Neck

Question 1

Describe the superficial cervical fascia:

Answer 1

Lies between dermis and deep cervical fascia
Contains superficial neurovascular structures and lymph nodes
Contains connective tissue and subcutaneous fat
Muscles - platysma

Question 2

Describe deep cervical fascia:

Answer 2

4 layers (superficial to deep)

Investing layer - encloses trapezius and sternocleidomastoid

Pre tracheal layer - anterior region of neck, encloses thyroid gland, trachea and oesophagus

Pre vertebral layer - tubular sheath surrounds the vertebral column and associated muscles

Carotid sheath - layer of
deep fascia that surrounds the internal jugular vein, common carotid artery and vagus nerve

Question 3

Describe the bony features of the cervical vertebrae

Answer 3

Vertebral body - supports weight of neck

Transverse process - extend laterally, attachment point for neck muscles

Spinous process - split into 2 parts, muscular attachment

Superior and inferior articular facets - articulation of corresponding ribs, form synovial joints

Foramen transversarium - allow the passage of the vertebral arteries, veins, and sympathetic nerves that supply the brain

Vertebral foramen - spinal cord passes through

Question 4

Describe C1 Atlas and C2 axis

Answer 4

Lacks vertebral body
Anterior and posterior arch instead
The atlanto-occipital joint, formed between the atlas and the skull, permits nodding motion
Articulates with C2 via odontoid process - allows for rotational movement of the head

Question 5

Describe the muscles innervated by the ansa cervicalis

Answer 5

Innervates anterior neck muscles
Formed by spinal nerves C1, C2, C3
Innervates

Sternohyoid
Omohyoid
Sternothyroid
Thyrohyoid

Question 6

What are the infra hyoid muscles and their attachment points ?

Answer 6

Sternothyroid - manubrium + thyroid cartilage

Omohyoid;
- inferiorly scapula
- superiorly hyoid bone
- Intermediate tendon attaches to clavicle

Thyrohyoid - thyroid cartilage and hyoid bone

Sternohyoid - sternum and sternoclavicular joint
Hyoid bone

Question 7

Describe the carotid sheath:

Answer 7

Layer of deep fascia that surrounds the internal jugular vein, common carotid artery and vagus nerve

Borders;
- anteriorly sternocleidomastoid
- posteriorly pre vertebral fascia
- medially thyroid gland and trachea

Question 8

Describe the boundaries of and structures within the anterior triangle of neck

Answer 8

Boundaries;
- superiorly mandible
- laterally sternocleidomastoid
- medially midline of neck
- roof deep cervical fascia and platysma
- floor pre tracheal fascia, thyrohyoid

Contents;
- submental triangle
- submandibular/ digastric triangle
- carotid triangle
- muscular triangle

Question 9

Describe the boundaries of and structures within the posterior triangle of neck

Answer 9

Boundaries;
- Anterior– posterior border of sternocleidomastoid
- Posterior– anterior border of trapezius
- Inferior– middle 1/3 of clavicle
- Floor - prevertebral fascia and muscles
- Roof - investing layer of deep fascia, superficial fascia and skin

Contents;

Occipital triangle - contains accessory nerve (XII), larger superior aspect
Subclavian triangle - smaller, inferior aspect, contains the subclavian artery and vein.
Cervical plexus
Phrenic nerve
Brachial plexus

Question 10

What are the muscles of the posterior triangle and their action ?

Answer 10

Splenius capitis - together draw head backwards, individually turn face to same side
Levator scapulae- elevates scapula
Posterior scalene - elevation of 2nd rib
Middle scalene - elevation of 1st rib
Anterior scalene - elevation of 1st rib.

Question 11

Describe the boundaries and contents of submental triangle

Answer 11

Boundaries;
Superiorly - anterior belly of digastric
Inferiorly - body of hyoid bone
Anteriorly by the midline.
Floor is formed by mylohyoid muscle

Function;
- if mandible is fixed in position then mylohyoid elevates the hyoid.
- if hyoid is fixed in position then mylohyoid depresses the mandible.
- contains submental lymoh nodes

Question 12

Describe the boundaries and contents of digastric triangle

Answer 12

Boundaries;
Superiorly by the mandible
Posteriorly by posterior belly of digastric
Anteriorly by anterior belly of digastric

Contents;
- submandibular gland
- Hypoglossal nerve (CN XII)
- facial artery and vein

Question 13

Describe the boundaries and contents of carotid triangle:

Answer 13

Boundaries;
Posterior belly of digastric/stylohyoid.
Anterior belly of omohyoid.
Anterior border of sternocleidomastoid

Contents;
- common carotid artery
- vagus, hypoglossal, glossopharyngeal, facial and accessory nerves
- internal jugular vein

Question 14

Describe the boundaries and contents of muscular triangle:

Answer 14

Boundaries;
Midline
Superior belly of omohyoid
Anterior border of sternocleidomastoid

Contents;
- infra hyoid muscles
- Thyroid gland and parathyroid glands