The Neck

Question 1

What is the superior and inferior limit of the neck?

Answer 1

• Superior: Mandible and base of skull

- Inferior: thoracic inlet

Question 2

Anatomically, the neck is divided into anterior and posterior portions of the neck. What is it divided by?

Answer 2

The sternocleidomastoid muscle

Question 3

What are the proximal and distal attachments of the sternocleidomastoid muscle?

Answer 3

• Proximal attachment: mastoid process

- Distal attachment: sternum and clavicle

Question 4

What does the sternocleidomastoid do when there is only one working?

Answer 4

Rotates head and moves slightly upwards

Question 5

What does the sternocleidomastoid do when both of them are working?

Answer 5

Head is bought forward and down

Question 6

What are the boundaries of the anterior triangle of the neck?

Answer 6

1. Sternocleidomastoid muscle
2. The midline
3. The lower border of the mandible

Question 7

What are the boundaries of the posterior triangle of the neck?

Answer 7

1. Sternocleidomastoid
2. Trapezius muscle
3. Middle third of the clavicle

Question 8

What can the contents of the anterior triangle of the neck be divided into?

Answer 8

1. Muscles
2. Skeletal elements and viscera
3. Glands
4. Nerves
5. Vessels

Question 9

What are the muscles found in the anterior triangle?

Answer 9

• Mylohyoid
• Anterior belly of digastric
• Infrahyoid muscles (Sternohyoid, sternothyroid, thyrohyoid, omohyoid)

Question 10

What are the skeletal elements of the anterior triangle of the neck?

Answer 10

• Thyroid cartilage: largest of the laryngeal cartilages
• Cricoid cartilage: below the thyroid cartilage, just above the trachea
• Hyoid bone: single bone not joined into any other bone
• Trachea

Question 11

What are the glands found in the anterior triangle of the neck?

Answer 11

• Thyroid gland
• Parathyroid glands
• Submandibular glands

Question 12

How would you examine the thyroid gland of a patient?

Answer 12

Offer the patient a drink of water and ask them to swallow for you - feel the neck when the patient swallows and should feel if there is any swelling round the gland

Question 13

What type of gland is the thyroid gland?

Answer 13

Endocrine

Question 14

What is the thyroid gland enclosed by?

Answer 14

Pre-tracheal fascia (band of fibrous tissue)

Question 15

What arteries supply the thyroid gland?

Answer 15

• Superior (external carotid) and inferior (thyrocervical trunk) arteries

Question 16

What is an isthmus?

Answer 16

Small bit of tissue between 2 larger bits of tissue

Question 17

What is the levator gandulae thyroidae?

Answer 17

Fibrous structure that passes from thyrohyoid muscle to the isthmus of the thyroid gland

Question 18

What is the function of the parathyroid hormone?

Answer 18

Helps increase blood calcium levels - if they are not at an appropriate level they can affect muscle function

Question 19

What are the 2 set of parathyroid glands?

Answer 19

Superior and inferior sets

Question 20

What % of the population has more than 4 parathyroid glands?

Answer 20

5% of the population

Question 21

Which set of parathyroid glands are more constant in their position?

Answer 21

The superior set

Question 22

What can happen if parathyroid glands are removed from the body?

Answer 22

Tetany - abnormal muscle contractions as there is not a regulated calcium load

Question 23

What nerves innervate the anterior triangle of the neck?

Answer 23

• Vagus
• Phrenic
• Hypoglossal

Question 24

What does the phrenic nerve innervate?

Answer 24

The diaphragm

Question 25

The diaphragm used to be surgically divided as a treatment for T.B. Why is this not done now?

Answer 25

If you cut the phrenic nerve the diaphragm cannot work and the lung will die off

Question 26

What blood vessels supply the anterior triangle of the neck?

Answer 26

- Common carotid artery | - Jugular veins

Question 27

What can the contents of the posterior triangle of the neck be divided into?

Answer 27

1. Nerves 2. Muscles 3. Vessels 4. Lymph nodes

Question 28

What nerves innervate the posterior triangle of the neck?

Answer 28

- Accessory nerve - Parts of the brachial plexus (supplies all of the upper limbs) - Cutaneous cervical nerves (supply sensation on the skin)

Question 29

What muscles in the neck does the accessory nerve supply?

Answer 29

- Purely motor nerve | - Supplies sternocleidomastoid and trapezius

Question 30

What is the clinical test to check that CNXI is working?

Answer 30

As the patient to look to one side and push against your hand

Question 31

What does the brachial plexus in the posterior triangle of the neck consist of?

Answer 31

- Starts at C5 and ends at C8 - It has: * Roots * Trunks * Divisions (anterior/posterior) * Cords * Terminal branches

Question 32

What do lymph nodes look like?

Answer 32

Small, oval to bean shaped structures

Question 33

What are the functions of lymph nodes?

Answer 33

- Filter lymph | - Offer defence against the spread of infection

Question 34

Where are the superficial lymph nodes found in the posterior triangle of the neck?

Answer 34

- Just on front of ear - Just over cheek - Some down to lower aspect and many more

Question 35

Where are the deep lymph nodes found in the posterior triangle of the neck?

Answer 35

Ones where patients tend to say their glands are up