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Head and Neck Anatomy > Neck > Flashcards

Neck Flashcards

1
Q

Which muscles does the spinal accessory nerve supply

A

Trapezius (shrug shoulders)
Sternocleidomastoid (turns head to the contralateral side)

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2
Q

What is the surface anatomy of the spinal accessory nerve?

A

Crosses the posterior triangle of the neck between the point of the junction between upper 1/3 and lower 2/3 of the sternocleidomastoid to the junction between upper 2/3 and the lower 1/3 of the trapezius

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3
Q

What does the great auricular nerve supply?

A

Skin over the angle of the mandible
skin over the parotid gland
skin of the lower 1/3 of the auricle

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4
Q

Which muscles make up the strap or infrahyoid muscles?

A

Deep - sternothyroid and thyrohyoid
Superficial - sternohyoid and omohyoid

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5
Q

What is the nerve supply for the strap muscles?

A

Ansa cervicalis (C1-C3) except for thryohyoid which is innervated by C1

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6
Q

What is the action of the strap muscles?

A

Depress the hyoid bone and larynx during swallowing and speaking

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7
Q

What are the boundaries of the anterior traingle of the neck

A

Anterior - midline of the neck
Superior - lower border of the mandible
Posterior - anterior border of the sternocleidomastoid

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8
Q

What are the subtriangles of the anterior triangle?

A
  1. Submental
  2. Submandibular
  3. Carotid
  4. Muscular
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9
Q

What are the boundaries and contents of the submandibular triangle

A

Superior boundary - Mandible
Anterior boundary - anterior belly of the digastric muscle
Posterior - posterior belly of the digastric muscle

Contents
- Submandibular gland and lymph nodes
- facial vessels
- hypoglossal nerve

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10
Q

What are the boundaries and contents of the carotid triangle

A

Superior - posterior belly of digastric muscle
Anterior - Superior belly of omohyoid
Posterior - anterior border of SCM

contents
- carotid sheath - common carotid artery, vagus nerve, IJV
- ansa cervicalis

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11
Q

What are the boundaries and contents of the muscular triangle

A

Anterior - midline of the neck
Superoposterior border - superior body of omohyoid
Inferoposterior border - anterior border of SCM

Contents
- Strap muscles - thyrohyoid, sternohyoid, omohyoid, sternothyroid

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12
Q

What are the boundaries and contents of the submental triangle?

A

Inferior - hyoid bone
Lateral - right and left anterior digastric muscles

contents - submental lymph nodes, mylohyoid nerve and veins

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13
Q

What is the nerve supply to the digastric muscles?

A

Anterior - myohyoid nerve
Posterior - facial nerve

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14
Q

What are the boundaries of the posterior triangle of the neck?

A

Apex - Sternocleidomastoid and the trapezius muscles at the occipital bone
Anterior - posterior border of the sternocleidomastoid muscle
Posterior - anterior border of trapezius muscle
Base - middle third of the clavicle

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15
Q

What are the contents of the posterior triangle?

A

Nerves - accessory nerve, phrenic nerve, three trunks of the brachial plexus, branches of the cervical plexus (supraclavicular nerve, transverse cervical nerve, great auricular nerve, lesser occipital nerve)

Vessels - external jugular vein, subclavian artery (3rd part)

Muscles - inferior belly of omohyoid, scalene

Lymph nodes - supraclavicular, occipital

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16
Q

What is the course of the external carotid artery?

A

Begins as a terminal branch of the common carotid artery at the upper border of the thyroid cartilage (C4) and terminates behind the neck of the mandible inside the parotid gland by dividing into the superficial temporal artery and the maxillary artery

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17
Q

What nerve passes anterior to the external carotid artery?

A

Hypoglossal nerve

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18
Q

What are the branches of the external carotid artery?

A

Some angry lady figured out PMS

Superior thyroid (anterior)
Ascending pharyngeal (deep)
Lingual (anterior)
Facial (anterior)
- tonsiar and labial branches
Occipital (posterior)
Posterior auricular (posterior)
Maxillary (terminal)
- inferior alveolar artery, middle meningeal artery
Superficial temporal

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19
Q

Where is the carotid body found and what is its function

A

Found on the posterior aspect of the bifurcation of the CCA
Contains chemoreceptors sensitive to changes in pH

20
Q

Where is the carotid sinus found and what is its function?

A

A dilated area at the base of the internal carotid artery, just superior to the bifurcation of the common carotid artery, at the superior border of the thyroid cartilage
contains baroreceptor for maintaining blood pressure

21
Q

What is the arterial supply and venous drainage of the thyroid gland?

A

Arterial supply
- superior thyroid artery (1st branch of the external carotid artery)
- inferior thyroid artery (from the thyrocervical trunk from the 1st part of the subclavian artery),
- thyroidea ima (in 10% of the population, from the brachiocephalic or aorta)

Venous drainage
- Superior and middle thyroid veins - drain into the IJV
- inferior thyroid vein - drains into the brachiocephalic veins

22
Q

What is the lymphatic drainage of the thyroid gland?

A

the pre-tracheal, pre-laryngeal, para-tracheal, upper and lower deep cervical, brachiocephalic lymph nodes

23
Q

What is the embryology of the thyroid gland?

A

Develops from the foramen caecum (2/3 along the length of tongue from the tip) and passes forwards and loops around beneath the hyoid bone

24
Q

What are two common conditions which arise from incomplete thyroid embryology?

A

Lingual or pyramidal thyroid - incomplete descent
Thyroglossal cyst - incomplete closure of the pathway of descent of the thyroid

25
Q

At what vertebral level is the thyroid cartilage located?

A

C4

26
Q

Why does the thyroid move upwards on deglutition?

A

The thyroid gland is present within the pretracheal fascia which is attached to the thyroid cartilage and hyoid bone. When the digastric muscles contract, they pull the hyoid bone upward which in turn pulls on the thyroid cartilage which pulls the pretracheal fascia and its contents

27
Q

What is a thyroglossal cyst

A

A fibrous cyst that forms from a persistent thyroglossal duct. The thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages

28
Q

Which nerves are commonly injured during thyroidectomy?

A

External laryngeal nerve (close the superior thyroid artery)
Recurrent laryngeal nerve (close to the inferior thyroid artery)
Cervical sympathetic chain (lateral ligature of the inferior thyroid artery trunk causing ischaemia induced neural damage)

29
Q

Which type of thyroid cancer spreads via the lymphatics

A

Papillary cancer of the thyroid is the only type of thyroid cancer which can spread via the lymphatics

30
Q

What is the cell of origin of medullary carcinoma of the thyroid?

A

Parafollicular C cells

31
Q

What are the late complications of thyroidectomy?

A

Hypothyroidism
Hypocalcaemia

32
Q

Where are the parathyroid glands located?

A

On the posterior aspect of the thyroid gland with 2 on each side

33
Q

Which hormone is secreted by the parathyroid glands and what is its function?

A

Parathormone, has a role in calcium homeostasis

34
Q

What is the embryology of the parathyroid glands?

A

Inferior parathyroid glands develop from the 3rd branchial pouch with the thymus
Superior parathyroid glands develop from the 4th branchial pouch

35
Q

What is the blood supply to the parathyroid glands

A

Inferior thyroid artery - branch of the thyrocervical trunk, from the 1st part of the subclavian artery

36
Q

What is the nerve supply of the larynx?

A

Motor - all laryngeal muscle supplied by RLN except for cricothyroid which is supplied by the external laryngeal nerve , which is a branch of the supperior laryngeal nerve which in turn is a branch of the vagus

Sensory - above the vocal cords internal laryngeal nerve which is a branch of the superior laryngeal nerve which in turn is a branch of the vagus nerve
below vocal cords - RLN from the vagus

37
Q

What are the attachments of the vocal cords?

A

Anterior - thyroid cartilage
Posterior - arytenoid cartilage
Lateral - Laryngeal muscles
Medial - free border

38
Q

Which muscles are responsible for opening the vocal cords?

A
  • 2 posterior cricoarytenoid muscles by externally rotating the arytenoids
39
Q

Which muscles are responsible for closing the larynx during swallowing?

A

Lateral cricoarytenoid muscles

40
Q

Which muscle is responsible for tensing the vocal cords

A

the 2 cricothyroid muscles

41
Q

Where is the site of a cricothyroidotomy?

A

the Cricothyroid membrane - between the thyroid and cricoid cartilage

42
Q

What does the recurrent laryngeal nerve supply?

A

All laryngeal muscles except the cricothyroid muscles (supplied by the superior laryngeal nerve)
Also provides sensory innervation to the mucous membrane of the larynx below the vocal cords

43
Q

What would injury of the RLN on one side lead to?

A

Diplophonia - hoarseness of the voice
Dysphagia

44
Q

What would bilateral injury of the RLN lead to?

A

Semon’s Law
Partial - adducted cords > Respiratory compromise
Full - 1/2 ab(ad)ducted - aphonia, inability to speak or cough

45
Q

What are the branches of the superior laryngeal nerve

A

External laryngeal nerve - motor
Internal laryngeal nerve - sensory

46
Q

What would be the result of damage to the superior laryngeal nerve

A

Abnormalities in pitch of voice
Inability to sing with smooth changes to each higher note (glissando)

Head and Neck Anatomy (4 decks)

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