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Anatomy > Superficial Anterior Neck > Flashcards

Superficial Anterior Neck Flashcards

1
Q
  • What layer of cervical fascia is a thin layer of subQ tissue?
  • What does this fascia lie between?
  • What does this fascia contain?
A
  • superficial cervical fascia
  • between the dermis of the skin and the deep cervical fascia
  • platysma, fat
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2
Q
  • What is the innervation of the platysma muscle?
  • What does this muscle do?
A
  • cervical br. of facial n. (CN VII)
  • draws corners of mouth inferiorly; draws skin of neck superiorly when teeth are clenched, indicating tension
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3
Q

What are the different layers of the deep cervical fascia?

A
  • investing (superficial) layer
  • pretracheal layer/fascia (middle layer)
  • prevertebral layer/fascia (deep layer)
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4
Q
  • Which deep cervical fascia layer encircles the neck like a collar?
  • What does this layer invest/wrap around?
  • What does this layer form the roof of?
A
  • investing (superficial) layer
  • SCM, trapezius m
  • anterior and posterior triangles of the neck
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5
Q
  • What is the sternocleidomastoid muscle innervated by?
  • What does the sternocleidomastoid muscle do?
A
  • spinal accessory n (CN XI)
  • unilaterally: laterally flexes neck and rotates it
  • bilaterally: extension of neck, flexes cervical vertebrae so chin approaches manubrium, extends superior cervical vertebrae while flexing inferior vertebrae
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6
Q

What triangle is the spinal accessory nerve found in?

A

posterior triangle (and anterior)

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7
Q
  • Which deep cervical fascia layer is the muscular division that invests the strap muscles?
  • What are the names of the strap muscles?
A
  • pretracheal layer/fascia (middle layer)
    muscles:
  • sternohyoid
  • sternothyroid
  • omohyoid
  • thyrohyoid
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8
Q
  • What is the action of sternohyoid?
  • What is the action of omohyoid?
  • What is the action of sternothyroid?
  • What is the action of thyrohyoid?
A
  • depresses hyoid
  • depresses and retracts hyoid
  • depresses thyroid cartilage and larynx
  • depresses hyoid and elevates the thyroid cartilage and larynx
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9
Q
  • What infrahyoid muscles does the ansa cervicalis (C1-C3) innervate?
  • What infrahyoid muscles does C1 via the hypoglossal n (CN XII) innervate?
A
  • sternohyoid, omohyoid, sternothyroid
  • thyrohyoid
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10
Q

Label

A
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11
Q

What are the distal attachments of the sternocleidomastoid muscle?

A
  • sternal head: anterior manubrium
  • clavicular head: medial third of clavicle
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12
Q
  • What are the levels of the cervical plexus?
  • What nerves come off the cervical plexus?
A
  • anterior rami C1-C5
    nerves:
  • lesser occipital n
  • great auricular n
  • transverse cervical n
  • supraclavicular n
  • ansa cervicalis
  • phrenic n
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13
Q

What do these nerves innervate:
- lesser occipital n
- great auricular n
- transverse cervical n
- supraclavicular n
- ansa cervicalis
- phrenic n

A
  • lesser occipital n: skin of neck and scalp posterosuperior to clavicle
  • great auricular n: skin over parotid gland, posterior aspect of auricle, skin extending from angle of mandible to mastoid process
  • transverse cervical n: skin covering anterior triangle of the neck
  • supraclavicular n: skin over neck and shoulder
  • ansa cervicalis: infrahyoid muscles
  • phrenic n: diaphragm, mediastinal pleura, pericardium
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14
Q
  • Which nerves of the cervical plexus provide sensory innervation?
  • What’s a mnemonic to remember this?
A
  • lesser occipital n, great auricular n, transverse cervical n, supraclavicular n
  • “Lets Go To Sleep”
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15
Q

What vertebral levels does the ansa cervicalis come from?

A

C1-C3

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16
Q

What are the two divisions of the pretracheal layer of the deep cervical fascia?

A
  • muscular division
  • visceral division
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17
Q
  • What does the visceral division of the pretracheal fascia of the deep cervical fascia cover?
  • What does it invest?
  • What other fascia is also included in this layer?
A
  • larynx, trachea, esophagus
  • invests thyroid gland (false capsule)
  • buccopharyngeal fascia
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18
Q
  • What fascia fuses with the adventitia of the pharynx?
  • Where is this found?
A
  • buccopharyngeal fascia
  • pretracheal layer
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19
Q
  • The pretracheal layer includes a thin muscular part, which encloses the (…), and a visceral part, which encloses the (…).
  • The pretracheal layer is continuous posterosuperiorly with the (…) and blends laterally with the (…).
A
  • infrahyoid muscles
  • thyroid gland, trachea, and esophagus
  • buccopharyngeal fascia
  • carotid sheaths
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20
Q
  • Describe the false capsule of the thyroid.
  • What does this form?
  • Describe the true capsule of the thyroid.
A
  • pretracheal fascia attached to cricoid and thyroid cartilages
  • forms suspensory ligament of thyroid (ligament of Berry)
  • condensation of CT of the thyroid gland
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21
Q

The (…) is a tubular fascial investment that extends from the cranial base to the root of the neck

A

carotid sheath

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22
Q

What is found in the carotid sheath?

A
  • common carotid arteries
  • internal carotid arteries
  • internal jugular v
  • vagus n (CN X)
  • ansa cervicalis
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23
Q

The prevertebral layer of deep cervical fascia forms a tubular sheath for the vertebral column and the muscles associated with it, such as the (…) anteriorly, the (…) laterally, and the (…) posteriorly

A
  • longus colli and longus capitis
  • scalenes
  • deep cervical muscles
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24
Q

What are the 2 divisions of the prevertebral layer of the deep cervical fascia?

A
  • prevertebral division
  • alar division
25
Q
  • What division of the prevertebral layer of the deep cervical fascia merges with the anterior longitudinal ligament?
  • This covers the anterior surface of what muscles?
  • This attaches to what parts of the vertebrae?
A
  • prevertebral division
  • longus capitis and colli mm
  • spinous processes of vertebrae
26
Q
  • What division of the prevertebral layer of the deep cervical fascia attaches to the transverse process of cervical vertebrae?
  • Where does this division end?
  • What does it fuse with when it ends?
A
  • alar division
  • ends at T2 (C6-T4)
  • fuses with visceral layer of pretracheal fascia
27
Q
  • What is the innervation of the longus colli muscle?
  • What does the longus colli muscle do?
  • What is the most common way to injury the longus colli muscle?
A
  • bilateral: neck flexion
  • unilateral: neck contralateral rotation, neck lateral flexion
  • anterior rami of spinal nerves C2-C6
  • whiplash
28
Q
  • What is the carotid sheath found deep to?
  • Fibers from (…) blend with the carotid sheath
A
  • SCM
  • all 3 deep cervical fascial layers
29
Q
  • What are the deep spaces of the neck?
  • Which one is a real space?
  • Where do these spaces begin?
A
  • retropharyngeal space, danger space, prevertebral space
  • retropharyngeal space
  • base of the skull
30
Q
  • What does the retropharyngeal space lie between?
  • What does it extend from?
  • What does this space consist of?
  • What do the lymph nodes drain?
  • What is the function of this space?
A
  • posterior pretracheal layer and the alar division
  • skull to tracheal bifurcation around T2
  • fatty areolar tissue, lymph nodes
  • pharynx, nose, and middle ear
  • permits movement of the aerodigestive tract during swallowing
31
Q
  • What does the danger space lie between?
  • What does it extend from?
  • Infections here occur rapidly because it is filled with (…) and leads to (…)
A
  • alar division and prevertebral divisions of deep layer of deep cervical fascia
  • skull base to diaphragm (involves mediastinum/heart)
  • minimal loose CT; mediastinal involvement
32
Q

The danger space is (…) from the true retropharyngeal space on imaging

A

indistinguishable

33
Q
  • What does the prevertebral space like anterior and posterior to?
  • What is it bounded laterally to?
  • What does it extend from?
  • What muscles are posterior to this space?
A
  • lies anterior to vertebral bodies, posterior to prevertebral division of deep layer of deep cervical fascia
  • transverse processes
  • base of skull to coccyx
  • longus collis and capitis
34
Q

What complication can result from prevertebral soft tissue swelling?

A
  • airway obstruction
  • hematoma
35
Q
  • (…) is the largest and most clinically important interfascial space in the neck because it is the major pathway for the spread of infection
  • The investing layer of deep cervical fascia helps prevent the spread of (…)
  • If an infection occurs between the (…) and the (…), the infection usually does not spread beyond the superior edge of the manubrium
  • If the infection occurs between the (…) and the (…), it can spread into the thoracic cavity anterior to the pericardium
A
  • retropharyngeal space
  • abscesses
  • investing layer of deep cervical fascia
  • pretracheal fascia muscular part surrounding the infrahyoid muscles
  • investing fascia
  • visceral part of the pretracheal fascia
36
Q

What are the bones of the neck?

A
  • cervical vertebrae (C1-C7)
  • hyoid bone
  • manubrium of sternum
  • clavicles
37
Q

What are the associated vertebral levels of these structures:
- hard palate
- lower border mandible
- hyoid bone
- thyroid cartilage
- cricoid cartilage
- carotid tubercle

A
  • hard palate: anterior arch C1 (axis)
  • lower border mandible: C2, 3
  • hyoid bone: C3
  • thyroid cartilage: C4-5
  • cricoid cartilage: C6
  • carotid tubercle: C6 anterior tubercle of transverse process
38
Q

What nerve do you risk cutting when dividing the platysma?

A

facial nerve - cervical branch

39
Q

In superficial dissection of the neck, what structures do you risk severing?

A

superficial veins:
- external jugular
- anterior jugular
- jugular venous arch

40
Q
  • What is the innervation of the posterior cricoarytenoid?
  • Loss of unilateral abduction of this muscle causes the vocal cord to assume a (…) position
  • The voice will be (…) and (…)
  • Airway is (…) due to intact contralateral muscle
A
  • recurrent laryngeal nerve
  • paramedian position
  • breathy; weak
  • adequate
41
Q

What is at risk when splitting the longus colli muscles longitudinally at the midline and then retracting each portion laterally?

A

sympathetic chain

42
Q
  • Describe what happens in Horner’s syndrome?
  • What is this caused by?
A
  • meiosis (constricted pupil), lid ptosis, anhidrosis (ipsilateral)
  • damage to sympathetic trunk/stellate ganglion
43
Q

After getting through to the prevertebral space during surgery, what structure is vulnerable?

A

C6 region of cervical esophagus (anterior to C6 vertebral body)

44
Q

The vertebral artery usually enters (…) transverse foramina

A

C6

45
Q

Which part of the vertebral artery is most commonly affected during traumatic injuries?

A

2nd part

46
Q

In surgery, what part of the vertebral artery is at risk when doing the posterior approach and why?

A
  • second part
  • pedicle screw fixation
47
Q

A high vertebral artery entry point into the transverse foramen above C6 could (…) the risk of iatrogenic vascular injury in anterior approaches to the cervical spine

A

increase

48
Q

What are the vulnerable structures if performing a high cervical approach in surgery?

A
  • SLN (superior laryngeal nerve)
  • hypoglossal n
49
Q

What does the external branch of the superior laryngeal nerve innervate?

A

cricothyroid m (important for singing)

50
Q
  • Which nerve traverses the surgical field and resembles a blood vessel?
  • What can happen if the superior laryngeal nerve is damaged?
A
  • hypoglossal nerve
  • laryngeal sensory impairment (aspiration, dysphagia); patient may have problems with high notes in singing due to damaged cricothyroid m
51
Q
  • What are the suprahyoid muscles?
  • What are their actions?
A
  • digastric: elevates hyoid and depresses mandible
  • stylohyoid: elevates hyoid
  • mylohyoid: supports floor of oral cavity
52
Q

What is the innervation of the suprahyoid muscles?

A
  • digastric: n to mylohyoid (CN V3)-anterior belly; facial n (CN VII)-posterior belly
  • stylohyoid: facial n (CN VII)
  • mylohyoid: n to mylohyoid (CN V3)
53
Q

Label

A
54
Q

What are the boundaries of the anterior triangle of the neck (anterior, posterior, superior, inferior, roof, floor)?

A
  • anterior: midline of neck
  • posterior: anterior border of SCM
  • superior: inferior border of mandible
  • inferior: superior sternum
  • roof: subcutaneous tissue, platysma
  • floor: pharynx, larynx, thyroid gland
55
Q

What are the boundaries of the posterior triangle of the neck (anterior, posterior, superior, inferior, roof, floor)?

A
  • anterior: posterior border of SCM
  • posterior: anterior border of trapezius
  • superior: merging of SCM and trapezius
  • inferior: clavicle (b/w SCM and trapezius)
  • roof: investing layer of deep cervical fascia, platysma
  • floor: muscles covered by prevertebral layer of deep cervical fascia
56
Q

What are the contents of the posterior triangle of the neck?

A
  • external jugular v
  • posterior branches of cervical plexus
  • spinal accessory n
  • lymph nodes
  • third part of subclavian artery and vein
  • cervicodorsal trunk
  • suprascapular a
57
Q

What are the contents of the anterior triangle of the neck?

A
  • submandibular gland, lymph nodes
  • hypoglossal n
  • mylohyoid n
  • parts of facial a and v (and n)
58
Q

What are the boundaries of the carotid triangle (part of anterior triangle)?

A
  • anterior: superior belly of omohyoid m
  • posterior: anterior border of SCM
  • superior: posterior belly of digastric m
  • floor: hyoglossus, thyrohyoid, inferior and middle pharyngeal constrictor mm
59
Q

What are the contents of the carotid triangle?

A
  • common carotid a and branches (external and internal carotid aa)
  • internal jugular v
  • vagus n
  • hypoglossal n
  • spinal accessory
  • superior root of ansa cervicalis
  • thyroid, larynx, pharynx

Anatomy (25 decks)

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