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Gross Anatomy > Exam 4 Root of Neck > Flashcards

Exam 4 Root of Neck Flashcards

1
Q

Bony/Cartilagenous Landmarks

A
  • Thyroid cartilage (level C4/C5)
  • Thyroid gland
  • Tracheal rings
  • Jugular notch (T2)
  • Body of 1st rib
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2
Q

Boundaries of root of neck

A
  • Lateral: First pair of ribs and costal cartilages
  • Anterior: Manubrium of sternum
  • Posterior: Body of T1 vertebrae
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3
Q

Cricothyroid muscle

  • Proximal Attachment
  • Distal Attachment
  • Action
  • Innervation
A
  • Proximal Attachment: Arch of cricoid cartilage
  • Distal Attachment: Inferior horn of thyroid cartilage
  • Action: Tenses vocal cords
  • Innervation: External laryngeal nerve
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4
Q

Longus colli muscle

  • Proximal Attachment
  • Distal Attachment
  • Action
  • Innervation
A
  • Proximal Attachment: Transverse processes of T2-T3
  • Distal Attachment: Vertebral bodies of C2-C3
  • Action: Flexes and rotates head
  • Innervation: C5-C8
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5
Q

Branches of subclavian artery

A
  • First segment: Medial to anterior scalene
    • Vertebral: B/w anterior scalene and longus colli
    • Internal thoracic: Descends through thorax
    • Thyrocervical trunk: Short trunk that divides into:
      • Suprascapular (1st branch)
      • Transverse cervical (2nd branch)
      • Inferior thyroid (3rd branch)
  • Second segment: Posterior to anterior scalene
    • Costocervical trunk: arises posterior, divides into:
      • Deep cervical
      • Supreme intercostal
  • Third segment: Lateral to anterior scalene
    • Dorsal scapular
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6
Q

Veins of root of neck

A
  • Anterior jugular vein drains into ->
  • External jugular vein drains into ->
  • Subclavian veins draininto ->
  • Brachicephalic veins
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7
Q

Sumpathetic trunk

  • What type of fibers are found in this?
  • What are its cervical ganglia?
    • Where are they located>
  • What is the ansa subclavia?
A
  • Pre and postganglionic sympathetic fibers and visceral afferent fibers found here
  • Superior cervical ganglion: Largest of cervical ganglia, lies in front of transverse processes of C1-C2, posterior to internal carotid
    • Synapse for postganglionic sympathetics traveling to head
  • Middle cervical ganglion: Lies at level of cricoid cartilage (C6 vertebral level)
    • Provides synapse for sympathetic innervation to heart and lungs
  • Inferior cervical ganglion: Results as fusion of inferior cervical ganglion with 1st thoracic ganglion
    • Lies anterior to neck of 1st rib, posterior to subclavian artery
  • Ansa subclavia: Cord connecting middle and inferior cervical ganglia
    • Loops around 1st portion of subclavian artery
    • Aids in connecting middle and inferior ganglion that contribute to cardiac and pulmonary plexuses
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8
Q

Other nerves found in root of the neck…

A
  • Vagus nerve: gives off left and right recurrent laryngeal nerves
    • Right recurrent laryngeal wraps around brachiocephalic trunk
    • Left recurrent laryngeal wraps around aortic arch
  • Phrenic nerve: Arises from C3, C4, C5 ventral rami near ansa cervicalis
    • Travels superficial to anterior scalene
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9
Q

Visera of the Neck

  • What are the layers?
  • What is found in each layer?
A
  • Alimentary layer (deepest layer): Consists of pharynx and esophagus
  • Respiratory layer (middle layer): Consists of larynx and trachea
  • Endocrine layer (superficial layer): Consists of thyroid and parathyroid glands
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10
Q

Tracheotomy

  • What is it?
  • Where is it performed?
A
  • Surgical opening of trachea
  • Performed at 3rd and 4th rings of trachea
    • Accessed by midline skin incision from jugular notch to thyroid notch of thyroid cartilage
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11
Q

Cricothyrotomy

  • What is it?
  • What is its clinical importance?
A
  • Incision through skin and cricothyroid membrane
  • Emergency relief of respiratory obstruction
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12
Q

Thyroid gland

  • What does it produce?
  • Structure
  • Arterial blood supply
  • Venous drainage
A
  • Endocrine organ that produces thyroxine and thyrocalcitonin
  • Right and left lobes connected by isthmus (crosses 2nd, 3rd, and 4th trachea rings)
  • Arterial blood supply:
    • Superior thyroid: Supplies superior and anterior portion of thyroid
    • Inferior thyroid: Supplies inferior and posterior portion of thyroid and parathyroid glands
    • Thyroid ima: Supplies middle inferior aspect of thyroid (variable branch off brachiocephalic trunk)
  • Venous drainage:
    • Superior thyroid vein
    • Middle thyroid vein
    • Inferior thyroid vein
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13
Q

Goiter

  • What is it?
  • What causes it?
  • What is it associated with?
  • Treatments
A
  • Enlargement of thyroid gland causing swelling in front part of neck
  • Caused by iodine deficiency
  • Associated with both hyperthyroidism (Graves’ disease) and hypothyroidism
  • Treatments:
    • Thyroid hormone replacement pills if caused by hypothyroidism
    • Radioactive iodine to shrink gland caused by hyperthyroidism
    • Surgery to remove all or part of gland
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14
Q

Parathyroid glands

  • What are they?
  • What is their function?
  • Blood supply
A
  • 2-6 small ovoid bodies that lie against dorsum of thyroid under its sheath but within their own capsules
  • Vital for calcium and phosphorus metabolism
  • Blood supply: Inferior thyroid artery
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15
Q

Parathyroidectomy

  • Why is it performed?
  • What can happen as a complication?
  • Symptoms experienced after surgery?
A
  • Removal of parathyroid glands as part of total thyroidectomy OR targeted due to parathyroid tumor
  • Can be fatal if parathyroid hormone, calcium, or vitamin D is not provided as treatment
  • Calcium plasma levels decrease after removal, causing increased neuromuscular activity (such as muscle spasms and nervous hyperexcitability, or tetany)
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16
Q

Superficial (investing) layer

  • What does it envelope?
  • Where does it run?
  • Where does it attach?
A
  • Most superficial layer; splits at trapezius and SCM to completely invest these muscles
  • Superior attachment: External occipital protuberance; superior nuchal line
  • Lateral attachment: Mastoid process and zygomatic arch
  • Inferior attachment: Scapular spine, acromion, clavicle, and manubrium

(Light blue tube)

17
Q

Pre-tracheal layer

  • What does it envelope?
  • Where does it run?
  • What are its parts?
A
  • Envelops trachea, esophagus, thyroid gland, and infrahyoid muscles
  • Runs from hyoid down to superior thorax
    • Fuses with pericardium
  • Splits into:
    • Visceral part: encloses thyroid gland, trachea, esophagus
    • Muscular part: encloses infrahyoid muscles

(Red tube)

18
Q

Buccopharyngeal fascia

  • What does it envelope?
  • Where does it run?
  • Where does it attach?
A
  • Envelopes constrictor muscles of pharynx and buccinator muscle
  • Runs parallel to carotid sheaths, along medial aspect
  • Attaches to pre-vertebral layer by loose connective tissue allowing for distension, forming retropharyngeal space

(Royal blue tube)

19
Q

Carotid sheaths

  • What does it envelope?
  • Where does it run?
A
  • Contains common/internal carotid arteries, internal jugular vein, vagus nerve, and deep cervical lymph nodes
  • Extends from base of skull to first rib and sternum
20
Q

Pharyngobasilar fascia

  • Where does it run?
  • What is its function?
A
  • Lines inner surface of pharyngeal wall
  • Along with buccopharyngeal fascia, reinforces pharyngeal wall where muscle is deficient

(Gray tube)

21
Q

Pre-vertebral fascia

  • What does it envelope?
  • Where does it attach?
A
  • Surrounds vertebral column and muscles (scalenes, pre-vertebral, and deep muscles of back)
    • Surrounds brachial plexus and subclavian artery
  • Anterior attachment: Transverse processes and vertebral bodies of vertebral column
  • Posterior attachment: Ligamentum nuchae

(Yellow tube)

22
Q

Where can infection spread in neck?

A
  • If infection is anterior to pre-vertebral fascia:
    • Can erode through prevertebral fascia and drain into retropharyngeal space (between pretracheal and pre-vertebral fascia)
    • Retropharyngeal space extends into thorax, and drainage of pus into thorax can lead to infection of mediastinal contents.
  • If infection is between superficial investing fascia and visceral part of pre-tracheal fascia:
    • Infection can spread inferiorly to chest, causing infection anterior to pericardium.

Gross Anatomy (21 decks)

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