Fascial Layer and Posterior Cervical Triangle Flashcards

1
Q

Term: band of connective tissue surrounding a structure?

A

Fascia

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2
Q

What gives rise to potential tissue space and pathways, allowing for infection to spread more easily?

A

Fascia

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3
Q

Which is immediately deep to skin?

superficial/deep fascia

A

superficial

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4
Q

Which is comprised of loose connective tissue and fat?

superficial/deep fascia

A

superficial

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5
Q

Which is composed of dense, organized connective tissue and is devoid of fat?

(superficial/deep fascia)

A

deep

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6
Q

Which envelops most body structures deep to skin and sub-cutaneous tissue?

(superficial/deep fascia)

A

deep

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7
Q

How many deep fascial layers of the neck are there?

Name them.

A
  1. Investing fascia
  2. Pretrachael fascia and buccopharyngeal fascia
  3. Alar fascia an dprevertebral fascia
  4. Carotid Sheath
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8
Q

Which deep fascial layer of the neck is the outermost layer?

A

investing fascia

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9
Q

Investing fascia surrounds _____

A

trapezius, SCM, infrahyoid mm

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10
Q

Pretrachael fascia surrounds _____

A

thyroid, trachae, esophagus, posterior surface of infrahyoid mm

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11
Q

Buccopharyngela fascia surrounds ____

A

posterior pharynx

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12
Q

Alar fascia is between which two deep fascial layers of the neck?

A

Alar fascia is anterior layer of prevertebral fascia

Runs behind the buccopharyngeal fascia

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13
Q

Prevertebral fascia surrounds ____

A

prevertebral and deep back muscles

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14
Q

Carotid sheath is a column of fascia surrounding _____

A

common carotid artery, internal carotid artery, internal jugular vein, CN X (vagus)

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15
Q

Which 2 vertebral layers are associated with each other?

A

pretrachael fascia and buccopharyngeal fascia

alar fascia and prevertebral fascia

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16
Q

What are the 4 fascial spaces in the neck?

A
  1. Carotid Sheath
  2. Pretrachael Space
  3. Retropharyngeal Space
  4. PRevertebral Space
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17
Q

The carotid sheath space is between ___ and ___

A

between SCM and prevertebral mm

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18
Q

The carotid sheath space is formed from ____

A

condensation of deep cervical fascia (all 4 layers)

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19
Q

The carotid sheath space encases ____

A

carotid aa., internal jugular v., CN X vagus

external carotid a. leaves carotid sheath at bifurcation to supply face

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20
Q

Infections in the carotid sheath can spread from ___ to ___

A

from skull down to middle mediastinum

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21
Q

Pretracheal space is between __ and __

A

trachae and infrahyoid mm

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22
Q

Infections in the pretrachael space can spread from ___ to___

A

trachae cartilage to anterior mediastinum

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23
Q

Retropharyngeal space is found between ___ and ___

A

buccopharyngeal fascia and alar fascia

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24
Q

Infections in retropharyngeal space can spread from __ to __

A

skull to superior mediastinum

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25
Q

In which fascial space can pharyngeal perforation take place?

A

Retropharyngeal space

pharyngeal perforation is caused by plugging your nose while sneezing (pharynx bursts open)

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26
Q

Which fascial space is called the danger space?

A

prevertebral space

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27
Q

Prevertebral danger space is found between __ and __

A

alar fascia and prevertebral fascia

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28
Q

Infections in the prevertebral danger space can spread from __ to __

A

skull base to posterior mediastinum (T12)

this is the entire length of the thoracic cavity, prone to infections!

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29
Q

Why is the prevertebral space known as the danger space?

A

it is notorious for inferior spread of infection from base of skull to posterior mediastinum

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30
Q

Describe zone 1 of the neck

A

Thoracic inlet to cricoid cartilage

most inferior zone

everything coming out of thoracic cavity going to head and upper limb

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31
Q

Describe zone 2 of neck

A

Cricoid cartilage to angle of mandible

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32
Q

Describe zone 3 of neck

A

Angle of mandible to base of skull

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33
Q

What are the 3 horizontal zones of the neck used for?

A

useful in clinical assessment of neck trauma

34
Q

What are the borders of the posterior cervical triangle?

A

anterior: SCM
posterior: trapezius m
inferior: middle 1/3 of clavicle

35
Q

Describe platysma muscle’s location in relation to posterior cervical triangle

A

Very superficial, passes over SCM

36
Q

Describe external jugular vein in relation to SCM

A

external jugular vein runs on the superficial surface of SCM

runs vertically

37
Q

What cutaneous nerves are found in the posterior cervical triangle?

A
  1. lesser occipital nerve
  2. great auricular nerve
  3. transverse cervical nerve
  4. supraclavicular nerve
38
Q

All cutaneous nerves in posterior cervical triangle emerge at ____

(Where is this relative to SCM?)

A

Erb’s point

this is deep to SCM

39
Q

What cervical levels are cutaneous nerves in posterior cervical triangle?

A

lesser occipital nerve, great auricular nerve and transverse cervical nerve are all C2-C3

Supraclavicular nerves are C3-C4

40
Q

Describe lesser occipital nerve relative to SCM

A

Lesser occipital nerve runs superiorly along posterior border of SCM

41
Q

Lesser occipital nerve crosses over a portion of _____

A

occipital artery

42
Q

Lesser occipital nerve supplies ______

A

skin of scalp at the apex of the triangle (near the occipital region)

43
Q

Describe great auricular nerve in relation to SCM

A

great auricular nerve ascends vertically on SCM surface

44
Q

Great auricular nerve runs with ____

A

great auricular nerve runs with external jugular vein towards ear

45
Q

Great auricular nerve supplies ____

A

ear lobe and skin posterior to auricle

and angle of mandible and mastoid process

46
Q

Describe transverse cervical nerve relative to SCM

A

transverse cervical nerve runs transversely across SCM

47
Q

Transverse cervical nerve supplies ____

A

skin of anterior cervical triangle and lateral neck

separates from transverse cervical artery which heads posteriorly

48
Q

Which of the 4 cutaneous nerves in the posterior cervical triangle has 3 main branches?

What are they?

A

supraclavicular nerve has 3 main branches

medial, intermediate, lateral (posterior)

49
Q

Describe the course in which supraclavicular nerve runs

A

runs superficial to clavicle and deep to platysma

50
Q

Supraclavicular nerve supplies ____

A

skin of clavicular region

51
Q

What makes up the cervical plexus of cutaneous innervation in the region of the posterior cervical triangle?

A

all of the cutaneous nerves found within the posterior cervical triangle

(lesser occipital n., great auricular n., transverse cervical n., supraclavicular nn)

52
Q

All of the cutaneous nerves of the posterior triangle together make up _____

A

cervical plexus of cutaneous innervation

53
Q

What motor nerves are found within the posterior cervical triangle?

A

accessory nerve and phrenic nerve

54
Q

Accessory nerve emerges from ____

A

jugular foramen of the skull

55
Q

How does accessory nerve run through posterior cervical triangle?

A

diagonally through triangle deep to investing fascia

56
Q

Accessory nerve supplies ____

A

SCM and trapezius muscle

57
Q

Phrenic nerve is which cervical levels?

A

C3,4,5 KEEP ME BREATHING AND ALIVE

58
Q

What muscle does phrenic n run over along it’s course to the diaphragm?

A

descends vertically along anterior scalene muscle

59
Q

Phrenic nerve is crossed anteriorly by ____

A

transverse cervical artery and suprascapular artery

60
Q

Phrenic nerve enters the thorax between ___ and ___

A

subclavian artery and subclavian vein

61
Q

Phrenic nerve travels along ___ to supply the diaphragm

A

pericardial sac

62
Q

What 3 vessels are found within the posterior cervical triangle?

A
  1. external jugular vein
  2. transverse cervical artery
  3. suprascapular artery
63
Q

external jugular vein crosses ___ to enter posterior traingle

A

SCM

64
Q

External jugular vein pierces ____ to drain into ____

A

pierces investing fascia to end in subclavian vein

65
Q

Transverse cervical artery and suprascapular artery both branch off of ____

A

thyrocervical trunk

66
Q

Do transverse cervical artery and nerve travel together?

A

NO

67
Q

What is the course of transverse cervical artery?

A

after branching from thyrocervical trunk, transverse cervical artery passes laterally across the base of the triangle anterior to the anterior scalene muscle and brachial plexus

68
Q

What is the course of suprascapular artery?

A

after branching from thyrocervical trunk, passes laterally to the lowest part of the triangle

ends posterior to the clavicle

69
Q

What are the deep muscles found in the posterior cervical triangle?

A
  1. splenius capitis muscle
  2. levator scapulae muscle
  3. scale muscles (3)
  4. omohyoid muscle, inferior belly
70
Q

What is the action of splenius capitis muscle?

A

extends/laterally rotates head and neck

71
Q

What is the innervation of splenius capitis muscle?

A

dorsal rami of spinal nn

72
Q

What is the action of levator scapulae mm?

A

elevate the scapula

73
Q

What is the innervation of levator scapulae m?

A

dorsal scapular n (C5)

74
Q

What are the 3 scalene muscles?

A

anterior scalene m
middle scalene m
posterior scalene m

75
Q

What is the difference between origin/insertion between the 3 scalene muscles?

A

anterior O: transverse process C3-6 –> I: 1st rib

middle O: transverse process C2-7 –> I: 1st rib

posterior O: transverse process C4-7 –> I: 2nd rib

76
Q

What is the action of all of the scalene muscles?

A

tilt neck laterally

77
Q

What is the innervation of the scalene muscles?

A

ventral rami C3-C8 nerves

78
Q

What is the interscalene triangle formed by?

A

anterior scalene m
middle scalene m
1st rib

79
Q

Where is the scalene triangle relative to the posterior cervical triangle

A

interscalene triangle is elongated triangle deep to posterior cervical triangle

80
Q

What passes through the interscalene triangle?

A

brachial plexus and subclavian artery

81
Q

Subclavian vein passes anterior to ____

A

anterior scalene muscle