Neck Flashcards

1
Q

Atlas (2)

A

First cervical body

Lacks vertebral body

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2
Q

Dens (3)

A

Upward extension of axis/remnant of atlas vertebral body

Rotational pivot for head

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3
Q

Axis (2)

A

Second cervical vertebrae

Has dens coming off

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4
Q

Transverse Foremena (2)

A

Lateral extensions w/ holes on cervical vertebrae

Vertebral artery passes through

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5
Q

of Cervical Vertebrae

A

7

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6
Q

Atlanto-occipital Joint (location and motion)

A

Between atlas and occipital bone

Allows head nodding

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7
Q

Atlanta-axial joint (location and motion)

A

Between atlas and axis

Allows shaking head in “no” motion

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8
Q

Tectorial Membrane

A

Extension of anterior vertebral ligament and inserts onto occipital base

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9
Q

Cruciform Ligaments (3)

A

Below tectorial membrane, extends from base of occipit to 2nd vertebrae, with supporting branch off each side

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10
Q

Alar and Apical Ligaments (3)

A

Supporting ligaments of cruciform ligaments that help support dens and check head rotation

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11
Q

Sternocleidomastoid Muscle (2)

A

Large muscle from mastoid down to sternum/clavicle, defines posterior and anterior of neck

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12
Q

Posterior triangle of the neck (2)

A

Between sternocleidomastoid m., trapezius m., and clavicle

Divided into occipital and subclavian triangles

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13
Q

Occipital Triangle Borders

A

Ant: sternocleidomastoid
Post: Trapezius
Inf: Omohyoid m., inferior belly

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14
Q

Subclavian Triangle Borders

A

Ant: Sternocleidomastoid
Sup: omohyoid m., inferior belly
Inf: Clavicle

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15
Q

Submandibular Triangle Borders

A

Sup: Mandible
Post: Digastric m., post. belly
Ant: Digastric m., ant. belly

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16
Q

Carotid Triangle Borders

A

Sup: Digastric m., post. belly
Inf: Omohyoid m., sup. belly
Post: Sternocleidomastoid

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17
Q

Muscular Triangle Borders

A

Anterior: midline
Post: Sternocleidomastoid
Sup: Omohyoid m., sup belly

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18
Q

Submental Triangle Borders

A

Lat: Digastric m., ant belly
Medial: Midline
Inferior: Hyoid bone

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19
Q

Superficial Veins of Ant. Neck (4)

A

Retromandibular and facial v.s join to make ext. jugular vein
Can be variable ant. jugular that runs down front

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20
Q

Ant. Jugular V. Clinical Consideration

A

If large and try to do tracheotomy, can have excess bleeding

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21
Q

Platysma

A

Superficial muscle extends from mandible all way down neck

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22
Q

4 Cutaneous Nerves of Neck (general type/source)

A
All ventral primary rami
From cervical plexus
Lesser occipital n.
Great auricular
Transverse Cervical
Supraclavicular
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23
Q

5 Muscular Contents of Occipital Triangle (Sup/Post-Inf/Ant)

A
Splenius capitus m.
Levator scapulae m.
Scalenus posterior m.
Scalenus medius m.
Scalenus ant. m.
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24
Q

Scalenus Muscles

A

Run from first/second vertebrae down to ribs

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25
4 Nerve/Vasculature Contents of Occipital Triangle
Spinal accessory nerve (XI) Nerves of cervical plexus Transverse cervical artery Upper roots of brachial plexus
26
5/6 Contents of Subclavian Triangle
``` Ant. Scalene m. Phrenic n. Lower roots of brachial plexus Suprascapular a. Subclavian a. and v. ```
27
Phrenic nerve relation in subclavian triangle
Runs right over belly of ant. scalene m.
28
Mylohyoid m.
Prevents tongue falling out, acts as floor of submandibular triangle
29
3.1 Muscular Contents of Submandibular Triangle
Mylohyoid m. Digastric m. (both bellies) Stylohyoid m.
30
Stylohoid m. (2)
Runs from styloid process of skull to hyoid bone | Splits around Digastric m.
31
4 Other Structures of Submandibular Triangle
Submandibular gland Facial a. Hypoglossal n. (XII) Lingual a.
32
3 Contents of Submental Triangle
Mylohyoid m.s Ant belly of digastric m.s Ant. jugular v.s
33
Contents of Muscular Triangle (2.3)
Infrahyoid m.s: Sternohyoid, thyrohyoid, sternothyroid m. | Thyroid gland
34
Function of infrahyoid m.s
Move hyoid down
35
4 Nerve/Vasculature Contents of Carotid Triangle
Hypoglossal n. (XII) Vagus n. (X) Common carotid a. Internal jugular v.
36
Neurovascular bundle of Carotid Triangle (ant-post)
Common carotid a. Vagus n. (X) Internal jugular v.
37
6 Non-Terminal Branches of External Carotid Artery & Paths (in order)
Superior thyroid - goes down to do thyroid Ascending pharyngeal - posterior and heads up, small Lingual - runs across to tongue, passing through submandibular triangle Facial - large, runs towards/across mandible then up towards eye Occipital - posterior under sternocleidomastoid towards greater occipital n.s Post. auricular - supplies skin behind ear
38
2 Terminal Branches of External Carotid Artery & Paths
Superficial temporal - continues superiorly over temporal bone, supplying side of head Maxillary - runs deep, behind ramus of mandible and supplies deep facial structures/pharynx
39
Ansa cervicalis (definition and 2 components/roots)
``` Motor nerves off cervical plexus Superior root (C1) - descendens hypoglossi Inferior root (C2,3) - descendens cervicalis ```
40
Descendens hypoglossi (path and 2 branches)
Travels w/ hypoglossal n. (XII) Nerve to thyrohyoid m. Nerve to geniohyoid m.
41
Descendens cervicalis (3)
Branches to sternohyoid, sternothyroid, and omohyoid m.s
42
Nerve in Both Cervical and Brachial Plexuses
Phrenic n.
43
Lesser Occipital n. path/roots
C2 - up posterior lateral side of head
44
Great Auricular n. path/roots
C2/3 - heads to posterior side of ear, also has a branch to posterior mandible
45
Transverse cervical n. path/roots
C2/3 - transversely towards anterior neck
46
Supraclavicular n.s path/roots
C3/4 - down over clavicle, has medial, intermediate, and lateral branches
47
Innervations of Glossopharyngeal Nerve (IX) (8 Sensory, 1 motor, 1.1 autonomic)
Sensory - Middle ear, internal tympanic membrane, carotid sinus, pharynx, soft palate, palatine tonsil, and posterior 1/3 of tongue Motor - Stylopharyngeus muscle Autonomic - parasymp to parotid gland via otic ganglion
48
Referred Pain of Vagus Nerve
Ear infection puts pressure on tympanic membrane, feels like upset stomach
49
Superior Cervical Ganglion (description and 4 branches/paths)
Fusion of C1-C4 cervical ganglia Internal carotid n. - follows a. Pharyngeal branches - supply pharynx Carotid branches - follows external carotid a. Superior cardiac nerve - go back down to heart
50
Middle Cervical Ganglion (description and 2 branches)
Fusion of C5/C6 cervical ganglia Middle cardiac nerve Ansa subclavia
51
Inferior Cervical Ganglion (description and 2 branches)
Fusion of C7/C8 cervical ganglia Inferior cardiac nerves Ansa subclavia
52
Stellate Ganglion
Anamolous ganglion made by fusion of C7-T1 ganglia
53
Ansa Subclavia
Loop of sympathetic nerve fibers attaching middle and inferior cervical ganglia
54
Horner's Syndrome (cause + 5 symptoms)
``` Loss of cervical sympathetics Pupil constriction Drooping of upper lid (ptosis) Enophthalmos (sunken eyes) Vasodilation of skin vessels Absence of sweating (anhydrosis) ```
55
Carotid Sheath Contents (3)
Internal jugular v. Common carotid a. Vagus n. (X)
56
Vertebral A.
Early branch off subclavian, passes through C6-1 foramena giving off spinal a.s, then bends medially to finally join to form basilar a.
57
3 Portions of Subclavian A.
1st - medial to anterior scalene m. 2nd - posterior to anterior scalene m. 3rd - lateral
58
3 Branches of 1st Portion of Subclavian A.
Vertebral a. Thyrocervical a. Internal thoracic a.
59
4 Branches of Thyrocervical Trunk (distal-prox)
Ascending cervical a. Inferior thyroid a. Transverse cervical a. Suprascapular a.
60
Anastomosis in Neck
Inferior thyroid a. from thyrocervical/subclavian and superior thyroid a. from external carotid
61
Branch of 2nd Portion of Subclavian A.
Costocervical trunk
62
2 Branches of Costocervical Trunk
Deep cervical a. - neck muscles | Superior intercostal a. - side of 1st 3 ribs
63
2 Anamolous Branches off 3rd Part of Subclavian
Suprascapular a. | Descending scapular a.
64
6 Sources of Internal Jugular v.
``` Retromandibular v. Facial v. Lingual v. Occipital v. Superior thyroid v. Middle thyroid v. ```
65
Left Lymphatic Drainage (5)
Left subclavian and jugular trunks drain into thoracic duct, which drains into junction of L internal jugular and subclavian v.s
66
Right Lymphatic Drainage (4)
R subclavian and jugular trunks drain directly into junction of R internal jugular and subclavian v.s
67
Trachea Beginning-Ending
C6-T4
68
Pyramidal Lobe
Anamolous lobe of thyroid sticking up in middle, remnant of how it came down from tongue
69
3 Veins of Thyroid
Superior, middle, and inferior thyroid v.s
70
Clinical Consideration of Inferior Thyroid V.
Tracheotomy risk
71
Superficial Fascia (2)
Most superficial fascial layer, envelops platysma m.
72
Enveloping Fascia (2.2)
2nd fascial layer, envelops muscles innervated by spinal accessory n. (XI) - trapezius m. and sternocleidomastoid m.
73
Infrahyoid fascia (2)
3rd fascial layer, envelops muscles of infrahyoid region
74
Visceral Fascia (4)
4th fascial layer, broken down into pretracheal fascia and buccopharyngeal fascia and contains visceral structures of neck
75
Pretracheal fascia
Envelopes thyroid
76
Buccopharyngeal fascia
Runs posterior to esophagus
77
Relation of Sympathetic Chain to Carotid Sheath (2)
Runs posterior to carotid sheath in prevertebral fascia
78
Prevertebral fascia
Wraps around vertebral column
79
Retropharyngeal space (2)
"Danger space" between buccopharyngeal and prevertebral fascias, perforations in posterior oral cavity wall can spread infections directly into thorax through this space
80
Subclavian Stick
Try to insert line into subclavian v., do it just above clavicle but not too deeply to avoid pneumothorax
81
Thyroidectomy (2)
Have to avoid damage to posterior structures: superior and recurrent pharyngeal n.s, and parathyroid glands