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Clinical Anatomy Block 2 > Neck (Fasciae Posterior Triangle) > Flashcards

Neck (Fasciae Posterior Triangle) Flashcards

1
Q

What is the function of the Fascia of the Neck?

A
  1. Support viscera, muscles, vessels, nerves and deep lymph nodes
  2. Allow structures in the neck to move during swallowing, speaking, and respiration
  3. Forms natural cleavage planes
  4. Determine the direction in which a fluid (infection) collection in the neck may spread
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2
Q

What are 2 major fascia in the neck?

A
  1. Superficial Cervical Fascia
  2. Deep Cervical Fascia
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3
Q

What is the Cervical Fascia?

A
  1. Contains Platysma muscle (Cutaneous branches of the cervical plexus)
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4
Q

What is the Deep Cervical Fascia?

A
  1. Contains:
    a. Investing layer
    b. Pretracheal layer
    c. Prevertebral layer
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5
Q

What is the Neurovascular bundle of the neck?

A
  1. Enclosed by Carotid fascia
  2. Contains:
    a. Carotid artery
    b. Internal Jugular vein
    c. Vagus Nerve

*Found in Pretracheal layer

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6
Q

What is the Investing Layer?

A
  1. Encloses the trapezius, SCM, and Parotid and submandibular glands
  2. Contains the Suprasternal space at the sternal notch, which fluid can’t spread
  3. Anteriorly contains:
    a. Anterior jugular veins
    b. Jugular venous arch
    c. Areolar tissue
    d. Lymph nodes
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7
Q

What is the Pretracheal Layer?

A
  1. Contains two layers: Visceral layer and Muscular layer
    a. Visceral layer: Encloses thyroid and parathyroid glands; Esophagus and Trachea
    b. Muscular layer: Encloses Infrahyoid muscles
  2. Contains the Pretracheal fascia that blends with:
    a. Carotid shealth (Neurovascular bundle)
    b. Fibrous Pericardium
    c. Buccopharyngeal fascia
  3. Fluid can’t spread between the investing and muscular layer
  4. Contains Pretracheal space: Fluid may spread anteriorly to mediastinum
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8
Q

What is the Prevertebral Layer?

A
  1. Encloses the vertebral column
  2. At the base of the skull to T3 vertebra
  3. Contains Axillary sheath
  4. Contains the Retropharyngeal space (between the Prevertebral layer and Buccopharyngeal fascia)
    a. Fluid can be in the Retropharyngeal space causing Dysphagia, dyspnea, and dysathria
    b. May spread laterally (Swelling posterior to SCM muscle)
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9
Q

What is the Anterior Triangle?

A
  1. Contains:
    a. Submandiublar
    b. Carotid
    c. Muscular
    d. Submental

*Internal jugular vein present (Deep to the triangular area betweeen the sternal and clavicular heads of the SCM)

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10
Q

What is the Posterior Triangle?

A
  1. Contains the Occipital and Supraclavicular Triangles; and Inferior belly of omohyoid
  2. Boundaries:
    a. Posterior border of SCM
    b. Anterior border of trapezius
    c. Middle 1/3 of clavicle
  3. Roof:
    a. Investing Layer
  4. Floor-Prevertebral fascia that contains:
    a. Scaleni group of muscles
    b. Levator Scapulae
    c. Splenius capitis muscle
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11
Q

What is the Platysma?

A
  1. Blends with the Deltoid; Pectoralis major fascia; and Muscles of facial expression
  2. Tenses the skin of the neck releasing pressure of the superficial veins
  3. Helps to depress the mandible
  4. Pull down the corner of mouth (grimace)
  5. Nerve supply: Cervical branch of the CN VII (facial nerve)
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12
Q

What is the Sternocleidomastoid?

A
  1. Key muscular landmark for the Triangles of the neck
  2. Connects with the Sternal (manubrium sterni) and Clavicular (medial third) head
  3. Attaches to Mastoid process
  4. Unilaterally movement: Ispsilateral flexion of neck and rotates it (chin to opposite side)
  5. Bilaterally movement: Flex the neck
  6. Nerve Supply: CN XI (accessory nerve)
  7. Torticollis (Wryneck) ‘twisted neck’
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13
Q

What are the Blood Vessels in the Posterior Triangle?

A
  1. Arteries:
    a. Subclabian artery (Supraclavicular triangle)
    - Gives rise to Suprascapular and transverse cervical arteries
    b. Occipital artery (Occipital triangle)
  2. Veins:
    a. External Jugular Vein: Containing Transverse Cervical and Suprascapular vein
    b. Subclavian vein
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14
Q

What are the Nerves of the Posterior Triangle of the Neck?

A
  1. Nerves at are superficial to investing layer:
    a. Cutaneous branches of Cervical plexus
  2. Nerves that are Deep to investing layer:
    a. Accessory Nerve (on the fascial covering of levator scapulae)
    - Most come nerve to be damaged by a physician (Iatrogenically)
    b. Phrenic Nerve (on the fascial covering of anterior scalene)
    c. Trunks of brachial plexus
    d. Suprascapular nerve
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15
Q

What is the Cervical Plexus?

A
  1. Formed from the Ventral rami of C1 through C4 spinal nerves
  • Cervical plexus 1 contains NO Sensory; ONLY Somatic motor fibers
  • Cervical plexus 2-4 Contain both Sensory and Motor fibers
  1. Cervical Plexus Nerve Block:
    a. At Midpoint of posterior border of SCM
    b. Risk of blocking phrenic nerve that can cause paralysis of the diaphragm
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16
Q

What are the 4 Cutaneous Branches in the Cervical Plexus?

A
  1. Lesser Occipital (Supply skin of posterior head)
  2. Greater auricular (Supply skin of mandible)
  3. Transverse cervical (Supply skin of Neck)
  4. Supraclavicular (Supply skin over the shoulder)
17
Q

What are the Muscles Involved in the Cervical Plexus?

A
  1. Muscular branches:
    a. Prevertebral
    b. Scaleni group
    c. Levator scapulae muscles
  2. Ventral Rami supply:
    a. C1 - The Geniohyoid and thyrohyoid muscles via hypoglossal nerve and runs down to the Superior root of ansa cervicalis
    b. C2 and C3 - Decend to the Inferior root of ansa cervicalis (Supplies the Infrahyoid muscle except for thyrohyoid)
    c. C4 - Phrenic nerve (C3 and C5 contribute)
    d. C5-C8 and T1 - Trunks of the brachial plexus
18
Q

What is the Prevertebral Muscles?

A
  1. Group into 2 sections:
    a. Anterior prevertebral muscles
  • Longus colli
  • Longus capitis
  • Rectus capitis anterior
  • Rectus capitis lateralis

b. Lateral prevertebral muscles

  • Splenius capitis
  • Levator scapulae
  • Anterior scalene
  • Middle Scalene
  • Posterior scalene
19
Q

What is the Muscular action of the Anterior Prevertebral Muscles?

A
  1. Bilateral: Flexion of the head
  2. Unilateral: Contralateral rotation of neck (FOR LONGUS COLLI)
20
Q

What is the Muscular action of Lateral Prevertebral Muscles?

A
  1. Splenius:
    a. Bilateral: Extension of the head and neck
    b. Unilateral: Ipsilateral rotation of the head and neck
  2. Levator scapulae:
    a. Bilateral: Elevates scapula (shrugging shoulders)
    b. Unilateral: Tilt glenoid cavity inferiorly by rotating scapula
  3. Scaleni Muscles:
    a. Ipsilateral flexion of neck
    b. Elevates ribs (forced inspiration)
21
Q

What is the Nerve Supply of the Prevertebral Muscles?

A
  1. Ventral primary rami of the cerivical spinal nerves
    a. Cervical and Brachial plexuses
  2. Splenius Capitis:
    a. Dorsal rami of cervical spinal nerves
  3. Levator Scapulae:
    a. Dorsal scapular nerve

Clinical Anatomy Block 2 (7 decks)

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