Theme 2 Anatomy Flashcards
what is the atlanto-occipital joint
articulation between superior articulation facets & the occipital condyles of the skull
what type of movement do you get at the atlanto-occipital joint
nodding and lateral flexion
what is the atlanto-axial joint
synovial joint
synocial articualtion between the superior articulating facet of axis and the inferior articulation facet of atlas
3rd articulation between dens of axis and anterior arch of atlas
what type of movement occurs at the atlanto-axial joint
rotation
what are types vertebra and how many are there of each
7 cervical
12 thoracic
5 lumbar
5 sacral
what are the main features of the cervical vertebra
bifid spinous process (except c1 and c7)
transverse foramina
triangular vertebral formane
what are the distinguishable features of the thoracic vertebrae
upper and lower articular facets (demifacets)
articular facet on front of each transverse process
round vertebral foramen
spinous process points downwards and backwards
what is different about the 7th cervical vertebra
the spinous process ends in single tubercle- it does not bifurcating
which vertebra has no body
atlas c1
what replaces the spinous process in atlas
small posterior tubercle
how can we identify upper and lower surfaces of atlas
sup articular facets are concave & kidney shaped
inf are round and flat
how can the front and back of atlas be distinguished
ant arch is straighter and shorter than the posterior arch
what are the ligaments the stabilise the joint between the first and second cervical vertebrae
transverse and longitudinal bands of the cruciform ligaments alar ligaments apical ligaments (small role) post longitudinal ligament of vertebra
what are the boundaries of the posterior triangle
anterior border trapezius
posterior border of scm
middle 1/3 of clavicle
what muscles form the floor of the posterior triagnle
splenius capitis
levator scapulae
scalenus post, med & ant
what is the function of the scm
bilaterally flex neck on head
when acting on one side rotates the head to the same side, turns face to opposite side
what nerve innervates the scm and trapezius
spinal accessory
what is the function of the trapezius
rotate the scapula and raise the arm
what is the function of scalenus anterior
aids in forced respiration by elevating the ribs and sternum
what are the contents of the posterior triangle
omohyoid muscle external jugular vein spinal accessory nerve subclavian artery phrenic nerve brachial plexus cutaneous nerves
what are the cutaneous nerves of the neck and their root values
lesser occipital C1-C2
greater auricular C2-C3
transverse cervical C2-C3
supraclavicular C3-C4
what are does the lesser occipital nerve supply sensory innervation
scalp in lateral area of head
what area does the greater auricular nerve supply sensory innervation
skin over the parotid gland and mastoid process and both surfaces of the outer ear
what area does the transverse cervical nerve supply cutaneous innervation
anterior and lateral parts of the neck
what area does the supraclavicular nerve provide cutaneous innervation
skin above and below the clavicle
what foramen does the spinal accessory nerve enter the skull
fo magnum
what fo does the spinal accessory nerve leave the skull
jugular formamen
what nerve overlies scalenus anterior
phrenic
what muscle lies over the 1st part of the subclavian artery
scalenus anterior (may be reflected on specimen)
the vagus nerve descends and wraps around the arch of aorta and ascends as what
recurrent laryngeal nerve RHS only
what are the boundaries of the anterior triangle
anterior border of scm
inf border of body of mandible
midline
what are the superficial infrahyoid strap muscle & what is their function
sternohyoid
omohyoid
depress hyoid bone and larynx
what are the deep infrahyoid strap muscles & what is their function
sternothyroid- depress larynx
thyrohyoid- depress hyoid bone
what are the suprahyoid muscles
digastric
mylohyoid
geniohyoid
stylohyoid
what is the function of the digastric muscles & stylohyoid
elevate hyoid bone
what is the function of the mylohyoid
elevates hyoid bone, base of tongue and floor of mouth
what is the function of geniohyoid
elevates & protracts hyoid bone
what is the innervation of the infrahyoid muscles except thyrohyoid
ansa cervicalis
what is thyrohyoid innervated by
C1 fibres that hitchhike the hypoglossal nerve
what is the innervation of the ant digastric
nerve to mylohyoid (br of v3)
what is the innervation of the mylohyoid
nerve to mylohyoid (br of v3)
what is the innervation of post digastric
facial nerve
what is the innervation of stylohyoid
facial nerve
what is the innervation of geniohyoid
C1 fibres hitchhiking the hypoglossal nerve
what are the root values for the cervical plexus
c1-c4
through what fo do spinal nerves exit the spinal cord
intervertebral foramen
once the paired spinal nerves exit the spinal cord what 2 branches do they immediately divide into
anterior and posterior rami
what are the root values of ansa cervicalis
c1-c3
what are the 2 neurovascular bundles in the neck & what do they contain
carotid sheath
- common carotid
- int jugular
- vagus n
subclavian
- subclavian artery
- subclavian vein
- brachial plexus
what are the branches of the external carotid artery
superior thyroid ascending pharyngeal lingual facial occipital posterior auricular
terminal branches:
- maxillary
- superficial temporal
what are the main br in the neck of vagus nerve
pharyngeal superior laryngeal - internal -external recurrent laryngeal (RHS only)
from which fo does the hypoglossal n leave the skull
hypoglossal canal
what are the br of the subclavian artery related to the scalenus anterior
vertebral
internal thoracic
throcervical trunk
of which larger artery is the inferior thyroid artery a br
thyrocervical trunk
what structures are anterior to scalenus anterior
phrenic nerve
subclavian vein
vagus nerve
int jugular vein
what 3 tributaries does the subclavian vein have in the neck
internal thoracic vein
external jugular vein
vertebral vein
what structures are medial to scalenus anterior
first part of subclavian artery and its br
vertebral vein
what is posterior to scalenus anterior
costocervical trunk (second part of subclavian artery)
what is lateral to the scalenus anterior
third part of subclavian artery
brachial plexus
what is the role of the thyroid gland
maintains metabolism
hormone (thyroxine) production
parafollicular cells produce calcitonin
what are the superior and inferior lobes of the thyroid gland unites by
isthmus
what are the main br of the internal jugular vein
brachiocephalic -inf thyroid subclavian middle thyroid sup thyroid lingual common facial
what is the arterial blood supply for the thyroid gland
superior thyroid
inferior thyroid
of what artery is the sup thyroid a branch
right ext carotid
of what artery is the inferior thyroid a branch
thyrocervical trunk of subclavian
what structure is the superior thyroid artery related to
external laryngeal nerve
what structure is the inferior thyroid artery related to
recurrent laryngeal nerve
what veins drain the thyroid gland & where do they drain
superior thyroid- int jugular
middle thyroid-internal jugular
inferior thyroid- left brachiocephalic vein
what are the parathyroid glands
4 glands 2 on the right 2 on the left
embedded within thyroid gland tissue
secrete PTH
what are the types of fascia of the neck
superficial fascia
deep cervical fascia
what are the types of deep cervical fascia
deep investing fascia
pretracheal (visceral) fascia
prevertebral fascia
carotid sheaths
what are the attachments of the carotid sheath
sup- base of skull around carotid canal
inf- visceral and prevertebral fascia
ant- visceral fascia
post- prevertebral fascia
what is the name of the tissue space that lies between the prevertebral and pretracheal fascia
retropharyngeal tissue space
what happens to infections that gain access to the retropharyngeal tissue space
spread rapidly to the base of the skull superiorly even into the posterior mediastinum inferiorly
how do infections create tissue ‘spaces’
they destroy the loose connective tissues that unites fascial planes allowing infection to spread widely
what is the function of the lymphatic system /lymph nodes
return fluid to the blood
what happens when fluid passes through lymph nodes
foreign particulate matter is filtered out by phagocytic cells
which nodes drain into jugulo-omohyoid nodes
sub mental and occipital nodes
which nodes drain into jugulo-digastric
submandibular
parotid
mastoid nodes
where do superficial tissues of the neck drain
superficial nodes of the neck alonfg the ext jugular vein
where do superficial tissues of head drain
nodes at the head neck junction
what do the submental nodes drain from
tip of tongue
where do the submandibular nodes drain from
lower face and anterior 2/3 of tongue
what do the parotid nodes drain from
skin of upper face
what do the mastoid nodes drain from
scalp and ear
what do the occipital nodes drain from
posterior scalp
what do the superficial cervical nodes drain from
superficial neck
during a neck examination what would you for (NHS guidlines)
infection spreas
metastases of oral tumours
TMD and orofacial pain
what are neck structures involved in
jaw movements
larynx movements
protective reflexes
structures of passage to face, mouth and jaw
what structures pass through the formamen magnum
spinal cord
vertebral arteries
anterior and posterior spinal arteries
spinal accessory nerve
what structure forms the roof of the posterior triangle
deep cervical fascia
what cutaneous nerve runs across the scm
transverse cervical and greater auricular
into what larger structure does the ext jugular vein drain
subclavian vein
what fo does XI leave the skull
jugular
which muscle does XI lie on in the posterior triangle
levator scapule
what would damage to XI cause in the posterior triangle
paralysis of trapezius
describe the autonomic (ps and s) nerve supplies to the parotid gland
ps- derived from glossopharyngeal nerve and postganglionic neurones are located in the otic ganglion
symp- derived from the thoracic spinal cord and post ganglion neurones are in superior cervical ganglion
do infrahyoid muscles do anything to help “open wide”
yes bc they stabilise the hyoid bone
what muscles lie immediately deep to the omohyoid muscle
sternothyroid and thyrohyoid
describe the sympathetic nerve supply of the submandibular salivary glands
preganglionic axons leave spinal cord at T1 to L3 and synapse in ganglia (sup cervical ganglion) close the spinal cord. post ganglionic travel far to the glands. they reach there in the walls of the ext carotid artery
where is the cervical plexus found
on the scalenus medius beneath the prevertebral fascia
what nerve appears to join cervical plexus
hypoglossal
what is the function of the hypoglossal nerve and which division of the peripheral ns is it from
provides motor innervation for the muscles of the tongue
somatic
where are motor neurone cell bodies that give rise to the axons in the nerve to be found in the cns
medulla oblongata of brainstem
(as its a spinal nerve)
what ligament attaches to the lesser horn of the hyoid bone & whats its function
stylohyoid ligament
limits the extent to which the hyoid bone can be lowered in the neck
what is the function of the phrenic
motor innervation to the diaphragm
large sensory component to the diaphragm itself and to the membranes that cover it
what is vein formed from confluence of subclavian and int jugular veins
brachiocephalic
which vessel does the inferior thyroid vein empty
left brachiocephalic
what muscle attaches to the medial aspect of mastoid process
post belly of digastric
which nerves contribute to the formation of ansa cervicalis
descendant hypoglossi
c1 axons that hitchhike the hypoglossal nerve
descendent cervicalis formed form branches that arise from C2 and C3 spinal nerves
what level does common carotid bifurcate
C3/C4
outline the anatomy of vagus nerve
lots of preganglionic ps axons (synapse in ganglia close to targets)
will have a sensory ganglion located on it similar to dorsal root ganglion
motor axons part of the somatic ns and will synapse directly onto muscle
what is the general function of the brachial plexus nerves
motor and sensory innervation to structures in the upper limb
which muscle is brachial plexus closely related in the neck
scalenus anterior
what is the function of carotid sinus (dilation at point of carotid artery bifurcation)
contains receptors that measure changes in blood gases and pressure
what class of axons do those which innervate the stomach from the vagus nerve belong to . what affect will they have on the stomach
preganglionic parasympathetic
stimulation of gastric secretion and motility
what is the ultimate destination of lymph passing through the jugulo-omohyoid nodes
thoracic duct
which fascia spilts to surround scm and trapezius
deep cervical
which fascia covers the muscles that make up the posterior triangle
prevertebral
what structures does pretracheal fascia surround
trachea
oesophagus
recurrent laryngeal nerves thyroid gland
where does the spinal accessory nerve originate
C1-C6
which pair of spinal nerves emerges from intervertebral fo between c3 and c4
c4 spinal nerve emerges from here
name the nerves to which the c4 spinal nerve contributes
phrenic
supraclavicular
which 2 muscles are attached to manubrium sterni
ant- scm
post- sternothyroid, sternohyoid
what is the destination in general of the post ganglionic axons from superior cervical ganglion and how do they reach these targets
sympathetic innervation to the head and neck
travels in the walls of the arteries of the carotid arterial tree
what is the name of the joint formed between intervertebral disc with 2 adjacent vertebra
joint between vertebral bodies
symphysis
which muscle is the cervical plexus deep to
scm
which nerve crosses the lingual artery in the neck
hypoglossal
