Surface anatomy and functional testing of the neck Flashcards
Locate the carotid pulse.
Use two fingers to palpate the carotid pulse just anterior to the sternocleidomastoid muscle in the neck.
Demonstrate the technique for palpation of the cervical lymph nodes.
Stand behind the patient and use a bilateral palpation technique, with the patient’s chin slightly elevated. Gently roll the fingers over the lymph nodes, noting any enlargement, tenderness, lack of mobility, hardness or assymetry. Enlargement or lymphadenopathy may indicate an infectious or inflammatory process, or malignant neoplasm.
Palpate submental, submandibular, cervical, supraclavicular, occipital, postauricular and preauricular nodes.
Locate the hyoid bone.
Body of hyoid is at vertebral level C3.
Locate the thyroid cartilage.
Upper border of thyroid cartilage is at vertebral level C4.
Label the following diagram:
Locate the cricoid cartilage.
Cricoid cartilage is at vertebral level C6.
Locate the spinous process of C7.
Ask patient to tuck their chin to their chest (flex neck) and expose the nape of the neck. Most prominent bump is spinous process of C7.
What are the boundaries of the anterior triangle of the neck?
Anterior border of sternocleidomastoid muscle.
Inferior border of mandible.
Anterior midline of neck.
What is contained within the anterior triangle of the neck?
Mainly muscles:
- Platysma
- Mylohyoid
- Digastric
- Infrahyoid (strap) muscles
Carotid arteries
Internal jugular vein
What are the borders of the posterior triangle of the neck?
Posterior border of sternocleidomastoid muscle
Superior border of medial third of clavicle
Lateral border of trapezius muscle
What is contained within the posterior triangle of the neck?
Mainly blood vessels and nerves:
- External jugular vein
- Subclavian artery
- Subclavian vein
- Trunks of the brachial plexus
- Vagus nerve
- Phrenic nerve
- Spinal accessory nerve
What are the surface landmarks for insertion of a central line into the internal jugular vein?
Lies between the 2 heads of the sternocleidomastoid, lateral to carotid, superior to clavicle.
Anterior triangle of neck.
How is the function of the accessory nerve (CNXI) tested?
Ask patient to turn their head to one side- contracts sternocleidomastoid on opposite side.
Ask patient to shrug their shoulders- contracts trapezius muscle.
What are the surface landmarks of the external jugular vein?
A point on the sternocleidomastoid at the level of the angle of the mandible.
Midpoint of clavicle.
Posterior triangle of neck.
