Root Of The Neck

Question 1

Describe the boundaries of the root of the neck

Answer 1

Anterior = top of manubrium and superior border of clavicle

Posterior = body of T1 and superior margin of the scapula, to the Coracoid process

Lateral = first pair of ribs and costal cartilages

Inferior = superior thoracic aperture (thoracic inlet) and axillary inlets

Question 2

Describe the form and position of the apex of the lung

Answer 2

The apex of the lung summits around 2.5cm above the middle 1/3 of the clavicle

It enters up from the superior thoracic aperture

Question 3

Describe the covering of the apex of the lung.

Answer 3

The apex of the lung is covered by the cervical pleura, a continuation of the parietal pleura, and forms a cup-like dome called the cupola.

Question 4

What are the pleural layers and the pleural sac?

Answer 4

The pleural layers (visceral and parietal) are 2 layers of tissue forming the pleural sac.

The inner visceral pleura surrounds the lungs, blood vessels, nerves and bronchi.

The parietal outer layer connects to the wall of the chest cavity.

Question 5

What is the suprapleural membrane? Where does it connect and what is its function? What is its other name?

Answer 5

(Sibson’s fascia) Strong firbrous connective tissue reinforcing the cervical pleura

Attaches to the internal surface of rib 1, and the transverse processes of C7.

Question 6

What is the origin, course and supplied structures of the Subclavian artery?

Answer 6

Origin = Aortic arch (left) or the brachiocephalic trunk (right)

Course = - (right) arises in the neck, moves laterally over the superior border of the first rib, behind the scalenus anterior

		- (left) arises in the superior mediastinum from aortic arch and enters neck, moves laterally along first rib behind SA

Supplied structures = thoracic wall, spinal cord, brain and meninges, neck, upper limb

Question 7

Give the origin, course and supplied structures of the vertebral artery

Answer 7

Origin = subclavian artery

Course = ascends through foramen transversium of C1-6 then wraps round posterior tubercle of atlas to then enter the foramen magnum and joins the opposing side vertebral artery

Supplied structures = upper spinal cord + cerebellum

Question 8

Give the origin, course and distribution of the thyrocervcial trunk

Answer 8

Origin = subclavian artery

Course = ascends off the subclavian artery just medial to scalenus anterior then divides almost right away

Distribution = inferior thyroid artery, transverse cervical artery, suprascapular artery

Question 9

Describe the origin, course and supplied structures of the internal thoracic arteries

Answer 9

Origin = subclavian arteries

Course = descends posterior to the clavicle into thoracic cavity down to the 6th intercostal space and gives rise to the anterior intercostal arteries

Supplied structures = intercostal spaces and overlying skin

Question 10

Describe the origin, course and supplied structures / distribution of the Costco cervical trunk

Answer 10

Origin = subclavian artery

Course = ascends posteriomedially and divides into the supreme intercostal artery and the deep cervical artery

SS/D = thoracic wall

Question 11

Describe the origin, course and drainage of the subclavian vein

Answer 11

Origin = axillary vein

Course = travels medially where it meets the internal jugular vein to form the brachiocephalic vein

Drainage = major drainage from the entire upper limb

Question 12

Describe the origin, course and drainage of the external jugular vein

Answer 12

Origin = union of posterior auricular vein and the retromandibular vein

Course = descends from the angle of the mandible superior to the sternocleidomastoid and drains into the subclavian vein

Drainage = face, scalp and neck

Question 13

What is the thoracic duct, its position, course and function?

Answer 13

Major lymphatic drainage beginning in the abdomen, ascending through the thoracic cavity and into the neck where it enters the brachiocephalic trunk between the internal jugular vein and the subclavian vein

Question 14

What are the anterior vertebral muscles and their functions?

Answer 14

Longus colli = flex the neck and rotation to opposing side

Longus captis

Recuts captis anterior

Anterior scalene

= flex the head

Question 15

What are the posterior vertebral muscles and their function?

Answer 15

Rectus capitis lateralis = flex and stabilise head

Splenus capitis = laterally flex and rotate head and neck to same side

Middle + posterior scalene = lateral flexion of neck. Middle scalene elevates first rib and posterior scalene elevates second rib

Levator scapulae = elevate and rotate scapula