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M1 Gross Anatomy > Triangles of the Neck > Flashcards

Triangles of the Neck Flashcards

1
Q

Fascia of the neck

A
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2
Q

Contents of superficial fascia

A

Platysma m.

Cutaneous nn.

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3
Q

Contents of the superficial cervical (investing) fascia

A

Sternocleidomastoid m.

Trapezius m.

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4
Q

Contents of the infrahydoid fascia

A

The strap muscles:

Sternohyoid m.
Omohyoid m.
Sternothyroid m.
Thyrohyoid m.

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5
Q

Contents of the pretracheal fascia

A

Thyroid and parathyroid glands

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6
Q

Contents of the carotid sheath

A

Internal jugular vein

CN X (vagus)

Common carotid aa

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7
Q

Contents of the prevertebral fascia

A

Deep neck muscles

Roots of brachial/cervical plexuses

Phrenic n.

Sympathetic trunk

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8
Q

Triangles of the neck

Surface anatomy

A
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9
Q

The nerve point

A

2/3 of the way up the sternocleidomastoid muscle

Supraclavicular nerve
Transverse cervical nerve
Great auricular nerve
Lesser occipital nerve
CN XI

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10
Q

Carefree zone

A
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11
Q

Careful zone

A
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12
Q

External jugular vein

Surface anatomy

A
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13
Q

Subclavian triangle

A

Subdivision of careful zone

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14
Q

Submental triangle

A

Anterior belly of digastric m. (CN V-3)

Mylohyoid (CN V-3)

Sumental lymphnode (lymph from tongue)

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15
Q

Submandibular triangle

A

Posterior belly of digastric (CN VII)

Mylohyoid/stylohyoid muscles (CN VII)

CN XII
Mylohyoid n.
Genioglossus (C1)

Facial artery and vein

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16
Q

Carotid triangle

A

Lots of nerves

CN IX
CN XII
Ansa cervicalis (C1-3)
Thyrohyoid n
Laryngeal n.

Deep cervical nodes
Jugulodigastric nodes
Jugulo-omohyoid nodes

Thyroid artery

Superior belly of omohyoid m. (ansa cervicalis innervates)

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17
Q

Muscular triangles

A

Sternohyoid+omohyoid+sternothyroid (ansa cervicalis innervates these) and thyrohyoid (innervated by C1)

Prelaryngeal nodes
Pretracheal nodes

Anterior jugular and communicating veins

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18
Q

Posterior triangle

A
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19
Q

Anterior triangle

A

CN XII is just anterior to the superior aspect of external jugular (image on left - lateral view)

CN XII pierces the carotid sheath

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20
Q
A

Submental triangle (center of image)

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21
Q

Branches of the external carotid artery

A
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22
Q

Anastomoses between the internal and external carotid arteries

A

The facial a./lingual a./ and ascending pharyngeal artery also anastomose at the palantine tonsil bed

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23
Q

Major branches off of the right subclavian

A

Transverse cervical a.
Inferior thyroid a.
Suprascapular a.
Dorsal scapular a. (sometimes off transverse cervical)

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24
Q

Branches of the external carotid a.

A
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25
Q

Branches of the right subclavian a.

A
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26
Q

Superior laryngeal nerve

A

Superior laryngeal nerve (CN X) branches to form the external superior laryngeal nerve

Innervates the cricothyroid muscle

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27
Q
A

The nerve point

Contains part of the C2-3 loop (common place to anesthetize)

Contains:

Lesser occipital n.
Greater auricular n.
Transverse cervical n.

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28
Q
A

The ansa cervicalis

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29
Q
A

The descending hypoglossi

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30
Q
A

The descending cervicalis

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31
Q
A

The phrenic nerve (C3-5)

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32
Q
A

Nerve to the thyrohyoid muscle

33
Q

The cervical plexus

A

C1-2 loop

C2-3 loop

C4

34
Q

C1-2 loop of the cervical plexus

A

Contains the nerve to the thyrohyoid muscle (tongue)

and the descending hypoglossi nerve

35
Q

C2-3 loop of the cervical plexus

A

Contains the descending cervicalis nerve, lesser occipital nerve, greater auricular nerve, transverse cervical nerve (also contains fibers from C4), supraclavicular nerve (also contains fibers from C4), and the phrenic nerve

36
Q

Anterior carotid triangle

A
37
Q

Cartilage/Bone landmarks

A
38
Q

What innervates the sternocleido mastoid muscle?

A

CN XI (spinal acessory nerve) - delineates the carefree and careful zone

39
Q

Anterior digastric innervation

A

CN V-3 (the mandibular branch)

Specifically by the nerve to the mylohyoid muscle

40
Q

Posterior digastric innervation

A

CN VII

41
Q

Vertebral level of bifurcation of the common carotid

A

CV4

42
Q

Ansa cervicalis

A

Loop from the cervical plexus carrying fibers from the descending hypoglossi n

C1-3

Motor to the muscles in the muscular triangle

Ansa - means loop

43
Q
A
44
Q

Motor innervation of the muscle that tenses the vocal cords

A

Cricothyroid muscle is innervated by the external laryngeal nerve

Travels right with the superior thyroid artery (commonly damaged during thyroid surgery)

45
Q

Muscle innervation and action of the sternohyoid

A

Ansa cervicalis innervates the sternohyoid muscle which pulls down on the hyoid when contracted (during swallowing)

46
Q

What is superficial to the thyroid gland (and location)

A

The thyroid is deep to the sternothroid and sternohyoid muscles

2nd and 3rd tracheal rings of the larynx

47
Q

The lateral region

A

Forms the posterior triangle (Home of the careful and carefree zones)

Borders:
Posterior - trapezius m
Inferior - clavicle
Anterior - sternocleidomastoid

48
Q

The anterior cervical region

A

Borders:
Posterior - sternocleidomastoid
Inferior - manubrium
superior - mandible

Four sub divisions (triangles) - submental, submandibular, carotid, and muscular

49
Q

Congenital torticollis

A

Sternocleidomastoid m. is damaged due to a tumor or tearing

50
Q

Zones of cutaneous innervation

A
51
Q

Virchow’s node

A

swelling indicative of infection or cancer in head, neck or chest

Deep to investing fascia

52
Q

Where is an emergency cricothyrotomy incision made?

A

Between the thyroid and cricoid cartilages

53
Q
A

A - great auricular n.
C - lessor occipital n.
D - spinal accessory n. (CN XI)

Zone A - carefree zone
Zone B - careful zone

54
Q

Careful zone contents

A

Muscles - Levator scapulae, anterior/middle/posterior scalene muscles

Nerves - Roots and trunks of cervical and brachial plexuses, phrenic nerve, dorsal scapular nerve

Blood vessels - subclavian artery and vein, transverse cervical artery, dorsoscapular artery, and suprascapular arteries, and the internal jugular vein

55
Q

What separates the border between the careful and carefree zones of the posterior triangle (lateral region)

A

CN XI (spinal acessory nerve) - pierces the sternocleidomastoid m. on its way to the trapezius, picks up branches of C2-3 en route.

56
Q

Thoracic outlet syndrome cause

A

Suffieicient muscle tension can build up in the scalenes to compress the C5-6 roots giving rise to nuerogenic symptoms

57
Q
A

A - mylohyoid
B - anterior belly of the digastric
C - hyoid bone

58
Q
A

A - Posterior belly of the digastric
B - Common facial v.
C - Hypoglossal n. (CN XII)
D - Submandibular gland
E - Anterior belly of digastric muscle

59
Q
A

A - Superior belly of the omohyoid m.
B - Ansa cervicalis
C - Facial artery
D - Carotid sheath

60
Q
A

A - CN XII (hypoglossal n.)
B - Omohyoid m.
C - CN X (vagus)
D - Internal carotid artery
E - External carotid artery
F - Common carotid a.
G - Phrenic nerve (anterior to the anterior scalene)

61
Q
A

A - Internal jugular
B - superior belly of omohyoid muscle
C - subclavian triangle
D - CN XI (spinal accessory n.)
E - transverse cervical a
F - prevertebral fascia

62
Q
A

A - sternohyoid muscle (innervated by ansa cervicalis)

B - Sternothyroid (also innervated by ansa cervicalis)

C - Superior belly of omohyoid m.

D - Thyrohyoid muscle

63
Q
A

A - Great auricular n.m (C2-3)

B - Lesser occipital n. ()

C - Transverse cervical (C2-3)

D - CN XI (spinal accessory n.)

E - Superficial cervical lymph node (deep are at the level of internal jugular vein)

F - Supraclavicular n. (C3-4)

64
Q
A

A - Sympathetic trunk (posterior to common carotid artery)

B - Anterior scalene m.

C - Phrenic n.

D - Vagus n.

65
Q
A

A - CN XI (spinal accessory n.)

B - CN X (vagus n.)

C - Cervical sympathetic trunk

66
Q
A

A - CN XII

B - C1 - nerve to the thyrohyoid

C - Interal laryngeal n.

D - External laryngeal n.

E - Ansa cervicalis

67
Q
A

Cricothyroid m.

68
Q
A

A - Maxillary atery

B - Facial artery

C - Lingual artery

D - Superior thyroid artery

E - Superificial temporal artery

F - Posterior auricular artery

G - CN XI (spinal accessory nerve - under occipital artery)

H - Internal carotid a.

I - Carotid sinus

69
Q
A

A - Occipital artery

B - CN XI

C - CN IX (nerve to the carotid sinus)

D - CN X (vagus between common carotid a. and internal jugular vein)

70
Q

Nerves that emerge from the jugular foramen

A

CN IX, X, and XI

71
Q
A

A - External carotid a.

B - Superior thyroid a.
C - Inferior thyroid a.

D - Transverse cervical a.

72
Q
A

A - Transverse cervical (superior to suprascapular, both run over anterior scalene m.)

B - Dorsal scapular a.

C - Suprascapular a. (inferior to transverse cervical, both run over the anterior scalene m.)

D - Anterior scalene (phrenic nerve runs over it)

E - Vertebral a.

73
Q

Boundaries of the submental triangle

A

Anterior bellies of the digastric muscle and anterior aspect of the hyoid bone

73
Q

Functions of the hypoglossal nerve

A

Somatic motor innervation of the intrinsic and some extrinisic muscles of the tongue

74
Q

Which muscles are not innervated by the
ansa cervicalis?
A. Omohyoid muscles.
B. Sternohyoid muscle.
C. Sternothyroid muscle.
D. Thyrohyoid muscle.

A

The thyrohyoid muscle is innervated by a branch of the ansa cervicalis (C1) called the nerve to the thyrohyoid muscle

75
Q

A 59-year-old man complains of numbness
in the anterior cervical triangle.
Therefore, damage has occurred to which
of the following nerves?
A. Greater auricular nerve
B. Lesser occipital nerve
C. Phrenic nerve
D. Supraclavicular nerve
E. Transverse cervical nerve

A

E. Transverse cervical nerve

76
Q

.During surgery on a 56-year-old man for a squamous cell carcinoma of the neck, the surgeon notices profuse
bleeding from the deep cervical artery. Which of the following arteries must be ligated immediately to stop
bleeding?
A. Ascending cervical artery
B. Costocervical trunk
C. Inferior thyroid artery
D. Thyrocervical trunk
E. Transverse cervical artery

A

B. Costocervical trunk

77
Q

8.Any irritation of the diaphragm (e.g. infection, tumor) may create referred pain that seems (to the patient) to
originate in the area atop the shoulder. This is due to the fact that the phrenic nerve shares spinal segments with
what cutaneous nerve in the shoulder region?
A. Dorsal scapular
B. Lesser occipital nerve
C. Long thoracic nerve
D. Supraclavicular nerve
E. Suprascapular nerve

A

D. Supraclavicular Nerve

78
Q
A

At the superior orbital fissure compressing the oculomotor nerve

M1 Gross Anatomy (16 decks)

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