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Head and Neck > Root of the Neck and Anterior Triangle of the Neck > Flashcards

Root of the Neck and Anterior Triangle of the Neck Flashcards

1
Q

what 4 things does the neck contain that are important for life

A

thyroid gland, trachea, jugular vein, and carotid artery

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2
Q

why are many of the neck contents vulnerable to penetrating injuries

A

they lack bony protection

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3
Q

how is the hyoid bone suspended

A

by muscles and ligaments (stylohyoid)

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4
Q

what 2 things are suspended from the hyoid bone

A

the larynx and trachea

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5
Q

what are 3 areas of muscle attachment on the mandible (on the inner surface)

A

genial tubercles, digastric fossae, and mylohyoid line

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6
Q

what are 3 areas of muscle attachment on the hyoid bone

A

greater and lesser horns and body of hyoid bone

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7
Q

what are 2 palpable landmarks on the mandible

A

mental protuberance (chin) and the angle of the mandible

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8
Q

what is a palpable landmark on the base of the skull

A

the mastoid process

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9
Q

what are 2 palpable landmarks on the hyoid bone

A

body and greater horns

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10
Q

what are 3 palpable landmarks on the larynx

A

laryngeal prominence (adam’s apple), cricothyroid membrane, and cricoid cartilage

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11
Q

what can you palpate during swallowing due to the mobility of the hyoid and larynx

A

the laryngeal prominence

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12
Q

what 3 muscles are in the lateral triangle

A

splenius capitus, levator scapulae, scalene muscles

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13
Q

what 3 vessels are in the lateral triangle

A

subclavian artery, external jugular vein and thyrocervial trunk (transverse cervical artery, dorsal scapular and suprascapular branches)

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14
Q

what 3 nerves are in the lateral triangle

A

spinal accessory nerve (11), brachial plexus, superficial branches of cervical plexus

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15
Q

what type of innervation do the sternocleidomastoid (SCM) and trapezius muscles receive

A

general efferents from the spinal accessory nerve (11)

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16
Q

what does the sternocleidomastoid divide the neck into

A

two triangles: lateral or posterior triangle and anterior triangle

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17
Q

where is the lateral/posterior triangle located

A

posterior to SCM, anterior to the trapezius muscle and superior to the middle part of the clavicle

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18
Q

where is the anterior triangle located

A

anterior to SCM, inferior to the inferior border of the mandible and lateral to the midline of the neck

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19
Q

what muscles are associated with the anterior triangle

A

the muscles that are associated with the hyoid bone

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20
Q

Name 5 glands and viscera that are associated with the anterior triangle

A

thyroid, parathyroid, larynx, trachea and esophagus

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21
Q

what vessels are associated with the anterior triangle

A

the great vessels (internal and external jugular veins and carotid arteries)

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22
Q

what nerves are associated with the anterior triangle

A

spinal and cranial nerves

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23
Q

how many smaller triangles make up the anterior triangle and what are they

A

4: submandibular triangle, submental triangle, muscular triangle, and carotid triangle

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24
Q

what 2 muscles subdivide the anterior triangle into smaller triangles

A

the anterior belly of the omohyoid and the digastric muscle (anterior and posterior bellies)

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25
Q

what are the muscles in the root of the neck

A

sternocleidomastoid (SCM), trapezius and scalene muscles

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26
Q

What does the root of the neck have

A

structures passing between the neck, thorax, and upper limb

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27
Q

Besides the structures passing through the root of the neck, what else projects into it

A

superior parts of the lungs

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28
Q

what are the arteries in the root of the neck

A

branches of subclavian arteries (vertebral artery, inferior thyroid artery and its ascending cervical branch, and the deep cervical artery)

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29
Q

what are the veins in the root of the neck

A

tributaries to the subclavian veins (only know internal and external jugular veins)

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30
Q

what nerves are in the root of the neck

A

phrenic and vagus nerves, the cervical parts of the sympathetic chains and the brachial plexus

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31
Q

where is the thoracic duct in the root of the neck

A

(major lymph channel from the abdomen)- passes through the root of the neck from the thorax on its way to the junction between left internal jugular vein and the left subclavian vein

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32
Q

what are the 2 types of muscles in the neck

A

suprahyoid and infrahyoid (strap) muscles

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33
Q

where are the 4 suprahyoid muscles located

A

in the submental and submandibular triangles

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34
Q

where are the 4 infrahyoid (strap) muscles located

A

in the muscular triangles

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35
Q

what action do the suprahyoid muscles do

A

raise the hyoid bone or depress the mandible

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36
Q

what action do the infrahyoid (strap) muscles do

A

depress hyoid bone

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37
Q

what innervates the suprahyoid muscles

A

nerve to mylohyoid (V3) and facial nerve

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38
Q

what innervates the infrahyoid (strap) muscles

A

ansa cervicalis (cervical plexus) except thyrohyoid muscle (nerve to thyrohyoid)

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39
Q

what are the 4 suprahyoid muscles

A

digastric- anterior and posterior belly, stylohyoid and mylohyoid muscles

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40
Q

what are the 4 infrahyoid (strap) muscles

A

omohyoid, sternohyoid, sternothyroid, and thryohyoid

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41
Q

where is the mylohyoid muscle

A

forms the floor of the mouth

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42
Q

what innervates the anterior belly of the digastric muscle and the mylohoid muscle

A

general efferents from the mandibular nerve (V3) via nerve to mylohyoid

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43
Q

what innervates the posterior belly of the digastric and the stylohyoid muscles

A

general efferents from the facial nerve

44
Q

what triangle is the superior belly of the omohyoid muscle in

A

the anterior triangle

45
Q

what triangle is the inferior belly of the omohyoid muscle in

A

the lateral triangle

46
Q

what are the thyrohyoid and sternothyroid muscles deep to

A

the superior belly of the omohyoid muscle and the sternohyoid muscle

47
Q

what innervates the thyrohyoid muscles

A

general efferents from C1 that hitchhike on the hypoglossal nerve (12)

48
Q

where is the cervical plexus located

A

ventral rami of C1-4 (mainly C2-4)

49
Q

what are the 4 parts of the cervical plexus (superficial to deep)

A

cutaneous branches, ansa cervicalis, deep muscular branches, and phrenic nerve

50
Q

where is the cutaneous branch located

A

C2-4

51
Q

where is the ansa cervicalis located

A

C1-3 (GE branches go to infrahyoid strap muscles)

52
Q

where is the deep muscular branch located

A

C1-4, general efferents to deep neck muscles

53
Q

where is the phrenic nerve located

A

C3-5 (overlaps the brachial plexus)

54
Q

what does the cutaneous branch of the cervical plexus carry

A

general afferents from the skin of the neck

55
Q

what does the deep muscular branch of the cervical plexus carry

A

innervate the deep cervical muscles including the rectus capitis anterior, rectus capitis lateralis, longus colli and longus capitis muscles

56
Q

what does the phrenic nerve of the cervical plexus carry

A

innervates the diaphragm

57
Q

where does the vagus nerve exit the cranial cavity

A

through the jugular foramen between glossopharyngeal (9) and accessory (11) nerves

58
Q

where does the vagus nerve go once it has exited the cranial cavity

A

enters the carotid sheath and descends through the neck behind the internal jugular vein and the internal carotid and common carotid arteries

59
Q

what are the 3 branches off the vagus nerve that monitor partial pressures of oxygen in the blood

A

pharyngeal, laryngreal, and cardiac

60
Q

what are the 4 cutaneous branches of the cervical plexus (superficial nerves)

A

transverse cervical nerves (C2-3), supraclavicular nerves (C3-4), great auricular nerves (C2-3), and lesser occipital nerves (C2-3)

61
Q

where is the superior root of the ansa cervicalis

A

branches from C1 travel with the hypoglossal nerve (12) and then descend to meet the inferior root on the anterior surface of the carotid sheath

62
Q

where is the inferior root of the ansa cervicalis

A

C2-3, descends either medial or lateral to internal jugular vein before turning medially to join the superior root

63
Q

where does the hypoglossal nerve (12) leave the cranial cavity

A

through the hypoglossal canal- medial to the internal carotid, passes between internal jugular vein and internal carotid artery

64
Q

where does the spinal accessory nerve (11) leave the cranial cavity

A

jugular foramen and supplies general efferents to the SCM and trapezius muscles

65
Q

what rami does the superior cervical ganglion pass through

A

C1-4

66
Q

what rami does the middle cervical ganglion pass through

A

C5-6

67
Q

what rami does the inferior cervical ganglion pass through

A

C7-8

68
Q

where does the motor component of the Trigeminal nerve (V3) go to

A

the mylohyoid muscles

69
Q

what are the 2 direct branches of the subclavian arteries

A

vertebral arteries, branches of thyrocervical trunk (inferior thyroid artery -> ascending cervical artery), and branches of the costocervical trunk (deep cervical artery)

70
Q

where does the common carotid divide into internal and external branches

A

near the hyoid bone

71
Q

what is the carotid sinus

A

near the bifurcation: the common carotid artery and the beginning of the internal carotid artery are dilated

72
Q

what does the carotid sinus contain

A

barorescptors that monitor changes in blood pressure

73
Q

Where is the carotid body and what does it do

A

near the carotid sinus, contains chemorescptors that monitor the partial pressure of oxygen and CO2 in the body

74
Q

what is carotid artery stenosis

A

narrowing of the common, internal or external carotid arteries

75
Q

what are 3 causes of a carotid artery stenosis

A

coronary artery disease, peripheral arterial stenosis, and hypertension

76
Q

what are 3 symptoms of carotid artery stenosis

A

TIA, artery bruits, and tinnitis

77
Q

what are 4 treatments for carotid artery stenosis

A

drugs, reduction of risk factors, endarterectomy, and stents

78
Q

what are 3 complications of carotid artery stenosis

A

stroke, myocardial infarction, and death

79
Q

is the plaque stable in carotid artery stenosis

A

yes and it will be asymptomatic or it can embolize and send small pieces to the brain

80
Q

what are the 3 pulse points in the neck region

A

external carotid artery, superficial temporal artery, and facial artery

81
Q

what forms the tributary of the external jugular vein

A

the union of the posterior auricular vein and the posterior division of the retromandibular vein

82
Q

what are the 6 tributaries of the internal jugular vein

A

common facial vein, superior thyroid vein, middle thyroid vein, lingual vein, pharyngeal plexus, and occipital veins

83
Q

what is the tributaries of the brachiocephalic veins

A

inferior thyroid vein

84
Q

what are the 2 tributaries of the external jugular vein

A

anterior jugular vein and indirectly the communicating vein (facial and anterior division of retromandibular)

85
Q

what type of gland is the thyroid gland

A

endocrine (ductless, hormone-secreting) *largest endocrine gland in body

86
Q

where is the thyroid gland

A

deep to sternothyroid and sternohyoid muscles from C5-T1

87
Q

what does the thyroid gland secrete

A

thyroxine (for regulation of metabolism by converting iodine)

88
Q

what are the 4 parts of the thyroid gland

A

2 lateral lobes, connected by Isthmus and a pyramidal lobe

89
Q

what surrounds the thyroid gland

A

a tough, fibrous sheath

90
Q

where does the thyroid develop from

A

from the floor of the pharynx at the base of the tongue at the foramen cecum

91
Q

what are parathyroid glands

A

endocrine glands on the posterior surface of the thyroid

92
Q

how many parathyroid glands are ther

A

usually 2 superior and 2 inferior

93
Q

what do the parathyroid glands secrete

A

parathyroid hormone involved in calcium metabolism

94
Q

what is the blood supply to the thyroid and parathyroid glands

A

external carotid -> superior thyroid artery

thyrocervical trunk -> inferior thyroid artery

95
Q

what are the veins that drain the thyroid and the parathyroid

A

superior and middle thyroid veins -> internal jugular vein

inferior thyroid vein -> brachiocephalic vein

96
Q

what does 10% of the population have in addition to the normal blood supply to the thyroid

A

thyroid ima artery (may arise from brachiocephalic trunk, aorta, right common carotid, subclavian or internal thoracic artery)

97
Q

what is the innervation to the thyroid and parathyroid glands

A

visceral efferents only from sympathetics: from superior, middle, and inferior cervical ganglia (constrict the blood vessels)

98
Q

what regulates the secretions of the thyroid and parathyroid glands

A

pituitary glands

99
Q

what is a thyroglossal duct cyst

A

the duct usually disappears early in development but remnants may persist as a cyst- usually excised with central part of hyoid bone

100
Q

what is a goiter

A

diffuse, irregular enlargement of the thyroid gland not related to neoplasm or swelling

101
Q

what causes a goiter

A

iodine insufficiency

102
Q

what can a goiter compess

A

trachea, esophagus, and recurrent laryngeal nerves

103
Q

what are 3 complications of thyroid surgery

A

post-op bleeding, damage to recurrent or external laryngeal nerves, and inadvertent removal of parathyroids

104
Q

what symptoms occur with damage to the recurrent or external laryngeal nerves

A

unilateral = hoarseness after surgery, bilateral= aphonia and/or laryngeal spasm

105
Q

what is tetany

A

severe convulsions: results if the parathyroid glands are removed and there is a decline in calcium levels

Head and Neck (10 decks)

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