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Neuro Exam 1 > Neck: Area Under the SCM > Flashcards

Neck: Area Under the SCM Flashcards

1
Q

contents of carotid sheath

A 
common and internal carotid arteries
internal jugular vein
vagus nerve
ansa cervicalis
deep cervical lymph nodes
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2
Q

relationships in carotid sheath

A

artery - medial and anterior
vein - lateral and posterior
vagus - posterior groove between vessels

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3
Q

ansa cervicalis location

A

lateral to arteries

crosses internal jugular vein anteriorly and courses superiorly and medial on its surface

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4
Q

common carotid artery

A

left side longer than right

  • right from brachiocephalic split
  • left from arch of aorta
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5
Q

bifurcation of common carotid artery

A

level of CV3

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6
Q

carotid sinus

A

dilated distal common carotid and proximal internal carotid artery

pressure receptor

increased pressure, decreased HR

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7
Q

carotid body

A

at carotid bifurcation
chemoreceptor
decreased O2 - increased rate and depth of breathing

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8
Q

afferents from carotid body and sinus

A

carotid sinus nerve (CN IX)

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9
Q

internal carotid artery

A

enters carotid canal

  • no branches prior to entering canal
  • supplies orbit and brain
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10
Q

external carotid artery

A

not in sheath
branches in carotid triangle
-has lots of branches

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11
Q

surgery in carotid triangle

A

access to carotid bifurcation, internal jugular vein, vagus/hypoglossal nerves, sympathetic trunk

can affect voice - vagus and recurrent laryngeal nn.

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12
Q

carotid endarterectomy

A

often at bifurcation

access via carotid triangle

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13
Q

superior thyroid artery

A

1st branch external carotid artery

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14
Q

branches of superior thyroid artery

A

superior laryngeal artery - pierces thyrohyoid membrane with internal laryngea nerve to interior of larynx

anterior branch - to gland - anastomose with opposite counterpart

posterior branch - posterior gland - anastomose with inferior thyroid artery

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15
Q

ascending pharyngeal artery

A

arises medially off of external carotid artery
-close to bifurcation

courses straight to base of skull

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16
Q

lingual artery

A

branch of external carotid artery

deep to posterior border of hypoglossus muscle to enter tongue

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17
Q

facial artery

A

branch of external carotid artery - either common trunk or just above lingual artery branch

courses to deep surface of submandibular gland
goes around mandible and comes around anterior edge of masseter muscle to enter face

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18
Q

occipital artery

A

branch of external carotid artery

posterior to external carotid at border of posterior belly of digastric

passes between transverse process of atlas and mastoid process

pierces cervical fascia where trapezius and SCM come together

enters scalp and courses with great occipital nerve

19
Q

mnemonic for external carotid artery branches

A

Sally Anne Likes Flirting On Philadelphias Main Streets

superior thyroid
ascending pharyngeal
lingual
facial
occipital
posterior auricular
maxillary
superficial temporal
20
Q

posterior auricular artery

A

branch of external carotid artery
passes posteriorly
to ear and external acoustic meatus and anterior to mastoid process

21
Q

final branches of external carotid artery

A

maxillary artery

superficial temporal artery

22
Q

external carotid ligation

A

needed to stem flow of blood from deeper branches which are not surgically accessible without damaging their major structures

ex/ carotid endarterectomy

23
Q

internal jugular veins

A

begins as dilation - superior jugular bulb
-at jugular foramen

ends at dilation - inferior bulb

  • joins subclavian vein
  • forms brachiocephalic vein
24
Q

tributaries to internal jugular vein

A 
occipital vein
pharyngeal vein
lingual vein
facial and common facial veins
superior and middle thyroid veins
25
Q

right internal jugular access

A

insert needle inferiorly at apex of triangle between clavicular and sternal heads of SCM
-inserted finger width lateral to carotid pulse at 30 degree angle inferiorly toward ipsilateral nipple

26
Q

branches of vagus and fiber type

A

meningeal - to dura sensory (GSA)
auricular - to pinna, auditory canal, external tympanic membrane (GSA)
pharyngeal - muscles of arch 4 (SVE)
nerve to carotid body (GVA)
superior laryngeal nerve - internal and external branches
cervical cardiac branches
recurrent laryngeal nerve

27
Q

internal branch of superior laryngeal nerve

A

pierces thyrohyoid membrane
-with superior laryngeal branch of superior thyroid artery

sensory - taste and general sense
parasympathetic - to base of tongue (glands), epiglottis, internal larynx (above vocal fold)

28
Q

fiber types of superior laryngeal nerve

A

SVA, GVA, GVE-P

29
Q

external branch of superior laryngeal nerve

A

innervates cricothyroid muscle

SVE

30
Q

recurrent laryngeal nerve

A

SVE, GVE-P, GVA
right - around subclavian artery
left - around aortic arch

both reach larynx
motor to intrinsic muscles of larynx
sensory to mucosa inferior to vocal folds

31
Q

above vocal folds

A

internal branch of superior laryngeal nerve

32
Q

below vocal folds

A

recurrent laryngeal nerve

33
Q

laryngeal nerve fibers

A

SVA, GVA, GVE-P

for recurrent and superior laryngeal nerves

34
Q

inferior laryngeal nerves

A

once recurrent passes into larynx

-becomes inferior

35
Q

deep cervical lymph nodes

A

associated with carotid sheath

  • superior and inferior groups
  • split by omohyoid
36
Q

superior deep cervical lymph nodes

A

receive from superificial of face and neck

37
Q

inferior deep cervical lymph nodes

A

get lymph

38
Q

jugular lymph trunks

A

left - to thoracic duct

right - to right lymphatic duct

39
Q

radical neck dissection

A

remove all deep cervical lymph nodes and surrounding tissue

40
Q

hypoglossal canal

A

near carotid sheath

-descends to submandibular triangle

41
Q

cervical plexus

A

ventral rami of C1-4

42
Q

branches of cervical plexus

A 
greater auricular
lesser occipital
transverse cervical
supraclavicular
phrenic
ansa cervicalis
43
Q

ansa cervicalis

A

C1 and C2 - superior root
C2 and C3 - inferior root

branches to infrahyoid muscles

Neuro Exam 1 (17 decks)

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