The Neck Flashcards
What is the superior and inferior limit of the neck?
- Superior: Mandible and base of skull
- Inferior: thoracic inlet
Anatomically, the neck is divided into anterior and posterior portions of the neck. What is it divided by?
The sternocleidomastoid muscle
What are the proximal and distal attachments of the sternocleidomastoid muscle?
- Proximal attachment: mastoid process
- Distal attachment: sternum and clavicle
What does the sternocleidomastoid do when there is only one working?
Rotates head and moves slightly upwards
What does the sternocleidomastoid do when both of them are working?
Head is bought forward and down
What are the boundaries of the anterior triangle of the neck?
- Sternocleidomastoid muscle
- The midline
- The lower border of the mandible
What are the boundaries of the posterior triangle of the neck?
- Sternocleidomastoid
- Trapezius muscle
- Middle third of the clavicle
What can the contents of the anterior triangle of the neck be divided into?
- Muscles
- Skeletal elements and viscera
- Glands
- Nerves
- Vessels
What are the muscles found in the anterior triangle?
- Mylohyoid
- Anterior belly of digastric
- Infrahyoid muscles (Sternohyoid, sternothyroid, thyrohyoid, omohyoid)
What are the skeletal elements of the anterior triangle of the neck?
- 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
What are the glands found in the anterior triangle of the neck?
- Thyroid gland
- Parathyroid glands
- Submandibular glands
How would you examine the thyroid gland of a patient?
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
What type of gland is the thyroid gland?
Endocrine
What is the thyroid gland enclosed by?
Pre-tracheal fascia (band of fibrous tissue)
What arteries supply the thyroid gland?
- Superior (external carotid) and inferior (thyrocervical trunk) arteries
What is an isthmus?
Small bit of tissue between 2 larger bits of tissue
What is the levator gandulae thyroidae?
Fibrous structure that passes from thyrohyoid muscle to the isthmus of the thyroid gland
What is the function of the parathyroid hormone?
Helps increase blood calcium levels - if they are not at an appropriate level they can affect muscle function
What are the 2 set of parathyroid glands?
Superior and inferior sets
What % of the population has more than 4 parathyroid glands?
5% of the population
Which set of parathyroid glands are more constant in their position?
The superior set
What can happen if parathyroid glands are removed from the body?
Tetany - abnormal muscle contractions as there is not a regulated calcium load
What nerves innervate the anterior triangle of the neck?
- Vagus
- Phrenic
- Hypoglossal
What does the phrenic nerve innervate?
The diaphragm
The diaphragm used to be surgically divided as a treatment for T.B. Why is this not done now?
If you cut the phrenic nerve the diaphragm cannot work and the lung will die off
What blood vessels supply the anterior triangle of the neck?
- Common carotid artery
- Jugular veins
What can the contents of the posterior triangle of the neck be divided into?
- Nerves
- Muscles
- Vessels
- Lymph nodes
What nerves innervate the posterior triangle of the neck?
- Accessory nerve
- Parts of the brachial plexus (supplies all of the upper limbs)
- Cutaneous cervical nerves (supply sensation on the skin)
What muscles in the neck does the accessory nerve supply?
- Purely motor nerve
- Supplies sternocleidomastoid and trapezius
What is the clinical test to check that CNXI is working?
As the patient to look to one side and push against your hand
What does the brachial plexus in the posterior triangle of the neck consist of?
- Starts at C5 and ends at C8
- It has:
- Roots
- Trunks
- Divisions (anterior/posterior)
- Cords
- Terminal branches
What do lymph nodes look like?
Small, oval to bean shaped structures
What are the functions of lymph nodes?
- Filter lymph
- Offer defence against the spread of infection
Where are the superficial lymph nodes found in the posterior triangle of the neck?
- Just on front of ear
- Just over cheek
- Some down to lower aspect and many more
Where are the deep lymph nodes found in the posterior triangle of the neck?
Ones where patients tend to say their glands are up
