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1. Anatomy - BLOCK 4 > NECK - nerves > Flashcards

NECK - nerves Flashcards

1
Q

What are the 5 Cranial Nerves located in the anterior triangle of the neck?

What are the spinal nerves located here?

A

Cranial nerves:

· Facial n. (CN VII)

· Glossopharyngeal n. (CN IX)

· Vagus n. (CN X)

· Accessory n. (CN XI)

· Hypoglossal n. (CN XII)

Spinal nerves:

  • Cervical plexus and branches
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2
Q

Facial nerve (CN VII):

motor, sensory, parasympathetic, both?

  1. where does it exit the cranial cavity?
  2. what 2 muscles are innervated by its digastric branch?
  3. What are the 2 divisions of CN VII in the parotid gland?
  4. The cervical n. is a branch of what division? It innervates what muscle?
A

motor, sensory, parasympathetic

  1. stylomastoid foramen
  2. digastric (posterior belly) + stylohyoid
  3. temporofacial division (upper) + cervicofacial division (lower)
  4. cervicofacial division; innervates platysma m.
    * (emerges from anterior border of parotid gland)*
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3
Q

Glossopharyngeal nerve (CN IX)

motor, sensory, parasympathetic, both?

  1. where does it exit the cranial cavity?
  2. what is its location as it descends ?
  3. What is its location in the anterior triangle?
  4. what 3 structures does it innervate?
A

motor, sensory, parasympathetic

  1. jugular foramen
  2. Descends between ICA and IJV
  3. anterior triangle = lies between ECA and ICA; lateral to stylopharyngeus m.
  4. stylopharyngeus m. (motor)

Ÿ pharynx (sensory by pharyngeal branch)

Ÿ carotid sinus and body (sensory by carotid branch)

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4
Q

Vagus nerve (CN X)

motor, sensory, parasympathetic, both?

  1. where does it exit the cranial cavity?
  2. what fascia is it enclosed in?
  3. What are its 5 branches in the anterior triangle?
A

motor, sensory, parasympathetic

1. jugular foramen

2. carotid sheath

3. 5-branches:

  • pharyngeal n. (motor to pharynx)
  • carotid br. (sensory to carotid body)
  • internal laryngeal n. (sensory and parasympathetic to supraglottic larynx) <– Sup. laryn.
  • external laryngeal n. (motor to cricothyroid m.) <– Superior laryngeal n.
  • cardiac br. (joins cardiac plexus in thorax) –> parasympathetic
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5
Q

Accessory nerve (CN XI)

motor, sensory, parasympathetic, both?

  1. where does it exit the cranial cavity?
  2. what is its location?
  3. What 2 muscles does it innervate?
A

motor

  1. jugular foramen
  2. Runs obliquely across the lateral aspect of neck
  3. sternocleidomastoid + trapezius mm (motor)
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6
Q

Hypoglossal nerve (CN XII)

motor, sensory, parasympathetic, both?

  1. where does it exit the cranial cavity?
  2. what is its location?
  3. What 2 muscles does it run deep to?
  4. where does it enter the tongue?
  5. what muscle groups does it innervate?
A

motor

1. hypoglossal canal

  1. Medial to IJV + ICA immediately outside cranial cavity; anterior triangle = lateral to ICA + ECA + lingual a.
  2. digastric (anterior belly) + stylohyoid mm.
  3. medial to hypoglossus m.
  4. 3 extrinsic + all intrinsic tongue muscles (motor)
    * * no branches in anterior triangle**
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7
Q

Transverse Cervical nerve (Cervical Plexus)

  1. arises from which ventral rami?
  2. where does it run?
A
  1. ventral rami of C2-C3 spinal nerves
  2. Across neck on anterior surface of sternocleidomastoid m.
    * * Cutaneous nerve**
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8
Q

Ansa Cervicalis

  1. Loop of nerve fibers from which spinal nn.?
  2. runs on lateral surface of what blood vessel?
  3. What spinal nerve fibers make up the superior root?
  4. What spinal nerve fibers make up the inferior root?
A
  1. C1-C3 spinal nn.
  2. IJV
  3. formed by C1 fibers; descends b/t IJV + ICA/CCA
  4. fibers from C2-C3 spinal nn
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9
Q

Name the 6 innervations of the Ansa Cervicalis + their spinal nn. levels:

A
  • superior belly of omohyoid (C1)
  • inferior belly of omohyoid (C2-C3)
  • upper part of sternohyoid (C1)

Ÿ - lower part of sternohyoid (C2-C3)

  • upper part of sternothyroid (C1)
  • lower part of sternothyroid (C2-C3)
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10
Q

What are the cranial nerves in the posterior triangle of the neck?

What are the spinal nerves here?

A

Cranial nerve(s):

  • Accessory n. (CN XI)

Spinal nerves:

  • Cervical plexus and branches
  • Brachial plexus (components and branches)
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11
Q

Cervical Plexus

  1. Formed by which ventral rami?
  2. what location is it formed in?
  3. what 2 types of branches does it consit of?
A
  1. C1-C4 spinal nn.
  2. muscles of the floor of posterior triangle
  3. cutaneous (superficial) branches + muscular (deep) branches
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12
Q

What are the 4 cutaneous branches of the cervical plexus?

A
  • lesser occipital n. (C2)
  • greater aruicular n. (C2-C2)
  • transverse cervical n. (C2-C3)
  • supraclavicular nn. (C3-C4)
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13
Q

Cervical Plexus: Cutaneous Branches

Lesser occipital n. (C2)

  • location?
  • innervation?
A
  • Ascends along the posterior border of SCM
  • Skin of neck and scalp posterior to ear
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14
Q

Cervical Plexus: Cutaneous Branches

Greater auricular n. (C2-C3)

  • location?
  • innervation?
A
  • Ascends across SCM to the base of ear
  • Skin of parotid region, ear, and mastoid area
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15
Q

Cervical Plexus: Cutaneous Branches

Transverse Cervical n. (C2-C3)

  • location?
  • innervation?
A
  • Runs horizontally across the midpart of SCM
  • Lateral and anterior parts of neck
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16
Q

Cervical Plexus: Cutaneous Branches

Supraclavicular n. (C3-C4)

  • location?
  • innervation?
A
  • Descends along the posterior border of SCM
  • Skin over clavicle and shoulder up to rib 2
17
Q

Cervical Plexus: Muscular Branches

  1. supplies which muscle groups?
  2. contribute to the formation of…?
A
  1. Supplies pre-vertebral and lateral vertebral muscles
  2. Contributes to the formation of ansa cervicalis
18
Q

Cervical Plexus: Muscular Branches

Phrenic nerve

  • what spinal cord segments?
  • location?
  • innervates?
A
  • C3-C4(5) spinal cord segments
  • runs inferiorly across the anterior surface of anterior scalene m.
  • supplies diaphragm (motor and sensory)
19
Q

Cervical Plexus: Muscular Branches

Rectus capitis anterior:

  • action/function?
  • innervation?
A
  • act: Flexion of head at atlanto-occipital joint
  • inn: C1-C2 ventral rami
20
Q

Cervical Plexus: Muscular Branches

Rectus capitis lateralis

  • action/function?
  • innervation?
A
  • act: Ipsilateral flexion of head
  • inn: C1-C2 ventral rami
21
Q

Cervical Plexus: Muscular Branches

Longus colli

  • action/function?
  • innervation?
A
  • act: Flexion and lateral flexion of neck; used during ipsilateral head turn to counteract lateral flexion of opposite SCM
  • inn: C2-C6 ventral rami
22
Q

Cervical Plexus: Muscular Branches

Longus capitis

  • action/function?
  • innervation?
A
  • act: Flexion and ipsilateral rotation of head
  • inn: C1-C3 ventral rami
23
Q

Cervical Plexus: Muscular Branches

Anterior scalene

  • action/function?
  • innervation?
A
  • act: Lateral flexion of neck; elevation of rib 1; used during inspiration
  • inn: Adjacent ventral rami (C3-C7)
24
Q

Cervical Plexus: Muscular Branches

Middle scalene

  • action/function?
  • innervation?
A
  • act: Lateral flexion of neck; used during ipsilateral head turn to counteract lateral flexion of opposite SCM; elevation of rib 1; used in forced inspiration
  • inn: Adjacent ventral rami (C3-C7)
25
Q

Cervical Plexus: Muscular Branches

Posterior scalene

  • action/function?
  • innervation?
A
  • act: Possible elevation of rib 2 (?)
  • inn: Adjacent ventral rami (C3-C7)
26
Q

Brachial Plexus

  • Roots from which ventral rami?
  • where are the roots + trunks located?
A
  • C5-T1 ventral rami

- Roots = between anterior + middle scalene mm.

- Trunks = cross base of posterior triangle

27
Q

Brachial Plexus

What are the branches from roots of brachial plexus in the posterior triangle of the neck?

A

*Dorsal scapular n. (C5) à Rhomboids

● *N. to subclavius (C5) à Subclavius

● *Long thoracic n. (C5-C7) à Serratus anaterio

*these nerves are NOT part of the brachial plexus

** Suprascapular n. (C5-C6) is the only branch of brachial plexus in the posterior r of neck.

28
Q

Nerves in the Root of the Neck

What are the spinal nerves located here?

What are the cranial nerves?

What components of the sympathetic nervous system are here?

A

Spinal nerve:

▪ Phrenic n.

Cranial nerve(s):

  • Vagus n. (CN X)
  • Recurrent laryngeal n. (CN X)

Sympathetic nervous system:

● Cervical components

29
Q

Phrenic nerve

spinal cord segments?

location?

innervates?

A
  • C3-C5 ventral rami
  • Runs inferiorly across anterior surface of anterior scalene m.;

enters thorax b/t subclavian a. and v.

  • Innervates diaphragm
30
Q

Vagus nerve (CN X)

location?

A

within carotid sheath

  • descends through neck posterior to/between CCA + IJV; lies between subclavian a. + v. in root of neck

* cardiac branches in the lower part of neck

31
Q

Recurrent Laryngeal nerve (CN X)

Right recurrent laryngeal n.:

  • originates from…?
  • loops around…?
  • goes to…?
A
  • Originates from right vagus n. (lower edge of R. subclavian a.)

● Loops around right subclavian a.

● Runs upward/medially in tracheoesophageal groove and goes to larynx

32
Q

Recurrent Laryngeal nerve (CN X)

Left recurrent laryngeal n.:

  • originates from…?
  • loops around…?
  • goes to…?
A

Originates from left vagus n. (superior mediastinum)

● Loops around aortic arch

● Ascends beside trachea to larynx

33
Q

Name the 3 parts of the Sympathetic Nervous System in the neck:

A

Ø cervical part of sympathetic trunk

Ø cervical sympathetic ganglia

Ø cardiac nerves (post-ganglionic)

34
Q

Cervical Sympathetic Trunk

  1. location?
  2. Connected to cervical spinal nn. by…?
  3. Name the 3 associated ganglia?
  4. Cervical ganglia receive pre-ganglionic sympathetic fibers from…?
A
  1. anterior to longus colli + longus capitis mm.; posterior to CCA in carotid sheath**

** fibers in sheath; trunk OUTSIDE sheath

  1. gray rami communicantes (GRC)
  2. superior + middle + inferior
  3. upper thoracic (T1-T5) spinal cord segments
35
Q

Superior Cervical Ganglion

  • spinal cord segements?
  • branches pass to what 4 places?
A

C1-C4 spinal cord segments

Branches pass to…

● cervical spinal nn. C1-C4 (through GRC)

● ICA and ECA, forming plexuses around these arteries

● pharynx

● heart via superior cardiac nn. (post-ganglionic fibers)

36
Q

Middle Cervical Ganglion

  • spinal cord segements?
  • branches pass to what 2 places?
A

C5-C6 spinal cord segments

Branches pass to…

● cervical spinal nn. C5-C6 through gray rami communicantes (GRC)

● heart via middle cardiac nn. (post- ganglionic fibers)

37
Q

Inferior Cervical Ganglion

  1. spinal cord segements?
  2. location?
  3. branches pass to what 3 places?
A

1. C7-C8 spinal cord segments

  1. Anterior to neck of rib 1 + C7 transverse process;
    * Posterior to* subclavian + vertebral aa.

3. branches:

- cervical spinal nn. C7-T1 (through GRC)

  • vertebral a. (form a plexus around the vessel)
  • heart via inferior cardiac nn. (post-ganglionic fibers)

* May occasionally receive WRC from T1(2) spinal nn.*

38
Q

**Stellate ganglion: **

  • which spinal cord segments?
  • can these exist silmultaneously with inferior cervical ganglia?
A

C7-T1 spinal cord segments

  • CANNOT have both inferior cervical ganglion AND stellate; can vary from side to side
39
Q

ANSA SUBCLAVIA:

A
  • R. recurrant laryngeal n. –> loops around R. subclavian a.; branch of vagus n.
  • Ansa subclavian –> loops arouns R. subclavian a.; is sympathetic & bilateral

1. Anatomy - BLOCK 4 (6 decks)

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