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Anatomy > Triangles of the neck > Flashcards

Triangles of the neck Flashcards

1
Q

Why are the triangles of the neck relevant to lung cancer?

A

pancoast tumours start in the apex of the lung

usually spreads into one or more structure is the upper thorax and neck

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2
Q

Where in the upper thorax and neck might a pancoast tumour spread to?

A

upper ribs
nerves in upper thorax and neck
bundles of nerves close to spinal cord
blood vessels that supply blood to the upper limb

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3
Q

Attachments of the sternocleidomastoid muscle

A

sternum - manubrium
clavicle - medial
mastoid process

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4
Q

What are two main triangles of the neck?

A

posterior and anterior

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5
Q

Describe the location of the posterior triangle

A

from trapezius to SCM

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6
Q

Describe the location of the anterior triangle

A

SCM to the midline down the neck

inverted triangle

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7
Q

What are the sub triangles?

A

1) SCM region
2) lateral cervical region
3) anterior cervical region
4) posterior cervical region
5) suboccipital region

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8
Q

What is the lateral cervical region separated into?

A

occipital triangle

omoclavicular triangle

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9
Q

What is the anterior cervical region separated into?

A

carotid triangle

muscular triangle

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10
Q

What can the lesser supraclavicular fossa be used for?

A

location of the where the heads of the sternocleidomastoid come in
landmark for canulation of veins

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11
Q

What will be found at the omoclavicular triangle?

A

roots of the brachial plexus

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12
Q

Where is the carotid bifurcation?

A

when the common carotid becomes the internal and external carotid
point where SCM region, muscular triangle and carotid triangle intersect

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13
Q

What muscle has an angle in it?

A

omohyoid

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14
Q

What attaches to the hyoid bone?

A

strap muscles

omohyoid, thyroid cartilage (thyrohyoid), sternohyoid, sternothyroid

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15
Q

Fascial layers of the neck

A 
outside in
subcutaneous/superficial cervical fascia
investing layer
pretracheal layer
prevertebral layer
alar fascia and carotid sheath
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16
Q

What may be found between the subcutaneous fascia

A

platysma

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17
Q

Which muscles are wrapped in the investing layer of fascia?

A

SCM and trapezius

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18
Q

Why is the pretracheal named this?

A

goes infront of the trachea

traps the thyroid gland, trachea and oesophagus

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19
Q

Location of the prevertebral layer

A

infront of vertebrae

traps spinal cord and postural muscles - erector spinae

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20
Q

What is found within the carotid sheath?

A

common corotid
IJV
lymphatics
vagus nerve

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21
Q

Why is the disposition of fascial layers in the neck important?

A

track infections and spread of tumours

planes of separation during surgery

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22
Q

Describe the platysma

A

most superficial structure of the neck
linear, thin layer
curves to upper limbs
blends into other smaller muscles in the chin for facial expression

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23
Q

What can be palapted from the investing and pretracheal layers of fascia?

A 
hyoid bone
thyroid cartilage (Adam's apple)
cricoid cartilage
thyroid glands (if swollen)
1st tracheal ring
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24
Q

What can cause a swollen thyroid?

A

low iodine

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25
Q

Where does the EJV run?

A

over the top of the SCM

sits in the the investing layer

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26
Q

Name the scalene muscles

A

anterior
middle
posterior

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27
Q

Attachments of anterior scalene

A

scalene tubercle on first rib

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28
Q

Attachments of middle scalene

A

first rib

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29
Q

Attachements of posterior scalene

A

2nd rib

30
Q

Importance of anterior scalene as a landmark

A 
subclavian veins - anterior
subclavian arteries - posterior
5 nerve roots to form brachial plexus - posterior to subclavian arteries
(VAN)
phrenic nerve - anterior
31
Q

What innervates the scalene muscles?

A

cervical spinal nerves

32
Q

What is a function of the scalene muscles?

A

accesory muscles of respiration

33
Q

Where are the infrahyoid muscles?

A

pre-tracheal fascial layer

anterior triangle

34
Q

Attachments of the infrahyoid muscles

A

thyrohyoid - thyroid cartilage and hyoid
sternohyoid - hyoid and manubrium
sternothyroid - back of manubrium to thyroid cartilage

35
Q

Attachments of omohyoid

A

hyoid to shoulder

36
Q

What causes the angle in the omohyoid?

A

fascial sling off the clavicle

37
Q

Attachments of the cricothyroid? and location

A

cricoid to the thyroid

lateral to midline

38
Q

Nerve supply of strap muscles

A

ansa cervicalis

39
Q

Which suprahyoid muscle has a sling?

A

digastric

40
Q

Spinal accessory nerve name

A

cranial nerve XI

41
Q

What does the spinal accessory nerve innervate and where does it run?

A

innervates SCM and trapezius

runs under SCM, across posterior triangle, to the trapezius

42
Q

How to define the internal carotid artery?

A

no branches in the neck

43
Q

Structure of the thyroid gland

A

butterfly shape

central part which crosses the midline

44
Q

Arterial supply of the thyroid gland

A

superior thyroid artery - off external carotid
inferior thyroid artery - off subclavian via thyrocervical trunk
10% have thyroid ima artery - up the midline off brachiocephalic trunk

45
Q

Which cervical vertebrae are atypical?

A

C1 - atlas

C2 - axis

46
Q

Where does C1 articulate on the skull?

A

occipital area, behind mastoid process

47
Q

Where does C2 articulate with C1?

A

odontoid process articulates with the anterior arch of the atlas bone, where they form a pivot join

48
Q

What is penetrated in a cricothyroidotomy?

A

cricothyroid membrane (between thyroid and cricoid cartilage)

49
Q

What is cricothyroidotomy used for?

A

temporary relief for when the airways are blocked

50
Q

What is penetrated in a tracheotomy?

A

subcutaneous fascia, investing and pre-tracheal

space between cartilage of trachea

51
Q

What is tracheotomy used for?

A

semi/permanent access to airways

52
Q

Danger of cricothyroidotomy on children?

solution?

A

increased risk to cutting vocal folds

needle cricothyroidotomy

53
Q

Use of Langer’s lines

A

cut along them, reduce scarring

54
Q

What to look out for

A

reccurent laryngeals

55
Q

Main sites for central venous catheterisation

A

right subclavian vein - midline of clavicle

vena cava - omaclavicular triangle

56
Q

Imaging

A

larger structures of cross-sections
at what level
use trachea as landmark

57
Q

Major groups of lymphatic vessels/nodes

A

superficial

deep

58
Q

SCM functions

A

lateral flexion with rotation
extension at atlanto-occipital joints
flexion of cervical vertebrae - supine position

59
Q

List the superficial nodes with location

A 
occipital
mastoid
pre-auricular
parotid
submental
submandibular
facial 
superficial cervical
60
Q

From where does fluid drain into the superficial nodes and where does this fluid then go?

A

from: scalp, face, neck

goes to: deep lymph nodes

61
Q

Main groups of deep lymph nodes

A

superior

inferior

62
Q

Location of superior deep cervical nodes

A

under the SCM in close relation to the accessory nerve and IJV

63
Q

Location of inferior deep cervical nodes

A

omiclavicular triangle

behind SCM

64
Q

Location of occipital node

A

back of the head, lateral border of the trapezius muscle

65
Q

Location of mastoid node

A

insertion of SCM into mastoid process

66
Q

Location of pre-auricular node

A

anterior to the auricle of the ear

67
Q

Location of parotid node

A

superficially to parotid gland

68
Q

Location of submental node

A

superficially to mylohoid gland

69
Q

Location of submandibular node

A

inferior to mandible, in submandibular triangle

70
Q

Location of superficial cervical node

A

close to anterior jugular vein

Anatomy (9 decks)

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