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Anatomy unit 4 > Triangles of neck > Flashcards

Triangles of neck Flashcards

1
Q

2 types of fascia and differences or key charactristics

A

Superficial: Immediately deep to skin/subcutaneous tissue, comprised of loose connective tissue and fat, contains platysma in neck
Deep: Deep to superficial fascia, dense, organized connective tissue, no fat, covers most body structures(muscles/organs)

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2
Q

Where does platysma originate and insert(generally), and what is it innervated by?

A

From fascia above pec major and clavicle to lateral neck and onto mandible
- Very variable- changes per person where starts and ends
-Innervated by CN 7 (facial n).

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3
Q

Innervation of Platysma

A

CN 7 (facial n)

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4
Q

Why is it important to isolate different triangles of neck

A

if you have an infection in one area, prevents it from getting to other areas
- Specifically, neck connects to mediastinum (heart, esophagus, trachea)

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5
Q

What are the deep fascia of the neck

A

Investing
Pre-Tracheal
- Visceral, muscular, and buccoparyngeal
Carotid sheath
Alar fascia
Prevertebral fascia

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6
Q

What does investing fascia sourround

A

Trapezius and SCM

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7
Q

What does pretracheal fascia sourround

A

Visceral: Thyroid, trachea, esophagus
Muscular: Wraps infrahyoid muscle
Buccopharyngeal: Sourrounds pharynx posteriorly

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8
Q

What does carotid sheath sourround

A

Column of fascia that sourrounds Common carotid a, Internal carotid artery, Internal jugular vein, and vagus nerve

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9
Q

What does Alar fascia sourround

A

Anterior layer of prevertebral fascia, runs behind buccopharyngeal fascia

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10
Q

What does prevertebral fascia sourround

A

Sourrounds prevertebral and deep back muscles

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11
Q

Where is pretracheal space(between what)
Where do infections spread here?

A

Between trachea and infrahyoid muscle
- From thyroid cartilage to anterior mediastinum
Infections here can spread between these 2 regions (infection of thyroid cartilage can go to anterior mediastinum (thymus)).

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12
Q

What is the “danger”space

A

Prevertebral space

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13
Q

Where does the Prevertebral space run

A

DANGER zone
Between alar and prevertebral fascia
Infections can spread from scull base down to posterior mediastinum ( has thoracic duct, azygous, sympathetic chain)
Common place for inferior spread of infections.
Eating food that cuts through pharynx can go down into this space

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14
Q

Which muscles is the carotid sheath between

A

Between SCM and prevertebral muscle

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15
Q

What is the carotid sheath formed by

A

Condensations of deep cervical fascia

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16
Q

What does the carotid sheath encase

A

Carotid artery, Internal jugular veins, vagus nerves

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17
Q

Where do infections in the carotid sheath spread

A

From skull to middle mediastinum (heart)

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18
Q

If you have an infection in the middle mediastinum, where is it possible this began?

A

Carotid sheath (base of skull) can run to mid mediastinum

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19
Q

If you have an infection in your anterior mediastinum, where is it possible this began?

A

In your thyroid cartilage in the pretracheal space (runs thyroid to anterior mediastinum)

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20
Q

If you have an infection in your posterior mediastinum, what space is it possible this started in

A

The prevertebral space (runs from skull base to post mediastinum)

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21
Q

What is the Retropharyngeal space and what is it inbetween

A

Between buccopharyngeal and alar fascia
From scull base to superior mediastinum

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22
Q

If you have an infection in the superior mediastinum, where is it possible this began?

A

In the skull base in the retropharyngeal space

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23
Q

Where is zone 1 of the neck

A

Thoracic inlet to cricoid cartilage

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24
Q

Where is zone 2 in the neck

A

Cricoid cartilage to angle of mandible

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25
Q

Where is zone 3 in the neck

A

Angle of mandible to base of scull

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26
Q

Which muscle seperates the anterior and posterior triangles of the neck

A

SCM

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27
Q

What are the boundaries of the posterior triangle

A

Anterior: posterior border of SCM
Posterior: Anterior border of trapezius
Base: Clavicle
Contents: IJV, Roots of brachial plexus, accessory nerve, cervical and supraclavicular lymph nodes

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28
Q

Which vein is anterior to the SCM

A

External jugular vein

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29
Q

Which vein is posterior to the SCM

A

Internal jugular vein

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30
Q

Which muscle sits inbetwen the Interior and External jugular vein

A

SCM

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31
Q

Which nerve goes through the parotid gland

A

Facial nerve (cervical branch of facial nerve descends on anterior neck over anterior triangle)

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32
Q

Which superficial cutaneous nerve runs ascending directly inferior to posterior of the ear

A

Great auricular (C2-C3)

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33
Q

In the posterior triangle of the neck, describe the 5 superficial cutaneous nerves and where they travel

A

2 go up, 3 go down
Up:
1. Lesser occipital (C2)
2. Great auricular (C2-3)
Down:
1. Lateral supraclavicular (C3-C4).
2. Intermediate supraclavicular (C3-C4)
3. Medial supraclavicular (C3-C4)
The Transverse cervical also originates at Erb’s point, but travels transverse-anteriorly.

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34
Q

Where do all of the superficial nerves in the posterior triangle of the neck originate from

A

Erb’s point (Posterior to SCM in the posterior triangle)

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35
Q

Which foramen does the accessory nerve (CN 11) emerge from

A

jugular foramen

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36
Q

Which nerve emerges from the jugular foramen

A

Accessory nerve (CN 11)

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37
Q

Which nerve innervates the SCM and trapezius

A

Accessory nerve

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38
Q

Which muscles does the Accessory nerve innervate

A

SCM and Trapezius

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39
Q

Which fascia does the accessory nerve run deep to

A

investing fascia

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40
Q

Which nerve descends vertically along the anterior scalene muscle

A

Phrenic nerve (c3-C5)

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41
Q

Which 2 arteries cross the phrenic nerve anteriorly

A

transverse cervical a and suprascapular a

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42
Q

What structures are on either side of the phrenic nerve as it enters the thorax

A

Phrenic nerve enters thorax between the subclavian artery and vein

43
Q

What does the phrenic nerve travel along to supply the diaphragm

A

The pericardial sac

44
Q

Which nerve innervates the diaphragm

A

Phrenic n

45
Q

Describe where vagus vs phrenic nerves are

A

Both run vertically down neck
Vagus is inside carotid sheath between carotid artery and carotid vein, phrneic is on top of anterior scalene (not in carotid sheath)
Vagus is slightly more anteriorly

46
Q

What is inside the carotid sheath

A

Carotid a/v, vagus nerve between

47
Q

Which nerves run deep to the anterior scalene muscle

A

Brachial plexus (between anterior and middle sxalene muscle)

48
Q

The brachial plexus runs between which 2 muscles in the anterior triangle of the neck

A

Anterior and middle scalene

49
Q

Which muscle does the accessory nerve run on top of

A

Levator scapulae

50
Q

How are scalene muscles classified and when are they activated

A

They are secondary muscles of respiration, activated when we take a deep breath

51
Q

Boundaries of anterior triangle

A

Anterior: Midline of neck
Posterior: Anterior border of SCM
Base: Mandible on either side

52
Q

What are the boundaries of the submental triangle

A

Inferior: Hyoid bone
Lateral (right): Anterior belly of digastric
Lateral (Left): Anterior belly of digastric

53
Q

Contents of submental triangle

A

Mylohyoid, submental lymph nodes

54
Q

Which muscle and lymph nodes are in the submental triangle

A

Submental lymph nodes, mylohyoid muscle

55
Q

What are the borders of the submandibular (digastric) triangle

A

Superior: Inferior border of mandible
Anterior/Inf: Anterior belly of Digastric
Posterior/inf: Posterior belly of digastric

56
Q

Contents of Submandibular/Digastric triangle

A

Submandibular gland, Submandibular lymph nodes, Marginal mandibular branch of facial nerve (CN 7), Hypoglossal nerve ( CN 12), Mylohyoid n.(off mandibular branch of trigeminal), Facial artery and vein

57
Q

Which triangle is the submandibular gland in

A

Submandibular (digastric triangle)

58
Q

Borders of muscular triangle

A

Anterior: Midline of neck
Inferoposterior: Anterior margin of SCM
Posterosuperior: Superior belly of omohyoid

59
Q

Contents of muscular triangle

A

Omohyoid, sternohyoid, sternothyroid, thyrohyoid

60
Q

Viscera in muscular triangle

A

Thyroid and parathyroid glands, trachea and esophagus, common carotid/internal jugular v

61
Q

Carotid triangle borders

A

Superior: Stylohyoid and posterior belly of digastric
Posterior: Anterior border of scm
Anterioinferior:Superior belly of omohyoid

62
Q

Contents of carotid triangle

A

Nerves: Accessory (CN 11), Vagus (CN 10), Hypoglossal (CN 12), Ansa cervicalis (C1-C3), Laryngeal (CN 10 branches). (10+ laryngeal branches, 11, 12, C1-C3)
Arteries: Common, internal, external carotid arteries, 6 branches of external carotid (3 internal, 3 external)
Veins: All draining into IJV

63
Q

Is external jugular vein anterior or posterior triangle

A

posterior

64
Q

Which vein drains most of the face

A

Retromandibular vein

65
Q

Which veins form the retromandibular vein

A

Superficial temporal (superior) and maxillary vein (face)

66
Q

What makes up the anterior division of the retromandibular vein/ which vein does this drain into

A

Anterior division+facial vein =common facial vein, drains into internal jugular vein

67
Q

What makes up the posterior division of the retromandibular vein/what does it drain into

A

Posterior division+posterior auricular vein= drain into external jugular vein

68
Q

Which veins drain into external jugular vein

A

Posterior division of retromandibular vein and posterior auricular vein

69
Q

What veins drain into the internal jugular vein

A

Anterior division of retromandibular vein and facial vein (form common facial vein and then go into internal jugular)

70
Q

Which veins run superficially on top of the SCM and where do they come from

A

External jugular vein run superficially, Posterior division and posterior auricular make up EJ

71
Q

If you have an infection in the face, how does it travel to the brain?

A

Could travel via retromandibular vein

72
Q

Where does the transverse cervical nerve start and where does it supply superficial cutaneous innervation

A

Arises from erb’s point and travels anteriorly- supples skin of anterior cervical neck and lateral neck

73
Q

Where does C1 go of the cervical plexus/ansa cervicalis

A

Joins the hypoglossal nerve and travels with it, and then splits off to let superior root join with inferior root that arose from C2/C3

74
Q

Where do C2/C3 from the cervical plexus ansa cervicalis go

A

C2/C3 (anterior rami) make inverior root that joins superior root

75
Q

What is the relationship between vagus and ansa cervicalis descending from the head?

A

The vagus nerve runs inside of the sheath
The ansa cervicalis runs on top of the sheath

76
Q

Which muscle does the phrenic nerve run on top of in the anterolateral neck

A

anterior scalene

77
Q

Where does the common carotid artery arise from on the L and R side

A

R side: Branch of brachiocephalic trunk
L side: Branch of aortic arch

78
Q

What does the common carotid split into and where do those branches go?

A

Internal carotid: Towards brain and to circle of willis
External carotid: Many branches that go different places (3 anterior, 3 posterior)

79
Q

What are the 3 anterior external carotid arteries and where do they go

A

Superior Thyroid- to thyroid gland
Lingual- to tongue
Facial-to mandible

80
Q

What are the 3 posterior external carotid arteries

A

Ascending pharyngeal
occipital
posterior auricular

81
Q

What does external carotid a terminate as

A

Superficial temporal artery and maxillary artery

82
Q

Which nerve runs on top of the lingual artery

A

Hypoglossal crosses from posterior over it to go to anterior face

83
Q

The external carotid artery branches are deep to which muscles

A

Deep to stylohyoid and posterior belly of digastric

84
Q

What groups of muscles does the hyoid bone seperate

A

The suprahyoid muscles and infrahyoid muscles

85
Q

What are the suprahyoid muscles

A

Stylohyoid
digastric
mylohyoid
geniohyoid

86
Q

What are the infrahyoid muscles

A

omohyoid
sternohyoid
thyrohyoid
sternothyroid

87
Q

What are the right and left lobes of the thyroid connected by

A

isthmus

88
Q

Which lobe of the thyroid extends superiorly from isthmus

A

pyramidal lobe

89
Q

Where are the parathyroid glands in relation to the thyroid gland

A

4 glands within the posterior surface of the thyroid

90
Q

Where does R recurrent laryngeal nerve run

A

Under Right subclavian artery and ascends to Right lobe of thyroid

91
Q

Where does the L recurrent laryngeal nerve run

A

Loops under aortic arch and up to L thyroid lobe

92
Q

What nerve do the R and L recurrent laryngeal nerves arise from

A

from Vagus nerve
- R goes under subclavian to R thyroid gland
- L goes under aortic arch to L thyroid gland

93
Q

If you are looking from the anterior side, are you able to see the L or R recurrent laryngeal nerve

A

Can see the Right side- Vagus nerve loops in front of aortic arch and when it splits it gives off branch
Left side is posterior to internal jugular and subclavian

94
Q

Where does vertebral artery cross a foramen

A

Enters transverse foramen of C6 and superior
Runs posterior to vertebral vein and deep in the neck

95
Q

Which structure runs directly posterior to the vertebral vein

A

Vertebral artery

96
Q

Which structure arises from the subclavian artery prior to the thyrocervical trunk

A

the vertebral artery

97
Q

What is the sympathetic chain located inbetween

A

Anterior to prevertebral muscle, posterior to cervical viscera

98
Q

What are the 3 sympathetic ganglia found in cervical region

A

Superior cervical ganglion- anterior to longus capitis muscle
middle cervical ganglion- posterior to thyroid gland
cervicothoracic (stellate) ganglion ( inside thoracic inlet

99
Q

Which sympathetic ganglion is anterior to longus capitus

A

superior cervical

99
Q

which sympathetic ganglion is posterior to thyroid gland

A

middle cervical

100
Q

which sympathetic ganglion is inside the thoracic inlet

A

cervicothoracic (stellate) ganglion

101
Q

Which structure is the superior cervical ganglion in relation to

A

anterior to longus capitus m

102
Q

which structure is middle cervical ganglion in relation to

A

sits posterior to thyroid gland

103
Q

which structure is cervicothoracic (stellate) ganglion in relationship to

A

inside of thoracic inlet

Anatomy unit 4 (6 decks)

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