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Neuroendocrinology > Triangles of the Head and Neck > Flashcards

Triangles of the Head and Neck Flashcards

1
Q

What is present at vertebral level C3-C4?

A

Body of hyoid bone, upper margin thyroid cartilage, bifurcation of common carotid artery

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2
Q

What is present at vertebral level C5-C6?

A

Arch of cricoid cartilage, superior end of esophagus, superior end of trachea

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3
Q

What is another name for the posterior triangle?

A

Lateral cervical region

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4
Q

What are the borders of the posterior triangle?

A

SCM, trapezius, clavicle

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5
Q

What are the borders of the anterior triangle?

A

SCM, midline of neck, lower border of mandible

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6
Q

What triangles are found in the anterior triangle?

A

Submandibular, submental, carotid, muscular

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7
Q

What are the borders of the submandibular triangle?

A

Anterior belly of digastric, posterior belly of digastric, inferior border of mandible

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8
Q

What are the borders of the submental triangle?

A

Midline of neck, anterior belly of digastric, body of hyoid

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9
Q

What are the borders of the carotid triangle?

A

Posterior belly of digastric, superior belly of omohyoid, SCM

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10
Q

What are the borders of the muscular triangle?

A

Body of hyoid, superior belly of omohyoid, SCM

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11
Q

What muscles make up the floor of the posterior triangle?

A

Splenius capitus, levator scapulae, posterior/middle/anterior scalene

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12
Q

What are the branches off the subclavian artery?

A

Vertebral a, internal thoracic a, thyrocervical trunk (suprascapular a, transverse cervical a, inferior thyroid a), costocervical trunk (supreme intercostal a, deep cervical a), dorsal scapular a

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13
Q

What are the divisions of the subclavian artery?

A

I - vertebral a, internal thoracic a
II - (under anterior scalene m) costocervical trunk
III - dorsal scapular a

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14
Q

What arteries off the subclavian are located in the posterior triangle?

A

Transverse cervical a and suprascapular a (both off the thyrocervical trunk)

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15
Q

What veins are located in the posterior triangle?

A

External jugular vein (retromandibular v + posterior auricular v) and subclavian vein (joins with internal jugular vein to form brachiocephalic vein)

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16
Q

Clinically, what does it mean if you can see the external jugular vein?

A

Increased venous pressure = heart failure or obstruction of SVC

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17
Q

Why is the subclavian vein clinically relevant?

A

Used for central lines

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18
Q

What cutaneous nerves are located in the posterior triangle? What is this location called clinically?

A

Cervical plexus cutaneous nerves - lesser occipital, great auricular, transverse cervical, supraclavicular. Erb’s point.

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19
Q

What are the nerve roots of the posterior triangle cutaneous nerves?

A

Lesser occipital - C2
Great auricular - C2, C3
Transverse cervical - C2, C3
Suprascapular - C3, C4

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20
Q

What other nerves are located in the posterior triangle?

A

Spinal accessory nerve (CN XI), phrenic nerve, roots of brachial plexus, ansa cervicalis

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21
Q

What is the most common nerve that is accidentally cut?

A

Spinal accessory nerve (CN XI)

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22
Q

What does CN XI innervate?

A

SCM and trapezoid m

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23
Q

Where does CN XI lie?

A

Deep to SCM

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24
Q

What are the nerve roots of phrenic nerve?

A

C3, 4, 5 keep the diaphragm alive

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25
Q

Where does the phrenic nerve lie?

A

Anterior to anterior scalene m

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26
Q

Where does the brachial plexus exit?

A

Between anterior and middle scalene muscles

27
Q

What arteries lie superficial to the phrenic nerve?

A

Transverse cervical a and suprascapular a

28
Q

What does the ansa cervicalis n innervate?

A

Infrahyoid muscles

29
Q

Where does the ansa cervicalis lie?

A

In the fascia of the carotid sheath

30
Q

What is torticollis?

A

Contraction of SCM causing head to tilt and face to turn AWAY from affected side

31
Q

What are the triangles located in the posterior triangle?

A

Occipital triangle and omoclavicular (subclavian) triangle

32
Q

What are the suprahyoid muscles and what do they do?

A

Anterior/posterior bellies of digastric m, mylohyoid m, stylohyoid m (straddles posterior belly of digastric m), and geniohyoid muscle. Elevate the hyoid bone and larynx during swallowing and phonation

33
Q

What are the infrahyoid (strap) muscles?

A

Sternohyoid m, omohyoid m, sternothyroid m, thyrohyoid m

34
Q

What innervates the infrahyoid muscles?

A

Branches of the ansa cervicalis

35
Q

What are the branches of the external carotid artery that are in the anterior triangle?

A

Superior thyroid a, lingual a, facial a, ascending pharyngeal a, occipital a, posterior auricular a (Seven Angry Ladies Fighting Over PMS)

36
Q

What are the contents of the submandibular triangle?

A

Submandibular gland, submandibular lymph nodes, hypoglossal n (CN XII), nerve to mylohyoid, facial a/v

37
Q

Where does the hypoglossal n lie?

A

On the hyoglossus m

38
Q

What are the contents of the submental triangle?

A

Submental lymph nodes, veins that unite to form anterior jugular vein

39
Q

What are the contents of the muscular triangle?

A

Thyroid , parathyroid glands, larynx, trachea, esophagus, common carotid a, superior thyroid a, inferior thyroid a, anterior jugular v, thyroid veins, ansa cervicalis, external laryngeal n, recurrent laryngeal n

40
Q

What are the contents of the carotid triangle?

A

Carotid sheath, external carotid a branches, internal/external laryngeal n, hypoglossal n, spinal accessory n, ansa cervicalis

41
Q

What does the carotid sheath contain (and in what order)?

A

Internal/common carotid arteries (medial)
IJV (lateral)
Vagus n (posterior)
Ansa cervicalis (anterior/embedded in sheath)
(plus deep cervical lymph nodes, carotid sinus n, and sympathetic nerve fibers)

42
Q

Where does the carotid sheath go?

A

Base of skull to mediastinum in thorax

43
Q

Hypoglossal n wraps around what artery in the carotid triangle?

A

The occipital a

44
Q

What does the superior laryngeal n branch into?

A

Internal laryngeal n and external laryngeal n (in the carotid triangle)

45
Q

What innervates the carotid sinus and carotid body?

A

Carotid sinus n (and vagus n)

46
Q

What structures exit the jugular foramen?

A

Glossopharyngeal n (CN IX), vagus n (CN X), and spinal accessory n (CN XI)

47
Q

With thoracic outlet syndrome, if the brachial plexus is compressed what happens?

A

Sensory loss to hand (ulnar n: C8-T1) (inferior trunk of brachial plexus)

48
Q

How far does the lung extend into the root of the neck?

A

About 2 inches

49
Q

What innervates the carotid sinus?

A

The superior cervical ganglion///the carotid sinus n from the glossopharyngeal n (CN IX)

50
Q

What layer of fascia does the platysma muscle lie in?

A

Subcutaneous layer between the dermis and investing layer of deep cervical fascia

51
Q

What are the layers of the deep cervical fascia?

A
  1. Investing layer
  2. Pretracheal layer
  3. Prevertebral layer
52
Q

Which layer of fascia blends with the pericardium of the heart?

A

The pretracheal layer of deep cervical fascia

53
Q

Which layer of fascia extends laterally as the axillary sheath into the arm?

A

The prevertebral layer of deep cervical fascia

54
Q

What are the borders of the retropharyngeal space?

A

Buccopharyngeal fascia (anterior), prevertebral fascia (posterior), carotid sheaths (laterally)

55
Q

Within the carotid sheath, where are the vagus nerve, IJV, and common carotid artery usually located?

A

Vagus nerve - posterior
IJV - anterior/lateral
Common carotid artery - anterio/medial

56
Q

What artery and nerve run into the thyrohyoid membrane together?

A

Internal branch of superior laryngeal nerve and superior laryngeal artery

57
Q

Which muscle of the larynx is an abductor? Which are adductors?

A

Posterior crico-arytenoid muscle is an abductor.

Transverse arytenoid, oblique arytenoid, and lateral crico-arytenoid muscles are adductors.

58
Q

What do the two branches of superior laryngeal nerve do?

A

Internal laryngeal nerve (sensory) innervates sensory above vocal folds. External laryngeal nerve (motor) innervates the cricothyroid muscle

59
Q

Where does larynx end and trachea begin?

A

At cricoid cartilage

60
Q

Line through laryngeal ventricle at vocal folds separates lymph, blood supply, and innervation how? (above vs below)

A

Above: lymph = superior deep cervicals, blood = superior laryngeal a, sensory = internal branch of superior laryngeal n
Below: lymph = pretracheal and prelaryngeal to inferior deep cervicals, blood = inferior laryngeal a, sensory = inferior laryngeal n (from recurrent laryngeal n)

61
Q

What are the five groups of lymph nodes in the head?

A

Occipital, mastoid, pre-auricular/parotid, submandibular, submental

62
Q

Where are the superficial cervical LNs found vs the deep cervical LNs?

A

Superficial cervical LNs are along the EJV, deep cervical LNs are along the IJV

63
Q

What does the R lymphatic duct drain?

A

R head, R neck, R chest, RUE

64
Q

What does the thoracic duct drain?

A

L head, L neck, L chest, LUE, abdomen, pelvis, perineum, BLE

Neuroendocrinology (16 decks)

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