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neck: prevertebral muscles & viscera Flashcards

1
Q

what groups are the prevertebral muscles divided into?

A

anterior and lateral

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2
Q

prevertebral muscles:
deep to ______ _______ of deep cervical fascia.
posterior to __________
anterolateral to _______ _______

A

Deep to prevertebral sheath of deep cervical fascia

Posterior to cervical viscera & anterolateral to cervical vertebrae

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3
Q

prevertebral muscles are deep to what?

viscera of the neck is deep to what?

A

prevertebral muscles: Deep to prevertebral sheath of deep cervical fascia
viscera: deep to pretracheal sheath of deep cervical fascia

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4
Q

what are the 3 layers of the viscera in the neck?

A

named Superficial to deep…

  1. Endocrine
  2. Respiratory
  3. Alimentary
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5
Q

what two things are in the endocrine viscera?

A

thyroid and parathyroid

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6
Q

what two things are in the respiratory viscera?

A

larynx and trachea

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7
Q

what two things are in the alimentary viscera?

A

pharynx and esophagus

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8
Q

prevertebral muscles: anterior group
Medial to plane of _________ & _______
Posterior to ________ _____

A

Medial to plane of cervical/brachial plexus & subclavian artery
Posterior to retropharyngeal space

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9
Q

prevertebral muscles: anterior group- what is there general function?

A

flex head and/or neck

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10
Q

prevertebral muscles: what are the 4 in the “anterior” group? which is the most important?

A

Longus colli muscle
Longus capitis muscle
Rectus capitis-anterior muscle
*Anterior scalene muscle - most important of the group

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11
Q

prevertebral muscles: lateral group
posterior to plane of _________ & ____________
form floor of what triangle?

A

Posterior to plane of cervical/brachial plexus & subclavian artery
Form floor of posterior triangle

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12
Q

prevertebral muscles: lateral group- what is their general fxn?

A

laterally flex neck

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13
Q

what 5 muscles make up the “lateral” prevertebral group

A 
Splenius capitis
Levator scapulae
Rectus capitis-lateralis
*Posterior scalene
*Middle scalene
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14
Q

which two lateral prevertebral muscles are often fused together?

A

posterior and middle scalene

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15
Q

what are the boundaries of the “scalene triangle” ?

A

Bounded by anterior/middle scalenes & 1st rib

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16
Q

what runs through the scalene triangle?

A

C5-T1 ventral rami: “Roots” of brachial plexus
3rd part of subclavian artery
Phrenic nerve (at apex & crosses anterior scalene)

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17
Q

what is the thyroid gland fxn ? what cells does it target?

A

Largest purely endocrine gland
Controls metabolic rate & calcium metabolism (vestigial)
Targets all cells except itself, spleen, testes, & ovaries

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18
Q

thyroid: deep to what 2 things? superficial to what 2 things?

A

Deep to sternothyroid & sternohyoid (infrahyoid muscles)
Superficial to cricoid & upper tracheal rings

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19
Q

R & L lobes of thyroid united by isthmus anterior to _____ tracheal rings

A

2nd/3rd tracheal rings

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20
Q

____% of people have midline pyramidal lobe - remnant of what?

A

40%

- remnant of descent of thyroid from tongue

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21
Q

superior thyroid artery: it is the __ branch of what artery? what does it run with?

A

1st branch of external carotid

Runs with external branch of superior laryngeal nerve

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22
Q

superior thyroid artery supplies what?

external branch of superior laryngeal nerve supplies what?

A

sup. thyroid artery: anterosuperior thyroid gland

sup. laryngeal nerve: cricothyroid muscle

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23
Q

inferior thyroid artery: branch of what? what does it course posterior to?

A

Inferior thyroid artery-branch of thyrocervical trunk

Courses posterior to carotid sheath

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24
Q

inferior thyroid artery supplies what?

A

posteroinferior thyroid gland

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25
Q

inferior thyroid artery is closely assoc. with what nerve?

A

recurrent laryngeal nerve

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26
Q

what artery do only 10% of people have ( it is variable in origin and supplies isthmus)?

A

thyroid ima artery

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27
Q

when ligating arteries to take out the thyroid: where do you want to ligate superior and inferior?

A

superior thyroid artery: ligate CLOSE to gland (save external branch of sup. laryngeal nerve)
inferior thyroid artery: ligate AWAY from gland (save recurrent laryngeal nerve)

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28
Q

why is saving the external branch of sup laryngeal nerve so important?

A
  • only nerve that supplies the cricothyroid muscle, which helps singer’s hit high notes.
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29
Q

what are the 3 thyroid veins?

A

superior, middle and inferior

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30
Q

thyroid veins:
Superior-travel with _________, drain to ____
Middle-parallel _________, drain to ______
Inferior-independent, drain to ________ _____.

A

Superior-travel with sup. thyroid artery, drain to IJV
Middle-parallel inferior thyroid artery, drain to IJV
Inferior-independent, drain to brachiocephalic veins

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31
Q

how many parathyroid glands do people usually have?

A

4: 2 superior, 2 inferior

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32
Q

what is the fxn of the parathyroid glands?

A

secrete PTH
Control calcium & phosphorus metabolism
Targets skeleton, kidneys, & intestine

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33
Q

parathyroid glands: located on the medial portion of what?

A

Medial portion of posterior thyroid lobes

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34
Q

where is the general location of the superior vs inferior parathyroid glands? which is more variable in location?

A

Superior pair usually ~1cm superior to entry of inferior thyroid artery
Inferior pair usually ~1cm inferior to entry of inferior thyroid artery
–More variable location due to longer descent

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35
Q

parathyroid glands are supplied by what artery?

A

inferior thyroid arteries

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36
Q

what does the larynx do?

A

Directs air to respiratory system, food to digestive system
Maintains patent airway
Produces sound

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37
Q

what are the 9 cartilages of the larynx? which are paired?

A 
Thyroid
Cricoid
Arytenoids (2)
Epiglottis
Corniculates (2)
Cuneiforms (2)
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38
Q

which is the largest laryngeal cartilage?

A

thyroid- composed of 2 laminae

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39
Q

what makes the adam’s apple?

A

(laryngeal prominence) -anterior fusion of thyroid cartilage

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40
Q

posterior laminae of thyroid cartilage have what 2 feature?

A

superior and inferior horns

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41
Q

what does the superior border/horn of thyroid cartilage attach to?

A

Superior border/horn attach to hyoid via thyrohyoid membrane

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42
Q

what does the inferior border/horn of thyroid cartilage attach to?

A

Inferior border/horn attach to cricoid cartilage via median cricothyroid ligament (membrane)

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43
Q

which larynx cartilage is the only one that is a complete ring?

A

cricoid cartilage

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44
Q

what is the shape/thickness of cricoid cartilage?

A

Taller posteriorly that anteriorly

Thicker/stronger than thyroid

45
Q

inferior border of cricoid cartilage attaches to what?

A

Inferior border attach to 1st tracheal ring via cricotracheal ligament

46
Q

which larynx cartilage are pyramid shaped?

A

arytenoids

47
Q

what does the base of the arytenoid cartilage articulate with?

A

Base articulates with posterior cricoid ring-allows mobility

48
Q

what are the two “processes” of the arytenoid cartilage ? which extends lateral + medial?

A

muscular- lateral

vocal - medial

49
Q

muscular process of the arytenoid attaches what?

A

crico-arytenoid muscles

50
Q

what do the vocal processes of arytenoid suspend?

A

Suspend vocal ligaments between arytenoid & junction of thyroid laminae

51
Q

what does the apex of the arytenoid suspend?

A

ary-epiglottic ligaments between arytenoid & epiglottis (laryngeal inlet).

52
Q

larynx cartilage: Heart-shaped, forms superior portion of anterior wall & laryngeal inlet

A

epiglottis

53
Q

the quadrangular membrane of the epiglottis extends from where to where?

A

Quadrangular membrane extends from lateral margins to arytenoids

54
Q

what are the superior and inferior free edges of epiglottis?

A

Superior free edge is ary-epiglottic fold (laryngeal inlet)

Inferior free edge is vestibular fold (false vocal cords)

55
Q

Corniculate & cuneiform cartilages are embedded in what ?

A

posterior portions of ary-epiglottic folds

56
Q

what make up the vocal folds (true vocal cords)?

A

Lateral cricothyoid ligaments extend laterally from vocal ligament to superior margin of cricoid

57
Q

what makes up the Conus elasticus?

A

vocal ligament + lateral cricothyroid ligament

58
Q

what is the aperture between the true cords called ?

A

rima glottidis (glottis)

59
Q

what do variations in the shape of the glottis do?

A

act as inspiratory sphincter & control sound

60
Q

what are the three laryngeal “spaces” ?

A

Vestibule-
Ventricle-
Infraglottic cavity-

61
Q

laryngeal space: vestibule

A

between laryngeal inlet & vestibular folds (false cords)

62
Q

laryngeal space: ventricle

A

between vestibular (false cords) & vocal folds (true cords)

63
Q

laryngeal space: infraglottic cavity

A

between vocal folds (true cords) & inferior border of cricoid

64
Q

what are the extrinsic muscles of the larynx and what do they do?

A

suprahyoid (and stylopharyngeus) + infrahyoid muscles

-depress and elevate hyoid + larynx

65
Q

what is the most important intrinsic laryngeal muscle? what does it do and what is it’s nerve supply?

A

Tensor (lengthen/tense vocal folds)

-cricothyroid

66
Q

what do the laryngeal intrinsic muscles do? ( in general)

A

move components of larynx
alter length & tension of vocal folds
alter size & shape of glottis
***(mostly about moving arytenoid, in order to change glottis shape)

67
Q

what are the 5 functional groups of intrinsic laryngeal muscles?

A 
Adductors (close vocal folds)
Abductors (open vocal folds)
Sphincters (close laryngeal inlet during swallowing)
Tensor (lengthen/tense vocal folds)
Relaxers (shorten/relax vocal folds)
68
Q

what are the adductor muscles?

A

lateral crico-arytenoid & transverse/oblique arytenoids

69
Q

what are the abductor muscles?

A

posterior crico-arytenoid

70
Q

what are the sphincter muscles?

A

lateral crico-arytenoid, transverse/oblique arytenoid, ary-epiglottic (in ary-epiglottic fold)

71
Q

what are the relaxer muscles?

A

thyro-arytenoid

72
Q

All intrinsic laryngeal muscles except _____ innervated by recurrent laryngeal nerve.

A

cricothyroid

73
Q

what is cricothyroid innervated by?

A

external laryngeal nerve (branch of sup. laryngeal nerve)

74
Q

what are the two sources of blood for the larynx?

A

superior laryngeal artery (from sup thyroid) - supply internal surface
inferior laryngeal artery (from inf thyroid) - supply inferior larynx

75
Q

sup. laryngeal artery: pierces what structure? (along with what?)

A

Pierces thyrohyoid membrane with internal branch of superior laryngeal nerve

76
Q

inf. laryngeal artery: accompanies what nerve?

A

Accompanies inferior laryngeal nerve (branch of recurrent laryngeal)

77
Q

what is the arterial supply of the cricothyroid? what nerve does it accompany?

A

Cricothyroid-branch of superior thyroid

Accompanies external branch of superior laryngeal nerve

78
Q

what are the two nerves of the larynx? what are they branches of?

A

sup. laryngeal nerve: vagus

inf laryngeal nerve: continuation of recurrent laryngeal

79
Q

where does recurrent laryngeal become inf. laryngeal nerve?

A

when recurrent laryngeal ascends and enters larynx DEEP to thyroid cartilage

80
Q

what does the inf. laryngeal nerve supply? (motor and sensory)

A

All intrinsic muscles (except cricothyroid)

Sensation to mucosa below vocal folds

81
Q

what is the fxn of the trachea?

A

Conduit for air to/from lungs

Moves debris-laden mucus to pharynx

82
Q

what is the structure of the trachea?

A

Fibrous tube supported by incomplete (posteriorly) cartilaginous rings.

83
Q

what structures surround the trachea? (lateral and posterior)

A

lateral: Common carotid & thyroid lobes
posterior: Esophagus adheres posterior
(Recurrent nerves in tracheoesophageal groove)

84
Q

posteiror gaps of the trachea “c” rings are covered by what?

A

trachealis muscle (smooth)

85
Q

what does the pharynx do?

A

directs food to esophagus

86
Q

3 parts of the pharynx

A

Nasopharynx-superior to soft palate/uvula
Oropharynx-between uvula & epiglottis
Laryngopharynx-epiglottis to inferior cricoid

87
Q

what are the openings of the pharynx?

A

Two external openings- nose and mouth

88
Q

what are the “abundant lymphoid tissue” masses in the pharynx?

89
Q

what is the fxn of the nasopharynx? what 3 structures does it contain?

A

Respiratory-air conduit, warms, humidifies, purifies

  • adneoids
  • eustachian tube openings
  • tubal tonsil
90
Q

where is the pharyngeal tonsils?

A

(aka adenoids) in roof & posterior wall of nasopharynx

91
Q

where are the eustachian tubes?

A

Pharyngeal opening of salpingopharyngeal (Eustachian) tube (in nasopharynx)

92
Q

when are the eustachian tubes open? what muscle does this?

A

Opened by salpingopharyngeus muscle during swallowing (“popping your ears”)

93
Q

where is the tubal tonsil of the nasopharynx?

A

medial to pharyngeal opening (posterior to eustachian tubes)

94
Q

what is the fxn of the oropharynx?

A

Digestive-mastication & deglutition

95
Q

what are the two types of tonsils in the oropharynx? where are each located ?

A

Palatine tonsil in lateral wall: Between palatoglossal & palatopharyngeal arches
lingual tonsil in anterior wall: Base of tongue

96
Q

where is the laryngopharynx? and what is it continuous with?

A

Posterior to larynx

Continuous with esophagus

97
Q

what creates the “piriform recesses” (where food notoriously gets stuck) ?

A

on lateral aspect of larynx, it invaginates anterior wall- Separated by ary-epigottic folds & epiglottis

98
Q

what nerves are “vulnerable” near the piriform recesses?

A

Submucosal branches of internal laryngeal nerve & recurrent laryngeal nerves
(if you eat something sharp and it pierces the mucosa)

99
Q

are the laryngopharynx muscles voluntary or involuntary?

A

completely voluntary!

100
Q

what are the 2 layers of the laryngopharynx muscles?

A

outer inner

101
Q

what 3 things make up the outer layer of the laryngopharynx muscle?

A

Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor

102
Q

laryngopharynx outer muscles:Inferior overlaps _____, middle overlaps _____

A

middle, superiorInferior overlaps middle, middle overlaps superior

103
Q

why do the outer laryngopharynx muscles contract in sequence?

A

during deglutition (swallowing) to constrict pharynx

104
Q

what makes the upper esophageal sphincter? why is this place significant?

A

laryngopharynx muscle:
Inferior portion of inferior constrictor (cricopharyngeus)-
*another place where foreign bodies get stuck
(narrowest part of pharynx/esophagus)

105
Q

what are the 3 parts that make up the inner longitudinal layer of the laryngopharynx muscles?

A

Salpingopharyngeus
Palatopharyngeus
Stylopharyngeus

106
Q

what is the fxn of the inner longitudinal layer of the laryngopharynx?

A

Shorten & widen pharynx in swallowing

107
Q

Stylopharyngeus passes through gap between ___________ with what nerve?

A

Stylopharyngeus passes through gap between superior/middle constrictor with glossopharyngeal nerve

108
Q

laryngopharynx muscles: inner longitudinal layer are all innervated by what?

A

branches from vagus supply motor to all except stylopharyngeus (glossopharyngeal)

109
Q

what two nerves contribute fibers to pharyngeal plexus?

A

Glossopharyngeal (sensory) & vagus (motor)

Anatomy (13 decks)

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