Triangles of the Neck 1

Question 1

What is the superior attachment to the investing layer of deep fascia of the neck?

Answer 1

external occipital protuberance, superior nuchal line

Question 2

What is the inferior attachment to the investing layer of deep fascia of the neck?

Answer 2

manubrium sterni, spine of scapula, acromion

Question 3

What is the lateral attachment to the investing layer of deep fascia of the neck?

Answer 3

mastoid process, zygomatic arch

Question 4

What is the posterior attachment to the investing layer of deep fascia of the neck?

Answer 4

ligamentum nuchae, C7 spine

Question 5

What is the anterior attachment to the investing layer of deep fascia of the neck?

Answer 5

join its twin from the other side, surrounds infrahyoid muscle

Question 6

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

Answer 6

trapezius; posterior; sternomastoid

Question 7

What veins (2) and nerves (3) pierce the investing layer of deep fascia of the neck?

Answer 7

veins: external jugular vein, anterior jugular vein
nerves: suprascapular, transverse cervical, 3 supraclavicular nerves

Question 8

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

Answer 8

prevertebral fascia

Question 9

Prevertebral fascia ensheathes the ____ artery and ____ plexus to form the ___ sheath behind clavicle at the lower part of the posterior triangle

Answer 9

subclavian; brachial; axillary

Question 10

Superiorly, the pretracheal fascia is attached to what bone?

Answer 10

hyoid bone

Question 11

Inferiorly, the pretracheal fascia is attached to the posterior surface of the ____ and the upper thoracic ___

Answer 11

pericardium; cavity

Question 12

Anteriorly, the pretracheal fascia covers what?

Answer 12

trachea and the thyroid gland

Question 13

Laterally, the pretracheal fascia covers what?

Answer 13

thyroid gland and esophagus

Question 14

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

Answer 14

Buccopharyngeal

Question 15

The carotid sheath is a column of cervical deep fascia derived form the surrounding layers. What vessels does it encase?

Answer 15

It surrounds the common carotid artery, internal carotid artery, internal jugular vein, and vagus nerve as they pass through the neck

Question 16

___ ____ is embedded in the carotid sheath wall

Answer 16

Ansa cervicalis

Question 17

The first fascial compartment is the ____, includes the 3 other compartments, and is surrounded by an ____ layer

Answer 17

largest; investing

Question 18

The second fascial compartment consists of the ____ ___ and surrounding muscles. It is surrounded by a ____ layer

Answer 18

vertebral column; prevertebral

Question 19

The third fascial compartment (visceral) contains what? What layer surrounds it?

Answer 19

pharynx, trachea, esophagus, and thyroid gland; surrounded by pretracheal layer

Question 20

The fourth fascial compartment is the carotid sheath. True or false?

Answer 20

true

Question 21

The pretracheal space is between the investing layer in front of the hyoid and pretracheal fascia. What is its clinical significance?

Answer 21

pus in this space may pass down from neck to the superior mediastinum and may point in the neck, above the manubrium

Question 22

The retropharyngeal space is between the buccopharyngeal layer and the prevertebral fascia. What is its clinical significance?

Answer 22

pus in this space may pass down posterior to the pharynx and esphophagus, to posterior mediastinum

Question 23

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?

Answer 23

pus from cervical vertebrae flows either forwards to reach retropharyngeal space of laterally to reach posterior triangle

Question 24

What is the origin, insertion, and innervation of platysma?

Answer 24

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

Question 25

What are the anterior, posterior, and superior borders of the anterior triangle?

Answer 25

anterior: midline of neck posterior: sternomastoid muscles superior: lower border of mandible

Question 26

For the following subdivision of the anterior triangle, give its boundaries and contents: submental triangle

Answer 26

boundaries: mandibular symphysis; anterior belly of digastric muscle; body of hyoid bone contents: submental lymph nodes; tributaries forming the anterior jugular vein

Question 27

For the following subdivision of the anterior triangle, give its boundaries and contents: submandibular triangle

Answer 27

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

Question 28

For the following subdivision of the anterior triangle, give its boundaries and contents: carotid triangle

Answer 28

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

Question 29

For the following subdivision of the anterior triangle, give its boundaries and contents: muscular triangle

Answer 29

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

Question 30

Stylohyoid, digastric, mylohyoid, and geniohyoid are all ____ muscles

Answer 30

suprahyoid

Question 31

Sternohyoid, sternothyroid, thryohyoid, and omohyoid are all ____ muscles

Answer 31

infrahyoid

Question 32

What is the origin, insertion, innervation, and main action of mylohyoid

Answer 32

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

Question 33

What is the origin, insertion, innervation, and main action of Geniohyoid

Answer 33

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

Question 34

What is the origin, insertion, innervation, and main action of stylohyoid

Answer 34

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

Question 35

What is the origin, insertion, innervation, and main action of digastric: anterior belly/ posterior belly

Answer 35

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

Question 36

What is the origin, insertion, innervation, and main action of sternohyoid

Answer 36

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

Question 37

What is the origin, insertion, innervation, and main action of omohyoid

Answer 37

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

Question 38

What is the origin, insertion, innervation, and main action of sternothryoid

Answer 38

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

Question 39

What is the origin, insertion, innervation, and main action of thryohyoid

Answer 39

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

Question 40

The ___ CCA arises from the brachiocephalic trunk, while the ___ CCA arises from the aorta

Answer 40

right; left

Question 41

Both CCA ascend in neck inside carotid sheath and end at the upper border of what?

Answer 41

thyroid cartilage by dividing into two branches: internal and external carotid arteries

Question 42

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?

Answer 42

inside cranial cavity, it supplies cerebral hemispheres, eyes, orbital contents, and forehead

Question 43

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

Answer 43

superior thyroid artery

Question 44

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.

Answer 44

lingual artery

Question 45

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

Answer 45

facial artery

Question 46

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

Answer 46

occipital artery

Question 47

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

Answer 47

posterior auricular artery

Question 48

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

Answer 48

ascending pharyngeal artery

Question 49

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

Answer 49

superficial temporal artery

Question 50

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.

Answer 50

maxillary

Question 51

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)

Answer 51

carotid sinus

Question 52

This is another accumulation of receptors monitoring changes in blood chemistry especially oxygen content and is innervated by glossopharyngeal (IX) and Vagus (X) nerves

Answer 52

carotid body

Question 53

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

Answer 53

sigmoid dural; jugular

Question 54

The initial upper part of the IJV is dialed forming the ___ ____ which receives inferior petrosal sinus as a tributary

Answer 54

superior bulb

Question 55

The IJV ends by joining what vein?

Answer 55

subclavian at sternal end of clavicle to form brachiocephalic vein

Question 56

What is the clinical point regarding jugular venous pressure?

Answer 56

it is a reflection of functioning right side of heart - clinical sign to asses venous pressure