Lec 5 Regions and Triangle Flashcards
Cervical Pleura
double layered membrane that cover lungs and extends above first rib, makes dome shape (culpa)
Hyoid
free floating bone, only muscular attachment
located at c3/c4
Landmarks on the Hyoid bone
Body
Greater horn
Lesser horn
Groove for spinal nerve is located where and does what
indention on cervical vertebrae lateral and inferior to the intervertebral foramina, protects spinal nerve when exiting spinal cord
between anterior and posterior tubercle of transverse process
the gutter
*remember where intervertebral foramina are to help you understand. it is not the transverse forearm used for vertebral artery
name of the place where vertebrae meet
superior articular facet
inferior articular process
facet joint
where is another place that c1 and c2 connect
dens of c2 on dens facet of c1
Upper, Middle and Lower cervical regions
C1-C2 upper
C3, C4, C5 middle
C6 C7 lower
Where on the vertebral column are there no intervertebral discs? What joint is there instead?
between occipital bone and C1 (OA joint)
and
C1 and C2 (AA joint)
OA joint - synovial condyloid joint
AA joint - synovial pivot joint
where is the carotid process
c6, anterior to transverse foramen
Sternocleidomastoid MA
MA:
- unilateral; laterally flexes neck, contralateral rotation so face is facing superiorly to opposite side
- bilateral; (1) extends OA joint, (2) flexes cervical vertebrae so chin approaches manubrium (3) extends superior cervical vertebrae while flexing inferior vertebrae so chin is thrust forward with head level
with cervical vertebrae fixed, may elevate manubrium and medial clavicles as part as deep respiration
Sternocleidomastoid OINs
SMA: mastoid process and superior nuchal line
ILA; sternal head; manubrium of sternum
clavicular head; medial third of clavicle
N: Spinal Accessory Nerve C3, C4
Torticollis (and adult name)
fibrous tissue tumor - infant
spasm of SCM
head side bent with contralateral rotation
cervical dystonia (spasmodic torticollis)
Platysma
MA: draws corners of mouth inferiorly and widens it as in expressions of sadness and fright, draws skin of neck superiorly when teeth are clenched
SMA: inferior border of mandible, skin and subcutanous tissues of lower face
ILA: pec major and delts
N: facial nerve
Suprahyoid muscles
Mylohyoid (think molar)
Digastric (anterior and posterior belly)
Stylohyoid
Geniohyoid )think chin)
Be able to identify but done worry about attachments!
Diagastric - posterior belly goes to mastoid, anterior goes to tip of chin
mylohyoid: behind anterior belly of digastric
stylohyoid: connects hyoid bone to behind ear area (tiny skinny one)
geniohyoid; tip of chin straight back to hyoid bone
Infrahyoids
Thyrohyoid (right behind thyroid cartilage)
Sternothyroid (sternum/thyroid cartilage area so lower, to hyroid)
Omohyoid (inferior belly lines clavicle, superior belly goes to hyoid, makes L)
Sternohyoid (from sternum to hyroid)
borders of anterior triangle
anterior - median line of neck
posterior - anterior border of the SCM
superior boundary - inferior border of mandible
apex at jugular notch of the manubrium
roof formed by subcutaneous tissue containing platysma
Floor formed by pharanyx, laranyx and thyroid gland
triangles in the anterior triangle
submental
submandibular
carotid
muscular (omotrachel) triangle
focus on carotid
muscular triangle (omotracheal)
- sternohyoid and sternothyroid muscle
- thyroid and parathyroid glands
submental triangle
- submental lymph nodes
- veins that untie into anterior jugular vein
submandibular (digastric) triangle
- submandibular gland almost fills triangle, submandibular lymph nodes, mylohyoid nerve, hypoglossal nerve, parts of facial artery and vein
*Carotid triangle (borders and contents)
- spinal accessory nerve, facial nerve, marginal mandibular branch
- internal jugular vein
- common carotid artery (carotid sinus, carotid body)
- ansa cervicalis; nerve loop are IJV
- the superior belly of omohyoid
- posterior digastric (upper border/anterior border)
- anterior belly of SCM (border)
- top tip at ear lobe
What does the carotid artery split into? What two important features exist at the split?
- internal and external carotid artery
at the split:
- carotid sinus - baroreceptor, detects changes in blood pressure
- carotid body - chemoreceptor, cluster of cells that detect changes in the levels of oxygen and carbon dioxide in the blood.
ansa cervicalis
The ansa cervicalis is a loop-shaped nerve structure composed of contributions from the cervical nerves C1, C2, and C3. It forms a loop around the internal jugular vein and the carotid sheath.
What splits the lateral triangle?
omohyoid muscle (inferior belly)
into occipital triangle and omoclavicular triangle (think name)
lateral region (focus more on this than the individual contents)
- spinal accessory nerve
- external jugular vein
- serratus anterior
- suprascapular nerve
- brachial plexus
- suprascapular artery and vein
occiptial triangle
- spinal accessory nerve
- part of external jugular vein
- post, branches of cervical plexus
- cervical lymph
omoclavivular (subclavian) triangle
- subclavian artery
- trunks of brachial plexus
- part of subclavian vein
- suprascapular artery
- supraclavicular lymph nodes
Arteries of the lateral triangle
- brachiocephalic trunk splits into right common carotid artery and right subclavian
- subclavian artery has three parts; 1; medial, 2; posterior and 3; lateral to the anterior scalene muscle
posterior triangle
- upper trap
- levator scap
- splenius cervicis
- omohyoid inferior belly (remember inferior runs laterally like along clavicle so it extends into this region too)
what vertebral level is thyroid cartilage at?
C5 C6
Nerves in the neck
- spinal accessory nerve (XI)
- phrenic nerve (C5 accessory phrenic, C3/4 roots of phrenic nerve)
- suprascapular nerve (right under clavicle, so injuries to clavicle would affect)
- brachial plexus
Nerves in the root of the neck
- phrenic nerve
- vagus nerve (X)
- recurrent laryngeal nerve
What levels make up the cervical plexus
C1-C5 anterior rami forming roots of cervical plexus
Know the dermatome locations (vaguely)
CN XI Lesion - Palsy
lesions of the spinal accessory nerve may be caused by
- penetrating trauma
- surgical procedures in the lateral cervical region
- tumors at the cranial base or cancerous cervical lymph nodes
- fractures of the jugular foramen, where CN XI leaves the cranium
Prevertebral neck muscles
- rectus capitis anterior
- longus capitis
- longus coli
Deep to thyroid cartilage
**What joint do the anterior muscles control and what conditions might hurt them?
Deep anterior muscles control OA joint
Get hurt with whiplash and ACDF - anterior cervical discectomy and fusion
