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Anatomy > Neck: bones, fascia, posterior triangle > Flashcards

Neck: bones, fascia, posterior triangle Flashcards

1
Q

3rd part of the subclavian artery lies ____ and ____ to the subclavian vein, emerging between what two muscles?

A

posterior and superior.

emerging between anterior and middle scalenes

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2
Q

3rd part of the subclavian artery: crosses over ___ ____ to become axillary, and usually gives rise to what?

A

crosses over 1st rib

dorsal scapular artery

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3
Q

the neck is relatively slender and flexible to allow for what?

A

efficient use of sensory organs

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4
Q

the hyoid bone is at what C level? what is it suspended between?

A

C3

Suspended between styloid process & thyroid cartilage

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5
Q

C__ has a carotid tubercle. while C__ has longer spinous processes that is NOT bifid (aka ____ _____)

A

C6

C7- vertebrae prominens

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6
Q

what is clinically important about facet joints of cervical vertebrae?

A

facet joints are zygopophysial (in transverese plane- slope inferior-laterally- (not truly horizontal) ) - permits flexion, extension, lateral flexion.

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7
Q

which is the widest cervical vertebrae with no body or spinous process?

A

C1- atlas

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8
Q

which cervical vertebrae? … Ring-shaped with large lateral masses (support occipital condyles of cranium). Transverse ligament between

A

C1- atlas

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9
Q

Strongest cervical vertebrae

A

C2- axis

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10
Q

which cervical vertebrae has the Dens (odontoid process)-superior projection from body?

A

C2- axis

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11
Q

vertebral arteries begin ascent at level C__

A

6

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12
Q

hyoid bone is in the angle between ____ and _____ _______.

A

Angle between mandible & thyroid cartilage

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13
Q

hyoid bone is suspended by the _____ _______. connected by muscles to what 4 things?

A

Suspended by stylohyoid ligament

Connected by muscles to skull, thyroid cartilage, manubrium, & pectoral girdle

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14
Q

the hyoid bone has what 3 parts? what is are its two purposes?

A

Body, lesser horns, greater horns

Adds rigidity to airway & attachments for anterior cervical muscles

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15
Q

what are the 4 layers of cervical fascia?

A

Superficial layer

3 separate deep columns: Investing, Pretracheal, Prevertebral

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16
Q

what are the 3 functions of cervical fascia?

A

Compartmentalize muscles & viscera
Conduit for neurovascular structures
Allows gliding of structures

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17
Q

what cervical fascia is just Deep to dermis, very thin? what two structures are within this layer?

A

superficial layer (aka hypodermis, aka subcutaneous)

  • platysma muscle (highly variable)
  • external jugular vein (anterolaterally)
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18
Q

what is the platsyma muscle used for? what is it innervated by?

A

Facial expression

Cervical branch of facial nerve (CN VII)

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19
Q

how wide and how thick is the platysma? where is it located?

A

about 1mm thick, about 1 hands width on either side.

-starts at body of mandible and fans down to clavicles. does NOT meet in the midline.

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20
Q

investing deep cervical fascia, splits to invest what two muscles? invests what two glands?

A

muscles: sternocleidomastoid & trapezius
glands: submandibular & parotid

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21
Q

origins, insertions and innervations of SCM and trapezius muscle ?

A

Nearly continuous origins at base of skull
Nearly continuous insertions to scapular spine, acromion, clavicle, & manubrium
Both muscles innervated by spinal accessory nerve (CN XI)

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22
Q

pretrachial deep cervical fascia invests what two types of structures? extends from _____ to ______.

A

Invests muscles & viscera in anterior neck

Extends from hyoid to pericardium of heart

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23
Q

the pretrachial deep cervical fascia forms pulleys for what two things?

A

Forms pulleys for intermediate tendons of digastric & omohyoid

Continuous superiorly as buccopharyngeal fascia of pharynx

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24
Q

muscular vs visceral portion of pretrachial deep cervical fascia? ( thin vs thick, what does each surround? )

A

Muscular portion-thin, surrounds infrahyoid muscles

Visceral portion-thick, surrounds thyroid, trachea, & esophagus

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25
Q

what fascia layer is Continuous superiorly as buccopharyngeal fascia of pharynx?

A

pretracheal deep cervical fascia

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26
Q

what is the clinical significance of the buccopharyngeal fascia?

A

buccopharyngeal fascia that invests posterior wall of pharynx. BEHIND that is potential space: where pharyngeal infections can rapidly spread superior or inferiorly “retropharyngeal space”

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27
Q

prevertebral deep cervical fascia surrounds what structures?

A

Surrounds vertebral column & associated muscles

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28
Q

the carotid sheath is formed by which layers of the cervical fascia? from where to where does it extend?

A

Formed from all 3 deep sheaths

Extends from cranial base to root of neck

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29
Q

what does the carotid sheath contain? (5)

A

Common, external, & internal carotids
Internal jugular
Vagus (CN X)
Nerve to carotid sinus
Carotid arterial plexuses (postganglionic sympathetic neurons)

“CN IVS”

30
Q

what is the Potential space between pretracheal & prevertebral sheaths? what is this subdivided by?

A

retropharyngeal space- subdivided by alar fascia

31
Q

retropharyngeal space: which end is opened and which is closed?

A

Closed at cranial base superiorly & carotid sheath laterally
Open to superior mediastinum inferiorly

32
Q

retropharyngeal space- pretracheal (visceral portion) and carotid sheaths are continuous with ______superiorly and _______ inferiorly ?

A

with cranial cavity superiorly & mediastinum inferiorly

33
Q

superficial neck is deep to what fascia(s)? superficial to what fascia(s)?

A

Deep to superficial fascia

Superficial to prevertebral & visceral pretracheal fascias

34
Q

superficial neck: ___ regions based on ___ muscles ?

A

4, 2

35
Q

four regions of the superficial neck

A

Sternocleidomastoid
Posterior
Lateral (posterior triangle)
Anterior (anterior triangle)

36
Q

SCM: O, I, A, In

A

O-mastoid process
I-manubrium (sternal head); medial 1/3 of clavicle (clavicular head)
A- Extension of head, flexion of cervical spine, laterally flexes (ipsi) & rotates head (contra)
In- Spinal accessory nerve (CN XI)

37
Q

what fossa is between the heads of the SCM? what structure is within here?

A

lesser superclavicular fossa - inferior IJV

38
Q

the internal jugular vein is near the (superior/inferior) 1/2 of SCM while the external jugular vein is near the (superior/inferior) 1/2.

A

internal JV- inferior SCM

external JV - superior SCM

39
Q

what two nerves cross the SCM?

A

greater auricular
transverse cervical
(both C2 and C3)

40
Q

cervical portion trapezius: O, I, A, In

A

O-superior nuchal line, nuchal ligament, spinous processes C7-T12
I-lateral third of clavicle, acromion, spine of scapula
A- Superior fibers elevate scapula
In -Spinal accessory nerve (CN XI)

41
Q

dorsal rami of cervical spinal nerves supply what type of innervation?

A

cutaneous innervation
C2 (Greater occipital)
C3 (Least occipital)
C4

42
Q

what are the borders of the posterior triangle?

A

Anterior-posterior border of SCM
Posterior-anterior border of trapezius
Inferior-middle third of clavicle
Superior-union of SCM & trapezius at mastoid process

43
Q

what makes up the floor of the posterior triangle?

A

Floor-prevertebral fascia & muscles:

  • Middle & posterior scalene
  • Levator scapulae
  • Splenius capitis
44
Q

Inferior belly of omohyoid divides posterior triangle into what two triangles?

A

occipital & omoclavicular (subclavian) triangles

45
Q

what artery is a Branch of external carotid at the

Apex of occipital triangle?

A

occipital artery

46
Q

what arteries are branches of thyrocervical trunk at the Base of occipital triangle?

A

suprascapular artery

and transverse cervical artery

47
Q

suprascapular artery is superficial to what nerve(s)? and supplies what muscles?

A

Superficial to phrenic nerve & trunks of brachial plexus

Supplies muscles of posterior shoulder (“army over”)

48
Q

what two arteries are superficial to phrenic nerve and trunks of brachial plexus?

A

suprascapular artery and trans. cervical artery

49
Q

transverse cervical artery may divide into what two branches? what does each supply?

A

May divide into superficial & deep (dorsal scapular) branches
Superficial-trapezius
Dorsal scapular-levator scapulae, rhomboids, scapula

50
Q

the external jugular vein is formed by the merging of what two veins (superiorly)? where does it enter the occipital triangle? what does it empty into?

A

Merging of retromandibular & posterior auricular
Enters occipital triangle at posterior border of SCM
Empties into subclavian vein

51
Q

the subclavian vein is a continuation of what? what triangle does it cross?

A

Continuation of axillary vein

Crosses omoclavicular triangle anterior to anterior scalene

52
Q

primary loops of the cervical plexus form between what?

A

Primary loops form between adjacent ventral rami

C1-C2, C2-C3, C3-C4, C4-C5

53
Q

branches emerging from the loops: sensory course _____ while motor course ____.

A

sensory: posteriorly
motor: anteriorly

54
Q

what forms the superior and inferior roots of ansa cervicalis?

A

superior: C1 only (motor from C1-C2 loop)
inferior: C2 & C3 (motor)

55
Q

the motor branch of C1-C2 loop runs with what nerve initially?

A

hypoglossal (CN XII)

56
Q

Nerves to ________ & _____leave hypoglossal separate from superior root ( C_ fibers only)

A

Nerves to thyrohyoid & geniohyoid leave hypoglossal separate from superior root
C1 fibers only

57
Q

the inferior root of ansa cervicalis supplies what muscles?

A

Supply 3/4 infrahyoid muscles
Omohyoid
Sternohyoid
Sternothyroid

58
Q

C2-C3 loop: sensory- what are the three branches?

A

lesser occipital, greater auricular, transverse cervical

59
Q

lesser occipital nerve: what does it course along? what does it supply?

A

Parallels posterior SCM

Supplies posterolateral neck & scalp

60
Q

greater auricular nerve: what does it course along? what does it supply?

A

Courses with EJV

Supplies posterior auricle & parotid region (between mastoid process & angle of mandible)

61
Q

transverse cervical nerve: what does it cross? what does it supply?

A

Crosses SCM

Supplies anterior cervical region

62
Q

C3-C4 loop: sensory - what is the branch? what does it supply?

A

Supraclavicular

Supplies clavicular skin & shoulder

63
Q

C3-C4 loop: motor- what is the branch? what does it supply?

A

phrenic (Contribution from C5)
Motor to diaphragm
Visceral afferents from pericardium, pleura, etc.

64
Q

C4-C5 loop: contributes motor fibers what two nerves of the brachial plexus?

A

motor fibers to dorsal scapular (C4, C5) & long thoracic (C5) nerves of brachial plexus

65
Q

spinal accessory nerve (CN XI): enters occipital triangle where? what does it supply?

A

Enters occipital triangle at mid-SCM
Crosses triangle inferolaterally
Innervates SCM & trapezius

66
Q

Only motor nerve superficial to prevertebral fascia

A

spinal accessory CN XI

67
Q

posterior (cutaneous) branches of cervical plexus (C1-C4) emerge where in relation to the SCM?

A

at posterior midpoint of SCM

68
Q

what are the 4 posterior (cutaneous) branches of the cervical plexus ?

A

Lesser occipital
Great auricular
Transverse cervical
Supraclavicular

69
Q

roots/trunks of brachial plexus emerge between what two muscles? descend ______ to enter the axilla. what is this called?

A

Emerge between anterior & middle scalenes
Descend inferolaterally to enter axilla
“Cervico-axillary canal”

70
Q

suprascapular nerve is a branch of ____ trunk of the brachial plexus. where does it cross? what does it supply?

A

superior trunk
Crosses occipital triangle laterally
Innervates muscles of posterior scapula (“navy under”)

Anatomy (13 decks)

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