Neck

Question 1

Spinal accessory nerve

Answer 1

Passes deep to the SCM, supplying it before entering the lateral cervical region at or inferior to the junction of the superior and middle thirds of the posterior border of the SCM.

Question 2

Suprascapular nerve

Answer 2

Arises from the superior trunk of the brachial plexus, runs across her lateral cervical region to supply the supraspinatus and infraspinatus muscles on the posterior aspect of the scapula

Also sends articular branches to the glenohumeral joint

Question 3

Lesser occipital nerve

Answer 3

(C2) supplying the skin of the neck and scalp posterosuperior to the auricle

Question 4

Great auricular nerve

Answer 4

(C2 & C3), ascending vertically across the SCM onto the parotid gland, where it divides and supplies the skin and sheath over the gland, posterior aspect of triangle, and the area of the skin overlying the angle of the mandible to the mastoid process

Question 5

Transverse cervical nerve

Answer 5

(C2 & C3), supplying the skin coveting the anterior cervical region: the nerve curves around the middle of the posterior border of the SCM and passes anteriorly and horizontally across it, deep to the external jugular vein (EJV) and platysma

Question 6

Supraclavicular nerves

Answer 6

(C3 &C4) emerge as s common trunk under cover of the SCM and send small branches to the skin of the neck and cross the clavicle to supply the skin over the shoulder

Question 7

Regions of the neck

Answer 7

SCM region
Posterior cervical region
Lateral cervical region/posterior triangle
Anterior cervical region

Question 8

Major landmark of the posterior region ?

Answer 8

Descending part of trapezius

Question 9

Borders of the posterior triangle

Answer 9

Anterior superior border provinces of the trapezius
Posterior border of SCM
Inferior border of the clavicle

**suboccipital triangle in the posterior triangle region

Question 10

Phrenic nerve

Answer 10

Originates chiefly from the C4 nerve but also has contributions from the C3 and C5 nerves

Forms at the anterior scalene muscle at the level of the superior border of the thyroid cartilage

Contains sensory, motor, and parasympathetic nerve fibers

Main nerve innervating diaphragm

Question 11

Accessory phrenic nerve

Answer 11

Contribution from C5

Joins the phrenic nerve in the root of the neck or the thorax

Question 12

External jugular vein (EJV)

Answer 12

Begins near the angle of the mandible (inferior to the auricle of the external ear) by the Union of the posterior division of the retromandibular vein and the posterior auricular vein

Crosses the SCM obliquely, deep to the platysma, and pierces the investing layer of deep cervical fasciae, which forms the roof of the region at the posterior border of the SCM

Question 13

Subclavian vein

Answer 13

Major venous channel draining the upper limb

Courses through the inferior part of the lateral cervical region, passing anterior to the anterior scalene muscle and phrenic nerve

Question 14

Brachiocephalic vein

Answer 14

Formed by the junction of the subclavian vein to the internal jugular vein posterior to the medial end of the clavicle

Question 15

Lateral cervical region arteries

Answer 15

Cervicodorsal trunk (transverse cervical artery)
Suprascapular artery
Part of the occipital artery
Third part of the subclavian artery

Question 16

Cervicodorsal trunk (transverse cervical artery)

Answer 16

Originates from the thyrocervical trunk (branch of subclavian artery) and divides into the superficial cervical and dorsal scapular arteries

Runs superficially and laterally across the phrenic nerve and anterior scalene muscle two to three cm superior to the clavicle
Then crosses the trunk of the brachial plexus supplying branches of the vasa nervosum and passing deep to the trapezius

Question 17

Suprascapular artery

Answer 17

Arises from the transverse cervical artery or directly from the subclavian artery, and crosses the third part of the subclavian artery and the cords of the brachial plexus
Then passes posterior to the clavicle to supply muscles on the posterior aspect of the scapula

Question 18

Occipital artery

Answer 18

Branch of the external carotid artery, crosses the apex of the lateral cervical triangle ascending to supply the posterior half of the scalp

Question 19

Third part of the subclavian artery

Answer 19

Supplies blood to the upper limb

Begins superior to the clavicle opposite the lateral border of the anterior scalene muscle
Lies posterosuperior to the subclavian vein in the inferior part of the lateral cervical region

**felt via deep pressure in the omiclaviular triangle superior to the clavicle

Artery in contact with 1st rib so compression of the artery can control bleeding of the upper limb

Question 20

Platysma

Answer 20

Origin : inferior border of the mandible,skin, and subcutaneous tissue of the lower face
Insertion : fasciae covering superior parts of the pectoralis major and deltoid muscles
Innervation : cervical branch of facial nerve (CN VII)
Action : draws corners of mouth inferiorly and widens it as in expressions of sadness and fright ; draws skin of neck superiorly when teeth are clenched indicating tension

Question 21

Sternocleidomastoid (SCM)

Answer 21

Origin : lateral surface of mastoid process of temporal bone and lateral half of the superior nuchal line
Insertion : sternal head (rounded tendon ) - anterior surface of
manubrium of sternum
clavicular head (thicker) - superior surface of medial third of
clavicle
Innervation: spinal accessory nerve (CN XI : motor) C2 & C3 nerves
Action : unilateral contraction - tilts head to same side (same side
lateral flexion) and rotates it so face is turned superiorly
towards opposite site
bilateral contraction -1. extends head at atlanto-occipital joints
2. Flexes cervical vertebrae so that chin
approaches manubrium
3. Extends superior cervical vertebrae
while flexing inferior vertebrae so chin
is thrust forward with head kept level
*with cervical vertebrae fixed, may elevate manubrium and medial end of clavicles, assisting pump-handle action of deep respiration l

Question 22

Omohyoid

Answer 22

Origin : superior border of the scapular near the suprascapular notch
Insertion : inferior border of hyoid
Innervation: C1-C3 by a branch of the ansa cervicalis
Action : depresses, retracts, and steadies hyoid