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Neuro Exam 1 > Neck: Fascias, Spaces, Triangles, Superficial Structures > Flashcards

Neck: Fascias, Spaces, Triangles, Superficial Structures Flashcards

1
Q

occiput

A

external occipital protuberance and superior nuchal lines

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2
Q

mastoid process

A

of temoral bone

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3
Q

mandible

A

ramus, angle, inferior margin to midline

midline - symphysis menti

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4
Q

hyoid bone

A

superior to thyroid cartilage

opposite CV3

greater horn - palpable laterally

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5
Q

thyroid cartilage

A

opposite CV4 CV5

palpable superior thyroid notch and laryngeal prominence

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6
Q

cricoid cartilage

A

anterior to CV6

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7
Q

thyroid isthmus

A

usually palpable across level of 2,3,4 tracheal rings

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8
Q

platysma

A

neck cutaneous muscles seen anterior and lateral when straining

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9
Q

superficial fascia

A

CT and fat between skin and deep fascia

contains platysma

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10
Q

attachments of platysma

A

O: superficial fascia covering pec major and deltoid
I: inferior margin of mandible, skin and subQ of lower portion of face and corner of mouth

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11
Q

action of platysma

A

draws corners of mouth down
depresses mandlble
elevates skin of chest

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12
Q

innervation of platysma

A

cervical branch of CN VII (facial)

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13
Q

investing fascia

A

first layer of deep fascia
around entire neck

invests SCM and trapezius

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14
Q

attachments of investing fascia

A

superior - external occipital protuberance, superior nuchal line, mastoid process, inferior margin of mandible

posterior - external occipital protuberance, spinous processes of CV1-7 via nuchal ligament

inferior - scapula, acromion, clavicle, manubrium

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15
Q

suprasternal space

A

where the laminae of investing fascia from both surfaces of SCM fail to fuse anteriorly and inferiorly

contains fat and a vein

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16
Q

infrahyoid fascia

A

begins at hyoid bone and thyroid cartilage

forms two layers - superficial and deep

invest infrahyoid muscles

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17
Q

superficial layer of infrahyoid fascia

A

invests sternohyoid and omohyoid
attaches posterior to manubrium
lateral fusion with periosteum of clavicle and first rib

forms sling for intermediate tendon of omohyoid muscle

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18
Q

deep layer of infrahyoid fascia

A

invests sternohyoid and thyrohyoid

inferior to posterior surface of manubrium

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19
Q

inferior lamina of infrahyoid fascia

A

both layers fuse with adventitia of brachiocephalic veins and fibrous pericardium
-via superior sternopericardial ligament

laterally with carotid sheath

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20
Q

cervical visceral fascias

A

enclose viscera of neck

pre-tracheal and buccopharyngeal

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21
Q

pre-tracheal fascia

A

anterior to larynx and trachea
attached to hyoid bone superiorly

blends laterally with buccopharyngeal fascia

splits to enclose thyroid gland

inferiorly - attaches with adventitia of aortic arch
-fuses with fibrous pericardium

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22
Q

buccopharyngeal fascia

A

attaches superior to base of skull
-covers buccinator and pharyngeal constrictor muscles

fuses laterally with the pre-tracheal fascia at muscle attachment sites of pharyngeal constrictor and at posteromedial border of thyroid gland

inferior - fuse with adventitia of esophagus

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23
Q

pre-vertebral fascia

A

encircles vertebral column

bifurcates anteriorly alar fascia

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24
Q

alar fascia

A

attaches to midline of buccopharyngeal fascia

from bifurcation of pre-vertebral fascia

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25
Q

floor of posterior cervical triangle

A

pre-vertebral fascia attaches to cervical transverse processes

covers scalenes, levator scapulae, splenius and semispinalis muscles

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26
Q

sibsons fascia

A

prevertebral fascia continues on underside of scalene muscles

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27
Q

axillary sheath

A

prevertebral fascia reflected from scalene muscles latearally along subclavian and axillary veins and brachial plexus as they pass through scalene triangles

28
Q

carotid sheath

A

surrounds common and internal carotid arteries, internal jugular vein, and vagus nerve

superior - attaches to margins of jugular foramen
inferiorly - fuses with adventitia of great vessels

form from all deep fascias fusing

29
Q

infections in pretracheal, retrovisceral, and danger space

A

can go to carotid sheath

-and go inferiorly to involve aorta (aortitis)

30
Q

pretracheal space

A

between deep layer of infrahyoid fascia and pre-tracheal fascia

extends from level of attachment of infrahyoid muscles to thyroid cartilage above to attachment of pericardium to roots of major vessels in superior mediastinum below

31
Q

retropharyngeal spaces

A

2x
between buccopharyngeal, pre-vertebral, and alar fascias

extend from base of skull to posterior mediastinum

closed laterally - carotid sheath

32
Q

retrovisceral space

A

between buccopharyngeal and alar fascias
more anterior
base of skull to where alar blends with esophagus

33
Q

danger space

A

bewteen pre-vertebral and alar/buccopharyngeal fascias

  • base of skull to diaphragm
  • between vertebral column and esophagus
34
Q

infection of pre-tracheal space

A

to superior mediastinum

-inflammation of brachiocephalic veins, aorta, pericardium

35
Q

infection in danger space

A

retropharyngeal abscess

  • dysphagia/dysarthria
  • can dissect into posterior aspect of superior and posterior mediastinum
36
Q

chronic tonsillitis

A

mediastinal abscess

inflammation of esophagus as far inferior as the diaphragm

37
Q

attachments of SCM

A

O: sternal head - manubrium
clavicular head - proximal 1/3 clavicle
I: mastoid process, superior nuchal line

38
Q

action of SCM

A

unilateral - rotates head opposite while elevating chin

bilateral - flexes head and limits extension of AO joint**

39
Q

innervation of SCM

A

spinal accesory nerve CN XI

cervical spinal nerves C2 and C3

40
Q

torticollis

A

wry neck
congenital or acquired
shortening of SCM

patients head sidebent to same side and rotated opposite of muscle**

41
Q

posterior triangle

A

bounded by trap, SCM, and clavicle

42
Q

subdivision of posterior triangle

A

by omohyoid division

occipital - larger superior
omoclavicular - smaller inferior

43
Q

anterior triangle

A

bounded by SCM, angle of mandible, imaginary midline

44
Q

subdivision of anterior triangle

A

by omohyoid and digastric muscles

digastric (submandibular) triangle
submental triangle
carotid triangle - posterior lower
muscular triangle - anterior lower

45
Q

formation of external jugular vein

A

posterior division of retromandibular v.
posterior auricular vv.

extends SUPERIOR to SCM -then pierces investing fascia

terminates in the subclavian vein

46
Q

tributaries to external jugular vein

A

posterior external jugular vein
transverse cervical vein
suprascapular vein
anterior jugular vein

47
Q

prominence of external jugular vein

A

heart failure, SVC obstruction, enlarged supraclavicular lymph nodes, or increased intrathoracic pressure

48
Q

laceration of external jugular vein

A

air embolism

negative intrathoracic pressure sucks air in

reduced blood through right atrium
-accumulated air/dyspnea

49
Q

anterior jugular vein formation

A

from small veins in submental and submandibular regions that coalesce at hyoid bone area

has jugulovenous arch and then joins external jugular vein

50
Q

jugulovenous arch

A

communication of right and left anterior jugular veins

51
Q

common facial vein formation

A

facial veins join with anterior division of retromandibular vein

pierces carotid sheath to join internal jugular vein

also might get communicating vein
-to communicate with anterior jugular veins

52
Q

blockage of internal jugular vein?

A

emissary veins and opthalmic vein drain blood to retromandibular and facial veins

anastomose with posterior auricular v to form external jugular vein

common facial vein from anastomosis facial vein with anterior division of retromandibular vein returns blood to internal jugular vein distal to blockage

53
Q

dorsal rami of cervical nerves?

A

C1 - rare
C2 - greater occipital nerve
C3-6 - pierce uscle - cutaneous over trapezius

54
Q

greater occipital nerve

A

C2 dorsal rami

pierce semispinalis capitis and trapezius and ascends to innervate skin over vertex and posterolateral skull

55
Q

ventral rami of cervical nerves?

A

C1-4 cervical plexus

C2-4 of cervical plexus - to pinna of ear and in front of and behind ear

56
Q

lesser occipital nerve

A

ventral rami C2,3

57
Q

greater auricular nerve

A

ventral rami C2,3

58
Q

transverse cervical nerve

A

ventral rami C 2,3

59
Q

supraclavicular nerve

A

ventral rami C 3, 4

60
Q

branches of supraclavicular nerve

A

medial, intermediate, and lateral supraclavicular nerve

61
Q

medial supraclavicular nerve

A

crosses SCM to skin at base of neck, upper sternum, and SC joint

62
Q

intermediate supraclavicular nerve

A

cross clavicle to innervate skin over pectoralis major as far inferior as third rib

63
Q

lateral supraclavicular nerve

A

cross clavicle at AC joint and cutaneous to prominence of shoulder

64
Q

cervical nerve block

A

anesthetize the cutaneous nerves during surgical approach to neck

ex. radical neck dissection of cancerous lymph nodes

phrenic nerve - shares SC levels of innervation
-will get ipsilateral hemidiaphragm paralysis

don’t do this procedure on patient with respiratory or cardiac disease

65
Q

superficial cervical lymph nodes

A

submental, submandibular, external jugular, anterior jugular

drain to deep cervical lymph nodes that parallel internal jugular

66
Q

lymph drainage of head and neck

A

superficial - superficial cervical to deep cervical

deep and visceral - to deep cervical

Neuro Exam 1 (17 decks)

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