Triangles of the Neck Flashcards

1
Q

What are the 8 palpable bony and cartilaginous landmarks?

A

mastoid process of temporal bone, mandible, mental protuberance, hyoid bone, thyroid cartilage, cricoid cartilage, trachea, suprasternal notch

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2
Q

What are the parts of the mandible?

A

ramus, angle, and body

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3
Q

At what vertebral level is the hyoid bone?

A

C3

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4
Q

At what vertebral level is the thyroid cartilage?

A

C4-C5

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5
Q

At what vertebral level is the cricoid process?

A

C6

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6
Q

At what vertebral level is the trachea?

A

C6 (or C7) to T1

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7
Q

What is the Superficial Cervical Fascia?

A

fatty subcutaneous tissue between dermis and investing layer of deep cervical fascia

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8
Q

What does the superficial cervical fascia contain?

A

vv., nn., lymphatics, and platysma m.

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9
Q

what is the action of the platysma m.?

A

depress mandible and lower lip, tenses skin of neck

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10
Q

what is the innervation of the platysma m.?

A

cervical branch of the fascial n. (CN VII)

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11
Q

What is the Superficial Cervical Fascia?

A

fatty subcutaneous tissue between dermis and investing layer of deep cervical fascia

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12
Q

What does the superficial cervical fascia contain?

A

vv., nn., lymphatics, and platysma m.

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13
Q

what is the action of the platysma m.?

A

depress mandible and lower lip, tenses skin of neck

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14
Q

what is the innervation of the platysma m.?

A

cervical branch of the fascial n. (CN VII)

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15
Q

What are the 4 layers of deep cervical fascia?

A

investing layer, pretracheal layer, prevertebral layer, carotid sheath

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16
Q

what does the investing layer of the deep cervical fascia surround?

A

surrounds and encloses the entire neck deep to the superficial cervical fascia

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17
Q

what does the investing layer of the deep cervical fascia invest?

A

sternocleidomastoid m. and trapezius m.

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18
Q

what does the investing layer of the deep cervical fascia form?

A

the roof over the posterior and anterior triangles of the neck

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19
Q

where is the pretracheal layer of the deep cervical fascia?

A

limited to the anterior part of the neck; extends from hyoid into the throax

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20
Q

what does the pretracheal layer of the deep cervical fascia enclose?

A

the infrahyoid mm., thyroid glad, thrachea, esophagus

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21
Q

what does the prevertebral layer of the deep cervical fascia form?

A

forms a tubular sheath overlying cervical vertebral column and associated mm.
forms the floor of the posterior and anterior triangles of the neck?

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22
Q

what are the associated mm. that the prevertebral layer of the deep cervical fascia enclose?

A

anteriorly- longus colli m and longus capitis m.
laterally- scalene mm.
posteriorly- levator scapulae m. and deep cervical m.

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23
Q

what is the carotid sheath?

A

fascial tube that extends from the base of the cranium to the root of the neck

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24
Q

what does the carotid sheath contain?

A

common or internal carotid artery (anterior-medial)
internal jugular v. (anterior-lateral)
vagus n. (CN X) (posterior)

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25
Q

What are the superficial vessels of the neck?

A

external jugular v., anterior jugular v., fascial a. and v.

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26
Q

what does the external jugular v.?

A

drains most of the scalp and side of face

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27
Q

Where does the external jugular v. come from?

A

the union of retromandibular v. and posterior auricular v.

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28
Q

where does the external jugular v. drain to?

A

drains into the subclavian v.

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29
Q

where does the anterior jugular v. drain?

A

into the external jugular v.

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30
Q

what is the course of the fascia a. and v.?

A

curve around inferior border of the mandible to enter/exit the face

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31
Q

where is the nerve point of the neck?

A

midpoint of the inferior border of the sternocleidomastoid m.

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32
Q

what are the CUTANEOUS nn. of the cervical plexus?

A

lesser occipital n., great auricular n., transverse cervical n., supraclavicular nn.

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33
Q

what is the spinal segments of the lesser occipital n.?

A

C2

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34
Q

what is the spinal segments of the great auricular n.?

A

C2-C3

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35
Q

what is the spinal segments of the transverse cervical n.?

A

C2-C3

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36
Q

what is the spinal segments of the supraclavicular n.?

A

C3-C4

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37
Q

What are the superficial mm. of the neck?

A

platysma m. and sternocleidomastoid m.

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38
Q

what is the origin of the sternocleidomastoid m.?

A

two heads: manubrium and clavicle

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39
Q

what is the insertion of the sternocleidomastoid m.?

A

mastoid process and superior nuchal line

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40
Q

what is the action of the sternocleidomastoid m.?

A

unilateral: tilts head to same side and rotates face towards the opposite side
bilateral: flex or extend neck

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41
Q

what is the innervation of the sternocleidomastoid m.?

A

spinal accessory n. (CN XI)

42
Q

what is the course of the spinal accessory n.?

A

travels across floor of posterior triangle on top of levator scapulae m.

43
Q

what results in congenital torticollis?

A

damage to the sternocleidomastoid m. or spinal accessory n. (XI) during delivery

44
Q

what does congenital toricollis result in?

A

results in scarring (fibrosis) and shortening of the m. which cannot lengthen with the growing neck. the deficit resembles a normal unilateral contraction of the sternocleidomastoid m. causing head tilt towards the lesioned side and the chin turned superiorly towards the opposite, non lesioned side

45
Q

what are the two major triangles of the neck?

A

posterior cervical triangle and anterior cervical triangle

46
Q

what is the anatomic landmark dividing the two triangles?

A

sternocleidomastoid m.

47
Q

what are the borders of the posterior cervical triangle?

A

anterior: sternocleidomastoid m
posterior: trapezius m.
inferior: clavicle

48
Q

what are the borders of the anterior cervical triangle?

A

anterior: midline of the neck
posterior: sternocleidomastoid m.
superior: body of the mandible

49
Q

what are the subdivisions of the posterior cervical triangle?

A

occipital and subclavian triangles

50
Q

what are the boundaries of the occipital triangle?

A

sternocleidomastoid m., trapezius m., and omohyoid m. (inferior belly)

51
Q

what are the boundaries of the subclavian triangle?

A

sternocleidomastoid m., omohyoid m. (inferior belly), and clavicle

52
Q

what is the roof of the occipital triangle?

A

investing layer of deep cervical fascia

53
Q

what is the floor of the occipital triangle?

A

prevertebral layer of the deep cervical fascial overlying six mm.

54
Q

what are the six mm. that make up the floor of the occipital triangle?

A
semispinalis capitis m.
splenius capitis m.
levator scapulae m.
posterior scalene m.
middle scalene m.
anterior scalene m.
55
Q

what are the cutaneous (superficial) nn. in the occipital triangle?

A

lesser occipital n., great auricular n., transverse cervical n., supraclavicular n.

56
Q

what are the muscular (deep) nn. of the occipital triangle?

A

spinal accessory n. (XI)

branchial plexus

57
Q

what does the spinal accessory n. innervate?

A

trapezius m. and sternocleidomastoid mm.

58
Q

what results from damage of the spinal accessory n. (XI)?

A

weakness in the trapezius and sternocleidomastoid m.

59
Q

how do you test if their is damage to the spinal accessory n.?

A

patient shrugs shoulders against resistance and turns head to opposite side against resistance

60
Q

where does the brachial plexus emerge?

A

portion of it (usually C5, C6 roots) emerge between the anterior and middle scalene mm.
dorsal scapular n. (C5) often pierces through the middle scalene m.

61
Q

what are the vessels in the occipital triangle?

A

transverse cervical a. (branch of thyrocervical trunk)

inferior part of external jugular v.

62
Q

what are the contents of the subclavian (omoclavicular) triangle?

A

anterior scalene m., lower roots of brachial plexus, phrenic n. (C3-C5) which courses inferiorly on anterior surface of anterior scalene m., suprascapular a. (branch of thyrocervical trunk), subclavian a. and v.

63
Q

what are the 4 subdivisions of the anterior triangle?

A

submental, submandibular, muscular, and carotid triangles

64
Q

what are the boundaries of the submental triangle?

A

digastric (left and right anterior bellies) and hyoid

65
Q

what are the boundaries of the submandibular (digastric) triangle?

A

digastric (anterior belly), digastric (posterior belly), body of mandible
intermediate tendon attaching the anterior and posterior digastric mm.

66
Q

what are the boundaries of the muscular triangle?

A

omohyoid (superior belly), sternocleidomastoid m., midline of the neck

67
Q

what are the boundaries of the carotid triangle?

A

omohyoid (superior belly), digastric (posterior belly), sternocleidomastoid m.

68
Q

what are the contents of the submental triangle?

A

mylohyoid m., submental lymph nodes (which drain the tip of the tongue), small vv. uniting to form anterior jugular v.

69
Q

what are the suprahyoid mm.?

A

mylohyoid m.
digastric m.
stylohyoid m. (styloid process to the hyoid)

70
Q

what are the contents of the muscular triangle?

A

tyroid and parathyroid glands, infrohyoid mm. (strap mm.)

71
Q

what are the contents of the carotid triangle?

A

carotid sheath: common or internal carotid a. (external carotid a. is NOT in the sheath), internal jugular v., vagus n. (X)
hypoglossal n. (XII)
external carotid a.

72
Q

what are the muscle categories of the anterior cervical triangle?

A

suprahyoid mm.

infrahyoid mm. (strap mm.)

73
Q

what are the suprahyoid mm.?

A

mylohyoid m.

digastric m.

74
Q

what are the infrahyoid mm. (strap mm.)?

A

sternohyoid m., sternothyroid m., thyrohyoid m., omohyoid m.

75
Q

what is the origin of the mylohyoid m.?

A

mylohyoid line of mandible

76
Q

what is the insertion of the mylohyoid m.?

A

mylohyoid raphe and hyoid bone

77
Q

what is the action of the mylohyoid m.?

A

elevates hyoid and floor of mouth

78
Q

what is the innervation of the mylohyoid m.?

A

n. to mylohyoid (mandibular n. [V^3])

79
Q

what is the origin of the digastric m.?

A

anterior belly: digastric fossa of mandible

posterior belly: mastoid notch of temporal bone

80
Q

what is the insertion of the digastric m.?

A

intermediate tendon to hyoid bone

81
Q

what is the action of the digastric m.?

A

depresses mandible; elevates hyoid

82
Q

what is the innervation of the digastric m.?

A

anterior belly: n. to mylohyoid

posterior belly: facial n. (VII)

83
Q

what is the origin of the sternohyoid m.?

A

manubrium and clavicle

84
Q

what is the insertion of the sternohyoid m.?

A

hyoid bone

85
Q

what is the action of the sternohyoid m.?

A

depresses hyoid

86
Q

what is the innervation of the sternohyoid m.?

A

ansa cervicalis

87
Q

what is the origin of the sternothyroid m.?

A

manubruim

88
Q

what is the insertion of the sternothyroid m.?

A

thyroid cartilage

89
Q

what is the action of the sternothyroid m.?

A

depresses hyoid and larynx

90
Q

what is the innervation of the sternothyroid m.?

A

ansa cervicalis

91
Q

what is the origin of the thyrohyoid m.?

A

thyroid cartilage

92
Q

what is the insertion of the thyrohyoid m.?

A

hyoid bone

93
Q

what is the action of the thyrohyoid m.?

A

depresses hyoid and elevates larynx

94
Q

what is the innervation of the thyrohyoid m.?

A

C1 via hypoglossal n. (XII)

95
Q

what is the origin of the omohyoid m.?

A

suprascapular notch of scapula

96
Q

what is the insertion of the omohyoid m.?

A

hyoid bone

97
Q

what is the action of the omohyoid m.?

A

depresses and retracts hyoid

98
Q

what is the innervation of the omohyoid m.?

A

ansa cervicalis

99
Q

what is the ansa cervicalis?

A

motor root of cervical plexus

100
Q

what are the spinal segments of the ansa cervicalis?

A

C1-C3