Posterior Triangle of the Neck

Question 1

Palpable structures in the neck

Answer 1

hyoid bone
cricoid cartilage
thyroid cartilage
laryngeal prominence (Adam’s apple)

Question 2

What attaches to lesser horn of hyoid bone?

Answer 2

Stylohyoid ligament.

Runs from the styloid process to the lesser horn of the hyoid bone.

Question 3

C1-C7 pass ____ correspondingly numbered vertebrae

Answer 3

above

Question 4

C8 passes ____ correspondingly numbered vertebrae

Answer 4

below

Question 5

Atlanto-occipital joint

Answer 5

flexion/extension/lateral bending of skull on C1

Question 6

Atlanto-axial joint

Answer 6

rotation w/ some flexion/extension, lateral bending of C1 on C2

Question 7

alar ligaments

Answer 7

prevent excessive side-to-side motion of the skull on the cervical column

Question 8

cruciate ligament components

Answer 8

1. transverse ligament of the atlas
2. superior longitudinal ligament
3. inferior longitudinal ligament

Question 9

posterior longitudinal ligament

Answer 9

prevents hyper flexion of cervical column

Question 10

nuchal ligament

Answer 10

forms septum in posterior neck and prevents hyperflexion

Question 11

anterior longitudinal ligament

Answer 11

prevents hyperextension of cervical column

Question 12

Posterior atlanto-occipital membrane

Answer 12

Closes space between base of skull and C1.

Question 13

Hangman’s fracture

Answer 13

bilateral fracture posterior arch of C2 w/ anterior subluxation of C2 on C3

(pars interarticularis fractures)

hyperextension/distraction injury

Question 14

Clay shoveler’s fracture

Answer 14

tip of spinous process C6-T1 shears off

Question 15

Jefferson fracture

Answer 15

compression fracture of C1 anterior and/or posterior arch

lateral masses split

transverse ligament tears

Question 16

hyoid bone - which vertebral level?`

Answer 16

~C3

Question 17

Contents of 2 lateral neuromuscular compartments of the neck (carotid sheath)

Answer 17

carotid a.
IJV
vagus n.

^within carotid sheath

Question 18

Prevertebral fascia covers which m.?

Answer 18

surrounds all m. that attach to cervical vertebrae including…

scalenes
levator scapulae
suboccipital muscles

Question 19

Fascial layers of the neck

Answer 19

investing fascia
alar fascia
pretracheal fascia
carotid sheath

Question 20

Investing fascia covers which m.?

Answer 20

trapezius

sternocleidomastoids

Question 21

mental process

Answer 21

2 halves of mandible joining

Question 22

platysma m. nerve supply

Answer 22

cervical branch of facial nerve (CN VII)

Question 23

trapezius m. nerve supply

Answer 23

spinal accessory n. (CN XI)

Question 24

sternocleidomastoid m. nerve supply

Answer 24

spinal pt of accessory n. (motor) and ventral rami of C2-3 (proprioceptive)

Question 25

contraction of one st sternocleidomastoid m. moves face to same/opposite side?

Answer 25

opposite

Question 26

torticollis

Answer 26

"twisted neck" or "wry neck" can be acquired or congenital (labor/positioning issues) one SCM becomes shorter than opposite side

Question 27

posterior triangle of neck boundaries

Answer 27

Posterior: anterior side of trapezius m. Anterior: posterior side of SCM Inferior: middle 1/3 of clavicle Roof: skin, superficial fascia, platysma, investing layer of deep fascia Floor: muscles covered by prevertebral fascia

Question 28

Lesser Occipital n. (C2)

Answer 28

follows posterior border of SCM to innervate the scalp behind and above the ear

Question 29

Great Auricular n. (C2,3)

Answer 29

crosses superficial to SCM innervates the skin over the parotid gland, angle of the jaw and the posterior ear

Question 30

Transverse Cervical Nerves (C2,3)

Answer 30

crosses SCM superficially sensation for the skin of the front and side of the neck (anterior triangle)

Question 31

Supraclavicular Nerves (C3,4)

Answer 31

medial, intermediate, and lateral branches supply sensation over the shoulder (from the sternoclavicular joint to the acromion process), lateral neck and anterior upper thoracic wall.

Question 32

cervical plexus

Answer 32

connections between ventral primary rami of C1-C4 great auricular n. (C2,C3) lesser occipital n. (C2, C3) transverse cervical n. (C2,C3) supraclavicular n.s (C3,C4)

Question 33

sensory nerves of the cervical plexus supply sensation to which area of the neck?

Answer 33

area of the neck below the mandible

Question 34

Sensation from the posterior part of the neck and scalp is supplied by dorsal primary rami from

Answer 34

C2 – C4

Question 35

CN XI path

Answer 35

emerges through jugular foramen to innervate SCM then crosses posterior triangle to supply trapezius

Question 36

divisions of Trigeminal CN V

Answer 36

ophthalmic n. (V1) maxillary n. (V2) mandibular n. (V3) supply cutaneous sensation of head

Question 37

posterior portion of scalp and neck is supplied by

Answer 37

dorsal rami of cervical spinal n. from C2-C4

Question 38

scalene m. nerve supply

Answer 38

motor branches of cervical and brachial plexus

Question 39

The middle and anterior scalene insert on ____, while the posterior scalene inserts on ____.

Answer 39

The middle and anterior scalene insert on rib 1, while the posterior scalene inserts on rib 2.

Question 40

splenius captius nerve supply

Answer 40

dorsal rami of cervical n.

Question 41

levator scapulae nerve supply

Answer 41

dorsal scapular n.

Question 42

scalene compression syndrome

Answer 42

a type of Thoracic Outlet Syndrome brachial plexus and subclavian artery can be compressed sx: pain, muscle weakness, low BP in upper limb

Question 43

Central line catheterization

Answer 43

entry to venous system via R subclavian v.

Question 44

Inability to elevate shoulder on R. side --> possible damage to which n.?

Answer 44

spinal accessory (CN XI)

Question 45

semispinalis capitus nerve supply

Answer 45

dorsal rami of cervical n.

Question 46

suboccipital muscles

Answer 46

obliquius capitus (superior and inferior) rectus captius posterior (minor and major) - deepest group - supplied by br. of dorsal primary rami of occipital n.

Question 47

suboccipital n.

Answer 47

C1 dorsal ramus supplies muscles of the suboccipital triangle

Question 48

greater occipital n.

Answer 48

C2 dorsal ramus supplies sensation around vertex of head

Question 49

Angle of the mandible - which vertebral level?`

Answer 49

C2

Question 50

Thyroid cartilage - which vertebral level?`

Answer 50

C4-C5

Question 51

Cricoid cartilage - which vertebral level?`

Answer 51

C6

Question 52

Atlanto-Axial instability

Answer 52

any issue w/ C1-C2

Question 53

______ separates the anterior and middle scalenes

Answer 53

brachial plexus

Question 54

Which vessel descends across the SCM and pierces the deep investing fascia?

Answer 54

external jugular v.