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Neuro Exam 1 > Neck Superficial Triangle And Cervical Viscera > Flashcards

Neck Superficial Triangle And Cervical Viscera Flashcards

1
Q

Bones and cartilages of the neck

A

C1-C7

Mastoid process
Styloid process
Stylohyoid L
Mandible
Angle of mandible
Hyoid

Thyroid cartilage
Cricoid cartilage

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2
Q

What are the parts of the hyoid bone?

A

Greater horn
Lesser horn
Fibrocartilage
Body of hyoid

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3
Q

What are the four main regions of the superficial neck structures?

What two regions are on either side of the SCM?

A

Sternocleidomastoid

Posterior cervical region (trapezius)

Lateral cervical/posterior triangle

Anterior cervical/anterior triangle

Anterior and posterior triangles

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4
Q

What is the fx of the platysma m?

What CN supplies it?

What is its origin and insertion?

A

Muscle of facial expression

Cervical branch of facial N (CN VII)

Dermis of skin (superficial over SCM and other superficial muscles)

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5
Q

What two muscles are innervated by the spinal accessory N (CN XI)?

A

SCM

Trapezius

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6
Q

What are three fx of the SCM?

What is its origin and insertion?

A

Lateral flexion with rotation (rotate to opposite side)

Extension at atlanto-occipital joint

Flexion cervical vertebrae

Sternum, clavicle; skull

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7
Q

What usually causes muscular torticollis (“Wry neck”)?

What nerve can be affected?

What muscle is affected?

How can you treat it?

A

Birth trauma (congenital); benign fibrous tumor

Spinal accessory N

SCM -> causes bent neck

Physical therapy

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8
Q

What are the five fascia layers of the neck and what do they contain?

A

Superficial fascia: skin, fat, loose CT, platysma m

Investing layer: deep fascia

Pretracheal layer: around esophagus, trachea, and thyroid; muscular and visceral layer

Prevertebral layer: around deeper neck muscles

Carotid sheath: fascia tubes in neck; protects neck as it moves; alar fascia runs between carotid sheath

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9
Q

Zone I of penetrating trauma is the horizontal area between the ____ and the ____ encompassing the thoracic outlet structures including the _____.

Zone I contains what 7 structues?

A

Clavicle/suprasternal notch; cricoid cartilage; cupola of the lung

Proximal common carotid and vertebral A coming off the subclavian A, trachea, esophagus, thoracic duct, and thymus.

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10
Q

Zone II of penetrating trauma is the area between the _____ and _____.

What eleven structures does it contain?

A

Cricoid cartilage; angle of the mandible

Internal carotid A, external carotid A, jugular veins, pharynx, larynx, esophagus, recurrent laryngeal N, spinal cord, trachea, thyroid, and parathyroid glands

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11
Q

Zone III of penetrating trauma is the area that lies between the _____ and the _____.

It contains what three structures does it contain?

A

Angle of the mandible; base of the skull

Distal extracranial carotid A, vertebral A, upper segments of jugular vein

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12
Q

Where does a nerve block go in the lateral cervical region?

Where is this point located?

A

Erb’s point

In the lateral cervical region (posterior triangle) half way between the mastoid process and the clavicle

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13
Q

The bulk of the anteriolateral cutaneous innervation of the neck comes from branches of ____.

A

Erb’s point

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14
Q

What are the branches of Erb’s point that do cutaneous innervation of the head?

Where do they come from?

What other nerves come from the dorsal rami (not Erb’s point) and also do cutaneous innervation of the head?

A

Lesser occipital N (C2)
Great auricular N (C2, C3)
Transverse cervical N (C2, C3)
Lateral, intermediate, and medial supraclavicular N (C3, C4)

Ventral rami

Greater occipital N (C2)
Third occipital N (C3)
Lesser occipital N (C2)
Cutaneous branches of posterior rami (C4-C8)

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15
Q

What 7 structures are deep to the investing fascia?

A 
Accessory N (CN XI)
Dorsal scapular N
Nerve to levator scapulae
Roots of brachial plexus
Phrenic N (C3-C5)
Scalene muscles
Splenius capitis
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16
Q

The ____ is a loop of nerves from the cervical plexus that carry somatomotor innervation to most of the _____ muscles in the neck.

A

Ansa cervicalis

Infrahyoid

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17
Q

What nerve roots feed the ansa cervicalis?

What muscles does this innervate?

A

C1-C3

Inferior belly of omohyoid m
Sternohyoid m
Sternothyroid m
Superior belly of omohyoid m
Thyrohyoid m 
Geniohyoid m
18
Q

What are the anterior vertebral muscles and what is their fx?

A

Longus coli: flex neck, rotate opposite unilaterally

Longus capitis: flex neck

Rectus capitis anterior: flex neck

Anterior scalene: flex neck

19
Q

What are the lateral vertebral muscles and what is their fx?

A

Rectus capitis lateralis: flex and stabilize head

Splenius capitis: laterally flex and rotate head to same side; bilaterally extend head

Levator scapulae: elevate scapula and tilt glenoid cavity inferiorly

Middle and posterior scalenes: flex neck laterally; elevate 2nd rib

20
Q

____ is the space between the clavicle and first rib. This space contains subclavian A and V, brachial plexus, and scalenes and subclavius muscles.

What causes this?

What is the treatment?

What are the neurogenic and vascular symptoms?

What is a symptom in pitchers?

A

Thoracic outlet

Poor posture, repetitive motion

PT, surgery

Numbness of limb, pain, weakness, weak pulse, blood clots, pallor, coldness, pain in region

Hypertrophy of anterior scalene m -> blocks subclavian A

21
Q

What arteries are in the root of the neck?

A

Subclavian A

Thryocervical trunk: inferior thyroid, cervicodorsal trunk, suprascapular A

22
Q

What sympathetic innervation is in the root of the neck?

Parasympathetic innervation?

A

Superior cervical ganglion, middle cervical ganglion, inferior cervical ganglion

Vagus N (CN X)

23
Q

What are the three parts of the thyroid gland?

What veins drain the thyroid?

What arteries supply the thyroid?

A

R lobe, L lobe, isthmus

Superior and middle thyroid V -> internal jugular V -> brachiocephalic V -> SVC

L and R Inferior thyroid V -> both drain into L brachiocephalic V

External carotid -> superior thyroid A

Subclavian A -> thyrocervical trunk -> inferior thyroid A

Brachiocephalic trunk -> thyroid ima A

24
Q

The L vagus N becomes the L recurrent laryngeal N and wraps around the _____.

The R vagus N gives off the R recurrent laryngeal N and wraps around the ____.

What nerve is of concern when removing the thyroid because is sits deep to the thyroid in the tracheoesophageal groove? Fx?

A

Arch of the aorta

Brachiocephalic trunk

L recurrent laryngeal N: moves laryngeal muscles; critical for speech; helps closes airway

25
Q

The presence of _____ must be considered before a tracheotomy as a potential source of bleeding.

Where can this artery branch from?

Where does this artery travel?

A

Thyroid ima artery

Branch off the brachiocephalic trunk, arch of aorta, R common carotid, R subclavian, or internal thoracic A

Travels along the anterior surface of the trachea and continues to thyroid isthmus

26
Q

_____ refers to the presence of thyroid tissue in locations other than the normal anterior neck region between the ____ and ____ tracheal cartilages.

It is the most common form of ______.

A

Ectopic thyroid

2nd; 4th

Thyroid dysgenesis

27
Q

The ____ is the point of entry to the venous system for central line placement, such as a pulmonary A catheter.

What is this called?

Where is the needle entered?

A

R or L subclavian V

Subclavian venous puncture

Needle punctures skin inferior to the center of clavicle, advanced medially towards the jugular notch until needle enters venous angle posterior to the sternoclavicular joint

28
Q

A needle catheter may be inserted into the ____ for diagnostic of therapeutic reasons because it is larger and straighter.

What is this called?

Where is the needle entered?

A

R internal jugular V

Internal jugular venous puncture

Clinician palpate common carotid A and inserts the needle into the IJV just lateral at a 30 degree angle; aiming into the lesser supraclavicular fossa; needle directed inferolaterally toward the ipsilateral nipple

29
Q

A tumor near or inferior to the sigmoid sinus can cause _____.

This causes what symptoms due to the involvement of what three cranial nerves?

A

Jugular foramen syndromes

Loss of taste in posterior third of the tongue (glossopharyngeal N)

Paralysis of vocal cords and palate and anesthesia of larynx and pharynx (vagus N)

Ipsilateral trapezius and sternocleidomastoid m weakness and atrophy (accessory N)

30
Q

What cranial nerves are affected in Collet-Sicard syndrome?

Vernet’s syndrome?

Why?

A

IX, X, XI, XII

IX, X, XI

These syndromes are causes by a lesion near the jugular foramen/sigmoid sinus… IX, X, XI go through jugular foramen; XII goes through hypoglossal canal

31
Q

What does the carotid sheath cover?

A

Internal jugular V, internal/external carotid A, vagus N, ansa cervicalis

32
Q

The strap muscles of the neck lie in the _____ layer of the _____ fascia; superficial to the thyroid.

A

Muscular; pretracheal

33
Q

What is the innervation of the mylohyoid m?

Fx?

A

Nerve to mylohyoid from inferior alveolar N (trigeminal)

Elevate hyoid and tongue

34
Q

What is the innervation of the geniohyoid m?

Fx?

A

C1 via hypoglossal N

Shorten mouth floor

35
Q

What is the innervation of the digastric m?

Fx?

A

Anterior belly: mandibular division of trigemnial N (V3);
Posterior belly: facial N

Depress mandible; steady hyoid

36
Q

What is the innervation of the sternohyoid and omohyoid m?

Fx?

A

Ansa cervicalis

Depress and steady hyoid

37
Q

What is the innervation of the sternothyroid m?

Fx?

A

Ansa cervicalis

Depress hyoid and larynx

38
Q

What is the innervation of the thyrohyoid m?

Fx?

A

C1 via hypoglossal N

Depress hyoid and elevate larynx

39
Q

The thoracic duct is on the ____ side and drains into _____.

A

Left

L subclavian V

40
Q

What are the pharyngeal constrictor muscles?

A

Superior, middle, and inferior constrictor m

Stylopharyngeus m

Neuro Exam 1 (15 decks)

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