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Head & Neck Anatomy > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

Compartments in neck

A

Neuromuscular:
Muscles
Cervical plexus
Brachial plexus

Viscerovascular:
Organs
Blood vessels
Cranial nerves

Subdivided by fascial sheaths

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2
Q

Triangles in neck

A

Anterior
Posterior
Separated by Sternocleidomastoid m

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3
Q

Connection between neck and thorax

A

Between infrahyoid muscle and thyroid gland

Allows infection to pass through

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4
Q

Fascial space

A

Between prevertebral and pretracheal space

Infection causes friction in throat and pain in swallowing

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5
Q

Between anterior and middle scalene muscles

A

Brachial plexus

3rd part of subclavian artery

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6
Q

Lower down on anterior surface of anterior scalene

A

Phrenic nerve

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7
Q

Pretracheal fascia

A

Anterior and posterior layers

Buccopharyngeal fascia is posterior portion

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8
Q

Retropharyngeal space

A

Allows smooth swallowing

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9
Q

Preracheal and fascial space in prevertebral layer

A

Connects with thoracic cavity (danger)

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10
Q

Roof of posterior triangle

A

Deep investing fascia & skin

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11
Q

Borders of posterior triangle

A

Posterior = Trapezius m
Anterior = Sternocleidomastoid m
Inferior (base) = middle 1/3 clavicle

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12
Q

Posterior triangle floor

A

Prevertebral fascia over (superior to inferior)

  1. M splenius capitis
  2. M levator scapulae
  3. M scalenius posterior
  4. M scalenius medius
  5. M scalenius anterior
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13
Q

What is floor of posterior triangle crossed by?

A

Inferior belly of M omohyoid

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14
Q

Inferior belly of M omohyoid subdivides posterior triangle into

A 
Occipital triangle(superiorly)
Supraclavicular triangle(inferiorly)
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15
Q

Posterior triangle divided into careful and carefree areas by

A

Accessory nerve (CN XI)

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16
Q

Contents of posterior triangle

A
  1. Occipital artery
    Through apex of triangle
  2. External Jugular v
    From retromandibular and posteriorauricular vv –ends in subclavian v
  3. 3rd part of subclavian artery
    Pressure point against 1st rib
  4. Transverse cervical a
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17
Q

Nerves of posterior triangle

A
  1. Lesser occipital n (Carefree)
  2. Accessory n (CN XI)
  3. Cervical plexus (Careful)
  4. Phrenic n on anterior scalene
  5. Supraclavicular part of brachial plexus (Upper and middle trunks)
18
Q

Cervical plexus

A

Around post border of SCM

From C1–C4

  • Lesser occipital n–C2(3)
  • Great auricular n–C2,3
  • Transverse cervical–C2,3
  • Supraclavicular nn–C3,4
19
Q

Ventral rami C1 - C4

A

Superficial branches at posterior edge of SCM are all sensory:

  • Lesser occipital n –C2(3)
  • Great auricular n –C2,3
  • Transverse cervical –C2,3
  • Supraclavicular nn –C3,4

Deep branches pass anteromedially and are motor:

  • Phrenic –C3-C5
  • Ansa Cervicalis –C1-C3
20
Q

Ventral rami C1 - C3

A

Superior root (C1) accompanies Hypoglossal nerve
Inferior root (C2-C3)
Forms loop over IJV
Supplies the ‘Strap’ muscles (ant triangle)
1. Nn. to geniohyoidand thyrohyoid
2. N. to omohyoid
3. Nn. to sternothyroid and sternohyoid

21
Q

Structures deep to fascia layer

A

Trunks of brachial plexus
3rd part of subclavian a
Subclavian v
Long thoracic n (C5-7) exits through scalenius medius (to serratus ant m)
Nerve to levator scapulae (C3-4)
Dorsal scapular n(C5) pass between scalenius medius and levator scapulae
Phrenic n(C3-5)
Occipital a at apex of triangle
Transverse cervical and suprascapular aa
Subclavian n (C5-6) – Erb’s point lies anterior to the brachial plexus

22
Q

Carotid triangle borders

A
  1. Post - Sternocleidomastoid (SCM)
  2. Anterosuperior - Posterior belly of digastric
  3. Antero-inferior - Superior belly of omohyoid
23
Q

Floor of carotid triangle

A
  1. Parts of middle & inferior constrictors
  2. Thyrohyoid
  3. Part of hyoglossus
24
Q

Contents of carotid triangle

A
  1. Ansa cervicalis
  2. Common carotid a (CCA)
  3. CCA bifurcation into Internal carotid a(ICA) & External carotid a (ECA)
  4. Branches of ECA
  5. Internal jugular vein (IJV)
  6. CN XII (Hypoglossal)
  7. CN X (Vagus)
  8. Superior cervical ganglion
  9. Sympathetic trunk
25
Q

NB carotid triangle

A
  1. CCA, IJV & CN X in carotid sheath
  2. CCA bifurcates at C4
  3. ECA leaves carotid sheath
  4. Carotid sinus (baroreceptor)
  5. Carotid body (chemoreceptor –monitors acid-base status of blood)
  6. Both 4 & 5 innervated by CN IX
26
Q

Muscular triangle borders

A
  1. Midline of neck
  2. Superior belly of omohyoid
  3. Lower portion of anterior border of SCM
27
Q

Contents of muscular triangle

A
  1. Infrahyoid mm
  2. Thyroid gland
  3. Parathyroid glands
  4. Vessels & nn to area
28
Q

Thyroid gland

A

In muscular triangle

Below & lateral to thyroid cartilage

2 lateral lobes joined by isthmus

Isthmus crosses 2nd to 3rd(4th) tracheal cartilages

Deep to sternohyoid, sternothyroid & omohyoid

Invisceral compartmentof neck (with pharynx, trachea and oesophagus & RL nn) surrounded by pretracheal fascia

Arises from median outgrowth at base of tongue

Foramen caecum of tongue indicates site of origin

Thyroglossal duct marks path of migration to final adult location. Disappears early in development, but remnants may persist as a cystor as a connection with foramen caecum (fistula)

Remains of gland may be found:
Associated with tongue (lingual thyroid)
Along path of migration
Upward from gland (pyramidal lobe)

29
Q

Thyroid gland arteries

A
  1. Superior thyroid a (from ECA)
    Anterior glandular br (may anastomose with artery from other side across isthmus)
    Posterior glandular br (may anastomose with inferior thyroid a)
2. Inferior thyroid a (from thyrocervical trunk ofsubclavian a) - ascends on medial edge of ant scalene m
Inferior br (anastomose with post glandular br ofsuperior thyroid a)
Ascending br (supplies parathyroid glands)
  1. Thyroidea ima a (from brachiocephalic trunk or arch of aorta)
30
Q

Thyroid gland veins

A

Superior thyroid v (to IJV)
Drains area supplied by superior thyroid a

Middle thyroid v (to IJV)

Inferior thyroid v (to brachiocephalic v)
Drains rest of gland

31
Q

Thyroid gland

Lymphatic drainage

A

Paratracheal nodes

Deep cervical nodes - inferior to omohyoid along IJV

32
Q

Thyroid gland

Recurrent laryngeal nerve

A

Branch from Vagus n
L = loops around lig. arteriosum of aortic arch
R = loops around subclavian a
Ascends in groove between trachea & oesophagus
Enters larynx deep to lower margin of inferior constrictor of pharynx

33
Q

Parathyroid glands

A

2 pairs of small, yellowish, ovoid structures on deep surface of lateral lobes of thyroid

Superior parathyroids
Inferior parathyroids

Supplied by inferior thyroid aa

Venous & lymphatic drainage as for thyroid

34
Q

Applied anatomy (relating to thyroid)

A 
Ectopic tissue along path of descent(rare)
Thyroglossal cysts (presents as a midline mass, may involve anterior portion of hyoid bone, must be surgically removed)
Thyroglossal fistulae
Thyroidotomy (possibility of damage to parathyroids, recurrent laryngeal n, sympathetic trunk, sometimes nerves of carotid sheath)
Goiter(increase exophthalmos, nail changes, decrease myxoedema)
35
Q

Borders of submandibular triangle

A
  1. Ramus of mandible
  2. Ant belly of digastric (CN V3)
  3. Post belly of digastric (CN VII)
36
Q

Floor of submandibular triangle

A
  1. Anterior = mylohyoid

2. Posterior = hyoglossus (on deeper level) & small part of sup pharyngeal constrictor

37
Q

Contents of submandibular gland

A
  1. Submandibular gland
  2. Marginal mandibular branch of CN VII
  3. Lingual n (branch of CN V3)
  4. CN XII
  5. Lingual v
  6. Submandibular duct
  7. Plexus of vvdraining to facial v
  8. Lymph nodes
38
Q

Submental triangle borders

A
  1. Hyoid bone
  2. Anterior belly of digastric
  3. Midline of neck
39
Q

Floor of submental triangle

A
  1. Medial portions of mylohyoid & fibrous raphe

2. Geniohyoid & genioglossus mm (both deep to (1))

40
Q

Submental triangle contents

A

Fat and lymph nodes

Head & Neck Anatomy (3 decks)

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