Root Of Neck And Prevetetbral Muslces.

Question 1

What are the anterior and posterior borders of the neck

Answer 1

Anterior =Top of manubrium and superior border of clavicle

Posterior = body of T1 and superior margin of scapula to coracoid process

Question 2

What does the subclavian artery become when it passes into the upper limb

Answer 2

The subclavian artery passes through the cervicoaxillary canal into the axillla and upper limb to become the axillary artery

This change in name occurs at the lateral border of the the 1st rib

Question 3

What forms the jugular venous arch

Answer 3

Superior to the manubrium the right and left anterior jugular veins commonly unite across midline to form the jugular venous arch in the suprasternal space

Question 4

What is the venous drainage of the upper limb

Answer 4

The axillary vein which becomes the subclavian vein at the border of the first rib

Question 5

What is the brachial plexus

Answer 5

A major plexus of nerves from of the anterior rami of 5 spinal nerves C5-C8 and T1, which join to form three trunks and then split into divisions and then eventually become 5 main terminal branches which innverate the upper limb

Question 6

Where might you find some of the trunks of the brachial plexus

Answer 6

Running deep to the inferior belly of the omohyoid muscle

Question 7

Any structure going form thorax to head or upper limb and vice Versa must pass through what

Answer 7

Superior thoracic aperture

Question 8

What kind of pleura are the lungs covered in

Answer 8

Cervical pleura

This is a continuation of parts of the parietal pleura ( this lines the pulmonary cavities and and adheres to the thoracic wall and mediastinum )

Question 9

What is the cupola

Answer 9

The cervical pleura forms a dome shape/cap which above the first rib and its summit is located 2-3cm superior to the level of the medial third of the clavicle at the level of the neck of the first rib

Question 10

Why is the cervical pleura especially vulnerable to injury during infancy and early childhood

Answer 10

This is because it comparitively extends further superior because of the comparitivetly short length of their necks.

As the lungs extend into the neck, wounds at the base of the neck may compromise the lungs and pleural sacs, resulting in conditions where the lungs are infiltrated with air, blood or chyme from the lymphatic system

Question 11

What is Sibsons fascia

Answer 11

It is suprapleural membrane, a strong fibrous connective tissue that is an extension of endothoracic fascia. - it reinforces cervical pleaura ( anchors dome of cervical pleura)

It attaches to the internal surface of rib 1 and transverse processes of C7

It acts as a barrier to prevent changes in inter thoracic pressure drawing upon contents in the neck

Question 12

What are the three branches which come off of the aortic arch

Answer 12

1. Brachiocephalic - this branches to the Right common carotid and the subclavian arteries
2. Left common carotid artery
3. Left subclavian artery

Question 13

What artery does the left vagus nerve run parallel with

Answer 13

The left commmon carotid

Question 14

What to the subclavian arteries supply

Answer 14

Supply the upper limb and send branches to the neck and brain

Question 15

The subclavian artery is divided into three parts, discuss

Answer 15

They are all with respect to the scalene muscles

1st part ; MEDIAL to anteior scalene
2nd part; POSTEIOR to Anterior scalene ( can’t visualise with anteior scalene in place)
3rd part; LATERAL to anterior scalene muscle

Third part is the longest and most superficial ,lies anterior to trunks of the brachial plexus

Question 16

Where does the vertebral artery ascend from and what its course

Answer 16

The vertebral artery comes from the 1st part of the subclavian artery. It has several parts.

It ascends onto the neck as the CERVICAL part to enter foramen transversarium of C6 and ascends through C1-C6 as VERTEBRAL part

The subocciptal( Atlantic ) part runs in a groove in posterior arch of atals (C1) and enters the cranial cavity though the foramen magnum which then becomes CRANIAL part which supplies branches to the structures of the brain, spinal cord etc.

It then joins the vertebral artery from the other side at inferior border of pons to from bassilar artery

Bassilar artery then contributes to circle of willlis

Question 17

The thyrocervical trunk is also a branch of the 1st part of the subclavian artery. Discuss its course

Answer 17

It has three branches

The most important being the INFERIOR THYROID ARTERY - the primary visceral artery of the neck. Supplies the larynx, trachea, oesophagus and thyroid and parathyroid glands as well as adjacent muscles

The transverse cervical artery - runs anteiorly to anteior scalene, gives superficial branch to trapezius and deep branch to rhomboid (upper back muscle) and scapula

Suprascapular artery - runs anterior to anterior scalene supplies the supraspinuatus fossa ( on shoulder)

Question 18

What are the terminal branches of the thyrocervical trunk of the 1st part of the subclavian artery

Answer 18

Inferior thyroid artery

Ascending cervical artery - sends muscular branches to lateral muscles of the upper neck and spinal branches into intervertebral foramina

Question 19

As well as the vertebral artery and the thyrocervical trunk what is the last branch of the 1st part of the subclavian artery

What is its course

Answer 19

Innteral thoracic artery

It passes to the thorax to branch into the anteior intercostal arteries which supply the intercostal spaces between the ribs.

It’s cervical part has no branches

Question 20

What branch comes from the 2nd part of the subclavian artery and what’s its course

Answer 20

Costocerivcal trunk

This has 2 branches

The supreme intercostal supplying first two intercostal spaces
The deep cervical arteries supplying posterior deep cervical muscles - goes onto anastomose with occipital artery of ECA

This branch however shows variability in its origin and may branch off first part of subclavian

Question 21

What branch does the third part of the subclavian artery give off

Answer 21

Dorsal scapular artery

This is highly variable and may branch from another part of the subclavian

Question 22

Where does the subclavian vein begin?

Answer 22

It begins at the level of the 1st rib as a continuation of the axillary vein until it units with internal jugular vein

It runs parallel and anterior to subclavian artery and
anterior to anterior scalene

Question 23

What is the function of the subclavian vein

Answer 23

It is the major venous drainage from the upper limb

Question 24

Which two veins make up the brachiocephalic vein and what is there union called

Answer 24

Internal jugular vein and subclavian vein and there union is called the venous angle

Question 25

What happens at the venous triangle

Answer 25

This is the site where the thoracic duct ( left side) and the right lymphatic trunk ( right side) drain lymph collected throughout the body’s venous circulation

Question 26

Throughout its course the internal jugular vein is enclosed in which kind of fascia.

Answer 26

The carotid sheath

Question 27

What is the main action of the prevertebral muscles and which muscle is the exception to this

Answer 27

They act to flex and in some cases rotate the head and neck.

The levator scapulae -acts on scapulae to elevate and rotate it

Question 28

What is the thoracic duct and where is it located.

Answer 28

It located on the left side of the body at the venous angle ( between the left subclavian and left internal jugular veins)

It is a major lymphatic drainage which begins in the abdomen and ascends through the thoracic cavity and into the neck where it enters the venous system via the venous angle

Question 29

What is the thoracic ducts right counterpart

Answer 29

Right lymphatic trunk