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Anatomy > NSB 5. Posterior Triangle of the Neck > Flashcards

NSB 5. Posterior Triangle of the Neck Flashcards

1
Q

Which part of the spine is more easily damaged than others?

A

CERVICAL spine more easily damaged than lumbar or thoracic

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2
Q

What are the triangles of the neck?

A

[1] Anterior Triangle

[2] Posterior Triangles (2x)

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3
Q

What are the boundaries of the posterior triangle of the neck?

A

ANTERIOR:
- posterior edge of the sternocleidomastoid muscle

POSTERIOR:
- anterior edge of trapezius

INFERIOR:
- middle 1/3 of clavicle

SUPERIOR/APICALLY:
- occipital bone just posterior to mastoid process

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4
Q

What is the mastoid process?

A

a pyramidal bony projection from the posterior section of the temporal bone

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5
Q

What makes up the floor of the posterior triangle? (from superior to inferior)

A

[1] Splenius Capitis
[2] Levator Scapulae
[3] Posterior, Middle and Anterior Scalene Muscles

  • they are covered by prevertebral layer of cervical fascia
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6
Q

What makes up the roof of the posterior triangle?

A

Cervical Fascia:

  • prevertebral layer
  • investing layer
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7
Q

How can infection spread from the neck to the mediastinum?

A

through the Retropharyngeal Space

- or spaces that are created around the fascia layers

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8
Q

What is the retropharyngeal space?

A

space of the head and neck, bounded by the buccopharyngeal fascia anteriorly and the alar fascia posteriorly
- it contains lymph nodes

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9
Q

What are the layers of the cervical fascia from outside to in?

A

[1] Superficial Cervical Fascia
[2] Deep Cervical Fascia
(a) Investing Fascia
— goes around sternocleidomastoid, trapezius + “strap” muscle

(b) Pretracheal Fascia
- – around the trachea, oesophagus and thyroid gland

(c) Prevertebral Fascia
- – surrounds cervical vertebrae + surrounding muscles

(d) Carotid Sheath
- – around internal jugular vein, carotid arteries (common, internal + external) and vagus nerves

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10
Q

What are the attachments of the sternocleidomastoid muscle? Where does it originate from? Where does it end up?

A
  • it originates from the mastoid
  • there are 2 heads of the sternocleidomastoid
  • the first part attaches to the sternum
  • the second part attaches to the clavicle
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11
Q

What is the nerve supply of the sternocleidomastoid?

A

the accessory nerve (XI)

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12
Q

If a sternocleidomastoid muscle was to act on its own/individually (only one side working) what movement will occur?

A

it will turn the chin towards the opposite shoulder

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13
Q

If the sternocleidomastoid muscles were to act together, what movement will occur?

A

when the 2 sides are working together, it will draw the head forward

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14
Q

What path does the accessory nerve (XI) take?

A
  • it starts from the upper 1/3 of the posterior border of the sternocleidomastoid
  • passes deep to the investing layer of deep cervical fascia
  • descends and enters the posterior triangle
  • enters lower 1/3 of anterior border of trapezius
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15
Q

What is the nerve supply of the trapezius?

A

accessory nerve (XI)

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16
Q

What is the action of the trapezius?

A
  • assist in rotating the scapula during abduction of the humerus above the horizontal (raise your hand)
  • shrug the shoulders
17
Q

How do you test the XI nerve?

A

[1] Sternocleidomastoid
- make the person turn their head to the opposite side – the examiner needs to resist their movements

[2] Trapezius

  • shrug shoulders
  • examiners tries to push person’s shoulder down
18
Q

What are the roots of the cervical plexus?

A

C1 to C4

19
Q

What are the cutaneous branches of the cervical plexus?

A
  • accessory nerve [XI]
  • lesser occipital nerve
  • great auricular nerve
  • transverse cervical nerve
  • supraclavicular nerves
20
Q

What are the nerve roots of the brachial plexus?

A

C5, C6, C7, C8 and T1

- the nerve roots are located in the posterior triangle

21
Q

What are the branches of the aorta?

A

[1] Braciocephalic

(a) Right Subclavian
(b) Right Common Carotid

[2] Left Common Carotid

[3] Left Subclavian Artery

22
Q

What are the arteries in the posterior triangle of the neck?

A
  • 1st Part of Subclavian Artery
  • 3rd Part of Subclavian Artery
  • Suprascapular Artery
  • Transverse Cervical Artery
23
Q

What are the main veins of the posterior triangle?

A

[1] External Jugular Vein
- it is at the angle of the mandible to 3cm above middle 1/3 of the clavicle where it pierces the investing fascia to join the subclavian vein

[2] Subclavian Vein
- crosses the base of the posterior triangle

[3] Internal Jugular Vein

  • found between the 2 heads of the SCM
  • from he temperomandibular joint to the sternoclavicular joint
24
Q

Where is the internal jugular vein located?

A

between the 2 heads of the sternocleidomastoid

25
Q

What is the path that the internal jugular vein takes?

A

it goes from the temperomandibular joint to the sternoclavicular joint

26
Q

What are the lymph nodes in the posterior triangle of the neck?

A

[1] Occipital Nodes

[2] Supraclavicular Nodes

27
Q

What are the 2 structures within the chest cavity which extends up into the posterior triangle of the neck?

A

[1] Apex of the Lung
[2] Cervical Pleura

they extend 2cm above the middle 1/3 of the clavicle

28
Q

To summarize, what are the major contents of the posterior triangle?

A

[1] Accessory Nerve (XI)

[2] Cervical Plexus - Cutaneous Branches

[3] Subclavian Artery (3rd part) + Suprascapular + Transverse Cervical (from 1st part)

[4] Subclavian Vein

[5] Upper Trunk of Brachial Plexus

[6] Apex of Lung

[7] Occipital and Supraclavicular Lymph Nodes

29
Q

If there is injury to the cervical pleura, what can this lead to?

A

pneumothorax

30
Q

If there is injury to the subclavian vessels, what can this lead to?

A

it can lead to potentially catastrophic bleeding

31
Q

If the accessory nerve is injured what happens?

A

Dropped Shoulder

- since it gives action to the trapezius and sternocleidomastoid

32
Q

What is Erb Duchenne Palsy?

A
  • upper brachial plexus injury (C5 + C6)
  • leads to over extension of the neck

outcomes:

  • internal rotation of shoulder
  • wasting of the arm
  • “waiter’s tip”
33
Q

What is the path that the external jugular vein takes?

A

it is at the angle of the mandible to 3cm above middle 1/3 of the clavicle where it pierces the investing fascia to join the subclavian vein

Anatomy (16 decks)

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