Superficial Triangles and Cervical Viscera Flashcards
The 3 important landmarks of the neck
C6 (sixth cervical vertebra)
greater horn of the hyoid bone (greater cornu)
anterior scalene muscle
important structure in suboccipital triangle
vertebral artery
vertebral artery enters the transverse process of what vertebra
C6
Phrenic N roots
C3, C4, C5
hangman’s fracture risks damaging
phrenic nerve
hangman fracture = fracture of C2
________N runs on the anterior surface of what muscle
Phrenic N, anterior scalene.
Lateral Neck Layer 1 contents
platysma m.
external jugular vein
Lateral Neck Layer 2 contains
SCM
CN XI
3 structures you want to preserve in a Radical Nec dissection
SCM
IJV
CN XI
SCM innervated by
CN XI
Posterior triangle borders
SCM
Trapezius
middle 1/3 of clavicle
EJV is formed by the conjunction of what veins
posterior auricular v
retromandibular v
Spinal Accessory N
CN XI
innervates SCM and Trapezius
enters triangle slightly above midpoint of SCM
contributions from C2-C3 (SCM) C3-C4 (trapezius)
2 places we care about branchial fistulas and cysts being distributed
along SCM
along midline - development of thyroid, thyroglossal duct cyst
What does the IJV drain
the brain
Contents of the Root of the Neck
Carotid Sheath (IJV, common carotid, vagus N) subclavian v phrenic n anterior scalene subclavian a brachial plexus
contents of the carotid sheath
common carotid a
IJV
vagus n.
Structures of the lateral root of the neck
suprascapular artery and subclavian vein
transverse cervical artery
suprascapular artery
Structures in the mid portion of the root of the neck
centered on the anterior scalene and its relationships with subclavian v transverse cervical a suprascapular a subclavian a brachial plexus
Root of the neck medial to anterior scalene
carotid sheath, thoracic duct, costocervical trunk, inf thyroid artery, ascending cervical a, recurrent laryngeal n, sympathetic chain, vertebral a and ganglion
structures that run anterior to anterior scalene m (2)
subclavian v
phrenic n.
Structures that run posterior to anterior scalene m
subclavian a
brachial plexus
How do you tell the difference between external carotid and internal carotid
external has branches in the neck
first branch is superior thyroid.
Anterior triangle of then neck contains what triangles (4)
muscular triangle
carotid triangle
submandibular triangle
submental triangle
submandibular triangle borders
bounded by the inferior edge of the mandible, and the anterior and posterior digastric
submandibular triangle contains what important structure
submandibular gland
what structure do we want to be carful to dissect out of the submandibular salivary gland
facial artery
Innervation of the submandibular gland
preganglionic parasympathetic fibers from superior salivatory nucleus (exit brainstem with facial nerve, travel through chorda tympani, and join with lingual nerve before terminating in the submandibular ganglion)
postganglionic fibers from submandibular ganglion distribute as numerous short branches to the paranchyma of the gland
postganglionic sympathetic fibers originate in superior cervical ganglion and reach teh gland by coursing in external caroti and facial plexuses in the adventitia of respective arteries
What structure will you find with inferior thyroid a
recurrent laryngeal n
Where is the thyroid gland located
midline, around the trachea at tracheal rings 2-4
What is the name of a not uncommon extra lobe of the thyroid
pyramidal lobe, may extend upwards from the isthmus
Thyroid gland lymph drainage
deep cervical lymph nodes, can and DOES cross sides of the body.
relationship of recurrent laryngeal n to the thyroid
RLN located medial to lobes, between trachea and esophagus
innervates all of the mucles of the larynx, except cricothyroid
cut RLN== dysphonia
Blood supply of thyroid (arterial)
superior thyroid artery (from common or external carotid)
inferior thyroid artery (thyrocervical trunk)
lowest thyroid artery
Blood supply of the thyroid (venous)
veins are what drain the hormones out
superior and middle thyroid veins drain into IVC
inferior thyroid drains into brachiocephalic vein
Cricothyrotomy
risk of thryoglossal duct cyst and blood loss
if they need it just do it
establishes emergency airway by cutting through the cricothyroid membrane
esophagus is _______ to trachea
posterior
Cupula of pleura
(of the lung)
pyramidal shaped portion of thoracic cavity that extends into root of the nec between scalenes and longus colli mm
extends 3 cm into root of neck at midclavicular line
Penetrating wounds to the base of the neck may puncture the pleural cavity and/or lung, collapse the lung, and result in pneumothorax
Retropharyngeal space
posterior to the esophagus and the prevertebral fascia
