Surface anatomy of the neck

Question 1

Name the columns of the neck with their fascia

Answer 1

1 - Neuro-muscular skeletal column with prevertebral fascia.
2- Visceral column with pretracheal and buccopharyngeal fascia.
3 - Carotid neurovascular bundle with carotid sheath

Question 2

Name the fascial layers

Answer 2

1. Investing/superficial fascia.
2. Pretracheal fascia.
3. Carotid sheath.
4. Prevertebral fascia

Question 3

What potential space allows for the movement of pharynx, larynx, trachea and oesophagus? Where does it extend too?

Answer 3

Retropharyngeal space, this permits movement for swallowing. It extends from the base of the skull to the diaphragm via the mediastinum.

Question 4

What fascia further divides the retropharyngeal space and what is this space called and its clinical significance?

Answer 4

The alar fascia further subdivides the space and forms the Danger space which is a major pathway for spread of infection

Question 5

What is the clinical significance of dental abscesses?

Answer 5

It can spread mediastinum

Question 6

Name the boarders of the anterior triangle?

Answer 6

Superiorly - inferior boarder of mandible,
Laterally - anterior boarder of sternocleidomastoid,
Medially - Sagittal line down the midline of the neck

Question 7

Name the boarders of the Posterior triangle

Answer 7

Anterior - posterior boarder of sternocleidomastoid,
Posterior - anterior boarder of trapezius muscle,
Inferior - Middle 1/3 of clavicle

Question 8

What is the clinical relevance of the triangles of the neck?

Answer 8

It can help give clues for the reasons of neck lumps, along with other signs like; Tenderness, heat, size, pulsatile, solitary/multiple and is they move when swallowing or sticking out tounge.

Question 9

Where is the mastoid landmark?

Answer 9

It is the boney prominence directly behind the ear.

Question 10

Where can you palpate the position of the transverse process of Atlas?

Answer 10

It is midway between the mastoid and angel of the mandible

Question 11

Where is the Hyoid bone?

Answer 11

Superior to thyroid cartilage, it is suspended in the muscles of the neck.

Question 12

What does the thyroid cartilage articulate with?

Answer 12

The cricoid cartilage, this allows for rotation and gliding of thyroid cartilage and change in length of vocal cords.

Question 13

Anteriorly, what is the brachiocephalic trunk covered by?

Answer 13

Sternohyoid and sternothryroid muscles.

Question 14

Name the three parts of the subclavian artery and its branches

Answer 14

1st part has 3 branches (vertebral artery, thyrocervical trunk and internal thoracic artery).
2nd part has 1 branch (costocervical trunk) and the 3rd part has 1 branch (dorsal scapular artery)

Question 15

Where does the common carotid artery bifurcate and what does it turn into?

Answer 15

Bifurcation at the level of the superior thyroid cartilage and turns into the internal and external carotid artery.

Question 16

Where is the location of the carotid body and sinus and what is its nerve innervation

Answer 16

Found at bifurcation of common carotid artery. Innervated by afferent glossopharyngeal and its branch carotid sinus nerve and efferent vagus nerve

Question 17

What are the functions of the carotid sinus and carotid body?

Answer 17

Sinus - Has baroreceptors which react to changes in arterial blood pressure. Carotid body has chemoreceptors that monitor the partial pressure of CO2

Question 18

What does the internal carotid artery supply?

Answer 18

Intercrainal structures

Question 19

What does the carotid sheath surround?

Answer 19

Internal jugular vein, internal carotid artery and vagus nerve

Question 20

What are the branches of the external carotid artery

Answer 20

(Some Anatomist Like Freaking Out Poor Medical Students)

• Superior Thyroid a.
• Ascending pharyngeal a.
• Lingual a.
• Facial a.
• Occipital a.
• Posterior auricular a.
• Maxillary a.
• Superficial temporal a.

Question 21

What are the facial veins?

Answer 21

Superficial and deep veins

Question 22

What are the cranial veins?

Answer 22

Cerebral veins, Dural venous sinuses, Diplopic veins and Emissary veins

Question 23

What are the cervical veins?

Answer 23

External jugular veins, anterior jugular veins, vertebral veins

Question 24

What are the cranial veins drained by?

Answer 24

Dural venous sinus which is made up of Superior sagittal sinus, inferior sagittal sinus and sinus rectus, and the sigmoid sinus which becomes the IJV.

Question 25

What is the most common vein use for Central Venous Catheterisation? and what are the complications of CVC?

Answer 25

Most commonly used is IJV. Some of the complications are pneumothorax, puncture the subclavian artery and nerve injury

Question 26

What is the EJV route?

Answer 26

Crosses SCM, deep to platysma and enters the anterio-inferior part of posterior triangle. Finally it terminates as subclavian vein

Question 27

Describe features of the anterior jugular vein

Answer 27

It drains into external jugular or subclavian veins. Both anterior jugular veins join at the jugular venous arch.

Question 28

What is Erb’s point, the nerves here and the clinical relevance

Answer 28

This is the point at which the Lesser occipital nerve, the Great auricular nerve, transverse cervical nerve and supraclavicular nerve become superficial. Local anaesthetics can be injected here to numb a large area.