Neck (pg. 5 - 16 in note packet) Flashcards
Neck
Not a clear division between head and neck
Neck extends from base of skull and inferior border of mandible to first rib
Column of neck
Collar, neck
Nuchal
Back of neck
Cervix
Neck (a narrowing)
Thyroid cartilage vertebral level?
C4, C5
Landmark of thyroid cartilage of larynx
Laryngeal prominence
Hyoid bone vertebral level
C3
Hyoid bone purpose
Attachment site for anterior neck muscles and some tongue muscles
Bony landmarks of hyoid bone
Body, greater cornua, lesser cornua
Cricoid cartilage vertebral level
C6
Cricoid cartilage is
A cartilage of the larynx
Tracheal cartilage begins at what vertebral level
Below C6
Superficial veins of neck
Facial vein Retromandibular vein Posterior auricular vein External jugular vein Anterior jugular vein
Retromandibular vein
Anterior branch joins facial vein
Posterior branch joins posterior auricular vein
External jugular vein
Formed by union of posterior branch of retromandibular vein and posterior auricular vein
Platysma Origin
O: Fascia and skin of deltoid and pectoral regions
Platysma Insertion
I: Mandible and tissues around mouth
Platysma Innervation
N: facial nerve
Skin of neck Innervation by
C2, C3, C4 spinal nerves
Jugular venous dissension
Bulging of internal/external jugular veins
Caused by increased blood pressure at the right atrium or right ventricle of heart
Can indicate cardiovascular disease
Anterior triangle of neck (borders)
SCM
Inferior angle of mandible
Midline of anterior neck
Anterior Subtriangle names
Submandibular triangle
Sub mental triangle
Carotid triangle
Inferior carotid triangle
Submandibular triangle border
Inferior border of mandible
Posterior belly of digastric muscle
Anterior bell of digastric muscle
Submandibular triangle contents
Submandibular gland
Facial artery
Submental triangle borders
Hyoid bone
Anterior belly of right digastric muscle
Anterior belly of left digastric muscle
Carotid triangle borders
Posterior belly of digastric muscle
Superior belly of omohyoid muscle
SCM
Carotid triangle contents
Carotid sheath Common carotid artery Internal carotid artery (after bifurcation) Internal jugular vein Vegus nerve (CN X)
Inferior carotid triangle borders
Anterior midline of neck
SCM
Superior belly of omohyoid muscle
Inferior carotid triangle contents
Infrahyoid muscles
Thyroid gland
Lower larynx and trachea
Posterior triangle of neck borders
Clavicle
SCM
Trapezius
Posterior sub triangles of neck (names)
Supraclavicular triangle
Occipital triangle
Supraclavicular triangle borders
Clavicle
SMC
Inferior belly of omohyoid
Supraclavicular triangle contents
Subclavian artery
Subclavian vein
Roots and trunks of brachial plexus
Occipital triangle borders
Trapezius
SCM
Inferior belly of omohyoid
Occipital triangle contents
Spinal accessory nerve (CN XI)
Cutaneous nerves from cervical plexus
Lymphadenopathy
Swollen or enlarged lymph nodes
Surgical damage to spinal accessory nerve (CN XI)
May occur during lymph node biopsy or radical neck dissection
Results in decreased function of trapezius and SCM muscles
Sternocleidomastoid Origin
Sternal head - manubrium
Clavicular head - medial portion of clavicle
Sternocleidomastoid Insertion
I: Mastoid process of temporal bone and superior nuchal line of occipital bone
Sternocleidomastoid Innervation
N: Motor - spinal accessory nerve (CN XI)
Sensory - C2 (proprioception)
Sternocleidomastoid Action
Unilateral - ipsilateral flexion and contralateral rotation of neck and head
Bilateral - flexion of neck and extension of head
Occipital neuralgia
Chronic pain of upper neck and/or occiput
Lesser occipital nerve can be cause of/contributor to symptoms
Ansa cervicalis supplies:
Sternohyoid
Sternothyroid
Omohyoid
(All infrahyoid muscles EXCEPT thyrohyoid. Semi-unrelated, but note: Thyrohyoid innervation like Geniohyoid innervation… C1 via hypoglossal nerve)
Ansa cervicalis has two roots/rami:
Ventral primary rami of C1, C2, C3
Superior root - C1 fibers | descending hypoglossal ramus of ansa cervicalis
Inferior root - C2, C3 fibers | descending cervical ramus of ansa cervicalis
Phrenic nerve is fibers from:
Ventral primary rami of C3, C4, C5
Phren means
Diaphragm
Phrenic Nerve is motor fibers to ___ and sensory fibers to ___ and ___
Diaphragm;
Fibrous pericardium and mediastinal pleura
Segmental branches of cervical plexus supplies:
Scalene muscles and prevertebral muscles (deep muscles of anterior neck)
Hyoid bone landmarks:
Body
Greater cornua
Lesser cornua
Infrahyoid muscles used in:
Speech and swallowing
Name the four pairs of infrahyoid muscles
Sternohyoid
Sternothyroid
Omohyoid
Thyrohyoid
Sternohyoid Origin
O: Manubrium
Sternohyoid Insertion
I: Body of hyoid
Sternohyoid Action
A: depresses hyoid
All infrahyoid muscles (except 1) are innervated by:
Name the exception:
N: Ansa cervicalis (C1, C2, C3)
EXCEPT: thyrohyoid
Thyrohyoid Innervation
N: C1 (hitchhike with hypoglossal nerve)
Sternothyroid Origin
O: manubrium
Sternothyroid Insertion
I: Thyroid cartilage
Sternothyroid Action
A: depresses thyroid cartilage
Omohyoid Origin
O: scapula (superior border)
Omohyoid Insertion
I: body of hyoid
Omohyoid Action
A: depresses hyoid
Thyrohyoid Origin
O: Thyroid cartilage
Omohyoid Insertion
I: greater cornu of hyoid
Omohyoid Action
A: depresses hyoid, elevates thyroid cartilage
Name the four pairs of suprahyoid muscles
Digastric
Stylohyoid
Mylohyoid
Geniohyoid
Muscle that helps form the floor of the oral cavity:
Mylohyoid
Digastric Origin
- anterior belly
- posterior belly
O:
- inner mandible (near symphysis
- mastoid process
Digastric Insertion
- anterior belly
- posterior belly
I: Intermediate tendon held by tendinous sling to hyoid (both)
Digastric Action
- anterior belly
- posterior belly
A: protracts, retracts, elevates hyoid; assists in depressing mandible (both)
Digastric Innervation
- anterior belly
- posterior belly
N:
- Trigeminal nerve
- Facial nerve
Stylohyoid Origin
O: styloid process
Stylohyoid Insertion
I: Hyoid
Stylohyoid Action
A: elevates and retracts hyoid
Stylohyoid Innervation
N: Facial nerve
Mylohyoid Origin
O: body of mandible (inner surface)
Mylohyoid Insertion
I: median raphe and hyoid bone
Mylohyoid Action
A: elevates hyoid and floor of oral cavity
Mylohyoid Innervation
N: trigeminal nerve
Geniohyoid Origin
O: inner mandible (near symphysis)
Geniohyoid Insertion
I: Hyoid
Geniohyoid Action
A: elevates and protracts hyoid
Geniohyoid Innervation
I: C1 (via hypoglossal nerve)
Name the Scalene Muscles
Muscles of lateral neck
Anterior scalene
Middle scalene
Posterior scalene
Scalenus minimus (if present)
Anterior Scalene Origin
O: transverse processes of C3-C6
All Scalene Muscles (except 1) have a common Insertion point:
Name exception:
I: 1st rib
EXCEPT: Posterior scalene
Posterior Scalene Insertion
I: 2nd rib
Cornu means
Horn
All Scalene muscles (except 1) have a common Action:
Name exception:
A: elevates 1st rib, ipsilateral flexion of neck
EXCEPT: Posterior Scalene
Posterior Scalene Origin
O: TPs of C4-C6
Scalenus Minimus Origin
O: TP of C6 or C7
All Scalene muscles are innervated by:
N: lower cervical ventral primary rami
Borders of interscalene triangle (scalene hiatus)
First rib
Anterior scalene muscle
Middle scalene muscle
Structures associated with interscalene triangle to pass to upper limb
Subclavian artery (subclavian vein enters neck anterior to the anterior scalene)
Roots of brachial plexus (C5-T1 ventral primary rami)
Thoracic Outlet Syndrome
Brachial plexus or subclavian artery are subject to compressive injuries at the interscalene triangle leading to neurovascular problems of upper extremity
Name the prevertebral muscles
Longus colli
Longus capitis
Rectus capitis anterior
Rectus capitis lateralis
Longus Colli Origin
O: TPs and bodies of C3-T3
Longus Colli Insertion
I: TPs and bodies of C1-C6
Longus Colli Action
A: flexion and rotation of neck
Longus Colli Innervation
N: C2-C7 ventral primary rami
Longus Capitis Origin
O: TPs of C3-C6
Name two prevertebral muscles with common Insertion and common action
Longus Capitis
Rectus Capitis Anterior
Longus Capitis and Rectus Capitis Anterior Common Insertion
Occiput (basilar part)
Longus Capitis and Rectus Capitis Anterior common action
A: flexion of head
Longus Capitis Innervation
N: C1-C3 ventral primary rami
Rectus Capitis Anterior Origin
O: TP of C1 and lateral mass
Name the two prevertebral muscles with common innervation
Rectus Capitis Anterior
Rectus Capitis Lateralis
Rectus Capitis Anterior and Rectus Capitis Lateralis innervation
N: C1-C2 ventral primary rami
Rectus Capitis Lateralis Origin
O: TP of C1
Rectus Capitis Lateralis Insertion
I: Occiput (jugular process)
Rectus Capitis Lateralis Action
A: ipsilateral flexion of head
What does the deep cervical fascia do?
Surrounds muscles and organs of neck, longitudinally compartmentalizes neck, provides support to and permits independent movement of structures of neck
Three layers of deep cervical fascia
Superficial layer
Pretracheal layer
Prevertebral layer
Superficial layer attachments
Clavicle, hyoid, occiput, mandible, spinous processes of cervical vertebrae and nuchal ligament
Pretracheal layer surrounds:
Thyroid gland Trachea Esophagus Pharynx Larynx
Prevertebral layer surrounds
Cervical spine
Deep muscles of posterior neck
Deep muscles of the anterior neck
All three Deep Cervical Facial layers form the:
Carotid sheath
Middle Scalene Origin
O: TPs of C2-C7
What two muscles are Innervation by C1 via hypoglossal nerve?
Geniohyoid
Thyrohyoid
Names of 2 deep arteries of the neck
Common carotid artery
Internal carotid artery
The common carotid artery has a bulge called
Carotid sinus
The carotid sinus is this kind of receptor:
Baroreceptor, detects changes in blood pressure
This is the name of another thing located near the carotid bifurcation:
Carotid body
The carotid body is this kind of receptor:
Chemoreceptor
The carotid sinus and carotid body are inner ate delicious by the sinus branch of:
Glossopharyngeal nerve (CN IX)
From the carotid bifurcation, this artery travels deeply and superior to the base of the skull and has no defined branches in the neck
Internal carotid artery
What is ischemic stroke?
Result of an embolus due to atherosclerosis.
Where is a common place for an occlusion to happen? (Ischemic stroke)
Internal carotid artery
Name the 8 major branches of external carotid artery
Superior thyroid artery Ascending pharyngeal artery Lingual artery Facial artery Occipital artery Posterior auricular artery Maxillary artery Superficial temporal artery
What is giant cell arthritis?
Inflammatory disease of blood vessels. Especially branches of external carotid artery.
4 major branches of subclavian artery
Internal thoracic trunk
Vertebral artery trunk
Thyrocervical trunk
Costocervical trunk
What is the path of the internal thoracic artery?
Descends into the thorax along the internal surface of the thoracic wall.
What does the internal thoracic artery do?
Supplies the anterior wall of the thorax
What is the path of the vertebral artery?
Ascends and enters transfers foramen fo C6, sends branches to deep neck structures, spinal nerves and spinal cord
What does the vertebral artery become?
One of the major arteries to the brain
Name the 4 branches of thyrocervical trunk
Inferior thyroid artery
Ascending cervical artery
Transverse cervical artery (may have 2 branches)
Costocervical trunk
What does the inferior thyroid artery supply?
Thyroid, esophagus, larynx, trachea
What general structures does the ascending cervical artery supply?
Deep anterior and lateral cervical region
Superficial transverse cervical artery supplies:
Trapezius m.
Deep transverse cervical artery (present in ~30%) supplies:
Rhomboid major and minor AND levator scapulae m.
NOTE: called dorsal scapular a. if origin is from subclavian a.
What muscles does suprascapular artery supply?
Supraspinatus and infraspinatus m.
The costocervical trunk has 2 branches (also, name what they supply):
Deep cervical branch supplies deep posterior neck structures
Superior intercostal branch supplies superior thorax
