Pre lab Saurland

Question 1

The external jugular vein lies deep to what muscles? What muscle does it cross obliquely?

Answer 1

the platysma

SCM

Question 2

The SCM is surrounded by what fascia?

Answer 2

superficial layer (investing) of deep cervical fascia

Question 3

The external jugular vein is firmly attached to what fascia? What happens if the external jugular vein is severed because of the fascia?

Answer 3

Superficial layer (investing) of deep cervical fascia
The lumen will remain open :(  and negative intrathoracic pressure will suck air into the vein causing a churning noise in thorax and cyanoisis. This results in venous embolism which fills right side of heart with froth which stops blood flow and causes dyspnea.

Question 4

How do you save a person from a venous air embolism?

Answer 4

you apply pressure to the severed jugular vein into you can suture the break

Question 5

Which Internal jugular vein is larger and straight than the other? What is clinically signif about this?

Answer 5

the right vein is larger and straighter than the left

good for needle or catheter insertion

Question 6

Where should you put a central venous line i.e central venous catheter (CVC)?

Answer 6

internal jugular or subclavian vein

Question 7

What should you target with the CVC?

Why?

Answer 7

the Superior vena cava
obtain central venous oxygen sat.
long-term intravenous meds
measure CV pressure
dialysis

Question 8

What are some complications associated with a central line?

Answer 8

pneumothorax (2-3 percent even with experienced clinicians)
infections
venous thrombosis

Question 9

What structures do you need to avoid when giving a central line to the internal jugular vein?

Answer 9

the common carotid artery (medially)
the vagus nerve (posteriorly)
the ansa cervicalis

Question 10

The (blank) of the superifical (investing) layer of deep cervical fascia forms a tubular sheath around the vertebral column and its associated muscles

Answer 10

prevertebral layer

Question 11

Where can you get an infection that will spread to your heart?

Answer 11

between the trachea and the peritrachea fascia

Question 12

What are these:
1 Spread in anterior part of investing layer: stopped at sternum.
2 Spread along pretracheal layer: infection descends into
thorax anterior to the pericardium.
3 Pus along prevertebral layer and/or in retropharyngeal space:
may spread along pharynx into the superior mediastinum.

4 Conversely, air of a pneumomediastinum may enter the neck.

Answer 12

places you can spread infections along fascial spaces

Question 13

The (blank) is a small cluster of chemoreceptors located at the bifurcation of the carotid artery

Answer 13

carotid body

Question 14

What does the carotid body do?

Answer 14

it detects changes in composition of arterial blood (partial pressure of oxygen, CO2, pH changes, and even temperature changes in the arterial blood )

Question 15

The carotid chemoreceptors are innervated by a branch of the (blank) called the (blank)

Answer 15

glossopharyngel nerve, the “sinus nerve of Hering.”

Question 16

The (blank) is a localized dilation of the internal carotid artery at its origin.

Answer 16

The carotid sinus (carotid bulb)

Question 17

What does the carotid sinus contain and what for?

Answer 17

baroreceptors

for maintaining blood pressure

Question 18

The carotid baroreceptors are innervated by a branch of the (blank) called the (blank)

Answer 18

gloospharyngeal nerve

sinus nerve of hering

Question 19

Where else can you find baroreceptors other than the carotid sinus?

Answer 19

aortic arch (sensory input travels in the vagus)

Question 20

What are the three arteries of the deep neck?

Answer 20

basilar artery
internal carotid artery
vetebral artery

Question 21

What are three morphological varients of the internal carotid artery?

Answer 21

kinking,
coiling,
toruosity

Question 22

When your head is turned sharply to the left, rotation of atlas causes sharp angulation of left vertebral artery resulting in (blank).
how do you fix this?

Answer 22

obstruction of lumen

When head is returned to neutral position, sharp angulation of artery disapears and vessel fills normally.

Question 23

What can osteophytes cause?

Answer 23

compression of vertebral artery