posterior triangle and anterior triangle (buck anatomy)

Question 1

what makes up the roof and floor of the posterior triangle

Answer 1

roof cervical investing fascia

floor prevertebral fascial covering neck musculature

Question 2

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

Answer 2

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

Question 3

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

Answer 3

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

Question 4

spinal accessory innervation

Answer 4

provides innervation to the SCM and trapezius

Question 5

what are the cord levels of the brachial plexus

Answer 5

C5-T1 ventral rami

Question 6

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

Answer 6

between the anterior and middle scalene muscles

Question 7

what layer of fascia covers the brachial plexus

Answer 7

prevertebral fascia extension–> axillary sheath

Question 8

what are the branches of the brachial plexus in the neck

Answer 8

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

Question 9

what are the arteries of the posterior triangle

Answer 9

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

Question 10

what is the lymphatic drainage of the posteiror triangle

Answer 10

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

Question 11

what are the boundaries of the anterior triangle

Answer 11

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

Question 12

what are the attachments of the digastric

Answer 12

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

insertion:
hyoid bone via fascial sling from intermediate tendon

Question 13

what is the digastric

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

Answer 13

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

Question 14

what is the action of the digastric

Answer 14

elevates hyoid and base of tongue

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

Question 15

what is the innervation of the digastric muscle

Answer 15

anterior belly–> mylohyoid nerve CN V3

posterior belly –> digastric branch of facial nerve CN VII

Question 16

what are the attachments of the stylohyoid

Answer 16

origin
posterior base of styloid process

insertion
body of hyoid bone near lesser horn

Question 17

what is the action of the stylohyoid

Answer 17

elevates and retracts the hyoid and base of the tongue

Question 18

innervation of the stylohyoid

Answer 18

digastric branch of facial nerve CN VII

Question 19

attachments of the mylohyoid

Answer 19

o- mylohyoid line of both sides of mandible

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

Question 20

what is the action of the mylohyoid

Answer 20

elevates hyoid and floor of mouth

when hyoid is fixed depresses mandible

Question 21

what is the innervation of the mylohyoid

Answer 21

mylohyoid branch of the trigeminal (CN V3)

Question 22

attachments of the sternohyoid

Answer 22

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

insertion inferior margin of the hyoid

Question 23

what is the action and innervation of the sternohyoid

Answer 23

action
depresses hyoid and larynx

innervation ansa cervicalis of cervical plexus

Question 24

what are the attachments of the sternothyroid

Answer 24

origin- posterior surface of manubrium inferior to sternohyoid

insertion–> oblique line of thyroid cartilage

Question 25

what is the action and innervation of the sternothyroid

Answer 25

depresses larynx n- ansa cervicalis

Question 26

what are the attachments of the thyrohyoid

Answer 26

origin- oblique line of thyroid cartilage | insertion - inferior margin of body and greater horn of hyoid

Question 27

what is the action and innervation of the thyrohyoid

Answer 27

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.

Question 28

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

Answer 28

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

Question 29

what is the action and innervation of the omohyoid

Answer 29

stabilizes, retracts, and depresses hyoid and larynx innervation - ansa cervicalis of cervical plexus

Question 30

what do the follicular cells of the thyroid gland secrete

Answer 30

thyroxin - controls metabolic rate

Question 31

parafollicular c cells secrete what

Answer 31

calcitonin | decreases circulating Ca levels

Question 32

behind what muscles does the thyroid gland sit what is it limited above by extends below to what tracheal ring

Answer 32

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

Question 33

at which tracheal rings does the isthmus cross

Answer 33

2nd, 3rd and 4th

Question 34

what is located to the medial side of the thyroid glands what limits the thyroid gland laterally

Answer 34

trachea, recurrent laryngeal and esophagus | limited laterally by carotid sheath

Question 35

what is the cause of thyroglossal cysts

Answer 35

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

Question 36

pyramidal lobe is a remnant of what

Answer 36

thyroglossal duct

Question 37

what is the blood supply to the thryoid

Answer 37

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

Question 38

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

Answer 38

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

Question 39

what are the lymph nodes involves in thyroid gland drainage what is the general flow of lymph

Answer 39

``` 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`

Question 40

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

Answer 40

arteries parasympathetic nerves recurrent laryngeal

Question 41

what cord levels of preganglionic sympathetic fibers innervate the thyroid gland

Answer 41

T1-T4 ascend in the sympathetic chain where they synapse on superior, middle and stellate ganglia

Question 42

postganglionic sympathetic fibers travel from what ganglia and via what nerves

Answer 42

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

Question 43

what can happen with accidental removal of the parathyroid glands

Answer 43

tetany and death (hypocalcemia)

Question 44

where are the parathyroid glands

Answer 44

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

Question 45

at what level does the trachea begin

Answer 45

C6

Question 46

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

Answer 46

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

Question 47

what is posterior to the thyroid

Answer 47

esophagus | recurrent laryngeal nerves

Question 48

what supplies blood to the trachea

Answer 48

inferior thyroid arteries and veins drains

Question 49

what is the lymphatic drainage of the trachea

Answer 49

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

Question 50

what is the innervation of the trachea

Answer 50

sympathetics directly from sympathetic trunk parasympathetics from vagus and recurrent laryngeal

Question 51

where does the esophagus (cervical portion) start

Answer 51

C6 - inferior border of cricoid cartilage goes to the left as it descends in the neck muscle of cervical portion is striated

Question 52

what sits anterior to the esophagus what sits laterally posterior

Answer 52

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

Question 53

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

Answer 53

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

Question 54

what is the sympathetic and parasympathetic innervation to the esophagus

Answer 54

sympa- sympathetic trunk (vasomotor and glandular) paras- recurrent laryngeal nerves (muscular tone and glandular)