Head and Neck week 1 Flashcards
What 3 layers of the scalp move as a unit, and where is the vasculature found?
Skin
Connective Tissue (this is where vasculature is found)
Aponeurosis
What are the 5 layers of the scalp?
Skin, CT, Aponeurosis
Loose CT, Pericranium
What are the 6 nerves that innervate the cutaneous scalp?
3 Branches Trigeminal (V1, V2, V3)
Lesser Occipital nerve
Greater Occipital n.
Third Occipital n.
What are the 2 internal carotid branches?
Supraorbital (branch of ophthalmic a.)
Supratrochlear (branch of ophthalmic a.)
What are the 3 external carotid branches?
Superficial temporal
Posterior auricular
Occipital
In the brain, what are the 2 layers of dura mater?
Periosteal layer
Meningeal layer
What layer of meninges is filled with CSF in the brain?
The Arachnoid
The perioseal layer in the dura is continuous with what structure?
The periosteum of the cranium.
The meningeal layer of the dura is continuous with…
The spinal dura mater.
Where does the Dura Mater of the spinal cord fuse with the periosteal layer in the skull cavity?
Inferior cranial cavity
What layer of Dura make up the reflections (infoldings) in the brain?
The meningeal layer
Name 4 reflections of Dura in the brain.
Falx Ceribri
Falx Cerebelli
Tentorium Cerebelli
Sellar Diaphragm
The Straight Sinus defines the border between…
Falx Cerebri and Tentorium Cerebelli
What lines the inside of the dural reflections of the brain?
Endothelium
The endothelial layer in the sinuses separate what two layers?
The periosteal layer and the meningeal layer
draw it out
What is the function of the Dural Sinuses
Drain blood, CSF, diploic veins
What is the terminal drain of the dural sinuses?
The Jugular vein
Trace the sinuses leading into and out of the Confluence of the Sinuses.
Superior saggital sinus from the tom Inferior saggital sinus > Straight Sinus then, Confluence then, two Transverse sinuses > Sigmoid Sinus Finally, Jugular vein
Name 4 singular sinuses.
Superior saggital
Inferior saggital
Straight
Occipital
Name 6 paired sinuses.
Cavernous Intercavernous (ant and post) Superior petrosal Inferior petrosal Transverse Sigmoid
What does the Straight sinus divide?
The Falx cerebri and the Tentorium cerebelli
What sinus contains the internal carotid artery and several nerves?
Cavernous
T/F
Scalp, bone, and dura do not have sensory innervations.
False.
What nerves innervate the Dura?
Trigeminal (V1, V2, V3)
Vagus - CN X
Dorsal roots of cervical nerves C1-C3
What arteries feeds the Dura?
Middle meningeal a. (frontal and parietal branches)
Occipital a. (mastoid branch
What structure releases CSF into dural sinuses?
Arachnoid Granulations
What fluid is in the dural sinuses?
CSF and blood
Where is the CSF layer thin?
Everywhere except the Cisterns.
What is the epidural space?
Where the dura meets the inside of the skull.
Not filled with anything
What is the subdural space?
Where the Dura meets the Arachnoid layer.
Not filled with anything
What is the Subarachnoid space?
Space between the Arachnoid layer and the Pia Mater of the brain. Filled with CSF.
Pathology of Epidural space.
Epidural Hematoma
Pathology of Subdural space.
Subdural Hematoma
Pathology of Subarachnoid space.
Subarachnoid Hemorrhage
Where is CSF produced?
Choroid Plexus cells in the Lateral Ventricles.
What do the ventricles of the brain contain?
CSF
Describe the flow of CSF in the brain.
Choroid Plexus > Ventricles > Subarachnoid space > Arachnoid granulations > dural Sinuses > Internal Jugular vein
Name the 3 ventricles of the brain.
Two lateral (in cerebral hemispheres) Third Ventricle (diencephalon) Fourth Ventricle (between pons, medulla, cerebellum)
What structure drains CSF from the Third ventricle into the Fourth ventricle?
Cerebral aqueduct of Sylvias
What structures drain CSF into the subarachnoid space?
2 lateral apertures & 1 median aperture
in fourth ventricle
What are some functions of the CSF?
Supports brain, nutrients, gas exchange.
What is the function of the Choroid Plexus?
Produces CSF
From whence does the blood supply of the brain come?
Internal carotid and vertebral arteries.
From posterior to anterior, name the structures of the Circle of Willis.
Vertebral aa. (2) > Basilar a. > Posterior Cerebral aa. > Posterior communicating aa. > Internal Carotid aa. > Anterior cerebral aa. > Anterior communicating aa.
What is the one thing missing from the following:
Vertebral aa. (2) > Basilar a. > Posterior Cerebral aa. > Posterior communicating aa. > Internal Carotid aa. > Anterior cerebral aa. > Anterior communicating aa.
Middle cerebral a.
next to internal carotid aa.
Generally the flow in the Circle of Willis goes what direction?
Posterior to anterior
main outlets are Middle cerebral a. and
Posterior cerebral artery
What makes up the Zygomatic Arch?
The Temporal process of the Zygomatic &
The Zygomatic process of the Temporal
What is the Glabella?
Third Eye
What is the Bregma?
Where Parietal/Frontal come together.
technically very Top of skull
What makes up the nasal septum?
The perpendicular plate of the Ethmoid and the Vomer
What are the alveolar processes in the maxilla?
Bumps that make room for teeth
What bone makes up the Inferior Nasal Concha?
The Inferior Nasal Concha bone
Where is the Pterygoid hamulus?
It is a projection of the medial plate of the pterygoid process on its inferior end
(broken off in my skull)
Where is the Scaphoid fossa?
Between the medial and lateral pterygoid plates.
What does Crista Galli mean?
Crest of the rooster
What does the Perpendicular plate of the Ethmoid join with?
The Vomer
What is the area of the ethmoid with concentrated lacunae?
Cribiform plate
The Superior and Middle Conchae are part of what bone?
The Ethmoid
Where is the Lamboid suture?
Between occipital and parietals
Where is the Squamous suture?
Between parietal and temporal bones
What is the “H” shaped suture between the coronal, sphenofrontal, squamous, and sphenosquamous sutures?
Pterion
Where is the Canine Fossa?
Indentation between inferior border of the orbit to the upper canine.
Where is the Maxillary Tuberosity?
Behind last molars of the maxilla.
What bone is the mastoid process and styloid process a part of?
Temporal (bony)
What lines the external acoustic meatus?
Tympanic plate
Where is the mandibular fossa?
Articulation point of mandible
The anterior part of the TMJ rises to the…
Articular eminence
What space does the superior orbital fissure communicate with?
The Cavernous Sinus
T/F
The inferior orbital fissure communicates with the same space as the superior orbital fissure.
FALSE
Inferior orbital fissure communicates with the Pterygomaxillary Fissure with communicates with the pterygopalatine fossa.
Name four nerves that go through the superior orbital fissure.
CN III
CN IV
CN V - 1
CN VI
What nerve passes through the Supraorbital Notch?
Supraorbital n.
from Frontal n. > From V1
What goes through the Optic Canal?
The Optic n.
CN II
The zygomaticofacial and zygomaticotemporal foramen are derived from what nerve?
V2
What nerve emerges from the infraorbital foramen and from where is it derived?
The Infraorbital n. from V2
What is in the infraorbital groove?
Inraorbital n.
Where is the Pterygoid fovea?
medial and inferior to the mandibular condyle on the anterior surface
Where is the Lingula?
Just anterior to the mandibular foramen
Where is the Mylohyoid groove?
groove extending down and anterior to the mandibular foramen
Where is the Mylohyoid line?
Angled line bordering thicker bone below the molars on the interior of the mandible
Retromolar area
Behind last mandibular molar
Where is the mental protuberance?
Midline mandible
What are the genial (mental) tubercles?
Spines coming up from lower part of mid-mandible
What are the contents of the mental foramen?
The mental n.
branches further into the inferior Denta branches
Where is the mandibular foramen, what nerve goes through, and what nerve comes after?
Interior and posterior mandible.
Mandibular n. > Inferior alveolar n.
Where are the nuchal lines?
Lateral to the occipital protuberance
superior and inferior
Where is the digastric notch?
Medial side of the Mastoid process
deep groove
What are the choane?
Medial to the pterygoid process of the sphenoid.
swallowing and breathing canal
What is bigger, the pterygoid or the scaphoid fossa?
The Pterygoid.
Scaphoid is smaller, superior, medial
Where is the spine of the Sphenoid bone?
Just medial to the TMJ
Very sharp
Where is the pharyngeal tubercle?
Just anterior Foramen Magnum as bone slope upwards
Where are the greater and lesser palatine foramen?
Medial to molars on hard palate.
Where is the Stylomastoid Foramen?
Directly posterior to the styloid process
Describe the Pterygoid Canal and the Pharyngeal canal.
Both are small canals located lateral to the Vomer on the sphenoid
Where is the Infratemporal fossa?
Below zygomatic arch
What is the home of V3 and all things mandibular?
The Infratemporal Fossa
Name four ways into the Infratemporal Fossa.
Foramen Ovale
Foramen Spinosum
Inferior Orbital Fissure
Pterygomaxillary Fissure
Where is the home of V2 and all things Maxillary?
Pterygopalatine fossa
Name 6 things that communicate with the Pterygopalatine Fossa?
Pterygomaxillary fissure Foramen Rotundum Sphenopalatine foramen Palatine canal (foramen) Inferior Orbital Fissure Pterygoid/Pharyngeal canals
What does the Sphenopalatine foramen connect?
The pterygomaxillary fissure to the nose
What are the 3 main fossae of the internal cranium?
Anterior, Middle, Posterior
What’s the border of the middle and posterior fossae of the cranial cavity?
Petrous ridge
What foramen in the middle cranial fossa is an artifact?
Foramen lacerum
Where is the hypoglossal canal?
Just lateral to the foramen magnum
Describe a cranial Motor pathway.
UMN & LMN
LMN cell body is in brain and exits CNS to target.
Where are the cell bodies in sensory Cranial Nerves?
In PNS Ganglia
1st order sensory neuron, and ganglia are just like dorsal root ganglia
Describe a parasympathetic pathway of a cranial nerve.
UPM > LMN > exits brain (this LMN is pre-ganglionic) > synapse on or near the target > Post-gangliionic neuron
What cranial nerves have a parasympathetic function?
III, VII, IX, and X
What are CNS nuclei?
Site of cell bodies and synapses.
Group of neuronal cells sharing same function and in the same area.
What are the 4 cranial nerves with Somatic Motor functions?
III, IV, VI, and XII
think eye and tongue
Name the 5 cranial nerves with Branchial Motor innervations.
V, VII, IX, X, XI
What cranial nerves have Parasympathetic functions?
III, VII, IX, X
What is the target of the visceral efferent (Parasympathetic) functions of CN III, VII, IX, and X?
Constricor pupillae muscles and ciliary muscles
Lacrimal gland, submandibular/sublingual glands
Parotid gland
Pharynx, Larynx, thorax, abdomen smooth muscle/glands
Name the cranial nerves with a General Sensory function.
V, VII, IX, X
What cranial nerves have a special sensory function?
I, II, VII, IX, VIII, X
What special sensory characteristics to cranial nerves I, II, VII, IX, VIII and X have?
Smell Sight Taste (ant 2/3 tongue) Taste (post 1/3 tongue) Hearing/balance Taste
Which nerves have a Visceral Sensory function, and what tissues are involved?
IX and X Parotid gland, carotid body, middle ear pharynx, larynx, trachea, bronchi, lungs Heart esophagus, stomach, intestines
Name all the Cranial Nerves:
ooh, ooh, ooh, to touch and feel van gough’s vagina, AH!
Olfactory, Optic, Oculomotor, Trochlear, Abducens, Facial, Vestibulochoclear, Glossopharyngeal, Vagus, Accessory, Hypoglossal
Where is the origination of a branched nerve?
At the branching
A named nerve, originating at a branch, still has a…
pathway
explain the pathway of the Olfactory n.
Best seen inferior on the brain. Travels out and connects to the Cribiform plate.
Explain the pathway of the Optic n.
Travels through optic chiasma, optic canal, and into the eye.
What function do the olfactory and optic nn. have?
Special Sensory
What are the 2 functions of the Oculomotor n.?
Somatic motor
Parasympathetic (visceral motor)
Oculomotor (CN III) somatic pathway:
Cavernous sinus > Superior orbital fissure > 2 divisions
Superior and Inferior division
Oculomotor (CN III) Parasympathetic pathway:
Cavernous sinus > Superior orbital fissure > pre-ganglionic synapse in ciliary ganglion > post-ganglionic nn. called short ciliary nn. > eyeball > ciliary muscles an pupillae muscles.
Trochlear (CN IV) pathway:
Cavernous sinus > Superior orbital fissure > superior oblique m.
Trigeminal (CN V) V1 pathway:
Trigeminal ganglion in the cavernous sinus > superior orbital fissure > orbit > sensory nn. branch
Trigeminal (CN V) V2 pathway:
Trigeminal ganglion in the cavernous sinus > Foramen Rotundum > Pterygopalatine Fossa >
(Branches to Orbit and Palate)
(Orbital branch) > Inferior orbital fissure > Infraorbital canal > Infra orbital foramen >
Trigeminal (CN V) V3 sensory pathway:
Trigeminal ganglion in the cavernous sinus > Foramen Ovale > Infratemporal fossa > Mandibular foramen > mandibular canal > Mental Foramen
Trigeminal (CN V) V3 Branchial Motor pathway:
Cavernous sinus > Foramen Ovale > Infratemporal Fossa > Branches to mm.
Abducens (CN VI) pathway:
Cavernous sinus > Superior orbital fissure > lateral rectus m.
Facial (CN VII) Branchial motor pathways:
Internal acoustic meatus > Facial canal > Stylomastoid Foramen > branches to facial expression mm.
Internal acoustic meatus > facial canal > middle ear > Stapedius m.
Facial (CNVII) Parasympathetic pathways:
Internal acoustic meatus > facial canal > Greater Petrosal n. > pterygoid canal > pterygopalatine fossa > PterygoPalatine Ganglion > then, 1) inferior orbital fissure > lacrimal gland or, 2) sphenopalatine foramen > mucous glands nose/palate
Internal acoustic meatus > facial canal > Chorda Tympani n. > Middle Earl > Petrotympatic Fissure > Infratemporal fossa > rides with lingual n. of V3 > Submandibular Ganglion > submandibular/sublingual glands
Facial (CNVII) General Sensory pathway:
Internal acoustic meatus > Geniculate Ganglion in the facial canal > stylomastoid foramen > small parts by the ear
Facial (CNVII) Special Sensory pathway:
Internal acoustic meatus > Geniculate Ganglion in the facial canal > Chorda Tympani n. > middle ear > Petrotympanic Fissure > Infratemporal Fossa > rides with lingual n. V3 > ant. 2/3 tongue
Vestibulocochlear (CNVIII) function:
Hearing & Balance
Glossopharyngeal (CN IX) functions / innervations:
Branchial motor : stylopharyngeus
General sensory (2) : tongue/pharynx & tympanic
Visceral sensory : carotid body/sinus
Special sensory : post 1/3 tongue
Parasympathetic (visceral motor) : parotid gland
Glossopharyngeal (CN IX) Branchial pathway:
jugular foramen > stylopharyngeus m.
Glossopharyngeal (CN IX) General Sensory pathways:
jugular foramen > Glossopharyngeal Ganglia (sup/inf) > tongue/pharynx
jugular foramen > Glossopharyngeal Ganglia (sup/inf) > tympanic canal > middle ear > tympanic plexus > branches
(NOTE: this is the ONE OF TWO that goes out, then back into the Cranial Cavity)
Glossopharyngeal (CN IX) Visceral Sensory pathway:
jugular foramen > superior and inferior glossopharyngeal ganglia > carotid body/sinus
Glossopharyngeal (CN IX) Special Sensory pathway:
jugular foramen > sup/inf glossopharyngeal ganglia > Posterior 1/3 Tongue
Glossopharyngeal (CN IX) Parasympathetic pathway:
jugular foramen > tympanic canal > middle ear > tympanic plexus > Lesser Petrosal n. > Foramen Ovale > infratemporal fossa > Otic Ganglion > join V3 > parotid gland
(this is 2nd that goes out/in. BUT, this one goes out again)
Name the functions of the Vagus n.
Branchial
Parasympathetic
Visceral sensory
Special sensory
Vagus n. (X) Branchial pathway:
Jugular foramen > muscles
What 3 general areas do the branchial motor pathway of the vagus nerve innervate?
Pharynx
Palate
Larynx
Vagus (CN X) parasympathetic pathway:
jugular foramen > ganglion synapse on or near organ > gland/organ
Vagus (CN X) general sensory pathway:
jugular foramen > Vagal Ganglion > target organ
Vagus (CN X) visceral sensory pathway:
jugular foramen > Vagal Ganglion > thorax/abdomen
Vagus (CN X) special sensory pathway:
jugular foramen > Vagal Ganglion > Epiglottis
Accessory (CN XI) pathway:
Foramen Magnum > jugular foramen > trapezius and SCM
This is a Branchial Motor pathway
Hypoglossal (CN XII) pathway:
Hypoglossal Canal > mm.
What function does CN XII have?
Somatic Motor
What defines the root (bottom) of the neck?
junction of thorax/neck
1st Rib, T1 vertebrae, manubrium of sternum
How many layers of superficial fascia are there in the neck?
One
Name 3 types of deep fascia of the neck?
Thyroid
Carotid
Vertebral
What type of fascia envelopes the Trapezius and SCM?
Investing Fascia
What type of fascia surrounds the Trachea?
Pre-tracheal fascia
Does pre-tracheal fascia envelope mm.?
no
What fascia envelopes vertebrae and mm.?
Prevertebral
What is composed of all three fascia layers?
Carotid fascia
What 3 structures does the carotid fascia surround?
Carotid a.
Internal Jugular v.
Vagus n.
The SCM, working unilaterally, does what to the head?
Pulls the head up and in the opposite direction.
This is because its upper attachment is so lateral to its lower.
What are the 2 main triangles of the neck?
Posterior
Anterior
What are the borders of the posterior triangle of the neck
SCM
Trapezius
Clavicle
What is the roof and floor of the posterior triangle of the neck?
Roof: Skin, superficial fascia
Floor: Prevertebral fascia
What are the 5 mm. in the floor of the posterior triangle of the neck?
Spenius capitus Levator scapulae posterior scalene middle scalene anterior scalene
What muscle divides the posterior triangle?
Omohyoid
What are the two sub-triangles of the posterior triangle?
Occipital triangle
Supraclavicular triangle
What are the borders of the anterior triangle of the neck?
Midline, SCM, inferior border of the mandible
What are the 4 subtriangles that make up the anterior triangle?
Submental
Submandibular
Carotid
Muscular (omotracheal)
Which anterior subtriangle is NOT bilateral?
Submental
this is a midline structure
What is the difference between thyroid and cricoid cartilage?
Thyroid - forms prominence
Cricoid - forms complete rings
What muscle lies in the Superficial Cervical Fascia?
Platysma muscle
In addition to the Trapezius and SCM mm. what does Investing Fascia encapsulate?
Parotid and Submandibular glands.
T/F Pretrachial Fascia envelopes muscles.
False
What type of fascia is Pretrachial fascia continuous with?
Buccopharyngeal fascia
What type of fascia envelopes vertebrae and muscles?
Prevertebral
What structure in the neck is composed from all three fascial layers?
Carotid Sheath
What muscle separates the posterior from the ant. triangle?
SCM
What are the 5 FLOOR muscles of the Posterior Triangle of the neck?
Splenius Capitus Levator Scapulae Posterior Scalene Middle Scalene Anterior Scalene
Where is the splenius capitus?
Superior muscle, fibers run crosswise with Traps
What’s the origin/insertion of the Levator Scapulae?
Dorsal parts of C1-4 to Scapula
What 3 muscles make up the inferior lateral portion of the posterior triangle?
Scalenes
What triangles does the Omohyoid separate?
The Occipital and the Supraclavicular
What muscle originates in superficial fascia of deltoid/pectoral and inserts on inferior border of mandible?
Platysma
What n. innervates the Platysma?
CN VII - facial
What muscle in the neck should be considered part of facial expression?
Platysma
Innervation of SCM?
Spinal Accessory (XI)
General O/I for Splenius Capitus?
Lower c-spine > Mastoid process
From the spine, the splenius capitus runs _____ and the trapezius runs _____
Up
Down
Wha innervates the splenius capitus?
Cervical spinal nn.
General O/I for Levator Scapulae?
Upper c-spine to scapula
What innervates the Levator Scapulae?
Dorsal Scapular n.
General O/I for Scalenes?
Transverse processes of cervical spine > 2nd and 1st rib
What are the two actions of the scalenes?
Lateral flexion and aid in forced inspiration by lifting ribs
What innervates the scalenes?
C3-C8
What m. is part of the roof of the Anterior Triangle?
Platysma
What makes up the floor of the Anterior triangle?
pharynx, larynx, and thyroid
Name the 4 triangles of the Anterior triangle.
Submental
Submandibular
Carotid
Muscular (omotracheal)
What makes up the border of the submental triangle?
Anterior digastric mm. with the hyoid bone
What muscle attaches to the interior of the mandible and comprises the mm. in the submental and submandibular triangles?
Mylohyoid
What forms the boundaries of the Submandibular triangle?
Anterior and Posterior Digastric mm. with jawline
What makes up the Carotid triangle?
Posterior Digastric
SCM
Omohyoid
What makes up the Muscular triangle?
Omohyoid
SCM
Sternohyoid (which is the midline)
What are the 4 Infrahyoid mm.?
Omohyoid
Sternohyoid
Sternothyroid
Thyrohyoid
What are the 5 Suprahyoid mm.?
Ant. Digastric Post. Digastric Mylohyoid Stylohyoid Geniohyoid
What are the Actions and Innervations of the: Omohyoid Sternohyoid Sternothyroid Thyrohyoid
Depresses Hyoid, Larynx, or both
C1-C3 spinal nn. EXCEPT Thyrohyoid, which is innervated by Hypoglossal (XII)
What are the functions of the Suprahyoid mm.?
Elevate hyoid bone (& floor of mouth/base of tongue)
Innervations of the Suprahyoid mm.
Post. Digastric CNVII Stylohyoid CNVII Ant. Digastric V3 Mylohyoid V3 Geniohyoid C1
Name 4 Prevertebral mm. in the posterior that aren’t considered part of the floor.
Longus coli
Longus capitus
Rectus capitus anterior
Rectus capitus lateralis
Innervation/Action of 4 Prevertebral posterior mm.
C1-C8
Head flexion
General O/I for longus coli.
C3-T3 > Ant. Atlas and C3-C5
General O/I for longus capitus
C3-6 > Base of skull
O/I for:
Rectus capitus anterior
Atlas > Base of skull/foramen magnum
O/I for:
Rectus capital lateralis
Atlas > Occipital bone
What cranial nerves innervate the neck?
IX, X, XI, XII
What spinal nerves make up the brachial plexus?
C5-T1
What spinal nerves make up the cervical plexus?
C1-4
What two mm. does the Brachial plexus emerge between?
Anterior and Middle Scalenes
What branches does the Glossopharyngeal n. have in the neck?
Submandibular and Carotid
What does the branchiomotor function of the Glossopharyngeal n. innervate?
Stylopharyngeus m.
What 3 things does the visceral sensory function of the Glossopharyngeal innervate?
Pharynx
Chemoreceptor (carotid body - regulates heart rate and respiration)
Baroreceptor (carotid sinus - regulates BP)
T/F
The vagus n. travels through the carotid triangle.
True
What are the 3 main branches of the vagus n. ?
Pharyngeal
Superior laryngeal
Recurrent Laryngeal
What are the 2 functions of the Superior laryngeal branch of the vagus n.?
Internal laryngeal n. - larynx General Sensory
External laryngeal n. - branchial motor (1 m.)
T/F
The Recurrent laryngeal branch of the vagus n. is bilaterally symetrical
False
What does the Left/Right side of the Laryngeal n. loop under?
Left: Aortic arch
Right: Subclavian
What 2 neck mm. does the Accessory n. innervate?
SCM and Traps
What is the pathway of CN XI to the SCM and traps?
Foramen magnum > Jugular foramen > mm.
What triangles does CN XII pass through?
Anterior triangle > Submandibular triangle
How does the Hypoglossal n. get to the tongue?
Between the Mylogyoid and Hyoglossus mm.
Does CN XII have any innervations in the neck?
No
Deep to the ______ is a bundle of nerves called the ______
SCM
Cervical Plexus
What division of the Cervical Plexus supplies 3 of 4 Infrahyoid mm.?
Ansa Cervicalis (C1-3)
What are the roots of the Cervical Plexus?
Ventral Rami of C1-4
What suprahyoid and infrahyoid mm. does the cervical plexus innervate?
Suprahyoid - only the Geniohyoid
Infrahyoid (ALL) - Omo, Sterno, Thyrohyoid plus Sternothyroid
What are the Cutaneous Sensory nn. of the Cervical Plexus?
Lesser Occipital
Greater Auricular
Transverse cervical
Supraclavicular
Which cutaneous sensory n. in the cervical plexus innervates the anterior neck?
Transverse cervical
Which cutaneous n. of the cervical plexus has sensory innervation of the posterior ear, neck, and scalp?
Lesser Occipital
Which n. does C1 ride with?
They Hypoglossal (CN XI)
The RCL & RCA are innervated by what nerves?
C1 & C2
T/F
The RCL and RCA are associates with the Ansa Cervicalis.
False
Deep branch not associated with Ansa
What nerves innervate the Longus Coli?
C1-8
Innervation Middle scalene?
C3-4
T/F
C5 is NOT in the cervical plexus
True
How many sympathetic chain ganglia are in the cervical region and what are they called?
3
Inferior ganglion - C7-8
Middle - C5-6
Superior C1-4
Which of the three sympathetic cervical ganglion is the biggest? which is smallest?
Superior
Middle
Do cervical sympathetic ganglia have white communicating rami?
NO
Innervations: Longus Coli Levator Scapulae Ant. Scalene Middle Scalene Post. Scalene
C1-3 C2-8 C3-5 C5-8 C3-4 C5-8 (trends: high, low, length)
What is the Splenius Capitus innervated by?
Dorsal rami of the cervical nn.
T/F
ALL the infrahyoid muscles are innervated via the Ansa Cervicalis.
True
On which side of the body is the brachiocephalic trunk?
Right
Where does the Subclavian a. divide into three parts?
Anterior Scalene
What are the first three branches (making up the 1st part) of the Subclavian a.?
Vertebral a.
Internal thoracic a.
Thyrocervical trunk a.
What are the 3 divisions of the Thyrocervical Trunk?
Suprascapular a.
Transverse Cervical a.
Inferior thyroid a.
What are 3 divisions of the Inferior Thyroid a. ?
Ascending cervical branch
Inferior laryngeal branch
Pharyngeal branch
What makes up the 2nd part of the Subclavian branches?
Costocervical trunk
Divides into the Deep cervical a.
and the Superior intercostal a.
What are the two major branches off the brachiocephalic trunk?
The Subclavian and Common Carotid
From whence does the Common Carotid come on the left side?
Branches right out of the Aortic Arch
Where are the chemo and baro-receptors from the Glossopharyngeal n. located on the Common Carotid?
Near the bifurcation between Common and Internal branches.
T/F
The internal carotid does not branch before the head.
True
Name the 6 branches of the External Carotid in ascending order.
Superior Thyroid a. Lingual a. Facial a. Occipital a. Ascending pharyngeal a. Posterior auricular a.
What is the only medial branch off the External Carotid?
Pharyngeal
Name 2 branches of the Superior Thyroid a.
Muscular branches
Superior laryngeal a.
Name 3 branches of the Facial a.
Ascending palatine a.
Tonsilar a.
Glandular branches
Popular Question:
What are the terminating branches (incidentally, not part of the six major branches) of the External Carotid a.?
Maxillary a.
Superficial Temporal a.
What branch of the External Carotid goes through the posterior triangle of the neck?
Occipital a.
Generally, the ______a. goes posterior and the ______a. goes anterior
Subclavian
External Carotid
What is the venous pathway exiting the cranium?
Internal Jugular > jugular foramen > External Jugular v. subclavian v. > Brachiocephalic v. > Superior Vena Cava
What are the 4 main superficial external veins of the head and neck?
Superficial temporal v.
Retromandibular v.
Posterior auricular v.
External jugular v.
What forms the Retromandibular v.
Superficial temporal and the Maxillary vv.
What forms the External jugular v.?
Posterior Auricular and Retromandibular
Besides the cranial cavity, what does the Internal Jugular v. drain?
Infratemporal region, then facial lingual pharyngeal thyroid
What structure located in the carotid triangle does the internal jugular v. pass through?
Carotid sheath
What does the internal jugular v. ultimately drain in to?
Joins with the Subclavian to form the Brachiocephalic v.
What does the common facial v. drain in to?
Internal jugular v.
In what layer is the Anterior jugular v.?
superficial cervical fascia
Name all the jugular vv.
Anterior, Internal, External
What are the 3 layers of Cervical Viscera?
Superficial endocrine layer
Middle respiratory layer
Deep alimentary layer
What is the largest endocrine gland, what does it produce, and where is it located?
Thyroid gland
Calcitonin
Superficial layer cervical viscera
Describe the arterial, venous, and nerve supply to the thyroid.
Superior & Inferior thyroid aa. (carotid/subclavian)
superior, middle, inferior thyroid vv.
Cervical sympathetic ganglia
T/F
Parathyroid and thyroid glands get blood, lymph, and nerves the same way.
True
What makes up the middle layer of the cervical viscera?
Larynx and Trachea
What are the 2 structures that make up the deep layer of cervical viscera?
Pharynx and esophagus
Lymph from the Right side of the head and neck drains into the:
Right lymphatic duct
then onto the right subclavian v.
Lymph fromt the Left side of the head and neck drains into the:
Thoracic duct (then left lymphatic duct and into left subclavian v.)
Where are the two horizontal rings of nodes located?
Horizontal superficial is around the neck/head border.
Horizontal deep ring is around the visceral structures.
What vertical structures run down the horizontal rings?
Deep cervical (jugular) trunk
aka - Common Right lymphatic duct &
Left side Thoracic duct
Name the 6 lymph nodes of the Superficial Horizontal Ring:
Submental Submandibular Parotid superficial Parotid deep Retroauricular Occipital
What are the 5 nodes of the Deep Horizontal Ring:
Retropharyngeal Paratracheal Pre-tracheal Pre-laryngeal Infrahyoid
