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Neck Triangles Flashcards

1
Q

What is unique about the hyoid bone and where is it?

A

U-shaped bone located at C3 in anterior neck

does not articulate with any skeletal elements

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2
Q

What are the borders of the anterior triangle?

A

Bounded by inferior border of mandible, anterior border of SCM & midline of neck

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3
Q

What type of fascia is at the roof of the anterior triangle?

A

deep investing fascia around msucles

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4
Q

What type of fascia is at the floor of the anterior triangle?

A

pretracheal fascia and carotid carotid sheath (posterolaterally)

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5
Q

What are the subdivisions of the anterior triangle?

A

submandibular
submental
carotid
muscular triangles

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6
Q

What does the submandibular (digastric) triangle contain?

A

Contains submandibular gland, lymph nodes, (parts of) CN XII, mylohyoid nerve & parts of the facial artery & vein

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7
Q

What does the submental triangle contain?

A

Contains submental lymph nodes & some small veins

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8
Q

What does the carotid triangle contain?

A

Contains thyroid gland, larynx, pharynx, carotid sheath (& its contents), branches of cervical plexus, superior root of the ansa cervicalis, deep cervical lymph nodes & (parts of) CN XI & XII

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9
Q

What does the muscular (omotracheal) triangle contain?

A

Contains sternohyoid & sternothyroid muscles, thyroid & parathyroid glands

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10
Q

What are the contents of the carotid sheath?

medially, laterally, posteriorly

A

Medially
* Common carotid artery (CCA)
* Internal carotid artery (ICA)
* External carotid artery (ECA; part)

Laterally
* Internal jugular vein (IJV)

Posteriorly
* CN X

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11
Q

What does the common carotid artery bifurcate into?

A

internal
external carotid arteries

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12
Q

What are the anterior triangle muscles?

A

suprahyoid
infrahyoid

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13
Q

What are the suprahyoid muscles?

A

mylohoid
geniohyoid
diagastric
stylohyoid

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14
Q

What are the infrahyoid (strap) muscles?

A

omohyoid
sternohyoid
thyrohyoid
sternothyroid

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15
Q

What do suprahyoid muscles do?

A

raise the hyoid bone as required during swallowing

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16
Q

Where does the mylohyoid originate and where does it insert?

A

originates at mylohyoid line on mandible

inserts into body of hyoid & fibres of opposite mylohyoid

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17
Q

What are the actions of the mylohyoid?

A

Elevates the hyoid & forms the floor of the oral cavity

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18
Q

What is on top of the mylohyoid?

A

the geniohyoid

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19
Q

Where do both parts of digastric originate and insert?

A

muscle has anterior & posterior bellies;

anterior belly originates at digastric fossa on mandible

posterior belly originates at mastoid notch on temporal bone

both insert at attachment of their intermediate tendon at hyoid

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20
Q

What are the actions of the digastric?

A

Anterior belly elevates hyoid and depresses mandible;

posterior belly elevates & retracts hyoid bone

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21
Q

What is the mylohyoid innervated by?

A

CN V3 - inferior alveolar branch

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22
Q

What is the digastric innervated by?

A
  • Anterior belly – nerve to mylohyoid
    (CN V3)
  • Posterior belly – Digastric branch of
    CN VII
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23
Q

What are origins/insertions of stylohyoid and what is it’s action?

A

originates at the styloid process & inserts into body of hyoid (laterally)
Action: Pulls hyoid bone upward (posterosuperior direction)

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24
Q

What is the innervation of the stylohyoid?

A

CN VII

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25
What are the origins/insertions of the geniohyoid?
originates from the mandible (mental spine) & inserts at body of hyoid (located superior to mylohyoid; floor of oral cavity)
26
What are the actions of the geniohyoid?
Fixed mandible – elevates & pulls hyoid forward; Fixed hyoid – pulls mandible downward & inward
27
What is the innervation of the geniohyoid?
anterior ramus of C1 (travels with CNXII)
28
What are the origins/insertions of the sternohyoid and what is it's action?
originates at posterior surface of sternoclavicular joint & manubrium; inserts into body of hyoid medially Action: Depresses hyoid after elevation during swallowing
29
What are the origins/insertions of the omohyoid and what is it's action? | inferior/superior belly
Superior belly originates at its intermediate tendon & inserts into body of hyoid laterally Inferior belly originates at superior border of scapula & inserts/ends at its intermediate tendon in posterior triangle Actions: Depresses & fixes the hyoid
30
How does the intermediate tendon of the omohyoid attach to the clavicle?
via a fascial sling
31
What are the origins/insertions of the thyrohyoid and what is it's action?
originates at oblique line on thyroid cartilage; inserts into greater horn & adjacent body of hyoid Actions: Depresses the hyoid; can raise larynx when hyoid is fixed
32
What are the origins/insertions of the sternothyroid and what is it's action?
originates at posterior surface of manubrium; inserts into oblique line on thyroid cartilage Action: Draws the larynx downward
33
What are the infrahyoid muscles innervated by?
Sternohyoid, omohyoid & sternothyroid are innervated by anterior rami of C1 to C3 (through the ansa cervicalis) Thyrohyoid is also innervated by anterior rami of C1, but fibres run with CN XII
34
Where does the right CCA originate?
Branch of brachiocephalic trunk
35
Where does the left CCA originate?
Direct branch from aortic arch
36
Where do the ICA and ECA originate?
branches of CCA atC4
37
What branches does ICA have?
No branches in the neck & ascends to enter the carotid canal & supply the brain
38
What are the branches of the ECA? | 8
* Superior thyroid * Ascending pharyngeal * Occipital * Lingual * Facial * Posterior auricular * Superficial temporal * Maxillary
39
What is the transverse facial artery a branch of?
superficial temporal
40
Where does the IJV drain blood from?
brain, skull, face & parts of neck
41
What is the signoid sinus?
a pair of S-shaped sinuses located in the base of the skull that drain blood into the internal jugular vein
42
How does the IJV exit the skull and what does it run lateral to?
* Exits skull via the jugular foramen & enters carotid sheath * Runs lateral to CCA
43
What veins drain into the IJV | 7
* Inferior petrosal sinus * Pharyngeal * Occipital * Facial * Lingual * Superior thyroid * Middle thyroid
44
What does the IJV join?
Joins subclavian vein to become brachiocephalic vein (left & right)
45
What are the lobes of the thyroid gland?
pyramidal lobe right lobe isthmus (seperation) left lobe
46
Where is the thyroid gland and where do the lobes lie?
* Within visceral compartment of neck * 2 lateral lobes (right & left) (extends from thyroid cartilage to 5th tracheal ring) * Midline isthmus (level of 3rd tracheal ring)
47
What is the arterial supply of the thyroid gland?
* Superior thyroid artery (1st branch of external CA) * Inferior thyroid artery (branch of thyrocervical trunk from subclavian)
48
What is the venous drainage of the thyroid gland?
* Superior thyroid vein (into IJV) * Middle thyroid vein (into IJV) * Inferior thyroid vein (into bracheocephalic)
49
Where are the parathyroid glands and how many?
2 pairs (superior & inferior) of small glands usually on posterior surface of thyroid, but exact position varies
50
What is the arterial supply/ venous drainage of the parathyroid glands?
* Inferior thyroid arteries (branch of thyrocervical trunk from subclavian) supply parathyroid glands * Venous drainage same as thyroid
51
What innervates both the thyroid and parathyroid glands?
innervated by thyroid branches from the cervical (sympathetic) ganglia
52
What are symptoms of damage to the recurrent laryngeal nerves?
Symptoms of injury (or pressure from post- surgical blood or exudate accumulation) include hoarseness or aphonia
53
What nerves lie close to the parathyroid glands?
recurrent laryngeal
54
What are the posterior triangle borders?
Posterior border of SCM (anterior), anterior border of trapezius (posterior), middle 3rd of clavicle (inferior) & occipital bone In direct continuity with upper limbs
55
What type of fascia is found in the roof of the posterior triangle and what is it innervated by?
deep investing fascia around muscles (SCM & trapezius) | CN XI
56
What type of fascia is found at the floor of the posterior triangle?
(muscular) prevertebral fascia surrounding splenius capitus, levator scapulae & p., m., a. scalenes innervated by cervical nerves
57
What muscles are in the posterior triangle?
SCM anteior scalene middle scalene inferior belly of omohyoid trapezius levator scapulae
58
Where does the SCM originate/insert and what are it's actions?
* Sternal head originates at manubrium of sternum & inserts lateral half of the superior nuchal line * Clavicular head originates at medial 3rd of clavicle & inserts into lateral surface of mastoid process Actions: Draws the head forward (both SCMs); or tilts head toward ipsilateral shoulder while turning face contralaterally (one SCM)
59
What is the SCM innervated by?
spinal accessory nerve (CN XI)
60
Where does trapezius originate/insert and what are it's actions?
Originates at superior nuchal line, external occipital protuberance, ligamentum nuchae & spinous processes (C7-T12) Inserts into lateral 3rd of clavicle, acromion & spine of scapula Actions: Assists in rotating scapula during abduction of humerus; upper fibres elevate, middle adduct & lower depress scapula
61
Which nerve controls the patient's ability to shrug their shoulders?
CN XI
62
What is the trapezius innervated by?
spinal accessory nerve (CN XI)
63
Where does levator scapulae (floor) originate/insert and what is it's action?
originates at C1-C4 (transverse processes); inserts into scapula (upper medial border) Action: Elevates scapula
64
What is the innervation of the levator scapulae?
innervated by C3, C4 and dorsal scapular nerve (C4, C5)
65
Where doanterior and middle scalene (floor) originate/insert and what are their actions?
Anterior scalene originates at C3-C6 (anterior tubercle of transverse processes); inserts into upper surface of rib 1 & scalene tubercle Middle scalene originates at C4-C7 (transverse processes); inserts into upper surface of rib 1, posterior to groove for SCA Action: Elevates 1st rib
66
What is the innervation of the anterior/middle scalene?
Innervated by anterior rami of C4-C7 (both anterior & middle), C3 (also for anterior)
67
What is the cervical plexus?
anterior rami of C1-C4
68
What are the muscular branches of the cervical plexuses? | 3
* Phrenic nerve (C3, C4, C5) * Ansa cervicalis (C1, C2, C3) * branches to prevertebral & vertebral muscles
69
What are the cutaneous branches of the cervical plexuses? | 3
* C2: lesser occipital nerves, greater occiptal * C2, C3: great auricular & transverse cervical nerves * C3, C4: supraclavicular nerves
70
What are the contents of the posterior triangle?
acessory nerve (XI) inferior belly of omohyoid muscle 1st + 3rd part of subclavian artery subclavian vein brachial plexus
71
What do the external and anterior jugular veins drain into?
* External jugular vein, crosses over SCM, drains into the subclavian vein * Anterior jugular vein drains into the external jugular vein
72
What symptoms would a patient have, if the cervical sympathetic trunk is damaged?
Horner's syndrome, a condition caused by disruption of sympathetic nerve supply. The classic triad of symptoms includes: Ptosis: Drooping of the upper eyelid due to paralysis of the smooth muscle (Müller's muscle). Miosis: Constriction of the pupil due to unopposed parasympathetic activity. Anhidrosis: Decreased sweating on the affected side of the face due to loss of sympathetic innervation to sweat glands.
73
What arteries mainly supply the thyroid gland?
Superior thyroid artery: Branch of the external carotid artery. Supplies the superior aspect of the thyroid gland, as well as parts of the larynx and infrahyoid muscles. Inferior thyroid artery: Branch of the thyrocervical trunk, which comes from the subclavian artery. Supplies the inferior and posterior aspects of the thyroid gland.
74
Where do the left and right CCA derive from and at which level do they bifurcate and into what?
Right - brachiocephalic trunk (or brachiocephalic artery), which is the first major branch of the aortic arch. Left - aortic arch directly They bifurcate at C4 into the internal and external carotid arteries (usually at the upper border of the thyroid cartilage)
75
What is the position of both the internal and external carotid?
Internal Carotid Artery (ICA): Medial and posterior. External Carotid Artery (ECA): Lateral and anterior.
76
Where do both the external and internal jugular vein drain into?
they both drain into the subclavian vein which drains into the brachiocephalic vein
77
Describe the contents and position of the carotid sheath
Common carotid artery (CCA) Located medially, the common carotid artery (CCA) runs within the sheath. Internal jugular vein (IJV): Located laterally to the artery, the IJV drains blood from the brain and superficial parts of the face and neck. Positioned posteriorly and between the artery and vein, the vagus nerve descends within the carotid sheath and provides parasympathetic innervation to the thoracic and abdominal organs.
78
What does the anterior jugular vein drain and what does is it drain into?
The anterior jugular vein is formed from small superficial veins in the submandibular region and drains the anterior neck structures, eventually emptying into the external jugular vein or directly into the subclavian vein.
79
Do checkout sheet
done
80
What is the origin, course and drainage of IJV?
Originates at superior bulb of Internal jugular vein, passes through the foramen, gives off 7 branches, and travels down the carotid sheath, drains into subclavian vein
81
What is the origin, course and drainage of the external jugular vein? What are its tributaries
Originates from union of retromandibular and posterior auricular vein, courses superficial to SCM and drains into subclavian. Cervical, suprascapular, anterior jugular veins
82
What is the origin, course, and drainage of anterior jugular?
Originates from submandibular veins, courses through anterior aspect of neck, drains into external

Anatomy (13 decks)

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