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Neuro Exam 1 > posterior triangle and anterior triangle (buck anatomy) > Flashcards

posterior triangle and anterior triangle (buck anatomy) Flashcards

1
Q

what makes up the roof and floor of the posterior triangle

A

roof cervical investing fascia

floor prevertebral fascial covering neck musculature

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2
Q

what are the anterior, posterior and inferior borders of the posterior triangle

A

anterior posterior border of SCM
posterior anterior border of trap
inferior border superoir margin of clavicle

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3
Q

what vein, nerves, muscles , arteries and lymph nodes are in the posterior triangle

A

veins:
external jugular vein

nerves:
cutaneous nerves of the cervical plexus–> lesser occ, greater auric, transver cervic, supraclavicular

spinal accessory n.
brachial plexus

Muscles:
inferior belly of omohyoid

artery:
third portion of subclavian artery , transverse cervical, suprascapular, descending or dorsal scapular and occipital arteries

deep cervical lymph nodes

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4
Q

spinal accessory innervation

A

provides innervation to the SCM and trapezius

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5
Q

what are the cord levels of the brachial plexus

A

C5-T1 ventral rami

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6
Q

where do roots of the brachial plexus pass in the posterior triangle

A

between the anterior and middle scalene muscles

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7
Q

what layer of fascia covers the brachial plexus

A

prevertebral fascia extension–> axillary sheath

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8
Q

what are the branches of the brachial plexus in the neck

A

dorsal scapular C5
-rhomboids

accessory phrenic C5

nerve to subclavius C5-6

suprascapular C5,6- supra and infraspinatous

long thoracic nerve C5,6, 7
-serratous anterior

direct branches to scalene muscles supplied collectively by C5-C8

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9
Q

what are the arteries of the posterior triangle

A

occipital = very superior portion off the external carotid

transverse cervical- off thyrocervical trunk
leaves deep to trap

suprascapular off thyrocervical trunk
joined by the suprascapular n.

subclavian artery
-passes b/w anterior and middle scalenes accompanied by trunks of the brachial plexus and invested with prevertebral fascia

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10
Q

what is the lymphatic drainage of the posteiror triangle

A

deep to investing fascia

composed of the deep cervical system along with the accessory nodes of the spinal accessory nerve
and the transverse cervical nodes

accessory nodes–> receive lymph from superficial lymph nodes of the head (occipital and retroauricular)

transverse cervical nodes receive lymph from posteiror thorax under traps, accessory chain of nodes, lateral areas of neck, upper anterior thoracic wall (mammary gland)
-drain to inferior deep cervical nodes along the internal jugular vein to the jugular lymph trunk

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11
Q

what are the boundaries of the anterior triangle

A

roof
investing cervical fascia

anterior - line from symphysis menti to sternal notch

posterior- anterior border of SCM

superior : inferior margin of mandible

floor - structural components of the visceral compartment of the neck

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12
Q

what are the attachments of the digastric

A

origin - anterior belly- digastric fossa of mandible
posterior belly- mastoid notch of temporal bone

insertion:
hyoid bone via fascial sling from intermediate tendon

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13
Q

what is the digastric

what is the intermediate tendon of this muscle and where does it pass

A

a two-bellied muscles with an intermediate tendon which passes through the attachment of the stylohyoid muscle and is tethered to the hyoid bone via a fascial sling

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14
Q

what is the action of the digastric

A

elevates hyoid and base of tongue

with hyoid fixed via infrahyoid musculature it assists in opening the mouth

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15
Q

what is the innervation of the digastric muscle

A

anterior belly–> mylohyoid nerve CN V3

posterior belly –> digastric branch of facial nerve CN VII

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16
Q

what are the attachments of the stylohyoid

A

origin
posterior base of styloid process

insertion
body of hyoid bone near lesser horn

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17
Q

what is the action of the stylohyoid

A

elevates and retracts the hyoid and base of the tongue

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18
Q

innervation of the stylohyoid

A

digastric branch of facial nerve CN VII

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19
Q

attachments of the mylohyoid

A

o- mylohyoid line of both sides of mandible

insertion– midline raphe from symphysis menti to body of hyoid bone

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20
Q

what is the action of the mylohyoid

A

elevates hyoid and floor of mouth

when hyoid is fixed depresses mandible

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21
Q

what is the innervation of the mylohyoid

A

mylohyoid branch of the trigeminal (CN V3)

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22
Q

attachments of the sternohyoid

A

o- posterior surface of manubrim at sternolavicular joint, clavicle and posterior sternoclavicular ligament

insertion inferior margin of the hyoid

23
Q

what is the action and innervation of the sternohyoid

A

action
depresses hyoid and larynx

innervation ansa cervicalis of cervical plexus

24
Q

what are the attachments of the sternothyroid

A

origin- posterior surface of manubrium inferior to sternohyoid

insertion–> oblique line of thyroid cartilage

25
Q

what is the action and innervation of the sternothyroid

A

depresses larynx

n- ansa cervicalis

26
Q

what are the attachments of the thyrohyoid

A

origin- oblique line of thyroid cartilage

insertion - inferior margin of body and greater horn of hyoid

27
Q

what is the action and innervation of the thyrohyoid

A

action - depresses hyoid and tongue when larynx is fixed from below;

elevates larynx when hyoid is fixed from above

these different attachments are used in different functions such as eating or speaking
C1 of hypoglossal n.

28
Q

what are the attachments of the omohyoid and what is the fascial sling connected to that holds up the omohyoid

A

o– superior belly- inferior margin greater horn of hyoid
inferior belly- superior margin of scapula near notch and suprascapular ligament

insertion-> via fascial sling of infrahyoid fascia to clavicle and first rib

the two bellied muscle has an intermediate tendon which is tetherd to the posterior surface of the clavicle and first rib via a fascial sling

29
Q

what is the action and innervation of the omohyoid

A

stabilizes, retracts, and depresses hyoid and larynx

innervation - ansa cervicalis of cervical plexus

30
Q

what do the follicular cells of the thyroid gland secrete

A

thyroxin - controls metabolic rate

31
Q

parafollicular c cells secrete what

A

calcitonin

decreases circulating Ca levels

32
Q

behind what muscles does the thyroid gland sit

what is it limited above by

extends below to what tracheal ring

A

sits behinds sternohyoid and sternothyroid muscles

limited above by attachment of the sternothyroid to the oblique line of the thyroid cartilage

extends below to level of 6th tracheal ring

33
Q

at which tracheal rings does the isthmus cross

A

2nd, 3rd and 4th

34
Q

what is located to the medial side of the thyroid glands

what limits the thyroid gland laterally

A

trachea, recurrent laryngeal and esophagus

limited laterally by carotid sheath

35
Q

what is the cause of thyroglossal cysts

A

ectopic glandular tissue may remain active along the route of descent of the thyroid gland thereby forming cysts

36
Q

pyramidal lobe is a remnant of what

A

thyroglossal duct

37
Q

what is the blood supply to the thryoid

A

superior thyroid artery - 1st branch off external carotid
branches off the superior thyroid artery including:
Superior laryngeal
Anterior branch
Posterior branch

Inferior thyroid artery- branch off thyrocervical trunk- goes behind carotid sheath and sump. trunk

thyroid ima artery- branch of brachiocephalic or aoritc arch _DONT CUT
pierces thyroid isthmus
anastomoses with inferior thyroid artery

38
Q

what are the 3 pairs of thyroid veins which drain the thyroid

A

superior thyroid veins
-drain into internal jugular

middle thyroid

  • drain lateral suface and into the internal jugular
  • no counterpart artery

inferior thyroid vein:
drain to left and right brachiocephalic veins
may fuse to form single thyroid ima vein which drains to the LEFT brachiocephalic vein

39
Q

what are the lymph nodes involves in thyroid gland drainage

what is the general flow of lymph

A 
pre-laryngeal 
pre-tracheal
para-tracheal
superior deep cervical nodes
inferior deep cervical nodes

lymph from superior one-half–> superior deep cervical nodes

inferior one half–> inferior deep cervical nodes`

40
Q

postganglionic sympathetics that are innverating the thyriod gland follow what three things

A

arteries
parasympathetic nerves
recurrent laryngeal

41
Q

what cord levels of preganglionic sympathetic fibers innervate the thyroid gland

A

T1-T4

ascend in the sympathetic chain where they synapse on superior, middle and stellate ganglia

42
Q

postganglionic sympathetic fibers travel from what ganglia and via what nerves

A

travel from superior, middle and stellate (cervicothoracic) ganglia via the sympathetic cardiac nerves, superior and inferior laryngeal nerves and on surface of arteries

43
Q

what can happen with accidental removal of the parathyroid glands

A

tetany and death (hypocalcemia)

44
Q

where are the parathyroid glands

A

located beneath the capsule of the thyroid gland on its dorsal surface

superior – at the level of cricoid cartilage
inferiorly - inferior pole of thyroid gland

45
Q

at what level does the trachea begin

A

C6

46
Q

what is the muscle that closes the cartilaginous rings of the trachea

A

trachealis muscle –> autonomically innervate smooth muscle which regulates tracheal diameter

47
Q

what is posterior to the thyroid

A

esophagus

recurrent laryngeal nerves

48
Q

what supplies blood to the trachea

A

inferior thyroid arteries and veins drains

49
Q

what is the lymphatic drainage of the trachea

A

juxtavisceral nodes (pre-tracheal, para-tracheal, inferior deep cervical nodes)

50
Q

what is the innervation of the trachea

A

sympathetics directly from sympathetic trunk

parasympathetics from vagus and recurrent laryngeal

51
Q

where does the esophagus (cervical portion) start

A

C6 - inferior border of cricoid cartilage

goes to the left as it descends in the neck

muscle of cervical portion is striated

52
Q

what sits anterior to the esophagus
what sits laterally
posterior

A

anterior- trachea, recurrent laryngeal
lateral- thyroid gland, carotid sheath, thoracic duct on the left
posterior- pre-vertebral fascia over pre-vertebral muscle and vertebral column

53
Q

what is the blood supply, venous drainage and lymphatic drainage of the esophagus

A

artery- inferior thyroid
venous inferior thyroid
lymph- paratracheal and inferior deep cervical lymph nodes

54
Q

what is the sympathetic and parasympathetic innervation to the esophagus

A

sympa- sympathetic trunk (vasomotor and glandular)

paras- recurrent laryngeal nerves (muscular tone and glandular)

Neuro Exam 1 (9 decks)

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