Triangles of the Neck 1 Flashcards
What is the superior attachment to the investing layer of deep fascia of the neck?
external occipital protuberance, superior nuchal line
What is the inferior attachment to the investing layer of deep fascia of the neck?
manubrium sterni, spine of scapula, acromion
What is the lateral attachment to the investing layer of deep fascia of the neck?
mastoid process, zygomatic arch
What is the posterior attachment to the investing layer of deep fascia of the neck?
ligamentum nuchae, C7 spine
What is the anterior attachment to the investing layer of deep fascia of the neck?
join its twin from the other side, surrounds infrahyoid muscle
In regards to the investing layer of deep fascia of the neck, from posterior to anterior: it encloses ___ then reunites to form roof of ____ triangle. It then splits again to enclose ____ then unite again to join its opposite twin
trapezius; posterior; sternomastoid
What veins (2) and nerves (3) pierce the investing layer of deep fascia of the neck?
veins: external jugular vein, anterior jugular vein
nerves: suprascapular, transverse cervical, 3 supraclavicular nerves
This fascia covers prevertebral muscles and extends laterally on each side behind carotid sheath and in front of scalene muscles to form the floor of the posterior triangle
prevertebral fascia
Prevertebral fascia ensheathes the ____ artery and ____ plexus to form the ___ sheath behind clavicle at the lower part of the posterior triangle
subclavian; brachial; axillary
Superiorly, the pretracheal fascia is attached to what bone?
hyoid bone
Inferiorly, the pretracheal fascia is attached to the posterior surface of the ____ and the upper thoracic ___
pericardium; cavity
Anteriorly, the pretracheal fascia covers what?
trachea and the thyroid gland
Laterally, the pretracheal fascia covers what?
thyroid gland and esophagus
Posteriorly, the pretracheal fascia is named _____ fascia; which separates the pharynx and esophagus form prevertebral fascia. It extends superiorly from the base of the skull to end inferiorly in the thoracic cavity
Buccopharyngeal
The carotid sheath is a column of cervical deep fascia derived form the surrounding layers. What vessels does it encase?
It surrounds the common carotid artery, internal carotid artery, internal jugular vein, and vagus nerve as they pass through the neck
___ ____ is embedded in the carotid sheath wall
Ansa cervicalis
The first fascial compartment is the ____, includes the 3 other compartments, and is surrounded by an ____ layer
largest; investing
The second fascial compartment consists of the ____ ___ and surrounding muscles. It is surrounded by a ____ layer
vertebral column; prevertebral
The third fascial compartment (visceral) contains what? What layer surrounds it?
pharynx, trachea, esophagus, and thyroid gland; surrounded by pretracheal layer
The fourth fascial compartment is the carotid sheath. True or false?
true
The pretracheal space is between the investing layer in front of the hyoid and pretracheal fascia. What is its clinical significance?
pus in this space may pass down from neck to the superior mediastinum and may point in the neck, above the manubrium
The retropharyngeal space is between the buccopharyngeal layer and the prevertebral fascia. What is its clinical significance?
pus in this space may pass down posterior to the pharynx and esphophagus, to posterior mediastinum
The third space is within the prevertebral layer as it splits into 2 laminae creating a fascial space that begins superiorly at base of skull passing by the posterior mediastinum and ending inferiorly at the diaphragm. What is its clinical significance?
pus from cervical vertebrae flows either forwards to reach retropharyngeal space of laterally to reach posterior triangle
What is the origin, insertion, and innervation of platysma?
origin: deep fascia covering pec major
insertion: muscle fibers proceed upwards and medially to the lower border of mandible and blend with muscles of the angle of the mouth
innervation: cervical branch of facial nerve
What are the anterior, posterior, and superior borders of the anterior triangle?
anterior: midline of neck
posterior: sternomastoid muscles
superior: lower border of mandible
For the following subdivision of the anterior triangle, give its boundaries and contents: submental triangle
boundaries: mandibular symphysis; anterior belly of digastric muscle; body of hyoid bone
contents: submental lymph nodes; tributaries forming the anterior jugular vein
For the following subdivision of the anterior triangle, give its boundaries and contents: submandibular triangle
boundaries: lower border of mandible; anterior belly of digastric muscle; posterior belly of digastric muscle
contents: submandibular gland, submandibular lymph nodes, hypoglossal nerve, mylohyoid nerve, facial artery and vein
For the following subdivision of the anterior triangle, give its boundaries and contents: carotid triangle
boundaries: posterior belly of digastric muscle; superior belly of omohyoid muscle; anterior border of sternocleidomastoid muscle
contents: tributaries to common facial vein; cervical branch of facial nerve; common carotid artery; external and internal carotid arteries
For the following subdivision of the anterior triangle, give its boundaries and contents: muscular triangle
boundaries: midline of neck, superior belly of omohyoid muscle, anterior border of sternocleidomastoid muscle
contents: sternohyoid, omohyoid, sternohyoid, and thyrohyoid muscles, thyroid and parathryoid glands, pharynx
Stylohyoid, digastric, mylohyoid, and geniohyoid are all ____ muscles
suprahyoid
Sternohyoid, sternothyroid, thryohyoid, and omohyoid are all ____ muscles
infrahyoid
What is the origin, insertion, innervation, and main action of mylohyoid
origin: mylohyoid line of mandible
insertion: mylohyoid raphe and body of hyoid
innervation: nerve to mylohyoid
main action: elevates hyoid, floor of mouth, and tongue during swallowing and speaking
What is the origin, insertion, innervation, and main action of Geniohyoid
origin: inferior mental spine of mandible
insertion: body of hyoid
innervation: C1 via hypoglossal nerve
main action: pulls hyoid anteriosuperiorly; shortens floor of mouth; widens pharynx
What is the origin, insertion, innervation, and main action of stylohyoid
origin: styloid process of temporal bone
insertion: body of hyoid
innervation: stylohyoid branch of facial nerve
main action: elevates and retracts hyoid, thus elongating floor of mouth
What is the origin, insertion, innervation, and main action of digastric: anterior belly/ posterior belly
origin: anterior belly: digastric fossa of mandible; posterior belly: mastoid notch of temporal bone
insertion: intermediate tendon to body and greater horn of hyoid
innervation: anterior belly: nerve to mylohyoid, a branch of inferior alveolar nerve; posterior belly: digastric branch of facial nerve
main action: working with infra hyoid muscles, depresses mandible against resistance; elevates and steadies hyoid during swallowing and speaking
What is the origin, insertion, innervation, and main action of sternohyoid
origin: manubrium and medial end of clavicle
insertion: body of hyoid
innervation: C1-C3 by a branch of ansa cervicalis
main action: depress hyoid after elevation during swallowing
What is the origin, insertion, innervation, and main action of omohyoid
origin: superior border of scapula
insertion: inferior border of hyoid
innervation: C1-C3 by a branch of ansa cervicalis
main action: depresses, retracts, and steadies hyoid
What is the origin, insertion, innervation, and main action of sternothryoid
origin: posterior surface of manubrium
insertion: oblique line of thyroid cartilage
innervation: C2 and C3 by a branch of ansa cervicalis
main action: depresses hyoid and larynx
What is the origin, insertion, innervation, and main action of thryohyoid
origin: oblique line of thyroid cartilage
insertion: inferior border of body and greater horn of hyoid
innervation: C1 via hypoglossal nerve
main action: depresses hyoid and elevates larynx
The ___ CCA arises from the brachiocephalic trunk, while the ___ CCA arises from the aorta
right; left
Both CCA ascend in neck inside carotid sheath and end at the upper border of what?
thyroid cartilage by dividing into two branches: internal and external carotid arteries
The internal carotid artery ascends upwards in the carotid sheath towards the head without giving branches in the neck to end by entering the carotid canal in petrous part of temporal bone where it branches to supply what?
inside cranial cavity, it supplies cerebral hemispheres, eyes, orbital contents, and forehead
This is a branch from the anterior aspect of the external carotid artery. It is near the bifurcation, down to the superior pole of thyroid gland. It supplies thryohyoid, sternomastoid, cricothryoid muscles and internal structures of the larynx
superior thyroid artery
This is a branch from the anterior aspect of the external carotid artery. It is just above the superior thyroid artery at the level of the hyoid bone, passes deep to the hypoglossal nerve between the middle constrictor and hypoglossus muscles. It supplies the tongue, tonsils, epiglottis, floor of the mouth, and sublingual glands.
lingual artery
This is a branch from the anterior aspect of the external carotid artery. It is just above the lingual artery an passes deep to stylohyoid and posterior belly of digastric and then between submandibular gland and mandible, then emerges under edge of mandible to enter the face. It supplies all structures in the face in front of the master and above the mandible till the eagle of the eye, soft palate, tonsil, and submandibular gland
facial artery
This is a branch from the posterior aspect of the external carotid artery. It is just above the facial artery and then goes upwards and backwards deep to the posterior belly of the digastric to scalp. It supplies sternomastoid, meninges, mastoid cells, deep muscles of back, and posterior part of scalp
occipital artery
This is a branch from the posterior aspect of the external carotid artery. It is upwards and backwards behind the auricle to scalp. It supplies external, middle, and inner ear structures, parotid gland and nearby muscles, and scalp area posterior to the auricle
posterior auricular artery
This is a branch from the medial aspect of the external carotid artery. It is the smallest branch and ascends to the side of the pharynx deep to ICA. It supplies the pharyngeal constrictor muscles, sylopharyngeus, phayrngotympanic tube and meninges of the posterior cranial fossa
ascending pharyngeal artery
This is a terminal branch from the external carotid artery. It is behind the neck of mandible as an upward continuation of the ECA, crossing the zygomatic arch to anterior aspect of the auricle. It supplies the parotid gland and cut, temporalis, lateral face, anterior part of the external ear, parietal and temporal fossa
superficial temporal artery
This is a terminal branch from the external carotid artery. It is the larger of the 2 terminal branches at the neck of mandible. It passes backwards through the parotid gland into infra temporal fossa and then into pterygopalatine fossa. It supplies chin, ear, and nasal areas.
maxillary
This is a dilation at the bifurcation of CCA and the beginning of ICA that contains receptors monitoring changes in blood pressure. It is innervated by the glossopharyngeal nerve (IX)
carotid sinus
This is another accumulation of receptors monitoring changes in blood chemistry especially oxygen content and is innervated by glossopharyngeal (IX) and Vagus (X) nerves
carotid body
The internal jugular vein being as a downward continuation of ___ ___ sinus at the base of the skull. It exists through the ____ foramen together with IX, X, and XI cranial nerves to enter the carotid sheath
sigmoid dural; jugular
The initial upper part of the IJV is dialed forming the ___ ____ which receives inferior petrosal sinus as a tributary
superior bulb
The IJV ends by joining what vein?
subclavian at sternal end of clavicle to form brachiocephalic vein
What is the clinical point regarding jugular venous pressure?
it is a reflection of functioning right side of heart - clinical sign to asses venous pressure
