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Anatomy > Neck - Bones, Fasciae, and Posterior Triangle > Flashcards

Neck - Bones, Fasciae, and Posterior Triangle Flashcards

1
Q

Importance of the neck?

A

Conduit for important structures from the head to the body

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2
Q

The bones of the neck do what?

A

Support the head and provide flexibility

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3
Q

Where is the hyoid bone found?

A

C3 level

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4
Q

Which bone doesn’t articulate with any other bones?

A

hyoid bone

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5
Q

The hyoid bone is suspended by?

A

stylohyoid ligament

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6
Q

what are the atypical cervical vertebrae?

A

C1, C2, C7

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7
Q

What is unique to the cervical vertebrae?

A

Transverse foramen in the transverse processes

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8
Q

The spinal cord is largest in which region?

A

Cervical

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9
Q

The uncinate processes are located where?

A

Laterally (superolaterally)

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10
Q

Where is the carotid tubercle?

A

C6

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11
Q

What’s unique about the spinous processes in cerical vertebrae?

A

Short and bifid

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12
Q

What population especially has short and bifid spinous processes?

A

White males

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13
Q

What’s unique to C7?

A

Spinous process is long and it is usually not bifid

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14
Q

What’s unique to the facet joints in the cervical vertebrae?

A

They slope superiorly

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15
Q

What is the significance of the superior slope of the facet joints?

A

Doesn’t allow for rotational movements, but allows for flexion/extension and some lateral flexion

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16
Q

Which vertebrae is the atlas?

A

C1

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17
Q

Which vertebrae is the axis?

A

C2

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18
Q

Which vertebrae supports the weight of the cranium?

A

C1

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19
Q

What is the significance of the transverse ligament of C1?

A

Holds the dens of C2 in place

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20
Q

What is unique to the C1 shape?

A

It doesn’t have a body or spinous process

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21
Q

Lateral masses of C1 do what?

A

Support the occipital condyles of the cranium

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22
Q

Where is the transverse ligament found?

A

between the lateral masses of C1

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23
Q

What causes the “yes” gesture?

A

Rocking on the occipital condyles of C1

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24
Q

What causes the “no” gesture?

A

Rotation of C2

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25
Q

Which is the strongest cervical vertebrae?

A

C2

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26
Q

The dens is also known as what?

A

Ondontoid process

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27
Q

Where is the vertebral foramen the smallest? and why?

A

C7

It only holds the vertebral vein, the vertebral artery goes up C6

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28
Q

Which joint provides rotational movement of the cervical spine?

A

Atlanto-axial joint (C1 and C2)

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29
Q

What creates the angle between the mandible and the thyroid cartilage?

A

Hyoid bone

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30
Q

What parts make up the hyoid bone?

A

body, greater and lesser horns

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31
Q

What is the significance of the hyoid bone?

A

Adds rigidity to the airway (which is prone to collapse because of pressure) and provides attachments for cervical muscles

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32
Q

Layers of the cervical fascias?

A

Superficial layer

Investing-Pretracheal-Prevertebral

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33
Q

What allows the structures of the neck to glide against each other?

A

Cervical fascia

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34
Q

What fascia layer circumferentially surrounds the neck and contains the platysma and external jugular vein?

A

Superficial fascia

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35
Q

What nerve innervates the platysma?

A

CN VII - cervical branch of the facial nerve

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36
Q

Where is the external jugular vein located?

A

Deep to the platysma muscle

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37
Q

What muscle in the neck contributes to facial expression?

A

Platysma

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38
Q

What are the three deep columns of the cervical fascia?

A

Investing
Pretracheal
Prevertebral

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39
Q

What does the cervical fascia do?

A

Compartmentalizes muscles and viscera
Conduit for neurovascular structures
Allows the structures to glide off of each other

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40
Q

Which cervical fascia layer is deep to the dermis?

A

Superficial fascia

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41
Q

Where is the superficial fascia found?

A

circumferentially surrounding the neck

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42
Q

What does the superficial fascia contain?

A

Platysma and external jugular vein (anterolaterally)

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43
Q

What nerve innervates the superficial fascia?

A

Cervical branch of the facial nerve (CN VII)

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44
Q

Which muscle originates on the mandible and its insertion blends in with the pectoral fascia below the clavicle?

A

Platysma

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45
Q

Where is the investing cervical fascia found?

A

Surrounding the entire neck

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46
Q

Which muscles do the investing fascia envelope?

A

SCM and trapezius

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47
Q

Which two muscles have nearly continusous origins and insertions?

A

SCM and trapezius

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48
Q

The SCM is innervated by what?

A

CN XI, spinal accessory nerve

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49
Q

The trapezius is innervated by what?

A

CN XI, spinal accessory nerve

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50
Q

What, besides muscles, does the investing fascia also develop?

A

submandibular and parotid glands

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51
Q

Which cervical deep fascia layer invests the muscles and viscera in the anterior neck?

A

Pretracheal

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52
Q

The pretracheal deep cervical fascia extends from where to where?

A

From hyoid to the pericardium of the heart

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53
Q

The intermediate tendons of the pretracheal fascia form what? Which muscles does that involve?

A

pulleys; digastric and omohyoid

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54
Q

The muscular portion of the pretrachial fascia invests what?

A

infrahyoid muscles

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55
Q

The visceral portion of the pretracheal fascia invests what?

A

Thyroid, trachea, and esophagus

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56
Q

Which portion (muscular and visceral) of the pretrachial fascia are thick and thin?

A

Muscular - thin

Visceral - thick

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57
Q

Superiorly, the pretrachial fascia becomes what? Inferiorly?

A

Buccopharyngeal fascia

Fibrous pericardium

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58
Q

What is the buccopharyngeal fascia?

A

Extension of the pretrachial fascia superiorly (out of the neck region) in the head

59
Q

The prevertebral fascia surrounds what?

A

vertebral column and associated muscles

60
Q

The carotid sheath is made up of what?

A

The investing, pretrachial, and prevertebral fascia

61
Q

Where does the carotid sheath extend?

A

Extends from the cranial base to the root of the neck

62
Q

What does the carotid sheath contain?

A

Common/external/internal carotids, internal jugular, Vagus nerve (CN X), nerve to carotid sinus, carotid arterial plexuses (postganglionic sympathetic neurons)

63
Q

What is the potential space called in the cervical fascia? What is its significance?

A

Retropharyngeal space; this is the danger zone; if an infection from the buccopharyngeal fascia gets in here, there’s no stopping it from spreading down to the pericardium

64
Q

Where is the retropharyngeal space found? What is in it?

A

Between the pretracheal and prevertebral sheaths

loose areolar connective tissue

65
Q

What divides the retropharyngeal space?

A

alar fascia

66
Q

What areas are closed/opened to the retropharyngeal spaces? Why is this significant?

A

Closed at cranial base superiorly and the carotid sheath laterally
Open to the posterior mediastinum inferiorly

Infections that get in here cannot ascend, but they can descend into the mediastinum

67
Q

How is the superficial neck divided?
Into 2?
Into 4?

A

Between the mandible and the clavicle, the trapezius and the midline of the neck make up the superficial neck area.

The SCM divides this area into two triangles - anterior and posterior

The inferior belly of the omohyoid muscle divides this again into 4 triangles - submandibular, submental, carotid, and muscular triangles

68
Q

Which areas make up the posterior triangle of the neck?

A 
occipital triangle (between trapezius, SCM, and omohyoid)
omoclavicular (between SCM, omohyoid, and clavicle)
69
Q

Origin of SCM?

A

mastoid process

70
Q

Insertion(s) of SCM?

A

Manubrium (sternal head)

Medial 1/3 of clavicle (clavicular head)

71
Q

Actions of SCM?

A

Extension of the head, flexion of the cervical spine, laterally flexes (ipsilateral side), rotates the head (contralaterally)

72
Q

SCM innervation?

A

CN XI spinal accessory nerve

73
Q

Where is the supraclavicular fossa found? Why is this significant?

A

Between the SCM heads

This is a landmark for a jugular vein approch for a central line

74
Q

Which neurovascular structures run with SCM?

A

Superior 1/2 of external jugular vein, great auricular nerve, the transverse cervical crosses the midpoint of the muscle, lesser occipital parallels the posterior border of SCM

75
Q

The neck is mostly supplied by what kind of nerves?

A

Spinal nerves

76
Q

The face anterior to the ears are supplied by what kinds of nerves?

A

Cranial nerves

77
Q

Most superficial posterior neck muscle?

A

Trapezius

78
Q

Trapezius origin?

A

Superior nuchal line, nuchal ligament, spinous processes C7-T12

79
Q

Trapezius insertion?

A

lateral 1/3 of clavicle, acromion, spine of scapula

80
Q

Trapezius innervations?

A

CN XI

81
Q

Cutaneous innervation of the posterior neck is supplied by?

A

C2 (greater occipital) C3 (least occipital), C4

82
Q

Which nerve crosses the posterior triangle to reach trapezius?

A

CN XI spinal accessory nerve

83
Q

Between which two muscles is the posterior triangle of the neck found?

Superior and inferior parts of the triangle?

A

posterior border of SCM and the anterior border of trapezius

Superior (apex) SCM and trapezius union at the mastoid process
Inferior middle 1/3 of the clavicle

84
Q

What makes up the floor of the posterior triangle of the neck?

A

Prevertebral fascia and the middle and posterior scalene, levator scapulae, and splenius capitus

85
Q

What musle divides the posterior triangle inferiorly? What does it divide it into?

A

inferior belly of omohyoid muscle dividies into occipital and omoclavicular triangles

86
Q

The occipital artery is found where?

A

Apex of the occipital triangle of the posterior triangle of the neck

87
Q

The occipital artery is a branch off of what?

A

External carotid

88
Q

The Suprascapular artery is a branch off os what?

A

thyrocervical trunk

89
Q

Where is the suprascapular artery found?

A

Base of the omoclavicular triangle

90
Q

Suprascapular artery is found in what relation to the phrenic nerve and the brachial plexus?

A

Superficially

91
Q

What does the suprascapular artery supply?

A

muscles of the posterior shoulder

92
Q

The transverse cervical artery is a branch off of what?

A

Thryocervical trunk

93
Q

Where is the transverse cervical artery found?

A

At the base of the occipital triangle, crossing anterior scalene

94
Q

The transverse cervical artery can divide into what?

A

superificial and deep (dorsal scapular) branches

95
Q

If the transverse cervical artery doesn’t branch, where is the dorsal scapular artery usually found?

A

Branching off the subclavian

96
Q

The phrenic nerve is found underneath what?

A

Transverse and suprascapular arteries

97
Q

The subclavian artery emerges between which muscles?

A

Anterior and middle and posterior scalenes

98
Q

What artery crosses over the 1st rib to become axillary?

A

Subclavian

99
Q

The roots of the brachial plexus and the subclavian artery come through what?

A

Scalene triangle

100
Q

Where does the external jugular vein enter the occipital triangle?

A

Posterior border of SCM

101
Q

From what two veins does the external jugular come to be?

A

Retromandibular and posterior auricular

102
Q

The subclavian vein crosses what?

A

The omoclavicular triangle anterior to the anterior scalene

103
Q

The cervical plexus is formed from what ventral rami?

A

C1-C4

104
Q

Sensory branches of the cervical plexus course which way (at least initially)?

A

Posteriorly

105
Q

Motor branches of the cervical plexus course which way (initially)?

A

anteriorly

106
Q

What cranial nerve becomes indistinguishable from C1?

A

CN XII, hypoglossal nerve

107
Q

What nerves make up ana cervicalis?

A

C1 and C2

108
Q

Superior root of ansa cervicalis is supplied by what nerves?

A

C1 and C2

109
Q

What is the inferior root of ansa cervicalis made up of?

A

C2

110
Q

What muscles does C1 go on to innervate?

A

Geniohyoid and thyrohyoid

111
Q

The branches of inferior ansa innervate what muscles?

A

3 of the infrahyoid muscles: omohyoid, sternohyoid, sternothyroid

112
Q

Transverse cervical is make up of what nerve?

A

C2

113
Q

Greater auricular nerve and the lesser occipital nerve arise from what nerve?

A

C2

114
Q

What nerve does the supraclavicular nerve come off of?

A

C3

115
Q

What nerves make up the phrenic nerve?

A

C3-C5

116
Q

Supraclavicular has how many branches?

A

3; anterior, middle, posterior

117
Q

The greater auricular nerve courses with what? What does it supply?

A

External jugular vein to supply posterior auricle and parotid region (between mastoid process and the mandible angle)

118
Q

What does the transverse cervical nerve innervate?

A

anterior cervical region

119
Q

What doe sthe lesser occipital nerve supply? And what muscle does it parallel?

A

Supplies posterolateral neck and scalp; parallels posterolateral neck and scalp

120
Q

What does the supraclavicular nerve supply?

A

clavicular skin and shoulder

121
Q

The phrenic nerve does what?

A

Motor supply to diaphragm and visceral afferents from pericardium, pleura, etc.

122
Q

The C4-C5 loop of the cervical plexus also contributes motor fibers to what?

A

dorsal scapular (C4,C5), long thoracic (C5) of the brachial plexus

123
Q

The nerve point in the neck is also called what?

A

Erb’s point

124
Q

The spinal acessory nerve crosses the occipital triangle where?

A

Inferolaterally

125
Q

CN XI (spinal accessory) is the only motor nerve that ?

A

is found superficial to the prevertebral fascia

126
Q

Cutaneous branches of the cervical plexus emerge where?

A

Posterior midpoint of SCM

127
Q

What nerves are found in the nerve point of the neck?

A

Lesser occipital, great auricular, transverse cervical, supraclavicular

128
Q

Which cervical nerves make up the superior trunk of the brachial plexus?

A

C5 and C6

129
Q

Which nerve crosses the occipital triangle laterally?

A

Suprascapular

130
Q

When a cervical dislocation happens, what happens to the vertebrae?

A

The superior vertebrae displace anteriorly

131
Q

In slight cervical dislocations, why is the there not as bad spinal cord damage?

A

Because the size of the vertebral foramen gives space for the cord

132
Q

What constitutes a cervical true dislocation?

A

“jumped facets,” when the inferior facet of the superior vertebrae is pushed anteriorly to the inferior vertebrae’s superior facet

133
Q

A subluxation is defined as what? Why is this not a true dislocation?

A

when the inferior facet has jumped anteriorly, but it’s only a complete dislocation if the inferior facet has jumped so anteriorly it crosses the superior facet of the inferior vertebrae

134
Q

Why would you need an MRI to show the extend of a cervical dislocation?

A

Because it can see soft tissue damage; sprains and sublxations may self-reduce

135
Q

A Jefferson fracture is also known as what? What is it? Why does this happen?

A

Burst fracture; fracture of the anterior and posterior arches of C1; vertical compression injury (diving accidents)

136
Q

Why may a spinal cord injury not occur in a Jefferson fracture?

A

Because it widens the vertebral foramen (the lateral masses are pushed aside)

137
Q

In what case is a CNS injury more likely in a Jefferson fracture?

A

When the transverse ligament ruptures

138
Q

What is a hangman’s fracture?

A

Fracture to C2 between the pedicle and the lamina by forced hyperextension of the head

139
Q

Why is a hangman’s fracture more severe? What can happen as a result?

A

The body of C2 subluxates anteriorly, separating it from its facet

Quadriplegia, death

140
Q

What are the three types of dens fractures? Which has the best prognosis?

A

Type I - fracture of the upper part of the dens
Type II - fracture at the base of the dens
Type III - fracture of the dens and a part of C2 body

Type III has the best prognosis; the other two are unstable

141
Q

If C1 and C2 subluxate together is that better or worse?

A

Better, less likely to compress the spinal cord

142
Q

If the transverse ligament ruptures without a dens fracture, is that better or worse?

A

Worse becaues C1 subluxates alone, making spinal cord compression more likely

143
Q

Sign of retropharyngeal abscess?

A

Bulge posterior to SCM

144
Q

What would you look for on an X-ray or MRi for a retropharyngeal abscess?

A

Thickening of the soft tissue - swelling in the prevertebral space

Anatomy (4 decks)

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