions of the scalene muscles?
LF and rib elevation
What are the 2 big categories of muscles that make up the anterior triangle?
1) suprahyoid muscles (raise hyoid)
2) infrahyoid muscles (lower hyoid)
What are the 4 suprahyoid muscles from superficial to deep?
1) stylohyoid
2) digastric (also known as lower jaw when mouth is open, it has 2 bellies-anterior and posterior belly)
3) mylohyoid
4) geniohyoid
What are the 4 infrahyoid muscles from superficial to deep?
1) omohyoid (superior belly)
2) sternohyoid
3) sternothyroid
4) thyrohyoid
Note: the inferior belly of the omohyoid is in the posterior triangle
T/F: the names of hyoid muscles indicate origin and insertion from which you can derive the actions
True
Which muscle divides the neck into anterior and posterior triangles?
SCM
CN XII (hypoglossal n.) courses through the upper corner of the ____________ triangle, passes into the ____________________ triangle and goes between the mylohyoid and hypoglossus muscle. “The hypoglossal is located on the hypoglossus.”
carotid, submandibular
What are the “3 friends of the neck”?
Test q
-common carotid a.
-CN X (vagus n.)
-internal jugular v.
The 3 friends of the neck (CCA, CN X, IJV) are contained within the carotid sheath of the…..
Deep cervical fascia
The 3 friends of the neck (CCA, CN X, IJV) are under the ______ and surface in the carotid triangle of the neck
SCM
The ________________ of the cervical plexus overlies the carotid sheath
Ansa cervicalis
Which vein courses on top of the SCM?
external jugular v.
The muscles which make up the floor of the posterior triangle is covered by the prevertebral fascia and are from posterior to anterior. What are the 4 muscles?
1) splenius capitis
2) levator scapulae
3) posterior scalene
4) middle scalene
The cervical plexus arises from the…
C1-C4 spinal cord segments
CN XI (spinal accessory n.) receives fibers from nuclei in spinal cord segments C1-C5 to form its spinal part which enters the ___________________. This spinal part meets up with the cranial part from the medulla and together exit through the __________________
foramen magnum, jugular foramen
Which CN courses on top of the levator scapulae m.?
CN XI
Which CN innervates the SCM and traps?
CN XI
Which nerve innervates the levator scapulae and rhomboid muscles?
dorsal scapular n. (from C5 root of brachial plexus)
The brachial plexus and subclavian a. emerge from between the….
anterior and middle scalene muscles
Which nerve courses on top of the anterior scalene muscle on its way to the diaphragm?
phrenic n. (C3-C5)
*remember: C3-C5 keep the diaphragm alive
The floor of the anterior triangle consists of the viscera of the neck (from superior to inferior) are the….
pharynx, larynx, and thyroid gland
The hyoid muscles (supra- and infra-) are contained within the ___________ triangle
anterior
The 2 primary suppliers of oxygenated blood to the brain are the….
test q
internal carotid a. and vertebral a.
The 1st branch off of the external carotid a. after the bifurcation of the common carotid a. is the….
superior thyroid a.
The primary drainage of deoxygenated blood from the brain are the…
internal jugular veins
Where is the superficial cervical fascia located?
under the skin
What is the superficial cervical fascia composed of?
adipose CT
What does the superficial cervical fascia envelope?
platysma muscles (muscles of facial expression, innervated by CN VII/facial n., action is to draw corners of the mouth down as in sadness or fright)
What are the divisions of the deep cervical fascia?
A) investing layer
B) pre-tracheal fascia
B1) buccopharyngeal fascia
C) prevertebral fascia
D) carotid sheath
D1) alar fascia
D2) retropharyngeal space
note: all fascial layers of the neck extend from the base of the skull or inferior mandible to the root of the neck with the exception of the pre-tracheal fascia which extends from the hyoid bone to the pericardium
What does the investing layer of the deep cervical fascia invest?
the entire neck “SCM and traps”
The pre-tracheal fascia of the deep cervical fascia surrounds the neck viscera like the….
thyroid, trachea, and esophagus
What is the posterior continuation of the pre-tracheal fascia?
buccopharyngeal fascia
What does the pre-vertebral fascia surround?
the cervical spine and pre-vertebral muscles
What does the carotid sheath contain?
the 3 friends of the neck- CCA, vagus n. and IJV
What does the alar fascia connect?
R and L carotid sheaths
What is the space called that is immediately adjacent to the alar fascia?
retropharyngeal space
What are the 3 major categories for pre-vertebral muscles?
1) anterior vertebral muscles
2) lateral
3) posterior
What are the 4 anterior vertebral muscles?
1) rectus capitis anterior
2) anterior scalene
3) longus capitis
4) longus coli
What are the 2 muscles/categories for lateral vertebral muscles?
1) rectus capitis lateralis
2) floor of posterior triangle muscles
What are the 4 muscles that make up the floor of the posterior triangle?
1) splenius capitis
2) levator scapulae
3) posterior scalene
4) middle scalene
What are the 3 arteries at the root of the neck?
1) R brachiocephalic trunk
2) CCA
3) subclavian a.
What are the 3 veins at the root of the neck?
1) brachiocephalic v.
2) internal jugular v.
3) subclavian v.
What are the nerves at the root of the neck?
-CN X (vagus n.) has parasympathetic innervation to the thoracic and abdominal viscera
-phrenic n. innervates diaphragm
-L/R sympathetic trunks and ganglia
The cervical spine has ____________________________ cervical sympathetic ganglia
superior, middle, and inferior
The thoracic spine has ___________ sympathetic ganglia
T1-T12
The lumbar spine has __________ sympathetic ganglia
L1-L5
The sacral spine has ________ sympathetic ganglia. The coccyx has 1 ganglion of impar
S1-S5
Stellate ganglia= “star”, which is the merging of _________ cervical sympathetic ganglia with the ______ sympathetic ganglia
inferior, T1
What are the 3 visceral layers of the neck?
1) endocrine layer
2) respiratory layer
3) alimentary layer (digestive)
What 2 glands are a part of the endocrine layer of the neck?
thyroid gland and parathyroid gland
What 2 structures are a part of the respiratory layer of the neck?
larynx and trachea
What are the 2 structures that are a part of the alimentary layer of the neck?
pharynx and esophagus
What is the largest endocrine gland called?
thyroid gland
What hormones does the thyroid secrete?
1) thyroid hormone
2) calcitonin
What is the function of thyroid hormone?
increase metabolism
What is the function of calcitonin?
-calcium regulation
-decreases blood calcium
The thyroid gland innervation is ___________, not secretomotor
vasomotor
The thyroid gland is covered by connective tissue capsule which has….
septa partitioning gland
The pre-vertebral deep cervical fascia covers the ___________ capsule
thyroid
What are the 2 arteries on the thyroid gland?
1) superior thyroid a.
2) inferior thyroid a.
What artery is the 1st branch off of the external carotid after the bifurcation of the common carotid a.?
superior thyroid a.
The inferior thyroid a. is a branch of the….
thyrocervical trunk
What are the 3 veins on the thyroid gland?
1) superior
2) middle
3) inferior thyroid v.
The superior thyroid vein drains into the….
internal jugular v.
The middle thyroid vein drains into the…
internal jugular v.
The inferior thyroid vein drains into the…
brachiocephalic v.
The thyroid gland has ANS innervations. The sympathetic and parasympathetic NS are both ________________. The sympathetic NS innervation is with the superior, middle, and inferior cervical sympathetic ganglia, which increases blood flow. The parasympathetic NS innervation is with the branches of the laryngeal nerves from CN X (vagus n.) which decreases blood flow
vasomotor
Which glands are located on the medial 1/2 of posterior surface of each lobe of the thyroid?
parathyroid gland
Which gland is found between the visceral part of the pre-tracheal layer of the deep cervical fascia, and the fibrous capsule of the thyroid?
parathyroid gland
How many parathyroid glands are there?
2 superior, 2 inferior
What hormone does the parathyroid gland secrete and what is its function?
parathyroid hormone, which increases blood calcium
T/F: the parathyroid arteries, veins, and nerves are branches of thyroid counterparts
true
What are the 9 cartilages of the larynx?
-1 thyroid cartilage
-1 cricoid cartilage
-2 arytenoid cartilages
-2 corniculate cartilages
-2 cuneiform cartilages
-1 epiglottis cartilage
All laryngeal cartilages are composed of hyaline cartilage, except the ____________ which is made of elastic cartilage
epiglottis cartilage
What are the functions of false (vestibular/ventricular) vocal cords/ligaments/folds?
-helps prevent food and drinks from entering airway
-co-oscillation with true vocal cords to produce low pitched sounds like Tibetan and Mongolian chants and death metal
What is the function of true vocal cords/ligaments/folds?
phonation/ voice
T/F: the false vocal cords are located inferior to the true vocal cords
test q
FALSE- the false vocal cords are superior to true vocal cords
The ventricles of the larynx are ___________ situated cavities between the false and true vocal cords. The superior border is the false vocal cord and the inferior border is the true vocal cord
test q
laterally
Both the false and true vocal cords course from…..
test q
thyroid cartilage to arytenoid cartilage
All muscles of the larynx are innervated by…
test q
CN X (vagus n.)
The superior laryngeal branch of CN X innervates the ______________________. All other laryngeal muscles are innervated by recurrent laryngeal branch of CN X on the same side
test q
cricothyroid muscle
Is the internal branch of the superior laryngeal nerve sensory or motor?
sensory
What does the external branch of the superior laryngeal nerve innervate?
-cricothyroid m.
-branches also go to thyroid and parathyroids
The recurrent laryngeal nerve innervates….
all laryngeal muscles EXCEPT cricothyroid m.
The R recurrent laryngeal nerve loops posteriorly under the _______________ before ascending to the laryngeal muscles on the right. The left recurrent nerve loops posteriorly under the _____________ before ascending to laryngeal muscles on the left
R subclavian a., aortic arch
The nasopharynx is ______________ to the nasal cavity
posterior
Which part of the pharynx is an opening to the eustachian (auditory/ pharyngotympanic) tube (also known as salpinx)?
nasopharynx
The nasopharynx has a __________ which is a tubal elevation around the opening
torus
The nasopharynx has tonsils. What are the 2 tonsils here?
1) pharyngeal tonsils (they’re called adenoids when inflamed/enlarged)
2) tubular tonsils
Where are the tubular tonsils found?
posterior to the torus (in the nasopharynx)
Which pharynx is posterior to the oral cavity?
oropharynx
The oropharynx includes the soft palate and….
uvula
The oropharynx has 2 types of tonsils. What are they?
1) lingual tonsils
2) palatine tonsils
Where are the lingual tonsils found?
on the root of the tongue (of the oropharynx)
Where are the palatine tonsils found?
under the soft palate between the palatoglossus and palatophayngeus muscles (of the oropharynx)
What are 2 muscle arches found in the oropharynx?
1) palatoglossus
2) palatopharyngeus
Where is the palatoglossus found?
between the soft palate and the tongue (of the oropharynx)
Where is the palatopharyngeus found?
between the soft palate and pharynx (of the oropharynx)
Which pharynx is found posterior to the larynx?
laryngopharynx
Which pharynx separates the respiratory and digestive tracts?
laryngopharynx
There are 4 pairs of tonsils. Tonsils are lymphoid organs with immune function. What are the 4 tonsils?
1) pharyngeal
2) tubal
3) lingual
4) palatine
What is the only tongue muscle that is innervated with CN X?
test q
palatoglossus m.
All tongue muscles besides the palatoglossus is innervated by….
test q
CN XII (hypoglossal n.)
T/F: all spinal nerve plexi (cervical, brachial, lumbosacral, and coccygeal) are derived from ventral rami of spinal nerves of which they are comprised
true
The cervical plexus is comprised of __________ rami of C1-C4 spinal nerves
ventral
The ________________ (“handle of the neck”) is a loop of nerve fibers of the cervical plexus that lies on the carotid sheath deep to the SCM
ansa cervicalis
The Ansa cervicalis of the cervical plexus innervates most of the muscles of the ____________ triangle (hyoid muscles), with the following exceptions: CN V innervates the anterior belly of the digastric and mylohyoid and CN VII innervates the posterior belly of the digastric and stylohyoid
test q
anterior
Which nerve innervates the anterior belly of the digastric and the mylohyoid?
test q
CN V (trigeminal n.)
Which nerve innervates the posterior belly of the digastric and the stylohyoid?
test q
CN VII (facial n.)
The platysma (like all muscles of facial expression) is innervated by….
CN VII (facial n.)
Levator scapula and the rhomboids are innervated by the….
dorsal scapular n. (C5 root of brachial plexus)
What nerve innervates the SCM and traps?
CN XI (spinal accessory n.)
All pharyngeal muscles are innervated by CN X, except the _____________________ which is innervated by ______________________
stylopharyngeus m., CN IX (glosspharyngeal n.)
All laryngeal muscles are innervated by….
CN X (vagus n.)
