Neck Flashcards
Platysma muscle
Superficial muscle originating from the clavipectoral fascia. It courses superiorly over the neck and then inserts into the skin around the chin and mouth
What nerve innervates the platysma muscle?
Cervical branch of the fascial nerve.
Investing Layer of Dense Connective tissue
A sleeve binding ALL structures in the neck. It encompasses the SCM muscle and the Trapezius muscle.
Infrahyoid Fascia
It covers the supra and infrahyoid muscles (called the strap muscles)
Pretracheal Fascia
Viscera covered with a layer of fascia including the thyroid, parathyroid, trachea, and esophagus
Carotid Sheath
Carotid Artery
Internal Jugular Vein
Vagus Nerve
Prevertebral (Deep cervical) Fascia
Covers the vertebral musculature
Superficial muscles of the neck
- ) SCM- tilts head to side; laterally flexes neck and rotates head toward opposite side (and somewhat superiorly)
- ) Trapezius
What are the borders of the Anterior Triange?
Superiorly: Inferior border of the mandible
Posteriorly: SCM
Anteriorly: Anterior median
What muscles divide the anterior triangle into four smaller triangles?
- ) Omohyoid Muscle (Superior Belly)
2. ) Digastric Muscle ( Anterior and Posterior Belly)
Submental Triangle Borders
Inferior: hyoid bone
Left: Anterior belly of the digastric muscle
Right: Anterior belly of the digastric muscle
Submandibular Triangle (Digastric Triangle)
Superior: Inferior border of the mandible
Posteriorinferior: Posterior belly of the digastric muscle
Anteroinferior: Anterior belly of the digastric muscle
Carotid Triangle
Posterior: Anterior surface of the SCM
Anterosuperior: Posterior belly of the digastric muscle
Anteroinferior: Superior belly of the omohyoid muscle.
Muscular Triangle (omotracheal triangle)
Anterior: Anterior median line
Posterosuperior: Superior belly of the omohyoid muscle
Posterioinferior: SCM
Suprahyoid Muscles
These are the muscles within the submandibular triangle.
- ) Digastric muscle (Which is divided into anterior and posterior bellies by a FASCIAL SLING)
- ) Stylohyoid
- ) Mylohyoid
- ) Geniohyoid
Suprahyoid Muscles
There are a total of 5 muscles these are the muscles within the submandibular triangle.
- ) Digastric muscle (Which is divided into anterior and posterior bellies by a FASCIAL SLING)
- ) Stylohyoid- splits and wraps around the intermediate tendon of the digastric muscle
- ) Mylohyoid- forms the floor of the oral cavity
- ) Geniohyoid- lies deep to the mylohyoid muscle
What nerve is the Geniohyoid muscle innervated by?
C1 root of the ansa cervicalis
What is the function of the mylohyoid
Helps to raise the tongue
What is the function of the mylohyoid?
Helps to raise the tongue
What is the function of the suprahyoid muscles?
They function to raise the hyo-laryngeal complex during swallowing and vocalization. They also assist in depression of the mandible (jaw opening)
Which triangle does the suprahyoid muscles lie in?
Submandibular triangle.
Which muscles are the infrahyoid muscles?
- ) Superior belly Omohyoid
- ) Inferior belly Omohyoid
- ) Sternohyoid
- ) Sternothyroid
- ) Thyrohyoid
what is the function of the fibrous sling in the infrahyoid muscles?
Holds down the intermediate tendon of the omohyoid muscle to the clavicle
What is the function of the infrahyoid muscles?
Lower either the hyoid or thyroid cartilage
What nerve innervates most of the infrhyoid muscles? What muscle is the exception? What nerve is this muscle exception innervated by?
The ansa cervicalis C1-C3.
Muscle exception = thyrohyoid
The thyrohyoid is innervated by the nerve to the thyrohyoid which comes directly from C1
What muscles does the facial nerve (Cranial nerve VII) innervate?
- ) Posterior belly of the digastric
2. )Stylohyoid
What muscles does the nerve to the mylohyoid (Nerve V3) innervate?
- ) Anterior belly of the digastric
2. ) Mylohyoid muscle
What muscles does the ansa cervicalis innervate?
- ) Sternohyoid muscle
- ) Sternothyroid muscle
- ) Omohyoid muscle (both)
What muscles does C1 innervate?
Note: C1 is traveling with the hypoglassal nerve
- ) Thyrohyoid
2. ) Geniohyoid
What can you find in the submandibular triangle?
- ) Submandibular gland
- ) Mylohyoid Nerve (V3)
- ) Hypoglassal Nerve (XII)
- ) Facial Artery (passing deep through the submandibular gland)
- ) Facial Vein (Passing superficial to the submandibualr gland)
- ) Lingual Artery
- ) Lingual Nerve
What can you find in the submental triangle?
The submental triangle contain lymph nodes and small veins that unite to form the anterior jugular vein
What vessels are in the Carotid Triangle?
1.) Superior portion of the common carotid
2.) A large part of the Internal carotid.
3.) External Carotid Artery and it branches
Superior Thyroid Artery
Ascending Pharyngeal Artery
Lingual Artery
Facial Artery
Occipital Artery
Posterior Auricular Artery
Superficial Temporal Artery
Maxillary Artery
What muscles are the external carotid artery responsible for supplying?
The external carotid artery is responsible for supplying the neck, superficial face, and the deep face.
What artery gives off the Transverse Facial Artery?
Superficial Temporal Artery
What artery gives off the Superior Laryngeal Artery?
Superior Thyroid Artery
What are the branches of the external Carotid?
mneumonic- Some Angry Lady figured out PMS.
Superior Thyroid Artery Ascending Pharyngeal Artery Lingual Artery Facial Artery Occipital Artery Posterior Auricular Artery Superficial Temporal Artery Maxillary Artery
What nerves are in the carotid triangle?
- ) Vagus Nerve (X)- It runs between the internal jugular vein and the internal carotid artey.
- ) Spinal accessory Nerve (XI)- Enters the carotid triangle from behind the posterior belly of digastric
- ) Hypoglossal Nerve (XII) - Also enters from behind the posterior belly of digastric. It then loops into the floor of the mouth.
4.) Cervical Sympathetic Trunk- Located behind the posterior wall of the carotid sheath.
Here we can see the superior, middle, and inferior cervical ganglia.
What nerve branches does the Vagus Nerve give off?
- ) Pharyngeal branch
- ) Superior Laryngeal nerve
a. ) Internal Laryngeal nerve
b. ) External Laryngeal nerve - ) Nerve to the Carotid Body
- ) Cardiac Nerves
- ) Recurrent Laryngeal Nerve
a. ) On the right loops around the subclavian artery
b. ) On the left wraps around the arch of the aorta
Note: On the right side the recurrent Laryngeal nerve provides motor innervation to all of the muscles of vocalization with the exception of the circothyroid muscle.
What nerve innervates the cricothyroid muscle?
External laryngeal nerve
What nerve innervates all of the muscles of vocalization with the exception of the cricothyroid muscle?
Right recurrent laryngeal nerve.
Cervical Sympathetic Ganglia
- ) Superior- C1-C4 Large ganglion that supplies structures of the head via the internal carotid plexus.
- ) Middle - C5-C6
- ) Inferior C7-C8
What can present if the sympathetic chain in the neck is interrupted?
Horner’s Syndrome
What is Horner’s syndrome?
Marked by ptosis of the effected eyelid; miosis of the affected pupil; and anhydrois (lack of sweating) on the affected side.
Subclavian Artery Branches marked by Anterior Scalene Musclce.
Braches of the subclavian artery
V = vertebral
I = internal thoracic (mammary) artery
T = thyrocervical trunk
1.) Inferior thyroid artery,
2.) Ascending Cervical artery
3.) Transverse Cervical artery
4.)suprascapular artery,
C = costocervical trunk
1. ) supreme intercostal artery 2. ) deep cervical artery
D = dorsal scapular artery
Where does the lymphatics of the face and head drain? Elaborate.
Inferiorly into the pericervical lymphatic collar. The collar consist of a series of connected lymph nodes which form a chain that encircles the junction of the head and neck.
The following lymph nodes make up the collar:
- ) Occipital nodes
- )Postauricular nodes
- ) Preauricular nodes
- ) Buccal
- ) Submandibular nodes
- ) Submental nodes
There is only ONE thoracic duct. Where is it located? Where does it receive lymphatic drainage from? Where does it dump its fluids back into the main circulatory system?
Thoracic duct located on the LEFT SIDE ONLY. Receives lymphatic drainage from the entire body except the right head, neck, upper extremity and thorax.
The thoracic duct enters the venous system at the junction of the left internal jugular vein and left subclavian vein.
On the right side it enters at the right internal jugular, or right subclavian vein.
Where does the right lymphatic duct empty? What lymph is it draining?
Right neck, head, upper arm and thorax. It enters into the right internal jugular, or right subclavian vein.
what is cervical pleura aka cupula
It is an area in the neck region where the membraneous covering of the lung(pleura) can be seen extending approximtately one inch above the medial third of the clavical.
What arteries supply the thyroid gland? What are they branches of?
The superior and inferior thyroid arteries. A branch of the external carotid artery and a branch of the thyrocervical trunk of the subclavian artery respectively.
How does sympathetic and parasympathetic supply reach the thyroid gland?
Sympathetic: via the middle cervical ganglion
Parasympathetic: supplied by the laryngeal branches of the vagus nerve.
How many parathyroid glands do we have? Where are they loacted? What do they secrete?
Four. Located on the posterior aspect of the thyroid gland.
They secrete parathyroid hormone, a small protein that regulates calcium and phosphorus homeostasis.
Take a moment to appreciate how important calcium regulation is.
Prevertebral Muscles
These muscles lie deep to the prevertebral fascia
Anterior Group:
- Longus coli
- Longuscapitis
- Rectus capitas anterior
- Anterior Scalene
Lateral Group:
- Rectus capitis lateralis
- Splenius Capitis
- Levator Scapulae
- Middle and Posterior Scalenes
What is the relationship between the facial artery, facial vein and the submandibular gland?
They can all be found in the submandibular triangle?
The facial artery lies deep to the submandibular gland while the facial vein lies superficial to the submandibular gland.
How many nerves should we find in the submandibular triangle? Which ones are they?
Hypoglossal nerve
Facial nerve
Lingual nerve
Nerve to the mylohyoid
Which three of the arteries branching from the external carotid branch off posteriorly?
- Ascending Laryngeal artery
- Occipital artery
- Posterior auricular artery