root of neck Flashcards
What are the boundaries of the root of neck
post: body of T1, head and neck of first rib
lateral: body of first rib
anterior: distal portion first rib, articulation of rib wtih manubrium
what are the o and i of anterior scalene
o: anterior tubercles of transverse processes of CV3-CV6
i: scalene tubercle of first rib
what are the actions of anterior scalene
elevates 1st rib, side bends, rotates cervical column to opp sides
both sides when acting together flex vertebral column
what inn anterior scalene
ventral rami, spinal nn C5-C7
what are the o and i of middle scalene
o: posterior tubercle transverse processes CV2-CV7
i: superior surface first rib post to groove for subclavian a
what are the actions of middle scalene
elevates 1st rib side bends and rotates cervical column
when both sides act if flexes vertebral column
what nn inn middle scalene
ventral rami, spinal nn C3-C8
What structures run between and and middle scalene
brachial plexus and subclavian a
What are signs of thoracic outlet syndrome
pain, numbness and tingling of neck medial forearm as well as 4th and 5th fingers, paresis of intrinsic mm of hand and poor circulation
Where is a brachial nerve plexus block given
injection around supraclavicular portion of brachial plexus in region superior to middle third of clavicle
o and i of posterior scalene
origin: posterior tubercles of transverse processes CV5-CV7
i: outer surface 2nd rib
what are the actions and inn of post scalene
elevates 2nd rib, sidebends and rotates cervical column, both sides acting to flex vertebral column
inn: ventral rami C7-C8 from brachial plexus
o and i of longus capitis
o: anterior tubercles of transverse processes CV3-CV6
i: inferior surface, basilar portion of occipital bone
action and inn of longus capitis
flexes head and neck, ventral rami, spinal nn C1-C4
o and i of longus colli
upper parts extend from ant surface of vertebral bodie to the transverse process of vertebra below
lower parts extend from ant surface of vertebral bodies below to the transverse process of vertebrae above
what are the actions of longus colli
flex neck and assist in rotation
upper rotate to same side
lower rotate to opp side
what is the inn of longus colli
ventral rami spinal nn C2-C7
describe the differences in arteries from L to R in neck
on the right the brachiocephalic trunk splits into subclavian and common carotid
on L common carotid comes right off arch and same with subclavian
What splits subclavian into 3 divisible parts
anterior scalene
what aa come off subclavian medial to anterior scalene
vertebral a, thyrocervical trunk and internal thoracic a
describe path of vertebral a
ascend between longus colli and ant scalene until reach CV6 then enter transverse cervical foramina and ascend through foramen magnum to fuse and form basilar
What are the branches of the thyrocervical trunks
inferior thyroid a
transverse cervical a
suprascap a
ascending cervical a
where does the inferior thyroid a run in relation to carotid sheath
posterior
what does the inferior thyroid a anastomose with
posterior branches of superior thyroid a
where is the transverse cervical a in relation to the inferior belly omohyoid
deep, medially
where can ascending cervical also arise from besides thyrocervical trunk
inferior thyroid a
what aa does the ascending cervical a anastomose with
vertebral, ascending pharyngeal and occipital
what crosses the internal thoracic a anteirorly
phrenic n
What a comes off subclavian when it is behind anterior scalene
costocervical trunk
what are the branches off costcervical trunk
deep cervical a and highest(posterior) intercostal a
where does deep cervical a run
dorsal to brachial plexus between semispinalis cervicis and capitis mm
anastomoses with descending branch of occipital a
where does the highest intercostal a run
descends anterior to head of 1st rib, terminates as 2nd posterior intercostal a
what branches off subclavian a when it is lateral to anterior scalene
dorsal scap a
where do the right and left brachiocephalic v form
immediately posterior to sternoclavicular joint where subclavian and internal jugular vv join
what are tributaries to subclavian v
external jugular and dorsal scap
what are tributaries to brachiocephalic v
vertebral and inferior thyroid v
where is the most used place for central venous lines
subclavian v
what ganglia provide post-ganglionic inn to head, neck and some of thorax
cervical: superior middle vertebral and inferior
what spinal levels are contatined in superior cervical ganglion
C1-C4
where is the superior cervical ganglion located
anterior surface longus capitis
why are there no preganglioni sympathetic fibers in head
because the superior cervical ganglion provides ALL post-ganglionic SAN fibers to head
What nn comes from the postganglionic fibers of superior cervical ganglion
internal carotid nn which forms plexus on internal carotid a gray rami communicans C1-C4 external carotid n pharyngeal branches superior cervical cardiac n
what nn come from the internal carotid n
caroticotympanic plexus
deep petrosal n
cavernous plexus
What does deep petrosal inn
mucosa of nasal cavities and palate and upper pharynx via V2
what do the sympathetic fibers in cavernous plexus inn
dilator pupillae mm and blood vessels of eye
what does the external carotid n inn
blood vessels, salivary, oral and labial glands as well as the carotid body
What CN send off branches to join pharyngeal branches of the superior cervical ganglion to form pharyngeal plexus
IX X
where does the superior cervical cardiac n join
cardiac plexus of thorax
what spinal levels are in the middle cervical ganglion of neck
C5C6
where is the middle cervical ganglion located
near inferior thyroid a as it arches posterior to carotid sheath
what nn come from middle cervical ganglion
gray rami to C5 C6
middle cervical cardiac nerve and ansa subclavia
which n is the largest of SAN cardiac nn in cardiac plexus
middle cervical cardiac n
where is ansa subclavia
wrap around anteiror surface of subclavian medial to thyrocervical trunk and vagus
where is the vertebral ganglion located
base of vertebral a
what fused ganglia form inferior cervical ganglion
C7C8
may fuse with 1st thoracic to form cervicothoracic or stellate ganglion
what nn come from inferior cervical ganglion
gray rami to C7-T1
inferior cardiac n of cardiac plexus
vasomotor to subclavian and inferior thyroid aa
join with recurrent laryngeal
what type of injections are used to relieve vasospasms of aa supplying upper limb and brain
injections around cervicothoracic ganglion blocks transmission as well as through cervical sympathetic ganglia
Where does phrenic n enter thorax
medial to anterior scalene between subclavian a and vein
where is the cupola of the lung
superior to anterior border of 1st rib
covered in parietal and suprapleural membrane called sibsons fascia
what side of the trachea is the esophagus on
left
where does the thoracic duct enter the root of neck
between left border of esophagus and cervical pleura
what lymph trunks may the thoracic duct receive
left jugular, transverse cervical, subclavian and bronchi-mediastinal lymph trunks
What parts of the body does the right lymphatic trunk drain
R upper limb, right side of head and face and right half thorax
