Theme 2 Flashcards

The Neck

1
Q

Atlanto-occipital joint

A

join between (occipital condyles of) skull and C1 Atlas

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2
Q

atlantoaxial joint

A

Joint between Axis and atlas

Synovial articulation between the (superior articular facets of the) axis and the (inferior articulating facets of the) atlas

Aritculations take place:

  • Median: Dens and anterior arch C1
  • Lateral: articular facts of C1 & C2
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3
Q

SCM

  1. Attachments
  2. Actions
  3. Innervation
A

1.

Superior:

  • Mastoid process
  • Superior nuchal line

Inferior:

  • Manubrium sternal head
  • middle 1/3 Clavicle
  1. -

Acting Bilaterally = flexes the neck

Acting Unilaterally = rotates the head to the opposite side and pulls up the sternum during forced inspiration

  1. CNXI
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4
Q

Trapezium Muscle

  1. Attachments
  2. Actions
  3. Innervation
A

1.

Medial:

  • Superior Nuchal Line
  • External Occipital Protuberance
  • C1 - T12
  • Scapula (Shoulder blade)

Lateral: 1/3 of Clavicle

  1. Elevates arm and rotates the scapula
  2. CNXI
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5
Q

What does the SCM provide to the Neck?

A

Provides sensory innervation to the skin on the anterior aspect of the neck

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6
Q

CNXI - Spinal Accessory Nerve

A

Through Jugular Foramen Deep to SCM - motor innervation

Emerges from posterior SCM to Levator Scapulae into Trapezius

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7
Q

Border of Posterior Triangle

A
  • Posterior Border of SCM
  • Middle 1/3 of Clavicle
  • Anterior border of Trapezius
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8
Q

Muscles of the Floor of the Posterior Triangle (Superior to Inferior)

A

Splenius Capitis

Levator Scapulae

Sclenus Post, Medius, Ant

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9
Q

What are the contents of the Posterior Triangle?

A

​Some Say Batman Can Punch Out Every-Joker

  1. Spinal accessory nerve
  2. Subclavian artery
  3. Brachial plexus - between scalenus med & ant
  4. Cutaneous nerves
  5. Phrenic nerve - across levator scapulae
  6. Omohyoid muscle
  7. External Jugular vein
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10
Q

Border of Anterior Triangle

A
  • Anterior border of SCM
  • Midline Inferior border of the Mandible
  • Apex: Manubrium Sterni
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11
Q

What are the contents of the Anterior Triangle?

A

Central City-Citizens Have Hoped-Badly That-Good Is-Just Victorious

  1. Cervical Plexus
  2. Common, External (inc. branches) & Internal Carotid
  3. CNXII - Hypoglossal
  4. Hyoid Bone
  5. Thyroid Gland
  6. Internal Jugular vein
  7. CNX - Vagus
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12
Q

What are the 4 Suprahyoid muscles? Role? Innervation?

A

Role: Raise Hyoid bone

  1. Digastric =
  • Posterior Digastric belly: CNVII
  • Anterior digastric belly: CNV3
  1. Stylohyoid - CNV3
  2. Mylohyoid - CNV3 Elevates hyoid bone, base of tongue & floor of the mouth
  3. Geniohyoid - C1 hitchhiking along CNXII
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13
Q

Roof of Ant. & Post. Triangles

A

Skin

Superficial Facia

Platysma

Deep investing fascia

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14
Q

What are the 4 Infrahyoid muscles? Roles? Innervation?

A

Action: Lower Hyoid bone

Innervation: Ana Cervicalis (C1-C3) but Thyrohyoid by fibers of C1 hitchhiking along CNXII

  1. Sternohyoid
  2. Omohyoid (omo = shoulder)
  3. Sternothyroid
  4. Thyrohyoid

1&2 = Superficial and depress the larynx

3&4 = Deep

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15
Q

Visceral Units

A

Hyoid bone

(Thyrohyoid mebrnae)

Thyroid Cartilage

(Circothyroid membrane)

Circoid membrane

Trachea

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16
Q

Cervical Plexus

Branches & Function

A

Formed by Anterior rami of C1 - C4

Supplies structures in the anterior & lateral regions of the neck

  • Lesser occipital: innervates the skin and the scalp posterosuperior to the auricle (C2)
  • Great auricular nerve: innervates skin near concha auricle (outer ear) and external acoustic meatus (ear canal) (C2&C3)
  • Transverse cervical nerve: innervates anterior region of neck (C2&C3)
  • Supraclavicular nerves: innervate the skin above and below the clavicle (C3,C4)
17
Q

Ansa Cervicalis

A

C1 -C3 (cervical plexus)

Motor supply to Infrahyoid muscles

18
Q

Brachial plexus

A

Formed by anterior rami of C5-T1

Supplies all upper limb structures

19
Q

Branches of the Vagus Nerve - CNX

A

Meningeal, re-enter skull through jugular foramen to supply Dura

Pharyngeal branches in pharynx + CNIX + CNXI = Pharyngeal Plexus

Superior Laryngeal: splits into internal external Laryngeal = supply Larynx & Thyroid

Recurrant Laryngeal:

Right - curves under subclavian artery & loops to ascent into the neck

Left - curves around aorta

Both Run back to supply Larynx & Thyroid

20
Q

Arteries of the Roof of the Neck (Branches)

A
21
Q

What forms the Vena Cava

A

2 Brachiocephalic Veins descend and =

22
Q

Branches of Brachiocephalic Vein

A
  • Inferior Thyroid
  • Internal Jugular
  • Subclavian
  • External Jugular
  • Vertebral
  • Internal Thoracics
23
Q

2 Lymphatic Vessels of the Root of the Neck

A

Thoracic Duct:

  • Arises from thorax, behind oesophagus
  • Drains: Lymph from Thorax & L.Arm into confluence of L. Internal Jugular Vein + L.Subclavian Vein

Right Lymphatic Duct:

Drains R.Arm into confluence of R.Internal Jugular Vein + R.Subclavian Vein

24
Q

What does the Subclavian Vein receive?

A

It receives 3 tributaries:

  1. Internal thoracic vein
  2. External jugular vein
  3. Vertebral vein
25
Q

Neurovascular Bundles of the Neck

A

Carotid Sheath:

  • Common Carotid artery & branches
  • Internal jugular vein
  • Vagus nerve

Subclavian:

  • Subclavian Artery
  • Subclavian Vein
  • Brachial Plexus
26
Q

Pathway of Hypoglossal - CNXII

A

Hypoglossal Canal Descends externally to Carotid Sheath Loops under Posterior Digastric –> Ant.Triangle –> Submandibular Region

Crosses Lingual Artery

Innervates intrinsic & extrinsic muscles of tongue expect palatoglossus

27
Q

Thyroid Glands

  1. Where do the R & L lobes join?
  2. Blood supply
  3. Venous drainage
  4. Innervation
  5. Function
  6. Secretes
A
  1. Isthmus

2.

  • Superior Thyroid arteries (branch of ext.carotid artery)
  • Inferior Thyroid arteries (branch of thyrocervical trunk)

3.

  • Superior Thyroid
  • Internal Jugular
  • Middle Thyroid
  • Inferior Thyroid

4.

  • Superior Laryngeal
  • Recurrent Laryngeal
  1. Function:
  • Hormones production
  • Maintenance of metabolism
  1. Secretes:
  • Thyroid hormone
  • Calcitonin
28
Q

Relationships of Scalenus Anterior

A

Anterior:

  • Phrenic Nerve
  • Subclavian Vein
  • CNX
  • Internal Jugular

Medial:

  • First part of Subclavian Artery and its Branches
  • Vertebral Vein

Posterior: Second part of Subclavian Artery

Lateral:

  • Third part of Subclavian Artery
  • Brachial Plexus
29
Q

Layers of Deep Cervical Fascia

A

Deep Investing Fascia completely encircles the neck & splits to pass round the Sternocleidomastoid and Trapezius muscles

Visceral/Pretracheal Fascia forms around the visceral unit of the neck (pharynx/oesophagus, larynx/trachea and thyroid gland)

Prevertebral Fascia surrounds the cervical vertebral unit (C1-C7 vertebrae, C1-C8 nerves, cervical spinal cord, anterior vertebral muscles)

Carotid Sheath

30
Q

How does infection spread in fascia?

A

Several routes:

  • Through tissue planes & spaces
  • Venous routes
  • Lymphatic system

Spaces: filled with loose connective tissue = vulnerable to being destroyed by infection

Communications between spaces allow infections to spread widely via lymphatic system

31
Q

Lymphatic drainage of head and neck

A

Superficial Lymph Nodes of

Head: drain to nodes at the head-neck junction

Neck: drain to nodes along external jugular vein

Both of these drain to deep cervical nodes along the internal jugular vein

32
Q

Superficial Ring of lymph drainage - Function

A

Submental - tip of tongue, floor of mouth, lower lip &chin

Submandibular - lower face & anterior 2/3 tongue

Parotid - skin of upper face

Mastoid - scalp & ear

Occipital - posterior scalp

Superficial cervical - superficial neck

33
Q

Where do the Superficial Lymph nodes drain

A

Superior deep nodes & jugulo-digastric —> receives all drainage (Submandibular, Parotid, Mastoid, Superficial cervical)

Inferior deep nodes & jugulo-omohyoid —> receives more anterior & posterior drainage (Submental & Occipital)