Surface anatomy and functional testing of the neck Flashcards
Locate the carotid pulse.
Use 2 fingers to palpate the carotid pulse
between lateral side of thyroid carilage + anterior border of sternocleidomastoid muscle
Demonstrate the technique for palpation of the cervical lymph nodes.
Stand behind patient + use a bilateral palpation, with patient’s chin slightly elevated.
Roll fingers over 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 + preauricular nodes.
What is shown in the diagram? What vertebral level is this at?
Body of hyoid
Vertebral level C3.
What is shown by the arrow? What vertebral level is this at?
Thyroid cartilage
Upper border of thyroid cartilage is at vertebral level C4.
Locate the spinous process of C7.
Ask patient to tuck chin to their chest (flex neck) + 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?
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
Medial 3rd of clavicle
Anterior border of trapezius muscle
What is contained within the posterior triangle of the neck?
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?
Insertion is within the triangle formed by the lower 2 heads of sternocleidomastoid + the clavicle
Palpate carotid artery, ensure needle enters lateral to it
Aim towards ipsilateral nipple
How is the function of the accessory nerve (CNXI) tested?
Ask patient to look over opposite shoulder- contracts sternocleidomastoid on opposite side.
Ask patient to shrug shoulders- contracts upper fibres of 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 to Midpoint of clavicle.
(Posterior triangle of neck)
What is shown by the arrow? What vertebral level is this found at?
Cricoid cartilage
At vertebral level C6
How would you locate the lateral masses of the atlas?
Palpate from behind
Lateral mass of atlas is between mastoid process + ramus of mandible
What are the surface landmarks of the internal jugular vein?
A point on the sternocleidomastoid at the level of the angle of the mandible to sternoclavicular joint/ sternal end of clavicle
