Lecture 1 - Root of Neck

Question 1

Root of neck is

Answer 1

immediately superior to superior thoracic aperture

- contains major BVs, nerves and cervical viscera

Question 2

Root of Neck Boundaries: Anterior

Answer 2

Manubrium of sternum

Question 3

Root of Neck Boundaries: Lateral

Answer 3

By first ribs, which slope upward as they pass posteriorly to articulate with vertebra T1

Question 4

Root of Neck Boundaries: Posterior

Answer 4

Vertebra T1

Question 5

Pleural Cavity in Root of Neck

Answer 5

Anteriorly, pleural cavities and apical portion of LUNGS extend into root of neck
- Cervical pleurae, apices of lung, and sympathetic trunks lie posterior to first part of subclavian arteries.

Question 6

Root of Neck Vessels

Answer 6

Subclavian artery

Subclavian vein

Question 7

Root of Neck Nerves

Answer 7

1. Phrenic
2. Vagus
3. Recurrent laryngeal
4. Components of Symp NS

Question 8

Subclavian artery

Answer 8

RIGHT of BT: terminal branch
Left: direct branch of arch of aorta
Both:
- pass ANTERIOR to pleural cavity in root of neck
- lie POSTERIOR to anterior scalene muscle which divides each into 3 parts
- Become AXILLARY ARTERIES as they cross lateral border of first rib

Question 9

Subclavian Artery: 3 parts

Answer 9

First Part: Medial to anterior scalene muscle
- vertebral artery, internal thoracic artery and thyrocervical trunk arise from first part of subclavian artery.
Second Part: Posterior to muscle
- Costocervical trunk arises from second part
Third part: lateral to muscle
- Dorsal scapular artery, often arising from third part

Question 10

Vertebral artery ascends in transverse foramen of cervical vertebrae and enters

Answer 10

Foramen magnum

Question 11

Internal thoracic artery runs

Answer 11

inferiorly through thoracic inlet and PARALLEL to body of sternum.
Descends on internal aspect of anterior chest wall, giving off segmented anterior intercostal branches.

Question 12

thyrocervical trunk

Answer 12

arises as short stem and abruptly divided into 2 cervical branches and 1 thyroid branch

Question 13

suprascapular artery

Answer 13

crosses anterior scalene muscle, enter posterior triangle and passes posteriorly to suprascapular region of back

Question 14

transverse cervical artery

Answer 14

crosses scalenus anterior muscle to enter posterior triangle to supply lateral structures of neck

Question 15

inferior thyroid artery

Answer 15

ascends in neck, arches MEDIALLY and DOWNWARD to enter/supply INFERIOR portion of thyroid gland
- large musclar branch from inferior thyroid artery, ASCENDING cervical artery travels STRAIGHT/ UPWARD

Question 16

costocervical trunk

Answer 16

short branch supplies muscles of root of neck (deep cervical artery) and sends branches to upper 2 intercostal spaces (supreme intercostal artery)

Question 17

Dorsal scapular artery

Answer 17

independent branch of 2nd or 3rd part of subclavian (may also arise as deep descending branch of transverse cervical artery)
- wraps around posterior scapula, forms anastomosis with supra scapular artery, rotator cuff muscles

Question 18

DSA branch of subclavian..

Answer 18

dorsal scapular artery passes laterally through trunks of BRACHIAL PLEXUS, anterior to middle scalene

Question 19

DSA then

Answer 19

runs deep to elevator scapulae and rhomboid muscles, supplies both and participates in arterial anastomoses around scapula
*arteries can be joined to each other via anstomosis (able to feed each other’s territory)