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ANAT380 > Neck > Flashcards

Neck Flashcards

1
Q

pharynx

A

fibromuscular tube that extends from base of the skull to the upper esophageal sphincter (UES)

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2
Q

fibromuscular walls of pharynx formed by what muscles

A

3 pairs of constrictor muscles: superior, middle and inferior pharyngeal constrictors

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3
Q

upper esophageal sphincter

A
  • formed by lower part of inferior constrictor muscle of pharynx
  • prevents reflux of food into airway and prevents air from entering digestive tract
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4
Q

divisions of pharynx

A
  • nasopharynx
  • oropharynx
  • laryngopharynx
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5
Q

pharynx in relation to larynx

A

the pharynx is situated posterior to, and communicates with nasal cavities, oral cavity and larynx

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6
Q

the nasopharynx

A
  • communicates with nasal cavities anteriorly by choanae (posterior nasal apertures)
  • openings to eustachian tubes located on lateral walls of nasopharyns
  • roof of nasopharynx = collection of lymphatic tissues called the pharyngeal tonsil
  • inferiorly, the nasopharynx communicates with the oropharynx by the pharyngeal isthmus (can be closed by elevation of the soft palate during swallowing)
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7
Q

the oropharynx

A
  • communicated anteriorly with oral cavity through the oropharyngeal isthmus
  • each side of the oropharynx consists of 2 folds of mucous membranes supported by underlying muscles: anterior palatoglossal arch and posterior palatoglossal arch
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8
Q

palatine tonsil

A
  • collection of lymphatic tissue located between the folds on either side
  • its medial surface projects into oropharynx and its lateral surface lies against the superior constrictor muscle
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9
Q

the laryngopharynx

A
  • extends from oropharynx to esophagus
  • laryngeal inlet opens into the anterior wall of the laryngopharynx
  • cavity of laryngopharynx extends anteriorly on each side of the laryngeal inlet forming 2 recesses called the piriform recesses (fossae)
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10
Q

piriform recesses

A

form channels that direct food from oral cavity to either side of the raised laryngeal inlet, towards the esophagus

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11
Q

vestibular and vocal ligaments of the layrnx

A

both ligaments enclosed by respective folds (the vestibular fold/false vocal fold, and the vocal fold/true vocal fold)

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12
Q

cricothyroid ligament

A

originates from upper border of cricoid cartilage and extends superiorly where its free upper margin forms the vocal ligament (true vocal cord)

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13
Q

arytenoid cartilage

A
  • located at back of larynx
  • primary function is to close vocal folds when swallowing
  • secondary function is to change tension of vocal cords for production of sound
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14
Q

intrinsic muscles of larynx

A
  • control shape of the rima glottidis, and the length and tension of vocal ligaments during breathing, swallowing and phonation
  • thyroarytenoid
  • cricothyroid
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15
Q

thyroartyenoid

A
  • originates from inferoposterior aspect of the thyroid cartilage
  • inserts on anterolateral part of arytenoid cartilage
  • acts to relax vocal ligament, producing softer voice
  • motor innervation from the recurrent laryngeal nerve (a branch of the vagus nerve)
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16
Q

cricothyroid

A
  • originates from anterolateral aspect of cricoid cartilage attaching to inferior margin of thyroid cartilage
  • cricothyroid muscle stretches and tenses the vocal ligaments for production of loud speech and different tones of voice
  • motor innervation of external laryngeal nerve, branch of superior laryngeal nerve
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17
Q

thyroid gland

A
  • thyroid gland found deep to musculature of neck
  • consists of right and left lateral lobes with an isthmus that connects the lateral lobes and sits on anterior surface of trachea, just inferior to larynx
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18
Q

arterial supply of thyroid gland

A

thyroid gland supplied by superior thyroid artery (branch of the external carotid artery) and the inferior thyroid artery (branch of the thyrocervical trunk which arises from the subclavian artery)

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19
Q

venous drainage of the thyroid gland

A
  • thyroid drained by paired superior, middle and inferior thyroid veins which form a venous plexus on the anterior surface of the thyroid gland and descends anterior to the trachea
  • superior and middle thyroid veins drain into internal jugular vein
  • inferior thyroid vein drains into brachiocephalic vein
  • inferior thyroid veins may be source of bleeding during tracheostomy
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20
Q

innervation of thyroid gland

A
  • regulated by ANS (both parasympathetic and sympathetic)
  • vagus nerve: parasympathetic fibres arise from superior laryngeal nerve and the recurrent laryngeal nerve (both branches of vagus nerve)
  • sympathetic trunk: fibres arise from superior, middle and inferior cervical ganglia of the sympathetic trunk
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21
Q

superficial muscles of the neck

A
  • located closest to skin
  • allow for gross and fine motor movements of head, face and neck
  • sternocleidomastoid
  • platysma
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22
Q

sternocleidomastoid

A
  • originates inferiorly on manubrium of the sternum and medial end of clavicle
  • inserts superiorly on mastoid process
  • 2 muscles together flex the head and neck while individually will tilt head toward the shoulder on the same side rotating the head to turn the fave to the opposite side
  • innervated by accessory nerve
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23
Q

platysma

A
  • located in subcutaneous tissue (superficial fascia)
  • runs from upper 2 ribs to lower margin of mandible
  • when it contracts, tenses skin of neck and is responsible for facial expression
  • much of anterior neck is covered by 2 platysma muscles
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24
Q

deep muscle of the neck

A
  • stabilize and facilitate movement of head, neck and spine
  • work together with superficial muscles to promote good posture and mobility
  • scalenes
  • levator spaculae
25
Q

scalenes

A
  • 3 muscles in deep lateral neck, spanning between transverse processes of cervical vertebrae and ribs 1 and 2
  • main functions = flex and rotate neck
  • accessory muscles of respiration, elevating ribs during forced inspiration
26
Q

levator scapulae

A
  • long muscle situated at posterolateral neck
  • origin: transverse processes of C1-4
  • insertion: scapula
  • main function = lift scapula and support vertebral column
  • without immobilising effect of levator scapulae, vertebral column would flex and rotate during rotation of scapula
27
Q

hyoid bone

A
  • U-shaped bone, superior to larynx and is attached by the thyrohyoid membrane
  • does not articulate with any other bones, suspended in neck by muscles and ligaments
  • 2 groups of muscles in anterior neck grouped according to their relationship to hyoid bone: suprahyoid muscles and infrahyoid muscles
28
Q

suprahyoid muscles

A
  • 4 pairs of suprahyoid muscles that play a role in swallowing and phonation by elevating hyoid bone and subsequently the larynx
  • digastric
  • stylohyoid
  • mylohyoid
  • geniohyoid
29
Q

digastric

A
  • posterior belly attaches to mastoid process
  • anterior belly attaches to mandible
  • intermediate tendon (running between anterior and posterior bellies) is held by a fascial sling to the hyoid bone
30
Q

stylohyoid

A
  • origin: styloid process of temporal bone

- insertion: hyoid bone

31
Q

mylohyoid

A
  • paired mylohyoid muscles form floor or oral cavity by joining together at midline raphe
  • origin: mandible
  • insertion: hyoid bone
32
Q

geniohyoid

A
  • medial and deep to mylohyoid
  • originates from mandible
  • inserts onto hyoid bone
33
Q

infrahyoid muscles

A
  • 4 pairs of infrahyoid muscles
  • during swallowing and phonation, depress hyoid bone and subsequently the larynx
  • sternohyoid
  • omohyoid
  • thyrohyoid
  • sternothyroid
34
Q

sternohyoid

A
  • origin: manubrium of sternum

- insertion: hyoid bone

35
Q

omohyoid

A
  • 2 bellies
  • inferior belly originates on scapula and inserts on intermediate tendon
  • intermediate tendon attached to clavicle by fascial sling
  • superior belly originates at intermediate tendon and inserts on hyoid bone
36
Q

thyrohyoid

A
  • origin: thyroid cartilage

- insertion: hyoid bone

37
Q

sternothyroid

A
  • origin: manubrium of sternum

- insertion: thyroid cartilage

38
Q

arterial supply of neck

A
  • common carotid arteries

- subclavian arteries

39
Q

common carotid arteries

A
  • internal carotid arteries supply brain and eyes

- external carotid arteries supply face and neck

40
Q

subclavian arteries

A
  • paired arteries originating in thorax
  • supply thorax, head, neck and upper limbs
  • on left side of body, subclavian artery arises directly from aortic arch
  • right subclavian artery arises from brachiocephalic trunk
41
Q

venous drainage of neck

A
  • internal jugular veins

- subclavian veins

42
Q

internal jugular veins

A
  • drain blood from brain and superficial regions of face and neck
  • at junction of neck and thorax, internal jugular vein joins the subclavian vein from the brachiocephalic vein
43
Q

subclavian veins

A
  • originate at outer border of 1st rib as continuations of the axillary veins
  • subclavian veins are large, central and relatively superficial
  • often used to place central venous lines
  • important role in lymphatic drainage of head and neck
44
Q

lymphatic drainage

A
  • lymphatic drainage of head and neck achieved by 2 main groups
  • superficial ring of nodes at junction of head and neck (collar nodes)
  • 2 vertical groups of lymph nodes in neck (superficial and deep cervical lymph nodes)
45
Q

superficial ring of nodes

A
  • includes submandibular nodes and submental nodes inferior to chin
46
Q

superficial cervical nodes

A
  • in vertical group of nodes, superficial cervical nodes found on surface of sternocleidomastoid muscle and are associated with external jugular vein
  • deep cervical nodes found deep to sternocleidomastoid and closely related to internal jugular vein
47
Q

where does the lymphatic drainage of the head and neck go?

A
  • ultimately all lymphatic vessels of head and neck drain into deep cervical nodes
  • from deep cervical nodes, lymphatic vessels drain into the jugular trunks
  • jugular trunks empty into thoracic duct on left side and right lymphatic duct on right side
48
Q

cranial nerves of neck

A

CN IX-XII enter the neck from the skull initially passing deep to posterior digastric muscle

49
Q

glossopharyngeal nerve

A
  • CN IX

- travels anteriorly to provide sensory innervation to the tongue, pharynx and middle ear

50
Q

hypoglossal nerve

A
  • CN XII

- curves anteriorly, passing deep to posterior digastric muscle to supply the muscles of the tongue

51
Q

vagus nerve

A
  • CN X
  • located in both superior and posterior mediastinum
  • each vagus nerve descends through the neck, passing anterior to the subclavian artery to enter thorax
  • right and left vagus nerves give rise to nerves that form the pharyngeal, parasympathetic cardiac, pulmonary and esophageal plexuses
  • vagus nerve also branches to form superior laryngeal nerves
  • right recurrent laryngeal nerve (branch of right vagus nerve) loops around right subclavian artery and ascends in groove between the esophagus and trachea to travel towards larynx
  • left recurrent laryngeal nerve (branch of left vagus nerve) loops beneath the arch of the aorta ligamentum arteriosum and ascends in groove between esophagus and trachea towards larynx
52
Q

cervical plexus

A
  • all 4 infrahyoid muscles are supplied by the cervical plexus
  • thyrohyoid innervated by C1 of hypoglossal nerve
  • cervical plexus formed by ventral rami of C1-4 (these branches supply motor innervation to skin of neck and back of scalp)
53
Q

phrenic nerve

A
  • provides motor and cutaneous innervation to diaphragm
  • on the way to the thoracic inlet, each phrenic nerve crosses obliquely over anterior surface of scalene muscles and subclavian arteries
54
Q

right phrenic nerve

A
  • passes anterior to right subclavian artery
  • enters thorax through thoracic inlet
  • descends anterior to right lung root
  • courses along pericardium of right atrium of heart
  • pierces diaphragm at opening of IVC
55
Q

left phrenic nerve

A
  • passes anterior to left subclavian artery
  • enters thorax through thoracic inlet
  • crosses aortic arch and left vagus nerve
  • courses along pericardium of left ventricle
  • pierces and innervated diaphragm
56
Q

the sympathetic trunk

A
  • after leaving spinal cord, sympathetic nerve fibres form the sympathetic trunk
  • structure spans the length of the vertebral column from the base of the skull to the coccyx and is formed by sympathetic nerve fibres and ganglia
57
Q

superior cervical ganglia

A
  • largest of the 3 ganglia

- superior cervical ganglion, posterior to carotid arteries, anterior to C1-2

58
Q

middle cervical ganglion

A
  • located anterior to inferior thyroid artery and C6 vertebra
  • absent in some individuals
59
Q

inferior cervical ganglion

A
  • anterior to C7

- usually fused with 1st thoracic ganglion

ANAT380 (7 decks)

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