Posterior Triangle Flashcards

1
Q

A: What are the 2 primary zones of the neck

B: What protects and segregates these zones?

A

A:

  1. Visceral region anteriorly
  2. Musculoskeletal block Posteriorly

B: FASCIA

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2
Q

Name the 6 types of Cervical Fascia

A
  1. Superficial Cervical Fascia
  2. Investing Fascia
  3. Infrahyoid Fascia
  4. Carotid Sheath
  5. Prevertebral Fascia
  6. Pretracheal Fascia
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3
Q

Describe the Superficial Cervical Fascia [4]

A

Surrounds fat, cutaneous nerves, vessels, platysma

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4
Q

Describe Cervical: DEEP INVESTING FASICA [3]

2) This is also known as the _____ Fascia

A
  1. Surrounds all neck structures except platysma
  2. Attaches to ligamentum nuchae & C7 spinous process posteriorly
  3. Splits to surround Traps & sternocleidomastoid

AKA ENVELOPING FASCIA

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5
Q

Describe Cervical: Infrahyoid Fascia

A

Surrounds and isolates movements of Strap Muscles

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6
Q
  1. Describe Cervical:Carotid Sheath
A
  1. Surrounds ViiC! –>
    Vagus n. / iNternal Carotid/ iNternal Jugular / Common Carotid
    ————————————————
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7
Q

A: What are the Boundaries of the Posterior Triangle
B: Describe Roof of Posterior Triangle [4]
C: Describe the FLOOR [4]

D: How is the Posterior Triangle subdivided

A

A:
ANTERIOR: Sternocleidomastoid
INFERIOR: Clavicle
POSTERIOR: Traps

B: Platysma, Superficial & Investing fascia & skin

C: FLOOR: Splenius/Levator/Posteior & middle Scalene (all covered in deep/prevertebral fascia)

D: Subdivided by inf-Omohyoid muscle into
[superior Occipital Triangle] & [Omoclavicular/Supraclavicular] triangle inferiorly

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8
Q

What are the 4 Layers of the Posterior triangle starting from outside –>in

A
  1. Skin (MOST OUTER)
  2. Subcutaneous Connective Tissue Package [a lot]
  3. Investing layer of Deep Cervical fascia =surrounds sternocleidomastoid & traps
  4. Deeper Contents
    [CN11 C3-C4/ inf-Omohyoid/ Subclavian vein in front of
    ANT scalene]
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9
Q

Describe just the [Subcutaneous Connective Tissue Package layer] that surrounds Posterior Triangle [3]

BB) This is the ___superficial layer of the Posterior Triangle

A

Package Contains:
1. Platysma (facial expression muscle/shaving muscle)

  1. External Jugular Vein (formed by Retromandibular v. & POST auricular v.)
  2. Cutaneous Branches of Cervical Plexus:
    A: C2/C3->lesser occipital / great auricular / Trnverse Crvcial
    B: C3/C4–>supraclavicular nerve
    ————————————————–
    BB: Subcutaneous Connective Tissue Package layer is the 2nd most superficial
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10
Q

1) Subclavian artery and its “early kids”/branches are ____ to the ANTerior Scalene
2) Describe the Division of this Artery [3]

A

1) Subclavian artery and its “early kids”/branches are DEEP to ANT Scalene
2) VITamin - C - and sometimes D!

*1st segment =
VIT=Vertebral a. / Internal Thoracic / Thyrocervical

**2nd segment= Costacervical [Deep cervical vs. Supreme Intercostal branches]

***3rd segment= sometimes Dorsal Scapular a.–>Levator & both Rhomboid

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11
Q

What are the 4 branches of the Thyrocervical trunk/artery?

2) Where does this artery stem from?

A

“SITA came from the Thyrocervical”

1) A:Suprascapular a.
B: inf-Thyroid
C: Trnsverse Cervical
D: Ascending Cervical

2) Thyrocervical comes from 1st segment of Subclavian “early kids”

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12
Q

A: What organs does the Vertebral a. supply?

B: What happens after Subclavian a. & v. crosses the 1st rib and what is the Clinical Relevance to this?

A

A: Circle of Willis and Brainstem

B: Once Subclavian a/v passes 1st rib they become Axillary a/v. Pressing subclavian against 1st rib is IMP pressure point to STOP UE severe bleeding

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13
Q

Brachial plexus & Subclavian Artery passes between which 2 scalene muscles?

A

Anterior Scalene & Middle Scalene

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14
Q

Where is the Subclavian VEIN located?

B: What else is located in this same area?

A

sits ON TOP of the ANT SCALENE

B: PHRENIC NERVE ALSO Sits ON TOP of ANT SCALENE

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15
Q

The Middle Scalene muscle is pieced by the ____ ____ n. and attaches to the ___rib (along with ___) while the Posterior Scalene muscle attaches to the ____ rib

A

Middle scalene muscle is pierced by DORSAL SCAPULAR NERVE & attaches to 1st rib (along with ANT Scalene) while.. Posterior Scalene muscle attaches to 2nd rib

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16
Q

Where and What is Erbs point?

A

Located on POSTERIOR border of Sternocleidomastoid and is the spot where all Cervical Plexus cutaneous branches become superficial!

17
Q

What are the Arteries and Veins found within the Posterior Triangle? [4]

A
  1. External Jugular Vein
  2. Subclavian a & v
  3. Transverse Cervical a & v
  4. Suprascapular a & v
18
Q

Name the Muscles located INSIDE the Posterior Triangle [5]

A

The “Floor” + omohyoid

  1. SCALENE MUSCLES [middle & POST]
  2. OMOHYOID
  3. Splenius capitis
  4. Levator scapulae
19
Q

Where would you find the Brachial Plexus?

A

INSIDE the posterior triangle behind ANT Scalene

20
Q

Describe the pathway of the [Spinal Accessory CN11] Nerve and what it innervates?

A

Exits C3-C4–>innervates Sternocleidomastoid from behind

–>then traverse across Levator Scapula —>innervate Traps

21
Q

ANTERIOR SCALENE:

1) Attachments
2) Nerve associated
3) Function [2]

A

1) [ANT of C3-C6 vertebrae] and [1st rib/Lisfranc scalene tubercle]
2) C4-6 spinal n.
3) elevates 1st rib on forced inspiration and laterally flexes neck

22
Q

MIDDLE SCALENE:

1) Attachments
2) Nerve associated
3) Function
4) What’s special about this scalene muscle?

A

1) [1st rib upper surface] and [posterior tubercles of transverse processes C3-7 & transverse processes C1-2]

2) 1st rib upper surface
3) C3-8 n.

4) LARGEST AND LONGEST SCALENE muscle!

23
Q

POSTERIOR SCALENE:

1) Attachments
2) Nerve associated
3) Function
4) What’s special about this scalene muscle?

A

1) [2nd rib upper surface] and [posterior tubercles of transverse processes C4-6]
2) C5-7 n.
3) Elevate 2nd rib on forced inspiration and flex neck laterally

4) smallest scalene muscle

24
Q

1) Ansa Cervicalis

2) What are the STRAP Muscles? [4]

A

C1 motor derivative/daughter that loops around after a lil leaving C1 to reinsert into C2 and C3 = innervates front Strap Muscles (Sternohyoid/Sternothyroid/BOTH Omohyoid)

*STRAP= + Thyrohyoid(innervated by C1 ventral rami)

25
Q

1) What nerve innervates the geniohyoid and thyrohyoid muscles?
2) What’s special about this nerve?
3) Motor Branches are ___ to the Sternocleidomastoid Muscle

A

1) C1 spinal nerve ventral rami alone (with no Ansa cervicalis)
2) C1 spinal nerve Loops right along with Hypoglossal CN12 nerve b4 it reaches destination

3) Motor Branches are DEEP to the Sternocleidomastoid Muscle

26
Q
  1. Describe the pathway of the Transverse Cervical Nerve [3]
A

Exits C2-C3 spinal nerves posteriorly–> quickly loops around Sternocleidomastoid muscle and heads front
—>travels Front terminates in throat = throat sensory

27
Q

Which artery is the Vagus Nerve usually running course/paired with?

A

Vaugs n. pairs with the Common Carotid Artery

28
Q

Which brachial plexus nerve is specifically responsible for Opposable Thumbs?

A

MEDIAN NERVE!

29
Q

Pretracheal Fascia is laterally continuous with the ____ _____. It wraps the ___, ____ and _____, eventually forming ______________

A

Laterally continuous w/Carotid Sheath, and Encapsulates trachea, esophagus & thyroid gland, eventually forming 2 lobes connected by [Buccopharyngeal Fascia]

30
Q

A: Prevertebral Fascia [3]

B: How is Sibson’s fascia related to this?

A
  1. Covers 4 Vertebral column BACK muscles
    [rectus lateralis/anterioris] and [longus colli/capitis]
  2. Extends over ALL scalene, levator scapulae & Splenius m.
    3.Laterally continuous w/Carotid Sheath
    ———————————————————————————
    B: Sibson’s is an extension of Prevertebral that inferiorly inserts onto cervical pleura