Module 7: Neck, Face, and Parotid Flashcards
What are the names of the deep cervical fascia?
- investing fascia
- pre-tracheal fascia
- pre-vertebral fascia
- carotid sheath
What are the boundaries of the investing fascia?
extends from mastoid process & mandible to clavicle & acromion, and from nuchal ligament & spinous processes to the midline/sternum
What are the contents of the investing fascia?
- encircles entire neck
- surrounds the trapezius, sternocleidomastoid, and inferior portion of parotid gland
- continuous with remainder of parotid fascia
What are the contents of the carotid sheath?
- common and internal carotid arteries
- internal jugular vein
- vagus nerve
What are the boundaries of the pre-vertebral fascia?
- encircles vertebrae
- extends lateral & anterior to levator scapulae, longus colli & capitis, and scalene muscles to form the floor of the posterior triangle
- from base of skull to mediastinum; continuous with axillary sheath and anterior longitudinal ligament
- defines boundary of retropharyngeal space
What are the contents of the pre-vertebral space?
- deep neck flexor and extensor muscles (scalene muscles, levator scapulae, splenius capitis, longus capitis & colli, etc)
What are the contents of the pre-tracheal fascia?
- infra hyoid muscles, thyroid gland, esophagus, trachea, thyroid cartilage
- continuous with buccopharyngeal fascia
What are the suprahyoid muscles?
- digastric (anterior and posterior belly)
- mylohyoid
- geniohyoid
- stylohyoid
What are the infrahyoid muscles?
- omohyoid (superior and inferior belly)
- sternohyoid
- sternothyroid
- thyrohyoid
What are the OIANs of the anterior belly of the digastric?
Origin: digastric fossa of mandible
Insert: intermediate tendon
Action: depression of mandible or elevation of hyoid
Nerve: mylohyoid branch of inferior alveolar nerve: CN V3 trigeminal
What are the OIANs of the posterior belly of the digastric?
Origin: temporal mastoid notch
Insert: intermediate tendon and body and cornu of hyoid
Action: depression of mandible or elevation of hyoid
Nerve: CN VII Facial Nerve
What are the OIANs of the geniohyoid?
Origin: inferior genial tubercle of mandible
Insert: anterior aspect of body of hyoid
Action: elevation of tongue and hyoid or depress mandible
Nerve: ventral ramus of C1 via CN XII
What are the OIANs of the mylohyoid?
Origin: mylohyoid line of mandible
Insert: midline raphe & anterior aspect of body of hyoid
Action: elevation of floor of oral cavity
Nerve: mylohoid branch of inferior alveolar branch of CN V3 trigeminal
What are the OIANs of the stylohyoid?
origin: styloid process of temporal bone
insert: body of hyoid bone
action: elevation and retraction of hyoid
nerve: CN VII facial nerve
What are the OIANs of the omohyoid?
origin: superior border of scapula and scapular notch
insert: lateral aspect of hyoid passing through an intermediate tendon sling loosely associated with the clavicle and 1st rib
action: depression of hyoid
nerve: ansa cervicalis (C1-C3)
What are the OIANs of the sternohyoid?
origin: posterior side of the proximal clavicle & adjacent manubrium
insert: inferior border of body of hyoid
action: depress hyoid
nerve: ansa cervicalis (C1-C3)
What are the OIANSs of the sternothryoid?
origin: posterior aspect of manubrium & costal cartilage of 1st rib
insert: thryroid lamina
action: depression of the elevated larynx
nerve: ansa cervicalis (C1-C3)
What are the OIANs of the thyrohyoid?
origin thyroid lamina
insert: greater horn of hyoid bone
action: depression of hyoid or elevation of thyroid cartilage
nerve: ventral ramus of C1 via CN XII
Which infrahyoid muscles are innervated by the ansa cervicalis?
- omohyoid
- sternohyoid
- sternothyroid
- thyrohyoid innervated by C1 via CN XII
What are the triangles of the neck?
Anterior and posterior triangles
What sub triangles are located in the anterior triangle of the neck?
- submental
- submandibular
- carotid
- muscular
What sub triangles are located in the posterior triangle of the neck?
- occipital
- supraclavicular
What are the borders of the submandiubular triangle?
- inferior mandible
- superior border of posterior digastric
- posterior border of anterior digastric
What are the contents of the submandibular triangle?
- submandibular lymph nodes
- submandibular gland
- facial artery
- hypoglossal nerve
- mylohyoid nerve
What are the borders of the carotid triangle?
- sup border SCM
- inf border of posterior digastric
- superior belly of omohyoid
What are the contents of the carotid triangle?
- common carotid artery split
- hypoglossal nerve CN XII
- carotid sheath
- ansa cervicalis
What are the borders of the submental triangle?
- hyoid bone
- anterior digastric muscle
- mandible
What are the contents of the submental triangle?
- submental lymph nodes
- small veins
What are the borders of the muscular triangle?
- superior belly of omohyoid
- SCM
- midline of neck
What are the borders of the occipital triangle?
- ant border of trapezius
- inferior belly of omohyoid
- SCM
What are the contents of the occipital triangle?
- CN XI accessory nerve
- trunks of brachial plexus
What are the borders of the supraclavicular triangle?
- inferior belly of omohyoid
- SCM
- clavicle
What are the contents of the supraclavicular triangle?
- thyrocervical trunk
- subclavian artery
What are the branches of the thyrocervical trunk?
- inferior thyroid artery
- ascending cervical artery
- suprascapular artery
- transverse cervical artery
What does it mean when we say C1 via CN XII
CN XII is large and sits on C1 branch of cervical plexus making it seem the nerves are coming from CN XII
What are the motor & sensory branches of the cervical plexus?
- suboccipital nerve
- C1 via CN XII to geniohyoid and thyrohyoid
- ansa cervicalis (C1-C3): sup omohyoid, inf omohyoid, sternothyroid, sternohyoid
- phrenic nerve (C3-C5)
What are the strictly sensory branches of the cervical plexus?
- greater occipital nerve (C2)
- lesser occipital nerve (C2)
- great auricular nerve (C2-C3)
- 3rd occipital nerve (C3)
- supraclavicular nerve (C3-4)
- transverse cervical nerve (C2-C3)
What infrahyoid muscle is innervated by the superior root of the ansa cervicalis?
superior belly of omohyoid
What infrahyoid muscles are innervated by the inferior root of the ansa cervicalis?
- inferior belly of omohyoid
- sternothyroid
- sternohyoid
What are the branchial (pharyngeal) arches the origin of?
- head and neck structures
What are the names of the branchial arches?
- mandibular
- hyoid
- third
- fourth
- sixth
fifth arch is reabsorbed
What are the muscles associated with the mandibular branchial arch?
- muscles of mastication
- mylohyoid
- ant belly of digastric
What nerve innervates the mandibular branchial arch muscles?
CN V3 trigeminal
What are the muscles associated with the hyoid branchial arch?
- facial expression muscles
- post belly of digastric
- stylohyoid
What nerve innervates the hyoid branchial arch muscles?
facial nerve CN VII