Triangles of the Neck 2 Flashcards

1
Q

What nerves are found in the carotid triangle?

A
Glossopharyngeal IX
vagus X
accessory XI
Hypoglossal XII
Ansa Cervicalis
Transverse Cervical
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2
Q

What makes up the muscular triangle? (anterior neck)

A

thyroid and parathyroid glands and the hyoid bone

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3
Q

This nerve found in the carotid triangle exits though the jugular foramen and descends between IJV and ICA, deep to the styloid process and muscles attached to it. It then proceeds forwards between ECA and ICA and curves around the lateral border of stylopharyngess muscles anterior and deep to hypoglossus until it reaches the base of the tongue

A

Glossopharyngeal nerve IX

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4
Q

Glossopharyngeal nerve provides 3 branches. What are they?

A

motor: stylopharyngeus muscle
sensory: pharynx
carotid sinus

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5
Q

This nerve found in the carotid triangle exits through the jugular foramen between IX and XI cranial nerves. In the carotid sheath, it descends medial to IJV and posterior to ICA and CCA.

A

Vagus nerve X

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6
Q

The vagus nerve provides 4 branches in the anterior triangle. What are they?

A

motor to pharynx
carotid body
superior laryngeal nerve
cardiac branch

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7
Q

This nerve found in the carotid triangle exits through jugular foramen and descends medial to IJV and then travels between IJV and ICA then crosses lateral to IJV to pass downwards and backwards to disappear under sternomastoid muscle traversing the floor of the posterior triangle and then disappearing under the trapezius. It provides no branches in the anterior triangle.

A

Accessory Nerve XI

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8
Q

This nerve exits the cranial cavity through the hypoglossal canal. At first it lies medial to IJV and ICA and then it travels outward between IJV and ICA and then courses forwards hooking around occipital artery, crossing lateral to ICA, ECA and Lingual artery. It then goes deep to posterior belly of digastric and stylohyoid muscle and then superficial to hypoglossus and then deep to mylohyoid muscles. It provides no branches in the anterior triangle. It supplies the tongue.

A

hypoglossal nerve XII

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9
Q

This is a loop of nerve fibers in front of the carotid sheath. It arises form C1-3 and innervates strap muscles except thyrohyoid muscle

A

ansa cervicalis

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10
Q

The superior root of ansa cervicalis supplies what?

A

upper parts of sternohyoid and sternothryoid; superior belly of omohyoid

note: inferior root supplies lower parts of sternohyoid and sternothryoid and inferior belly of omohyoid

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11
Q

This nerve found in the carotid triangle arises from anterior rami of C2-C3. It emerges from the posterior border of sternomastoid in the posterior triangle. It then loops around it to cross its anterior surface in a transverse direction to the anterior triangle giving cautious innervation to such are of skin.

A

Transverse Cervical nerve

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12
Q

The thyroid gland lies in the __ compartment of the neck together with trachea, esophagus. It is covered by ____ fascia

A

3rd (visceral); pretraceal

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13
Q

The thyroid gland is connected to the hyoid bone by an embryological remnant made of fibromuscular band called what?

A

levator glandulae thryoidae

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14
Q

The isthmus of the thyroid gland lies opposite the ___ and ___ tracheal rings

A

2nd; 3rd

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15
Q

In regards to arterial supply to the thyroid gland, the superior thyroid artery from the ECA is accompanied by the ___ ____ nerve to the superior pole of the lateral lobes of the thyroid gland

A

external laryngeal

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16
Q

The superior thyroid artery branches into what?

A

anterior and posterior glandular branches

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17
Q

In regards to arterial supply to the thyroid gland, the inferior thyroid artery is from the thyrocervical trunk and is accompanied by the ___ ____ nerve

A

recurrent laryngeal

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18
Q

The inferior thyroid artery branches into what?

A

inferior branch: supplies inferior pole and lateral lobes; anastomoses with posterior branch of superior thyroid

ascending branch: supplies parathyroid glands

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19
Q

In regards to arterial supply to the thyroid gland, the ___ ___ artery is form the arch of aorta or brachiocephalic trunk and supplies the isthmus

A

thryoida ima

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20
Q

The superior thyroid vein joins IJV and cranes the area supplied by what artery?

A

superior thyroid artery

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21
Q

The middle thyroid vein joins IJV and drains what?

A

the rest of the thyroid gland

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22
Q

The inferior thyroid vein joins left innominate vein and drains what?

A

the isthmus

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23
Q

The thyroid gland is an endocrine gland that developed as pharyngeal floor outgrowths at the base of ___

A

tongue - migrates caudally to front of neck

24
Q

The ___ ___ indicates the thyroid gland’s site of origin and the ___ duct marks its way of passage during migration

A

foramen cecum; thyroglossal

25
Q

The thyroglossal duct usually disappears during development but abnormal arrest of migration may leave remnants which form cysts, fistulas, or aberrant thyroid tissue anywhere through the path of migration form ___ to ___ lobe

A

tongue; pyramidal

26
Q

During a thyroidectomy, which nerve needs to be considered with caution

A

recurrent laryngeal - found near the gland

injury causes hoarseness

27
Q

When is a thyroidectomy needed?

A

Goiter or malignancies

28
Q

During a thyroidectomy, the part of the thyroid gland in which parathyroid glands are embedded, should be left in place so as not to disturb ___ metabolism

A

calcium

29
Q

During a thyroidectomy, injury of ____ trunk or nerves in the carotid sheath should be avoided

A

sympathetic

30
Q

What indicates a diagnosis for ectopic thyroid tissue?

A

feeling midline mass and an ultrasound

31
Q

Thyroid pathology should show thyroid function - secretion of T3 and T4 hormones. Describe what happens to the levels of these hormones in Myxedema and Grave’s disease

A

Myxedema: atrophy of gland (decreased secretion)

Grave’s disease: increased secretion

32
Q

In regards to enlargement of the gland, ____ ____ is the most common. It presents as a diffuse mass in the neck and thyroid hormone levels are usually normal

A

multinodular goiter

33
Q

Describe what happens in Hashimoto Disease

A

body produces antibodies against thyroid tissue

34
Q

What artery supplies the superior and inferior parathyroid gands

A

Inferior thyroid artery

35
Q

The larynx is found ___ to the hyoid. The pharynx is found ___ to the hyoid.

A

inferior; posterior

36
Q
What are the boundaries of posterior triangle of the neck?
anterior:
posterior:
inferior:
apex:
A

anterior: sternomastoid
posterior: trapezius
inferior: middle 1/3 of clavicle
apex: occipital bone

37
Q

The posterior triangle is divided by the inferior belly of omohyoid muscles into 2 smaller triangles. What are they?

A

occipital triangle, supraclavicular triangle

38
Q

What vein pierces the roof of the posterior triangle of the neck?

A

external jugular vein

39
Q

The external jugular vein is formed near the angle of the mandible by the union of the posterior branch of the ____ vein with the ____ ____ vein

A

retromandibular; posterior auricular

40
Q

The external jugular vein terminates in the ___ vein

A

subclavian

41
Q

The suprascapular vein, transverse cervical vein, and anterior jugular vein are all tributaries for what vein?

A

external jugular vein

42
Q

For the following neck muscle, give the origin, insertion, innervation and function: sternocleidomastoid

A

origin: manubrium
insertion: lateral half of superior nuchal line
innervation: accessory nerve
function: tilts head toward shoulder on same side; draw head forward (both sides)

43
Q

For the following neck muscle, give the origin, insertion, innervation and function: posterior scalene

A

origin: posterior tubercles of TPs of C4-C6
insertion: upper surface of 2nd rib
innervation: anterior rami of C5-C7
function: elevation of 2nd rib

44
Q

For the following neck muscle, give the origin, insertion, innervation and function: middle scalene

A

origin: TPs of C2-C7
insertion: upper surface of first rib
innervation: anterior rami of C3-C7
function: elevation of first rib

45
Q

For the following neck muscle, give the origin, insertion, innervation and function: anterior scalene

A

origin: anterior tubercles of the TPs of C3-C6
insertion: scalene tubercle and upper surface of first rib
innervation: anterior rami of C4-C7
function: elevation of first rib

46
Q

For the following neck muscle, give the origin, insertion, innervation and function: omohyoid

A

origin: superior border of scapula medial to scapular notch
insertion: inferior border of hyoid bone
innervation: ansa cervicalis; anterior rami of C1-C3
function: depress the hyoid bone

47
Q

For the following muscle, give the origin, insertion, innervation and function: rectus capitis anterior

A

origin: anterior surface of lateral part of atlas and its TPs
insertion: inferior surface of basilar part of occipital bone
innervation: branches from anterior rami of C1-C2
function: flexes head at atlanto-occipital joint

48
Q

What causes Torticollis (twisted neck)?

A

difficult delivery; interfering with the profuse arterial supply within the bulk of the muscle or venous occlusion leading to muscle necrosis

49
Q

Describe the phases of examination of toriollis:
early after delivery
few months later
late

A

early after delivery: neck swelling
few months later: cord-like sternomastoid
late: child unable to straighten head; head is drawn down towards affected sternomastoid and chin is towards opposite side

50
Q

Describe the phases of examination of a whiplash injury (cervical syndrome)
immediately after
next few days
later

A

immediately after: intense neck pain
next few days: increased intensity of pain
later: decreased pain but increased rigidity of head

51
Q

When palpating a whiplash energy, you should feel tenderness over TPs of ___-___

A

C4-C5

52
Q

Radiographs of whiplash injuries show what?

A

disappearance of normal cervical lordosis with absence of any signs of fracture of cervical vertebrae

53
Q

For the following muscle, give the origin, insertion, innervation and function: rectus capitis lateralis

A

origin: TPs of atlas
insertion: occipital bone
innervation: anterior rami of C1-C2
function: flexes head laterally to same side

54
Q

For the following muscle, give the function: longus coli

A

flexes neck anteriorly and laterally and slight rotation to opposite side

55
Q

For the following muscle, give the origin, insertion, innervation and function: longus capitis

A

origin: tendinous slip to TPs of C3-C6
insertion: occipital bone
innervation: anterior rami of C1-C3
function: flexes the head