Neck

Question 1

Superiorly, the investing layer of deep cervical fascia attaches to what?

Answer 1

Superior nuchal lines, mastoid process of temporal bone, zygomatic arches, inferior border of mandible, hyoid bone, spinous processes of cervical vertebrae.

Question 2

Deep cervical fascia consists of which layers?

Answer 2

Investing, pretracheal, prevertebral

Question 3

The SCMs produce movement at which joints?

Answer 3

Craniovertebral joints, cervical intervertebral joints.

Question 4

Main structures in Sternocleidomastoid region

Answer 4

SCM muscle, EJV, great auricular nerve, transverse cervical nerve.

1. Lesser supraclavicular fossa: IJV.

Question 5

Main contents of Posterior cervical region

Answer 5

Trapezius, cutaneous branches of posterior rami of cervical spinal nerves.

Question 6

Main contents of lateral cervical region

Answer 6

1. Occipital triangle: EJV, posterior branches of cervical plexus, CNXI, brachial plexus, cervicodorsal trunk, cervical lymph node.
2. Omoclavicular (subclavian) triangle: Subclavian a. (3rd part), suprascapular artery, supraclavicular lymph nodes.

Question 7

Main contents of anterior cervical regions

Answer 7

1. Submandibular (digastric) triangle: submandibular gland, hypoglossal nerve, mylohyoid nerve, facial a. and v.
2. Submental triangle: submental lymph nodes.
3. Carotid triangle: carotid sheath and its contents, superior root of ansa cervicalis, CNXI, thyroid gland, larynx and pharynx, deep cervical lymph nodes, branches of cervical plexus.
4. Muscular (omotracheal) triangle: Sternothyroid and sternohyoid muscles, thyroid and parathyroid glands.

Question 8

Sternocleidomastoid

Answer 8

Superior: Mastoid process of temporal bone, lateral half of superior nuchal line.

Inferior: Sternal head: manubrium. Clavicular head: medial third of clavicle.

N: CNXI (motor), C2, C3 (pain and proprioception).

Question 9

Trapezius

Answer 9

Superior: superior nuchal line, external occipital protuberance, nuchal ligament, spinous processes of C7-T12, lumbar and sacral spinous processes.

Inferior: Lateral third of clavicle, acromion, and spine of scapula.

N: CNXI (motor), C2 and C3 (pain and proprioception).

Question 10

Boundaries of posterior triangle

Answer 10

Anteriorly: SCM.
Posteriorly: Trapezius.
Inferiorly: Middle third of clavicle.
Apex: Where SCM and trapezius meet on superior nuchal line.
Roof: investing layer of deep cervical fascia.
Floor: muscles covered by prevertebral layer.

Question 11

At which vertebral level is the thyroid gland?

Answer 11

C5-T1, deep to sternothyroid and sternohyoid muscles.

Question 12

Over which tracheal ring does the isthmus of thyroid gland unite its right and left lobes?

Answer 12

Anterior to 2:nd and 3rd tracheal ring.

Question 13

Muscles of pharynx

Answer 13

External layer: Superior pharyngeal constrictor, Middle pharyngeal constrictor, Inferior pharyngeal constrictor.

Internal layer: Palatopharyngeus, Salpingopharyngeus, Stylopharyngeus.

Question 14

All the muscles of the pharynx receives innervation from pharyngeal branch of vagus except for one, which one and in which layer is it?

Answer 14

Stylopharyngeus, innervated by glossopharyngeal nerve CNIX. Internal layer.

Question 15

Main action of the external layer of muscles of pharynx

Answer 15

Constricts walls of pharynx during swallowing.

Question 16

Main action of the internal layer of muscles of pharynx

Answer 16

Elevate (shorten and widen) pharynx and larynx during swallowing and speaking.

Question 17

Which muscles open the pharyngotympanic tube during swallowing?

Answer 17

Tensor veli palatini, Levator veli palatini, Salpingopharyngeus, Tensor tympani.

Question 18

Larynx is located at what vertebral level?

Answer 18

C3-C6

Question 19

Cartilaginous boundaries of the laryngeal inlet

Answer 19

Epiglottic cartilage, Cuneiform cartilage, Corniculate cartilage, Arytenoid cartilage (posterior surface, muscular process).

Question 20

What is the aperture between vocal folds called?

Answer 20

Rima glottidis

Question 21

Space between the vestibular ligaments is called?

Answer 21

Rima vestibuli

Question 22

Muscles of larynx and their main action

Answer 22

Cricothyroid - streches and tenses vocal ligament.
Thyro-arytenoid - relaxes vocal ligament.
Posterior crico-arytenoid - abducts vocal folds.
Lateral cricoarytenoid - adducts vocal folds.
Transverse and Oblique arytenoids - Adduct arytenoid cartilages, “real phonation”.
Vocalis - Relaxes posterior vocal ligament while maintaining tension of anterior part, “fine regulation”.