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MD4001 > Posterior & Anterior Triangles of the Neck, Thyroid & Parathyroid* > Flashcards

Posterior & Anterior Triangles of the Neck, Thyroid & Parathyroid* Flashcards

1
Q

Identify the boundaries of the anterior triangle.

A
  • Inferior border of mandible (SUP)
  • Anterior border of sternocleidomastoid (SCM) (LAT)
  • Midline of neck (MED)
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2
Q

What are the roof, and floor of the anterior triangle covered by ?

A
  • Deep investing fascia around muscles (covers ROOF)

* Petracheal fascia and carotid sheath (latter posterolaterally) (cover FLOOR)

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3
Q

What is fascia ?

A

Thin sheath of CT enclosing muscle or other organs

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4
Q

What are the fascial layers of neck ?

A
  • Investing fascia (around circumference of neck, composed of deep cervical fascia)
  • Neurovascular column, composed of carotid sheath (contains vagus, common carotid, internal jugular)
  • Visceral column, made of pre-tracheal fascia (larynx, pharynx, oesophagus, trachea)
  • Pre-vertebral column (spine, muscles of back)
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5
Q

What are the fascial layers of neck ? State what each one contains.

A
  • Investing fascia (around circumference of neck, composed of deep cervical fascia)
  • Neurovascular column, composed of carotid sheath (contains vagus, common carotid, internal jugular)
  • Visceral column, made of pre-tracheal fascia (larynx, pharynx, oesophagus, trachea)
  • Neuromusculoskeletal column, made of pre-vertebral fascia (spine, muscles of back)
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6
Q

Identify the main subdivisions of the anterior triangle.

A
  • Submandibulardivision
  • Submental
  • Carotid
  • Muscular
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7
Q

Identify the main contents of the submandibular (digastric) subdivision of the anterior triangle.

A

Contains

  • Submandibular gland
  • Lymph nodes
  • (parts of) CN XII
  • Mylohyoid nerve
  • Parts of facial artery and vein
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8
Q

Identify the main contents of the submental triangle subdivision of the anterior triangle.

A

Contains

  • Submental lymph nodes
  • Some small veins
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9
Q

Identify the main contents of the carotid triangle subdivision of the anterior triangle.

A

Contains

• Thyroid gland
• Larynx
• Pharynx
• Carotid sheath (and its contents)
• Branches of cervical plexus
• Superior root of ansa
cervicalis
• Deep cervical lymph nodes
• (Parts of) CNXI and XII
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10
Q

Identify the main contents of the muscular (omotracheal) triangle subdivision of the anterior triangle.

A 
Contains
• Sternohyoid muscles 
• Sternothyroid muscles 
• Thyroidgland
• Parathyroid glands
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11
Q

Where are the suprahyoid muscles located ? Where do they connect ?

A

SUPRAHYOID MUSCLES
• Above hyoid
• Connect to skull or
mandible

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12
Q

Where are the infrahyoid muscles located ? Where do they connect ?

A

INFRAHYOID MUSCLES
• Below hyoid
• Connect to inferior structures (sternum, scapula, thyroid cartilage)

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13
Q

Identify the main suprahyoid muscles.

A

Mylohyoid
Digastric
Stylohyoid
Geniohyoid

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14
Q

Identify the main infrahyoid muscles.

A

Sternohyoid
Omohyoid
Thyrohyoid
Sternothyroid

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15
Q

What do suprahyoid muscles do ?

A

Raise the hyoid bone as required during swallowing

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16
Q

MYLOHYOID MUSCLE

  • Origin
  • Insertion
  • Actions
A

MYLOHYOID MUSCLE

  • Origin: mylohyoid line on mandible
  • Insertion: body of hyoid and fibers of opposite mylohyoid
  • Actions: elevates hyoid and floor of the mouth + supports floor of mouth + reinforces floor of oral cavity
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17
Q

DIGASTRIC MUSCLE

  • Origin
  • Insertions
  • Actions
A

DIGASTRIC MUSCLE

1) Anterior Belly
- Origin: digastric fossa on lower medial aspect of mandible
- Insertions: at attachment of their intermediate tendon at hyoid
- Actions: raises hyoid and opens mouth by lowering mandible

2) Posterior Belly
- Origin: mastoid notch on medial side of mastoid process
- Insertion: at attachment of their intermediate tendon at hyoid
- Actions: elevates and retracts hyoid bone

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18
Q

STYLOHYOID

  • Origin
  • Insertion
  • Actions
A

STYLOHYOID

  • Origin: styloid process
  • Insertion: body of hyoid (laterally)
  • Actions: pulls hyoid bone upwards (posterosuperior direction)
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19
Q

GLENOHYOID

  • Origin
  • Insertion
  • Actions
A

GLENOHYOID
-Origin: mental spine of mandible
-Insertion: body of hyoid
-Actions:
Fixed mandible- elevates and pulls hyoid forward
Fixed hyoid- pulls mandible downwards and inward

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20
Q

Describe innervation of suprahyoid muscles.

A
  • Mylohyoid is innervated by CN V3 inferior alveolar branch (known as nerve to mylohyoid)
  • Digastric muscle is innervated by:
  • Anterior belly – nerve to mylohyoid (CN V3,)
  • Posterior belly – Digastric branch of CN VII
  • Sytlohyoid is innervated by CN VII
  • Glenohyoid is innervated by anterior ramus of C1 (travels with CNXII)
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21
Q

What do infrahyoid muscles do ?

A

Depress hyoid after elevation during swallowing

22
Q

What is another name for infrahyoid muscle ?

A

Strap muscle

23
Q

STERNOHYOID

  • Origin
  • Insertion
  • Actions
A

STERNOHYOID

  • Origin: posterior surface of sternoclavicular joint and manubrium
  • Insertion: body of hyoid medially
  • Actions: depresses hyoid after elevation during swallowing
24
Q

OMOHYOID

  • Origin
  • Insertion
  • Actions
A

OMOHYOID

1) Superior belly
- Origin: intermediate tendon
- Insertion: body of hyoid laterally

2) Inferior belly
- Origin: superior border of scapula
- Insertion: Its intermediate tendon in posterior triangle (tendon attaches to clavicle using fascial sling)

-Actions: depress and fix the hyoid

25
Q

THYROHYOID

  • Origin
  • Insertion
  • Actions
A

THYROHYOID

  • Origin: oblique line on thyroid cartilage
  • Insertion: greater horn and adjacent body of hyoid
  • Actions: depress hyoid + can raise larynx when hyoid is fixed
26
Q

STERNOTHYROID

  • Origin
  • Insertion
  • Actions
A

STERNOTHYROID

  • Origin: posterior surface of manubrium
  • Insertion: oblique lines on thyroid cartilage
  • Actions: draws larynx downwards
27
Q

Describe innervation of infrahyoid muscles.

A

Anterior rami of C1 to C3
• Sternohyoid
• Omohyoid
• Sternothyroid

THYROHYOID
-Innervated by anterior rami of C1 (whose fibers run with CNXII)

28
Q

Which compartment of the neck is the thyroid gland present in ?

A

Within visceral compartment of the neck

29
Q

Identify the main structural features of the thyroid gland.

A
  • Composed of 2 lateral lobes (right and left) (extends from thyroid cartilage to 5th tracheal ring)
  • Midline isthmus (level of 3rd tracheal ring)
  • Midline pyramidal lobe (variably present, remnant of thyroglossal duct)
30
Q

Describe arterial supply of the thyroid gland.

A

• Superior thyroid artery (1st
branch of external CA)
• Inferior thyroid artery (branch of thyrocervical trunk from subclavian)

31
Q

Describe venous drainage of the thyroid gland.

A

Thyroid venous plexus:
• Superior thyroid vein (into IJV)
• Middle thyroid vein (into IJV)
• Inferior thyroid vein (into brachiocephalic)

32
Q

Describe anatomical position of parathyroid glands.

A

Two pairs (superior and inferior) of small glands usually on posterior surface of thyroid, but exact position varies

33
Q

Describe arterial supply, and veinous drainage of parathyroid glands.

A

Arterial supply:
-Inferior thyroid arteries (branch of thyrocervical trunk from subclavian)

Veinous drainage: Thyroid venous plexus
• Superior thyroid vein (into IJV)
• Middle thyroid vein (into IJV)
• Inferior thyroid vein (into brachiocephalic)

34
Q

Describe innervation of thyroid and parathyroid.

A

Both thyroid and parathyroid glands are innervated by thyroid branches from the cervical (sympathetic) ganglia

35
Q

Why is it important to consider the recurrent laryngeal nerve’s relationship to the thyroid and parathyroid glands?

A

Recurrent laryngeal nerve is around area of thyroid gland. Hence, concern during neck (e.g. when doing surgery on thyroid gland) surgery – symptoms of injury include hoarseness or aphonia

36
Q

Identify the main boundaries of the posterior triangle.

A
  • Posterior border of SCM (anterior)
  • Anterior border of trapezius (posterior)
  • Middle 3rd of clavicle (inferior)
  • Occipital bone (apex)
37
Q

What are the roof, and floor of the posterior triangle covered by ?

A

Deep investing fascia around muscles (SCM and trapezius) (covers ROOF)

-(muscular) prevertebral fascia surrounding splenius capitus, levator scapulae, and P, M, A scalenes (covers FLOOR)

38
Q

SCM

  • Origin
  • Insertion
  • Actions
A

SCM

1) Sternal head
- Origin: manubrium of sternum
- Insertion: inserts lateral half of the superior nuchal line

2) Clavicular head
- Origin: medial 3rd of clavicle
- Insertion: lateral surface of mastoid process

-Actions: Draws the head forward (both SCMs), or tilts head toward ipsilateral shoulder while turning faces contralaterally (one SCM)

39
Q

What is the innervation of the SCM ?

A

Spinal Accessory Nerve (CNXI)

40
Q

TRAPEZIUS

  • Origin
  • Insertion
  • Actions
A 
TRAPEZIUS
-Origin: 
• superior nuchal line
• external occipital protuberance
• Ligamentum nuchae
• Spinous processes (C7-T12)

-Insertion:
• Lateral 3rd of clavicle
• Acromion
• Spine of scapula

-Actions
• Assists rotating scapula during abduction of
humerus
• Upper fibres elevate scapula
• Middle fibres adduct scapula
• Lower fibres depress scapula
41
Q

What is the innervation of the Trapezius ?

A

Spinal accessory nerve (CN XI)

42
Q

LEVATOR SCAPULAE

  • Origin
  • Insertion
  • Actions
A

LEVATOR SCAPULAE

  • Origin: C1-C4 (transverse processes)
  • Insertion: scapula (upper medial border)
  • Actions: Elevates scapula
43
Q

What is the innervation of Levator Scapulae ?

A

C3, C4, Dorsal scapular nerve (C4, C5)

44
Q

ANTERIOR SCALENE

  • Origin
  • Insertion
  • Actions
A

ANTERIOR SCALENE

  • Origin: C3-C6 (anterior tubercle of transverse processes)
  • Insertion: upper surface of rib 1 and scalene tubercle
  • Actions: Elevates 1st rib
45
Q

MIDDLE SCALENE

  • Origin
  • Insertion
  • Actions
A

MIDDLE SCALENE

  • Origin: C4-C7 (transverse processes)
  • Insertion: upper surface of rib 1, posterior to groove for SCA
  • Actions: Elevates 1st rib
46
Q

What is the innervation of the anterior scalene ? middle scalene ?

A

ANTERIOR SCALENE
• Anterior rami of C4-C7
• C3

MIDDLE SCALENE
• Anterior rami of C4-C7

47
Q

What are the main components of the cervical plexus ?

A

Anterior rami of C1, C2-C4

48
Q

Identify the muscular branches of the cervical plexus, including the spinal nerves that contribute to each.

A

Muscular branches
• Phrenic nerve (C3, C4, C5)
• Ansa cervicalis (C1, C2, C3) branches to prevertebral and vertebral muscles

49
Q

Identify the cutaneous branches of the cervical plexus, including the spinal nerves that contribute to each.

A

Cutaneous branches
• Lesser occipital branches (C2)
• Great auricular and transverse cervical nerves (C2, C3)
• Supraclavicular nerves (C3, C4)

50
Q

What is the main function of the ansa cervicalis ?

A

Superior and inferior roots innervate infrahyoid muscles

51
Q

Identify contents of the posterior triangle.

A
  • Inferior belly of omohyoid muscle
  • CNXI
  • Branches of cervical plexus
  • Distal part of Sc artery
  • Sc vein
  • Trunks of brachial plexus
52
Q

Describe superficial venous drainage of the neck.

A
  • External jugular vein drains into the subclavian vein

* Anterior jugular vein drains into the external jugular vein

MD4001 (74 decks)

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