Neck Lecture Flashcards
Superior Cervical Ganglion Vertebral Level?
C2
Hyoid Bone Vertebral Level?
C3
Vertebral Level of Common Carotid Artery Bifurcation ?
C4
Vertebral Level of Superior Border of Thyroid Cartilage?
C4
Vertebral Level of Rest of Thyroid Cartilage (Under Superior Border)?
C5
Vertebral artery enters the transverse foramen of _____
C6
Cricoid Cartilage Vertebral Level?
C6
Middle Cervical Ganglion Vertebral Level?
C6
The Larynx Becomes the Trachea at Which Vertebral Level?
C6
The Pharynx Becomes the Esophagus at Which Vertebral Level?
C6
Inferior Cervical (Stellate) Ganglion Vertebral Level?
C7
The investing fascia surrounds everything but the _____ in the subcutaneous fat
Platysma Muscle
The investing fascia is so named because it invests which two muscles?
Sternocleidomastoid & Trapezius Muscles
The prevertebral fascia contains which muscles?
All deep muscles associated with the articulation of the vertebrae (Scalenes, longus colli m., etc.)
The prevertebral fascia attaches to the _____
Ligamentum Nuchae
The axillary sheath, which invests the brachial plexus, is a continuation of the _____
Prevertebral Fascia
The pretracheal fascia surrounds the _____, the _____, and the _____
The thyroid gland, the trachea, and the esophagus
Fascia covering the _____ aspect of the trachea is the pretracheal fascia, while the fascia covering the posterior aspect of the trachea _____ depending on the vertebral level.
Fascia covering the ANTERIOR aspect of the trachea is the pretracheal fascia, while the fascia covering the posterior aspect of the trachea CHANGES NAMES depending on the vertebral level (visceral/buccopharyngeal fascia)
(That’s so fucking stupid.)
Below C6, the _____ fascia covers the esophagus posteriorly to the trachea.
Visceral Fascia
Above C6, the _____ fascia covers the pharynx. It extends to the cheeks.
Buccopharyngeal Fascia
The _____ is formed by contributions from three surrounding fascia layers (investing, prevertebral, pretracheal)
Carotid Sheath
Medially, the _____ is found in the carotid sheath
Common Carotid Artery (does not bifurcate until C4)
Laterally, the _____ is found in the carotid sheath
Internal Jugular Vein
Posteriorly, the _____ is found in the carotid sheath
Vagus Nerve (X)
Superior Attachment of Anterior Scalene
Transverse Processes of C3-C6
Inferior Attachment of Anterior Scalene
1st Rib
Innervation of Anterior Scalene
Ventral Rami of Cervical Spinal Nerves
Anterior Scalene Action
Flex Neck
Middle Scalene Superior Attachment
Posterior Tubercle of Transverse Processes of C2-C7
Middle Scalene Inferior Attachment
1st rib
Posterior to the groove for the subclavian artery
Middle Scalene Innervation
Ventral Rami of Cervical Spinal Nerves
Middle Scalene Action
Flex Neck
Posterior Scalene Superior Attachment
Posterior Tubercles of Transverse Processes of C5-C7
Posterior Scalene Inferior Attachment
2nd Rib
Posterior Scalene Innervation
Ventral Rami of Cervical Spinal Nerves
Posterior Scalene Action
Flex Neck
Deep Muscles of the Neck?
Longus colli, Longus capitis, Rectus capitis lateralis, Rectus capitis anterior mm.
Longus Colli Superior Attachments
Anterior Tubercle of C1
Bodies of C1-C3
Transverse Processes of C3-C6
Longus Colli Inferior Attachments
Bodies of C5-T3
Transverse Processes of C3-C5
Longus Colli Innervation
Ventral Rami of C2-C6 Spinal Nerves
Longus Colli Action
Flex Neck
Longus Capitis Superior Attachment
Basilar Part of Occipital Bone
Longus Capitis Inferior Attachment
Anterior Tubercles of C3-C6 Transverse Processes
Longus Capitis Innervation
Ventral Rami of C1-C3
Rectus Capitis Lateralis Superior Attachment
Jugular Process of Occipital Bone
Rectus Capitis Lateralis Inferior Attachment
Transverse Process of Atlas
Rectus Capitis Lateralis Action
Flexor and Stabilizer of Head
Rectus Capitis Lateralis Innervation
Branches from loop between C1 & C2 (Ansa Cervicalis?)
Rectus Capitis Anterior Superior Attachment
Base of cranium, anterior to occipital conyles
Rectus Capitis Anterior Inferior Attachment
Anterior surface of lateral mass of atlas
Rectus Capitis Anterior Innervation
Branches from loop between C1 & C2 (Ansa Cervicalis)
Rectus Capitis Anterior Action
Flexion of the Head
The retropharyngeal space allows communication from the head & neck to the _____
Posterior Mediastinum
This communication allows for the spread of infection. No bueno.
Above C6, the retropharyngeal space is between the _____ and the _____
Buccopharyngeal Fascia & Prevertebral Fascia
Below C6, the retropharyngeal space is between the _____ and the _____
Visceral Fascia & Prevertebral Fascia
The lateral pharyngeal space sits between the _____ (with tonsils) and the _____
Pharyngeal Wall & Parotid Gland
The _____ is found within the lateral pharyngeal space
Carotid Sheath
Its contents (CCA, IJV, CN X) should be considered in infection of the lateral pharyngeal space
The _____ includes the sublingual and submaxillary spaces
Submandibular Space
Borders of the Posterior Triangle (Lateral Cervical Region)?
Posterior Portion of Sternocleidomastiod
Anterior Border of Trapezius
Middle Third of Clavicle
The Posterior Triangle is further divided into the _____ and the _____ by the inferior belly of the omohyoid muscle
Occipital Triangle & Omoclavicular Triangle
Contents of Occipital Triangle?
Occipital artery and CN XI (Spinal Accessory Nerve)
Contents of Omoclavicular Triangle?
Subclavian artery, deep to external jugular vein
The cervical plexus is composed of _____, and has _____ branches
Ventral Rami of C1-C4
Motor AND Sensory Branches
The _____ is sensory to the neck and the scalp (posterosuperior to the ear).
Lesser Occipital Nerve
The lesser occipital n. is a branch of _____
Ventral Ramus of C2
The lesser occipital n. runs posterior to the _____ muscle, to the _____, then to the scalp.
Posterior to SCM > Mastoid Process > Scalp
The great auricular n. is sensory to the _____ and _____. It is also sensory to the skin and sheath of the _____ and a piece of skin over the _____.
Inferior aspect of the auricle (ear)
Angle of mandible
Parotid gland
Ear
The great auricular nerve runs with the _____ as it crosses the SCM
External jugular vein
The great auricular nerve receives branches from _____ and _____
C2 & C3
The _____ is sensory to the skin covering the anterior cervical region
Transverse cervical nerve
The transverse cervical nerve runs deep to the _____, and transversely across the neck.
Platysma muscle
The transverse cervical nerve receives branches from _____ and _____
C2 & C3
The supraclavicular nerves are sensory to the _____ and the _____
Skin crossing the clavicle and the skin of the deltoid region of the shoulders
Three divisions of the supraclavicular nerve?
Medial, Intermediate & Lateral
The supraclavicular nerve receives branches from _____ and _____
C3 & C4
The _____ is both motor and sensory to the diaphragm
Phrenic nerve
The _____ can cause referred pain to the shoulder region via the supraclavicular n. since both receive branches from _____ & _____
Phrenic nerve
C3 & C4
The ansa cervicalis has a superior loop formed by _____, and an inferior loop formed by _____
Superior - C1 (Descendens hypoglossi)
Inferior - C2 & C3 (Descendens cervicalis)
The ansa cervicalis muscle is purely motor. It innervates 3 of the infrahyoid muscles. Which?
1) Sternohyoid
2) Sternothyroid
3) Omohyoid (both bellies)
The ansa cervicalis runs on the _____ and _____
Internal jugular vein and carotid artery
The hypoglossal nerve (CN XII) carries branches of _____ that innervate the _____ and _____ muscles
Branches of C1
Geniohyoid & Thyrohyoid (NOT INNERVATED BY CN XII, INNERVATED BY BRANCHES OF C1 THAT RUN WITH CN XII)
The common point of branching of C2 & C3 (origin of cutaneous nerves) is known as _____
Erb’s Point
Borders of the Anterior Cervical Region (Anterior Triangle)?
Inferior Border of Mandible
Anterior Border of SCM
Midline of neck
Sternohyoid Superior Attachment
Inferior body of hyoid
Sternohyoid Inferior Attachment
Manubrium of sternum
Medial end of clavicle
Sternohyoid Innervation
Ansa Cervicalis (C1-C3)
Sternothyroid Superior Attachment
Oblique line of thyroid cartilage
Sternothyroid Inferior Attachment
Posterior surface of manubrium of sternum
Sternothyroid Innervation
Ansa Cervicalis (C2-C3)
Thyrohyoid Superior Attachment
Oblique line of thyroid cartilage
Thyrohyoid Inferior Attachment
Body of hyoid
Thyrohyoid Innervation
C1 VIA THE HYPOGLOSSAL NERVE (CN XI)
Strap Muscle Action
Lower entire apparatus (swallowing)
What exits the Jugular Foramen?
Internal Jugular Vein
Glossopharyngeal n. (CN IX)
Vagus n. (CN X)
Spinal Accessory n. (CN XI)
The tympanic branch of _____ enters the tympanix plexus then becomes the _____
Glossopharyngeal n. (CN XI)
Lesser Petrosal n.
The lesser petrosal n. synapses in the _____, then sends _____ via the _____ to the _____
The lesser petrosal n. synapses in the OTIC GANGLION, then sends POSTGANGLIONIC PARASYMPATHETICS via the AURICULOTEMPORAL N. to the PAROTID GLAND
The _____ of the glossopharyngeal n. supplies _____ to the carotid sinus and carotid body
The CAROTID BRANCH. of the glossopharyngeal n. supplies GVA INNERVATION to the carotid sinus and carotid body
The _____ is a dilation of the proximal part of the internal carotid artery once it branches from the common carotid.
Carotid Sinus
The carotid sinus receives _____ from CN IX.
GVA Sensation
The carotid sinus contains _____ that detect changes of blood pressure.
Baroreceptors
The _____ is a small epithelioid body in the bifurcation of the common carotid artery. It receives GVA sensation from _____.
Carotid Body
GVA sensation from CN IX (Glossopharyngeal)
The carotid body has _____ to detect hypoxia (-oxygen) and hypercapnia (+CO2)
Chemoreceptors
The _____ is the first branch of the Vagus n. (X). It runs anterior to the _____ and posterior to the _____.
Pharyngeal branch.
Anterior to the ICA, Posterior to the ECA
The _____ is the second branch of the Vagus n. (X). It runs posterior to the _____.
Superior laryngeal n.
Internal Carotid Artery
The superior laryngeal nerve branches to form the _____ and the _____
Internal Branch (Sensory)
External Branch (Motor)
The internal branch of the superior laryngeal n. provides sensory innervation to the _____
Mucosa in the larynx above the vocal cords
The external branch of the superior laryngeal n provides motor innervation to the _____ and the _____
Cricothyroid muscle and cricopharyngeus m. of esophagus
The third branch of the vagus nerve is the _____
Recurrent laryngeal nerve
The right recurrent laryngeal n. curves around the _____
The left recurrent laryngeal n. curves around the _____ posterior to the _____
Right > Right Subclavian Artery
Left > Arch of the aorta, posterior to the ligamentum arteriosum
The hypoglossal n. (CN XII) exits the skull via the _____, near the neck of the occipital condyle
Hypoglossal Canal
The hypoglossal n. (CN XII) descends posterior to the _____
Intermediate tendon of the digastric m.
What structures would you find behind the posterior belly of the digastric muscle?
Hint: There are seven structures
1) Internal Carotid Artery
2) External Carotid Artery
3) Internal Jugular Vein
4) Facial Artery
5) CN X
6) CN XI
7) CN XII
The Spinal Accessory nerve innervates which two muscles?
SCM and Trapezius
The superior cervical ganglion contains _____ cell bodies
Postganglionic Sympathetic
List the five structures associated with the superior cervical ganglion
1) Internal Carotid Plexus
2) External Carotid Plexus
3) Gray rami communicans (C1-C4)
4) Pharyngeal plexus branches
5) Superior cervical cardiac n.
List the three structures associated with the middle cervical ganglion
1) Gray Rami Communicans (C5-C6)
2) Branches to the thyroid
3) Middle cervical cardiac n.
List the two structures associated with the inferior cervical ganglion
1) Gray Rami Communicans (C7-C8)
2) Inferior cervical cardiac n.
Four branches of the subclavian artery?
1) Vertebral artery
2) Internal thoracic artery
3) Thyrocervical trunk
4) Costocervical trunk
Five branches of the thyrocervical trunk?
1) Suprascapular artery
2) Transverse cervical artery
3) Inferior thyroid artery
4) Ascending cervical artery
5) Dorsal scapular artery
The _____ passes over the transverse scapular ligament. Supplies the supraspinatus and infraspinatus muscles
Suprascapular artery
The _____ a. supplies the trapezius and rhomboid muscles
Transverse cervical artery
The _____ artery goes from the thyrocervical trunk to the thyroid and parathyroid glands
Inferior thyroid artery
The _____ goes upward from the thyrocervical trunk to supply the deep muscles of the neck.
Ascending cervical artery
Two branches of the costocervical trunk?
1) Deep cervical artery
2) Supreme intercostal artery
The supreme intercostal artery supplies _____
1st & 2nd posterior intercostal spaces
Branch of Medial Division of External Carotid Artery?
Ascending Pharyngeal a.
Branches of Posterior Division of External Carotid Artery?
Occipital a.
Posterior Auricular a.
Branches of Anterior Division of External Carotid Artery?
Superior Thyroid a. (has Superior laryngeal a. branch)
Lingual a.
Facial a.
The great auricular nerve runs posterior to the _____
External jugular vein
The lesser occipital n. generally follows the anterior border of the _____
Trapezius m.
The phrenic nerve runs on the anterior surface of the _____. Next to it is the _____.
Anterior Scalene
Ascending Cervical Artery