Functional/Clinical Anatomy of the Neck Flashcards by Emily Zaniker

Describe motion at the atlas.

It does flexion and extension at the antlanto-occipital joint

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Describe motion at the axis?

It pivots around the dens for rotation at the atlanto-axial joint.

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What is A?

Atlas (C1) vertebra

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What is B?

Axis (C2) vertebra

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What is C?

normal cervical vertebra (C3)

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What is the star?

Dens (odontoid process)

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What are the attachments of the sternocleidomastoid?

Manubrium (sterno-), clavicle (cleido-), mastoid process of temporal bone

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What are the functions of the sternocleidomastoid muscle?

Flex cervical intervertebral joints

Laterally bend the neck

Rotate the head and neck to opposite sides of the contracting muscle

Extend atlanto-occipital joint

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What is torticollis?

A shortening of one muscle in the neck, usually congenital or from a baby lying frequently with head to one side

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What are the attachments of the trapezius?

External occipital protuberance of the occipital bone

Medial border of scapula + scapula spine

Spinous processes of cervical and thoracic vertebra

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What are the functions of the trapezius muscle?

Extension, lateral bending, and rotation to the opposite side of the contracting muscle

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What are the attachments of the inferior oblique muscle?

Spine of C2 to transverse process of C1

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What is the function of the inferior oblique muscle?

Rotates the head (to the side of the muscle that is contracting) at the atlanto-axial joint

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What are the attachments of the scalene muscles?

Transverse processes of cervical vertebrae and ribs

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What are the actions of the scalene muscles?

Lateral bending of the neck

Rotation to the opposite side of contracting muscles

Elevation of the rib cage (for respiration)

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What is the interscalene triangle?

Triangle between the anterior and middle scalene muscles

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What are the contents of the interscalene triangle?

Brachial plexus, subclavian artery

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What is scalenus anticus syndrome?

Compression of the brachial plexus and subclavian artery due to triangle narrowing, obstruction from fascia

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What is costoclavicular syndrome?

Compression of the brachial plexus and subclavian artery by the clavicle and first rib

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What structures are anterior to the anterior scalene muscle?

Phrenic nerve, subclavian vein

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What is A?

Digastric muscle

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What is B?

Mylo-hyoid muscle

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What is C?

Sterno-hyoid muscle

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What is D/E?

Omo-hyoid muscle

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What is F?

Sterno-thyroid muscle

What is G?

Crico-thyroid muscle

What is H?

Thyro-hyoid muscle

What is I?

Hyoid

What nerve innervates the strap muscles?

Ansa cervicalis (motor component of cervical plexus)

What is a whiplash injury?

An injury resulting from hyperextension (anterior structures are injured)

What structures are injured in whiplash injuries?

Anterior structures - anterior longitudinal ligament, intervertebral disc, larynx, anterior scalene, longus colli, phrenic nerve

What structures might be damaged from hyperflexion neck injuries?

Torn interspinous ligaments, dislocate intervertebral synovial joints Can cause spinal cord damage from sliding vertebrae

What structures might be injured from neck compression injuries?

Fracture/shatter vertebral bodies Spinal cord may be damaged

What is A?

Posterior triangle

What is B?

Anterior triangle

What is C?

Muscular triangle

What is D?

Carotid triangle

What is E?

Submandibular triangle

What is F?

Submental triangle

What is G?

Parotid region

What is A?

Trapezius

What is B?

Pre-vertebral fascia

What is C?

Carotid sheath

What is D?

Pretracheal fascia

What is E?

Investing fascia

What is F?

Sternocleidomastoid

What is G?

Internal jugular vein

What is H?

Common carotid artery

What is I?

Vagus nerve

What is J?

Scalenes

What are the contents of the carotid compartment?

common carotid artery internal jugular vein vagus nerve

What are the components of the visceral compartment?

Larynx, pharynx, trachea, esophagus, thyroid, and parathyroid glands

What is the name of the enveloping fascia around the visceral compartment?

Pretracheal fascia

What structures are in the vertebral compartment?

Vertebral column and all surrounding skeletal muscles

What is the name of the fascia around the vertebral compartment?

Prevertebral fascia

What is the retropharyngeal space?

A space between the visceral and vertebral compartments that can spread infection from head to mediastinum

What is A?

Superior constrictor

What is B?

Middle constrictor (to hyoid bone)

What is C?

Inferior constrictor (to thyroid/cricoid cartilage)

What is D?

Esophagus

What is E?

Epiglottis

What is F?

Hyoid bone

What is G?

Thyrohyoid membrane

What is H?

Thyroid cartilage

What is I?

Cricothyroid membrane

What is J?

Cricoid cartilage

What does the inferior constrictor attach to?

Cricoid and thyroid cartilages

What does the middle constrictor attrach to?

Hyoid bone

What nerve passes between the middle and inferior constrictors?

Internal branch of superior laryngeal nerve

What is the superior constrictor attached to?

Pharyngeal tubercle and buccinator muscles (via pterygomandibular raphe)

What nerve passes between themiddle and superior constrictors?

Glossopharyngeal nerve (contributes visceral sensory to pharyngeal plexus)

Where is the "danger space" of the neck?

Between visceral and vertebral compartments - infection can pass from head to mediastinum

What does the thyroid gland develop from?

The thyroglossal duct

What are the general nerve components of the cervical plexus?

Ventral rami of spinal nerves C1 to C5

What are the cutaneous branches of the cervical plexus that originate in the posterior triangle?

Greater auricular Transverse cervical lesser occipital supraclavicular

What are the motor branches of the cervical plexus?

Ansa cervicalis --\> infrahyoid strap muscles Phrenic nerve --\> diaphragm Branches to deep neck muscles

What is the path of the spinal accessory nerve XI?

Originates in cervical spinal cord, passes through foramen magnum, exits jugular foramen to supply sternoclediomastoid and trapezius muscle

What is A?

Internal jugular vein

What is B?

Anterior jugular vein

What is C?

Communicating branch

What is D?

External jugular vein

What is E?

Common facial vein

Fracture of the odontoid process will result in the most pain upon which of the following movements? a) flexion at intervertebral joints b) rotation of the neck at intervertebral joints C2-C6 c) flexion at the atlanto-occipital joint (nodding of head) d) rotation at the atlanto-axial joint

d) rotation at the atlanto-axial joint ## Footnote *atlas pivots around the odontoid process of the axis during rotation of the atlanto-axial joint*

Which of the following is a function of the LEFT trapezius muscle? a) lateral bending of the neck to the right b) rotation of the neck to the left c) extension at the atlanto-occipital joint

c) extension at the atlanto-occipital joint ## Footnote *it would rotate the neck to the **right** and laterally bend the neck to the **left***

Damage to which of the following would cause pain during contraction of the middle constrictor muscle during swallowing? a) greater horn of hyoid bone b) cricoid cartilage c) medial pterygoid plate d) pharyngeal tubercle e) superior horn of the thyroid cartilage

a) greater horn of hyoid bone ## Footnote *middle constrictor attaches to hyoid bone*

A penetrating wound just anterior to the anterior scalene muscle might damage which of the following? a) brachial plexus b) subclavian artery c) spinal accessory nerve d) subclavian vein

d) subclavian vein * brachial plexus and subclavian artery pass between anterior and middle scalenes*

What nerve innervates the infrahyoid strap muscles? a) cervical branches of the facial nerve b) ansa cervicalis c) transverse cervical nerves d) supraclavicular nerve e) glossopharyngeal nerve

b) ansa cervicalis

The upper part of the posterior triangle of the neck is a "safe" zone that has no major neurovascular structures. What structure separates the anterior triangle from the posterior triangle? a) omohyoid muscle b) external jugular vein c) sternocleidomastoid muscle d) carotid sheath e) anterior scalene muscle

c) sternocleidomastoid muscle

What artery is the primary source of blood for the larynx? a) superior thyroid b) costocervical trunk c) thyrocervical trunk d) internal carotid e) ascending pharyngeal

a) superior thyroid ## Footnote *branch off of external carotid artery*

A tumor within the carotid sheath in the middle of the neck will impair function of which of the following nerves? a) glossopharyngeal b) spinal accessory c) phrenic d) ansa cervicalis e) vagus

d) ansa cervicalis ## Footnote *innervates strap muscles and lies upon the carotid sheath*