Neck 2/2 Flashcards

1
Q

list the infrahyoid muscles that attach to the hyoid bone. What is the destination from the hyoid?

A

infra hyoid uscles ( the strap muscles)

  1. located in muscular compartment
  2. 3 of them attache to the hyoid bone
  3. a superficial layer of two parallel muscles
    1. STERNOHYOID
      1. medially attaches to manubrium of sternum
    2. OMOHYOID (omo =shoulder)
      1. superior belly, laterally
      2. joins the inferior belly by an intermediate tendon/attache to scapula
  4. a deep layer formed by two muscles in series attaching to the thyroid cartilage
    1. STERNOTHYROID
      1. inferiorly attaches to manubrium of sternum
    2. THYROHYOID
      1. superiorly
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2
Q

which of the infrahyoid muscles does not attache to the hyoid bone? What does it attache to?

A

infra hyoid uscles ( the strap muscles)

  1. located in muscular compartment
  2. 3 of them attache to the hyoid bone
  3. a superficial layer of two parallel muscles
    1. STERNOHYOID
      1. medially attaches to manubrium of sternum
    2. OMOHYOID (omo =shoulder)
      1. superior belly, laterally
      2. joins the inferior belly by an intermediate tendon/attache to scapula
  4. a deep layer formed by two muscles in series attaching to the thyroid cartilage
    1. STERNOTHYROID
      1. inferiorly attaches to manubrium of sternum
    2. THYROHYOID
      1. superiorly
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3
Q

describe the infrahyoid muscles with respect to the mandible, hyoid, thyroid and sternum

A

infra hyoid uscles ( the strap muscles)

  1. located in muscular compartment
  2. 3 of them attache to the hyoid bone
  3. a superficial layer of two parallel muscles
    1. STERNOHYOID
      1. medially attaches to manubrium of sternum
    2. OMOHYOID (omo =shoulder)
      1. superior belly, laterally
      2. joins the inferior belly by an intermediate tendon/attache to scapula
  4. a deep layer formed by two muscles in series attaching to the thyroid cartilage
    1. STERNOTHYROID
      1. inferiorly attaches to manubrium of sternum
    2. THYROHYOID
      1. superiorly
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4
Q

function of the infrahyoid muslces

A

infrahyoid muscles

  1. stabilize the hyoid bone in position to provide a base for tongue movements or depress the hyoid bone; the thyrohyoid muscle can also elevate the laynx
  2. are innervated by
    1. nerve loop
      1. ansa acervicalis
    2. formed by
      1. anterior rami of cervical spinal nerves 1-3
      2. THYROHYOID = C1 ONLY
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5
Q

describe the innervation of the infrahyoid muscles

A

infrahyoid muscles

  1. stabilize the hyoid bone in position to provide a base for tongue movements or depress the hyoid bone; the thyrohyoid muscle can also elevate the laynx
  2. are innervated by
    1. nerve loop
      1. ansa cervicalis
    2. formed by
      1. anterior rami of cervical spinal nerves 1-3
      2. THYROHYOID = C1 ONLY
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6
Q

describe the formation of the ansa cervicallis. what is the exception?

A

infrahyoid muscles

  1. stabilize the hyoid bone in position to provide a base for tongue movements or depress the hyoid bone; the thyrohyoid muscle can also elevate the laynx
  2. are innervated by
    1. nerve loop
      1. ansa cervicalis
    2. formed by
      1. anterior rami of cervical spinal nerves 1-3
      2. THYROHYOID = C1 ONLY
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7
Q

Describe the location of the thyroid gland

A

the thyroid gland

  1. location
    1. deep to the infrahyoid muscles
    2. ~C5-C7
    3. in the muscular compartment
  2. An “H” shaped endocrine gland
  3. contents
    1. 2 lateral lobes
    2. an isthmus across tracheal rings 2-4
    3. frequently, a pyramidal lobe extending superiorly from the isthmus
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8
Q

10% of the time the thyroid get arterial supply from which artery?

A

the thyroid gland

  1. location
    1. deep to the infrahyoid muscles
    2. ~C5-C7
    3. in the muscular compartment
  2. An “H” shaped endocrine gland
  3. contents
    1. 2 lateral lobes
    2. an isthmus across tracheal rings 2-4
    3. frequently, a pyramidal lobe extending superiorly from the isthmus
  4. vasculature
    1. superior thyroid arteries
      1. from external carotids
    2. inferior thyroid arteries
      1. from thyrocervical trunk
        3.
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9
Q

Arterial supply is reached to the thyroid 10% of the time by what?

A

the thyroid gland

  1. location
    1. deep to the infrahyoid muscles
    2. ~C5-C7
    3. in the muscular compartment
  2. An “H” shaped endocrine gland
  3. contents
    1. 2 lateral lobes
    2. an isthmus across tracheal rings 2-4
    3. frequently, a pyramidal lobe extending superiorly from the isthmus
  4. vasculature
    1. artery
      1. superior thyroid arteries
        1. from external carotids
      2. inferior thyroid arteries
        1. from thyrocervical trunk
      3. 10% of the time = Thyroid Ima artery
    2. venous
      1. superior middle vein
      2. inferior thyroid veins
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10
Q

describe the arterial supply to the thyroid gland

A

the thyroid gland

  1. location
    1. deep to the infrahyoid muscles
    2. ~C5-C7
    3. in the muscular compartment
  2. An “H” shaped endocrine gland
  3. contents
    1. 2 lateral lobes
    2. an isthmus across tracheal rings 2-4
    3. frequently, a pyramidal lobe extending superiorly from the isthmus
  4. vasculature
    1. artery
      1. superior thyroid arteries
        1. from external carotids
      2. inferior thyroid arteries
        1. from thyrocervical trunk
      3. 10% of the time = Thyroid Ima artery
    2. venous
      1. superior middle vein
      2. inferior thyroid veins
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11
Q

Describe the venous supply to the thryoid gland

A

the thyroid gland

  1. location
    1. deep to the infrahyoid muscles
    2. ~C5-C7
    3. in the muscular compartment
  2. An “H” shaped endocrine gland
  3. contents
    1. 2 lateral lobes
    2. an isthmus across tracheal rings 2-4
    3. frequently, a pyramidal lobe extending superiorly from the isthmus
  4. vasculature
    1. artery
      1. superior thyroid arteries
        1. from external carotids
      2. inferior thyroid arteries
        1. from thyrocervical trunk
      3. 10% of the time = Thyroid Ima artery
    2. venous
      1. superior middle vein
      2. inferior thyroid veins
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12
Q

describe the contents of the thyroid gland

A

the thyroid gland

  1. location
    1. deep to the infrahyoid muscles
    2. ~C5-C7
    3. in the muscular compartment
  2. An “H” shaped endocrine gland
  3. contents
    1. 2 lateral lobes
    2. an isthmus across tracheal rings 2-4
    3. frequently, a pyramidal lobe extending superiorly from the isthmus
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13
Q

essential for life and involved in calcium homeostasis. Describe its location

A

parathyroid gland

  1. 2-8 small ovoid endocrine organs that typically lie in superior and inferior pairs on the posterior surface of the thryoid gland
  2. involved in calcium homeostasis and are ESSESTIAL FOR LIFE
  3. vasculature
    1. inferior thyroid arteries
  4. disease manifestion
    1. subject to disease processes such as tumor development
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14
Q

parathyroid glands are located where? Can you function with out them?

A

parathyroid gland

  1. 2-8 small ovoid endocrine organs that typically lie in superior and inferior pairs on the posterior surface of the thryoid gland
  2. involved in calcium homeostasis and are ESSESTIAL FOR LIFE
  3. vasculature
    1. inferior thyroid arteries
  4. disease manifestion
    1. subject to disease processes such as tumor development
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15
Q

descirbe the blood source of the parathyroid glands and subject of disease.

A

parathyroid gland

  1. 2-8 small ovoid endocrine organs that typically lie in superior and inferior pairs on the posterior surface of the thryoid gland
  2. involved in calcium homeostasis and are ESSESTIAL FOR LIFE
  3. vasculature
    1. inferior thyroid arteries
  4. disease manifestion
    1. subject to disease processes such as tumor development
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16
Q

list the borders of the carotid triangle

A

the carotid triangle

  1. boundaries
    1. superior belly of omohyoid
    2. posterior belly of the digastric
    3. antterior border of tthe SCM
  2. contents
    1. cervical branch of CN VII
    2. common carotid artery and itts division intto the internal carotid and external carotid artteries
    3. branches of the extternal carotid artery
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17
Q

list the contents in the cardiac triangle

A

the carotid triangle

  1. boundaries
    1. superior belly of omohyoid
    2. posterior belly of the digastric
    3. antterior border of tthe SCM
  2. contents
    1. nerves
      1. cervical branch of CN VII
      2. vagus nerve
      3. accessory nerve
      4. hypoglossal nerve
      5. superior and inferior roots of the ansa cervicalis
    2. arteries
      1. common carotid artery and its division into the internal carotid and external carotid artteries
      2. branches of the extternal carotid artery
    3. veins
      1. ​internal jugular vein
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18
Q

describe the two sides of the common carotid, with repect to the origin.

A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. common carotid arteris
    1. details
      1. two sides have different origins
        1. right
          1. arises from the brachiocephalic tunk
        2. left
          1. branches direcly from tha arch of the aorta
      2. division
        1. divide into internal and exernal carotid arteries NEAR THE UPPER BORDER OF THE THYROID CARTILAGE
        2. at the bifurcation, there are specialized recepors
          1. carotid sinus
            1. dilated proximal part of the internal carotid (an often the terminal part of the common carotid)
            2. this is a blood pressure receptor from CN-IX
            3. the carotid sinus may become hypersensitive to external pressure in some individuals. this may result in fainting (carotid sinus syncope. The upper border of the thyroid cartilage is NOT a good place to check a pulse in children and elderly patients with cardiac issues.
          2. carotid body
            1. flattened body deep to the birfurcation
            2. a chemoreceptor for blood gases
    2. route
      1. ascend thte neck within the carottid sheaths, along with
        1. internal jugular veins
        2. vagus nerves
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19
Q

describe the route of the common carotid. What do they ascend with?

A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. common carotid arteris
    1. details
      1. two sides have different origins
        1. right
          1. arises from the brachiocephalic tunk
        2. left
          1. branches direcly from tha arc of the aorta
      2. division
        1. divide into internal and exernal carotid arteries NEAR THE UPPER BORDER OF THE THYROID CARTILAGE
        2. at the bifurcation, there are specialized recepors
          1. carotid sinus
            1. dilated proximal part of the internal carotid (an often the terminal part of the common carotid)
            2. this is a blood pressure receptor from CN-IX
            3. the carotid sinus may become hypersensitive to external pressure in some individuals. this may result in fainting (carotid sinus syncope. The upper border of the thyroid cartilage is NOT a good place to check a pulse in children and elderly patients with cardiac issues.
          2. carotid body
            1. flattened body deep to the birfurcation
            2. a chemoreceptor for blood gases
    2. route
      1. ascend the neck within the carottid sheaths, along with
        1. internal jugular veins
        2. vagus nerves
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20
Q

describe the location of the common carotid divide. what do they travel with?

A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. common carotid arteris
    1. details
      1. two sides have different origins
        1. right
          1. arises from the brachiocephalic tunk
        2. left
          1. branches direcly from tha arc of the aorta
      2. division
        1. divide into internal and exernal carotid arteries NEAR THE UPPER BORDER OF THE THYROID CARTILAGE
        2. at the bifurcation, there are specialized recepors
          1. carotid sinus
            1. dilated proximal part of the internal carotid (an often the terminal part of the common carotid)
            2. this is a blood pressure receptor from CN-IX
            3. the carotid sinus may become hypersensitive to external pressure in some individuals. this may result in fainting (carotid sinus syncope. The upper border of the thyroid cartilage is NOT a good place to check a pulse in children and elderly patients with cardiac issues.
          2. carotid body
            1. flattened body deep to the birfurcation
            2. a chemoreceptor for blood gases
    2. route
      1. ascend thte neck within the carottid sheaths, along with
        1. internal jugular veins
        2. vagus nerves
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21
Q

what structures exist at thte bifurcation? describe these.

A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. common carotid arteris
    1. details
      1. two sides have different origins
        1. right
          1. arises from the brachiocephalic tunk
        2. left
          1. branches direcly from tha arc of the aorta
      2. division
        1. divide into internal and exernal carotid arteries NEAR THE UPPER BORDER OF THE THYROID CARTILAGE
        2. at the bifurcation, there are specialized recepors
          1. carotid sinus
            1. dilated proximal part of the internal carotid (an often the terminal part of the common carotid)
            2. this is a blood pressure receptor from CN-IX
            3. the carotid sinus may become hypersensitive to external pressure in some individuals. this may result in fainting (carotid sinus syncope. The upper border of the thyroid cartilage is NOT a good place to check a pulse in children and elderly patients with cardiac issues.
          2. carotid body
            1. flattened body deep to the birfurcation
            2. a chemoreceptor for blood gases
    2. route
      1. ascend thte neck within the carottid sheaths, along with
        1. internal jugular veins
        2. vagus nerves
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22
Q

describe the possible temperment of a structure near the upper border of the thyroid cartilage

A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. common carotid arteris
    1. details
      1. two sides have different origins
        1. right
          1. arises from the brachiocephalic tunk
        2. left
          1. branches direcly from tha arc of the aorta
      2. division
        1. divide into internal and exernal carotid arteries NEAR THE UPPER BORDER OF THE THYROID CARTILAGE
        2. at the bifurcation, there are specialized recepors
          1. carotid sinus
            1. dilated proximal part of the internal carotid (an often the terminal part of the common carotid)
            2. this is a blood pressure receptor from CN-IX
            3. the carotid sinus may become hypersensitive to external pressure in some individuals. this may result in fainting (carotid sinus syncope. The upper border of the thyroid cartilage is NOT a good place to check a pulse in children and elderly patients with cardiac issues.
          2. carotid body
            1. flattened body deep to the birfurcation
            2. a chemoreceptor for blood gases
    2. route
      1. ascend thte neck within the carottid sheaths, along with
        1. internal jugular veins
        2. vagus nerves
23
Q

Upon checking the carotid pulse of an elderly man with heart problems, the patient faintted. What is the possible reason for this? explain difference in origin bettween the L and R carotid.

A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. common carotid arteris
    1. details
      1. two sides have different origins
        1. right
          1. arises from the brachiocephalic tunk
        2. left
          1. branches direcly from tha arc of the aorta
      2. division
        1. divide into internal and exernal carotid arteries NEAR THE UPPER BORDER OF THE THYROID CARTILAGE
        2. at the bifurcation, there are specialized recepors
          1. carotid sinus
            1. dilated proximal part of the internal carotid (an often the terminal part of the common carotid)
            2. this is a blood pressure receptor from CN-IX
            3. the carotid sinus may become hypersensitive to external pressure in some individuals. this may result in fainting (carotid sinus syncope. The upper border of the thyroid cartilage is NOT a good place to check a pulse in children and elderly patients with cardiac issues.
          2. carotid body
            1. flattened body deep to the birfurcation
            2. a chemoreceptor for blood gases
    2. route
      1. ascend thte neck within the carottid sheaths, along with
        1. internal jugular veins
        2. vagus nerves
24
Q

How many branches are in the neck, from the internal carotid? What is the destination for the internal carotid?

A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. internal carotid arteries
    1. details
      1. have no branches in the neck
      2. enter the skull to become the principal blood supply for:
        1. cerebral hemiphseres
        2. structtures with in the orbit
  3. external carotid arteries
    1. details
      1. 4-5 of the 8 branches present in the carotid triangle
        1. superior thyroid
          1. usually the firstt
        2. lingual artery
          1. to the tongue
        3. facial artery
          1. may arise from a common stem with the lingual artery
        4. ascending pharyngeal artery
          1. which arises from the medial side of the external carotid
        5. occipital artery
          1. may arise in the carotid triangle
      2. 3 branches not present in the carotid ttriangle
        1. posterior auricular artery
        2. superficial temporal artery
          1. one of the terminal branches
          2. ascends in front of the ear
        3. maxillary artery
          1. other terminal branch
          2. passes to the infratemporal fossa deep to the ramus of the mandible
25
Q

describe the branches of the carotid artery.

A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. internal carotid arteries
    1. details
      1. have no branches in the neck
      2. enter the skull to become the principal blood supply for:
        1. cerebral hemiphseres
        2. structtures with in the orbit
  3. external carotid arteries
    1. details
      1. 4-5 of the 8 branches present in the carotid triangle
        1. superior thyroid
          1. usually the firstt
        2. lingual artery
          1. to the tongue
        3. facial artery
          1. may arise from a common stem with the lingual artery
        4. ascending pharyngeal artery
          1. which arises from the medial side of the external carotid
        5. occipital artery
          1. may arise in the carotid triangle
      2. 3 branches not present in the carotid ttriangle
        1. posterior auricular artery
        2. superficial temporal artery
          1. one of the terminal branches
          2. ascends in front of the ear
        3. maxillary artery
          1. other terminal branch
          2. passes to the infratemporal fossa deep to the ramus of the mandible
26
Q

name the branches with respect to the external carotid arteries

  1. usually the first
      1. to the tongue
      1. may arise from a common stem with the lingual artery
      1. which arises from the medial side of the external carotid
      1. may arise in the carotid triangle
  2. 3 branches not present in the carotid ttriangle
      1. behind the ear
      1. one of the terminal branches
      2. ascends in front of the ear
      1. other terminal branch
      2. passes to the infratemporal fossa deep to the ramus of the mandible
A
  1. common carotid can be divided into
    1. internal carotid
    2. external carotid
  2. internal carotid arteries
    1. details
      1. have no branches in the neck
      2. enter the skull to become the principal blood supply for:
        1. cerebral hemiphseres
        2. structtures with in the orbit
  3. external carotid arteries
    1. details
      1. 4-5 of the 8 branches present in the carotid triangle
        1. superior thyroid
          1. usually the firstt
        2. lingual artery
          1. to the tongue
        3. facial artery
          1. may arise from a common stem with the lingual artery
        4. ascending pharyngeal artery
          1. which arises from the medial side of the external carotid
        5. occipital artery
          1. may arise in the carotid triangle
      2. 3 branches not present in the carotid ttriangle
        1. posterior auricular artery
        2. superficial temporal artery
          1. one of the terminal branches
          2. ascends in front of the ear
        3. maxillary artery
          1. other terminal branch
          2. passes to the infratemporal fossa deep to the ramus of the mandible
27
Q

has dilations at its superior and inferior ends. describe the location of each.

A

the intternal jugular vein

  1. details
    1. is the continuation of the sigmoid sinus, a dural venous sinus
    2. is the largest vein of the head and neck
    3. has dilations at its superior and inferior ends, the superior and inferior bulbs of the internal jugular vein
      1. the inferior bulb is located just above the union of the internal jugular vein with the subclavian vein tto form the brachiocephalic
    4. may become distended if venous return to the right atrium is obstructed
      1. tension pneumothorax
      2. cardiac tamponade
      3. superior vena cava syndrome
    5. has deep cervical lymph nodes located along it
      1. they drain all of the lymph from the head and neck
      2. the two groups are
        1. upper/superior deep cervical nodes (jugulodigastric)
        2. lower/inferior deep cervical nodes (jugulo-omohyoid)
  2. route
    1. it descends within the carotid sheath lateral to the carotid artery
28
Q

the largest vein of the head and neck. describe its route and its continuation.

A

the intternal jugular vein

  1. details
    1. is the continuation of the sigmoid sinus, a dural venous sinus
    2. is the largest vein of the head and neck
    3. has dilations at its superior and inferior ends, the superior and inferior bulbs of the internal jugular vein
      1. the inferior bulb is located just above the union of the internal jugular vein with the subclavian vein tto form the brachiocephalic
    4. may become distended if venous return to the right atrium is obstructed
      1. tension pneumothorax
      2. cardiac tamponade
      3. superior vena cava syndrome
    5. has deep cervical lymph nodes located along it
      1. they drain all of the lymph from the head and neck
      2. the two groups are
        1. upper/superior deep cervical nodes (jugulodigastric)
        2. lower/inferior deep cervical nodes (jugulo-omohyoid)
  2. route
    1. it descends within the carotid sheath lateral to the carotid artery
29
Q

descrivbe the complication that arise from right tatrium obstructiton. What are three conditions that may lead to this?

A

the intternal jugular vein

  1. is the continuation of the sigmoid sinus, a dural venous sinus
  2. is the largest vein of the head and neck; it descends within the carotid sheath lateral to the carotid artery
  3. has dilations at its superior and inferior ends, the superior and inferior bulbs of the internal jugular vein
    1. the inferior bulb is located just above the union of the internal jugular vein with the subclavian vein tto form the brachiocephalic
  4. may become distended if venous return to the right atrium is obstructted
    1. tension pneumothorax
    2. cardiac tamponade
    3. superior vena cava syndrome
  5. has deep cervical lymph nodes located along it
    1. they drain all of the lymph from the head and neck
    2. the two groups are
      1. upper/superior deep cervical nodes (jugulodigastric)
      2. lower/inferior deep cervical nodes (jugulo-omohyoid)
30
Q

drain all the cervical lymph. define the following

  1. location
  2. categories
A

the intternal jugular vein

  1. is the continuation of the sigmoid sinus, a dural venous sinus
  2. is the largest vein of the head and neck; it descends within the carotid sheath lateral to the carotid artery
  3. has dilations at its superior and inferior ends, the superior and inferior bulbs of the internal jugular vein
    1. the inferior bulb is located just above the union of the internal jugular vein with the subclavian vein tto form the brachiocephalic
  4. may become distended if venous return to the right atrium is obstructted
    1. tension pneumothorax
    2. cardiac tamponade
    3. superior vena cava syndrome
  5. has deep cervical lymph nodes located along it
    1. they drain all of the lymph from the head and neck
    2. the two groups are
      1. upper/superior deep cervical nodes (jugulodigastric)
      2. lower/inferior deep cervical nodes (jugulo-omohyoid)
31
Q

descends within the carotid sheaths behind and between the carotid arteries and internal jugular veins.

name this item and involvement with the larynx, and lower part of the pharynx

A

vagus nerves(CN X)

  1. descends within the carotid sheaths behind and between the carotid arteries and internal jugular veins
  2. supply sensory innervation to the larynx and lower part of the pharynx
  3. innervate
    1. most muscles of the larynx, pharynx, and soft palate
    2. thoracic and abdominal organs
32
Q

nerve loop.

What does it innervate?

A
  1. nerves
    1. vagus nerves
      1. descends within the carotid sheaths behind and between the carotid arteries and internal jugular veins
      2. supply sensory innervation to the larynx and lower part of the pharynx
      3. innervate
        1. most muscles of the larynx, pharynx, and soft palate
        2. thoracic and abdominal organs
  2. other nerves in the anterior triangle
    1. Ansa cervicalis
      1. the nerve loop that innervates the infrahyoid muscles
      2. the cervical plexus forms the ansa cervicalis
        1. has a supperior root from C1 and an inferior root from C2-C3
          1. the nerve to the thyrohyoid (and glenihyoid) appear to branch from XII
        2. forms its nerve loop anywhere between the angle of the mandible and th clavivle
        3. gives rise to the most of the phrenic nerve to the diaphragm
          1. formed by the anterior rami of C3,C4,C5
        4. contributes proprioceptive nerve fibers to the SCM-C2 and Trap-C3 and C4
        5. gives cutaneous branch
    2. hypoglosal nerve (CNXII)
      1. innervates the muscles ofthe tongue, except for palatoglossus
33
Q

what innervates all the muscles of the tongue, except for ______?

A
  1. nerves
    1. vagus nerves
      1. descends within the carotid sheaths behind and between the carotid arteries and internal jugular veins
      2. supply sensory innervation to the larynx and lower part of the pharynx
      3. innervate
        1. most muscles of the larynx, pharynx, and soft palate
        2. thoracic and abdominal organs
  2. other nerves in the anterior triangle
    1. Ansa cervicalis
      1. the nerve loop that innervates the infrahyoid muscles
      2. the cervical plexus forms the ansa cervicalis
        1. has a supperior root from C1 and an inferior root from C2-C3
          1. the nerve to the thyrohyoid (and glenihyoid) appear to branch from XII
        2. forms its nerve loop anywhere between the angle of the mandible and th clavivle
        3. gives rise to the most of the phrenic nerve to the diaphragm
          1. formed by the anterior rami of C3,C4,C5
        4. contributes proprioceptive nerve fibers to the SCM-C2 and Trap-C3 and C4
        5. gives cutaneous branch
    2. hypoglosal nerve (CNXII)
      1. innervates the muscles ofthe tongue, except for palatoglossus
34
Q

forms the ansa cervicalis.

describe the root contributions.

A
  1. nerves
    1. vagus nerves
      1. descends within the carotid sheaths behind and between the carotid arteries and internal jugular veins
      2. supply sensory innervation to the larynx and lower part of the pharynx
      3. innervate
        1. most muscles of the larynx, pharynx, and soft palate
        2. thoracic and abdominal organs
  2. other nerves in the anterior triangle
    1. Ansa cervicalis
      1. the nerve loop that innervates the infrahyoid muscles
      2. the cervical plexus forms the ansa cervicalis
        1. has a supperior root from C1 and an inferior root from C2-C3
          1. the nerve to the thyrohyoid (and glenihyoid) appear to branch from XII
        2. forms its nerve loop anywhere between the angle of the mandible and th clavivle
        3. gives rise to the most of the phrenic nerve to the diaphragm
          1. formed by the anterior rami of C3,C4,C5
        4. contributes proprioceptive nerve fibers to the SCM-C2 and Trap-C3 and C4
        5. gives cutaneous branch
    2. hypoglosal nerve (CNXII)
      1. innervates the muscles ofthe tongue, except for palatoglossus
35
Q

describe the cervical plexus with respect to the mandible and the clavicle.

Gives rise to a nerve going to the diaphragm, what is it formed by?

What are the contributions to SCM and the traps?

A
  1. nerves
    1. vagus nerves
      1. descends within the carotid sheaths behind and between the carotid arteries and internal jugular veins
      2. supply sensory innervation to the larynx and lower part of the pharynx
      3. innervate
        1. most muscles of the larynx, pharynx, and soft palate
        2. thoracic and abdominal organs
  2. other nerves in the anterior triangle
    1. Ansa cervicalis
      1. the nerve loop that innervates the infrahyoid muscles
      2. the cervical plexus forms the ansa cervicalis
        1. has a supperior root from C1 and an inferior root from C2-C3
          1. the nerve to the thyrohyoid (and glenihyoid) appear to branch from XII
        2. forms its nerve loop anywhere between the angle of the mandible and th clavivle
        3. gives rise to the most of the phrenic nerve to the diaphragm
          1. formed by the anterior rami of C3,C4,C5
        4. contributes proprioceptive nerve fibers to the SCM-C2 and Trap-C3 and C4
        5. gives cutaneous branch
    2. hypoglosal nerve (CNXII)
      1. innervates the muscles ofthe tongue, except for palatoglossus
36
Q

the vagus nerve (CN X) innervates what structures in the face and rest of body?

A

vagus nerves(CN X)

  1. descends within the carotid sheaths behind and between the carotid arteries and internal jugular veins
  2. supply sensory innervation to the larynx and lower part of the pharynx
  3. innervate
    1. most muscles of the larynx, pharynx, and soft palate
    2. thoracic and abdominal organs
37
Q

Describe the subdivisions of the subclavian artery

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the anterior scalene
      2. second= posterior to it
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
38
Q

describe the branches ofthe first part of the subclavian artery

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
39
Q

describe the branches of the second division

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
      2. details
        1. take note of the anastamosis between
          1. deep cervical artery and descending branch of the occipital artery
          2. betweenthe carotid and subclavian
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
40
Q

what are some important anastamosis involving the subclavian branches?

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
      2. details
        1. take note of the anastamosis between
          1. deep cervical artery and descending branch of the occipital artery
          2. betweenthe carotid and subclavian
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
41
Q

describe the branches of the thirs part of the subclavian artery.

what is the route of this section?

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
      2. details
        1. take note of the anastamosis between
          1. deep cervical artery and descending branch of the occipital artery
          2. betweenthe carotid and subclavian
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
42
Q

this section of the subclavian artery extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib.

What is its importance in maintanance of bleeding?

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
      2. details
        1. take note of the anastamosis between
          1. deep cervical artery and descending branch of the occipital artery
          2. betweenthe carotid and subclavian
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
43
Q

one of the principle muscular landmarks in the neck. What is anterior tto it?

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
      2. details
        1. take note of the anastamosis between
          1. deep cervical artery and descending branch of the occipital artery
          2. betweenthe carotid and subclavian
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
44
Q

One of the principle muscular landmarks in the neck. What is posterior to it?

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
      2. details
        1. take note of the anastamosis between
          1. deep cervical artery and descending branch of the occipital artery
          2. betweenthe carotid and subclavian
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
45
Q

subclavian artery and vein arch across the ____ ____ and _____.

what is vulnerable during a subclavian venous puncture.

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
      2. details
        1. take note of the anastamosis between
          1. deep cervical artery and descending branch of the occipital artery
          2. betweenthe carotid and subclavian
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
46
Q

this arterial structure leaves an impression on the apex of an embalmed lung.

A

subclavian artery

  1. details
    1. dived into three partts relative to the anerior scalene muscle
      1. first = medial to the antterior scalene
      2. second= posterior to itt
      3. third=lateral to the anterior scalene
  2. parts
    1. first part
      1. has three branches
        1. vertebral artery
          1. ascending to the transverse foramen of C6
        2. internal thoracic artery
          1. descending into the mediastinum
        3. thyrocervical trunk
          1. 4 branches
            1. transverse cervical
            2. suprascapulat
            3. inferior thyroid
            4. ascending cervical
    2. second part
      1. one branch
        1. costocervical trunk-two branches
          1. deep cervical artery
          2. supreme/superior intercostal
      2. details
        1. take note of the anastamosis between
          1. deep cervical artery and descending branch of the occipital artery
          2. betweenthe carotid and subclavian
    3. third part
      1. one branch
        1. dorsal scapular artery
          1. goes to rhomboids and levator scapula muscles
      2. details
        1. extends between the lateral border of the anterior scalene muscle and the lateral border of the first rib
        2. may be compressed against the first rib in the supraclavicular triangle to control bleeding from the upper extremity

anterior scalene

  1. details
    1. is one of the principal muscular landmarks of the neck
    2. the subclavian arttery and vein arch acros the cervical pleura and apex of the lung
      1. this means the pleura and lung are vulnerable during a subclavian venous puncture
      2. subclavian artery causes a contact impression on the embalmed lung
    3. anterior to it
      1. phrenic nerve
      2. transverse cervical artery
      3. suprascapular artery
      4. subclavian vein
      5. ascending cervical artery
    4. posterior to it
      1. subclavian artery
      2. roots of the brachial plexus
47
Q

describe the midline structures that pose hazards during tracheostomy

  1. formed from confluence of superficial mandibular veins and arises near the hyoid bone and passes downward along the midline of the neck. feeds in the #2
  2. just superior to the manubrium, connects to the large connecting vein
A
  1. tracheosttomy
    1. midline strutures presenting potential hazards
      1. anterior jugular vein or a large communicating vein from the facial vein
      2. jugular venous arch
      3. isthmus of the thyroid gland
      4. inferior thryoid veins
      5. thyroid ima artery
      6. inchildren
        1. left brachiocephalic vein or
        2. thymus
    2. in the tracheoesophageal groove on each side is a recurrent laryngeal nerve
      1. the nerves of the two side supply all but one pair of the intrinsic muscles of the larynx
      2. the recurrent layrngeal nerves are in danger during thyroid surgery as well
48
Q

describe the midline structures that pose hazards during tracheostomy

3- bridge that connects this organ on both sides of the trachea

4-arises from unpaired thryoid plexus and descends to the brachicephalic vein

5-in 10% of people and delivers blood to the thyroid

6-something to consider for children

A
  1. tracheosttomy
    1. midline strutures presenting potential hazards
      1. anterior jugular vein or a large communicating vein from the facial vein
      2. jugular venous arch
      3. isthmus of the thyroid gland
      4. inferior thryoid veins
      5. thyroid ima artery
      6. inchildren
        1. left brachiocephalic vein or
        2. thymus
    2. in the tracheoesophageal groove on each side is a recurrent laryngeal nerve
      1. the nerves of the two side supply all but one pair of the intrinsic muscles of the larynx
      2. the recurrent layrngeal nerves are in danger during thyroid surgery as well
49
Q

recurrent laryngeal nerve is found where?

A
  1. tracheosttomy
    1. midline strutures presenting potential hazards
      1. anterior jugular vein or a large communicating vein from the facial vein
      2. jugular venous arch
      3. isthmus of the thyroid gland
      4. inferior thryoid veins
      5. thyroid ima artery
      6. inchildren
        1. left brachiocephalic vein or
        2. thymus
    2. in the tracheoesophageal groove on each side is a recurrent laryngeal nerve
      1. the nerves of the two side supply all but one pair of the intrinsic muscles of the larynx
      2. the recurrent layrngeal nerves are in danger during thyroid surgery as well
50
Q

found inside the tracheoesophageal groove. describe the destination and function.

A
  1. tracheosttomy
    1. midline strutures presenting potential hazards
      1. anterior jugular vein or a large communicating vein from the facial vein
      2. jugular venous arch
      3. isthmus of the thyroid gland
      4. inferior thryoid veins
      5. thyroid ima artery
      6. inchildren
        1. left brachiocephalic vein or
        2. thymus
    2. in the tracheoesophageal groove on each side is a recurrent laryngeal nerve
      1. the nerves of the two side supply all but one pair of the intrinsic muscles of the larynx
      2. the recurrent layrngeal nerves are in danger during thyroid surgery as well
51
Q

this srtructure is in danger during thyroid surgery.

A
  1. tracheosttomy
    1. midline strutures presenting potential hazards
      1. anterior jugular vein or a large communicating vein from the facial vein
      2. jugular venous arch
      3. isthmus of the thyroid gland
      4. inferior thryoid veins
      5. thyroid ima artery
      6. inchildren
        1. left brachiocephalic vein or
        2. thymus
    2. in the tracheoesophageal groove on each side is a recurrent laryngeal nerve
      1. the nerves of the two side supply all but one pair of the intrinsic muscles of the larynx
      2. the recurrent layrngeal nerves are in danger during thyroid surgery as well
52
Q

passes behind th sttructures in the left carotid sheath.

decribe it with respect to the venous angle

A
  1. the thoracic duct
    1. passes behind tthe structures in the left carotid sheath
    2. it loops anteriorly and inferiorly to end in or near the junction of the left intternal jugular and subclavian veins (left venous angle)
  2. right lymphatic ductt
    1. on the right side of the root of the neck
    2. the right lymphattic duct is formed by the union of the righr jugular, subclavian and bronchomediastinal lymphatic trunks
    3. it drains into the right venous
53
Q

formed by the union of the right jugular, subclavian and _______.

what does it drain into?

A
  1. the thoracic duct
    1. passes behind tthe structures in the left carotid sheath
    2. it loops anteriorly and inferiorly to end in or near tha junction of the left intternal jugular and subclavian veins (left venous angle)
  2. right lymphatic duct
    1. on the right side of the root of the neck
    2. the right lymphattic duct is formed by the union of the righr jugular, subclavian and bronchomediastinal lymphatic trunks
    3. it drains into the right venous