Root of the Neck

Question 1

List the boundaries of the superior thoracic inlet

Answer 1

Body of T1 Vertebrae, medial border of the 1st Rib and Costal Cartilages, Manubrium of the Sternum.

Question 2

Name two causes of thoracic outlet syndrome

Answer 2

Neurogenic, Vascular

Caused by compression of the structures due to muscle hypertrophy or a cervical rib

Question 3

Where in relation to the Scalenus Anterior muscle do the subclavian artery and vein pass?

Answer 3

Vein passes anteriorly and Artery passes posteriorly.

Question 4

Name 2 structures which pass anteriorly to the Scalenus Anterior muscle

Answer 4

Subclavian vein and phrenic nerve

Question 5

Where do the subclavian vessels change their name to axillary vessels?

Answer 5

Lateral border of the first rib

Question 6

Describe the course of the Vertebral Artery

Answer 6

It is a branch of the 1st part of the subclavian artery and passes between Scalenus Anterior and longus coli before passing into the transverse foramina of the cervical vertebrae and entering the cranial cavity through foramen magnum.

Question 7

What structures are supplied by the internal thoracic artery?

Answer 7

Breast tissue, pectoralis, intercostal muscles.

Question 8

What is the 4th branch or the subclavian artery?

Answer 8

Costocervical artery.

This produces the deep cervical artery and the 1st and 2nd posterior intercostal arteries.

Question 9

Describe the course of the dorsal scapula Artery. In anatomical variation what is this the equivalent of?

Answer 9

It is a branch of the 3rd part of the subclavian artery and passes through the brachial plexus to supply latissimus Doris, trapezius and the rhomboid muscles.
It’s equivalent branch is the deep branch of the transverse cervical artery.

Question 10

Name the 3 branches of the thyrocervical trunk

Answer 10

Inferior thyroid
Suprascapular
Superficial cervical. (Transverse cervical superficial branch).

Question 11

Which artery supplies supraspinatous and infraspinatous muscles and glenohumoral and acromioclavicular joints

Answer 11

Suprascapular Artery

Question 12

A branch of which nerve runs with the inferior thyroid artery?

Answer 12

Recurrent laryngeal nerve which is a branch of the vagus nerve.

Question 13

List the venous structures which contribute to the brachiocephalic vein.

Answer 13

The vein forms from the Internal Jugular Vein and the subclavian vein. It receives drainage from the vertebral vein and the inferior thyroid veins.

Question 14

Name the structures which form the superior vena cava

Answer 14

Left and right brachiocephalic veins

Question 15

Where do the vertebral veins drain to?

Answer 15

The brachiocephalic veins

Question 16

Where do the internal thoracic veins drain into?

Answer 16

Subclavian vein

Question 17

describe the course of blood within the external jugular vein to the superior vena cava.

Answer 17

EJV drains into the subclavian vein which then joins with the IJV to form the brachiocephalic vein which then forms the SVC with the contralateral brachiocephalic vein.

Question 18

What two structures are connected by the communicating vein?

Answer 18

Anterior and External Jugular Veins.

Question 19

Which brachiocephalic vein does the majority of thyroid venous drainage enter?

Answer 19

Left

Question 20

Where are sympathetic cervical ganglia found in the neck

Answer 20

In a chain posterior to the common carotid artery,

Question 21

What is the stellate ganglion?

Answer 21

This is the most inferior sympathetic ganglion in the neck and is made up from the inferior cervical and superior thoracic ganglia.

Question 22

What are cervical cardiac nerves and where do they originate?

Answer 22

These are autonomic fibres which pass down through the root of the neck.
Parasympathetic fibres are branches of the vagus nerve.
Sympathetic fibres originate from the ganglia in the neck.

Question 23

Discuss the course of the phrenic nerve inferior to the subclavian artery

Answer 23

It splits giving off an accessory phrenic nerve and these pass either side of the internal thoracic artery.

Question 24

What is of clinical importance in cannulation of the neck.

Answer 24

Care must be taken not to penetrate the suprapleural membrane which surrounds the parietal pleura of the lung as this may lead to a pneumothorax.

Question 25

Which region of the body is not drained by the thoracic duct?

Answer 25

RUQ

Question 26

Where does the thoracic duct return lymph into venous circulation?

Answer 26

Where the subclavian and internal jugular veins meet on the Left side of the neck.