The Neck Flashcards
Fascial planes def
Band of connective tissue that surrounds structures
Superficial Investing Layer
Attaches and passes
Encloses
Surrounds
- Attaches posteriorly along midline and passes anteriorly to surround entire neck
- Encloses
- Trapezius, SCM, Submandibular gland, parotid gland
- Surrounds
- Occipital, mastoid process, Zygomatic arch to scapular spine, Acromion, clavicle, manubrium
Muscular Pretracheal Fascia
Encloses
Encloses Infrahyoid muscles
Visceral Pretracheal Fascia
Surrounds 5
Continous and blends with
- Surrounds
- Thyroid gland
- Larynx
- Trachea
- Pharynx
- Esophagus
- Continous with the buccopharyyngeal fascia
- Blends
- Laterally with carotid sheaths
- Inferiorly with fibrous pericardium
Prevertebral Fascia
Surrounds 1
Envelopes 3
What travels along it
- Surrounds cervical vertebral column
- Envelopes Deep neck muscles including scalenes, and deep back muscles
- CN 11 travels along the fascial layer to the trapezius and SCM
Carotid Sheath
What makes it and the space it spans
- Made from contributions of superficial, middle, and deep layers of DCF
- Blends with investing, pretracheal and prevertebral fascia
- Travels from base of skull to aortic arch
- Inner space- Carotid space
Carotid sheath Contents
6
- Common carotid artery (inferior sheath)
- Internal carotid artery (superior sheath)
- Internal jugular vein
- CN 10, Vagus
- Cervical lymph nodes
- Ansa cervicalis
- Embeded in wall of sheath
What are the 3 groups of Fascial spaces
- Suprahyoid fascial spaces
- Infrahyoid fascial spaces
- Fascial spaces that span the neck
Suprahyoid Fascial spaces
3 grps and subgroups
- Submandibular Space
- Sublingual space
- Submaxillary space
- Lateral (para) pharyngeal space
- Masticator space
Sublingual space
Contains 5
- Contains
- CN 12
- Lingual nerve
- Subingual gland
- Submandibular deep
- Submandibular duct
Submaxillary space
contains 2 and clinical note
- Contains
- Submandibular gland
- Anterior digastric muscle
- Infections of mandibular molars spread though here
Lateral (para) pharyngeal space
Continous with
SUsceptible to
- Continous with submandibular spaces and retromandibular spaces
- Susceptible to infections from teeth, jaw, and pharynx
Masticator Space
Contains 4
- Contains
- Masseter
- Lateral pterygoid
- Medial pterygoid
- Insertion for temporalis
What fascial spaces span the neck
Retropharyngeal space
Danger Space
Carotid Space
Retropharyngeal space
Located
Extends
- Located between buccopharyngeal and alar fascia
- Carotid sheath is lateral boundary
- Extends from clivus to T2
- Communicates with mediastinum
Retropharyngeal space
Contains 2
Areolar tissue
Retropharyngeal lymph nodes
Danger space
Location
Extends
Contains
Clinical notes
Located between alar fascia and prevertebral fascia
Extends from clivus to diaphragm
Contains life sustaining organs
Spread infections from pharynx to mediastinum
Anterior triangles
Submandibular triangle
Submental triangle
Muscular triangle
Carotid triangle
Posterior triangles
Occipital triangle
Subclavian, supraclavicular, or omoclavicular triangle
Anterior triangle borders
Anterior SCM
Inferior border of Mandible
Midline of neck
Submandibular Traingle
Borders
Inferior border of mandible
Anterior Digastric
Posterior digastric
Submandibular Triangle
Contents
- Arteries
- Facial a
- Submental a
- Lingual a
- Veins
- Facial v
- Submental v
- Lingual v.
- Nerves
- Mylohyoid nerve
- CN 12 Hypoglossal nerve
- Structures
- Submandibular gland
- Submandibular lymph nodes
- Inferior part of parotid
SUbmental Triangle
Borders and Contents
Left and right anterior digastric, inferior border of mand
No major contents
Muscular Triangle Borders
Anterior SCM
Midline
Superior Omohyoid
Muscular Triangle Contents
- Arteries
- Superior thyroid a.
- Veins
- Inferior thyroid vein
- Anterior jugular vein
- Muscles
- Sternohyoid, Sternothyroid, Thyrohyoid
- Thyroid, parathyroid
- Pharynx, Larynx, Trachea, Esophagus
Carotid Triangle
Borders
Posterior digastric
Superior Omohyoid
Anterior SCM
Carotid triangle
Contents
- Arteries
- Common carotid artery
- External carotid artery
- Superior thyroid, Ascending Pharyngeal, Lingual, Facial, Occipital
- Veins:
- Internal jugular vein
- Superior thyroid, middle thyroid, Lingual, common facial
- Internal jugular vein
- Nerves
- CN X, CN XI, Ansa cervicalis, superior cervical ganglion
- Carotid sheath
Posterior Triangle
Borders
Anterior trapezius
Posterior SCM
Occipital triangle
Location
Superior to inferior omohyoid
Occipital triangle
Contents
- Arteries
- Thyrocervical trunk
- Tranverse cervical
- Thyrocervical trunk
- Nerves
- Cervical plexus
- Accessory CN XI
SUbclavian triangle
Location
Inferior to inferior omohyoid
Subclavian triangle
Contents
- Arteries
- Subclavian artery
- Thyrocervical trunk
- Suprascapular artery
- External Jugular vein
- Brachial plexus
Suboccipital triangle
Borders
Suboccipital muscles
Suboccipital triangle
Contents
- Vertebral artery
- Vertebral vein
- Greater occipital nerve
- Suboccipital nerve
- Obliquus capitis superior
- Obliquus capitis inferior
- Rectus capitis posterior major
- Rectus capitis posterior minor
Visceral structures of the neck
6
Pharynx
Larynx
Traches
Esophagus
Thyroid
Parathyroid
Where is the thyroid located
Anterior to the upper tracheal rings
Inferior to larynx
Between C6-T1
What type of gland is the thyroid
What does it secrete
Characteristics
Largest pure endocrine gland
Secretes T3, T4 or thyroxine, and calcitonin
Highly vascular
2 lobes
Isthmus- crosses 2nd and 3rd tracheal rings
Thyrois arterial supply
2
Superior thyroid a. (ECA)
Inferior thyroid (Thyrocervical trunk from subclavian)
Thyroid venous drainage
Superior and middle thyroid veins drain into IJV
Inferior thyroid vein drains into brachiocephalic vein
Thyroid Innervation
Glandular branches of cervical ganglia of sympathetic trunk
Parathyroid gland
Describe
Encased in the posterior surface of thyroid
Small pea sized
Parathyroid gland
Arterial and venous drainage
Superior thyroid artery (ECA)
Inferior thyroid artery (thyrocervical trunk )
Superior middle and inferior thyroid veins
Parathyroid innervation
Glandular branches of cervical ganglia of sympathetic trunk
Superior thoracic aperture or thoracic outlet
Bounded by
Manubrium
1st rib and cartilage
1st thoracic vertebrae
Contains apex of lung
Root of neck contents
4
Subclavian artery
Subclavian vein
Phrenic nerve
Brachial plexus
Thoracic Outlet Syndrome
What is it
Causes
Symptoms
- Compression of trunks of brachial plexus and subclavian artery
- Causes
- Tumors of neck
- Misplaced cervical rib
- Hypertrophy of scalene muscles
- Symptoms
- Numbness/pain medial arm/hand
- Weakness of hand muscles
- Decreased blood flow to upper limb, decreased radial pulse
- May affect sympathetic trunk
SCALP Layers
- Skin
- Connective Tissue
- Dense CT
- Distributes neurovascular supply to scalp
- Aponeurosis
- Occipitalis, galea aponeurotica and frontalis
- Loose CT
- Periosteum
Arterial supply to scalp
- ICA
- Opthalmic artery
- Supratrochlear
- Supraorbital
- Opthalmic artery
- ECA
- Superficial temporal
- Posterior auricular
- Occipital
Cutaneous Innervation to Scalp
- V1
- Supratrochlear
- Supraorbital
- V2
- Zygomaticotemporal
- V3
- Auriculotemporal
- C2
- Lesser occipital
- Greater occipital
- C3
- Least occipital
