Neck Flashcards
Describe the borders of anterior triangle
Midline
Inferior border of mandible
medial border of sternocleidomastoid
Can be further divided into 4 triangles
How can anterior triangle be further divided?
Submental
Submandibular
Carotid
Muscular
Submental
Midline
Hyoid bone
anterior belly of digastric
contains the mylohyoid muscle, Lymphn nodes
Submandibular
Inferior border of mandible
Anterior & posterior belly of digastric
Contains the submandibular gland, lingual nerve, hypoglossal nerve
Facial artery
Carotid
Medial border of sternocleidomastroid
posterior belly of digastric
superior belly of omohyoid
Contains the carotid sheath and hypoglossal nerve
Muscular
Medial border of sternocleidomastoid
superior belly of omohyoid
midline
contains the midline organs, thyroid, parathyroid, larynx, trachea, infrahyoid muscle
Describe the borders of the posterior triangle
Anterior margin of trapezius
superior border of clavicle
lateral border of sternocleidomastoid
Covered by investing layer of fascia and floor formed by prevertebral fascia
Content of posterior triangle
Muscles - scalene, levator scapulae, splenius capitis
Vascular - EJV (formed by retromandibular and posterior auricular vein)
Nerves - Spinal accessory nerve, cervical plexus
Fascial layers of the neck
Investing fascia
Pretracheal fascia
Prevertebral fascia
Carotid sheath
Superficial layer
CN11
Extrajugular vein
Platysma
Pretracheal fascia
Trachea, larynx, thyroid, parathyroid, oesophagus
infrahyoid muscles
prevertebral fascia
paraspinal muscles (longus coli) Phrenic nerve
Carotid sheath
CCA, IJV, vagus nerve
Investing layer
Trapezius and sternocleidomastoid
Cervical spine
Spinous process is bifid
foramina transversalis - VA passes through from C6
C1 axis - no verterbral body, no spinous process
C2 atlas - odentoid peg
Hyoid bone
Sits at C3
Muscle attachment to hyoid muscle
Suprahyoid - digastric, stylohyoid, geniohyoid, mylohyoid
Infrahyoid - thyrohyoid, omohyoid, sternohyoid
Fractured by strangulation
Superficial Lymph nodes
Occipital Mastoid Pre-auricular Parotid Submandibular Submental Facial Superficial cervical
Deep lymph nodes
Deep jugular nodes
Supraclavicular
Waldeyer’s ring
Lingual tonsil
Palatine tonsil
tubal tonsil
pharyngeal tonsil (adenoi)
Cervical plexus
C1-C4 in the prevertebral layers
Branches of cervical plexus
Motor:
Phrenic nerve (C3-C5)
Ansa cervicalis (C1-C3) - omohyoid, sternohyoid, sternothyroid
Nerves to geniohyoid and thyrohyoid (travels with hypoglossal nerve)
Sensation: Greater auricular (C2/3) Lesser occipital (C2) Transverse cervical (C2/3) Supraclavicular C3/4
Phrenic nerve
Anterior rami of C3-5, Both sensory and motor
innervates the diaphragm
Sensation to mediastinum, pericardium
Arises lateral border of anterior scalene, deep to prevertebral layer
Right - anterior to Subclavian artery, descends over the right bronchus/right heart, pierce diaphragm with IVC
Left - anterior to subclavian artery, over the arch of aorta, anterior to lung roots, left side of pericardium
Suprahyoid muscle
Stylohyoid
Digastric
Mylohyoid
Geniohyoid
Stylohyoid
Origin - Styloid process
Insertion - lateral aspect of Hyoid bone
innervation - Facial nerve
action - pulls the hyoid posterior & superior
Digastric
Anterior belly Digastric fossa to hyoid CN5iii Posterior belly Hyoid to mastoid process facial nerve
Mylohyoid
Floor of mouth
Myohyoid line to hyoid bone
CNViii
Geniohyoid
Inferior mental spine to hyoid
C1 nerve root
Infrahyoid muscles
Omohyoid
Thyrohyoid
Sternohyoid
Sternothyroid
Omohyoid
Superior/inferior belly of omohyoid
scapula to clavicle via intermediate tendon
intermediate tendon to hyoid
C1-C3
Thyrohyoid
Hyoid to Thyroid
C1
Sternohyoid
Sternum/sternoclavicular joint to hyoid
C1-C3
Sternothyroid
Manubrium to thyroid
C1-C3
Anterior scalene
Posterior to subclavian vein and anterior to subclavian artery
Anterior tubercle of transverse process of C3-C6 to scalene tubercle (1st rib)
innervation - C5-C6
Middle scalene
Posterior tubercle of transverse process of C2-C7 to scalene tubercle
innervation - C3-C8
Posterior scalene
Posterior tubercle of transverse process of C5-C7 to 2nd rib
innervation - C6-8
Pharynx
Muscular tube common for both respiratory and gastrointerstinal system
Separated into Naso/Oro/Laryngopharynx
two types of muscles - circular and longitudinal
Nasopharynx
From Skull to soft palate
pseudostratified columnar epithelium
Oropharynx
soft palate to epiglottis
Laryngopharynx
Epiglottis to cricoid cartilage
Circular muscles
Superior, middle, inferior contrictors
Superior is found in oropharynx
Middle is found in laryngopharynx
Inferior has 2 components - thyropharyngeus and cricopharyngeus (outpounching = diverticulum)
Longitudinal muscles
Stylopharyngeus (CN9)
Palatopharyngeus (CN10)
Salpingopharyngeus (CN10)
Larynx
C3-C6
Continuous with trachea
Cartilage + ligaments + membranes
Supply by Superior thyroid (ECA) & inferior thyroid artery (TCT)
Innervated by superior laryngeal nerve (cricothyroid) and recurrent laryngeal nerve (the rest)
Cartilage of larynx
unpaired:
Thyroid, Cricoid, epiglottis
paired:
Arytenoid, corniculate (apex of arytenoid), cuneiform
Ligaments of larynx
Extrinsic: Thyrohyoid, hyo-epiglottic, Cricotracheal, median cricothyroid ligaments Intrinsic: Cricothyroid Quadrangular membrane
Laryngeal folds
Vocal cord:
Non keratinised stratified squamous epithelium
Vestibular folds
lower edge of quadrangular membrane
Intrinsic muscles of larynx
Cricothyroid Thyroarytenoid posterior cricoarytenoid lateral cricoarytenoid Transverse and oblique arytenoid
Thyroid gland
Endocrine organ
Descends from floor of mouth
Originating from ventral 4th pharyngeal pouch
Within pretracheal fascia
2 lobes attached with isthmus in the middle
Supplied by superior & inferior thyroid artery
Parathyroid gland
Endocrine organ for calcium homeostasis
Superior gland derived from 4th pharyngeal pouch, 1cm superior to inferior thyroid artery
inferior gland derived from 3rd pharyngeal pouch, can sometimes be found in superior mediastinum
