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Anatomy > Neck 1-3 > Flashcards

Neck 1-3 Flashcards

1
Q

Functions of Neck (4)

A
  • Supporting + moves head, moves VC
  • Move + support larynx for swallowing/speaking,
  • Connect upper + lower respiratory digestive tract via pharynx + larynx w/esophagus + trachea
  • Communication – sounds from larynx -> pharynx + oral cavity = speech
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2
Q

Neck Superior Boundary (2)

A
  • inferior mandible, skull base, MP, trap attachments

- Post neck higher than ant neck to connect cervical viscera w/post opening of nasal + oral cavities

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3
Q

Neck Inferior boundary (base of neck) (1)

A

top of sternum, spine of scapula + clavicle, to SP C7 + adjacent acromion

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4
Q

Superior thoracic aperature (2)

A
  • thoracic inlet or outlet: Space btwn T1 + rib 1 (all that travels to/from thorax)
  • transitional area btwn thorax + neck
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5
Q

Traits of CV (1)

A

Transverse foramen, Bifid SPs, Square VB, triangular vertebral foramen, sloped APs

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6
Q

Joints of Cervical Column (4)

A
  • AO – synovial condyloid
  • AA – synovial (2 Articular facet – plane, 1 dens – pivot)
  • ZP – synovial plane
  • IV disc – secondary cartilaginous
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7
Q

Superficial Cervical Fascia (3)

A
  • subcutaneous CT;
  • superficial fatty layer + deep thin fibrous layer
  • superficial nerves, vessels, lymph nodes and platysma muscle
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8
Q

Investing fascia (2)

A
  • tube (cont across midline), whole body, surrounds SCM+ traps in neck
  • fuses w/periosteum at tendon
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9
Q

Infrahyoid fascia (3)

A
  • sheet, continuous across midline
  • begins at hyoid bone, forms investing fascia for infrahyoid (strap) muscles (attach to hyoid bone)
  • superficial + deep layers due to diff muscle layers
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10
Q

Pretracheal fascia (3)

A
  • tube, continuous across midline, posterior to infrahyoid muscles
  • surrounds viscera in neck (thyroid gland, trachea, pharynx, esophagus), + vocal cords
  • Pre-tracheal + Buccopharyngeal
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11
Q

Prevertebral Fascia (4)

A
  • tube, attaches to skull base
  • in front of vert, encloses deep prevertebral + back muscles
  • specializations: alar fascia, axillary sheath and Sibson’s fascia
  • Wraps around VC/SPs + muscles attached to it (lateral cervical muscles)
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12
Q

Carotid Sheath (6)

A

tube that wraps common + internal carotid arteries, cervical lymph nodes, IJV, vagus nerve, superior root of ansa cervicalis

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13
Q

Fascial Layers

A

BIG PICTURE: spaces btwn layers = spread of infection, etc. Some contained, some large + spread out.

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14
Q

Platysma (4)

A
  • thin muscle, over mandible, down neck past clavicle, limited connection to bone, mostly to superficial fascia
  • Changes tension of skin in neck, depresses mandible (makes sad face)
  • innervated by CN VII (facial nerve)
  • Gap in btwn platysma muscle on left + right side of neck
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15
Q

Investing Fascia Attachments (4)

A
  • Follows attachments for/surrounds traps
  • Superiorly to external occipital protuberance + superior nuchal line
  • Laterally to MP and zygomastic arch
  • Inferiorly to spine of scapula, acromion, clavicle, manubrium of sternum
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16
Q

Vessels + Nerves that pierce investing fascia (2)

A
  • vessels = external and anterior jugular veins
  • nerves = lesser occipital, great auricular, transverse cervical, and supraclavicular nerves (all branches of cervical plexus)
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17
Q

Pre-tracheal proper of Pre-tracheal Fascia

A
  • in front of airway – attaches to hyoid bone above + fibrous pericardium (upper thoracic cavtiy) below
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18
Q

Buccopharyngeal layer of Pre-tracheal fascia (3)

A
  • behind pharynx, separates it from prevert layer, attaches to skull base
  • covers buccinator and pharyngeal constrictors
  • fuses w/pre-tracheal + CT of esophagus
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19
Q

Sibson’s Fascia (2)

A
  • from prevertebral fascia, deep to subclavian artery, closes superior aperature of lung -> Forms CT roof
  • protects lung apex in subclavian puncture (if go through it = pneumothorax)
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20
Q

Axillary Sheath (2)

A
  • from pre-vertebral fascia

- follows nerves + vessels to upper limb (brachial plexus, subclavian artery, etc)

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21
Q

Digastric Muscle (3)

A
  • down to hyoid
  • tendon in middle where sling changes muscle direction
  • anterior + posterior belly
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22
Q

omohyoid muscle (3)

A
  • 2 bellied, deep to SCM
  • scapula -> neck -> hyoid
  • tendon in middle where sling fascia loop changes muscle direction, angles it back to hyoid bone
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23
Q

Infection btwn investing/infrahyoid fascia + pretracheal fasica (2)

A
  • spread inferiorly to pericardium (superior mediastinum)

- up to hyoid bone (neck to thorax)

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24
Q

Deep to prevertebral layer (space) infection (2)

A
  • infection contained by prevertebral layer

- extend laterally, bulge out in neck by posterior border of SCM

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25
Q

Infection in space btwn buccopharygeal fascia and alar fascia (2)

A
  • go up to skull base

- down to lower neck/cervical areas since alar fascia blends w/buccopharyngeal fascia

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26
Q

Infection in space btwn alar/buccopharyngeal fascia and prevertebral layer (3)

A
  • up to skull base thru posterior mediastinum down to diaphragm
  • most imp, wide open space for spreading infection
  • air from ruptured airway/esophagus = pneumomediastinum via fascial space
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27
Q

SCM (3)

A
  • Attachment = MP, sternum, clavicle
  • action = contralateral rotation of head (opp side)
  • innervation = spinal accessory CN XI, C3 + C4(sensory)
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28
Q

Trapezius (3)

A
  • attachment = spine of scapula, clavicle, acromion, SP C7-T12, ligamentum nuchae
  • Action = elevates/retract scapula, abduction of humerus above shoulder
  • Innervation = spinal accessory CN XI, C3 + C4 (sensory)
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29
Q

Congenital Torticollis (4)

A
  • SCM scarred + shortened (act like its contracted)
  • damaged during birth (no mastoid process)
  • head always tilted to side of damage
  • spasmodic - from disease in basal nuclei
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30
Q

Suprahyoid (2)

A
  • above hyoid bone, connections to skull + mandible

- actions = swallowing

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31
Q

Suprahyoid Innervations (3)

A
  • Stylohyoid + Post digastric = CN VII
  • Ant digastric + mylohyoid = CN V
  • geniohyoid = cervical plexus
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32
Q

Infrahyoid (3)

A
  • strap muscles
  • actions = stabilize hyoid bone + larynx, reposition after swallowing
  • omohyoid, sternohyoid (most anterior), sternothyroid (middle), thyrohyoid (deepest)
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33
Q

Scalene triangle (2)

A
  • btwn anterior + middle scalene, base = rib 1

- subclavian art + nerves of brachial plexus pass thru triangle

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34
Q

Anterior to scalene triangle (2)

A
  • subclavian vein + phrenic nerve

- phrenic nerve (C3-5) -> innervates diaphragm (paralysis = death)

35
Q

Anterior Scalene Muscle dysfunction

A

If muscle too short (dysfunction)-> rib 1 out of place -> impinges on nerves + BVs = numbness, pain, tingling in upper extremity, cold hands

36
Q

4 compartments of neck

A

visceral - parts of digestive/resp systems, endocrine glands
vertebral - cervical vert, SC, cervical nerves
2 vascular components - major BVs + vagus nerve

37
Q

Hyoid Bone (2)

A
  • tethered to skull, connected to larynx via ligs

- anchors airway, muscles aid in swallowing

38
Q

Prevertebral + Lateral Neck muscles (3)

A
  • actions = flex head
  • innervation = cervical plexus
  • rectus capitis muscles, longus muscles, scalene muscles
39
Q

Rectus Capitis Muscles (2)

A
  • Rectus Capitis Anterior = flexs head at AO joint, side bending
  • Rectus Capitis Lateralis - flex head laterally to same side, side bending
40
Q

Longus Muscles (3)

A

Longus Capitis - flexes head
Longus Colli - bilaterally flexes neck anteriorly, unilaterally rotation/side bending to opp side
if longus colli paralyzed on one side, won’t notice because other muscles to flex head

41
Q

Scalene Muscles (3)

A

Anterior Scalene - CV TPs -> elevation of rib 1
Middle Scalene - CV TPs -> elevation of rib 1
Posterior Scalene - CV TPs -> elevation of rib 2

42
Q

3 parts of subclavian artery (3)

A
  • part 1 = in front of anterior scalene
  • part 2 = behind anterior scalene, in scalene triangle
  • part 3 = outside of scalene triangle (sometimes branch off here)
43
Q

4 branches of Subclavian artery (4)

A
  • Costocervical trunk – ascending branch (deep cervical artery)
  • Vertebral artery – in transverse foramen of C1-C6
  • Thyrocervical trunk - 1 branch to thyroid gland, 1 branch to neck/shoulder
  • Internal thoracic artery
44
Q

Suprascapular Artery (2)

A
  • under deep of clavicle

- clavicle = most commonly fractured -> suprascapular art at risk of damage

45
Q

Thyrocervical trunk branches (3)

A
  1. inferior thyroid art (and ascending cervical art)
  2. TCA (superficial br + deep br) OR superficial cervical art (50% of time)
  3. suprascapular art
46
Q

Rhomboids blood supply

A

deep br of TCA OR descending (dorsal) scapular art (off subclavian art, goes thru brachial plexus)

47
Q

Vertebral Artery (2)

A
  • goes to skull, supplies brainstem, muscles

- sends feeder arts to spinal cord -> gives rise to spinal artery

48
Q

Common carotid artery (3)

A
  • right common carotid shorter than left
  • divides into internal + external carotid at lvl of thyrocartilage (adam’s apple)
  • no branches from internal carotid artery
49
Q

1-3 Branches of External Carotid

A
  • Superior thyroid art - down to thyroid (dbl blood supply from above/below)
  • Occipital - first off, goes post under MP + back of head
  • Ascending pharyngeal art - off crotch region, up to skull base, supplies meninges
50
Q

4-6 branches of external carotid

A
  • posterior auricular artery - goes posterior behind external ear
  • lingual (oral cavity, tongue) + facial branch - separate or together (10% of ppl, lingual-facial trunk)
51
Q

Terminal Branches of External Carotid (2)

A

Internal maxillary artery (temple) + superficial temporal artery (up side of head)

52
Q

External Carotid Branches related to digastric muscles (2)

A
  • occipital art (posterior) + lingual art (anterior) = below posterior digastric
  • posterior radicular art (posterior) + facial art (anterior) = above posterior digastric
53
Q

Lingual Branches (2)

A

Dorsal Lingual
Deep Lingual
Sublingual

54
Q

Facial Branches (5)

A 
Tonsillar (tonsils)
Ascending palantine (oral cavity)
Glandular (submandibular glands)
Muscular 
Submental
55
Q

Occipital Branches (7)

A
  • Relation to CN XII
  • muscular to SCM
  • Mastoid
  • Stylomastoid
  • Aurical
  • descending
  • meningeal
56
Q

Posterior Auricular Branches (4)

A
  • relations to CN XII
  • stylomastoid
  • auricular
  • occipital
57
Q

Carotid Sinus (4)

A
  • baroreceptor
  • dilation at lower internal carotid artery
  • tunica intima thinner, adventitia thicker
  • sensory nerve endings from CN IX (glossopharyngeal)
58
Q

Carotid Body (2)

A
  • reddish-brown vascular chemoreceptor at carotid crotch

- innervation by CN IX (mostly), CN X, pre-gang symp axons (post-gangs in carotid body)

59
Q

Collateral circualtion (2)

A
  • descending branch of occipital art forms anastomoses

- if something closed off (plaques, etc.), upper limb/facial structures still survive

60
Q

Ligation of Subclavian Artery (3)

A
  • tie off artery in surgery, but main supply to upper limbs
  • limbs live from collateral circulation from int. thoracic art + scapular vessels
  • thyrocervical trunk forms anastomosis, bypasses subclavian
61
Q

block in common carotid (2)

A
  • overcome by anastomosis btwn thyrocervical trunk, costocervical trunk w/descending branch
  • backfill occipital + ext. carotid
62
Q

Carotid Endartectomy (2)

A
  • clean out plaque in carotid artery

- not an issue in external carotid, but huge issue in internal carotid = 1/2 brain dead

63
Q

Superficial + Deep Venous Networks (4)

A
  • deep veins travel w/main arteries (branches from carotid)
  • superficial veins outside deep fascia
  • superficial + deep veins anastomoses
  • 3 jugular veins: Internal, External, Anterior
64
Q

Internal Jugular Vein

A
  • skull base in int. jugular foramen -> carotid sheath (deep to pre-tracheal fascia)
  • tributaries in neck = vessels that dump into it, follow arteries
  • joins subclavian vein = venous angle, forms brachiocephalic vein (becomes superior vena cava)
65
Q

IJV tributaries

A
  • inferior petrosal sinus (skull)
  • occipital
  • pharyngeal
  • lingual
  • facial (joins anterior division of retromandibular vein)
  • thryoid veins
66
Q

Superficial Veins

A
  • external jugular vein = superficial to SCM + investing fascia
  • anterior jugular vein = drains submental region, in carotid sheath
  • communicating vein = connects branches of external to anterior vein
67
Q

Draining Anterior + External Jugular Veins

A
  • dump out to side, near venous angle

- blood has to get back to superior vena cava + heart

68
Q

Brachiocephalic Vein

A
  • IJV, subclavian vein + venous angle joining
  • left brachiocephalic longer than right
  • venous blood shifts to right of body, forms superior vena cava
69
Q

Subclavian Venipuncture

A
  • get into venous system via subclav puncture
  • if miss vein/puncture it thru, can damage lung (protected by Sibson’s Fascia) = pneumothorax, hemothorax
  • watch for rib 1, subclavian art, phrenic nerve (paralysis of diaphragm)
70
Q

Lymph

A
  • superficial nodes of head, superficial cervical nodes in EJV, deep cervical nodes along IJV
  • Accessory nodes (on CN XI), transverse cervical nodes
  • blood plasma -> cap beds -> lymph vessels + nodes -> venous system
71
Q

Superficial Nodes

A
  • in skin/superficial fascia
  • submental
  • submandibular
  • external + anterior jug
  • pre-auricular/parotid
  • mastoid
  • occipital
72
Q

Deep Cervical Nodes

A
  • around IJV, get lymph from head + neck
  • superior deep cervical = jugulodigastric node
  • inferior deep cervical = jugulo-omohyoid node
73
Q

Cervical Lymph Node Level 1

A
  • submental, submandibular

- drains mainly oral cavity (oral cancer spreads here first)

74
Q

Cervical Lymph Node Level 2

A
  • along IJV, deep to SCM
  • superior deep cervical, from skull base to hyoid
  • jugulogastric nodes
75
Q

Cervical Lymph Node Level 3

A
  • along middle 1/3 of IJV, deep to SCM
76
Q

Cervical Lymph Node Level 4

A
  • along lower 1/3 of IJV to clavicle, deep to SCM
  • inferior deep cervical
  • jugularo-omohyoid nodes - everything converges here
77
Q

Cervical Lymph Node Level 5

A
  • posterior triangle
78
Q

Cervical Lymph Node Level 6

A
  • pre-laryngeal + pretracheal midline btwn hyoid and sternal notch
79
Q

Cervical Lymph Node Level 7

A
  • superior mediastinal, below sternal notch, btwn common carotid
80
Q

Submandibular cancer

A
  • deep cervical nodes, tumor cells -> lymph trunks -> venous system
  • look for capillary bed b/c leaky
81
Q

dissemination of cancer

A

1) direct seeding of body cavities/surfaces (peritoneum/pleura)
2) lymphatic spread - follows lymph drainage of affected organ
3) hematogenous spread - after passage thru lung cap beds, tumor cells leave at next encountered cap bed

82
Q

Exceptions to cancer dissemination

A
  • bronchogenic carcinomas involve adremals + brain

- skeletal muscle (despite dense cap beds) rarely affected by metastasis

83
Q

Alar Fascia

A

divides space into 2 compartments (small + big), ends at T2

Anatomy (10 decks)

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