plan of neckkk Flashcards
what are the 2 categories of bony landmark of the neck?
Upper limit bones
Inferior limit bones
what are the bony landmarks in the upper limit of the neck?
Inferior border of mandible
MASTOID process of temporal bone
external occipital protuberance
what are the bones in the inferior limit of the neck?
- Manubrium ( jugular notch )
-Clavicle
what is hyoid bone? what are the components of it?
U shaped bone
has a body
2 horns
moves during swallowing
what are the horns of the hyoid bone?
Lesser horn –> found anteriorly
greater horn —> found more laterally
what is the level of hyoid bone in corresponding to the vertebrae?
C3
what ligament connects the styloid process to the hyoid bone?
stylohyoid ligament
there are muscles connecting the hyoid bone to which structures?
Tongue
mandible
sternum
larynx
pharynx
what is the tubercle that is found in the mandible from behind?
genio tubercle
what happens when hyoid bone is fractured?
hyoid bone would be pulled in many directions causing problems in breathing, speaking . swallowing
what is laryngeal prominence ?
prominence found in the neck formed by thyroid cartilage
more prominent in males and raise with swallowing ( similar to hyoid bone )
what is the level of laryngeal prominence in corresponding to the vertebrae?
C4 and C5 vertebrae
what is the cartilage below the thyroid cartilage?
cricoid cartilage
ring shaped
felt below the laryngeal prominence
what is the level of cricoid cartilage in corresponding to the vertebrae?
C6
what happens at the level of C6?
pharynx continue as THE esophagus
larynx continue as THE trachea
trachea terminate at T4
esophagus enter diaphragm at T10
what is the sternocleidomastoid muscle?
a muscle from the sternum to the mastoid process of temporal bone
what is the origin of the sternocleidomastoid muscle?
Origin :
Sternal head : upper part of the anterior surface of the manubrium sterni
Clavicular head : Upper surface of the medial 1/3 of the clavicle
what is the insertion of sternocleidomastoid?
mastoid process
lateral 1/3 of superior nuchal line
what does the sternocleidomastoid muscle continue as?
superior nachal line
what is the nerve supply of sternocleidomastoid muscle?
Motor supply –> spinal accessory nerve
proprioceptive –> C2, C3
what are the actions of sternocleidomastoid muscle?
moves insertion toward origin –> moves the mastoid process towards the manubrium and clavicle —> Tilt the head on the same side
Turn the face to the opposite side
what is the action of it if the neck is fixed?
Elevation of the ribe during forced inspiration
what is digastric muscle?
muscles from the mandible to the mastoid process BUT theres a tendon in the middle of it connecting it to the hyoid bone via fibrous sling
what is the ANTERIOR belly of digastric muscle attached to?
Mandible
what is the posterior belly of digastric muscle attached to?
mastoid process
where is the intermediate tendon ?
hyoid bone connected to it via fibrous sling
what is omohyoid muscle?
muscle from hyoid bone to the scapula BUT theres a tendon binding it in the middle on the sternocleido mastoid
where is the SUPERIOR belly of omohyoid attached to?
on the hyoid bone lateral to sternohyoid and runs downwards and laterally passing DEEP/UNDER to sternomastoid
where is the INFERIOR belly of omohyoid muscle attached to?
scapula
passes in the posterior triangle to reach the scapula
how are the 2 bellies joined together? ( intermediate tendon )
flat tendon deep to sternocleidomastoid
how many triangles in the necks we have given by the sternocleidomastoid ?
2 triangles
anterior triangle
posterior triangle
what are the boundaries of the posterior triangle?
anteriorly –> sternomastoid
posteriorly –> trapezius
apex –> meeting point between the trapezius and sternomastoid at the back of the skull
base –> middle of third of the clavicle , between the attachment of sternocleidomastoid and trapezius
what are the boundaries of the anterior triangle ?
anteriorly –> midline
posteriorly –> sternocleidomastoid
base –> mandible line from angle to the mastoid
apex –> suprasternal notch
what are the boundaries of the muscular triangle?
base is median line
medial border of superior belly of omohyoid muscle
medial border of sternocleidomastoid
what are the boundaries of the carotid triangle ?
lateral border of the superior omohyoid muscle
medial border of sternocleidomastoid
lower border of the posterior digastric muscle
what vessels are found in the carotid triangle?
carotid sheath with the carotid vessels and vagus nerve
what are the boundaries of the digastric/submandible triangle?
lateral border of the anterior digastric
upper border of posterior digastric
lower border of the mandible
what gland is found in the digastric triangle ?
submandibulum gland
what are the borders of submental triangle ?
midline
lateral border of the anterior digastric
upper border of the posterior digastric
what are the suprahyoid muscles ?
muscles above the hyoid bone
digastric
stylohyoid
mylohyoid
geniohyoid
hyoglossus
what is geniohyoid muscle?
extends from genio tubercle of the mandible and hyoid bone
what is the stylohyoid muscle?
muscle from the styloid process of temporal bone to the hyoid bone
it is above the posterior belly of digastric
what is mylohyoid bone?
extend from the mandible to the hyoid bone
attached to the midline raphe
what is hyoglossus ?
extend from the hyoid bone to the tongue ( tongue muscle )
what are the infrahyoid muscles?
sternohyoid
omohyoid
sternothyroid
thyrohyoid
what is the sternohyoid muscle?
between manubrium and hyoid bone
superficial to sternothyroid and thyrohyoid
Most superficial
what is sternothyroid muscle?
between the manubrium and the oblique line of the thyroid cartilage
what is thyrohyoid muscle?
from oblique line of the thyroid cartilage to the hyoid bone
what is the nerve supply of infrahyoid muscles ?
ansa cervicalis
what are the components of ansa cervicalis?
superior loop C1
inferior loop of cervical plexus C2, C3
what are the branches of Superior Loop C1?
Descending hypoglossal nerve
hypoglossal nerve
what is the nerve supply of thyrohyoid muscle?
hypoglossal branch from C1
what are the layers of fascia around the neck?
Superficial fascia
Deep fascia
what are the blocks deeper to the deep fascia?
respiratory digestive block
musculo vertebral block
what is respiratory digestive block?
connective tissue enclosing the trachea, esophagus, infrahyoid muscles, thyroid gland and thyroid cartilage
what is the musculo vertebral block?
connective tissue enclosing the vertebral muscles
AKA PRE VERTEBRAL FASCIA
what is the investing layer of deep cervical fascia?
the fascia that surrounds the whole neck it also splits and envelopes around the trapezius and the sternocleidomastoid
the content of respiratory digestive block is surrounded by what?
pre tracheal fascia –> it encloses trachea , esophagus and thyroid gland + the infrahyoid muscles
the content of the musculo vertebral block is enclosed by what?
prevertebral fascia
it surrounds the musculo-vertebral block
what are the deep fascias of the neck?
investing layer ( Surround sternocleidomastoid + traps )
pretracheal fascia –> surrounds the content of the respiratory block
carotid fascia —> surrounds carotid vessels and vagus nerve
prevertebral fascia –> Surrounds the content of musculo vertebral block
where is the carotid sheath located?
between the respiratory digestive block and the vertebral block
what nerve occupies the groove betweeen trachea and esophagus?
recurrent laryngeal nerve
what are the muscles in musculo vertebral block?
longus colli
scalenus anterior —> arise from the anterior transverse tubercle processes
scalenus medius and posterior –> arise from posterior tubercles
levator scapulae and deep muscle of the necks –> most posteriorly
where is the longus colli located?
in front of the vertebral bodies
what nerve is in front of the scalenus anterior?
phrenic nerve
what nerve is between the scalenus anterior and scalenus medius and posterior?
brachial plexus
what is blood supply of the neck?
Right common carotid artery from brachiocephalic
and left common carotid artery from the aorta
where do the carotid vessels run?
in the carotid sheath
when does the carotid artery divide into internal and external ?
upper border of thyroid cartilage
where does the internal brachial artery supply?
intracranial inside the skull
what are the branches of external carotid artery?
Maxillary
superficial temporal
posterior auricular
occiptal
ascending pharyngeal
superior thyroid
Fascial
lingual
what are the terminal branches of the external carotid artery?
superficial temporal
Maxillary
what are the veins of the neck?
external jugular vein –> superficial to the external sternocleidomastoid
internal jugular vein
anterior jugular vein
where does the external jugular vein empty?
subclavian vein
what happens to the internal jugular vein?
internal jugular vein joins the subclavian to form the BRACHIOCEPHALIC
where does the anterior jugular vein empty to?
external jugular vein then the external jugular vein will terminate in the subclavian
Runs in superficial muscular triangle
which jugular vein runs in the carotid sheath?
internal jugular vein
where does external jugular vein run ?
superficial to the sternocleidomastoid muscle
Terminate in the subclavian vein in the investing fascia in the posterior triangle
Anterior jugular vein empties in the external jugular vein
