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CNS Anatomy > Fascia Of The Neck & Posterior Triangle Till Last 4 CN > Flashcards

Fascia Of The Neck & Posterior Triangle Till Last 4 CN Flashcards

1
Q

Mention tributaries of EJV

A

AJV
Transverse cervical vein
Suprascapular vein
Posterior external jugular vein

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2
Q

……LN accompany EJV. It acts as….in clinical settings.

A

Superficial cervical
Vebous manometer

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3
Q

Investing layer of deep fascia encoles……..muscles and……glands and…….spaces

A

Trapezius , sternocleidomastoid
Parotid , submandibular
Supraclavicular , suprasternal

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4
Q

Describe superior attachment of investing layer

A

External occipital protuberance, superior nuchal line, mastoid process, base of mandible

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5
Q

Describe inferior attachment of investing layer of deep fascia

A

Spine of scapula, acronmion, clavicle, manubrium

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6
Q

Describe attachments of prevertebral layer of deep fascia

A

Superior, attached to base of the skull
Inferior, extends in superior mediastinum till level of anterior longitudinal ligament of T3, T4
Laterally, deficient below trapezius
Ant, separated from pharynx and buccopharyngeal fascia by retropharyngeal space

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7
Q

Describe relations of prevertebral fascia

A

Behind it, are prevertebral and scalene muscles, brachial and cervical plexus in addition to subclavian artery
In front of it are pharynx, larynx , esophagus, trachea, carotid sheath, sympathetic chain and subclavian vein.

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8
Q

Describe attachments of pretracheal fascia

A

Sup, hyoid bone in midline the oblique line of tgyroid and crcoid cartialges.
Inf: descends to enclose thyroid vein, infrahyoid muscles and descend in thorax behind bracheocephalic vein to blend with adventitia of aortic arch and fibrous pericardium

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9
Q

…..surrounds brachial plexus and subcalvian art

A

Axillary sheath

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10
Q

Neck infection behind prevertebral fascia may pass

A

A) Forward in median plane pushing pharyngeal wall
B) laterally to bulge into posterior triangle
C) inferiorly to superior mediastinum

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11
Q

Neck infection in front of pretracheal fascia can estend to……

A

Anterior mediastinum/ superasternal area

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12
Q

Neck infection in front of prevertebral fascia extends to…..

A

Posterior mediastinum

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13
Q

Retropharyngeal space is closed superiorly by…..and on each side by…..and opens inferiorly into…..c

A

Cranial base
Carotid sheath
Superior mediastinum

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14
Q

Mention contents of carotid sheath

A
  1. Common or ICA , med
  2. IJV lat
  3. Vagus nerve in between
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15
Q

….lies in front of carotid sheath while….lies behind

A

Ansa cervicalis
Sympathetic trunk

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16
Q

…….LN lie along carotid sheath

A

Deep cervical

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17
Q

Describe origin and insertion of sternocelido mastoid

A

O, sternal head, superolateral aspect of ant surface of manubrium. Clavcular head, medial 1/3 of clavicle
I, mastoid process and lat 1/3 of superior nuchal line.

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18
Q

Describe nerve supply of scm m

A

Motor, spinal accessory n
Sensory: ventral rami of C2 and C3 proprioceptive

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19
Q

Relations of scm m

A

Covered by:
1. Skin amd superficial fascia containing platysma EJV, 3 nerves great auricular, trsanverse cervical amd medial supraclavicular and superficial cervical LN
2. Deep fascia

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20
Q

Describe action of scm m

A
  1. On one side, tilts head towards its own side and turns face to opposite side
  2. Both together, forward neck flexion
  3. Act from above in forced inspiration
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21
Q

Describe roof amd floor of posterior triangle of neck

A

Roof, skin, superficial fascia, investing layer of deep cervical facscia
Floor, prevertebral layer of deep cervical fascia, and muscles from above downwards: semispinalis capitits, splenius capitis, levator scapulae, scalenus medius, scalenus ant (hidden behind scm m)

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22
Q

The superior part of posterior triangle is…..while its inferior part is…..they are divided by….

A

Occipital triangle
Supraclavicular triangle
Inferior belly of omohyoid muscle

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23
Q

Mention nerves of posterior triangle if neck

A
  1. Spinal part of accessory nerve
  2. Roots & trunks of brachial plexus
  3. Cutaneous nerves of cervical plexus
  4. Muscular branches to muscles of floor & boundaries
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24
Q

Mention vessels of posterior triangle of neck

A
  1. 3rd part of subclavian artery
  2. Subclavian vein
  3. Suprascapular artery & vein
  4. Transverse cervical artery & vein
  5. External jugular vein
  6. Occipital artery
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25
Q

Mention cutaneous branches of cervical plexus with root values

A

Great auricular(C2&3), lesser occipital(C2), transverse cervical(C2&3) & supraclavicular (C3&4)

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26
Q

Roots & trunks of brachial plexus lie between……along with…..art.

A

Scalenus anterior & medius
Subclavian

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27
Q

3rd part of subclavian artery is separated from vein by……

A

Scalenus anterior

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28
Q

Mention branches of 3rd part of subclavian art

A

Deep branch of transverse cervical (in 65% of subjects)

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29
Q

Suprascapular & transverse cervical are branches of…….which arises from……

A

Thyrocervical trunk
1st part of subclavian artery

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30
Q

The transverse cervical artery passes deep to….

A

Trapezius

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31
Q

With regards posterior triangle of neck, lower part drains to….., while upper part drains to…..

A

Supraclavicular nodes
Occipital nodes

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32
Q

Describe superior border of anterior triangle

A

Inferior border of mandible and line joining angle of mandible to mastoid process

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33
Q

Mention bounds of submental triangle

A

Base(inf): body of hyoid bone
Lat: ant belly of digastric
Apex: symphsis menti
Floor: two mylohyoid muscles with their median raphe

34
Q

Mention contents of submental triangle

A

Submental LN, artery, vein & mylohyoid nerve and vessels & small veins that unit to form AJV

35
Q

Mention bounds of digastric triangle

A

Ant: anterior belly of digastric
Post: post belly if digastric & stylohyoid
Base: same as base of ant triangle
Roof: skin, superficial fascia, deep fascia (splits to enclose submandibular gland)
Floor: mylohyoid & hyoglossus muscle

36
Q

Mention contents of anterior part of digastric

A

Submandibular gland with its LNs & facail vein (superficial) & facial artery (deep)
Structures superficial to mylohyoid (sunmental artery, vein & LNs) & mylohyoid nerve & vessels
Structures superficial to hyoglossus (SM gland (deep part), SM duct, SM ganglion, lingual & hypoglossal nerves)

37
Q

Mention contents of posterior part of digastric triangle

A
  1. Lower part of Parotid gland
  2. External carotid artery
  3. Carotid sheath & its contents
38
Q

Mention bounds of carotid triangle

A

Sup: post belly of digastric
Ant: sup belly of omohyoid
Post: ant border of scm m
Floor: ant, hyoglossus & thyrohyoid. Post, middle & inf constrictors of pharynx

39
Q

Mention arterial contents of carotid triangle

A

CCA, ICA, ECA (branches: superior thyroid, ascending pharyngeal, lingual, facial & occipital arts) also carotid sinus & body.

40
Q

Mention veins & lymph nodes of carotid triangle

A

Internal jugular vein with 4 tributaries (pharyngeal, lingual, common facial, superior thyroid veins)

41
Q

Mention nerves of carotid triangle

A

Last 3 cranial nerves
Ansa cervicalis (ant to sheath) & sympathetic chain (post to sheath)

42
Q

Mention bounds of muscular triangle

A

Ant: midline of the neck
Postero-sup: superior belly of omohyoid
Postero-inf: ant border of scm m
Roof: skin, superficial fascia & investing layer of deep cervical fascia
Floor: pretracheal fascia

43
Q

Describe origin & insertion of
1.sternohyoid &
2.sternothyroid

A
  1. O, back of manubrium + medial end of clavicle. I, lower border of hyoid bone
  2. O, back of manubrium and back of 1st costal cartilage. I, oblique line of thyroid cartilage
44
Q

Describe origin & insertion of
1.thyrohyoid &
2.omohyoid

A
  1. O, olique line of thyroid cartilage. I, lower border of the body and greater cornu of hyoid bone
  2. O, sup belly, lower border of body of hyoid bone, inf belly, upper border of scapula & suprascapular ligament. I, intermediate tendon held in position by fascial sling connected to clavicle.
45
Q

Describe nerve supply of infrahyoid muscles

A

All are supplied by ansa cervicalis ex thyrohyoid supplied by C1 fibers joining hypoglossal nerve.

46
Q

Describe movements of infrahyoid muscles

A

All depress larynx ex thyrohyoid which elevate or depress larynx
Sternohyoid: depress hyoid bone after its elevation during swallowing and vical movements
Sternothyroid: depress larynx after its elevation in swallowing & vocal movements
Thyrohyoid: depress hyoid bone + elevate larynx
Omohyoid: depress hyoid in prolonged inspiratory efforts & tenses the lower deep cervical fascia

47
Q

Describe origin & insertion & nerve supply of
1.digastric &
2.stylohyoid

A
  1. O, Ant belly, digastric fossa of mandible. Post belly, digastric notch on medial surface of mastoid process. I, intermediate tendon held to hyoid by fibrous loop. N, ant belly, n. to mylohyoid (1st pharyngeal arch) & post belly: facial n. (2nd pharyngeal arch)
  2. O, posterior surface of styloid process. I, hyoid bone where its tendon is perforated by posterior belly of digastric m. N,: facial n. (2nd pharyngeal arch)
48
Q

Describe origin & insertion & nerve supply of
1.mylohyoid &
2.geniohyoid

A
  1. O, mylohyoid line of mandible. I, ant & mid fibers inserted into the mylohyoid raphe (from symphsis menti to body of hyoid bone). Post fibers into hyoid fibers. Nerve to mylohyoid (1st pharyngeal arch)
  2. O, inferior genial tubercle of body of mandible. I, body of hyoid bone. N, C1 via hypoglossal n.
49
Q

Describe actions of suprahyoid muscles

A
  1. Digastric, depresses mandible if hyoid is fixed, or elevate hyoid during swallowing
  2. Stylohyoid, pulls hyoid upwards and backwards
  3. Mylohyoid, supports floor of mouth, helps in depression of mandible, elevates the mandible during early stage of swallowing.
    Geniohyoid, elevates hyoid or depress mandible
50
Q

Describe exit of cervical plexus roots from bone

A

Between ant and post tubercles of cervical transverse process

51
Q

…..is ant to cervical plexus while….is post to it.

A

Prevertebral fascia
Scalenus medius

52
Q

Mention communicating branches of cervical plexus

A
  1. Grey rami from superior cervical ganglion to all roots
  2. C1 fibers joining hypoglossal n
  3. From C2 to sternomastoid & C2,3 & 4 to trapezius (sensory)
53
Q

List muscular branches of cervical plexus

A
  1. Infrahyoid muscles by ansa cervicalis
  2. Prevertebral & scalene muscles
  3. Levator scapulae
  4. Diaphragm by phrenic nerve
54
Q

Describe structure of ansa cervicalis

A

Superior limb (descending hypoglossi): formed of C1 fibers joining hypoglossal nervethen leave & descend in front of carotid sheath
Inferior limb (descending cervicalis): formed of fibers C2&3 that descend in front of IJV then joint sup limb infront of sheath

55
Q

The sympathetic chain lies between…….

A

Prevertebral fascia (post) & carotid sheath (ant)

56
Q

List the groups of postganglionic parasympathetic fibers

A

A- 1st group acts as communicant rami to nearest nerve
B-2nd group forms plexus around nearest artery
C- 3rd group sends vesceral branches to nearest viscera

57
Q

Fibers connecting middle & inferior ganglia are called…..

A

Ansa subclavia

58
Q

Preganglionic fibers from cervical symp chain is from……

A

Upper thoracic ganglia

59
Q

The largest cervical ganglion is….while smallest is….

A

Superior
Middle

60
Q

Describe site of each cervical ganglion

A

Sup: between ECA & longus capitis at C2,3 level
Mid: related to inf thyroid at level of C6& C7
Inf: at level of transverse process of C7 & neck of 1st rib

61
Q

Mention branches of sup cervical ganglion

A

A) Communicating with upper 4 cervical +lower 4 cranial nerves
B) Vascular plexus arounf ECA & ICA
C)Visceral branches (pharyngeal branch to pharyngeal plexus, superior cervical cardiac to superficial cardiac plexus, thyroid nerves)

62
Q

Mention branches of middle cervical ganglion

A

A) Communicating with C5&6
B) Ansa subclavia & plexus around inf thyroid art
C) visceral branches: to thyroid plexus, middle cardaic cervical to deep cervical plexus, tracheal & esophageal branches

63
Q

Mention branches of inf cervical ganglion

A

A) communicating to C7&8
B) Vascular plexus around vertebral artery
C) Visceral branches: inf cervical cardiac to deep cardiac plexus

64
Q

At fisrt CN IX passes between……while later passes between…..

A

IJV & ICA
ECA & ICA

65
Q

CN IX passes between …..muscles

A

Superior constrictor & middle constrictor

66
Q

CN IX has …..ganglia, exits from…..in skull

A

2 (sup & inf)
Middle part of jugular foramen

67
Q

Enumerate branches if CN IX

A

Tympanic branch
Carotid branch (carotid sinus & body)
Pharyngeal: share in phraygeal plexus
Muscular to stylopharyngeus
Tosillar (tonsillar plexus to supply tonsil & soft palate)
Lingual to mucosa of post 1/3 of tongue & vallate papillae

68
Q

CN IX is tested by…….

A

Gentle tickling of posterior wall of pharynx

69
Q

CN IX is affected in combination with….

A

CN X

70
Q

Describe course of tympanic branch of CN IX

A

Enters middle ear via tympanic canaliculus shares in tympanic plexus gives fibers to greater & lesser petrosal nerves for parotid gland + sensory supply to mucosa of middle ear, auditory tube & mastoid air cells

71
Q

Cranial accessory n joining vagus has most of its fibers distributed through……

A

Pharyngeal & recurrent laryngeal nerves

72
Q

Vagus passes at first between…..then between…..

A

IJV & ICA
IJV & CCA

73
Q

Enumerate branches of vagus nerve from superior vagal ganglion

A
  1. Meningeal nerve -supplies dura of posterior cranial fossa
  2. Auricular nerve: get outside via tympano-mastoid fissure to supply concha & root of auricle + post 1/2 of external auditory meatus & tympanic membrane
74
Q

Mention branches of vagus from inferior vagal ganglion

A
  1. Pharyngeal nerve passes between ICA & ECA to reach mid contrictor & share in pharyngeal plexus
  2. Superior laryngeal nerve: passes behind ICA on pharyngeal constrictors where it divides into 2 branches:
    -External laryngeal nerve pierces inferior constrictor supplying it & cricothyroid m
    -Internal laryngeal nerve: passes downwards, pierces thyrohyoid membrane to supply laryngeal mucosa above vocal cord
75
Q

Mention branches of vagus in neck

A
  1. Carotid nerve to carotid body
  2. Cardiac nerves (superior & inferior) from each vagus, the left inferior end in superficial cardiac plexus while the rest end in deep cardiac plexus
  3. Rt recurrent laryngeal arise from vagus in front of subclavian a then turns around & ascends in tracheo-esophageal groove to pass with inferior thyroid a to supply larynx
76
Q

Enumerate branches of vagus in thorax

A

Left recurrent laryngeal nerve
Pulmonary & cardiac branches

77
Q

Mention results of vagal paralysis

A

Nasal regurgitation, hoarseness of voice, flattened palatal arches, cadaveric position of vocal cords & dysphagia

78
Q

Irritation of auricular branch of vagus n leads to….

A

Reflex cough

79
Q

In case of vagal paralysis uvula is….

A

Deviated to opposite side

80
Q

Irritation of 11th nerve leads to

A

Torticollis

81
Q

Mention branches of hypoglossal nerve

A

1st group: Fibers from C1 related anatomically to hypoglossal
1. Meningeal branch to post cranial fossa
2. Geniohyoid
3. Thyrohyoid
4. Descending hypoglossi or upper roots of ansa cervicalis
2nd group: from hypoglossal itself:
Styloglossus, genioglossus, hyoglossus + all intrinsic muscle

CNS Anatomy (19 decks)

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