Neck Flashcards
Describe movements of the head:
flexion, extension, lateral tilt, rotation
How many cervical vertebrae are there?
7
Name of C1? How does it contribute to head rotation?
atlas; moves with the skull
Name of C2? How does it contribute to head rotation?
axis; moves with the neck
Describe vertebral body of C1:
None, anterior tubercle
Describe vertebral arteries in respect to the foramen transversarium.
vertebral arteries bypass C7 as they ascend tin the neck, but pass through C6 to C1 as they ascend to the brain.
Describe spinous process of C1.
None, posterior tubercle
Describe the zygophysial (“facet”) joints of C1:
present, plus atlantooccipital joint
Describe the vertebral body of C2:
odontoid process (dens)
Describe the spinous process of C2:
present, usually bifid
Describe the vertebral body of C3-C7:
present, C7 is “vertebral prominence”
Anterior Longitudinal Ligament, present in other vertebrae? Attachments? Action?
In thoracic and lumbar vertebrae. Attached to anterior surface of the vertebral bodies and anterior tubercle of C1. Attaches superiorly to the base of the occipital bone. Prevent hyperextension of the neck.
Posterior longitudinal ligament, present in other vertebrae? Attachments? Action?
In thoracic and lumbar ligaments. Attaches to posterior surface of the vertebral bodies and odontoid process of C2. Prevent hyperflexion of neck, divert herniation of the nucleus pulposis of intervertebral disks away from spinal cord. Renamed as tectorial membrane at C1 and C2.
What is the tectorial membrane?
It’s the posterior longitudinal ligament renamed at the level of C1 and C2.
Ligamentum Flavum present in other vertebrae? Attachments? Action?
In thoracic and lumbar vertebrae. Attached to lamina. Actions:????? (nothing written in outline)
Interspinous ligaments and Supraspinous ligaments present in other vertebrae? Attachments? Action?
In thoracic and lumbar vertebrae. Interspinous ligaments attach to superior and inferior surfaces of adjacent spinous processes Supraspinous attaches to posterior edge of nuchal ligament. Actions: help nuchal ligament prevent hyperflexion of the neck.
Nuchal Ligament present in other vertebrae? Attachments? Action?
Unique to neck, it is a sheet of connective tissue that connects the edges of the interspinous ligament and supraspinous ligament. Attaches superiorly to base of skull via external occipital crest of occipital bone. Action: prevents hyperflextion of the neck.
Cruciate Ligament present in other vertebrae? Describe it. Attachments? Action?
Unique to C1 and C2 levels of the neck) Cross shaped ligament with superior and inferior longitudinal bands and two transverse ligaments of the atlas http://en.wikipedia.org/wiki/File:Gray307.png Located anterior to the tectorial membrane and posterior to the dens with synovial joint in between. Actions: allows for atlanto axial rotation without damage to spinal cord
Alar Ligament, other name? present in other vertebrae? Attachments? Action?
Check ligament Unique to C1 Attached to medial and lateral sides of odontoid process of the axis and laterally to medial edges of the occipital bone of the foramen magnum. Action: prevent over rotation of the skull.
Function of hyoid bone:
point of attachment for muscles that raise it towards (swallowing, suprahyoid m) and lower away from the epiglottis (respiration, infrahyroid m).
Name the suprahyoid muscles:
mylohyoid, stylohyoid, genohyoid, digastric
Name infrahyoid muscles: What another name for them?
sternohyoid m, omohyoid, sternothyroid, thyrohyoid Strap muscles.
Attachment of mylohyoid:
mylohyoid line of internal mandible -> hyoid bone
Attachment of Stylohyoid
styloid process of temporal bone -> lesser horn of hyoid
Attachment of Geniohyoid
– lateral edge of tongue greater horn of hyoid bone
Attachment of Digastric
digastric fossae on anterior-inner surface of mandible and posteriorly to mastoid process of temporal bone -> body of hyoid via fibrous loop
Attachment of Sternohyoid
– manubrium of sternum -> hyoid
Attachment of Omohyoid
– superior border of scapula + clavicle via fibrous loop -> hyoid
Attachment of Sternothyroid
– manubrium of sternum -> oblique line of thyroid cartilage
Attachment of Thyrohyoid
– oblique line of thyroid cartilage -> hyoid. Aids sternothyroid.
Name of ligament that anchors the hyoid bone to the skull and the ligamentous sheet that attaches the hyoid bone to the larynx.
Stylohyoid ligament attaches it to the skull Thyrohyoid membrane- attaches it to thyroid cartilage of the larynx by the = acts analogous to curtain rod.
Name the 4 compartments of the neck.
Superfical and Deep (Divides into: investing, prevertebral and pretracheal)
Describe the Superficial fascia
aka subcutaneous – only the platysma, innervated by cervical branch of facial nerve, skin innerv by cutaneous banches of transverse cervical nerves.
Describe the Investing layer of deep cervical fascia: Whats in it?
deep to subcutaneous compartment sternocleidomastoid and trapezius within this compartment, infrahyoids deep to this layer. Accessory n. within, ansa cervicalis within (innerv. Infrahyoids). Sensory nerves from cervical plexus penetrate this layer. Submandibular and parotid glands within this layer.
Describe the Prevertebral layer of deep cervical fascia
anterior flexors and posterior extensors. Phrenic nerve within and along anterior surface of the anterior scalene, n. of occipital triangle here too. Anterior Group (flex)– longus colli and longus capitus, scalenes (anterior, middle and posterior) Posterior Group (extend)– erector spinae (longissimus and spinalis), splenius, semispinalis capitis, rectus capitis, obliquus capitis
Describe the Pretracheal layer of deep cervical fascia
surrounds trachea, esophagus and thyroid and inferior portions of pharynx.
Describe the muscles of the prevertebral layer of deep cervical fascia:
Anterior Group– longus colli and longus capitus, scalenes (anterior, middle and posterior) Posterior Group– erector spinae (longissimus and spinalis), splenius, semispinalis capitis, rectus capitis, obliquus capitis
Describe the Carotid sheath
4th portion of deep cervical fascia or continuation of pretracheal. Contents include common carotid a., vagus n. and internal jugular.
Clinical significance of retropharyngeal space?
deep to investing layer of deep cervical fascia but outside of all of the compartments. Lies posterior to back of the back of the throat. Communicates w/ mediastinum inferiorly, which is the reason for clinical significance – infections can run from the root of the neck to the mediastinum through ulcers (or truama) that pierce through the mucous and muscle Has poor blood supply, immune system has trouble fighting infections.
Describe how the muscles of the superficial and prevertebral compartments contribute to head and neck movements. Platysma SCM Scalenes Longus colli and longus capitus Longissiums and spinalis Deep cervicals (splenius, semispinalis capitis) Occipital triangles (rectus capitis, obliquus capitis)
Platysma – facial expression SCM – lateral rotation, flexion of neck/extension of head?? Scalenes – accessory muscles of inspiration, flexion Longus colli and longus capitus – flexion Longissiums and spinalis – extension Deep cervicals (splenius, semispinalis capitis) – extension Occipital triangles (rectus capitis, obliquus capitis) – extension
Name borders of the posterior triangle of the neck: Name contents:
Borders: lateral edge of trapezius, clavicle, posterior edge of SCM Contents:
Name borders of the Muscular triangle
superior belly of omohyoid (superiorlateral edge), midline (medial edge), medial edge of SCM (inferolateral edge)
Name borders of the Carotid triangle
superior belly of omohyoid (medial edge), SCM (posterior edge), posterior belly of digastric (superior edge)
Name borders of the Submandibular triangle
anterior belly of digastric (medial edge), posterior belly of digastric muscle – posterior edge, mandible (lateral edge)
Name borders of the Mental triangle
digastric muscle (two lateral edges), body of hyoid (posterior edge)
Name borders of the Root of the neck
superior thoracic apterture where neck meets thorax (inferior border), superior edge of subclavian artery and superior edge of pulmonary cavity (superior border). This is just where important features of thorax protrude into neck
Name borders of the Anterior triangle of the neck.
Anterior edge of SCM, midline, and mandible
Contents of posterior triangle:
Omoclavicular or subclavian triangle and occipital triangle. CN XI
Contents of muscular triangle:
infrahyoid muscles (superior belly of omhyoid, sternohyoid, sternohyoid, thyrohyoid) Nerves: superior root of ansa cervicalis Endocrine organs (thyroid and parathyroid glands)
Contents of the Carotid Traingle
carotid sheath, inferior root of ansa cervicalis, common carotid will usually bifurcate here. Carotid sinus and carotid body.
Submandibular triangle contents: Whats the floor made of?
submandibular gland Floor: mylohyoid, hyoglossus muscles, middle pharyngeal constrictor
Mental triangle floor/contents:
mylohyoid muscles = floor
submental lymph nodes, and veins the form anteiro jugular vein.
Contents of the root of the neck:
brachiocephalic trunk and subclavian artery (right and left) + pretracheal fascia contents (trachea, esophagus, thyroid gland).
Name parts of hyoid Bone:
Identify carotid sinus:
dialation of proximal part of internal carotid artery innervated by CN IX = baroreceptor = reacts to changes in arterial BP
Carotid body:
small red/brown ovoid mass on medial side of carotid bifurcation, monitors o2, can increase RR, heart rate and BP
Carotid sheath:
contains common and internal carotid arteries, Internal jugular veins, vagus nerve, carotid sinus nerve and sympathetic nerve fibers
Know Vessels of the anterior neck
Arteries: SAL OF PMS: Superior thyroid, ascending pharyngeal, lingual, occipital, facial, posterior auricular, maxillary, superfical temporal
Common carotid, external carotid,
Veins: external carotid (on top of SCM), internal jugular (below SCM, over the carotid artery)
Nerves of the anterior neck region:
transverse cervicle, vagus(X), superior laryngeal n (internal laryngeal n and external laryngeal n), recurrent laryngeal n., hypoglossal n. (XII), glossopharyngeal n. (ix)
Review hyoid bone (body, greater horn, lesser horn), Thyroid cartilage (laryngeal prominence), Thyrohyoid membrane, cricoid cartilage, membrane between cricoid cartilage and first tracheal ring, cricoid membrane/ligament, tracheal rings, epiglottis
