Root of The Neck Flashcards
What is the anterior border of the root of the neck?
Top of manubrium and superior border of clavicle
What is the posterior border of the root of the neck?
Body of T1 and superior margin of scapula to coracoid process
What is the lateral border of the root of the neck?
First pair of ribs and costal cartilages
What is the inferior border of the root of the neck?
Superior thoracic aperture (thoracic inlet) and axiliary inlets
When do the subclavian vessels become axillary vessels?
Lateral border of the 1st rib
What is the brachial plexus formed from?
5 anterior rami - C5,6,7,8 and T1
What are the divisions of the brachial plexus?
3 trunks - superior, middle and inferior
3 anterior divisions - superior, middle, inferior
3 posterior divisions - lateral, posterior, medial
What is the superior thoracic aperture?
All structures going from the thorax to head/upper limb pass through it
Where is the apex of the lungs?
About 2.5cm above middle 1/3 of the clavicle - above first rib into root of neck
What is the cervical pleura?
The superior continuation of the costal and mediastinal parts of the parietal pleura
What is the pleural cupola?
A cup-like dome formed superiorly to the pleura
What is important about the cervical pleura in children?
More susceptible to injury since it extends higher due to the relatively short length of the neck
What is Sibson’s fascia?
The suprapleural membrane that reinforces the cervical pleura
A strong fibrous connective tissue that is an extension of the endothoracic fascia
Where does Sibson’s fascia attach?
To the internal surface of rib 1 and the transverse processes of C7
What is the purpose of Sibson’s fascia?
Acts as a barrier to prevent changes in intrathoracic pressure drawing upon contents in the neck
What are the branches of the aortic arch?
Brachiocephalic trunk
Left common carotid artery
Left subclavian artery
What does the brachiocephalic trunk divide into?
Right common carotid artery
Right subclavian artery
What are the parts of the subclavian artery?
1st part - Medial to anterior scalene muscle (from origin to muscle)
2nd part - Posterior to anterior scalene
3rd part - Lateral to anterior scalene (from muscle until lateral border of 1st rib)
What are the branches of the 1st part of the subclavian artery?
Vertebral artery
Thyrocervical trunk
Internal thoracic artery
What are the branches of the 2nd part of the subclavian artery?
Costocervical trunk
What are the branches of the 3rd part of the subclavian artery?
Dorsal scapular artery
Describe the path of the vertebral artery
Ascends in neck as cervical part to enter foramen transversarium of C6 and ascends through C1 to C6 as vertebral part
Exits foramen transversarium crossing over posterior tubercle of C1 and travels medially to foramen magnum to eventually become basilar artery
What are the branches of the thyrocervical trunk?
Inferior thyroid artery
Transverse cervical artery
Suprascapular artery
Describe the inferior thyroid artery
Largest branch of thyrocervical trunk
Supplies thyroid
Gives off ascending cervical artery to prevertebral muscles and spinal cord
Describe the transverse cervical artery
Second branch of thyrocervical artery
Anterior to anterior scalene
Gives superficial branch to trapezius and deep branch to rhomboids and scapula
Describe the suprascapular artery
3rd branch of thyrocervical artery
Anterior to anterior scalene
Supplies supraspinatus fossa
What are the terminal branches of the thyrocervical artery?
Inferior thyroid artery
Ascending cervical artery
Describe the path of the internal thoracic artery
Descends inferomedially posterior to the clavicle into the thoracic cavity to the 6th intercostal space and gives rise to anterior intercostal arteries that supply the intercostal spaces
What are the divisions of the costocervical trunk?
Supreme intercostal artery
Deep cervical artery
Describe the path of the supreme intercostal artery
To 1st rib as posterior intercostal arteries to 1st and 2nd intercostal spaces
Describe the path of the dorsal scapular artery
Highly variable origin
Part of subclavian artery or can arise from a common trunk with the transverse cervical artery
Describe the subclavian vein
Continuation of axillary vein beginning at lateral border of 1st rib
Major venous drainage from upper limb
Runs parallel and anterior to subclavian artery and anterior to anterior scalene
EJV drains into subclavian
What makes up the brachiocephalic vein?
Internal jugular vein
Subclavian vein
Where does the inferior thyroid vein drain?
Directly into the brachiocephalic vein
What is the thoracic duct
A major lymphatic drainage channel that begins in the abdomen ascending through the thoracic cavity
Describe the path of the thoracic duct
Begins in abdomen and ascends through thoracic cavity into the neck where it enters the venous system between the left IJV and left subclavian vein
On the right side, there is a right lymphatic trunk/duct entering the same venous areas
What are the anterior prevertebral muscles?
Longus coli
Longus capitis
Rectus capitis anterior
Anterior scalene
What are the lateral vertebral muscles?
Rectus capitis lateralis
Splenius capitis
Levator scapulae
Middle and posterior scalenes
What are the actions of the anterior vertebral muscles?
Longus colli - flexes neck with rotation to opposite side (unilaterally)
Longus capitis, rectus capitis anterior, anterior scalene - flex head
What is the action of the splenius capitis?
Laterally flexes and rotates head and neck to same side
Bilaterally - extends head and neck
What is the action of the middle and posterior scalenes?
Flex neck laterally
Middle scalene elevated 1st rib
Posteriors elevates 2nd rib during forced inspiration
What is the action of the levator scapulae?
Elevates scapula and rotates it
