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Y2S1 ANATOMY > Plan of the neck > Flashcards

Plan of the neck Flashcards

1
Q

What are the important surface landmarks of the neck?

A
  • Upper limit

1) The inferior border of the mandible

2) The mastoid process of the temporal bone

3) The external occipital protuberance

  • Inferiorly

1) The upper border of the manubri sterni

2) Clavicle

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2
Q

What is the hyoid bone?

A
  • U-shaped bone, with a body, lesser and greater cornu (horns), it is the first resistant structure that can be felt in the midline inferior to the chin
  • It is leveled with the C3 vertebrae
  • It moves during swallowing
  • Suspended from the styloid process via the stylohyoid ligaments
  • Muscles (supra & infrahyoid) connects the hyoid bone to the tounge, mandible, sternum, larynx and pharynx
  • A fracture to it will cause problems in breathing, swallowing, and speaking
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3
Q

Describe the laryngeal prominence

A
  • Formed by the thyroid cartilage
  • More prominent in males and it rises with swallowing
  • It lies at the level of the C4 & C5 Vertebrae
  • Below it is the cricoid cartilage located at C6
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4
Q

What is the vertebral relation of the hyoid bone?

A

C3

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5
Q

What is the vertebral relation of the thyroid cartilage?

A

C4 and C5

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6
Q

What is the vertebral relation of the cricoid cartilage?

A

C6

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7
Q

What is the cricoid cartilage?

A
  • Prominence that is felt at the inferior of the laryngeal prominence
  • At the level of C6
  • At C6 the pharynx continues as the esophagus and the larynx as the trachea
  • Posteriorly -> Broad Portion
  • Anteriorly -> Narrow Arch
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8
Q

What is the origin of the sternocleidomastoid?

A

It has two heads:

1) The sternal head: From the upper part of the anterior surface of the manubrium sterni

2) The clavicular head: Upper surface of the medial 1/3 of the clavicle

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9
Q

What is the insertion of the sternocleidomastoid?

A

1) Mastoid process

2) The lateral 1/3 of the superiornuchal line

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10
Q

What is the nerve supply of the sternocleidomastoid?

A
  • The spinal accessory nerve (motor & proprioceptive)
  • C2 & C3 (cranial nerve 11)
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11
Q

What is the action of the sternocleidomastoid?

A

1) Elevates the ribs during forced inspiration when the neck is fixed

2) It tilts the head to the same side & turns the face to the opposite side

  • Allows left ear to touch the shoulder & pointing chin upwards to the opposite side
  • Pigeon/Chicken Movement of the head is also done by this muscle (Moving chin forward)
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12
Q

What are the attachments of the digastric muscle?

A
  • 2 bellies that are joined by an intermediate tendon (anterior & posterior)

1) The anterior belly is attached to the mandible

2) The posterior belly is attached to the mastoid process

3) The intermediate tendon connects it to the hyoid bone via a fibrous sling

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13
Q

What are the attachments of the omohyoid bone?

A
  • It consists of superior and inferior bellies

1) The superior belly is lateral to the sternohyoid and runs downwards and laterally, passing deep into the sternomastoid

2) The inferior belly passes in the posterior triangle to reach the superior scapular fossa

  • The two bellies are joined by a flat tendon deep to the posterior surface of the sternomastoid
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14
Q

What are the attachments of the sternohyoid muscle?

A
  • Extends from the hyoid to the sternum (bilateral)
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15
Q

What are the subdivisions of the neck?

A
  • It is divided by the sternocleidomastoid muscle into two main triangles:

1) Anterior triangle

2) Posterior triangle

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16
Q

What are the boundaries of the anterior triangle?

A

1) Anteriorly: The median line

2) Posteriorly: The sternocleidomastoid

3) Base: Ramus of the mandible + the line from the angle to the mastoid

4) Apex: The suprasternal notch

17
Q

What are the subdivisions of the anterior triangle?

A

1) Muscular triangle

2) Carotid Triangle

3) Digastric/submandibular triangle

4) Submental triangle

18
Q

What are the boundaries of the muscular triangle?

A

1) Superiorly: Belly of the superior omohyoid

2) Anterior lower border of the sternomastoid

3) Mid-imaginary plane

19
Q

What are the boundaries of the carotid triangle?

A

1) Posterior belly of the digastric

2) Upper posterior border of the sternomastoid

3) Posterior border of the superior belly of the omohyoid

  • It contains the carotid sheath
20
Q

What are the boundaries of the Digastric/submandibular triangle?

A

1) Posterior border of the anterior belly of the digastric

2) Lined below by the mandible

3) Posterior belly of the digastric

  • Contains the submandibular gland
21
Q

What are the boundaries of the submental triangle?

A

1) Anterior border of the anterior gastric

2) Base by the hyoid bone

3) Mid-imaginary line

  • Contains the submental lymph nodes
22
Q

What are the boundaries of the posterior triangle?

A

1) Anteriorly: Sternomastoid

2) Posteriorly: Trapezius

3) Apex: The meeting point between the trapezius & sternomastoid at the back of the skull

4) Base: The middle 1/3 of the clavicle between the attachments of the sternomastoid and the trapezius

23
Q

What are the suprahyoid muscles?

A
  • Don’t Sit More, Go Harder

1) Digastric muscle

2) Stylohyoid

  • Above the posterior belly of the digastric muscle
  • It extends between the styloid process & hyoid bone

3) Mylohyoid

-It extends between the mandible and hyoid bone
- It is attached to a midline raphe

4) Geniohyoid

  • Extends between the mandible and hyoid bone

5) Hypoglossus

  • Between the hyoid bone and the tongue
24
Q

What are the infrahyoid muscles?

A

1) Sternohyoid

  • Superficial to the sternothyroid and thyrohyoid
  • It is between the manubrium and hyoid bone

2) Omohyoid

3) Sternothyroid

  • It extends between the manubrium and the oblique line of the thyroid cartilage

4) Thyrohyoid

  • From the oblique line of the thyroid cartilage to the hyoid bone

FYI: All of them are innervated by the Ansa cervicalis nerve (except the thyrohyoid innervated by C1 “Hypoglossal nerve”)

25
Q

What forms the Ansa cervicalis?

A
  • Ansa means LOOP
  • Found superficial to the carotid sheath
  • It is a loop formed of two components:

1) Superior loop: Descending Hypoglossal Nerve (From C1)

2) Inferior Loop: Descending Cervical Nerve (From C2 & C3)

Ventral Rami of C1 heads to a region on its travelling alongside the hypoglossal nerve (Supplies the muscles of the tongue):

  • A branch of the C1 goes down & merges with C2 & C3
  • This loop is known as the Ansa Cervicalis
26
Q

What does the ansa cervicalis innervate?

A

All of the infrahyoid muscles except the thyrohyoid (Which is innervated by C1 through the hypoglossal nerve)

27
Q

What are the blocks found in the neck?

A

1) Respiratory-digestive block:

  • Anteriorly
  • Connective tissue encloses the larynx which forms the trachea at C6, pharynx which forms the esophagus at C6, infrahyoid muscles, thyroid gland & thyroid cartilage
  • They are also partially (only the lower half) enclosed by an extra layer called the pre-tracheal fascia

2) Musculo-vertebral block:

  • Located posteriorly
  • Connective tissue that encloses the vertebral muscles and cervical vertebra
  • They are covered extra by a prevertebral fascia

FYI: Plastysma is found in the superficial fascia

28
Q

What is the Investing Layer of Deep Cervical Fascia?

A
  • The whole neck is enclosed in a musculo-fascial tube composed of sternomastoid and trapezius muscles and the investing layer of the deep fascia
  • Splits to envelope around the trapezius & sternocleidomastoid
  • To reveal it:

Remove the Skin
Remove the Superficial Fascia & Platysmas Muscle
Remove the Investing Layer of Deep Cervical Fascia

29
Q

What is the pretracheal Layer?

A
  • Muscular part
  • Encloses the infrahyoid muscles
  • Visceral part
  • Encloses the thyroid gland, trachea, and esophagus
  • The laryngeal nerve occupies the groove between the trachea and the esophagus
30
Q

What is the Prevertebral Layer?

A

Surrounds the vertebral column and its associated muscles

30
Q

What does the common carotid sheath enclose?

A
  • Common carotid artery
  • Internal jugular vein
  • Vagus nerve
  • Accompanying cervical lymph node
  • It fills the angle between the vertebral block and the respiratory-digestive block (Between the pretracheal & prevertebral fascia)

FYI: Ansa cervicalis is anterior to it

31
Q

Where is the laryngeal nerve found?

A

In the groove between the trachea and esophagus

32
Q

What does the prevertebral fascia enclose?

A

1) Longus colli: It is in front of the vertebral bodies

2) Scalenus anterior: Arises anteriorly to the transverse process of the tubercles

3) Scalenus medius and posterior: Posterior to the tubercle

4) Levator scapulae and deep muscles of the neck: posterior to the scalenus media & posterior

  • The phrenic nerve is anterior to the scalenus anterior
33
Q

What are the branches of the External carotid artery in the neck?

A
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  • Medial

1) Ascending Pharyngeal

Anterior:

2) Superior Thyroid

3) Lingual

4) Fascial

  • Posterior

5) Occipital

6) Posterior Auricular

  • Termination

7) Maxillary

8) Superficial Temporal

34
Q

What are the veins of the neck?

A

1) Anterior Jugular vein

2) External Jugular vein

3) Subclavian

4) Internal Jugular vein

Internal + subclavian = 5) brachicephalic

6) Superior Vena Cava

35
Q

Where is the external jugular vein?

A

1) It is superficial to the sternomastoid muscle

2) Terminates by piercing the investing fascia in the posterior triangle in the subclavian vein

3) Joined inferiorly via the anterior jugular vein

36
Q

Where is the internal jugular vein?

A
  • It runs lateral to the internal and common carotid artery withing the carotid sheath
  • It joins the subclavian vein to form the brachiocephalic vein
37
Q

Where is the anterior jugular vein?

A
  • Superficial to the muscular triangle
  • Terminates in the external jugular vein
38
Q

General Summary

A

Pretracheal Fascia – Surrounding the infrahyoid muscles & thyroid gland
Prevertebral Fascia – Surrounding the musculo-vertebral block
Investing Layer of Deep Cervical Fascia – Around trapezius & sternocleidomastoid

Y2S1 ANATOMY (14 decks)

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