Neck Flashcards
What are the boundaries of the anterior triangle?
- Anterior: Midline of the neck
- Posterior: Anterior border of sternocleidomastoid
- Superior: Lower border of mandible
- Inferior: Suprasternal notch
What are the divisions of the anterior triangle?
- Digastric triangle
- Muscular triangle
- Carotid triangle
What are the contents of the digastric triangle?
Submandibular glands
What are the contents of the carotid triangle?
- Common/internal carotid arteries (no branches)
- External carotid artery
- Internal jugular vein
- Vagus nerve
What are the contents of the muscular triangle?
- Sternohyoid
- Sternothyroid
- Thyrohyoid
- Thyroid/parathyroid glands
- Larynx
- Trachea
- Pharynx
- Oesophagus
What are the boundaries of the posterior triangle?
- Anterior: Posterior border of sterncleidomastoid
- Posterior: Anterior border of trapezius
- Inferior: Middle 1/3 of clavicle
What are the contents of the posterior triangle?
- Deep cervical lymph nodes
- Roots and trunks of the brachial plexus
- Phrenic nerve
- Cervical plexus
- Accessory nerve (XI)
- Subclavian artery
What are the compartments of the neck?
- Visceral compartment: Contains the endocrine glands, oesophagus and trachea.
- Vertebral compartment: Vertebrae, nerves and muscles of the vertebrae.
- Vascular compartment: Contains the internal jugular vein, common carotid artery and vagus nerve.
What is the muscle within the superficial fascia of the neck?
Platysma
What are the important fascia in the neck?
- Investing layer of deep tracheal fascia
- Pretracheal fascia
- Prevertebral fascia
- Carotid sheath
What are the attachments of the investing layer?
Superior: External occipital protuberance, superior nuchal line.
Lateral: Mastoid process.
- Inferior: Spine of scapula, acromion, clavicle, manubrium.
What are the attachments of the pre-tracheal fascia?
Thyroid cartilage, 2nd-4th tracheal rings, hyoid bone.
What are the attachments of the pre-vertebral fascia?
Superior: Forms circular ring around base of skull; attaching anteriorally to basilar part of occipital bone, laterally to mastoid process and posteriorally to ligamentum nuchae.
What are the relations of structures in the carotid sheath?
- Lateral: Internal jugular vein
- Anteromedial: Common carotid artery
- Posteromedial: Vagus nerve
Where does the common carotid artery bifurcate?
C4
What is the retropharyngeal space?
- Space bound by buccopharyngeal fascia anteriorly and pre-vertebral fascia posteriorly.
- Connection between neck and thorax through which infections can spread.
What are the suprahyoid muscles?
- Digastric
- Stylohyoid
- Mylohyoid
- Geniohyoid
What is the arterial supply to the thyroid artery?
- Superior thyroid artery (branch of external carotid artery): Bifurcates into superior/inferior glandular branches
- Inferior thyroid artery (branch of thyrocervical trunk, from subclavian artery): Bifurcates into the inferior branch and the ascending branch (supplies the parathyroid glands)
- Thyroid ima artery
What is the venous drainage of the thyroid artery?
- Superior thyroid vein (internal jugular vein)
- Middle thyroid vein (internal jugular vein)
- Inferior thyroid vein (left brachiocephalic vein)
What is the lymphatic drainage of the neck?
- The superficial cervical lymph nodes are associated with the external jugular vein.
- The deep cervical lymph nodes are associated with the internal jugular vein.
- The deep cervical lymph nodes are separated into the upper and lower groups by the tendon of the omohyoid.
- The most prominent upper node is the jugulodigastric node draining the tongue, tonsils, thyroid, lower pharynx, larynx.
- The most prominent lower node is the jugulo-omohyoid node draining the thyroid, larynx and oesophagus.
What is the composition of the carotid sheath?
- Areolar tissue
- Strong over carotid arteries and weak over internal jugular vein to allow for distension
What are the major sympathetic ganglia in the neck?
- Inferior cervical ganglion: Fuses with upper thoracic ganglion to form stellate ganglion. Forms plexus associated with the subclavian artery.
- Middle cervical ganglion: Closely associated with inferior thyroid artery.
- Superior cervical ganglion: Lies opposite atlas/axis and forms plexuses associated with the internal/external carotid arteries.
- All 3 ganglia give branches to the cardiac plexuses.
What is the innervation of the infrahyoid muscles?
C1-C3 (ansa cervicalis)
What are the relations of the thyroid to the trachea?
Lies between 2nd and 4th tracheal cartilage
What are the origins of the external jugular vein?
- Retromandibular vein
- Posterior auricular vein
What are the surface markings of the internal jugular vein?
Ear lobe to sternoclavicular joint
What are the surface markings of the external jugular vein?
Ear lobe to midpoint of clavicle
What are the surface markings of the accessory nerve?
Line from 1/3 down posterior border of sternocleidomastoid to line 1/3 up anterior border of trapezius
