Neck and Suboccipital Region Learning Objectives

Question 1

Name the deep cervical fascia and their contents.

Answer 1

Investing fascia:

• encircles neck
• splits around SCM
• contains trapezius
• deep to platysma, most superficial layer

Pretracheal fascia:

• thyroid cartilage
• trachea
• esophagus

Prevertebral fascia

• spinal cord
• vertebrae

Carotid sheath

• neurovascular bundle
  
  • internal jugular vein
  • common carotid artery
  • vagus nerve (CN X)

Question 2

Name the anterior muscles of the neck, their innervation, and whether they are categorized as supra- or infrahyoid.

Answer 2

Suprahyoid (above hyoid bone):

• mylohyoid (Trigem, V3)
• anterior belly of digastric (Trigem, V3)
• posterior belly of digastric (facial VII)
• stylohyoid (facial VII)
• geniohyoid (C1 via XII)

Infrahyoid (below hyoid bone):

• thryohyoid (C1 via XII)
• sternothyroid (ansa cervicalis)
• sternohyoid (ansa cervicalis)
• omohyoid superior and inferior belly (ansa cervicalis)

Question 3

Name the triangles of the neck, their borders and contents.

Answer 3

Rectangle:

• inferior border: clavicle
• superior border: inferior border of mandible
• anterior border: midline of neck
• posterior border: trapezius

Sternocleidomastoid muscle form anterior and posterior triangles.

Anterior: 
Carotid
- Common carotid artery
Muscular
Submental ("below chin")
- lymph nodes
Submandibular
- lymph nodes

Posterior:
Occipital
- trunks of brachial plexus
- CN XI
Supraclavicular
- Subclavian a.
- Thyrocervical trunk
- Suprascapular a.
- Transverse cervical a.

Question 4

Name the branchial (pharyngeal) arches and what muscle(s) derive from each.

Answer 4

1. Mandibular: trigeminal nerve V3
   - mastication, mylohyoid, anterior belly of digastric
2. Hyoid: facial nerve VII
   - facial expression, posterior belly of digastric, stylohyoid
3. Third: glossopharyngeal nerve IX
   - stylopharyngeus
4. Fourth: vagus nerve X, superior laryngeal nerve
   - cricothyroid, inferior pharyngeal constrictor
5. NO FIVE. RESORBS/GOES AWAY.
6. Sixth: vagus nerve X, recurrent laryngeal nerve
   - intrinsic laryngeal

Question 5

Define branchial motor axon function and relate this to the function of cranial nerves.

Answer 5

Branchial motor axon: innervation of skeletal muscles derived from pharyngeal arches (synonymous with motor innervation of skeletal muscle)

Muscles from head and neck derive from pharyngeal arches.

Question 6

Identify the unique features of the cervical vertebrae.

Answer 6

C1: atlas

• ring of bone
• anterior/posterior arch
• no spinous process
• large vertebral foramen
• superior articular surface for occipital condyles of skull
• inferior articular surface for C2

C2: axis

• dens (part of pivot joint, atlantoaxial joint)
• superior articular facet for atlas (C1)

C7: vertebrae prominens

Cervical vertebrae:

• bifid spinous process
• transverse foramen for vertebral artery (does not usually run through C7 TF)

Question 7

Identify the suboccipital muscles of the neck, their innervation, and function.

Answer 7

Rectus capitis posterior minor
Rectus capitis posterior major
Obliquus capitis superior (superior oblique)
Obliquus capitis inferior (inferior oblique)

Suboccipital nerve for all.