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Head and neck radiology > Suprahyoid And Infrahyoid Neck > Flashcards

Suprahyoid And Infrahyoid Neck Flashcards

1
Q

Suprahyoid neck level

A

Skull base to hyoid bone, excluding orbit, sinuses and oral cavity

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2
Q

Infrahyoid neck level

A

Below hyoid bone with some continuing into mediastinum

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3
Q

Contents of suprahyoid neck

A 
Parapharyngeal space
Pharyngeal mucosal space
Masticator space
Parotid space
Carotid space
Buccal space
Retropharyngeal space
Perivertebral space
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4
Q

Contents of infrahyoid neck

A

Visceral space, posterior cervical space, anterior cervical space,
CS, RPS, PVS

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5
Q

From skull base to posterior mandibular space

A

Parapharyngeal space

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6
Q

Contents of parapharyngeal space

A

Fat and pterygoid venous plexus

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7
Q

Medial to parapharyngeal space and anterior to retropharyngeal space

A

Pharyngeal mucosal space

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8
Q

Contents of pharyngeal mycosal space

A

Mucosa, minor salivary glands, PMS lymphatic ring, constrictor muscles

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9
Q

PMS of nasopharynx

A

Torus tubarius, adenoids, superior constrictor, levator palatini muscles

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10
Q

PMS of oropharynx

A

Anterior and posterior tonsillar pillars, palatine and lingual tonsils, soft palate

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11
Q

Anterolateral to PPS

A

masticator space

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12
Q

Contents of masticator space

A

Ramus and condyle of mandible

CNV3, masseter, medial and lateral pterygoid and temporalis musles, pterygoid venous plexus

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13
Q

Fascia or masticator space

A

Superficial layer of deep cervical fascia

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14
Q

Importance of masticator space

A

Perineural tumor on CNV3, sarcoma

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15
Q

Lateral to PPS

A

Parotid space

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16
Q

Contents of parotid space

A

Parotid gland, extracranial CN7, nodes, retromandibular vein, external carotid artery

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17
Q

Posterior to PPS in SHN, lateral to VS and RPS

A

Carotid space

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18
Q

Carotid space begins at

A

Inferior jugular foramen and carotid canal or skull base

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19
Q

Carotid space extends inferiorly down to

A

Aortic arch

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20
Q

Contents of carotid space

A

CN9-12, internal jugular vein, carotid artery

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21
Q

Fascia or cervical space

A

All 3 layers of deep cervical fascia

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22
Q

Posterior to PMS in suprahyoid neck and VS in infrahyoid neck

A

Retropharyngeal space

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23
Q

Contents of retropharyngeal space

A

Nodes and fat in suprahyoid neck

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24
Q

Retropharyngeal space begins at and ends at

A

Begins at clivus and ends at T3

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25
Q

Anterior fascia of RPS

A

Middle layer DCF

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26
Q

Lateral and posterior fascia of RPS

A

Deep layer DCF/alar fascia

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27
Q

Importance of retropharyngeal space

A

Inferior communication with danger space allows access to mediastinum

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28
Q

Posterior to RPS and continous inferiorly into mediastinum

A

Danger space

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29
Q

Behind RPS and around spine in SHN and IHN, defined by skull base above to clavicle below

A

Perivertebral space

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30
Q

Contents of perivertebral space

A

Prevertebral and paraspinal components

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31
Q

Fascia of perivertebral space

A

Deep layer DCF

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32
Q

Traverses visceral space

A

Trachea and esophagus

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33
Q

Contents of visceral space

A

Thyroid, parathyroid, paratracheal nodes, esophagus, trachea, recurrent laryngeal nerve

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34
Q

Fascia of visceral space

A

Middle layer

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35
Q

Posterior cervical space begins at and extends to

A

Begins at mastoid tip and extends to clavicle

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36
Q

Contents of posterior cervical space

A

Fat, CN11, spinal accessory nodes

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37
Q

Fascia of posterior cervical space

A

Between SL and DL

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38
Q

PMS mass displaced PPS

A

Laterally

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39
Q

MS mass displaces PPS

A

Posteriorly

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40
Q

PS mass displaces PPS

A

Medially

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41
Q

CS mass displaces PPS

A

Anteriorly

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42
Q

Lateral RPS nod mass displaces PPS

A

Anterolaterally

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43
Q

Foramen ovale contains what nerve

A

CNV3

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44
Q

Foramen spinosum contains

A

Middle meningeal artery

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45
Q

Stylomastoid foramen contains

A

CN7

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46
Q

Jugular foramen contains

A

Cranial nerves 9-11

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47
Q

“Elevator shaft” thru which infection and tumor from the adjacent neck spaces may travel from skull base to superior cornu of hyoid bone

A

Parapharyngeal space

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48
Q

Critical contents of parapharyngeal space

A 
Fat
Minor salivary glands 
Internal maxillary artery
Ascending pharyngeal artery
Pterygoid venous plexus
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49
Q

Attachment area of PMS posteriorly

A

Basisphenoid (sphenoid sinus floor)

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50
Q

Anterior attachment of PMS

A

Anterior basiocciput (anterior clivus)

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51
Q

Includes foramen lacerum

A

PMS

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52
Q

Cartilagenous floor of anterior horizontal petrous internal carotid artery which represent perivascular route for nasopharyngeal carcinoma to access intracranial structures

A

Foramen lacerum

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53
Q

Lymphatic ring of PMS

A

Waldeyer ring

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54
Q

Lateral wall of oropharynx in PMS

A

Palatine (faucial) tonsil

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55
Q

Base of tongue in oropharynx of PMS

A

Lingual tonsil

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56
Q

Tough aponeurosis that connecta superior constrictor muscle to skull base

A

Pharyngobasilar fascia

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57
Q

Levator palatini muscle and eustachian tube pass thru this notch on way from skull base to PMS

A

Sinus of Morgagni/ posterosuperior margin notch

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58
Q

PMS muscles

A

Superior, middle and inferior constrictor muscles
Salpingopharyngeus muscle
Levator palatini muscle, distal end

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59
Q

Cartilagenous end of eustachian tube found in PMS

A

Torus tubarius

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60
Q

Fascia of PMS

A

Middle layer of DCL

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61
Q

Contents of masticator space

A

Muscles of mastication, posterior body and ramus of mandible

CNV3

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62
Q

Suprazygomatic MS contains

A

Belly of temporalis muscle

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63
Q

Infrazygomatic masticator space contains

A

Masseter, medial and lateral pterygoids, CNV3 and ramus/posterior body of mandible

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64
Q

Mandibular division of trigeminal nerve contains

A 
Masticator nerve branch
Mylohyoid nerve branch
Inferior alveolar nerve branch
Lingual nerve
Auriculotemporal nerve
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65
Q

Fascia of masticator space

A

Superficial layer of DCL

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66
Q

Primary tumor of MS

A

Sarcoma

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67
Q

Contents of parotid space

A

Parotid glands, nodes, extracranial facial nerve branches

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68
Q

Deep lobe of the parotid gland projects into

A

Lateral parapharyngeal space

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69
Q

Vessel that is seen just behind the mandibular ramus in parotid space medially

A

External carotid artery

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70
Q

Vessel that is seen just behind the mandibular ramus in parotid space laterally

A

Retromandibular vein

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71
Q

Intraparotid facial nerve branches course just lateral to what vessel

A

Retromandibular vein

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72
Q

Widening of stylomandibular gap indicates the lesion is in what space

A

Parotid space

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73
Q

Parotid glands appear more fatty in adult or pedia?

A

Adult

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74
Q

Contents of carotid space

A

Carotid arteries, internal jugular veins, cranial nerves 9-12

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75
Q

Lower limit of carotid space

A

Aortic arch

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76
Q

Sympathetic plexus is in between

A

Medial CS and lateral RPS

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77
Q

Carotid sheath incomplete or less substantial

A

Suprahyoid carotid space

78
Q

Carotid sheath is well-defined, tenacious fascia

A

Infrahyoid carotid space

79
Q

Midline space just posterior to pharynx and cervical esophagus

A

Retropharyngeal space

80
Q

RPS runs from skull base down to what vertebral level

A

T3

81
Q

RPS nodes are only found in suprahyoid or infrahyoid neck?

A

Suprahyoid

82
Q

Posterior to RPS

A

Danger space

83
Q

Lateral to RPS

A

Carotid space

84
Q

RPS empties into fascial door trap into what space inferiorly at T3 level

A

Danger space

85
Q

Lateral group of RPS lymph nodes also called

A

Nodes of Rouviere

86
Q

Anterior to RPS

A

PMS

87
Q

Perivertebral space extends from skull base above to what vertebral level

A

T4 in posterior mediastinum

88
Q

Prevertebral muscles

A

Longus colli and capitis

89
Q

Brachial plexus

A

C5 to T1

90
Q

Brachial plexus pass between what muscles of PVS

A

anterior and middle scalene

91
Q

Called “the carpet”

A

Anterior deep layer of DCF

92
Q

Prevertebral PVS contains

A

Proximal brachial plexus, phrenic nerve, vertebral arteries

93
Q

Two major components of PVS

A

Prevertebral and paraspinal

94
Q

Most PVS lesions originate in

A

Vertebral body (infection or metastasis)

95
Q

Path of least resistance of spreading pus or tumor is deep through

A

Neural foramen into epidural space

96
Q

Posterolateral fat-containing space in the neck with complex fascial boundaries

A

Posterior cervical space

97
Q

Posterior cervical space extends from

A

Posterior mastoid tip to clavicle

98
Q

Lesions from posterior cervical space typically arise from

A

Spinal accessory nodal chain

99
Q

Appears as “tilting tent” when viewed on the side

A

Posterior cervical space

100
Q

Primary component of posterior cervical space

A

Fat

101
Q

Critical contents of posterior cervical space

A 
Fat
Accessory nerve (CN11)
Spinal accessory lymph node chain (level 5A and 5B)
Pre-axillary brachial plexus
Dorsal scapular nerve
102
Q

Region of cervical neck posterolateral to sternomastoid muscle and anteromedial to trapezius muscle

A

Posterior triangle

103
Q

Posterior triangle is subdivided by

A

Inferior belly of omohyoid (into occipital and subclavian triangles)

104
Q

Two triangles in posterior cervical space

A

Occipital triangle and subclavian triangle

105
Q

Majority of posterior cervical space is what triangle

A

Occipital triangle

106
Q

Most commonly injured during neck dissection for malignant sCCa nodes

A

CN11

107
Q

Midline infrahyoid neck space enclosed by middle layer DCF

A

Visceral space

108
Q

Visceral space extends from

A

Hyoid bone above to superior mediastinum below

109
Q

Contents of visceral space

A

Larynx, trachea, hypopharynx, esophagus, thyroid and parathyroid glands

110
Q

Largest space of infrahyoid neck

A

Visceral space

111
Q

Less reliable location of parathyroid glands, superior or inferior?

A

Inferior

112
Q

Inferior parathyroid glands may be normally found in

A

Cervicothoracic junction or superior mediastinum

113
Q

Left recurrent laryngeal nerve recurs at

A

Level of arch where it passes through the aortopulmonic window

114
Q

Right recurrent laryngeal nerve recurs in

A

Most inferior infrahyoid neck around right subclavian artery

115
Q

Visceral lymph nodes is what level

A

Level VI

116
Q

First order of drainage for thyroid malignancy

A

Paratracheal lymph nodes (level VI)

117
Q

Also referred to as visceral fascia

A

Middle layer DCF

118
Q

Mass centered between thyroid love anteriorly and longus colli muscle posteriorly

A

Parathyroid (tracheoesophageal groove) mass lesion

119
Q

Caudal continuation of pharyngeal mucosal space, between oropharynx and esophagus

A

Hypopharynx

120
Q

Junction of upper and lower airway

A

Larynx

121
Q

Hypopharynx extends from level of glossoepiglottic and pharyngoepiglottic folds superiorly to

A

Inferior cricoid cartilage (cricopharyngeus muscle)

122
Q

Hypopharynx: oropharynx above, ____________ below

A

Esophagus

123
Q

Larynx: oropharynx above, ___________ below

A

Trachea

124
Q

3 regions of hypopharynx

A

Pyriform sinus
Posterior wall
Post-cricoid region

125
Q

Anterolateral recess of hypopharynx, between inner surface of thyrohyoid membrane above, thyroid cartilage below and lateral aryepiglottic fold

A

Pyriform sinus

126
Q

Anterior wall of lower hypopharynx

A

Post-cricoid region

127
Q

Provides all motor and most sensory to hypopharynx

A

Pharyngeal plexus (CN9-10)

128
Q

Laryngeal cartilages

A

Thyroid, cricoid, arytenoid, corniculate

129
Q

Largest laryngeal cartilage

A

Thyroid cartilage

130
Q

Only complete ring in endolarynx, provides structural integrity

A

Cricoid cartilage

131
Q

Paired pyramidal cartilages that sit atop posterior cricoid cartilage

A

Arytenoid cartilage

132
Q

Rests on top of superior process of arytenoid cartilage, within AE folds

A

Corniculate cartilage

133
Q

Extends from tip of epiglottis above to laryngeal ventricle below

A

Supraglottis

134
Q

Leaf-shaped cartilage, larynx lid with free margin and fixed portion

A

Epiglottis

135
Q

Free margin of epiglottis is at

A

Suprahyoid

136
Q

Fixed portion of epiglottis

A

Infrahyoid

137
Q

Fat-filled space between hyoid bone anteriorly and epiglottis posteriorly

A

Pre-epiglottic space

138
Q

Projects from cephalad tip of arytenoid cartilages to inferolateral margin of epiglottis

A

Aryepiglottic fold

139
Q

Mucosal surfaces of laryngeal vestibule of supraglottis

A

False vocal cords

140
Q

Paired fatty regions beneath fals and true vical cords

A

Paraglottic spaces

141
Q

Contains true vocal cords and anterior and posterior commisures

A

Glottis

142
Q

Only soft tissue structures of glottic region, comprised of thyroarytenoid muscle

A

True vocal cord

143
Q

Fibroelastic membrane extends from medial margin of TVC above to cricoid below

A

Conus elasticus

144
Q

Fibrous membrane extends from upper arytenoid and corniculate cartilages to lateral margin epiglottis and medial margin of paraglottic space

A

Quadrangular membrane

145
Q

Formed from primitice buccopharyngeal anlage and has rich lymphatics

A

Supraglottic larynx

146
Q

Forms from tracheobronchial buds and has few lymphatics

A

Glottic and subglottic larynx

147
Q

Pyramidal lobe of thyroid gland can be seen from

A

Isthmus area toward hyoid bone

148
Q

Thyroid glands extends from C5 to

A

T1

149
Q

Arterial supply to thyroid gland

A

Superior thyroid arteries, inferior thyroid arteries, thyroidea ima

150
Q

1st anterior branch of external carotid artery

A

Superior thyroid artery

151
Q

Arises from thyrocervical trunk, a branch of subclavian artery

A

Inferior thyroid artery

152
Q

Runs superficially on anterior border of lateral thyroid lobe, with its proximal course closely associated with superior laryngeal nerve

A

Superior thyroid arteries

153
Q

Most of its branches penetrate posterior aspect of lateral thyroid lobe with close association with recurrent laryngeal nerve

A

Inferior thyroid artery

154
Q

Single vessel originating from aortic arch or innominate artery, which enters the thyroid gland at inferior border of isthmus

A

Thyroidea ima

155
Q

Venous drainage of thyroid gland

A

Superior, middle and inferior thyroid veins

156
Q

Superior and middle thyroid veins drain into

A

Internal jugular vein

157
Q

Inferior thyroid vein drain into

A

Left brachiocephalic vein

158
Q

Lymphatic drainage of thyroid gland

A

Level 6

159
Q

Fascia or thyroid gland

A

Middle later DCF and true capsule

160
Q

First endocrine gland to develop

A

Thyroid gland

161
Q

Thyroid gland originates as proliferation of endodermal epithelial cells on median surface of developing pharyngeal floor termed

A

Foramen cecum

162
Q

Most common location of ectopic thyroid gland

A

Deep to foramen cecum in tongue base= lingual thyroid

163
Q

Posterior visceral space endocrine glands that control calcium metabolism by producing parathormone

A

Parathyroid gland

164
Q

Superior parathyroid gland normal locations

A

Posterior border of middle 1/3 of thyroid (75%)

165
Q

Inferior parathyroid gland normal locations

A

Lateral to lower pole of thyroid gland (50%)

166
Q

Arterial supply of parathyroid gland

A

Superior thyroid artery and inferior thyroid artery

167
Q

Fascia of parathyroid gland

A

Middle DCF

168
Q

Superior parathyroid gland develops from

A

4th branchial pouch

169
Q

Inferior parathyroid gland develops from

A

3rd branchial pouch

170
Q

Most frequent ectopic site of parathyroid gland

A

Just below inferior thyroid pole

171
Q

Trachea extends in midline from inferior larynx at what vertebral body level to what level

A

C6 to T5 (carina)

172
Q

Tracheal length

A

10-13 cm

173
Q

Length of esophagus and extent

A

25 cm

From C6 to T11

174
Q

Broadest of all tracheal cartilage

A

First tracheal cartilage

175
Q

Blood supply of trachea

A

Inferior thyroid artery and vein

176
Q

Upper limit of esophagus

A

Cricopharyngeus muscle

177
Q

Blood supply of esophagus

A

Inferior thyroid artery and vein

178
Q

Sentinel or highest node found at apex of internal jugular chain at angle of mandible

A

Jugulodigastric node

179
Q

Node found at bottom of internal jugular chain in supraclaviculsr fossa

A

“Signal” Virchow node

180
Q

Level IA nodes, found between anterior bellis of digastric muscles

A

Submental

181
Q

Level IB nodes, found around submandibular glands in submandibular space

A

Submandibular nodes

182
Q

Level 2 nodes from posterior belly of digastric muscle to hyoid bone

A

Upper internal jugular chain

183
Q

Contains the jugulodigastric nodal group

A

Level 2A

184
Q

Level 3 nodes from hyoid bone to inferior margin of cricoid

A

Mid IJC nodes

185
Q

Level 4 nodes from inferior cricoid margin to clavicle

A

Lower internal jugular chain

186
Q

Nodes of posterior cervical space or spinal accessory chain

A

Level 5

187
Q

Level 5A nodes are from skull base to

A

Bottom of cricoid cartilage

188
Q

Nodes of visceral space

A

Level 6

189
Q

Superior mediastinal nodes

A

Level 7

190
Q

Parotid nodal group drain into

A

Level 2

191
Q

Retropharyngeal nodal group recieve drainage from

A

Posterior pharynx

192
Q

Final commin pathway for all lymphatics of upper aerodigestive tract and neck

A

Internal jugular chains

Head and neck radiology (15 decks)

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