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Anatomy > Neck > Flashcards

Neck Flashcards

1
Q

What is a pancoast tumour?

where does it normally spread?

A

cancers that start in the apex of lung

upper ribs of thorax

nerves in upper thorax and neck

bundles of nerves close to spinal cord

blood vessels that supply blood to the upper limb

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2
Q

what are pancoast tumours normally called?

what type of cancer are they normally?

A

non small cell cancer

squamous cell cancer

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3
Q

symptoms of pancoast tumours

A

may put pressure/ damage brachial plexus

this can cause severe pain in shoulder or scapula

pain in arm and weakness of hand

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4
Q

what is Horner syndrome and what is it characterised by?

A

lesion of a sympathetic trunk in the neck

pupillary constriction resulting from paralysis of dilator pupillae muscle

ptosis: paralysis of levator palpebrae superioris

sinking in of eyeball

vasodilation and absence of sweating on face and neck: lack of sympathetic nerve supply to blood vessels and nerve glands

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5
Q
A

X is for carotid pulse and bifurction to external and internal branches

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6
Q

what bone is this?

A

clavicle

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7
Q

locate: mandible- body, angle, rammus

mastoid process

A
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8
Q

structures penetrated in emergency cricothyroidotomy

what are the dangers in performing this operation on a child?

A

cricothyroid membrane into trachea

small neck can accidentally penetrate oesophagus

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9
Q

structures penetrated in a tracheotomy

A

infrahyoid muscles and isthmus (tissue joining two lobes of thyroid gland)

opening made between 1st and 2nd tracheal rings

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10
Q

what are langer’s lines, why are they clinically important and how are they arranged in the neck?

A

lines to correspond to natural orientation of underlying muscle fibres

  • incisions made parallel may produce less scarring

they run along the circumference in the neck

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11
Q

the other name for posterior triangle of neck

A

lateral cervical region

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12
Q

borders of posterior triangle

A

anterior: SCM
lateral: trapezius
inferior: middle 1/3 clavicle

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13
Q

floor and covering of posterior triangle

A

preverebral fascia and investing fascia

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14
Q

muscles in the posterior triangle

A

splenius capitis

levator scapulae

middle scalene

posterior scelene

(sometimes anterior scalene)

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15
Q

major contents of posterior triangle

A

spinal accessory nerve CN XI (passes deep to SCM)

trunks of brachial plexus ( roots are between anterior and middle scalene muscles)

phrenic nerve

posterior branches of cervical plexus

lymph nodes: cervical, suprascapular

arteries: suprascapular, transverse cercival, subclavian,

veins: external jugular, subclavian

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16
Q

carefree and careful areas for surgery in posterior triangle

A

area above spinal accessory nerve is carefree

area careful is careful due to EJV, subclavian artery and vein, and brachial plexus

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17
Q
A
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18
Q

why is a knowledge of fascia layers important in the neck clinically?

A

tracking of infections and spread of tumours in the neck

finding planes of separation during surgery

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19
Q
A
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20
Q
A
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21
Q

what structures are located in the carotid sheath?

A

common and internal carotid arteries

IJV

vagus nerve

deep cervical lymph nodes

carotid sinus nerve

sympathetic nerve fibres

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22
Q

what happens when there is an infection between investing layer of deep cervical fascia and the muscular part of pretracheal fascia?

A

does not spread beyond superior edge of manubrium

if the infection is between investing layer and visceral part then it can spread to thoracic cavity anterior to pericardium

23
Q

anterior triangle: muscles

A

suprahyoid: stylohyoid, digastric, mylohyoid, geniohyoid
infrahyoid: omohyoid, sternohyoid, thryohyoid, sternothyroid

24
Q

anterior triangle: vascular structures

A

common carotid artery and bifurcation into external and internal carotid

internal jugular veins

cranial nerves: facial, glossopharyngeal (IX), vagus, accessory, hypoglossal (XII)

25
Q

borders of anterior triangle of neck and subdivisions

A

superior: inferior border of mandible
lateral: anterior border of SCM
medial: midline of neck

carotid, submental, submandibular and muscular triangles

26
Q

rami of cervical plexus

A

C1-4

deep branch makes up root of ansa cervicalis and phrenic

27
Q

where is the carotid sinus located

A

in between common carotid and internal carotid

28
Q

superior thyroid artery is a branch of

A

external carotid artery

29
Q

inferior thyroid artery is a branch of

A

thyrocervical artery (from subclavian)

30
Q

where does thyroid ima arise from

what does it supply

A

brachiocephalic trunk

thyroid and thymus gland

31
Q

what does costocervical trunk arise from

A

subclavian artery

32
Q

what is the carotid body

A

small mass of epitheloid cells and nerve endings located above bifurcation of common carotid and next to carotid sinus

chemoreceptor organ (detects changes in pO2 pCO2 and pH)

33
Q

where do the jugular veins arise from

A

internal: brachiocephalic vein
external: subclavian vein
anterior: external jugular vein

34
Q

what is the atlas

A

C1

35
Q

what is the axis

A

c2

36
Q
A
37
Q

vasculare supply of thyroid gland

A

superior and inferior thyroid artery

thyroid plexus of veins

superior -> IJV

middle -> IJV

inferior-> brachiocephalic

38
Q

why do thyroid gland and lumps embedded in it move on swallowing?

A

pre tracheal fascia enclosing it moves

39
Q

which nerves are closely related to inferior and superior thyroid arteries?

A

inferior: recurrent layngeal
superior: external laryngeal nerves

40
Q

surgical importance of thyroid ima

A

small size and exists in 10% of people

potential source of bleeding during surgery in midline of neck

41
Q

How are parathyroid glands related to the thyroid?

what is their blood supply?

why must they be considered when contemplating a thyroidectomy

A

four glands on medial half of posterior surface of each lobe

two superior, two inferior

inferior thyroid arteries and (superior, thyroid ima, laryngeal, tracheal and oeseophageal)

parathyroid veins drain into thyroid plexus of veins

during thyroidectomy (excision of malignant thyroid gland)- they are in danger of being damaged or removed

these glands are safe during subtotal thyroidectomy becuase most posterior part of thyroid is preserved

if removed, patients suffer from tetany- convulsive disorder due to fall in blood calcium levels

42
Q

where else my thyroid and parathyroid tissue be found and why?

A

acessory thyroid tissue may develop in neck lateral to thyroid cartilage on thyrohyoid muscle

pyramidal lobe (extension of thyroid tissue superior to isthmus)- remnants of thyroglossal duct (carries thyroid forming tissue)

43
Q

what is the retropharyngeal space and why is it clinically important?

A

space between buccopharyngeal fascia (cont. with pretracheal layer) and prevertebral layer

alar fascia crosses it

permits movement of the pharnx, oesophagus, larynx and trachea relative to vertebral column when swallowing

largest and most clinically important interfascial space in neck

pathway of spread of infection

closed by cranium and carotid sheaths

44
Q

what does the pretracheal fascia enclose

A

thyroid gland, trachea, oesophagus

muscular part covers infrahyoid muscles

visceral part does the organs

45
Q

what do deep cervical lymph nodes form

A

L jugular lymphatic trunk: joins thoracic duct at root of neck

R jugular lymphatic trunk: empties into right lymphatic duct at root of neck

deep lymph nodes are close to IJV

46
Q

where do superficial lymph vessels drain

A

superficial ring of lymph nodes at junction of head and neck

47
Q
A
48
Q

subdivisions of anterior triangle

A

submandibular triangle

submental triangle

carotid triangle

muscular triangle

49
Q

submandibular triangle: boundaries and contents

A

between mandibular line and posterior and anterior belly of digastric

main content: submandibular gland

facial artery and veins

50
Q

submental triangle boundaries and contents

A

Inferiorly – hyoid bone.

Medially – midline of the neck.

Laterally – anterior belly of the digastric

base- mylohyoid muscle

contains submental lymph nodes

beginning of anterior jugular vein

51
Q

carotid triangle boundaries and contents

A

Superior – posterior belly of the digastric muscle.

Lateral – medial border of the sternocleidomastoid muscle.

Inferior – superior belly of the omohyoid muscle.

contains common carotid artery, internal jugular vein, hypoglossal nerve and vagus nerves

52
Q

muscular triangle boundaries and contents

A

Superiorly – hyoid bone.

Medially – imaginary midline of the neck.

Supero-laterally – superior belly of the omohyoid muscle.

Infero-laterally – inferior portion of the sternocleidomastoid muscle.

contains; the infrahyoid muscles, the pharynx, and the thyroid,

53
Q

does the internal carotid artery give branches

A

no

54
Q

what is the main vein of the neck and what does it travel with

A

internal jugular vein

common carotid artery and vagus nerve

Anatomy (9 decks)

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