Gross 2 Head and Neck Lect. Flashcards
Describe the Hyoid. (Osteology, and what does it help with)
Consist of 3 part: Body, Greater & Lesser horn
- This bone does not articulate with any other bone
- Helps maintain the airway open
What are the 3 unpaired Laryngeal Cartilages?
- Thyroid Cartilage: Largest of all cartilages, lies at level of C4-C5
- Cricoid Cartilage: Smaller than thyroid cartilage but is thicker and stronger, shaped like signet ring. Lies at level of C6
- Epiglottis: Attached by ligament to the posterior aspect of the thyroid cartilage
What are the 3 paired Cartilages?
- Arytenoids: Are 3-sided pyramid cartilages that articulate with the lateral parts of superior border of the Cricoid cartilage lamina
- Corniculates: Attach to apices (top) of arytenoid cartilage
- Cuneiforms: Do no directly attach to other cartilage
(The Corniculates and Cuneiform cartilages appear as small nodules in the posterior parts of the aryepiglottic folds)
Where is the Superficial Facia located in the neck?
Its a fatter layer located between the dermis and investing facia
What contents are found in the Superficial Facia?
The Platysma muscle, which is found in the anterior lateral aspect
What is the Platysma?
A sheet of muscle in the subcutaneous tissue
- The fibers of this muscle diverge which leaves a gap anterior to larynx and trachea
- This is a muscle considered of facial expressions
- Tenses skin of neck
- Draws corners of mouth inferiorly and laterally
- Also assist with mandibular depression
What contents are found in the Deep Fascia of the neck?
- Investing Layer
- Pretracheal Layer
–Muscular layer
–Visceral layer - Carotid Sheath
- Prevertebral Layer
This is from superficial to deep
What muscles are found in the Investing Layer?
- Sternocleidomastoid (SCM)
- Trapezius
What are the contents of the Pretracheal Layer? (Muscular and Visceral)
Muscular:
- Sternohyoid
- Sternothyroid
- Thyrohyoid
- Omohyoid
Visceral:
- Thyroid Glands
- Trachea
- Esophagus
What contents are in the Carotid Sheath?
- Carotid Artery
- Internal Jugular Vein
- Vagus Nerve
What are the muscles of the Prevertebral Layer?
(Anterior and Lateral)
Anterior:
- Rectus Capitis Anterior
- Anterior Scalene
- Longus Coli
- Longus Capitis
Lateral:
- Rectus Capitis Lateralis
- Middle Scalene
- Posterior Scalene
- Levator Scapulae
- Splenius Capitis
What is the relationship between the Scalene muscles, the brachial plexus, and the subclavian vessels?
- Roots of the brachial plexus course between Anterior and Middle Scalene
- The Subclavian Artery courses between the Anterior and Middle Scalene
- The Subclavian Vein courses anteriorly to the Anterior Scalene
This is known as Scalene Triangle
What does the Internal Jugular Vein drain blood from? And where does the Internal Jugular drain into?
- Brain
- Anterior Face
- Cervical Viscera
- Deep muscles of the neck
The internal jugular then drains into Subclavian Vein
What innervations does the Vagus Nerve supply?
- Major Parasympathetic nerve
- Pharyngeal, Laryngeal and Cardiac Branches
What are the Motor Nerves of the Neck, what are their nerve roots and what do they innervate? (2)
These are the Motor Nerves for Cervical Plexus
Ansa Cervicalis:
(Superior root- C1-C2)
(Inferior root- C2-C3)
Motor nerve for Infrahyoid Muscles
{Sternohyoid, Sternothyroid, Omohyoid, Thyrohyoid}
Phrenic:
(C3-C5)
Motor for the Diaphragm
What are the Sensory Nerves of the Neck, what are their nerve roots and what do they provide sensory for? (4)
These are the Sensory Nerves for Cervical Plexus
- Lesser Occipital: (C2) Posterior neck and scalp, superior to auricle
- Great Auricular: (C2-C3) Skin around angle of Mandible to Mastoid process, some posterolateral ear
- Transverse Cervical: (C2-C3) Anterior cervical region.
- Supraclavicular: (C3-C4) Skin of neck that cross the clavicle and supply the skin over the shoulder
What are the Cranial Nerves of the Neck, where do they originate what what do they innervate?
CN IX: Glossopharyngeal: Tonge and Pharynx
CN X: Vagus: Larynx and Pharynx
CN XI: Spinal Accessory: SCM and Trapezius (Motor)
CN XII: Hypoglossal: Tongue (Motor)
Where do all the Sensory nerves of the neck course?
- All of the nerves originate in the Lateral Region (Posterior Triangle) of the neck
- Exit via. Erb’s Point
Coures:
Lesser Occipital- Goes from lateral to posterior region of the neck
Great Auricular- Stays in the lateral region
Transverse Cervical- Goes from lateral to anterior region of the neck
Supraclavicular- Goes from lateral region and descends to root of the neck
The neck is divided into 4 regions, what are those regions?
1) Sternocleidomastoid Region
2) Posterior Cervical Region
3) Lateral Cervical Region (Posterior Triangle)
4) Anterior Cervical Region (Anterior Triangle)
What contents are in the Sternocleidomastoid Region?
- Superior part of External Jugular Vein
- Greater Auricular Nerve
- Transverse Cervical Nerve
What contents are in the Posterior Cervical Region?
(The Posterior Cervical region consist of the upper trap. and the areas deep to it)
- Cutaneous branches of posterior rami of cervical spinal nerves
- Suboccipital Triangle- lies deep to the Traps., splenius capitis, and semispinalis capitis
- The suboccipital triangle contains: Vertebral A., Suboccipital N (C1), and Suboccipital Venous Plexus.
What are the Boarders of the Lateral Cervical Region (Posterior Triangle)?
- Anterior: Posterior border of SCM
- Posterior: Anterior border of Traps.
- Inferior: Middle 3rd of clavicle between Traps and SCM
- Superior/Apex: Where SCM and Traps meet on superior nuchal line
- Roof: Investing Layer of Deep Fascia
- Floor: Muscles of the Prevertebral Layer of Deep Fascia
What are the muscles in the Lateral Cervical Region (Posterior Triangle)?
- Splenius Capitis
- Levator Scapulae
- Middle Scalene
- Posterior Scalene
What are the arteries in the Lateral Cervical Region (Posterior Triangle)? And what do these arteries supply?
- Vertebral Artery: Comes from 1st part of Subclavian Artery.
- Thyrocervical Trunk;
–Suprascapular Artery: Supply Infra/Suprasinatus
–Cervicodorsal Trunk/Transverse Cervical Artery:
Supply Trapezius, Levator Scapulae, and Middle
Scalene
–Inferior Thyroid: Supplies the Thyroid
(Anastomose with Superior Thyroid of External
Carotid Artery) - 3rd part of Subclavian Artery (lies on 1st rib): Supply UE (Via Axillary Artery)
- Occipital Artery (From External Carotid): Supply Occipital Region
The Vertebral Artery has 4 different parts, what are these parts and where do they course?
- Cervical Part: Ascends in space formed between the Scalene and Longus Colli and Capitis muscles
- Vertebral Part: Courses through transverse foramen starting a C6
- Atlantic Part: Enters the cranium though the foramen magnum
- Intracranial Part: The Left and Right Vertebral A. come together to form the Basilar Artery
What are the Veins in the Lateral Cervical Region (Posterior Triangle)?
And what do they drain?
- External Jugular:
–Begins below the angle of the mandible
–Its superficial to the SCM
–Drains scalp and lateral aspect of face - Subclavian Vein: Drains the UE
In the Lateral Cervical Region (Posterior Triangle), where are the Superficial and Deep Cervical Lymph Nodes?
Superficial Cervical: Lie along External Jugular Vein (Superficial to SCM)
Deep Cervical: Lie along Internal Jugular Vein
What are the 3 Triangles the make up the Anterior Cervical Region (Anterior Triangle)?
- Submental Triangle
- Submandibular Triangle
- Carotid Triangle
What contents are inside the Submental Triangle from the Anterior Cervical Region (Anterior Triangle)?
- Submental lymph nodes and small veins, these small veins unit to form anterior jugular vein
What contents are inside the Submandibular Triangle from the Anterior Cervical Region (Anterior Triangle)? (5)
- Submandibular Gland
- Submandibular Lymph nodes
- Hypoglossal Nerve (CN XII)
- Mylohyoid Nerve
- Parts of Facial A. and V.
What contents are inside the Carotid Triangle from the Anterior Cervical Region (Anterior Triangle)? (6)
- Carotid Sheath
- CN XI and XII (Spinal Accessory and Hypoglossal)
- Superior root of Ansa Cervicalis N.
- Thyroid Gland, Larynx, and Pharynx
- Deep Cervical Lymph nodes
- Branches of cervical plexus
What are the muscles of the Anterior Cervical Region (Anterior Triangle)? (4)
Also called Suprahyoid Muscles
- Mylohyoid
- Geniohyoid
- Stylohyoid
- Digastric
What would you expect to feel when palpating a normal lymph node?
Soft, non-tender
What would you expect to feel when palpating a abnormal lymph node?
Enlargement, hardness, tenderness
What are the Arteries in the Anterior Cervical Region (Anterior Triangle)?
- Common Carotid:
-Internal Carotid: Supplies structures internal to cranium
-External Carotid: Supplies neck and face
What are the Veins in the Anterior Cervical Region (Anterior Triangle)?
What do they drain?
Where do they drain?
- Internal Jugular Vein:
– Drains blood from the brain, anterior face, cervical viscera, deep muscles of the back
– Drains into Subclavian Vein - Anterior jugular Vein:
– Drains blood from anterior face and neck
– Drains into External Jugular or
Subclavian Vein
What are the 3 layers of Viscera of the Neck?
- Endocrine: Thyroid gland and Parathyroid
- Respiratory: Larynx and Trachea
- Alimentary: Pharynx and Esophagus
What are the roles of the Thyroid and Parathyroid Gland?
Both of these are part of the endocrine system, which secretes hormones
- Thyroid gland produces thyroid hormone
–Regulates metabolism and calcium - Parathyroid gland produces parathormone
–Regulates metabolism of phosphorus and calcium
in the blood
Describe the Larynx and its function.
“Voice Box”
- Composed of 9 cartilage (3 paired and 3 unpaired)
–Thyroid cartilage is the largest (serves as
attachment site for muscles) - Function:
–Maintain airway patent
–Route food and drink into the esophagus
–Voice production
What is in the Alimentary Layer?
Pharynx
(Which is the superior part of the alimentary system)
Has 3 parts:
-Nasopharynx
-Oropharynx
-Laryngopharynx
What is the Clinical presentation, MOI, and treatment for someone with Congenital Torticollis?
Presentation: Head positioned in ipsilateral side flexion and contralateral rotation
MOI: Fibrosis and shortening of SCM
Treatment: Gentle stretching or surgical release
