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NB2 > Triangles Of Neck > Flashcards

Triangles Of Neck Flashcards

1
Q

What arch forms CN V?

A

First arch

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2
Q

What arch forms CN VII?

A

Second arch

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3
Q

What arch forms CN IX?

A

Third arch

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4
Q

What arch forms CN X?

A

Fourth/sixth arch

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5
Q

What is cervical fascia?

A

Component of connective tissue forming
sheaths around structures in the neck

• Covers the triangles of the neck

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6
Q

Contrast a deep and superficial. Cervical fascia

A

• Superficial fascia
– Loose, fatty subcutaneous layer (contains the platysma m.)

• Deep fascia

  1. Carotid sheath
  2. Superficial (investing) layer
  3. Middle (pretracheal) layer
    Infrahyoid/muscular fascia (A)
    Visceral fascia
    – Pretracheal fascia (B)
    – Buccopharyngeal fascia (C)
  4. Deep (prevertebral) layer

All layers contribute to carotid sheath

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7
Q

What is the investing fascia?

A

Deep to superficial fascia and embedded platysma muscle

Surrounds the neck ‘investing’ around the SCM and trapezius m.

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8
Q

What are the boundaries of the posterior triangle?

A 
Boundaries of posterior triangle – trapezius m. (CN XI)
posterior triangle
• Upper fibers- elevate scapula
• Middle fibers- adduct scapula
• Lower fibers- depress scapula

– sternocleidomastoid m. (CN XI)
• Unilateral headrotationto
opposite side

• Bilateral draw head forward
– clavicle

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9
Q

What are the boundaries of the anterior triangle?

A

Boundaries of anterior triangle
– midline
– sternocleidomastoid m. (CN XI)
– mandible

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10
Q

What does the Omohyoid muscle do?

A

Omohyoid (inf. belly)

  • subdivides the posterior triangle into occipital and subclavian (supraclavicular) triangles
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11
Q

What nerves innervate posterior, anterior and middle scalene?

A

C3-7

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12
Q

What innervates splenus capitus?

A

(Dorsal ramus)

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13
Q

What nerve innervates the levator scapulae?

A

Dorsal scapular nerve

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14
Q

What’s the importance of cervical plexus?

A

Cervical plexus – ventral rami

of spinal nerves C1-C4

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15
Q

What are the cutaneous branches of the posterior triangle?

A

Cutaneous branches emerging from the posterior triangle

Lesser occipital (C2)
Great auricular (C2,3) 
Transverse cervical (C2,3)
Supraclavicular (C3,4)
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16
Q

What are the motor and cutaneous areas of the cervical plexus?

A

Formed by ventral rami of cervical spinal nerves C1-C4

Motor - to infrahyoid and prevertebral muscles of the neck and diaphragm (phrenic n.)

Cutaneous - areas of head, neck, shoulder upper chest, and central part of diaphragm (phrenic n.)

17
Q

What is the path of the hypoglossal nerve?

A

Path of the nerve:
• exits the skull through hypoglossal canal and descends medial to ICA and IJV
• passes between ICA and IJV and hooks around occipital a.
• passes deep to digastric and stylohyoid mm.
• disappears deep to mylohyoid m. on its way to tongue

18
Q

What does the hypoglossal nerve innervate?

A

C1 fibers piggyback along hypoglossal n. to geniohyoid and thyrohyoid mm.
All other infrahyoid muscles are innervated by the ansa cervicalis (C1-C3)

19
Q

What spinal level innervate the nerve to thyrohyoid?

A

C1

20
Q

What are the contents of the carotid sheath?

A

Contents of the carotid sheath:

Internal jugular v. (IJV)
Common carotid a. (CCA)
Vagus nerves

21
Q

What are the contents of the posterior sheath?

A

Carotid sheath:
Internal jugular v. (IJV)
Common carotid a. (CCA)
Vagus nerves

Inferior thyroid artery

Thyrocervical trunk

Phrenic nerve-

Phrenic n. (C3,4,5)
* On top of anterior scalene muscle

Transverse cervical artery
1. superficial branch
2. deep (descending) branch
Maybe absent if it came off directly from subclavian as the dorsal scapular artery

Structures emerging through the scalene gap (triangle) formed by ant. & mid. scalene muscles:

 - Brachial plexus trunks (C5-T1) 
 - Subclavian a.
22
Q

What does NOT pass through the scalene gap?

A

Subclavian v.

23
Q

What is the anterior triangle divided into?

A 
Subdivided by digastric and
omohyoid mm. into:
1. submental triangle
2. digastric (submandibular) triangle
3. carotid triangle
4. muscular triangle
24
Q

What is the vasculature from the internal and external carotid artery?

A

Internal carotid a. (ICA):
No branches until inside skull

External carotid a. (ECA):

  1. sup. thyroid artery
  2. ascending pharyngeal a.
  3. lingual a.
  4. facial a.
  5. occipital a.
  6. post. auricular a.
  7. maxillary a.
  8. superficial temporal a.
25
Q

What is the Carotid sinus?

A

Carotid sinus
dilated portion at the proximal part of ICA
• Contains baroreceptors to monitor blood
pressure
• Innervated by branches of CN IX

26
Q

What is the carotid body?

A 
Carotid body
small cluster of cells near carotid sinus
• Contains chemoreceptors to monitor
blood chemistry (i.e. O2, pH)
• Innervated by branches of CN IX and X
27
Q

What is the thyroid gland?

A

2 lobes connected by isthmus (anterior to 2nd and 3rd tracheal cartilages)

Pyramidal lobe (if present) – along the path of thyroglossal duct

28
Q

What is the arterial supply of the thyroid gland?

A

• superior thyroid (from ECA)
• inferior thyroid (from
thyrocervical trunk)
• thyroid ima – (variable presence)

29
Q

Whaat is the venous drainage of the thyroid gland?

A
  • Venous drainage
    • superior thyroid (into IJV)
    • middle thyroid (into IJV)
    • inferior thyroid (into brachiocephalic vein)
30
Q

Where does the recurrent pharyngeal nerve course in relation to the thyroid gland?

A

The recurrent laryngeal nerve courses posterior to the thyroid gland in the tracheoesophageal groove

31
Q

What are the contents of the carotid sheath?

A

Fascial tube extending from the base of the skull to thorax
contents:
• CCA (ICA)
• IJV
• Vagus n. (CN X)
• (CN IX, XI, XII – in the uppermost part of sheath for part of their course)

32
Q

What are the relationships of the carotid sheath?

A

Relationships:
– Phrenic n. lies posterior on top of anterior scalene (covered by prevertebral fascia)

– Sympathetic chain lies posteromedial to sheath (in front of prevertebral fascia)

– Inside the sheath the IJV is usually large and more superficial (anterior or lateral) to the CCA

– Vagus n. is usually found posterior to, and between CCA/IJV

33
Q

What are the collar lymph nodes?

A 
Collar nodes (superficial):
• occipital
• mastoid (posterior auricular)
• parotid (pre-auricular)
• submandibular
• submental
  • afferents drain superficial structures of face, scalp, and head
  • form a collar around the neck and efferents drain mainly to the
    deep cervical nodes (along IJV)
34
Q

What are the superficial cervical nodes?

A

Superficial cervical nodes

  • organized into anterior group (along anterior jugular v.) and posterolateral group (along EJV)
  • afferents drain superficial structures of the neck – efferents drain to the deep cervical nodes
35
Q

Describe the deep cervical lymph nodes

A

Deep cervical nodes:
- Receive most of the lymph from head and neck - located in a vertical chain along the IJV

  • afferents drain superficial cervical nodes and various other outlying nodes including: prelaryngeal, pretracheal, paratracheal, retropharyngeal, infrahyoid
  • efferents eventually form R & L jugular trunks and drain to right lymphatic duct or thoracic duct
  • often divided into superior and inferior groups where the omohyoid tendon crosses IJV
  1. Jugulo-digastric (tonsilar) node – large prominent node draining tonsillar region
  2. Jugulo-omohyoid node – large prominent node draining the tongue

NB2 (31 decks)

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