Functional/Clinical Anatomy of the Neck Flashcards
Describe motion at the atlas.
It does flexion and extension at the antlanto-occipital joint
Describe motion at the axis?
It pivots around the dens for rotation at the atlanto-axial joint.
What is A?
Atlas (C1) vertebra
What is B?
Axis (C2) vertebra
What is C?
normal cervical vertebra (C3)
What is the star?
Dens (odontoid process)
What are the attachments of the sternocleidomastoid?
Manubrium (sterno-), clavicle (cleido-), mastoid process of temporal bone
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
What is torticollis?
A shortening of one muscle in the neck, usually congenital or from a baby lying frequently with head to one side
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
What are the functions of the trapezius muscle?
Extension, lateral bending, and rotation to the opposite side of the contracting muscle
What are the attachments of the inferior oblique muscle?
Spine of C2 to transverse process of C1

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
What are the attachments of the scalene muscles?
Transverse processes of cervical vertebrae and ribs

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)
What is the interscalene triangle?
Triangle between the anterior and middle scalene muscles

What are the contents of the interscalene triangle?
Brachial plexus, subclavian artery

What is scalenus anticus syndrome?
Compression of the brachial plexus and subclavian artery due to triangle narrowing, obstruction from fascia
What is costoclavicular syndrome?
Compression of the brachial plexus and subclavian artery by the clavicle and first rib
What structures are anterior to the anterior scalene muscle?
Phrenic nerve, subclavian vein
What is A?
Digastric muscle
What is B?
Mylo-hyoid muscle
What is C?
Sterno-hyoid muscle
What is D/E?
Omo-hyoid muscle
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
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
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
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
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
innervates strap muscles and lies upon the carotid sheath