Lecture 1: Triangles of Neck and Larynx (Part 2) Flashcards

1
Q

What important structures are found in the Thoracic Inlet/Outlet?

A
  • APEX OF LUNGS
  • Subclavian Artery and Vein
  • Brachial Plexus
  • Thoracic Duct
  • Esophagus
  • Trachea
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2
Q

What is Thoracic Outlet Syndrome?

A

Compression of Subclavian Artery, Subclavian Vein or Brachial Plexus (especially inferior portion)

  • Can cause loss of hand movement (maybe shoulder and arm)
  • Loss of dermatome sensation in C8 and T1
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3
Q

How can a pneumothorax happen?

A

When inserting a central line into the Subclavian Vein, there is a chance the catheter can be threaded into the pleura of the lung, resulting in a pneumothorax.

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4
Q

What are the nerve roots for the Cervical Plexus?

A

C1-C4

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5
Q

In the cervical plexus, what do the superficial and deep branches do?

A

Superficial: Sensory

Deep: Motor

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6
Q

What are the nerve roots for the Ansa Cervicalis?

What does it innervate?

A

Superior Ansa Cervicalis: C1/C2

Inferior Ansa Cervicalis: C2/C3

Innervates strap muscles of neck (infrahyoid muscles)

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7
Q

Where is the superior cervical ganglion?

A

C1/C2

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8
Q

Where is the middle cervical ganglion?

A

C6 at the level of cricoid cartilage

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9
Q

Where is the inferior cervical ganglion?

A

Anterior to transverse process of C7

-Can fuse w/ thoracic ganglion and known as Stellate Ganglion

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10
Q

What two structures is the subcutaneous layer between?

A

Between dermis and investing layer of deep cervical fascia

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11
Q

What is found in the subcutaneous layer?

A
  • Cutaneous Nerves
  • Blood and Lymphatic Vessels
  • Superficial Lymph Nodes
  • Fat
  • Platysma Musle
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12
Q

What is found in the investing layer of the deep cervical fascia?

A
  • SCM and Trapezius Muscles
  • Parotid and Submandibular Glands
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13
Q

Why is mumps so painful?

A

Mumps infect the parotid gland, causing it to swell. However, the investing layer of the deep cervical fascia does not allow the gland to swell, causing a lot of pain.

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14
Q

Where is the pretracheal layer of the deep cervical fascia located?

A

Anterior region of the neck around the thyroid and trachea

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15
Q

What is found in the prevertebral layer of the deep cervical fascia?

A

Encloses the vertebral column and associated muscles

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16
Q

What does the prevertebral layer of the deep cervical fascia extend to?

A

Axillary Sheath

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17
Q

Where is the retropharyngeal space?

A
  • Posterior to pharynx
  • Buccopharyngeal Fascia is anterior
  • Prevertebral fascia is posterior
  • Carotid Sheath is lateral
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18
Q

What is the clinical significance of the retropharyngeal space?

A

The space extends from the base of the skull to the mediastinum. Abscess that develop can cause contiguous spread or infections and the swelling can cause difficulty in swallowing and speaking (can be life threatening).

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19
Q

Where is the thyroid located?

A
  • Deep to sternothyroid and sternohyoid muscles
  • At vertebral levels C5-T1
  • Isthmus anterior to the 2nd and 3rd tracheal rings
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20
Q

What are the two main arteries that supply the thyroid?

Where do the arteries come from?

A

Superior Thyroid Artery from ECA

Inferior Thyroid Artery from Thyrocervical Trunk

21
Q

In 10% of the population, an additional artery can supply the thyroid. What is this artery and what is its clinical significance?

A

Thyroid Ima Artery (anterior to trachea)

During surgery, have to be careful to avoid hemorrhage

22
Q

Where does the superior and middle thyroid veins drain into?

A

Internal Jugular Vein

23
Q

Where does the inferior thyroid veins drain into?

A

Brachiocephalic Vein

24
Q

Where is the recurrent laryngeal nerve on each side of the body?

A

Right: Around Subclavian Artery

Left: Around Aortic Arch

25
Q

What is the clinical significance of the left recurrent laryngeal nerve?

A

During surgery or even an MI, the nerve can be damaged leading to hoarseness.

26
Q

Where is the larynx found?

A

Located at vertebral levels C3-C6

Connected to the pharynx and trachea

27
Q

What does the larynx do?

A

Phonation and Patent airway

28
Q

Where is the thyroid cartilage located?

A

C4

29
Q

What is the proper name for Adam’s Apple?

A

Laryngeal Prominence

30
Q

Where is the cricoid cartilage?

A

C6

31
Q

What can you find in the aperture of the thyrohyoid membrane?

A

Internal branch of Superior Laryngeal Nerve

Superior Laryngeal Artery

32
Q

What structure allows speech?

A

Vocal Ligament

33
Q

How are the laryngeal spaces organized?

A

Laryngeal Cavity: Whole thing

Part 1: Laryngeal Vestibule

—separated by Vestibular Fold–

Part 2: Laryngeal Ventricle

—separated by Vocal Fold–

Part 3: Infraglottic Cavity

34
Q

What is Rima glottidis?

A

Space between vocal folds

35
Q

What muscle enables high pitch sounds?

A

Cricothyroid muscle

36
Q

What muscle allows low pitch sounds?

A

Thyro-arytenoid muscle

37
Q

What muscle abducts vocal folds?

A

Posterior crico-arytenoid muscle

38
Q

What muscles adduct vocal folds?

A
  • Lateral crico-arytenoid muscle
  • Transverse and oblique arytenoids
  • Vocalis muscle
39
Q

What does the Superior Laryngeal Artery run with?

A

External Branch of Superior Laryngeal Nerve

40
Q

What does the Inferior Laryngeal Artery run with?

A

Inferior Laryngeal Nerve

41
Q

Where does the Superior Laryngeal Nerve come off of?

A

Vagus Nerve

42
Q

Where does the Inferior Laryngeal Nerve come off of?

A

Recurrent Laryngeal Nerve

43
Q

Superior Part of Larynx (Above Vestibular Fold)

What provides sensory portion?

What is the blood supply?

What is the lymphatic drainage?

A

Internal Branch of Superior Laryngeal Nerve

Superior Laryngeal Artery

Superior Deep Cervical Lymph Nodes

44
Q

Inferior Part of Larynx (Below Vestibular Fold)

What provides sensory portion?

What is the blood supply?

What is the lymphatic drainage?

A

Inferior Laryngeal Nerve

Inferior Laryngeal Artery

Inferior Deep Cervical Lymph Nodes

45
Q

What is the conus elasticus?

A

Vocal Ligament

Lateral Cricothyroid Ligament

46
Q

Where does the superficial cervical lymph drain to?

A

External Jugular Vein

47
Q

Where does the deep cervical lymph drain to?

A

Internal Jugular Vein

48
Q

Where can you find jugulo-digastric lymph nodes?

A

C3

Collects lymph from tonsils and throat

49
Q

Where can you find jugulo-omohyoid lymph nodes?

A

C6