Organisation of Neck and Posterior Triangle

Question 1

boundaries of neck

Answer 1

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

Question 2

what are the three compartments of neck

Answer 2

visceral
vascular
vertebral

Question 3

contents of visceral compartment of neck

Answer 3

parts pf resp and GI systems
endocrine glands

Question 4

contents of vascular compartment of neck

Answer 4

CCA
IJV
vagus nerve CNX

Question 5

contents of vertebral compartment of neck

Answer 5

cervical vertebrae
spinal cord
muscles
cervical nerves

Question 6

what is faschia

Answer 6

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

Question 7

superficial faschia (cervical subcutaneous tissue)

Answer 7

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

Question 8

deep fascia (remaining layers)

Answer 8

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

Question 9

Investing faschia - deep

Answer 9

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

Question 10

superior attachments of investing layer

Answer 10

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

Question 11

inferior attachments of investing layer

Answer 11

spine of scapula
acromion
clavicle
manubrium - post and ant

Question 12

anterior attachments of investing layer

Answer 12

hyoid bone

Question 13

posterior attachments of the investing layer

Answer 13

ligamentum nuchae
periosteum of C7 spinous process

Question 14

what is the suprasternal space

Answer 14

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

Question 15

what does the pretracheal faschia visceral part enclose

Answer 15

trachea
oesophagus
thyroid gland

Question 16

what does the pretracheal faschia muscular part enclose

Answer 16

infrahyoid muscles

Question 17

how does the pretracheal faschia help suspend the hyoid

Answer 17

forms pulley for the intermediate tendon of digastric

Question 18

where does the pretracheal faschia start and end

Answer 18

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

Question 19

what pierces the pretracheal faschia

Answer 19

thyroid vessels

Question 20

what does prevertebral faschia surround

Answer 20

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

Question 21

what pierces the prevertebral faschia

Answer 21

cutaneous branches of cervical plexus
cervical parts of sympathetic trunk embedded

Question 22

attachments of prevertebral faschia

Answer 22

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

Question 23

what does the carotid sheath surround

Answer 23

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

Question 24

what does the carotid sheath connect

Answer 24

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

Question 25

what are the borders of the carotid sheath

Answer 25

other 3 layers of deep faschia

Question 26

posterior triangle borders

Answer 26

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)

Question 27

nerves/BV in SCM region of neck

Answer 27

great auricular transverse cervical superior part of EJV

Question 28

nerves in trapezius region of neck

Answer 28

cutaneous branches of posterior rami of cervical spinal nerves

Question 29

subdivisions of posterior triangle

Answer 29

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

Question 30

SCM origin and insertion

Answer 30

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

Question 31

SCM innervation

Answer 31

spinal accessory nerve CNXI 11

Question 32

SCM actions

Answer 32

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

Question 33

trapezius origin and insertion

Answer 33

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

Question 34

trapezius innervation

Answer 34

spinal accessory nerve CNXI 11

Question 35

trapezius actions

Answer 35

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

Question 36

cutaneous nerve

Answer 36

supplies skin

Question 37

muscular nerve

Answer 37

supplys muscle

Question 38

cutaneous branches of cervical plexus

Answer 38

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

Question 39

muscular branches of cervical plexus

Answer 39

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

Question 40

cervical plexus

Answer 40

a plexus of the anterior rami of C1-4

Question 41

plexus

Answer 41

a network of nerves

Question 42

ansa cervicalis

Answer 42

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

Question 43

what is innervated by the ansa cervicalis

Answer 43

infrahyoid muscles bar thyrohyoid

Question 44

vasculature of posterior triangle

Answer 44

anterior jugular vein drains into EJV which drains into subclavian vein

Question 45

structures that cross the SCM

Answer 45

great auricular nerve transverse cervical nerve EJV

Question 46

structures that cross the posterior traingle

Answer 46

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

Question 47

infrahyoid muscles in the posterior triangle

Answer 47

omohyoid sternohyoid