Triangles of the Neck 2

Question 1

What nerves are found in the carotid triangle?

Answer 1

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

Question 2

What makes up the muscular triangle? (anterior neck)

Answer 2

thyroid and parathyroid glands and the hyoid bone

Question 3

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

Answer 3

Glossopharyngeal nerve IX

Question 4

Glossopharyngeal nerve provides 3 branches. What are they?

Answer 4

motor: stylopharyngeus muscle
sensory: pharynx
carotid sinus

Question 5

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.

Answer 5

Vagus nerve X

Question 6

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

Answer 6

motor to pharynx
carotid body
superior laryngeal nerve
cardiac branch

Question 7

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.

Answer 7

Accessory Nerve XI

Question 8

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.

Answer 8

hypoglossal nerve XII

Question 9

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

Answer 9

ansa cervicalis

Question 10

The superior root of ansa cervicalis supplies what?

Answer 10

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

Question 11

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.

Answer 11

Transverse Cervical nerve

Question 12

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

Answer 12

3rd (visceral); pretraceal

Question 13

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

Answer 13

levator glandulae thryoidae

Question 14

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

Answer 14

2nd; 3rd

Question 15

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

Answer 15

external laryngeal

Question 16

The superior thyroid artery branches into what?

Answer 16

anterior and posterior glandular branches

Question 17

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

Answer 17

recurrent laryngeal

Question 18

The inferior thyroid artery branches into what?

Answer 18

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

ascending branch: supplies parathyroid glands

Question 19

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

Answer 19

thryoida ima

Question 20

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

Answer 20

superior thyroid artery

Question 21

The middle thyroid vein joins IJV and drains what?

Answer 21

the rest of the thyroid gland

Question 22

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

Answer 22

the isthmus

Question 23

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

Answer 23

tongue - migrates caudally to front of neck

Question 24

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

Answer 24

foramen cecum; thyroglossal

Question 25

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

Answer 25

tongue; pyramidal

Question 26

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

Answer 26

recurrent laryngeal - found near the gland injury causes hoarseness

Question 27

When is a thyroidectomy needed?

Answer 27

Goiter or malignancies

Question 28

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

Answer 28

calcium

Question 29

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

Answer 29

sympathetic

Question 30

What indicates a diagnosis for ectopic thyroid tissue?

Answer 30

feeling midline mass and an ultrasound

Question 31

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

Answer 31

Myxedema: atrophy of gland (decreased secretion) | Grave's disease: increased secretion

Question 32

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

Answer 32

multinodular goiter

Question 33

Describe what happens in Hashimoto Disease

Answer 33

body produces antibodies against thyroid tissue

Question 34

What artery supplies the superior and inferior parathyroid gands

Answer 34

Inferior thyroid artery

Question 35

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

Answer 35

inferior; posterior

Question 36

``` What are the boundaries of posterior triangle of the neck? anterior: posterior: inferior: apex: ```

Answer 36

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

Question 37

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

Answer 37

occipital triangle, supraclavicular triangle

Question 38

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

Answer 38

external jugular vein

Question 39

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

Answer 39

retromandibular; posterior auricular

Question 40

The external jugular vein terminates in the ___ vein

Answer 40

subclavian

Question 41

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

Answer 41

external jugular vein

Question 42

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

Answer 42

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)

Question 43

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

Answer 43

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

Question 44

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

Answer 44

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

Question 45

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

Answer 45

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

Question 46

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

Answer 46

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

Question 47

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

Answer 47

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

Question 48

What causes Torticollis (twisted neck)?

Answer 48

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

Question 49

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

Answer 49

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

Question 50

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

Answer 50

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

Question 51

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

Answer 51

C4-C5

Question 52

Radiographs of whiplash injuries show what?

Answer 52

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

Question 53

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

Answer 53

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

Question 54

For the following muscle, give the function: longus coli

Answer 54

flexes neck anteriorly and laterally and slight rotation to opposite side

Question 55

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

Answer 55

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