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Regional Gross Anatomy > Region 10 - Neck > Flashcards

Region 10 - Neck Flashcards

1
Q

What muscle divides the neck into anterior and posterior triangles?

A

Sternocleidomastoid

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2
Q

What is the anterior boundary of the anterior triangle of the neck?

A

Imaginary median line of neck

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3
Q

What is the posterior boundary of the anterior triangle of the neck?

A

Anterior border of SCM

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4
Q

What is the superior boundary/base of the anterior triangle of the neck?

A

Inferior border of mandible

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5
Q

What is the apex of the anterior triangle of the neck?

A

Jugular notch at manubrium

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6
Q

What is the roof of the anterior triangle of the neck?

A

Subcutaneous tissues and platysma

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7
Q

What is the floor of the anterior triangle of the neck?

A

Pharynx
Larynx
Thyroid

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8
Q

What is the sub-mental division of the anterior triangle of the neck bounded by?

A

Chin (superiorly)
Body of hyoid (inferiorly)
Anterior bellies of digastric muscles (laterally)
Mylohyoid muscles (floor)

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9
Q

What is the submandibular division of the anterior triangle of the neck bounded by?

A

Inferior border of mandible (superiorly)
The anterior and posterior bellies of the digastric muscle
Mylohyoid and hyoglossus muscles (floor)

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10
Q

What are the contents of the sub-mental division?

A

Submental lymph nodes

Beginning of anterior jugular vein

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11
Q

What are the contents of the submandibular division?

A

Submandibular salivary gland
Lymph nodes
Facial artery and vein
Hypoglossal nerve

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12
Q

What are the boundaries of the carotid triangle of the anterior triangle of the neck?

A

Superior belly of omohyoid (anteriorly)
Posterior belly of digastric (superiorly)
Anterior border of SCM (posteriorly)

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13
Q

What are the contents of the carotid triangle?

A 
Branching of common carotid into:
- External carotid artery (anterior)
- Internal carotid artery
Branches of external carotid artery
Internal jugular vein
Nerves:
- Hypoglossal
- Accessory
- Vagus
Deep cervical nodes
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14
Q

Within what structure are the neurovascular structures contained in the carotid triangle?

A

Carotid sheath:

  • Common and internal carotid arteries (lie medially)
  • Internal jugular vein (lies laterally)
  • Vagus nerve (lies posteriorly
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15
Q

What structures within the carotid triangle are not within the carotid sheath?

A

External carotid artery and its branches
Accessory nerve
Hypoglossal nerve
Deep cervical nodes

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16
Q

What are the boundaries of the muscular triangle of the anterior triangle of the neck?

A

Superior belly of omohyoid (superiorly)
Anterior border of SCM (posteriorly)
Median line of neck (anteriorly)

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17
Q

What are the contents of the muscular triangle?

A

Sternohyoid
Sternothyroid
(both form its floor)

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18
Q

What structures lie beneath the floor of the muscular triangle?

A

Thyroid
Larynx
Trachea
Oesophagus

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19
Q

What are the origins of platysma?

A

Deep fascia covering superior parts of:
- Deltoid
- Pectoralis major
Clavicle

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20
Q

What is the insertion of platysma?

A

Inferior border of mandible

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21
Q

What is the innervation to platysma?

A

Facial nerve

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22
Q

What are the functions of platysma?

A 
Releases pressure on superficial veins
Depresses mandible
Draws corners of mouth down (frown)
Facial expressions of:
- Tension
- Stress
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23
Q

What veins lie in the anterior triangle of the neck?

A

Tributaries to external jugular vein (superficial to SCM)
Internal jugular vein (deep to SCM)
Anterior jugular vein:
- In midline

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24
Q

What veins in the anterior triangle of the neck may be absent?

A

Anterior jugular veins

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25
Q

What are the main tributaries to the IJV?

A 
Inferior petrosal sinus
Facial vein
Lingual vein
Superior and middle thyroid veins
Occipital vein (sometimes)
Pharyngeal veins
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26
Q

What can the anterior jugular veins form superior to the manubrium?

A

Jugular venous arch

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27
Q

Where do the anterior jugular veins drain to?

A

External jugular vein usually

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28
Q

Where do the external jugular veins drain to?

A

Subclavian veins

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29
Q

What are the tributaries to the cervical plexus?

A

Anterior rami of C1-C4

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30
Q

The cervical plexus is joined by loops that lie anterior to what structures?

A

Levator scapulae

Middle scalene

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31
Q

What covers the cervical plexus?

A

Prevertebral layer of deep cervical fascia

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32
Q

What are the cutaneous sensory branches of the cervical plexus?

A 
Lesser occipital (C2)
Great auricular (C2 and C3)
Transverse cervical (C2 and C3)
Supraclavicular (C3 and C4)
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33
Q

What are the motor branches of the cervical plexus?

A

Ansa cervicalis (C1-C3)
Phrenic nerve (C3-C5)
Nerves to:
- Levator scapulae

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34
Q

Proprioception to which nerves is supplied by the cervical plexus?

A

SCM

Trapezius

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35
Q

What muscles is the ansa cervicalis branch of the cervical plexus responsible for supplying?

A

Sternohyoid
Sternothyroid
Omohyoid

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36
Q

How does the nerve supply to thyrohyoid reach the muscle?

A

A branch from C1 ventral ramus travels with the hypoglossal nerve

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37
Q

How does the branch from C1 ventral ramus reach the ansa cervicalis?

A

Travels initially with the hypoglossal nerve

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38
Q

Where is the suprahyoid region?

A

Between:

  • Hyoid bone AND
  • Skull/Mandible
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39
Q

Where is the infrahyoid region?

A

Between:

  • Hyoid bone AND
  • Sternum/Thyroid cartilage
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40
Q

What are the suprahyoid muscles?

A

Mylohyoid
Geniohyoid
Stylohyoid
Digastric

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41
Q

What are the functions of the suprahyoid muscles?

A

Raise hyoid bone

Depress mandible

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42
Q

What is the innervation to the suprahyoid muscles?

A 
Facial nerve:
- Posterior belly of digastric
- Stylohyoid
Mandibular division of trigeminal nerve:
- Anterior belly of digastric
- Mylohtoid
C1 via hypoglossal nerve:
- Geniohyoid
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43
Q

What are the infrahyoid muscles?

A

Sternohyoid
Omohyoid
Sternothyroid
Thyrohyoid

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44
Q

What are the functions of the infrahyoid muscles?

A

Depress:

  • Hyoid bone
  • Thyroid cartilage
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45
Q

What is the innervation to the infrahyoid muscles?

A 
Ansa cervicalis:
- Sternohyoid
- Omohyoid
- Sternothyroid
C1 via hypoglossal nerve:
- Thyrohyoid
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46
Q

What are the origins of the common carotid artery?

A

Right from brachiocephalic trunk

Left from arch of aorta

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47
Q

What are the anterior branches of the external carotid artery?

A

Superior thyroid artery
Lingual artery
Facial artery

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48
Q

What does the superior thyroid artery supply?

A

Thyroid gland
Infrahyoid muscles
SCM
Larynx (via superior laryngeal artery)

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49
Q

What does the lingual artery supply?

A

Posterior tongue

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50
Q

What are the branches of the lingual artery?

A

Deep lingual artery

Siblingual artery

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51
Q

What are the branches of the facial artery?

A

Ascending palatine artery
Tonsillar artery
Submental artery

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52
Q

How does the facial artery enter the face?

A

Hooks around the mid-inferior border of the mandible

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53
Q

What do the recurrent laryngeal branches of the vagus nerve hook around?

A

Left around arch of aorta

Right around right subclavian artery

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54
Q

What is the structure of the thyroid gland?

A 
External capsule
2 lobes running between:
- Thyroid cartilage
- 6th tracheal ring
Isthmus connecting lobes anterior to tracheal rings 2 or 3
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55
Q

What is the arterial supply to the thyroid gland?

A

inferior thyroid artery from thyrocervical trunk of subclavian artery
Superior thyroid artery from ECA

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56
Q

What is the venous drainage of thyroid gland?

A

Superior and middle thyroid veins:
- Drain to ipsilateral IJV
Inferior thyroid veins:
- Both drain to left brachicephalic vein

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57
Q

What does the submandibular salivary gland lie?

A

Part is inferior to mylohyoid

Part in floor of mouth superior mylohyoid

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58
Q

Where does the duct for each submandibular gland open?

A

Between 1st and 2nd lower incisors (either side of frenulum)

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59
Q

What is the innervation to the submandibular glands?

A

Facial nerve

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60
Q

What are the borders of the posterior triangle of the neck?

A

Posterior border of SCM (anterior)
Anterior border of trapezius (posterior)
Clavicle (base)
Apex:
- Where SCM and trapezius meet on superior nuchal line
Investing layer of deep cervical fascia (roof)
Muscles covered by prevertebral layer of deep cervical fascia (floor)

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61
Q

What are the non-muscular contents of the posterior triangle of the neck?

A

External jugular vein
Roots of brachial plexus
Accessory nerve
Cervical and supraclavicular lymph nodes

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62
Q

What are the muscular contents of the posterior triangle of the neck?

A

Anterior scalene (inferior part)
Middle and posterior scalenes
Splenius capitis
Levator scapulae

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63
Q

What are the superior attachments of the SCM?

A

Lateral surface of mastoid process of temporal bone

Lateral half of superior nuchal line

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64
Q

What are the inferior attachments of the SCM?

A

Sternal head:
- Anterior surface of manubrium
Clavicular head:
- Superior surface of medial 1/3 of clavicle

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65
Q

What is the innervation to SCM?

A

Motor = Spinal accessory nerve

Pain and proprioception = C2 and C3

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66
Q

What are the functions of SCM working unilaterally?

A

Flexes neck to ipsilateral side

Rotates face superiorly to contralateral side

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67
Q

What are the functions of SCM working bilaterally?

A

Extends neck at atlanto-occipital joints
Flexes cervical vertebrae
Protracts chin

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68
Q

What are the origins of trapezius?

A

Medial 1/3 of superior nuchal line
External occipital protuberance
Nuchal ligament
Spinous processes of C7-T12, lumbar and sacral vertebrae

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69
Q

What are the insertions of trapezius?

A

Lateral 1/3 of clavicle
Acromion
Spine of scapula

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70
Q

What is the innervation to trapezius?

A

Motor = Spinal accessory nerve

Pain and proprioception = C3 and C4

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71
Q

What are the functions of trapezius?

A 
Ascending part = Depresses scapula
Transverse part = Retracts scapula
Descending part:
- Elevates scapula
- Rotates glenoid cavity
Hold scapula in place while weightlifting
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72
Q

What muscles form the floor of the posterior triangle?

A

Omohyoid

Splenius capitis

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73
Q

What are the functions of splenius capitis?

A

Extends neck

Rotates neck

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74
Q

What is the innervation to splenius capitis?

A

Posterior rami C3 and C4

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75
Q

What are the origins of levator scapulae?

A

Transverse processes of:

  • Atlas
  • Axis
  • C3 and C4
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76
Q

What are the insertions of levator scapulae?

A

Medial scapular border between:

  • Superior angle of scapula AND
  • Medial end of scapular spine
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77
Q

What are the functions of levator scapulae?

A

Controls scapular position
Elevates shoulder (with trapezius)
Can laterally flex neck ipsilaterally if shoulder fixed

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78
Q

What is the innervation to levator scapulae?

A 
Cervical nerves (C3 and C4)
Dorsal scapular nerve (C5)
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79
Q

What are the origins of the scalene muscles?

A

Transverse processes of:

  • C3-C6 (anterior)
  • C2-C7 (middle)
  • C4-C6 (posterior)
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80
Q

What are the insertions of the scalene muscles?

A

Rib 1:
- Scalene tubercle (anterior)
- Behind subclavian artery groove (middle)
Rib 2 (posterior)

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81
Q

What is the innervation to the scalene muscles?

A

Anterior rami C4-C7 (anterior)
Anterior rami C3-C7 (middle)
Anterior rami C5-C7 (posterior)

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82
Q

What are the functions of the scalene muscles?

A

Flex neck (bilaterally)
Laterally flex neck (unilaterally)
Elevate upper ribs

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83
Q

What is the shape of the upper end of the pharynx at the base of the skull?

A

Funnel-shaped

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84
Q

At what level does the pharynx join the oesophagus?

A

C6

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85
Q

What is the epithelium of the pharynx?

A 
Superiorly = Ciliated columnar
Inferiorly = Stratified squamous
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86
Q

What does the fibrous layer underlying the epithelium of the pharynx connect it to?

A

Base of skull

Submucosa of oesophagus

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87
Q

What layer lies under the fibrous layer of the pharynx?

A

Muscular layer:

  • Circular constrictor muscles
  • Longitudinal muscles
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88
Q

Where is the nasopharynx?

A

Behind nasal cavities

Above soft palate

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89
Q

What structures form the roof of the nasopharynx?

A

Sphenoid bone
Occipital bone
Pharyngeal tonsil

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90
Q

What structure forms forms the floor of the nasopharynx?

A

Soft palate (pharyngeal isthmus)

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91
Q

What structures form the posterior wall of the nasopharynx?

A

Roof structures at the level of C1

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92
Q

What structures form the lateral wall of the nasopharynx?

A

Pharyngotympanic tube

Salpingopharyngeal fold

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93
Q

Where is the oropharynx?

A

From soft palate to upper border of epiglottis

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94
Q

What forms the roof of the oropharynx?

A

Soft palate

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95
Q

What forms the floor of the oropharynx?

A

Posterior 1/3 tongue
Lingual tonsil
Glossoepiglottic folds

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96
Q

What forms the posterior wall of the oropharynx?

A

C2/C3 level

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97
Q

What forms the lateral walls of the oropharynx?

A 
Palatoglossal folds (anteriorly)
Palatopharyngeal folds (posteriorly)
Palatine tonsil between the two
98
Q

Where is the laryngopharynx?

A

Behind larynx and laryngeal opening

99
Q

What lies posterior to the laryngopharynx?

A

C3-C6 vertebrae

100
Q

What is the laryngopharynx supported by laterally?

A

Thyroid cartilage
Aryepiglottic fold
Thyrohyoid membrane

101
Q

What are the origins of the superior constrictor of pharynx?

A 
Posterior aspect of medial pterygoid plate
Pterygoid hamulus
Pterygomandibular ligament
Mandible
Side of tongue
102
Q

What are the insertions of the superior constrictor of pharynx?

A

Pharyngeal tubercle of occipital bone
Midline fibrous raphe
Middle constrictor

103
Q

What is the innervation to the superior constrictor of pharynx?

A

CN X in pharyngeal plexus

104
Q

What are the functions of the superior constrictor of pharynx?

A

Upper fibres:
- Pull posterior pharyngeal wall anteriorly to close off nasopharynx
Propels food to middle constrictor

105
Q

What does the gap between superior and middle constrictors of pharynx allow passage of?

A

Stylopharyngeus
CN IX
Stylohyoid ligament

106
Q

What are the origins of the middle constrictor of pharynx?

A 
Stylohyoid ligament (lower part)
Greater and lesser cornu of hyoid
107
Q

What are the insertions of the middle constrictor of pharynx?

A

Midline fibrous raphe

Blends with superior and inferior constrictors of pharynx

108
Q

What is the innervation to the middle constrictor of pharynx?

A

CN X in pharyngeal plexus

109
Q

What is the function of the middle constrictor of pharynx?

A

Propels food to inferior constrictor of pharynx

110
Q

What does a gap between the middle and inferior constrictors of pharynx allow the passage of?

A

Internal laryngeal nerve

Superior laryngeal artery and vein

111
Q

What are the origins of the inferior constrictor of pharynx?

A

Lamina of:

  • Thyroid cartilage
  • Cricoid cartilage
112
Q

What are the insertions of the inferior constrictor of pharynx?

A

Midline fibrous raph

Blends with middle constrictor and oesophagus

113
Q

What is the thyropharyngeus?

A

The superior part of the inferior constrictor of pharynx

114
Q

What direction do the fibres of thyropharyngeus run?

A

Obliquely

115
Q

What is the innervation to thyropharyngeus?

A

CN X in pharyngeal plexus

116
Q

What is the function of thyropharyngeus?

A

Propels food into oesophagus

117
Q

What is the cricopharyngeus?

A

Inferior part of the inferior constrictor of pharynx

118
Q

What direction do the fibres of cricophayngeus run in?

A

Transversely

119
Q

What is the innervation to cricopharyngeus?

A

External laryngeal nerve (CN X)

120
Q

What is the function of cricopharyngeus?

A

Acts as a sphincter:

- Prevents entry of air between acts of swallowing

121
Q

What does the gap inferior to the inferior constrictor of pharynx allow passage of?

A

Allows passage of structures superiorly into larynx:

  • Recurrent laryngeal nerve
  • Inferior laryngeal artery
122
Q

What is the origin and insertion of stylopharyngeus?

A 
Origin = Styloid process
Insertion = Posterior border of thyroid cartilage
123
Q

What is the course of stylopharyngeus?

A

Runs across ICA

Passes between superior and middle constrictors

124
Q

What is the function of stylopharyngeus?

A

Elevates larynx and pharynx during swallowing

125
Q

What is the innervation to stylopharyngeus?

A

CN IX

126
Q

What is the origin and insertion of salpingophayngeus?

A 
Origin = Cartilage of pharyngotympanic tube
Insertion = Blends with palatopharyngeus
127
Q

What is the function of salpingopharyngeus?

A

Elevates pharynx

128
Q

What is the innervation to salpingopharyngeus?

A

CN X in pharyngeal plexus

129
Q

What are the origins of palatopharyngeus?

A

Hard palate

Palatin aponeurosis

130
Q

What are the insertions of palatopharyngeus?

A

Posterior border of lamina of thyroid cartilage

Side of pharynx and oesophagus

131
Q

What is the function of palatopharyngeus?

A

Elevates pharynx

132
Q

What is the innervation of palatopharyngeus?

A

CN X in pharyngeal plexus

133
Q

What is the ring of lymphoid tissue?

A 
Superiorly = Pharyngeal tonsil
Superolaterally = Tubal tonsils
Laterally = Lymph tissue along salpingopharyngeal folds
Inferolaterally = Palatine tonsils
Inferiorly = Lingual tonsil
134
Q

The pharyngeal plexus supplies motor fibres from CN X to all pharyngeal and soft palate muscles. What are the exceptions?

A

Stylopharyngeus (CN IX)
Tensor veli palatini (CN V3)
Cricopharyngeus (External laryngeal nerve = CN X)

135
Q

What nerve carries sensory fibres from the pharynx?

A

CN IX to pharyngeal plexus

136
Q

What is the arterial supply to pharynx?

A

Pharyngeal branches from maxillary artery - Nasopharynx
Ascending pharyngeal artery:
- From ‘deep’/medial surface of ECA

137
Q

What is the venous drainage of the pharynx?

A

Pharyngeal veins to IJV

138
Q

Where does lymph from the tonsils go?

A

Jugulodigastric node

139
Q

Where do other pre-vertebral structures lie? (ie aside from the pre-vertebral [anterior] muscles)

A

Between:
- Muscle sheath covering longus colli and longus capitis (prevertebral fascia)
AND
- Carotid sheath

140
Q

What are the attachments of longus capitis?

A 
Superiorly = Occipital bone (base)
Inferiorly = Anterior tubercles of C3-C6 transverse processes
141
Q

What is the function of longus capitis?

A

Flexion of head (nodding)

142
Q

What is the innervation to longus capitis?

A

Ventral rami of C1-C3

143
Q

What are the attachments of the inferior oblique part of longus colli?

A 
Superiorly = Anterior tubercles of C5-C6 transverse processes
Inferiorly = Body of T2 and T3
144
Q

What are the attachments of the superior oblique part of longus colli?

A 
Superiorly = Anterior tubercle of C1
Inferiorly = Anterior tubercles of C3-C5 transverse processes
145
Q

What are the attachments of the vertical part of longus colli?

A 
Superiorly = Anterior aspects of C4-C6
Inferiorly = Anterior aspects of T1-T3
146
Q

What is the function of longus colli?

A

Flexion of neck

147
Q

What is the function of the inferior oblique part of longus colli?

A

Rotation to contralateral side

148
Q

What is the innervation to longus colli?

A

Ventral rami of C2-C6

149
Q

What are the attachments of rectus capitis anterior?

A 
Superiorly = Occipital bone (anterior to condyles)
Inferiorly = Anterior surface of and root of transverse process of C1
150
Q

What is the function of rectus capitis anterior?

A

Flexion of atlanto-occipital joint

151
Q

What is the innervation to rectus capitis anterior?

A

Branches from loop between C1 and C2

152
Q

What are the attachments of rectus capitis lateralis?

A 
Superiorly = Jugular process of occipital bone
Inferiorly = Transverse process of C1
153
Q

What is the function of rectus capitis lateralis?

A

Lateral flexion of head

154
Q

What is the innervation to rectus capitis lateralis?

A

Branches from loop between C1 and C2

155
Q

What structure crosses rectus capitis lateralis?

A

IJV

156
Q

Where does the sympathetic chain lie in the neck?

A 
Posterior to ICA and CCA
Medial to CN X
Embedded in deep fascia between:
- Carotid sheath AND
- Fascia over longus colli and longus capitis
157
Q

What are the cervical ganglia of the sympathetic chain?

A

Superior, middle and inferior

158
Q

Where does the superior cervical ganglia lie?

A

Immediately below skull (~C1-C2)

159
Q

Where do postsynaptic fibres from the superior cervical ganglia travel to and in what?

A

Travel in internal carotid nerve:

  • Travel into carotid canal
  • Forms internal carotid plexus
160
Q

What do the grey rami communicantes from the superior cervical ganglia connect to?

A

C1-C4 ventral rami

161
Q

What branches are given off from the superior cervical ganglia?

A 
Branches to form plexuses on CCA and ECA
CN branches to CNs IX, X and XII
Pharyngeal branches:
- Pharyngeal plexus
- Joining CNs IX and X
162
Q

What cardiopulmonary splanchnic nerve is given off from the superior cervical ganglia?

A

Superior cardiac nerve

163
Q

At what level are the middle cervical ganglia?

A

Cricoid cartilage (~C6)

164
Q

What structure are the middle cervical ganglia related to?

A

Loop of inferior thyroid artery

165
Q

What do the grey rami communicantes from the middle cervical ganglia connect to?

A

C5 and C6 ventral rami

166
Q

What branches do the middle cervical ganglia give off?

A

Thyroid branches:
- Run along inferior thyroid artery
Middle cardiac nerve (cardiac plexus)

167
Q

The middle cervical ganglia is often connected to the inferior cervical ganglia by more than 2 nerve bundles. Where does the anterior bundle pass?

A

Passes anterior to 1st part of subclavian artery then behind it:
- Ansa subclavia

168
Q

What does the inferior cervical ganglia usually fuse with? What is this structure called?

A

1st thoracic ganglion = Stellate ganglion

169
Q

Where do the inferior cervical ganglia lie?

A

Posterior to vertebral artery
Between:
- Transverse process of C7 AND
- Head of first rib

170
Q

What do the grey rami communicantes from the inferior cervical ganglia connect to?

A

C7 and C8 ventral rami

171
Q

What branches do the inferior cervical ganglia give off?

A

Arterial branches to:
- Subclavian artery
- Vertebral artery
Inferior cardiac nerve (to cardiac plexus)

172
Q

What structures lie anterior to the larynx?

A

Infrahyoid muscles

Isthmus of thyroid

173
Q

What structures lie lateral to the larynx?

A

Lobes of thyroid

Carotid sheath

174
Q

What neurovascular structures is the larynx related to?

A

Superior and inferior thyroid arteries

Recurrent laryngeal nerves

175
Q

What is the larynx responsible for?

A

Voice production

176
Q

How many cartilages make up the larynx?

A

9

177
Q

What type of cartilage makes up the larynx? What is the exception?

A

All hyaline

Except epiglottis - Elastic cartilage

178
Q

What is the laryngeal prominence?

A

Where the inferior 2/3 of the laminae of the thyroid cartilages fuse anteriorly

179
Q

What structure lies superior to the laryngeal prominence?

A

V-shaped superior thyroid notch

180
Q

How does the thyroid cartilage connect to the hyoid?

A

Thyrohyoid membrane:

  • Thickened medially as median thyrohyoid ligament
  • Thickened laterally as lateral thyrohyoid ligament
181
Q

What does an oblique line on the anterolateral surface of each thyroid cartilage act as the attachment for?

A

Sternothyroid muscle
Thyrohyoid muscle
Inferior constrictor of pharynx

182
Q

What lies at either end of the oblique line on the anterolateral surface of each thyroid cartilage?

A

Superior tubercle

Inferior tubercle

183
Q

Why is the cricoid cartilage described as having a signet ring shape?

A

Anterior part is the arch (narrower)
Posterior part is the lamina:
- Broader
- Has a central ridge

184
Q

What distinguishing characteristic does the cricoid cartilage have other all other laryngeal or tracheal cartilages?

A

Only complete ring of cartilage to encircle any part of airways

185
Q

What are the facets on the superior aspects of the posterior part of the cricoid cartilage for?

A

Articulation with arytenoid cartilages

186
Q

What do the vocal processes on the arytenoid cartilages do?

A

Allow attachment of the vocal ligament

187
Q

Where are the vocal processes on the arytenoid cartilages?

A

Anteroinferiorly

188
Q

Where are the corniculate cartilages?

A

In posterior part of aryepiglottic folds

Attached to apices of arytenoid cartilages (superior)

189
Q

Where are the cuneiform cartilages?

A

Within aryepiglottic folds:

- Support the folds

190
Q

What are the connections of the epiglottis?

A 
Anteriorly:
- Body of hyoid
- Posterior surface of thyroid cartilage
Laterally:
- Arytenoid cartilages (via aryepiglottic fold)
191
Q

What structure does the mucous membrane covering the epiglottis reflect onto? What does this form?

A

Reflects onto posterior surface of tongue:

  • Median glossoepiglottic fold
  • Lateral glossoepiglottic folds
192
Q

Where does the quadrangular membrane/ligament run?

A

Arytenoid cartilages to epiglottis

193
Q

What do the free edges of the quadrangular membrane form?

A

Superiorly = Aryepiglottic fold
Inferiorly = Vestibular ligament:
- ie False vocal fold

194
Q

What does the cricothyroid membrane attach to?

A

Cricoid cartilage
Thyroid cartilage
Arytenoid

195
Q

What does the cricothyroid membrane form via its connection as its free edge to the arytenoid cartilages?

A

Vocal ligaments:

- ie True vocal folds

196
Q

Where do the vestibular folds lie in relation to the true vocal folds?

A

Superiorly

197
Q

What are the true vocal folds attached to?

A 
Anteriorly = Thyroid cartilage
Posteriorly = Arytenoid cartilages
198
Q

Movements of what structures create individual sounds and words?

A

Lips
Cheeks
Tongue

199
Q

How do the suprahyoid muscles affect the larynx?

A

Elevate larynx

200
Q

How do the infrahyoid muscles affect the larynx?

A

Depress larynx

201
Q

What assists the suprahyoid muscles in their action on the larynx?

A

Stylopharyngeus
Salpingopharyngeus
Palatopharyngeus

202
Q

What assists the infrahyoid muscles in their action on the larynx?

A

Its elastic recoil

203
Q

What is the origin of the cricothyroid muscle?

A

Anterolateral cricoid cartilage

204
Q

What are the insertions of the cricothyroid muscle?

A

Lamina of thyroid cartilage

Inferior cornu of thyroid cartilage

205
Q

What are the parts of the cricothyroid muscle?

A

Straight part - Lies more anteriorly

Oblique part - Lies anterolaterally

206
Q

What are the functions of the cricothyroid muscle?

A

Tenses vocal folds

Elongates vocal folds

207
Q

How does the cricothyroid muscle affect the vocal folds?

A

Increases distance between thyroid cartilage and vocal processes of arytenoid cartilages by:

  • Tilting thyroid cartilage forwards
  • Tilting cricoid cartilage backwards
208
Q

What is the innervation to cricothyroid?

A

External laryngeal nerve (CN X)

209
Q

What are the origins of the thyro-arytenoid muscle?

A

Inner surface of angle of thyroid cartilage

Cricothyroid ligament

210
Q

What is the insertion of the thyro-arytenoid muscle?

A

Anterolateral surface of arytenoid cartilages

211
Q

What can the upper fibres of the thyro-arytenoid muscle, which run alongside the vocal ligament, be called?

A

Vocalis muscle

212
Q

What is the function of the thyro-arytenoid muscle?

A

Pull arytenoids forwards towards thyroid cartilage:

  • Shortens vocal ligaments
  • Relaxes vocal folds
213
Q

What is the innervation to the thyro-arytenoid muscle?

A

Recurrent laryngeal nerve (CN X)

214
Q

What is the origin and insertion of the posterior cricoarytenoid muscle?

A 
Origin = Posterior surface of lamina of cricoid
Insertion = Muscular process of arytenoid
215
Q

What is the function of the posterior cricoarytenoid muscle?

A

Pulls muscular processes of arytenoid cartilages backwards:

  • Rotates vocal processes laterally
  • Vocal fold abduction
216
Q

What is the innervation to the posterior cricoarytenoid muscle?

A

Recurrent laryngeal nerve (CN X)

217
Q

What is the origin and insertion of the lateral cricoarytenoid muscle?

A 
Origin = Upper edge of arch of cricoid cartilages
Insertion = Muscular process of arytenoid cartilage
218
Q

What is the function of the lateral cricoarytenoid muscle?

A

Pulls muscular processes forwards:

  • Rotates vocal processes medially
  • Vocal fold adduction
219
Q

What is the innervation to the lateral cricoarytenoid muscle?

A

Recurrent laryngeal nerve (CN X)

220
Q

What is the origin and insertion of the oblique arytenoid muscle?

A 
Origin = Muscular process of one arytenoid cartilage
Insertion = Apex of contralateral arytenoid cartilage
221
Q

What do some of the fibres of the oblique arytenoid muscles form?

A

Aryepiglottic muscles in aryepiglottic fold

222
Q

What is the function of the oblique arytenoid muscles?

A

Act as a sphincter of the laryngeal inlet by adducting vocal folds

223
Q

What is the innervation to the oblique arytenoid muscle??

A

Recurrent laryngeal nerve (CN X)

224
Q

What is the origin and insertion of the transverse arytenoid muscles?

A 
Origin = Posterior and medial surfaces of arytenoid cartilages
Insertion = Contralateral arytenoid cartilage
225
Q

What is the function of the transverse arytenoid muscles?

A

Close the posterior part of rima glottidis

226
Q

What is the innervation to the transverse arytenoid muscles?

A

Recurrent laryngeal nerve (CN X)

227
Q

Where does the superior laryngeal nerve arise?

A

From inferior vagal ganglion at superior end of carotid triangle

228
Q

Where does the superior laryngeal nerve bifurcate? What does it bifurcate into?

A

Within carotid sheath into:

  • Internal laryngeal nerve
  • External laryngeal nerve
229
Q

What does the internal laryngeal nerve pierces? With what?

A

Thyrohyoid membrane:

- With superior laryngeal artery

230
Q

What is the function of the internal laryngeal nerve?

A

Sensory to;
- Laryngeal mucous membrane
- Including superior surface of vocal folds
ANS fibres

231
Q

What is the course of the external laryngeal nerve?

A

Descends posterior to sternothyroid muscle:
- With superior thyroid artery
Lies on then pierces inferior constrictor muscle

232
Q

What is the function of the external laryngeal nerve?

A

Motor fibres to:

  • Inferior constrictor
  • Cricothyroid
233
Q

What is the inferior laryngeal nerve a continuation of?

A

Recurrent laryngeal nerve

234
Q

How does the inferior laryngeal nerve enter the larynx?

A

Passes:

  • Deep to inferior border of inferior constrictor
  • Medial to lamina of thyroid cartilage
235
Q

What are the functions of the inferior laryngeal nerve?

A

Motor innervation to all intrinsic laryngeal muscles:
- Except cricothyroid
Sensory fibres to infraglottic cavity

236
Q

What is the course of the superior laryngeal artery?

A

Branches from superior thyroid artery

Pierces thyrohyoid membrane

237
Q

What does the superior laryngeal artery supply?

A

Internal surface of larynx

Cricothyroid muscle

238
Q

What is the course of the inferior laryngeal artery?

A

Branches from inferior thyroid artery

Accompanies inferior laryngeal nerve

239
Q

What does the inferior laryngeal artery supply?

A

Mucous membrane and muscles of inferior part of larynx

240
Q

What is the venous drainage of the larynx?

A 
Superior laryngeal veins:
- Into superior thyroid veins
- Into IJV (ipsilaterally)
Inferior laryngeal veins:
- Into inferior thyroid veins OR Venous plexus on trachea
- Into left brachiocephalic vein
241
Q

What is the lymphatic drainage of the larynx superior to the vocal folds?

A

Accompany superior laryngeal artery through thyrohyoid membrane
Drain to superior deep cervical nodes

242
Q

What is the lymphatic drainage of the larynx inferior to the vocal fodls?

A

Drain to:
- Pretracheal nodes
- Paratracheal nodes
Eventualls drains to inferior deep cervical nodes

Regional Gross Anatomy (14 decks)

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