The Neck Flashcards

1
Q

Submandibular/Digastric Triangle Borders

A

Anterior Digastric
Posterior Digastric
Inferior border of mandible

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2
Q

Submandibular/Digastric Triangle Floor

A

Mylohyoid
Hyoglossus
Middle Constrictor

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3
Q

Submandibular/Digastric Triangle Roof

A

Skin
Superficial fascia with platysma
Deep cervical fascia

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4
Q

Submandibular/Digastric Triangle

Arteries

A

Facial Artery
Submental Artery
Lingual Artery (small portion)

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5
Q

Submandibular/Digastric Triangle

Veins

A

Facial Vein
Submental Vein
Lingual Vein (small portion)

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6
Q

Submandibular/Digastric Triangle

Nerves

A

Mylohyoid n.

CN XII Hypoglossal

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7
Q

Submandibular/Digastric Triangle

Structures

A

***Submandibular salivary gland (occupies most of triangle)
Submandibular lymph nodes
Inferior portion of Parotid salivary gland

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8
Q
Submental Triangle (there's only 1)
Borders
A

Left anterior digastric
Right anterior digastric
Body of Hyoid bone

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9
Q

Submental Triangle

Floor

A

Mylohyoid

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10
Q

Submental Triangle

Roof

A

Skin
Superficial fascia w/ Platysma
Superficial/Investing layer of deep fascia

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11
Q

Submental Triangle

Major contents

A

no MAJOR contents

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12
Q

Submental Triangle

Veins

A
Anterior jugular
  (has poor drainage, little vasculature, infections here do not heal well)
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13
Q

Submental Triangle

Structures

A

Submental lymph nodes

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14
Q

Muscular Triangle

Borders

A

Anterior border of Sternocleidomastoid
Superior belly of omohyoid muscle
Midline

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15
Q

Muscular Triangle

Floor

A

Sternohyoid

Sternothyroid

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16
Q

Muscular Triangle

Roof

A

Skin
Superficial fascia w/ Platysma
Superficial/Investing layer of deep fascia

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17
Q

Muscular Triangle

Arteries

A

Superior Thyroid artery

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18
Q

What’s in the carotid space?

A
IC 10 CC's in the IJ (I see 10 cc's in the IV)
Internal carotid artery (superior)
Common carotid artery (inferior)
CN 10 Vagus
Internal Jugular vein
Cervical lymph nodes
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19
Q

Define Fascial Planes

A

Bands of connective tissue (dense irregular) that surrounds and protects structures.
The solid, colored lines in the cross-section

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20
Q

Define Tissue Spaces

A

Spaces & Pathways that allow infection to spread (from head and neck down to your heart)

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21
Q

The most superficial muscle on the back of the neck?

A

Trapezius

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22
Q

When you cut past the skin layer, what’s the first thing you’ll see?

A

Superficial fascia (aka subcutaneous tissue)
Surrounds our entire body
If being asked about fascia etc, it’s called superficial fascia.
If being asked about skin stuff, it’s called subcutaneous tissue.

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23
Q

What does superficial fascia contain?

A

Fat & the
Platysma is embedded in this layer
Contains sensory branches to the neck

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24
Q

Deep to the Superficial fascia

A

The layers of Deep fascia which also surround the whole body….Deep to this are the actual muscles (other than the platysma) and organs.

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25
Is there any deep fascia in the face?
No deep fascia in face | This allows for free spread of fluid and therefore infections around there
26
Purpose of deep fascia?
Protects muscles and organs Reduces friction of muscle movements Passageways for nerves and vessels Provides attachment for some muscles
27
BD*Which 2 muscles are surrounded by the investing/superficial layer of deep cervical fascia?
SCM | Trapezius
28
Layers of Deep Cervical Fascia & what kind of fascia does each contain?
``` Superficial/Investing layer Middle layer (pretracheal fascia: muscular & visceral, buccopharyngeal fascia) Deep layer (prevertebral fascia, alar fascia) Carotid sheath (=superficial,middle,deep combined) ```
29
Superficial/Investing Layer
Surrounds entire neck Encloses SCM & Trapezius *not so important...Surrounds: Clavicle, Manubrium, Acromion, Zygomatic Arch to Scapular Spine, Mastoid Process, Occipital Bone
30
in the Middle Layer the Muscular Pretracheal Fascia encloses what?
the 4 infrahyoid muscles: omohyoid sternohyoid, sternothyroid, thyrohyoid
31
in the Middle Layer the Visceral Pretracheal Fascia surrounds....like a horseshoe...
Pharynx Larynx Thyroid + Trachea + Esophagus
32
in the Middle Layer the Buccopharyngeal Fascia lies where?
in the back of the esophagus where you can see it
33
in the Deep fascia's deep layer, the Prevertebral Fascia Surrounds what? Envelopes what? *And what does it have to do with innervation?
Cervical vertebral column Deep neck muscles, including prevertebral scalenes & deep back muscles *CN XI travels along it to the SCM and Trapezius
34
in the Deep Cervical Fascia, the Carotid Sheath is made of
Contributions of the superficial/investing, middle, and deep layers of fascia
35
the carotid sheath travels from where to where?
aortic arch up to the base of the skull
36
what is the space called that's within the carotid sheath? | and what
carotid space
37
what is embedded in the wall of the carotid sheath?
ansa cervicalis. It is not "inside the sheath" nor in the "carotid space" It IS embedded inside "the wall" of the sheath
38
Buccopharyngeal fascia will be asked on bds in 1. it's relationship to the oropharynx 2. in regards to the spaces infections spread through....
1. you'll see it when your patient opens his/her mouth...it's the back of th oropharynx 2. it serves as a border to the spaces infections can spread through....right behind it is the danger space
39
What fascia lies btwn the buccopharyngeal & prevertebral fascias, and why is this fascia important?
the alar fascia. | It divides 2 spaces where infections spread...which 2?
40
What are the 3 Fascial Spaces
Spaces in between the individual fascial layers where disease can spread. *Different from the Cervical Triangles*
41
What are the Fascial Spaces that will be on the boards
Retropharyngeal space Danger space Carotid space
42
Boundaries of the Retropharyngeal space
Located btwn buccopharyngeal fascia and alar fascia Lateral boundaries are the carotid sheaths Extends from Clivus down to T2
43
Retropharyngeal space's inferior portion is sometimes also called what?
Retrovisceral space
44
Why is Retropharyngeal space so significant re infections? | What is the significant infection here called?
An absess tooth infection can travel down it, down into our entire neck. It's called a A RETRO-PHARYNGEAL ABSESS
45
Describe the danger space
Btwn Alar Fascia and Pre-vertebral Fascia From clivus to diaphragm *An infection can travel from Pharynx down to the mediastinum where the heart is.
46
When an infection builds up in the fascial spaces it will push what?
it will push tongue forward and upward*** | Can also lead to edema of vocal cords and airway obstruction
47
How many cervical triangles are there and what are their names
3: Anterior and Posterior and Suboccipital triangles (2 of each Divided into 11 divisions (5 paired, 1 single) Posterior: Occipital & Subclavian/Supraclavicular/Omoclavicular Anterior: Submandibular, Submental (single) Carotid, Muscular
48
Anterior Triangle borders
Anterior border of SCM Inferior border of mandible Midline of the neck
49
T/F: The roof is the same for all the cervical triangles
True!
50
Muscular Triangle | Veins
Inferior thyroid v. | Anterior jugular v.
51
*Muscular Triangle | Nerves
*Ansa cervicalis
52
Muscular Triangle | (Major) Structures
Pharynx, Larynx, Trachea (top), Esophagus (top) Thyroid, Parathyroid Sternothyroid, Sternohyoid, Thyrohyoid
53
Carotid Triangle | Borders
Ant border of SCM Post Digastric Superior border of omohyoid m.
54
Carotid Triangle | Floor
Hyoglossus Thyrohyoid Middle constrictor (of pharynx) Inferior constrictor (of pharynx)
55
Carotid Triangle | Roof
Skin Superficial fascia w/ Platysma Superficial/Investing layer of deep fascia
56
Carotid Triangle | Arteries
``` Common Carotid a. w/ Carotid Body Internal Carotid a. w/ Carotid Sinus External Carotid a. w/ its following branches: Superior thyroid a. Lingual a. Facial a. Ascending pharyngeal a Occipital a. ```
57
Carotid Triangle | Veins
``` Internal Jugular v. w/ its following branches: Common facial v. Lingual v. Superior thyroid v. Middle thyroid v. ```
58
Carotid Triangle | Nerves
``` Vagus CN X External laryngeal n. Internal laryngeal n. Accessory CN XI Hypoglossal CN XII Ansa Cervicalis' superior limb Superior cervical ganglion of sympathetic trunk ```
59
Carotid Triangle | Structures
Carotid sheath
60
Which triangle has 3 different names and what are they
Supraclavicular Omoclavicular Subclavian
61
Posterior Triangle | Borders
Posterior border of SCM Anterior border of Trapezius Clavicle
62
Posterior Triangle | Roof
Skin Superficial fascia w/ Platysma Superficial/Investing layer of deep fascia
63
Posterior Triangle | Floor
``` Splenius capitis Semispinalis capitis Scalenes Levator scapulae Omohyoid Prevertebral fascia SSSLOP ```
64
What divides the Posterior Triangle into 2 smaller triangles, and what are those 2 sub-triangles?
Inferior belly of the Omohyoid muscle divides it up. 1. Occipital Triangle (on top) 2. Omoclavicular/Supraclavicular/Subclavian Triangle (on bottom)
65
Occipital Triangle | Borders
1. Superior to the omohyoid's inferior belly 2. Posterior to SCM 3. Anterior to Trapezius m.
66
Occipital Triangle | Arteries
Thyrocervical trunk and a branch off it: Transverse cervical n.
67
Occipital Triangle | Nerves
1. Cervical Plexus: All portions of cervical plexus have a component there 2. Accessory CN XI, which travels along fascia to innrvte the SCM and Trapezius
68
Subclavian/Omoclavicular/Supraclavicular triangle | Borders
Inferior to the Omohyoid's inferior belly Posterior to the SCM Superior to the Clavicle
69
Subclavian/Omoclavicular/Supraclavicular triangle | Arteries
Subclavian a. | Thyrocervical trunk & it's branch: Suprascapular a.
70
Subclavian/Omoclavicular/Supraclavicular triangle | Veins
External jugular
71
Subclavian/Omoclavicular/Supraclavicular triangle | *Nerves
Bd *Brachial plexus
72
Subclavian/Omoclavicular/Supraclavicular triangle | Roof
Skin Superficial fascia w/ Platysma Superficial/Investing layer of deep fascia
73
Suboccipital triangle | Borders
Obliquus capitis superior Obliquus capitis inferior Rectus capitis posterior major
74
Suboccipital triangle | Roof
Skin Superficial fascia w/ Platysma Superficial/Investing layer of deep fascia (All roofs are Dense Connective Tissue, fyi :)
75
Suboccipital triangle | Floor
Posterior arch of atlas (C1)
76
Suboccipital triangle | Artery
Vertebral
77
Suboccipital triangle | Vein
Vertebral
78
Suboccipital triangle | Nerves
Greater occipital | Suboccipital
79
Suboccipital triangle | Muscles
Obliquus capitis superior Obliquus capitis inferior Rectus capitis posterior major Rectus capitis posterior minor
80
In what triangle are the visceral structures of the neck found?
Muscular triangle (of the anterior triangle)
81
List the visceral structures of the neck
``` Pharynx Larynx Trachea + Esophagus Thyroid Parathyroid ```
82
How many parathyroid glands are there and where are they located? What do they make?
Several (usually 4) They're embedded in the back of the Thyroid gland. They make parathyroid hormone
83
What does the thyroid make?
``` Calcitonin T3 (Triiodothyronine) T4 (Tetraiodothyronine or Thyroxine) ```
84
Name the lobes of the thyroid
Left and Right lobes | Sometimes a Pyramidal lobe
85
What connects the left and right lobes, | and where is it in relation to the trachea
the Isthmus of the thyroid | It crosses anterior to the 2nd and 3rd tracheal rings, lies right up against them
86
Is the Thyroid highly vascular or not?
Yes highly vascular | which is why cancer grows well in that area
87
Where is the Thyroid located relative to the vertebrae
Btwn C6 and T1
88
What vessels bring blood to the Thyroid? | Which ones take blood away from Thyroid?
To: Superior Thyroid a. Inferior Thyroid a. From: Superior thyroid v. Middle thyroid v. Inferior thyroid v. So thyroid gland is highly vascular!
89
Where's the "root of the neck"? And what does it consist of? What is the Superior thoracic aperture? What are this aperture's borders and what does it contain sometimes?
``` where neck attaches to thorax It's where the Superior Thoracic Aperture is, this is the top opening of the thoracic cage, a circle. It's bounded by: 1st rib and cartilage, L and Right 1st thoracic vertebrae Manubrium ``` During full inhalation it contains the Lung's apex which inflates up into it
90
List contents of the "root of the neck"
``` Just think, what arteries, veins, nerves, and other structures are located in both the thoracic cage and head/neck Rely on your basic anatomical knowledge. Here's the list anywy: Arteries=== Aortic Arch Common carotid Subclavian Vertebral Transverse cervical Veins=== Internal jugular Subclavian Brachiocephalic Inferior thyroid Vertebral Nerves=== Vagus Recurrent laryngeal Phrenic Sympathetic trunk Brachial plexus Structures=== Trachea Esophagus Thoracic duct Right lymphatic duct ```
91
List the layers of the Scalp | (superficial to deep)
S=kin C=onnective tissue Dense CT Distributes neurovascular supply to scalp A=poneurosis (a tough layer of dense fibrous tissue) Consists of Occipitalis, Galea Aponeurotica, & Frontalis L=oose CT P=eriosteum
92
What does the CT of the scalp do?
distributes neurovascular supply to the scalp
93
*What blood sources come up and feed the scalp | Why is this a beneficial arrangement?
*Internal and external carotid arteries both feed the scalp. Internal primarily feeds the brain, external primarily does everything else....but the scalp is one place where they actually both work together. Anastomosis occurs here (they're interconnected), so if one of these blood sources gets blocked another source can still supply the same tissue/scalp. A built-in back up plan.
94
Cutaneous innervation of the scalp | Which nerves do this?
``` CN V1 CN V2 CN V3 and Cervical plexus branches, C2 n C3 The scalp is a great meeting place for arteries, veins, and nerves. ```
95
Why is danger space more dangerous than the neighboring retropharyngeal space?
danger space goes farther down, all the way to the diaphragm