Triangles and muscles of neck

Question 1

how many cervical vertebrae and which ones are atypical?

Answer 1

seven, 2 atypical; atlas and axis.

Question 2

key features of cervical vertebrae?

Answer 2

foramen transversarium, bifid spinous process.

Question 3

features of atlas?

Answer 3

large articular facets, no body or spinous process, just anterior and posterior tubercles, groove on superior posterior arch for vertebral artery.

Question 4

features of axis?

Answer 4

dens (odontoid process)

Question 5

vertebral disks are —-, have two parts 1.—- 2—-

Answer 5

fibrocartilaginous, inner nucleus pulposus, outer annulus fibrosus.

Question 6

joints between articular facets of vertebrae are—– joints (type) called—–(name).

Answer 6

synovial joints, zygapophyseal joints

Question 7

what structures attach to ribs 1 and 2?

Answer 7

rib 1: from anterior to posterior-
Groove for subclavian vein, Tubercle for scalenus anterior==>groove for subclavian artery==> scalenus medius.
Rib2: tuberosity for serratus anterior==> tubercle for scalenus posterior.

Question 8

what does hyoid bone consist of and what joints do they make?

Answer 8

body, greater horn-forms cartilaginous joint with the body, lesser horn-forms fibrous joint with the body and synovial joint with the base of GH.

Question 9

what are the attachments of hyoid bone?

Answer 9

• strap muscles;supra and infrahyoid muscles of neck
• fibrous sling to intermediate tendon of digastric
• stylohyoid ligament
• middle pharyngeal constrictors
• thyrohyoid membrane-between hyoid bone and upper thyroid cartilage of larynx.

Question 10

what forms the anterior triangles and posterior triangles?

Answer 10

anterior:
1. digastric triangle formed by mandible and digastric tendon and both bellies & contains submandibular gland,
2. carotid triangle formed by medial side of sternocleidomastoid and superior belly of omohyoid and posterior belly of digastric & contains neurovascular bundle of neck (carotid, internal jugular, vagus, carotid sheath).
3. muscular triangle formed by medial side of superior belly of omohyoid and some medial side of sternocleidomastoid, anterior belly of digastric and midline-contains infrahyoid muscles and thyroid.

Posterior:

1. occipital triangle is above inferior belly of omohyoid and contains deep cervical lymph nodes and accessory nerve.
2. supraclavicular triangle-below omohyoid and contains subclavian artery and vein.

Question 11

what does the roof and floor of posterior triangle contain?

Answer 11

roof-the most superficial and lateral part is the deep cervical fascia+accessory nerve, brachial plexus,deep cervical lymph nodes.
Floor which is the most medial part is the fascia + muscles e.g. splenius capitis, levator scapulae, scalenus muscles

Question 12

attachments and movements of sternocleidomastoid?

Answer 12

sternum, manubrium, medial 1/3 of clavicle to anterolateral mastoid.
tilts and rotates head.
Flexes head and raises sternum.

Question 13

attachments o0f trapezius and its movements?

Answer 13

external occipital protuberance and superior nuchal line to T12 in midline. Laterally; to lateral clavicle and acromion.
pulls shoulders back, rotates shoulder, raises arm, extends head.

Question 14

what innervates trapezius and sternocleidomastoid?

Answer 14

both by:
motor-spinal accessory which is deep to both muscles
sensory-ventral cervical rami C2-C4, not ansa cervicalis, which travel with accessory nerve.

Question 15

attachments and movements of digastric M?

Answer 15

anterior belly attached to digastric fossa on inferior mandible near midline and posterior belly attached to mastoid/digastric notch.
intermediate tendon attached to hyoid by fibrous sling.
it depresses mandible, elevated the hyoid.

Question 16

The fibrous sling that connects the hyoid bone to digastric tendon is lined with —- —- & contains —–.

Answer 16

synovial membrane, synovial fluid.

Question 17

innervation of digastric?

Answer 17

anterior belly; mylohyoid nerve

posterior belly; facial nerve

Question 18

omohyoid attachments and movements?

Answer 18

superior belly: body of hyoid
inferior: upper border o9f scapula
intermediate tendon: clavicle and rib 1 by fascial sling.
depresses hyoid, tenses deep cervical fascia during prolonged inspiration.

Question 19

innervation of omohyoid?

Answer 19

ventral branches of cervical nerves/ansa cervicalis=both motor and sensory (c1-c3)

Question 20

sternocleidomastoid delineates —- and —–.

Answer 20

triangles of neck and superficial and deep lymph nodes.

Question 21

structures superficial to SCM?

Answer 21

ex.jugular,
lesser occipital nerve,
greater auricular nerve,
transverse cutaneous nerve of neck

Question 22

structures deep to SCM?

Answer 22

spinal accessory nerve and intermediate tendon of omohyoid

Question 23

structures deep to digastric?

Answer 23

tendon: hypoglossal nerve

posterior belly: ascending pharyngeal artery (below), occipital (behind), posterior auricular artery (above).
Close association with stylohyoid, jugulodigastric nodes inferiorly.

Question 24

landmarks associated with omohyoid?

Answer 24

divides muscular and carotid triangle, posterior into occipital and supraclavicular.

Question 25

describe the divisions of accessory nerve in terms of their course, and their targets.

Answer 25

cranial root: arises in hindbrain, collects spinal root and enters jugular foramen.
Spinal root: motor and possibly sensory, arises cervical spinal cord and enters foramen magnum, joins cranial root and enters jugular foramen.

both separate just outside jugular foramen, with cranial joining vagus. Cranial and vagus supply voluntary muscles of pharynx, larynx, and soft palate.

spinal part goes under SCM, across floow of posterior triangle, under trapezius. Motor to SCM and trap.

Question 26

list lateral vertebral muscles ?

and movements in general?

Answer 26

1.scalenus anterior-atatches to 1st rib between groove for subclavian vein and artery
2. scalenus medius-rib 1 behind groove for subclavian artery.
Anterior and medius are separated by brachial plexus and subclavian artery.
3.scalenus posterior-to rib 2

All of them elevate ribs, lateral flexors of neck

Question 27

scalene muscles arise from—–

Answer 27

transverse processes of cervical vertebrae.

Question 28

list prevertebral muscles? and their general movement and their innervation.

Answer 28

1. longus colli-atlas to T3
2. longus capitus-base of skull to transverse processes of C3-6
3. rectus capitus anterior-atlas to base of skull
4. rectus capitus lateralis-TP of atlas to base of skull

Flexe the neck and head
Innervated by cervical ventral rami.

Question 29

list suprahyoid muscles.

Answer 29

geniohyoid-mental spine to hyoid
mylohyoid-mylohyoid line on mandible to hyoid
digastric-digastric fossa of mandible==>tendon==>mastoid notch
stylohyoid-styloid process to hyoid,

Question 30

innervation of 
geniohyoid
mylohyoid
digastric 
stylohyoid

Answer 30

g=cervical ventral rami+some hypoglossal
m=mylohyoid nerve
d=facial n
s=facial n

Question 31

list infrahyoid muscles:

Answer 31

sternohyoid-sternum to hyoid
thyrohyoid-thryroid cartilage to h
sternothyroid-sternum to thyroid cartilage of larynx
omohyoid-obliquely oriented

Question 32

infrahyoid muscles movement?

Answer 32

larynx up and down, depress hyoid.

Question 33

innervation of infrahyoid muscles?

Answer 33

asna cervicalis-muscular branches of cervical ventral rami

some from hypoglossal to thyrohyoid.

Question 34

list the styloid muscles AND ligaments

Answer 34

• stylohyoid
• stylopharyngeus-styloid p. to pharynx between superior and middle constrictor.
• styloglossus-styloid p. to underside of tongue.
• Stylomandibular ligament-styloid p. to angle of mandible
• stylohyoid ligament- styloid p. to h. Medial to stylohyoid muscle.

Question 35

innervation of stylopharyngeus and its movement.

Answer 35

glossopharyngeal nerve

elevates pharynx during swallowing and speech

Question 36

innervation of styloglossus and movement?

Answer 36

hypoglossal nerve

elevates the tongue

Question 37

stylohyoid innervation?

Answer 37

motor facial nerve

Question 38

—- is often pierced by intermediate tendon of digastric.

Answer 38

stylohyoid

Question 39

name two plexuses derived from cervical ventral rami

Answer 39

cervical and brachial +phrenic nerve

Question 40

cervical plexus has —-branches (modality) and —- branches (arranged in—–)

Answer 40

cutaneous
muscular branches
arranged in ansa cervicalis (muscular ones).

Question 41

list the cutaneous branches of cervical plexus.

Answer 41

lesser occipital- C2, scalp, posterior to auricle
greater auricular-C2,C3, skin over mastoid, auricle, parotid, also sensory innervation of parotid
transverse nerve of neck-C2,C3,skin of anterolateral neck
supraclavicular nerves-C3,C4, skin over clavicle & upper thorax, skin of upper and posterior shoulder, only nerves of cutaneous cervical p. which DO NOT CROSS SCM.

Question 42

Ansa cervicalis is embedded in—-, has superior roots derived from — which accompanies ——, joining inferior root which is derived from —&—.

Answer 42

carotid sheath
C1
hypoglossal nerve
C2 &C3

Question 43

Hypoglossal nerve travels with —–, gives off branches to —-,—-,—-muscles. Then joins the —–, to supply the muscles —- and —–.

Answer 43

ansa cervicalis
styloglossus,hyoglossus, genioglossus.
Ansa cervicalis,
geniohyoid and thyrohyoid.