Organisation of Neck and Posterior Triangle Flashcards

1
Q

boundaries of neck

A

superior = base of skull and inferior border of mandible
inferior = top of sternum, clavicle, acromion(anterior) and C7(posterior)

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2
Q

what are the three compartments of neck

A

visceral
vascular
vertebral

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3
Q

contents of visceral compartment of neck

A

parts pf resp and GI systems
endocrine glands

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4
Q

contents of vascular compartment of neck

A

CCA
IJV
vagus nerve CNX

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5
Q

contents of vertebral compartment of neck

A

cervical vertebrae
spinal cord
muscles
cervical nerves

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6
Q

what is faschia

A

tissue which surrounds the neck compartments - contains, provides slipperiness and protects

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7
Q

superficial faschia (cervical subcutaneous tissue)

A

fatty connective tissue
contains cutaneous nerves, BV, lymphatics, platysma
connects to mandible and facial muscles and is continuous w superficial faschia of thorax

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8
Q

deep fascia (remaining layers)

A

3 types ; investing, pretracheal, prevertebral - also forms carotid sheath
connective tissue

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9
Q

Investing faschia - deep

A

surrounds neck completely and invests the trapezius, SCM, parotid and submandibular glands
can invest infrahyoids too
pierced by external anterior jugular veins and nerves such as cervical plexus

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10
Q

superior attachments of investing layer

A

superior nuchal line of occipital bone
mastoid process of temporal bone
zygomatic arches
inferior border of mandible

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11
Q

inferior attachments of investing layer

A

spine of scapula
acromion
clavicle
manubrium - post and ant

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12
Q

anterior attachments of investing layer

A

hyoid bone

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13
Q

posterior attachments of the investing layer

A

ligamentum nuchae
periosteum of C7 spinous process

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14
Q

what is the suprasternal space

A

space in investing faschia where is divides to enclose the heads of the SCM

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15
Q

what does the pretracheal faschia visceral part enclose

A

trachea
oesophagus
thyroid gland

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16
Q

what does the pretracheal faschia muscular part enclose

A

infrahyoid muscles

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17
Q

how does the pretracheal faschia help suspend the hyoid

A

forms pulley for the intermediate tendon of digastric

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18
Q

where does the pretracheal faschia start and end

A

base of skull -> hyoid -> upper thoracic cavity
continuous w buccopharyngeal faschia of the pharynx
laterally fuses w alar faschia and carotid sheaths

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19
Q

what pierces the pretracheal faschia

A

thyroid vessels

20
Q

what does prevertebral faschia surround

A

vertebral column
pre and post vertebral muscles (scalene, longus colli, longus capitis and deep cervical muscles)
laterally extends to surround axillary vessels and brachial plexus as axillary sheath

21
Q

what pierces the prevertebral faschia

A

cutaneous branches of cervical plexus
cervical parts of sympathetic trunk embedded

22
Q

attachments of prevertebral faschia

A

superiorly = cranial base
inferiorly = endothoracic faschia and anterior longitudinal ligament

23
Q

what does the carotid sheath surround

A

CCA
ICA
IJV
CN X - vagus
deep cervical lymph nodes
other nerves

24
Q

what does the carotid sheath connect

A

cranial cavity(foramen of carotid sheath) to aortic arch/mediastinum (thorax)
= potential pathway for infection

25
Q

what are the borders of the carotid sheath

A

other 3 layers of deep faschia

26
Q

posterior triangle borders

A

post border of SCM
ant border of trapezius
middle 3rd of clavicle
apex = superior nuchal line of occipital bone
roof = investing faschia, platysma, superficial faschia and skin
floor = prevertebral faschia surrounding muscles at floor of triangle (ant, post, middle scalenes, levator scapulae, splenius capitis)

27
Q

nerves/BV in SCM region of neck

A

great auricular
transverse cervical

superior part of EJV

28
Q

nerves in trapezius region of neck

A

cutaneous branches of posterior rami of cervical spinal nerves

29
Q

subdivisions of posterior triangle

A

occipital triangle
omoclavicular/subclavian triangle
divided by inferior belly of omohyoid

30
Q

SCM origin and insertion

A

o =
sternal head = manubrium
clavicular head = superior surface of medial 3rd of clavicle
i =
lateral surface of mastoid process
lateral half of superior nuchal line

31
Q

SCM innervation

A

spinal accessory nerve CNXI 11

32
Q

SCM actions

A

draw head forward bilaterally(both SCMs working)
tilts head forward towards ipsilateral shoulder while turning head contralaterally - unilaterally

33
Q

trapezius origin and insertion

A

o =
superior nuchal line
external occipital protuberance
ligamentum nuchae
spinous processes C7-T12
i=
lateral 3rd of clavicle
acromion
spine of scapula

34
Q

trapezius innervation

A

spinal accessory nerve CNXI 11

35
Q

trapezius actions

A

assists in rotating scapula during abduction of humerus - the upper fibres elevate, middle abduct and lower depress scapula

36
Q

cutaneous nerve

A

supplies skin

37
Q

muscular nerve

A

supplys muscle

38
Q

cutaneous branches of cervical plexus

A

C2 = lesser occipital nerves
C2 and 3 = great auricular and transverse cervical nerves
C3 and 4 - supraclavicular nerves

39
Q

muscular branches of cervical plexus

A

C3,4,5 = phrenic nerve
C1,2,3 = ansa cervicalis - branches to prevertebral and vertebral muscles

40
Q

cervical plexus

A

a plexus of the anterior rami of C1-4

41
Q

plexus

A

a network of nerves

42
Q

ansa cervicalis

A

anterior rami of C1-3 - nerves coming from C-3 all join into this loop of nerves
superior and inferior roots
loops carotid sheath

43
Q

what is innervated by the ansa cervicalis

A

infrahyoid muscles
bar thyrohyoid

44
Q

vasculature of posterior triangle

A

anterior jugular vein drains into EJV which drains into subclavian vein

45
Q

structures that cross the SCM

A

great auricular nerve
transverse cervical nerve
EJV

46
Q

structures that cross the posterior traingle

A

CNXI - spinal accessory
EJV
lesser occiptial nerve
transverse cervical artery and vein
supraclavicular nerves

47
Q

infrahyoid muscles in the posterior triangle

A

omohyoid
sternohyoid