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Anatomy - BB Exam 3 > Superficial Structures of Neck: Cervical Regions > Flashcards

Superficial Structures of Neck: Cervical Regions Flashcards

1
Q

congenital torticollis

A

contraction or shortening of cervical muscles that produces twisting of neck and slanting of head

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2
Q

what causes the most common type of torticollis?

A

fibrous tissue tumor in SCM around birth

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3
Q

if torticollis occurs prenatally, what type of delivery is necessary?

A

breech delivery

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4
Q

muscular torticollis

A

when SCM is injured when an infant’s head is pulled too much during a difficult birth - causes hematoma that forms a fibrotic mass -> compression of CN XI

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5
Q

cervical dystonia

A

abnormal tonicity of cervical muscles - aka spasmodic torticollis

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6
Q

what muscles does cervical dystonia involve?

A

any bilateral combo of lateral neck muscles - especially SCM and trap

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7
Q

characteristics of cervical dystonia

A
  • sustained turning/tilting of neck
  • involuntary shifting of head lat or ant
  • shoulder elevated and moved ant on side to which chin turns
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8
Q

what vein is used for central line placement?

A

R or L subclavian vein

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9
Q

infraclavicular subclavian vein approach

A
  • thumb on middle of clavicle
  • index finger on jugular notch (manubrium)
  • needle -> inferior to thumb, moved medially toward index finger until tip enters venous angle
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10
Q

what can happen if the needle is inserted incorrectly in subclavian vein puncture?

A

pneumothorax

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11
Q

purpose of right cardiac catheterization

A

to take measurements of pressure in the right chambers of the heart

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12
Q

path for right cardiac catheterization

A

needle -> IJV to R brachiocephalic v. to SVC to right side of heart

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13
Q

homeostatic purpose of EJV

A

internal barometer - prominent throughout course on neck if venous pressure up

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14
Q

what can prominent EJV indicate?

A
  • heart failure
  • SVC obstruction
  • enlarged supraclavicular lymph nodes
  • increased intrathoracic pressure
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15
Q

what happens if EJV is severed where it pierces roof of lateral cervical region?

A

-lumen held open by investing fascia
-negative intrathoracic pressure sucks air into vein
=churning noise in thorax + cyanosis

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16
Q

venous air embolism caused by severed EJV - what happens?

A

fills right side of heart w/ froth -> nearly stops blood flow through it -> dyspnea

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17
Q

how can CN XI be damaged? (4 things)

A
  • penetrating trauma
  • surgical procedures in lateral cervical region
  • tumors at cranial base or cancerous cervical lymph nodes
  • fractures of jugular foramen
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18
Q

signs of unilateral paralysis of the trapezius

A
  • inability to elevate and retract shoulder
  • difficulty elevating upper limb superior to horizontal
  • normal prominence of trap in neck is reduced
19
Q

what does drooping of shoulder indicate?

A

injury of CN XI

20
Q

what is the most common iatrogenic nerve injury?

A

CN XI

21
Q

what does severance of phrenic nerve cause?

A

paralysis of hemidiaphragm

22
Q

phrenic nerve block: action, where injected?

A

short period of paralysis of hemidiaphragm

injected around the nerve where it lies on anterior surface of middle 1/3 of anterior scalene

23
Q

phrenic nerve crush

A

can be caused by compression during surgery - longer period of paralysis

24
Q

cervical plexus block: what is it used for, where injected, who is it not used on?

A

before neck surgery -> no nerve impulse conduction

several points along posterior border of SCM, but mainly nerve point of neck

not used w/ pulmonary or cardiac disease b/c it usually paralyzes the phrenic nerve to half the diaphragm

25
Q

what is used for upper limb anesthesia and where is it injected?

A

supraclavicular brachial plexus block

around the supraclavicular part of brachial plexus - superior to midpoint of clavicle

26
Q

when is the suprascapular nerve vulnerable to injury? (what type of fracture)

A

fractures of middle 1/3 of clavicle

27
Q

what does injury to suprascapular nerve cause?

A
  • loss of lateral rotation of humerus at glenohumeral joint
  • relaxed limb rotates medially -> waiter’s tip position
  • can’t initiate limb abduction
28
Q

ligation of external carotid artery: when used, what happens?

A

to control bleeding from one of its inaccessible branches

decreases but does not eliminate blood flow -> retrograde flow instead (main collateral by occipital artery)

29
Q

what does the carotid triangle provide access to surgically?

A
  • carotid system of arteries
  • IJV
  • vagus n.
  • hypoglossal n.
  • cervical sympathetic trunk
30
Q

what can obstruct blood flow of the internal carotid artery?

A

atherosclerotic thickening of intima

31
Q

what can a partial occlusion of the internal carotid cause?

A
  • transient ischemic attack (TIA)

- minot stroke

32
Q

what is TIA?

A

sudden focal loss of neurological function (dizziness and disorientation) that disappears w/i 24h

33
Q

what is a minor stroke?

A

loss of neurological function (weakness, sensory loss on one side of body) that exceeds 24h but disappears w/i 3 weeks

34
Q

how can obstruction of blood flow be observed?

A

doppler color study - emits ultrasonic beam and detects it reflection from moving fluid in a manner that distinguishes fluid from static surrounding tissue
-provides info on pressure, velocity, turbulence

35
Q

how can carotid occlusion be relieved?

A

carotid endarterectomy - opening artery at origin and removing atherosclerotic plaque w/ intima

36
Q

what nerves are at risk during carotid endarterectomy?

A
  • CN IX
  • CN X (or superior laryngeal n. branch)
  • CN XI
  • CN XII
37
Q

carotid sinus hypersensitivity

A

exceptional responsiveness of the carotid sinuses in various types of vascular disease

38
Q

what is syncope?

A

fainting caused by cardiac ischemia/fall in blood pressure

39
Q

what causes symptoms of all forms of syncope?

A

sudden and critical decrease in cerebral perfusion

40
Q

what method of checking pulse is recommended for people with cardiac and vascular disease/ carotid sinus hypersensitivity?

A

not carotid - use radial instead

41
Q

functions of carotid bodies

A
  • monitor O2 content of blood before it reaches brain
  • responds to increased CO2 tension or free H+ in blood

info conducted along CN IX -> reflexive stimulation of respiratory centers of brain that increase depth and rate of breathing

42
Q

what can pulsations of the IJV tell you?

A

info about heart activity corresponding to ECGs and right atrial pressure

43
Q

what position must a patient be in to feel pulsations of IJV?

A

Trendelenburg position - when person’s head is inferior to lower limbs

44
Q

which IJV is examined and why?

A

the right IJV b/c it has a straighter, more direct course to RA

Anatomy - BB Exam 3 (13 decks)

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