Neck Flashcards
Anterior longitudinal ligament
Reinforces anterior discs, limits extension
Posterior longitudinal ligament
Reinforces posterior discs, limits flexion
Ligamentum nuchae = supraspinous ligament
Thicker than in thoracic/lumbar regions
Limits flexion
Interspinous/intertransverse ligaments
Limit flexion and rotation/limits lateral flexion
Ligamentum flavum
Attach lamina of one vertebrae to another, reinforces articular facets
Limits flexion and rotation
Whiplash
flexion on extension injury
Platysma
- Extends over front and side of neck
- Originates from subcutaneous tissue over the pectoralis major and deltoid and inserts on the lower border of the mandible and muscles around the mouth
- Depresses lower jaw and lip and angle of mouth, wrinkles skin of neck
External Jugular Veins
- Formed by joining of posterior auricular vein and retromandibular vein
- Inferior course, superficial to sternocleidomastoid
- Drain into subclavian vein
Anterior Jugular Veins
Drain anterior aspect of neck
Drain into subclavian vein
Anterolateral Neck Muscles
Sternocleidomastoid
Posterior Neck Muscles
Semispinalis capitis, Splenius capitis, Trapezius
Sternocleidomastoid Muscle
- divides neck into anterior and posterior triangles
- sternal & clavicular head insert onto mastoid process
Sternocleidomastoid Muscle innervation
Innervation is spinal accessory nerve (CN XI)
Sternocleidomastoid Muscle action
- Acting together, muscles flex cervical part of vertebral column
- Contraction of one muscle pulls ear down to tip of shoulder on same side and rotates head so that face looks upward to the opposite side
Bony and Cartilagenous Contents
- hyoid bone (C3 level)
- thyroid cartilage (C3/C4 level)
- cricoid cartilage (C5/C level)
- thyrohoid membrane
- cricothyroid membrane
Throhyoid membrane
Between hyoid bone and thyroid cartilage
Cricothyroid membrane
Between thyroid cartilage and cricoid cartilage
Larynx
Organ of voice production and part of respiratory tract between lower part of pharynx and trachea
Cartilages of larynx
thyroid cartilage
cricoid cartilage
epiglottis
Goiter
- enlargement of thryoid gland
- can compress structures such as: trachea, larynx and esophagus
- iodine deficiency
- treated with radioactive iodine
Part I of subclavian artery
vertebral artery
internal thoracic artery
thyrocervical trunk
Part II of subclavian arterty
costcocervical trunk
Part III of subclavian trunk
suprascapular artery
Anterior triangle boundaries
- anterior border of SCM
- midline of neck
- inferior border of manible
- roof=platysma and investing layer of deep cervical fascia
Stylohyoid muscle
styloid process to hyoid
Stylohyoid muscle innervation
CN VII
Stylohyoid muscle action
Elevates and retracts hyoid during swallowing; elongates floor of mouth
Digastric muscle
mandible to mastoid
Digastric muscle innervation
CN V3 and CN VIII
Digastric muscle action
Depresses mandible against resistance or elevates hyoid bone during swallowing or eating
Suprahyoid muscles
- stylohyoid
- digastric
- mylohyoid
- geniohyoid
Infrahyoid muscles
- omohyoid
- sternohyoid
- throhyoid
- sternothyroid
Omohyoid muscle
superior border of scapula to hyoid
-has 2 bellies connected by intermediate tendon attached to clavicle by fibrous sling
Omohyoid muscle innervation
C1-C3 ansa cervicalis
Omohyoid action
depresses and fixes hyoid
Sternohyoid muscle
manubrium and medial clavicle to hyoid bone
Sternohyoid innervation
C1-C3 ansa cervicalis
Sternohyoid action
depresses hyoid after elevation during swallowing
Thyrohyoid muscle
oblique line of thyroid cartilage to hyoid bone
Thyrohyoid innervation
C1 via XII
Thyrohyoid action
depresses hyoid and elevates larynx
Sternothyroid muscle
posterior manubrium to oblique line of thyroid cartilage
Sternothyroid innervation
C-C3 ansa cervicalis
Sternothyroid action
depresses hyoid and larync
Anterior common cartoid arteries
- bifurcate at upper border of thyroid cartilage (C4 level)
- internal carotid
- external carotid
Internal Carotid
no branches in neck and ascends and enters cranium through carotid canal to supply brain
External Carotid
supplies most structures external to the cranium including: structures in neck, face, scalp, tongue and maxilla
Anterior triangle veins
Tributaries of Internal Jugular Vein (IJV)
IJV leaves anterior triangle by passing deep to SCM muscle
Anterior triangle nerves
transverse cervical nerve (C2 and C3) hypoglossal nerve (CN XII)
transverse cervical nerve
skin over anterior cervical region
hypoglossal nerve
motor nerve of tongue
enters submandibular triangle deep to posterior belly of digastric muscle
Posterior triangle border
SCM
trapezius
clavicle
Floor of posterior triangle
prevertebral fascia covering:
- splenius capitis
- levator scapulae
- middle scalene
- posterior scalene
Roof of posterior triangle
platysma and deep cervical fascia
Nerves of posterior triangle
- spinal accessory (CN XI)
- roots of brachail plexus (C5-T1)
- cervical plexus (C1-C4)
Ansa cervicalis (C1,C2,C3)
innervates strap muscles (omohyoid, sternohyoid muscles)
Phrenic Nerve (C3-C5)
- mainly C4
- motor to diaphragm and sensory to central part
Anterior vertebral muscles
- longus colli
- longus capitis
- rectus capitis anterior
- anterior scalene
Longus colli attachments
runs between cervical and upper thoracic vertebrae
Longus colli innervation
anterior rami C2-C6
Longus colli action
flexes neck
Longus capitis attachments
from occipital bone to transverse processes C3-C6
longus capitis innervation
anterior rami C1-C3
longus capitis action
flexes head
Rectus capitis anterior attachments
base of cranium to C1
rectus capitis anterior innervation
C1 and C2 spinal nerves
rectus capitis anterior action
flexes head
anterior scalene attachments
transverse processes C3-C6 to first rib
Anterior scalene innervation
C4-C6 spinal nerves
Anterior scalene actions
flexes head
Lateral vertebral muscles
- rectus capitis lateralis
- middle scalene
- posterior scalene
- splenius capitus
- levator scapulae
Rectus capitis lateralis attachments
occipital bone to transverse process C1
Rectus capitis lateralis innervation
C1 and C2
Rectus capitis lateralis actions
flexes head and stabilization
Middle scalene attachments
transverse processes of C2-C7 to first rib
Middle scalene innervation
anterior rami of cervical spinal nerves
Middle scalene actions
Flexes neck laterally; elevates first rib during forced inspiration
Posterior scalene attachments
transverse processes of C5-C7 to second rib
Posterior scalene innervation
anterior rami of cervical spinal nerves
Posterior scalene action
Flexes neck laterally; elevates second rib during forced inspiration
Splenius Capitus attachments
Inferior nuchal ligament and spinous processes of T1-T6 to mastoid process and lateral nuchal line
Splenius Capitus Innervation
posterior rami of middle cervical spinal nerves
Splenius Capitus actions
Unilateral: Laterally flexes and rotates head and neck to same side
Bilaterally: extends head and neck
Levator Scapulae attachments
Transverse processes of C2-C6 to superior part of medial border of scapula
Levator Scapulae innervation
dorsal scapular nerve C5
Levator scapulae action
elevates scapula
Vagus Nerve (CN X)
-descend through neck in carotid sheath & posterior to sternoclavicular joint to enter thoracic cavity
Phrenic Nerve (C4-C5)
- formed at lateral border of anterior scalene muscle
- descend between subclavian arteries and veins to enter thorax on each side of mediastinum
Mylohyoid muscle
mandible to body of hyoid
Mylohyoid action
Elevates hyoid, floor of mouth and tongue during swallowing and speaking
Mylohyoid innervation
CN V3
Geniohyoid muscle
mandible to hyoid
Geniohyoid action
Pulls hyoid anterosuperiorly; shortens floor of mouth; widens pharynx
Geniohyoid innervation
C1 via CN XII