Posterior Triangle of the Neck

Question 1

Describe the layers of cervical fascia from superficial to deep?

Answer 1

Superficial fascia (just skin and platysma)
Deep fascia (investing layer, pretracheal layer and prevertebral layer)

Question 2

What is held within the investing layer of the deep fascia?

Answer 2

Surrounds the whole neck but specifically sternocleidomastoid, trapezius and infrahyoid muscles

Question 3

What is held within the carotid sheath?

Answer 3

Internal jugular vein, common carotid artery and vagus nerve. Has contribution from all three layers of fascia

Question 4

What is contained within the pretracheal layer of the deep fascia?

Answer 4

Thyroid, oesophagus and trachea

Question 5

What is contained within the prevertebral layer of the deep fascia?

Answer 5

Vertebral muscles

Question 6

What are the three potential cervical spaces?

Answer 6

Pretracheal space- between investing and pretracheal fascia
Retropharyngeal space- behind the esophagus and prevertebral layer
Prevertebral space- between vertebral bodies and prevertebral fascia

Question 7

Anterior posterior and base of posterior triangle (region V)

Answer 7

Anterior=posterior border of sternocleidomastoid
Posterior=anterior border of trapezius
Base=middle third of the clavicle

Question 8

Lymphatic drainage of neck

Answer 8

All drain to deep cervical nodes (run alongside internal jugular vein)

Question 9

Nerves of the posterior triangle (maybe count as in the roof)

Answer 9

Transverse cervical, lesser occipital nerve, supraclavicular, greater auricular and accessory nerve, all come from cervical plexus. Brachial plexus lies close to the base of the posterior triangle

Question 10

What is Erb’s point?

Answer 10

Origin of all superficial nerves (more superficial than accessory nerve)

Question 11

Venous drainage of posterior triangle

Answer 11

External jugular vein

Question 12

Arterial supply of posterior triangle

Answer 12

Third part of subclavian artery
Transverse cervical artery
Supraclavicular artery

Question 13

What is a key vein used for central venous catheterisation?

Answer 13

Internal jugular vein, found lateral to the carotid artery and can be accessed via posterior triangle

Question 14

Apex roof floor posterior triangle

Answer 14

Apex=superior nuchal line
Roof=skin, superficial fascia and platysma, cutaneous nerves and superficial veins + EJV
Floor=prevertebral fascia, splenius capitis, levator scapulae, ant mid and post scalene muscles

Question 15

Branches of subclavian artery

Answer 15

Vertebral artery
Internal Thoracic artery
Thyrocervical trunk (inferior thyroid, transverse cervical, suprascapular)
Costocervical artery
Dorsal scapular artery

Question 16

Which muscle is found within the posterior triangle?

Answer 16

inferior belly of omohyoid

Question 17

What is a risk during lymph node biopsy? What might a consequence of this be?

Answer 17

Accessory nerve runs superficial to lymph nodes

Damage accessory nerve you cant abduct the arm greater than 45%

Question 18

Surface anatomy of spinal accessory nerve

Answer 18

Runs straight or tortuous across posterior triangle (from sternoclediomastoid to trapezius) of the neck and nerve branches before penetrating trapezius