Exam3Lec1SuperficialNeck Flashcards
What is the order of the neck layers?
superficial fascia—>deep fascia—> cervical muscles
What layer is the superficial fascia and what does it contain?
Outermost layer of CT
Contains: platysma muscle, jugular vein, cervical plexus (of nerves), cervical lymph nodes
PJCC
What layer is the deep fascia and what layers does it divide into?
Innermost layer of CT
3 layers
investing, pre-tracheal, pre-vertebral
What is the musculature, vasculature, and innervation of the superficial fascia?
musculature: platysma
vasculature: jugualr veins
innervation: cervical plexus
What is the PA and DA of the platysma muscle?
PA: inf. mandible
DA: superficial fascia (of upper thorax)
What is the arterial supply, innervation, and action of the platysma muscle?
Arterial supply: n/a
Innervation: facial n. (CN VII=7)
Actions: pull angle of mouth downwards, tighten +pull skin on the neck upwards
What two jugular veins do we have for the superficial fascia and what does each drain?
External jugular v: drains superficial scalp + head
Anterior jugular v: drains anterior superficial neck
What are the cervical muscles of the neck?
SCM+ trapezius + suprahyoid muscles + infrahyoid muscles
For the cervical plexus, what are the superficial (cutaneous) branches?
lesser occipital, greater auricular, transverse cervical, supraclavicular
Lesser, Greater, Too Super
What is the lymphatic drainage of the superficial fascia?
superficial cervical lymph nodes
Which lymph nodes are included in the superficial fascia?
pre-auricular, posterior auricular, submental, submandibular, tonsilar, anterior cervical, posterior cervical, supraclavicular
What layer is the investing layer of the deep fascia?
outer layer
What does the investing layer of the deep fascia cover, form, and superiorly attach to?
covers SCM+trapezius muscles
forms capsule around parotid + submandibular glands
superiorly attaches to: superior nuchal line, zygomatic arch, mastoid process + mandible, hyoid bone
What layer is the pre-tracheal layer of the deep fascia?
middle layer
What does the pre-tracheal layer cover, form, and continue with?
covers the infrahyoid muscles (omohyoid, sternohyoid, sternothyroid, thyrohyoid m),thyroid gland, trachea, esophagus
forms the carotid + fascial sheaths
continues w/ the buccopharyngeal fascia
from the hyoid—> middle mediastinum–> fibrous pericardium
ttie
What layer is the pre-vertebral layer of the deep fascia?
inner layer
What does the pre-vertebral layer cover, form, blend with, and contain?
covers pre-vertebral + lateral muscles
forms the axillary sheath + post. boundary of retropharyngeal space
blends with the endothoracic fascia + ant. longitudinal ligament
contains the sympathetic trunk
The carotid sheath is formed by the ?
pre-tracheal layer
What does the carotid sheath contain?
” I See 10 CC’s in the IV”
common carotid artery
internal jugular vein
vagus nerve (CNX=10)
What is the carotid sheath crossed by, pierced by, and communicates with?
crossed by the intermediate tendon of the Omohyoid m.(=infrahyoid m.)
pierced by the Ansa Cervicalis=group of muscular nerves of the cervical plexus
communicates w/ the posterior mediastinum via pre-tracheal fascia
What is the PA, DA, Arterial supply, innervation, and actions of the Trapezius?
everything is low yield except innervation
PA: superior nuchal line + ligamentum nuchae + spinous processes of C7-T12
DA: spine of scapula + acromion + lateral clavicle
Arterial supply: none
Innervation: spinal accessory nerve (CN XI=11)
Actions: elevation/retraction/rotation of the scapula, uni-lateral flexion of the neck, bi-lateral extension of the neck
What is the trapezius covered by?
investing layer of deep cervical fascia
What is the SCM covered by?
investing layer of deep cervical fascia
What is the PA and DA of the SCM?
low yield
PA: manubrium (sternal head) + medial clavicle (clavicular head)
DA: mastoid process + superior nuchal line
What is the arterial supply, innervation, and actions of the SCM?
Arterial supply: n/a
Innervation: spinal accessory nerve (CN XI=11)
Actions: lateral flexion of the neck, rotation of the face upwards to the contralateral side
What is superficial to the SCM?
external jugular vein
cervical plexus–> greater auricular + transverse cervical nerves
greater auricular+transverse cervical nerve=erb’s point
What is torticollis (Wryneck)?
spasmodic contracture of the SCM muscle
What causes torticollis?
- Fibroma
- Excessive pull on the head of a baby during delivery
- Chronic trochlear nerve (CN4) palsy
- Dystonia (involuntary contraction) of the cervical muscles\
- Irritation of the spinal accessory nerve (CN11)
- Ear infections
2 and 5 could be in question stem
What is the result of torticollis?
twisting of the neck + slanting of the chin away from the affected side
If right SCM affected–> chin toward the left
If left SCM affected–> chin toward the right
What is the hyoid bone?
U-shaped bone–> suspended by the Stylohyoid ligament
connects to the thyroid cartilage via thyrohyoid membrane
How is the hyoid bone organized? (lower yield)
hyoid body
greater cornua (horn)
lesser cornua (horn)
What are the muscle attachments of the hyoid bone?
geniohyoid
stylohyoid
mylohyoid
sternohyoid
thyrohyoid
middle pharyngeal constrictor
What are the suprahyoid cervical muscles of the neck ?
“Supras Still Get Decent Mileage”
stylohyoid, digastric, mylohyoid, geniophyoid
all attach to hyoid bone
All of the suprahyoid muscles are above what? And what do they all do?
they are all above the hyoid bone and they all elevate the hyoid bone
What is the PA, DA, innervation, and action of the stylohyoid?
PA: styloid process
DA: hyoid body
Innervation: facial n (CNVII=7)
Action: elongation of mouth floor
What is the PA, DA, innervation, and action of the digastric?
PA: digastric fossa of the mandible (ant. belly), mastoid notch (posterior belly)
DA: hyoid body + greater horn
Innervation: mylohyoid n. (ant. belly) and facial n. (post. belly)
Action: depression of mandible–>opens mouth
What is the PA, DA, innervation, and action of the mylohyoid?
PA: mylohyoid line (of the mandible)
DA: hyoid body
Innervation: mylohyoid n.
Action: elevation of the mouth floor–> closes mouth
What is the PA, DA, innervation, and action of the geniophyoid?
PA: inferior mental spine
DA: hyoid body
Innervation: C1 of cervical plexus
Action: shortens mouth floor + widens the pharynx
What are the infrahyoid cervical muscles of the neck?
TOSS
thyrohyoid, omohyoid, sternohyoid, sternothyroid
All of the infrahyoid muscles are below what? And what do they do?
All infrahyoid muscles are below the hyoid bone, so all but 1 depress the hyoid bone
What is the PA, DA, innervation, and action of the omohyoid?
PA: superior scapula
DA: hyoid body
Innervation: ansa cervicalis (C1-3)
Action: retract + stabilize hyoid bone
What is the PA, DA, innervation, and action of the sternohyoid?
PA: manubrium + medial clavicle
DA: hyoid body
Innervation: ansa cervicalis (C1-3)
Action: depress hyoid bone
What is the PA, DA, innervation, and action of the sternothyroid?
PA: posterior manubrium
DA: oblique line of the thyroid lamina
Innervation: ansa cervicalis (C2-3)
Action: depress the larynx
What is the PA, DA, innervation, and action of the thyrohyoid?
PA: oblique line of thyroid lamina
DA: hyoid body + greater horn
Innervation: C1 of cervical plexus
Action: elevate the pharynx & depresses the hyoid bone
Action of the mylohyoid+ geniohyoid
pulls hyoid upward and forward
Action of the stylohyoid
pulls hyoid upward and backwards
Action of the digastric
pulls hyoid upwards through “pulley”
Action of the omohyoid + sternohyoid + thyrohyoid
pulls hyoid downward
Does the sternothyroid attach to the hyoid bone?
NO so it does not act on the hyoid bone
The neck is divided into what triangles?
anterior & posterior triangles by the SCM
The anterior triangle can be subdivided into what 3 triangles?
submental triangle, submandibular triangle, carotid triangle
What are the two muscles of the anterior triangle and what do they divide?
digastric muscle–> divides submental + submandibular triangles
omohyoid m–> divides carotid triangle
What are the anterior triangle boundaries? high yield
Anterior= median line of the neck
posterior= anterior surface of the SCM
superior (base)= inferior mandible
apex (point)= jugular notch of the manubrium
roof= superficial fascia + platysma m.
What are the contents of the anterior triangle? low yield
pharynx, layrnx, thyroid gland
What is the muscle of the submental triangle and what does it divide?
digastric m–> divides submental + submandibular triangles
What are the boundaries of the submental triangle? high yield
“CHIN”
inferior (base): hyoid body
lateral wall: ant. belly of digastric m.
apex (point): symphysis menti
floor: mylohyoid m.
What are the contents of the submental triangle? low yield
submental lymph nodes
tributaries of the ant. jugular vein
What is the muscle of the submandibular triangle and what does it divide?
digastric m–> divides submental + submandibular triangles
What are the boundaries of the submandibular triangle? high yield
Superior (base): inferior mandible
anterior: ant. belly of digastric m.
posterior: post. belly of digastric m. stylohyoid m.
apex (point): hyoid bone
floor: mylohyoid m. hypoglossus m
What are the contents of the submandibular triangle?low yield
submandibular gland+ lymph nodes
facial vessels
hypoglossal n (CN XII=12)
submental artery
What is the muscle of the carotid triangle and what does it divide?
omohyoid m–> divides the carotid triangle
What are the carotid triangle boundaries?high yield
Superior= posterior belly of digastric m
anterior (base)= superior belly of omohyoid m
posterior + apex= SCM
What are the contents of the carotid triangle?
Common carotid art + vein
-external art + vein
-internal carotid art + vein
Carotid body + sinus
Hypoglossal n. (CNXII=12)
What are the boundaries of the posterior(lateral) triangle? high yield
Anterior: posterior surface of the SCM
Posterior: trapezius
Floor (base)=middle 1/3 clavicle
Apex (point)=occipital bone
What are the posterior triangle contents? low yield
Muscles: splenius capitus, levator scapulae, middle scalene, posterior scalene
Nerves: spinal accessory nerve (CN XI=11), trunks of the brachial plexus
Arteries: subclavian artery–> transverse cervical artery
What is this arrow pointing to?
Stylohyoid muscle
What is this arrow pointing to?
Digastric muscle
What is this arrow pointing to?
Mylohyoid muscle
What is this arrow pointing to?
Geniohyoid muscle
What is this arrow pointing to?(high yield)
Omohyoid muscle
What is this arrow pointing to?
Sternothyroid muscle
What is this arrow pointing to? (High yield)
Sternohyoid muscle
What is this arrow pointing to?
Sternohyoid muscle
What is this arrow pointing to? (high yieldO
Thyrohyoid muscle
What is this arrow pointing to?
Thyrohyoid muscle
