Muscles, Fasical Layers + Neck Spaces Flashcards
List the muscles of the neck
Platysma
Stenocleidomastoid
Trapezius (descending part)
Scalene muscles
Supra- and infra- hyoids
Outline the platysma:
- location
- innervation
- action
- Location: lies superficially in subcutaneous tissue, immediately beneath skin
- Innervation: facial nerve
- Action: tenses skin of anterior neck + lowers inferior lip
Outline sternocleidomastoid:
- location
- origin
- insertion
- action
- innervation
- to test
- Location: lies beneath the platysma
- Origin: medial 1/3 clavicle + sternum
- Insertion: mastoid process
- Action: rotates head so chin turns to opposite side + flex neck when act together
- Innervation: accessory nerve
- To test: examiner opposes action of rotation
What is torticollis?
- Involuntary contraction of SCM
- causes asymmetrical head/neck position
- can be congential + acquired
Outline the neck/descending part of the trapezius:
- origin
- insertion
- action
- innervation
- to test
- Origin: occipital bone + nuchal ligament
- Insertion: lateral 1/3 clavicle + acromion of scapula
- Action: elevates shoulder + stabilises the scapula
- Innervation: accessory nerve
- To test - ask patient to shrug shoulders
What are the borders of the anterior triangle of the neck?
- Superior: inferior margin of mandible
- Lateral: anterior border of sternocleidomastoid
- Medial: mid sagittal line of neck
What are the borders of the posterior triangle of the neck including the floor and roof?
- Inferior: clavicle
- Lateral: anterior border of the trapezius
- Medial: posterior border of the sternocleidomastoid
- Floor: scalene muscles
- Roof: superficial cervical fascia
- inferior belly of omohyoid runs through it
Contents of the posterior triangle of the neck
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Sclaene muscles
Phrenic nerve
Brachial plexus
Subclavian vessels
Posterior belly Omohyoid
Accessory nerve
External jugular vein
What is in the neurovascular bundle of the neck?
Vagus nerve
Internal jugular vein
Common carotid artery
When does the common carotid artery bifurcation and into what?
-
C4 vertebral level - below hydoid bone
-Internal carotid artery continues up
-External carotid artery: branches off
What are the deep cervical fascial layers?
Pre-tracheal fascia
Buccopharyngeal fascia
Carotid sheath
Pre-vertebral fascia
Investing layer
Contents of the pre-tracheal fascia
Trachea
Thyroid
Oesophagus
Infrahyoids
Contents of the carotid sheath
Common carotid artery
Internal jugular vein
Vagus nerve
Outline the investing layer
Splits + surrounds the SCM and trapezius
Surrounds all deep cervical fascial layers + structures
Where is a retropharyngeal abscess located?
In the retropharyngeal space between the pre-vertebral fascia and buccopharyngeal fascia
Who does a retropharyngeal abscess often occur in and why?
Kids between 3-5
Lymph nodes in the retropharyngael space where infection has collected
(Adults don’t have these lymph nodes here)
Complications to deep neck space infections
- compromise airway
- expands down into thorax to mediastinum > risk of mediastinitis
Clinical presentation of a deep neck space infection
- fever
- sore throat
- difficulty swallowing > drooling
- painful neck movements
What are the boundaries of the carotid triangle?
- Superior: posterior body of digastric
- Lateral: sternocleidomastoid
- Medial: superior belly of omohyoid
Outline the fascial layers of the neck
- skin
- superficial cervical facial layer surround everything
- investing layer
- pre-tracheal fascia bends together with the buccopharyngeal fascia posteriorly
- carotid sheath
- pre vertebral fascia
What does the superficial cervical fascial layer contain?
Fat
Superficial cervical lymph nodes
Platysma muscle
Anatomical position of the subclavian vessels in the posterior triangle
- subclavian vein anterior to anterior scalene muscle
- subclavian artery posterior to anterior scalene muscle
What vertebral level is the hyoid bone at?
C3
