Root of Neck Flashcards
the apices of the lungs lie posterior to what arteries?
posterior to first part of subclavian arteries
What does the subclavian artery come off of?
Right is terminal branch of brachiocephalic artery
Left is branch of arch of aorta
axillary arteries arise from?
subclavian arteries become axillary arteries when cross lateral border of first rib
what are the 3 parts of the subclavian artery and where are they located?
- first part medial to anterior scalene
- second part posterior to anterior scalene
- third part lateral to anterior scalene
what arises from first part of subclavian artery
- vertebral artery
- internal thoracic artery
- thyrocervical trunk
what arises from second part of subclavian artery
- costocervical trunk
what arises from third part of subclavian artery
dorsal scapular artery (usually)
describe course of vertebral artery
arises from first part of subclavian artery
ascends in transverse foramen of cervical vertebrae and enters foramen magnum
thyrocervical trunk gives rise to
- suprascapular artery
- transverse cervical artery
- inferor thyroid artery
describe course of suprascapular artery
arises from thyrocervical trunk (from first part of subclavian artery)
crosses anterior scalene muscle, enters posterior triangle and passes posteriorly to suprascapular region of back
describe course of transverse cervical artery
arises from thyrocervical trunk (from first part of subclavian artery)
crosses anterior scalene to enter posterior triangle to supply lateral structures of neck
describe course of inferior thyroid artery
from thyrocervical trunk (from first part of subclavian artery)
ascends the neck and arches medially and down to enter inferior portion of thyroid gland
describe course of ascending cervical artery
from inferior thyroid artery (from thyrocervical trunk from first part of subclavian artery)
travels straight upward
what arises from the costocervical trunk and what do they supply blood to?
- deep cervical artery (supplies muscles of root of neck)
- supreme intercostal artery (to upper two intercostal spaces)
what does the dorsal scapular artery supply blood to?
levator scapulae and rhomboid muscles, participates in anastomoses around scapula
what are the three major tributaries to subclavian vein in root of neck?
external jugualr vein, vertebral vein, internal thoracic vein
describe the course of the phrenic nerve
- descends obliquely with IJV across anterior scalene deep to transverse cervical and suprascapular arteries
- left phrenic crosses anterior to first part of subclavian artery
- right phrenic crosses anterior to second part of subclavian artery
- both run posteriorly to subclavian vein and anterior to internal thoracic artery
What makes the stellate ganglion?
when inferior cervical ganglion fuses with ganglion of C1
where is the sympathetic trunk in relation to the carotid artery?
posterior to the carotid artery
3 major swellings of sympathetic ganglia in cervical region and where they’re located
- inferior cervical ganglia: just above subclavian artery
- middle cervical ganglion: vertebral level C6 opposite cricoid cartilage
- superior cervical ganglion: stretches from vertebral level C1-C2/3
what is contained in superficial cervical fascia?
- cutaneous nerves
- blood/lymph vessels
- superficial lymph nodes
- fat
- platysma muscle (anterolaterally)
3 layers of deep cervical fascia
- investing
- pretracheal
- prevertebral
what muscles are in investing fascial layer
trapezius and SCM (investing layer splits into superficial and deep layers to enclose these)
where is suprasternal space found?
between 2 layers of investing layer of deep cervical facia just above manubrium
where is pretracheal layer?
part of deep cervical facia, only on anterior part of neck
two divisions of pretracheal layer and what do they enclose
- muscular layer: infrahyoid muscles
- visceral layer: thyroid gland and trachea
what is the buccopharyngeal fascia
thin, posterior lamina of pretracheal fascia separating esophagus from prevertebral fascia
what does the prevertebral fascia enclose?
scalenes, deep back muscles, vertebrae
what part of the vertebrae does the prevertebral fascia attach to?
anterior tubercle
what’s the alar fascia?
anterior lamina of prevertebral fascia
what does the carotid sheath contain?
- common and internal carotid
- IJV
- vagus nerve (CN X)
- some deep cervical lymph nodes
- carotid sinus nerve
- sympathetic nerve fibers (carotid periarterial plexuses)
boudnaries of retropharyngeal space
- anterior: buccopharyngeal fascia (visceral)
- posterior: alar (prevertebral) fascia
- lateral: carotid sheaths
- superior: base of skull
- inferior: mediastinum
boundaries of parapharyngeal space
- superior: skull
- inferior: hyoid bone
- lateral: medial pterygoid muscle or SCM
- medial/anterior: superior constrictor and bucoopharyngeal fascia
- posterior border: alar fascia and carotid sheath
AKA lateral pharyngeal space
prevertebral space borders
between alar fascia and prevertebral fascia
