Neck Flashcards
borders of the neck region
anteriorly: lower border of mandible
manubrium
posteriorly: superior nuchal line on occipital to intervertebral disk between C2 and T1
what muscles are contained within the anterior triangle?
supra and infrahyoid muscles
[Toss my gravy spoon darling]
what does the posterior triangle contain?
important nerves and vessels
what muscle is contained in the superficial fascia alongside the skin and subcutaneous fat?
what innervates it?
platysma
innervated by cervical branch of CN VII (facial)
what are the 3 main compartments of the neck?
vertebral
visceral
vascular
what is contained in the vertebral compartment?
vertebrae and musculature
what is contained in the visceral compartment?
trachea
oesphagus
thyroid
what is contained in the vascular compartment?
internal jugular carotids CN X (vagus)
C1 level of the neck
open mouth
C2 level of the neck
superior cervical ganglion
C3 level of the neck
body of hyoid
C4 level of the neck
upper border if thyroid cartilage
bifurcation of the common carotid artery
C6 level of the neck
cricoid cartilage
middle cervical ganglion
larynx and pharynx end
C7 level of the neck
inferior cervical ganglion
what are the borders of the anterior triangle?
anterior border of sternocleidomastoid
midline
inferior border of the mandible
what is contained in the anterior triangle?
muscles
hyoid bone
carotids and internal jugular vein
what is the hyoid bone?
relates to all the anterior neck muscles and is suspended in space by an array of muscles and ligaments
which 4 muscles make up the supra hyoid group of the anterior triangle?
mylohyoid
stylohyoid
geniohyoid
digastric
what 4 muscles make up the infra hyoid aka strap muscles of the anterior triangle?
sternohyoid
omohyoid
thryohoid
sternothyroid
what is the anterior innervation to the supra hyoid muscles?
innervation by the mandibular division of the trigeminal nerve
to the mylohyoid and anterior belly of the digastric
what is the posterior innervation to the supra hyoid muscles?
innervation by trigeminal nerve
to the stylohyoid and posterior belly of the digastric
what is the innveration to the geniohyoid of the suprahoid?
C1 fibres via hypoglossal nerve
mylohyoid attachment and innervation
Attachments:
Body of mandible (mylohyoid line)
Body of hyoid
Innervation: V3
function of mylohyoid
support floor of oral cavity
elevate the hyoid
geniohyoid attachments and innervation
Attachments:
Internal aspect of mandible (inferior glenoid tubercles*)
Body of hyoid
Innervation: C1 fibres, via hypoglossal
function of geniohyoid
protracts hyoid
depresses the mandible
styloid attachments and innervation
Attachments:
Styloid process
Body of hyoid bone
Innervation:VII
function of stylohyoid
retracts and elevates the hyoid
anterior belly of digastric attachments and innervation
Anterior Belly Attachments: Internal aspect of mandible (digastric fossa*) Tendon (attached to hyoid) Innervation:V3
function of anterior belly of digastric
depresses mandible
elevates and protracts the hyoid
posterior belly of digastric attachments and innervation?
Attachments:
Mastoid process
Tendon (attached to body of hyoid)
Innervation: VII
function of the posterior belly of the digastric
retracts and elevates the hyoid
thyrohyoid attachments and innervation
Attachments:
Thyroid cartilage (oblique line)
Greater horn of hyoid
Innervation: C1 via hypoglossal
function of thyrohyoid
Depresses the hyoid
Elevates the larynx
omohyoid attachments and innervation
Attachments:
Sup. border of scapula
Body of hyoid
Anchored to the clavicle by fibrous tissue
Innervation: Ansa cervicalis (anterior rami of C1 to C3)
function of omohyoid
depresses hyoid
sternothryoid attachments and innervation
Attachments:
Posterior surface of manubrium
Thyroid cartilage (oblique line*)
Innervation: Ansa cervicalis
function of sternothryoid
depresses the larynx
sternohyoid attachments and innervation
Attachments:
Posterior aspect of manubrium
Body of hyoid
Innervation: Ansa cervicalis
function of sternohyoid
depresses hyoid after swallowing
innervation summary
The anterior suprahyoid muscles are innervated by V3
The posterior suprahyoid muscles are innervated by the VII
The infrahyoid muscles are innervated by the ansa cervicalis
Exceptions:
Geniohyoid &Thyrohyoid, are both innervated by C1 fibres via the hypoglossal nerve
what are the borders of the posterior triangle?
Posterior border of sternocleidomastoid
Anterior border of trapezius
Middle 1/3 clavicle
contents of the posterior triangle
3 vessels and 4 nerves: External jugular vein Subclavian artery & vein Trunks of brachial plexus Spinal accessory Phrenic nerve Vagus nerve
jugular veins
external is anterior to sternocleidomastoid while the internal lies underneath
where in the cranium base does the spinal accessory nerve exit?
jugular foramen
superficially on the posterior triangle therefore liable to injury
what does the spinal accessory innervate?
sternocleidomastoid
trapezius
testing the spinal accessory nerve
raised shoulders
where does the vagus leave the cranial base?
jugular foramen
travels in the carotid sheet
what does the vagus nerve innervate?
larynx
heart
lungs
GIT
how would you test the vagus nerve?
gag reflex
where does the phrenic nerve originate from?
C3,4,5 to keep the diaphragm alive
lies anterior to scalenus anterior
motor and sensory function the phrenic
motor to diaphragm
sensory to peritoneum and pleura around diaphragm
through which structures does it enter the thorax?
between the subclavian artery and vein
which arteries supply the thyroid?
superior and inferior thyroid arteries
superior is first branch of the external carotid
inferior arises from the first part of subclavian artery
what else does the inferior thyroid artery supply apart from the thyroid?
superior oesophagus
trachea
drainage of blood from thyroid
superior, middle and inferior thyroid veins
superior and middle drain into internal jugular vein
inferior drains into brachiocephalic trunk
what is the brachial plexus?
innervates the upper limbs
formed from anterior rami of C5-C8 and T1
Trunks pass between Scalenus Anterior and Scalenus Medius and proceed into the upper limb via the axilla
its cords are named in ration to the axially artery
when does the subclavian artery become the axillary artery?
at the lateral margin of the 1st rib
where do all the lymph nodes drain?
deep cervical node from a superficial region
where do the deep cervical nodes lie?
along the internal jugular vein
these then converge to become the right and left lymphatic trunks
where does the right jugular lymphatic trunk empty?
into right lymphatic duct
where does the left jugular lymphatic duct empty?
into the thoracic duct
two main causes of lymphoedema?
infection (reactive, local or generalised)
cancer (lymphoma, metastases)