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ANATOMY: thorax > Triangles of the neck > Flashcards

Triangles of the neck Flashcards

1
Q

What are the 4 types of fascia in the neck?

A

Investing layer of deep cervical fascia

Prevertebral fascia

Carotid sheath

Pretracheal fascia

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2
Q

Where is the investing layer of deep cervical fascia located?

A

Attached posteriorly to the ligamentum nuchae and is continuous around the neck

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3
Q

What is enclosed by the investing layer of deep cervical fascia?

A

sternocleidomastoid, trapezius and parotid glands

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4
Q

What are the parotid glands?

A

Largest of the salivary glands, 1 present either side of the mouth in front of the ears

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5
Q

Where is the prevertebral fascia located?

A

Anterior to the prevertebral muscles and posterior to the pharynx and oesophagus

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6
Q

What is covered by the prevertebral fascia?

A

Cervical and brachial plexuses and muscles in the floor of the posterior triangle

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7
Q

What is the carotid sheath made from?

A

Areolar tissue

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8
Q

How does the composition of the carotid sheath vary over the vessels it covers?

Why is this variation necessary?

A

Strong over the carotid arteries and weak over the jugular vein to allow for expansion

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9
Q

Where does the pretracheal fascia attach?

A

Thyroid and cricoid cartilages and the 2nd-4th tracheal rings

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10
Q

What is enclosed by the pretracheal fascia?

A

Invests the thyroid gland and passes down into the thorax to the pericardium

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11
Q

What forms the posterior border of the anterior triangle of the neck?

A

The anterior border of the sternocleidomastoid

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12
Q

What forms the anterior border of the anterior triangle of the neck?

A

The midline between the mentum and the suprasternal notch

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13
Q

What forms the superior border of the anterior triangle of the neck?

A

Inferior aspect of the mandible, rising to an apex at the mastoid process of the temporal bone

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14
Q

What are the major structures passing through the anterior triangle of the neck?

A

Pharynx

Larynx

Trachea

Oesophagus

Thyroid gland

Common carotid

Internal and external carotid arteries

Jugular veins

Vagus nerves

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15
Q

Does the shape of the posterior triangle of the neck remain constant?

A

No, it changes shape as the position of the head is altered

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16
Q

What forms the posterior border of the posterior triangle of the neck?

A

Anterior border of the trapezius

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17
Q

What forms the anterior border of the posterior triangle of the neck?

A

Posterior border of the sternocleidomastoid

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18
Q

What forms the inferior border of the posterior triangle of the neck?

A

Middle third of the clavicle

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19
Q

Which structures pass through the posterior triangle of the neck?

A

Most structures supplying the upper limb and the spinal accessory nerve

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20
Q

Where is the origin of the sternocleidomastoid?

A

The mastoid process and lateral third of the superior nuchal line

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21
Q

What direction does the sternocleidomastoid run?

A

Inferomedially

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22
Q

Where is the insertion of the sternocleidomastoid?

A

Fleshy insertion on the medial end of the clavicle

Tendinous insertion on the anterior aspect of the manubrium

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23
Q

What is the function of the sternocleidomastoid?

A

Rotates face in opposite direction and tilts ear towards same shoulder

Acting bilaterally, the muscles cause both flexion of the lower cervical spine and extension of the upper cervical spine

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24
Q

Where is the origin of the trapezius?

A

Superior nuchal line

External occipital protuberance

Ligamentum nuchae

The spines and supraspinous ligaments of all of the thoracic vertebrae

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25
Q

Where is the insertion of the trapezius?

A

Lateral third of the posterior border of the clavicle

Medial border of the acromion

Upper border of the spine of the scapula

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26
Q

What is the function of the trapezius?

A

Elevation of the shoulder (shrugging)

Bracing of the shoulder

Rotation of the scapula (with serratus anterior) so that the glenoid cavity faces upwards in full abduction of the upper limb

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27
Q

What is the action performed by the trapezius when acting unilaterally?

A

Rotates the head to the opposite side

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28
Q

What is the action performed by the trapezius when acting bilaterally?

A

Extends the cervical spine

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29
Q

Which nerve supplies sternocleidomastoid?

A

Spinal accessory nerve

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30
Q

Which nerve supplies the trapezius?

A

Spinal accessory nerve

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31
Q

Describe the path taken by the spinal accessory nerve to supply the sternocleidomastoid and trapezius

A

Emerges one third of the way down the posterior border of the sternocleidomastoid and crosses the posterior triangle to supply trapezius by entering its anterior border at the junction between its lower third and upper 2 thirds

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32
Q

Is the spinal accessory nerve superficial or deep?

Why is it said to have a characteristic appearance?

A

Superficial

Characteristic ‘wavy’ appearance

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33
Q

Which muscles form the floor of the posterior triangle?

A

Scalenes and levator scapulae

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34
Q

Which type of fascia covers the scalenes?

What movement does this enable?

A

Prevertebral fascia

Movement between scalenes and structures lying anteriorly

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35
Q

Where is the origin of the scalenes?

A

The transverse processes of the cervical vertebrae

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36
Q

Which direction do the scalenes run?

A

Inferolaterally

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37
Q

Where do the scalenes attach?

A

Scalenus anterior and medius:
-first rib

Scalenus posterior:
-second rib

38
Q

What are the main parts of the hyoid bone?

A

Body with greater and lesser horns

39
Q

What is the significance of the hyoid bone?

A

Supports the floor of the mouth and the tongue

Intimately related to the larynx and pharynx

40
Q

What functions are related to the hyoid bone?

A

Chewing, swallowing and speech

41
Q

What are the suprahyoid bones?

A

Diagrastic

Stylohyoid

Mylohyoid

Geniohyoid

42
Q

Where is the origin of the diagrastic?

A

ANTERIOR BELLY:
diagrastic fossa on the back of the body of the mandible

POSTERIOR BELLY:
deep to the mastoid process

43
Q

What are the components of the diagrastic muscle?

A

2 bellies and an intermediate tendon

44
Q

Where does the tendon of the diagrastic run?

A

Through a pulley attached to the hyoid bone

45
Q

What is the function of the diagrastics?

A

Elevate the hyoid in swallowing and depress the manible in chewing

46
Q

What are the 4 infrahyoid strap muscles ?

A

Sternohyoid

Sternothyroid

Omohyoid

Thyrohyoid

47
Q

Where is the origin of the sternohyoid?

A

Behind the manubrium and the clavicle

48
Q

What direction does the sternohyoid run?

A

Upwards

49
Q

Where is the insertion of the sternohyoid?

A

Hyoid bone

50
Q

Where is the insertion of the sternothyroid?

A

Manubrium

51
Q

What is more anterior, the sternohyoid or the sternothyroid?

A

Sternohyoid

52
Q

Where is the insertion of the sternothyroid?

A

Oblique line on the thyroid cartilage

53
Q

Where does the thyrohyoid originate?

A

Oblique line on the thyroid cartilage

54
Q

Where does the thyrohyoid insert?

A

Hyoid

55
Q

Describe the structure of the omohyoid

A

2 bellies united by an intermediate tendon

56
Q

Where is the origin of the omohyoid?

A

Upper border of the scapula

57
Q

Where is the insertion of the omohyoid?

A

Hyoid bone

58
Q

What is the function of the infrahyoid muscles?

A

Chewing, swallowing and speech

They fix the hyoid so that the suprahyoid muscles have a fixed point from which to act

59
Q

What is the innervation of the infrahyoid muscles?

A

First 3 cervical nerves via a loop of nerves called the ansa cervicalis

60
Q

Where is the thyroid gland located?

A

Within the pretracheal fascia, deep to the strap muscles

61
Q

How by the left and right lobes of the thymus gland connected?

A

Via an isthmus lying across the 2nd-4th tracheal rings

62
Q

Why can the thyroid gland not ascend any higher than the oblique line?

A

The sternothyroid attaches to the thyroid cartilages

63
Q

In what direction does an enlarged thyroid expand?

A

Laterally and downwards, even into the superior mediastinum

64
Q

What is produced by the thyroid gland?

A

Thyroxine and calcitonin

65
Q

What is the function of thyroxine?

A

Maintains the basal metabolic rate

66
Q

What is the function of calcitonin?

A

Lowers serum calcium

67
Q

Which arteries supply the thyroid gland?

A

Superior thyroid and inferior thyroid

68
Q

The superior thyroid is a branch of which artery?

A

External carotid

69
Q

The inferior thyroid is a branch of which artery?

A

Thyrocervical trunk from the subclavian

70
Q

Which vessels control venous drainage from the thyroid gland?

A

Superior, middle and inferior thyroid veins

71
Q

Where do the superior and middle thyroid veins drain to?

A

Internal jugular

72
Q

Where does the inferior thyroid vein drain to?

A

Left brachiocephalic vein

73
Q

How many parathyroid glands are there?

A

4

2 upper and 2 lower

74
Q

Where are the parathyroid glands located?

A

The back of the lateral lobes of the thyroid gland

75
Q

What is secreted by the parathyroid glands?

What is the function of this?

A

Parathormone

Raises serum calcium by mobilising it from the skeleton

76
Q

Is the position of the parathyroid glands constant or variable?

A

Variable

particularly inferior ones

77
Q

How is blood supplied to the parathyroid glands

A

Via branches arising from anastomotic channels between superior and inferior arteries

78
Q

Where does the carotid sheath attach?

A

The base of the skull at the margins of the carotid foramen

79
Q

Where does the vagus nerve lie in the neck?

A

Posterior between the internal jugular vain and common carotid artery

80
Q

Where does the phrenic nerve lie in the neck?

A

Under the prevertebral fascia on scalenus anterior, lateral to the sympathetic chain

81
Q

Where is the sympathetic chain located in the neck?

A

Medial to the phrenic nerve, anterior to the prevertebral fascia

82
Q

How is the external jugular vein formed?

A

The union of the posterior division of the retro-mandibular vein with the posterior auricular vein

83
Q

Where is the external jugular vein located?

A

Superficial to sternocleidomastoid

84
Q

Where does the external jugular enter the subclavian vein?

A

Just above the midpoint of the clavicle

85
Q

How is the brachiocephalic vein formed?

A

The internal jugular vein joins the subclavian vein behind the sternoclavicular joint

86
Q

What groups are the deep cervical lymph nodes divided into?

A

Superior and inferior

87
Q

Which group of the deep cervical lymph nodes are jugulodigrastic nodes found in?

What are these nodes especially associated with?

A

Superior

Afferents from the palatine tonsils

88
Q

Where do jugulodigrastic nodes receive lymph from?

A

Submanibular nodes, cranium, tongue, larynx, lower pharynx and thyroid gland

89
Q

Do afferents or efferents drain into the inferior deep cervical lymph node?

A

Efferents

90
Q

Which group of the deep cervical lymph nodes are the jugulo-omohyoid nodes found in?

A

Inferior

91
Q

What happens to efferents of the deep cervical lymph nodes?

A

Form a single trunk, the jugular lymphatic trunk, which opens into the thoracic duct on the left and the right lymphatic duct on the right

ANATOMY: thorax (5 decks)

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