Functional/Clinical Anatomy of the Neck

Question 1

Describe motion at the atlas.

Answer 1

It does flexion and extension at the antlanto-occipital joint

Question 2

Describe motion at the axis?

Answer 2

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

Question 3

What is A?

Answer 3

Atlas (C1) vertebra

Question 4

What is B?

Answer 4

Axis (C2) vertebra

Question 5

What is C?

Answer 5

normal cervical vertebra (C3)

Question 6

What is the star?

Answer 6

Dens (odontoid process)

Question 7

What are the attachments of the sternocleidomastoid?

Answer 7

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

Question 8

What are the functions of the sternocleidomastoid muscle?

Answer 8

Flex cervical intervertebral joints

Laterally bend the neck

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

Extend atlanto-occipital joint

Question 9

What is torticollis?

Answer 9

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

Question 10

What are the attachments of the trapezius?

Answer 10

External occipital protuberance of the occipital bone

Medial border of scapula + scapula spine

Spinous processes of cervical and thoracic vertebra

Question 11

What are the functions of the trapezius muscle?

Answer 11

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

Question 12

What are the attachments of the inferior oblique muscle?

Answer 12

Spine of C2 to transverse process of C1

Question 13

What is the function of the inferior oblique muscle?

Answer 13

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

Question 14

What are the attachments of the scalene muscles?

Answer 14

Transverse processes of cervical vertebrae and ribs

Question 15

What are the actions of the scalene muscles?

Answer 15

Lateral bending of the neck

Rotation to the opposite side of contracting muscles

Elevation of the rib cage (for respiration)

Question 16

What is the interscalene triangle?

Answer 16

Triangle between the anterior and middle scalene muscles

Question 17

What are the contents of the interscalene triangle?

Answer 17

Brachial plexus, subclavian artery

Question 18

What is scalenus anticus syndrome?

Answer 18

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

Question 19

What is costoclavicular syndrome?

Answer 19

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

Question 20

What structures are anterior to the anterior scalene muscle?

Answer 20

Phrenic nerve, subclavian vein

Question 21

What is A?

Answer 21

Digastric muscle

Question 22

What is B?

Answer 22

Mylo-hyoid muscle

Question 23

What is C?

Answer 23

Sterno-hyoid muscle

Question 24

What is D/E?

Answer 24

Omo-hyoid muscle

Question 25

What is F?

Answer 25

Sterno-thyroid muscle

Question 26

What is G?

Answer 26

Crico-thyroid muscle

Question 27

What is H?

Answer 27

Thyro-hyoid muscle

Question 28

What is I?

Answer 28

Hyoid

Question 29

What nerve innervates the strap muscles?

Answer 29

Ansa cervicalis (motor component of cervical plexus)

Question 30

What is a whiplash injury?

Answer 30

An injury resulting from hyperextension (anterior structures are injured)

Question 31

What structures are injured in whiplash injuries?

Answer 31

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

Question 32

What structures might be damaged from hyperflexion neck injuries?

Answer 32

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

Question 33

What structures might be injured from neck compression injuries?

Answer 33

Fracture/shatter vertebral bodies Spinal cord may be damaged

Question 34

What is A?

Answer 34

Posterior triangle

Question 35

What is B?

Answer 35

Anterior triangle

Question 36

What is C?

Answer 36

Muscular triangle

Question 37

What is D?

Answer 37

Carotid triangle

Question 38

What is E?

Answer 38

Submandibular triangle

Question 39

What is F?

Answer 39

Submental triangle

Question 40

What is G?

Answer 40

Parotid region

Question 41

What is A?

Answer 41

Trapezius

Question 42

What is B?

Answer 42

Pre-vertebral fascia

Question 43

What is C?

Answer 43

Carotid sheath

Question 44

What is D?

Answer 44

Pretracheal fascia

Question 45

What is E?

Answer 45

Investing fascia

Question 46

What is F?

Answer 46

Sternocleidomastoid

Question 47

What is G?

Answer 47

Internal jugular vein

Question 48

What is H?

Answer 48

Common carotid artery

Question 49

What is I?

Answer 49

Vagus nerve

Question 50

What is J?

Answer 50

Scalenes

Question 51

What are the contents of the carotid compartment?

Answer 51

common carotid artery internal jugular vein vagus nerve

Question 52

What are the components of the visceral compartment?

Answer 52

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

Question 53

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

Answer 53

Pretracheal fascia

Question 54

What structures are in the vertebral compartment?

Answer 54

Vertebral column and all surrounding skeletal muscles

Question 55

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

Answer 55

Prevertebral fascia

Question 56

What is the retropharyngeal space?

Answer 56

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

Question 57

What is A?

Answer 57

Superior constrictor

Question 58

What is B?

Answer 58

Middle constrictor (to hyoid bone)

Question 59

What is C?

Answer 59

Inferior constrictor (to thyroid/cricoid cartilage)

Question 60

What is D?

Answer 60

Esophagus

Question 61

What is E?

Answer 61

Epiglottis

Question 62

What is F?

Answer 62

Hyoid bone

Question 63

What is G?

Answer 63

Thyrohyoid membrane

Question 64

What is H?

Answer 64

Thyroid cartilage

Question 65

What is I?

Answer 65

Cricothyroid membrane

Question 66

What is J?

Answer 66

Cricoid cartilage

Question 67

What does the inferior constrictor attach to?

Answer 67

Cricoid and thyroid cartilages

Question 68

What does the middle constrictor attrach to?

Answer 68

Hyoid bone

Question 69

What nerve passes between the middle and inferior constrictors?

Answer 69

Internal branch of superior laryngeal nerve

Question 70

What is the superior constrictor attached to?

Answer 70

Pharyngeal tubercle and buccinator muscles (via pterygomandibular raphe)

Question 71

What nerve passes between themiddle and superior constrictors?

Answer 71

Glossopharyngeal nerve (contributes visceral sensory to pharyngeal plexus)

Question 72

Where is the "danger space" of the neck?

Answer 72

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

Question 73

What does the thyroid gland develop from?

Answer 73

The thyroglossal duct

Question 74

What are the general nerve components of the cervical plexus?

Answer 74

Ventral rami of spinal nerves C1 to C5

Question 75

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

Answer 75

Greater auricular Transverse cervical lesser occipital supraclavicular

Question 76

What are the motor branches of the cervical plexus?

Answer 76

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

Question 77

What is the path of the spinal accessory nerve XI?

Answer 77

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

Question 78

What is A?

Answer 78

Internal jugular vein

Question 79

What is B?

Answer 79

Anterior jugular vein

Question 80

What is C?

Answer 80

Communicating branch

Question 81

What is D?

Answer 81

External jugular vein

Question 82

What is E?

Answer 82

Common facial vein

Question 83

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

Answer 83

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

Question 84

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

Answer 84

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

Question 85

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

Answer 85

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

Question 86

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

Answer 86

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

Question 87

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

Answer 87

b) ansa cervicalis

Question 88

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

Answer 88

c) sternocleidomastoid muscle

Question 89

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

Answer 89

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

Question 90

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

Answer 90

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