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Anat Block 2 > Lec 4 > Flashcards

Lec 4 Flashcards

1
Q

What are the major landmarks of the neck

A

Platysma, laryngeal prominence, Cricoid Cartilage, Hyoid Bone, Sternocleidomastoid

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2
Q

What are the features of the Sternocleidomastoid

A

Most prominent; mastoid (temp bone) to sternal head at manubrium + clavicular head at mid 1/3 clavicle, SCM moves cranio-vertebral joints:

  1. Unilateral contraction - sidewats
  2. Bilateral contraction - flexes neck
  3. N = C34, CNXI
  4. Wry Neck (Torticollis) slanted head most commonly caused by fibrous tumor and dmg to CN11
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3
Q

Where do you find carotid pulse

A

deep to ant line of SCM at lvl of thryoid cartilage

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4
Q

Movement of Hyoid

A

moved by supra and infrahyoid muscles to close epiglottis to cover air passages and facilitate mvmt of food to esophagus. Nerves are V3, 7, 12 M=10.

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5
Q

Describe the Suprahyoid muscles

A

Muscles elevate and protract the hyoid laryngeal complex during swallowing

  1. Post belly of Digastric and Stylohyoid (CN 7)
  2. Ant belly of Digastric and Mylohyoid (CN V3)
  3. Geniohyoid (C1)
  4. Hyoglossus (CN12)
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6
Q

Describe the Infrahyoid Muscles

A

N by cervical plexus/ ansa cervicalis, used to depress the hyoid during speech

  1. Sternohyoid - lowers H
  2. Thyrohyoid - raises L
  3. Sternothyroid - lowers L
  4. Omohyoid - scapular notch to hyoid
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7
Q

What are the prevertebral muscles

A

Ant, mid, post Scalene
O - tubercle of transverse process of C vert and R1
A - assists in extreme inspiration by elevatinf R12
N - VPR of cervical spinal nerves
Levator Scapulae

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8
Q

Arteries of Head and Neck General

A

Common Carotid - int + ext Carotid

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9
Q

Describe the internal carotid artery

A

No braches in neck, enters carotid canal to supply brain. Bifurcation is strictly regulated and if blocked = unconcious

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10
Q

Describe the External Carotid

A
  1. Sup Thyroid - thyroid gland and sup laryngeal branch accompany inf laryngeal nerve (X) to larynx
  2. Ascending Pharyngeal - supps pharynx btwn ext and int carotid
  3. Lingual Art - tongue
  4. Facial Art - Passes across submand gland main supply of face and lips, ends as angular art at medial angle of eye
  5. Occipital - occipital region of scalp
  6. Posterior Auricular
  7. Superficial Temporal
  8. Maxillary
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11
Q

Describe the vertebral artery

A

Arises from subclavian and passes through foramen transversaria to join to basilar artery and supply brain blood useing circle of willis

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12
Q

What are the branches of the thyrocervical trunk

A

Suprascapular, inferior thyroid, and transverse cervical

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13
Q

What are the veins of the neck

A

many, drain areas of accompaning artery.
Internal jugular vein: brain to Sup VC
Facial vein to deep facial to int jugular (Cavernous sinus)
Ext jugular vein
Anterior jugular and communicating branches are variable

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14
Q

Describe the path of the external jugular vein

A

Arises near angle of mandible by confluence of retromandibular and posterior auricular vein. Drains the majority of the scalp and is visible superior to clavicle, increased venous pressure = increased visibility
Air embolism occurs if vein is cut
Terminates at subclavian vein with subscapular and cervicodorsal veins

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15
Q

Describe the lymphatics of the Head and Neck

A

No nodes in scalp and face besides near parotid. Superficial cervical lymph course along ext jugular vein and is made of the submandibular and submental lymph nodes. These drain to the deep cervical lymph near internal jugular veins. Deep consist of superior nodes, jugulo digastric and inferior nodes. Cervical nodes are known as sentinal nodes

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16
Q

Describe what superficial lymph drains

A

Submandibular: neck, side of nose, up + low lip, gums and part of tongue.
Submental nodes: btwn ant belly of digastric, drains floor of mouth and apex of tongue

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17
Q

What do the deep cervical lymph nodes drain?

A

Sup: occipital scalp, back of neck, tongue, larynx, thyroid gland
jugulodigastric: enlarged as tonsils or pharynx are inflamed drains those
Inf nodes: post scalp, back of neck, superficial pectoral region, part of arm

18
Q

Carcinoma and the lymph

A

Carcinomas travel through nodes and once lodged in node = swell,

19
Q

Path of H+N left side lymph

A

left side - left jugular tunk - brachiocephalic vein - thoracic duct at left venous angle

20
Q

Path of H+N right side lymph

A

Right - right jugular - internal jugular vein (right venous angle) to subclavian

21
Q

Posterior triangle boundaries

A

Post edge of SCM, ant edge of trap,
floor= scalenes, splenius cap, lev scapulae
base = mid 1/3 clavicle/ inferior omohyoid
apex = occipital bone

22
Q

Contents of posterior triangle

A

external jug vein at ant part of triangle
brachial plexus at lower border
medial portion contains 3rd part of subclav art (ligation pt)
CN XI to SCM and trap
Cervical plexus

23
Q

General outline of the cervical plexus

A

C1-5 VPR motor is dorsal to SCM and sensory is anterior to SCM

24
Q

Sensory innervation of Cervical Plexus

A
  1. Supraclavicular - shoulder
  2. Lesser Occipital - lower occipital region
  3. Greater Auricular - ear
  4. Transverse Cervical - Ant Neck
25
Q

Motor branches of Cervical Plexus

A
  1. Sup root - C1 - emerges from hypoglossal nerve to go to geniohyoid
  2. Inferior Root - C2-4 - Ansa Cervicalis (loop)
26
Q

Special nerve of Cervical Plexus

A

Phrenic (C3-5) is both motor and sensory and refers pain to supraclavicular area, blocked during lung surgery.

27
Q

Skin innervation of the neck

A

Skin innervated by sensory branches of the cervical plexus can be anesthetized via superficial cervical plexus block - done for carotid endarterectomy = buildup of atherosclerotic plaque in carotid artery

28
Q

What are the borders of the Submandibular triangle

A 
above= body of mandible
below= post belly of digastric and stylohyoid
front = ant belly of digastric
floor = mylohyoid and hyoglossus
29
Q

What are the contents of the Submandibular triangle

A 
Ant = submand gland crossed anteriorly by facial vein and artery
Deep = nerve to mylohyoid (V3), facial nerve and int jugular/vagus and Hypoglossal nerve
30
Q

What is important clinical significance of Submandibular triangle

A

Access to ext carotid and branches (post auricular, superficial temporal, maxillary)

31
Q

Submandibular gland information

A

Surrounds mylohyoid muscle and gland secretes saliva containing mucin which lubricates food and amylase. Exits via Wharton’s duct to the front of the mouth adjacent to frenulum of tongue - duct calculi

32
Q

Submandibular gland nerves

A

PSNS preg in sup saliv nucleus - chorda tympani - submand gang - gland
SNS = blood constriction = increases mucin

33
Q

What are the boundaries of submental triangle

A

ant belly of digastric, midline, body of hyoid

floor=mylohyoid

34
Q

Contents of submental triangle

A

Sebmental lymph, and small tributaries of anterior jugular veins

35
Q

Carotid triangle boundaries

A

ant border of SCM, sup belly of omohyoid, stylohyoid, and post belly of digastric
Floor = thyrohyoid, hyoglossus, and medial/inf pharyngeal constrictors

36
Q

Contents of Carotid Triangle

A

CN 12 motor branch and sup ansa cervicalis
Carotid sheath : carotid art, int jugular, vagus nerve
External carotid gives off (sup thyroid, lingual, facial, occipital, and ascending pharyngeal art)
Vagus gives off ext and int laryngeal nerves
Cervical sym trunk is behind carotid sheath
Carotid sinus and body lie below hyoid

37
Q

Describe the Carotid Sinus and Body

A

Maintains blood flow to brain for homeostasis and contains barioceptors which are stretch sensitive.

38
Q

Describe hypertension reaction

A

Distension of sinus by an increase of bp activates baroreceptors generating an action potential in afferent CN 9 - inf glassopharyngeal ganglion - Nuc of solitary tract - meet preg neurons in dorsal motor nucleus of vagus - vagus nerve - heart - acetylcholine release - slow down heart

39
Q

Describe hypotension response

A

Occurs in vascular diseasem brachycardia, and syncope. decrease in bp leads to decrease in CN9 activation Results in preg SNS in lam 7 of thoracic spinal cord - neurons reactively activate post g to the heart to release norepinephrine and increase heart rate

40
Q

Muscular triangle of neck

A

Contents are isthmus to thyroid, larynx and trachea

Anat Block 2 (11 decks)

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