Neck & Suboccipital Flashcards
What is the investing fascia?
Deep cervical fascia- splits around the sternocleidomastoid, encircles neck
What is the pretracheal fascia?
Deep cervical fascia- goes around thyroid, trachea, esophagus
What is the prevertebral fascia?
Deep cervical fascia- goes around vertebral and deep flexor/extensor muscles
What is the carotid sheath?
Deep cervical fascia- a neurovascular bundle with the IJ laterally, common carotid medially, vagus n posterior
Anterior digastric- suprahyoid
ATTACHMENTS- from the digastric fossa of the mandible to the intermediate tendon
FUNCTION- depression of the mandible or elevation of the hyoid
INNERVATION- mylohyoid branch of the inferior alveolar n. (from CN V3)
Posterior Digastric- suprahyoid
ATTACHMENTS- from the temporal mastoid notch to the intermediate tendon
FUNCTION- depression of the mandible or elevation of the hyoid
INNERVATION- facial n.
Geniohyoid- suprahyoid
ATTACHMENTS- from the inferior genial tubercle of the mandible to the anterior aspect of the body of the hyoid
FUNCTION- depresses mandible, elevates the hyoid and tongue
INNERVATION- ventral ramus of C1 via CN XII
Longus Capitis
ATTACHMENTS- from the anterior tubercles of the transverse processes of cervical vertebrae to the basilar occipital bone
FUNCTION- flexion of the head & neck (bilateral) ipsilateral rotation (unilateral)
INNERVATION- ventral rami of cervical spinal n. (C1-3)
Longus colli (L. neck)
ATTACHMENTS- from cervical vertebral bodies to cervical vertebral bodies & transverse processes
FUNCTION- flexion, lateral flexion of the neck and ipsilateral rotation
INNERVATION- ventral rami of cervical spinal n. (C2-7)
Mylohyoid- suprahyoid
ATTACHMENTS- from the mylohyoid line of the mandible to the midline raphe & anterior aspect of body of the hyoid
FUNCTION- elevation of the floor of the oral cavity
INNERVATION- mylohyoid branch of the inferior alveolar n. (from CN V3)
Omohyoid (G. omos, shoulder)- infrahyoid
ATTACHMENTS- superior border of the scapula medial to the scapular notch to lateral hyoid passing through an intermediate tendon sling loosely associated with the clavicle & 1st rib
FUNCTION- depression of the hyoid
INNERVATION- ansa cervicalis (C1-3)
Anterior scalene
ATTACHMENTS- from the anterior tubercles of middle cervical vertebrae to the scalene tubercle of the 1st rib
FUNCTION- elevation of 1st rib (during forced inspiration) & lateral flexion & contralateral rotation of the neck
INNERVATION- lower ventral rami of cervical spinal n.
Middle scalene
ATTACHMENTS- from the transverse processes of cervical vertebrae to 1st rib
FUNCTION- elevation of 1st rib (during forced inspiration) & lateral flexion & contralateral rotation of the neck
INNERVATION- lower ventral rami of cervical spinal n.
Posterior scalene
ATTACHMENTS- from lower cervical transverse processes to the 2nd rib
FUNCTION- elevation of the rib (during forced inspiration) & lateral flexion and contralateral rotation of the neck
INNERVATION- ventral rami of cervical spinal n. (C6-8)
Sternocleidomastoid
ATTACHMENTS- from the lateral aspect of the mastoid process & superior nuchal line to the manubrium & medial 1/3rd of the clavicle
FUNCTION- flexion, ipsilateral lateral flexion, and extension of the head & neck, & contralateral rotation of the head
INNERVATION- accessory n & C1,2
Sternohyoid- infrahynoid
ATTACHMENTS- from the posterior side of the proximal clavicle & adjacent manubrium to the inferior border of body of the hyoid
FUNCTION- depresses the hyoid
INNERVATION- ansa cervicalis (C1-3)
Sternothyroid- infrahynoid
ATTACHMENTS- from the posterior aspect of the manubrium & costal cartilage of 1st rib to the thyroid lamina
FUNCTION- depression of the elevated larynx
INNERVATION- ansa cervicalis (C1-3)
Stylohyoid- suprahyoid
ATTACHMENTS- from the styloid process of temporal bone to the body of hyoid bone
FUNCTION- elevation & retraction of the hyoid
INNVERATION- facial n.
Thyrohyoid- infrahyoid
ATTACHMENTS- from the thyroid lamina to the greater horn of the hyoid bone
FUNCTION- depression of the hyoid or elevation of the thyroid cartilage
INNERVATION- ventral ramus of C1 via XII
Rectus capitis posterior major
ATTACHMENTS- from spinous process C2 to lateral aspect inferior nuchal line
ACTIONS- extension and ipsilateral rotation
INNERVATION- suboccipital nerve
Rectus capitis posterior minor
ATTACHMENTS- from tubercle on posterior arch C1 to medial aspect inferior nuchal line
ACTION: extension
INNERVATION: suboccipital nerve
Obliquus capitis inferior (inferior oblique)
ATTACHMENTS: from spinous process of C2 to transverse process C1
ACTION: ipsilateral rotation
INNERVATION: suboccipital nerve
Obliquus capitis superior (superior oblique)
ATTACHMENTS: from transverse process of C1 to between superior and inferior nuchal lines on occipital bones
ACTIONS: extension and lateral flexion
INNERVATION: suboccipital nerve
What are the borders of the anterior triangle of the neck?
Anterior- midline of neck
Superior- Inferior border of mandible,
Sternocleidomastoid
What are the borders of the posterior triangle of the neck?
Posterior- Trapezius
Inferior- Clavicle
Sternocleidomastoid
What are the 4 triangles within the anterior triangle of the neck?
Carotid, muscular, submental, and submandibular.
What are the borders of the carotid triangle?
The posterior belly of digastric, SCM, and superior belly of omohyoid.
What are the two triangles within the posterior triangle of the neck?
Occipital and supraclavicular
What are the borders of the occipital triangle?
The trapezius, the inferior belly of omohyoid, and the SCM.
What are the borders of the supraclavicular triangle?
The inferior belly of omohyoid, the clavicle, and SCM.
What are the 5 pharyngeal (branchial) arches?
Mandibular, hyoid, third, fourth, sixth.
What muscles arise from the mandibular pharyngeal arch?
Mastication, mylohyoid, anterior belly of digastric.
What innervates the muscles of the mandibular pharyngeal arch?
Trigeminal N (CN V3)
What muscles arise from the hyoid pharyngeal arch?
Facial expression, posterior belly of digastric, stylohyoid.
What innervates the muscles of the hyoid pharyngeal arch?
Facial N (CN VII)
What muscles arise from the third pharyngeal arch?
Stylopharyngeus
What innervates the muscle of the third pharyngeal arch?
Glossopharyngeal N (CN IX)
What muscles arise from the fourth pharyngeal arch?
Cricothyroid, inferior pharyngeal constrictor
What innervates the muscles of the fourth pharyngeal arch?
Vagus N (CN X), superior laryngeal
What are the muscles that arrive from the sixth pharyngeal arch?
Intrinsic laryngeal
What innervates the muscles of the sixth pharyngeal arch?
Vagus N (CN X), recurrent laryngeal
What is the function of the branchial motor axons?
Innervate skeletal muscles from pharyngeal arches.
What are the suboccipital muscles of neck?
Rectus capitis posterior minor and major, superior oblique and inferior oblique.
What is included in the 1st pharyngeal arch?
name: mandibular
muscles: mastication, mylohyoid, anterior belly digastric
nerve: Trigeminal V3
What is included in the 2nd pharyngeal arch?
name: hyoid
muscles: facial expression, posterior belly digastric, stylohyoid
nerve: Facial VII
What is included in the 3rd pharyngeal arch?
Name: Third
muscles: stylopharyngeus
nerve: Glossopharyngeal IX
What is included in the 4th pharyngeal arch?
Name: fourth
muscles: cricothyroid, inf pharyngeal constrictor
nerve: Vagus X, sup laryngeal
What is included in the 6th pharyngeal arch?
name: sixth
muscles: intrinstic laryngeal
nerve: Vagus X, recur laryngeal
What is the functional component of motor axons?
innervate skeletal muscle
What is the functional component of sensory axons?
impulses from skin/viscera
What is the functional component of pre/post symp/parasymp axons?
innervate smooth muscle
What is the functional component of branchial motor axons?
innervate skeletal muscle from pharyngeal arches
What is the functional component of special sensory axons?
taste, smell
vision, hearing, equilibrium
- The parotid duct passes _____ and ____ to the masseter muscle.
superifical, anterior
- The parotid gland is positioned ____ and ______ to the masseter muscle
posterior, superficial
- The branches of the facial nerve pass _____ to the masseter muscle.
superficial
- The facial artery passes_____ to the mandible (body).
superficial
- On the face, the facial vein is positioned _____ to the facial artery.
posterior
- The sternocleidomastoid muscle is positioned _____ to both the omohyoid muscle and the carotid sheath.
superficial
- The external jugular vein passes ______ to the sternocleidomastoid muscle.
superficial
- The great auricular and transverse cervical nerves pass _____ and ______ to the sternocleidomastoid muscle.
posterior, superficial
- The lesser occipital nerve passes _____ to the sternocleidomastoid muscle.
posterior
- The accessory nerve passes ____ and then _____ to the sternocleidomastoid muscle.
deep, posterior
- The hyoid bone is positioned ______ to the thyroid cartilage.
superior
- The omohyoid muscle is positioned anterior-lateral to the sternothyroid muscle and passes _____ to the carotid sheath.
superifical
- At the level of the thyroid cartilage, the sternothyroid muscle is positioned ____ and _____ to the sternohyoid muscle.
deep and lateral
- The submandibular gland is positioned _____ and ______ to the mylohyoid muscle.
posterior, inferior
- The digastric muscle (anterior belly) is positioned _____ (inferior-lateral) to the mylohyoid muscle.
superficial
- The thyroid gland (lobes) is positioned directly _____ to the trachea.
lateral
- The ansa cervicalis (inferior root) passes (______) to the internal jugular vein.
superficial
- The ansa cervicalis (superior root) is positioned ____ to the internal jugular vein.
anterior
- The vagus nerve is positioned posterior-medial to the internal jugular vein and ______ to the common carotid artery.
posterior-lateral
- The internal jugular vein is positioned _____ to the carotid artery.
lateral
- The external carotid artery is positioned ____ to the internal carotid artery.
anterior
- The facial artery passes _____ to the stylohyoid muscle and the intermediate tendon of the digastric muscle.
deep
- The hypoglossal nerve passes _____to the stylohyoid muscle and the intermediate tendon of the digastric muscle and ___ to the hyoglossus muscle.
deep, superficial
- During its posterior course, the occipital artery first passes _____ and then ______ to the hypoglossal nerve.
deep, superficial
- The subclavian artery passes directly _____ to the anterior scalene muscle.
posterior
- The phrenic nerve and subclavian vein pass directly _____ to the anterior scalene muscle.
anterior
- The suprascapular and transverse cervical arteries typically pass directly _____ to the anterior scalene muscle.
anterior
Optic n. (CN II)
function- carries visual sensory information from the neural retina to the diencephalon & midbrain
Optic Chiasm
function- anatomical site where axons arising from the nasal (medial) half of the retina cross the midline to the contralateral optic tract
Superior ramus-muscular branches
function- motor innervation (oculomotor nucleus of the midbrain) of the superior rectus and levator palpebrae superioris muscles
Inferior Ramus
a. Muscular branches
function- motor innervation (oculomotor nucleus of the midbrain) of the medial rectus, inferior rectus and inferior oblique muscles
b. Parasympathetic communication to the ciliary ganglion
function- preganglionic parasympathetic innervation (Edinger-Westphal nucleus of the midbrain) of the ciliary ganglion, the postganglionic parasympathetic axons travel with the short ciliary nerves (branches of the ophthalmic division of the trigeminal nerve) and innervate the ciliary body and constrictor muscle of the iris
Trochlear n. (CN IV)
function- motor innervation (trochlear nucleus of the midbrain) of the superior oblique muscle
Ophthalmic n. (V1)
a. Lacrimal n. [L. lacrima, tear]
function- sensory innervation of the lacrimal gland and the skin overlying the lateral aspect of the upper lid, & postganglionic parasympathetic innervation of the lacrimal gland (via CN VII)
b. Frontal n.
i. Supraorbital n.
function- sensory innervation of the skin overlying the forehead
ii. Supratrochlear n.
function- sensory innervation of the skin overlying the medial aspect of the forehead
Nasociliary n.- Anterior ethmoidal n.
function- sensory innervation of the mucosa of the frontal and ethmoidal sinuses, the mucosa of the superior aspect of the nasal cavity, and the skin overlying the nose
Nasociliary n- Posterior ethmoidal n.
function- sensory innervation of the mucosa of the sphenoid and ethmoidal sinuses and superior nasal cavity
Nasociliary n-Long ciliary n
function- sensory innervation of the eye, and postganglionic sympathetic innervation of the dilator muscle of the iris
Nasociliary- short ciliary n
function- sensory innervation of the eye, postganglionic sympathetic (pupil dilation) & postganglionic parasympathetic (cell bodies in ciliary ganglion) innervation of the constrictor smooth muscle of the iris and ciliary bodies of lens (accommodation; via CN III)
Nasociliary n- infratrochlear n
function- sensory innervation of the skin overlying the bridge of the nose
Zygomatic n.
function- sensory & postganglionic sympathetic innervation of the skin overlying the zygomatic arch, and postganglionic parasympathetic (axons via CN VII arise from pterygopalatine ganglion) innervation of the lacrimal gland (communicates with the lacrimal n.of V1)
Posterior superior alveolar n.
function- sensory & postganglionic sympathetic innervation of the upper molars, and sensory, postganglionic sympathetic & postganglionic parasympathetic (via CN VII) innervation of maxillary sinus
Infraorbital n
function- sensory innervation of the skin of the upper lip, lateral nose and lower eyelid, and mucosa of upper lip
Masseter
ATTACHMENTS- from the zygomatic arch to the angle of the mandible & lateral aspect of the ramus
FUNCTION- elevation, protraction and retraction (deep fibers) of the mandible
INNERVATION- mandibular nerve of trigeminal nerve
Temporalis
ATTACHMENTS- from the temporal fossa to the coronoid process & anterior border of the ramus of the mandible
FUNCTION- elevation & retraction (posterior aspect of the muscle) of the mandible
INNERVATION- mandibular nerve from trigeminal nerve
Lateral pterygoid
ATTACHMENTS- infratemporal surface of the sphenoid & lateral surface of the lateral pterygoid plate to the neck of the mandible & the TMJ disc
FUNCTION- depresses mandible, protracts & acts with the ipsilateral medial pterygoid to rotate the mandible to produce the side-to-side movements during chewing
INNERVATION- mandibular nerve (V3)
Medial pterygoid
ATTACHMENTS- from the medial surface of the lateral pterygoid plate & adjacent maxilla to the medial aspect of the angle of the mandible
FUNCTION- elevation of the mandible & acts with the ipsilateral lateral pterygoid to rotate the mandible to produce the side-to-side movements during trituration of food
INNERVATION- mandibular nerve (from Trigeminal n)
Splenius capitis
ATTACHMENTS- from the ligamentum nuchae and lower cervical & upper thoracic spinous processes to the lateral third of the superior nuchal line
FUNCTION- extension & lateral flexion & ipsilateral rotation of the head
INNERVATION- dorsal rami of cervical spinal n.
Longissimus capitis
ATTACHMENTS- from the upper thoracic transverse processes to the posterior margin of the mastoid process
FUNCTION- extension & lateral flexion & ipsilateral rotation of the head
INNERVATION- dorsal rami of spinal n.
Semispinalis capitis
ATTACHMENTS- from upper thoracic & cervical transverse processes to the occipital bone between the inferior & superior nuchal lines
FUNCTION- extension & contralateral rotation of the head
INNERVATION- dorsal rami of cervical spinal n.
Ligamentum nuchae
ATTACHMENTS- from C7 spinous process to external occipital protuberance with slips to intervening spinous processes
FUNCTION- attachment for cervical muscles
Transverse (cruciate) of atlas
ATTACHMENTS- from lateral mass to lateral mass of atlas
FUNCTION- maintains articulation between dens and anterior arch of the atlas
Tectorial membrane
ATTACHMENTS- from the posterior surface of axial body to anterior margin of the foramen magnum
FUNCTION- supports atlanto-occipital & atlanto-axial joints, continuous with the posterior longitudinal lig.
Lateral temporomandibular
ATTACHMENTS- from zygomatic process of temporal bone to mandibular neck
FUNCTION- supports joint capsule in maintaining articulation, & helps to limit depression & retraction
Sphenomandibular
ATTACHMENTS- from spine of sphenoid to lingua
FUNCTION- a check ligament to prevent excessive depression
Stylomandibular
ATTACHMENTS- from styloid process to angle of mandible
FUNCTION- taut during moderate opening
