Root And Viscera Of The Neck Flashcards
The manubrium, first rib, clavicle, scapula and 1st thoracic vertebra are the boundaries of?
The superior aperture
What is the other name for the superior aperture?
The thoracic inlet(anatomist)/outlet (clinicians
A _________ reflects interference with the blood and nerves to the extremity and this usually occurs above the aperture in the root of the neck (apex of lung is here)
Thoracic outlet syndrome
What are the causes of thoracic outlet syndrome?
Physical trauma (car accident), repetitive injuries from a job or sports related activity and anatomical abnormalities (extra rib)
What causes neurological thoracic outlet syndrome?
Compression of the brachial plexus
What are the symptoms of neurological thoracic outlet syndrome?
Symptoms include pain in the shoulder and neck,
wasting of muscles at the base of the thumb,
weakening of the grip,
and numbness or tingling in the fingers
Note: all structures related to brachial plexus
What is a vascular thoracic outlet syndrome?
Caused by compression of arteries and veins
What are the symptoms of vascular thoracic outlet syndrome?
Symptoms include arm pain and swelling,
paleness or blue tint of the
hand,
weak pulse,
and blood clots in hand or shoulder.
_____ in which spasm or scarring of the scalene muscles
compress the subclavian a and brachial plexus.
Scalene syndrome (subclass of thoracic outlet syndrome)
What are the results of scalene syndrome?
ischemia of the limb and pain along the distribution of the affected nerves.
_____ is produced by compression of the
subclavian a. between the clavicle and 1st rib.
Costoclavicular Syndrome (subclass of thoracic outlet syndrome)
What are the results of costoclavicular syndrome?
Pallor and coldness of the skin of the upper limb
_______ resulting from a congenital supernumerary
rib from the C7 vertebra. The inferior trunk of the brachial plexus is compressed between the scalene muscles and the rib resulting in muscle weakness affecting the base of the thumb.
Cervical Rib Syndrome
What generally limits the anterior/posterior spread of abscesses, but also
provides potential spaces for the spread of infection to the mediastinum.
Fascia of the neck
What ensheaths the neck beneath the superficial fascia.
The superficial investing layer of the deep fascia
Where does the superficial (investing) layer of the deep cervical fascia attach?
A-Posteriorly it attaches to the ligamentum nuchae.
B- Superiorly it is attached along the mandible, mastoid process, and
ligamentum nuchae of the skull
C- Inferiorly, it finds attachment along the acromion, the clavicle, and
manubrium sterni.
Infections from the tonsils or punctures of the pharyngeal wall can extravasate into this ______ to the mediastinum.
retropharyngeal space
What thin layer of fascia is limited to the anterior part of the neck?
Pretracheal fascia
Between what structures does the pretracheal layer pass?
Between the infrahyoid muscle and the trachea
What is the middle fascial layer that originates as septa from the superficial layer of the deep fascia.
The pretracheal layer
Where does the pretracheal fascial layer continues to?
Inferiorly it continues into the middle mediastinum where it fuses with
the fibrous pericardium.
What does the pretracheal layer fuse with inferiorly?
The fibrous pericardium
What does the pretracheal layer of fascia attach to superiorly?
To the cricoid cartilage
On the posterior portion what does the pretracheal layer fuse with?
The buccopharyngeal of the pharynx, which extends from the base of the skull to T2 in the middle mediastinum
From where does the fusion of the pretracheal layer no the buccopharyngeal fascia extend?
From the base of the skull to T2 in the middle mediastinum
What does the pretracheal fascia enclose anteriorly?
it splits to surround and support the thyroid gland and has sheaths enclosing the infrahyoid muscles
What layer of the neck covers the floor of the posterior floor?
The prevertebral layer
What layer of the neck encircles the vertebral column and its associated muscles from the base of the skull to thoracic vertebra 3 defining the somatic portion of the neck.
The prevertebral layer
What are the layers of the neck? (Fascia)
BRAD P
Buccopharyngeal fascia
Retropharyngeal fascia
Alar Fascia
Dead space
Prevertebral fascia
What layer of fascia originates from the cervical spinous processes, it passes between the trapezius m and the intrinsic m of the cervical spine and invests the scalene ms.
The prevertebral layer
The nerves to the upper limb transverse the prevertebral fascia and acquire what layer?
The axillary sheath
Where does the prevertebral fascia attach before splitting into 2 layers?
It attaches to the transverse processes of the cervical vertebrae
What does the deep layer of the prevertebral fascia enclose?
The longus coli muscles
Note: it inserts onto the cervical veterbrae
Where does the superficial (alar) fascia of the prevertebral fascia attach to?
The contralateral transverse process
Note: the deep layer inserts onto the cervical vertebrae
What compartment in found between the alar and prevertebral fascia?
The danger space
What does the carotid sheath enclose?
Carotid artery, internal jugular vein and vagus nerve
What two fascia send septa to the carotid sheath?
The pretracheal fascia and the superficial layer of the deep cervical fascia
What space is posterior to the pharynx and esophagus, anterior to the prevertebral fascia and extends down to the posterior mediastinum.
The retropharyngeal (retrovisceral) space
Infection in the _____ can track deep into the mediastinum
Retrovisceral space (retropharyngeal)
Where does the danger space lie?
between the two layers of prevertebral fascia anterior to the longus coli muscles. Infection here can extend from the base of the skull into the abdomen
Where will infection tract down from the retropharyngeal space? From the somatic compartment (enclosed by the prevertebral fascia)?
Retro: into the mediastinum
Somatic: abdomen
The ___ can be compromised when the gland is enlarged.
Tracheal opening
What connects the two lobes of the thyroid?
The isthmus
What extra lobe is sometimes present and aberrant or accessory thyroid tissue can develop along the path of the embryonic thyroglossal duct, which normally disappears during embryonic development.
An extra (pyramidal) lobe
What does the thyroid gland secrete to regulate metabolism?
Thyroxin
What is the arterial supply to the thyroid gland?
Superior and inferior thyroid arteries from the external carotid and thyrocervical trunk, respectively
Note: thyroid IMA artery is sometimes present and comes from the brachiocephalic trunk or aortic arch
What drains the thyroid glands?
Superior
Inferior
Middle (unpaired)
Thyroid veins
What two vascular vessels to the thyroid have no counterpart?
Middle thyroid vein and the IMA artery
From where does the thyroid gland originate before migrating to its adult position?
The foramen caecum
An epithelial-lined thyroglossal duct sometimes remains in which what can form?
Cyst
Note: the thyroid gland originates from the foramen caecum of the tongue and
migrates to its adult position.
What can result in Goiters?
A- Inadequate dietary intake of iodine
B- Hereditary factors
C- disease (i.e graves)
D- It is more prevalent in females older than 40 years,
E- The swollen gland will enter the carotid triangle where it can exert
pressure on the trachea causing a shortness of breath.
Where can a goiter enter to cause shortness of breath due to pressure on the trachea?
The carotid triangle
What is Graves’ disease (hyperthyroidism)?
An autoimmune disease in which antibodies activate the thyroid stimulating receptor causing increased thyroid hormone synthesis and secretion and thyroid growth.
Note: MC in women
What disease cause these symptoms?
insomnia, hyperactivity, excessive
sweating, weight loss, diarrhea, muscle weakness, goiter, and warm moist skin.
Graves’ disease
______ can also result in heart dysfunctions, e.g. arrhythmias, and
exophthalmos.
Graves’ disease
What is Hashimotto’s disease?
An autoimmune disease of the thyroid gland that causes reduced thyroid
function. It is a leading cause of hypothyroidism and primarily affects middle-aged women.
What is the leading cause of hypothyroidism and primarily affects middle-aged women?
Hashimotto’s disease
What disease has these symptoms?
fatigue, dry skin, weight gain, swelling of the face,
constipation, muscle ache and weakness, etc
Hashimotto’s
Note: these are the opposite of Graves’ disease
What lie external to the thyroid capsul on the posterior surface of the thyroid gland?
The parathyroid glands
What are the vessels of the parathyroid glands?
A: inferior thyroid artery
V: thyroid venous plexus
What glands sole function is to maintain the body’s calcium level within a very narrow range, so that the nervous and muscular systems can function properly.
Parathyroid gland
What is secreted from the parathyroid glands when blood calcium levels drop below a certain point?
PTH (parathyroid hormone)
What does PTH do?
A- It increases blood calcium levels by stimulating osteoclasts to break down bone and release calcium.
B- It also increases gastrointestinal calcium absorption by activating vitamin D, and promotes calcium uptake by the kidneys.
______ results in neuromuscular activity such as spasms and tetany (muscle contraction).
Hypoparathyroidism
Why must the parathyroid glands be protected during thyroid surgery?
Because damage or destruction of the glands can cause death if parathyroid hormone, calcium or Vitamin D are not provided
At what point does the vagus only contain preganglionic parasympathetic axons and afferents?
After giving off the recurrent laryngeal nerve
