ppt2: deep NV of the neck Flashcards
the right and left subclavian arteries originate from what?
R originates from brachiocephalic trunk
L originates from aortic arch
the subclavian artery: arches superolateral to what? then descends of what two things?
Arch superolaterally behind anterior scalene
Descend over 1st rib & posterior to clavicle
what landmark does the subclavian artery become axillary?
Become axillary at lateral 1st rib
how many “parts” are there of the subclavian artery? how many branches in each part?
3 parts:
1st: 3 branches
2nd: 1 branch
3rd: 1 branch
where is the 1st part of the subclavian artery?
medial to anterior scalene
what are the 3 branches of the 1st part of the subclavian artery?
vertebral artery
internal thoracic artery (mammary)
thyrocervical trunk
the vertebral artery goes ______ and enters transverse foramen of C__
-goes posterior and enters transverse foramen of C6
the internal thoracic (mammary) artery goes where?
descends into thorax
the thyrocervical trunk divides into how many branches ? what are they?
3 : inferior thyroid, transverse cervical, suprascapular
which branch of the thyrocervical trunk is the major visceral artery?
inferior thyroid artery
the transverse cervical artery [ of the thyrocervical trunk (part 3 of subclavian) ] supplies blood to what 3 things?
muscles: trap, rhomboids, levator scapula
the suprascapular artery supplies blood to what?
supraspinatus and infraspinatus
where is part two of the subclavian artery? what is its branch?
posterior to anterior scalene
- costocervical trunk
what does the costocervical trunk supply blood to?
supplies intercostal spaces (1-2) & posterior cervical muscles
where is part three of the subclavian artery? what is its branch?
lateral to anterior scalene
- dorsal scapular artery
what does the dorsal scapular artery supply blood to?
medial scapular border muscles
what does the dorsal scapular artery pass between?
between trunks of brachial plexus
the dorsal scapular artery usually comes off part 3 of subclavian artery BUT may come from what other structure?
transverse cervical artery (deep branch) - of the thyrocervical trunk in part one of subclavian A.
subclavian vein passes over what? and unites with what to form the brachiocephalic vein?
Passes over 1st rib anterior to anterior scalene
Unites with internal jugular to form brachiocephalic
what is the “venous angle” of the subclavian vein?
Venous angle-merging of subclavian & internal jugular, major lymphatic trunks empty here.
recurrent laryngeals come off what nerve?
vagus
what do right and left recurrent laryngeals recur around?
R recurrent laryngeal recurs around R subclavian artery
L recurrent laryngeal recurs around aortic arch
recurrent laryngeal nerves recur in ________ _______
tracheoesophageal groove
Laryngeal muscles except cricothyroid
recurrent laryngeal nerves supply what muscles?
all Laryngeal muscles except cricothyroid
the phrenic nerve is motor or sensory ? what does it supply?
motor nerve of cervical plexus -
motor supply to hemidiaphragm
the phrenic nerve is formed where? it runs along the anterior surface of what muscle?
Formed at apex of scalene triangle (C3-C4 loop & C5)
-anterior scalene
the phrenic nerve is “strapped down” by what two structures?
transverse cervical & suprascapular arteries
the phrenic nerve enters the thorax between what two structures?
Enter thorax between subclavian artery & vein
phrenic nerve receives _______ afferents from where?
Visceral afferents from pericardium, pleura, etc.
the sympathetic chain in the neck is posterior to what?
carotid sheath
what are the 3 ganglia of the sympathetic chain in the neck? at what “C” level is each located?
Superior-large, level of C1, C2
Middle-small, level of C6
Inferior-often fused with 1st thoracic ganglion (stellate), level of C7
POSTganglionic neurons of the symp. chain supply cervical spinal nerves via what?
gray rami communicantes
POSTganglionic neurons of the symp. chain supply thoracic viscera via what?
cardiopulm. splanchnic
postganglionic neurons of the symp. chain supply head & viscera of neck via what?
cephalic/cervical arterial branches
nerves follow internal carotid & its branches
how can you tell the vagus nerve from the symp. chain?
symp chain has lots of branches
the brachial plexus is comprised of ventral rami ___ - ___
C5-T1
what are the 4 supraclavicular branches of the brachial plexus?
Dorsal scapular
Long thoracic
Suprascapular
Subclavian
“DSLs”
roots and trunks of brachial plexus emerge through the ____ triangle with the ______ artery
scalene triangle, subclavian artery
what make up the superior, middle and inferior trunks of the branchial plexus? (vertebral levels)
C5 & C6-superior trunk
Suprascapular
C7-middle trunk
C8 & T1-inferior trunk
