Triangles of the neck Flashcards

1
Q

What does the hyoid bone lie between

A

Manubrium of sternum and the mandible

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2
Q

What attachments does the hyoid have

A

Only muscular attachments

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3
Q

What function does the hyoid bone have

A

Serves as an attachment for anterior neck muscles and a prop to keep the airway open

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4
Q

Where does the subcutaneous tissue of the neck lie

A

Between the dermis of the skin and the investing layer of deep cervical fascia

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5
Q

Where is the platysma contained

A

Superficial fascia (subcutaneous tissue of the neck)

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6
Q

Where does the platysma arise from and where does it go

A

Arises in subcutaneous tissue covering superior parts of the deltoid and pectorals major muscles and sweeps over the clavicle to the inferior border of the mandible

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7
Q

What are the three fascial layers that the deep cervical fascia consists of

A
  • INvesting
  • Pretracheal
  • Prevertebral
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8
Q

What is the purpose of the three fascial layers

A

Provide slipperiness that allow structures in the neck to move and pass over one another without difficulty.

Also allows separation of tissues during surgery

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9
Q

What is the outermost deep cervical fascia called

A

Investing layer

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10
Q

What does the investing layer split into two to surround

A

Sternocleidomastoid and the trapezius muscles

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11
Q

What are the attachments of the investing layer of the deep cervical fascia superiorly

A
  • Superior nuchal line of the occipital bone
  • MAstoid processes of the temporal bones
  • zygomatic arches
  • Inferior border of the mandible
  • HYoid bone
  • Spinous process of the cervical vertebrae
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12
Q

Inferiorly, what does the investing layer of deep cervical fascia attach to

A
  • Manubrium of the sternum
  • Clavicles
  • Spines of the sternum
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13
Q

What is the investing layer of the deep cervical fascia like in relation to the manubrium

A

Fascia remains divided into two layers that enclose the SCM just above the manubrium and so one layer attaches to the anterior and one to the posterior surface of the manubrium. Suprasternal space lies between these layers

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14
Q

What does the suprasternal s[ace contain

A
  • INferior ends of the anterior jugular veins
  • Jugular venous arch
  • fat
  • LYmph nodes
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15
Q

What does the pretracheal layer of deep cervical fascia extend down to

A

Extends inferiorly from the hyoid bone into the thorax where it blends with fibrous pericardium

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16
Q

What is the pretracheal layer continuous with

A

Carotid sheaths on both sides of it

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17
Q

What does the carotid sheath contain

A
  • Common and internal carotid arteries
  • Internal jugular vein
  • VAgus nerve
  • Some deep cervical lymph nodes
  • carotid sinus sheaths
  • Sympathetic nerve fibres (carotid pre-arterial plexuses)
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18
Q

What space in the neck is a major pathway for the spread of infection in the neck

A

Retropharyngeal space

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19
Q

What does the retropharyngeal space do

A

Permits movement of the pharynx, oesophagus, larynx and trachea during swallowing

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20
Q

What is the platysma innervated by

A

Fascial nerve 7

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21
Q

What regions of the neck does the SCM divide

A

Divides each side of the neck into anterior and lateral cervical regions

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22
Q

What are the two heads of the SCM

A

Sternal head

Clavicular head

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23
Q

What are the two heads of the SCM separated by

A

Lesser supraclavicular fossa

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24
Q

What are the nerves of the lateral cervical region

A
  • Spinal accessory nerve 11
  • Roots of brachial plexus
  • Suprascapular nerve
  • CErvical plexus
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25
Q

Where does the spinal accessory nerve 11 pass

A

Deep to the SCM where it supplies it and then enters the lateral cervical region

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26
Q

Where does the cranial nerve 11 disappears

A

deep into anterior border of the trapezius at the junction of its superior two thirds with its inferior one third, then enters the muscle

27
Q

Where do the roots of the brachial plexus appear

A

Between the anterior and middle scalene muscles

28
Q

What does the supra scapular nerve arise from

A

Superior trunk of the brachial plexus

29
Q

Where does the suprascapular nerve run

A

Across the lateral cervical region to supply the supraspinatus and infraspinatus muscles on the posterior aspect of the scapula

30
Q

What are the ansa cervicalis part of

A

Cervical plexus

31
Q

Where does the lesser occipital nerve arise from

A

C2

32
Q

What does the lesser occipital nerve supply

A

Skin of the neck and scalp postosuperior to the auricle

33
Q

Where does the great auricular nerve arise from

A

C3 and C2

34
Q

What does the great auricular nerve supply

A

Skin and sheath over the gland, the posterior aspect of the auricle and the area of skin overlying the angle of mandible to the mastoid process

35
Q

Where does the transverse cervical nerve arise from

A

C2 and C3

36
Q

What does the transverse cervical nerve supply

A

Skin covering the anterior cervical region

37
Q

Where does the transverse cervical nerve go

A

Curves around the middle of the posterior border of the SCM and passes anteriorly and horizontally across it, deep to the external jugular vein and platysma

38
Q

Where do the supraclavicular nerves originate from

A

C3 and C4

39
Q

Where do the supraclavicular nerves emerge from

A

Beneath the SCM

40
Q

Where fo the supraclavicular nerves descend in

A

POsterior triangle of the neck beneath the platysma and the deep cervical fascia

41
Q

Where does the phrenic nerve originate from

A

C4

42
Q

What do the phrenic nerves supply in the thorax

A

Mediastinal pleura and the pericardium and the diaphragm

43
Q

What do the phrenic nerves lie anterior to

A

Subclavian arteries

44
Q

What do the phrenic nerves lie posterior to

A

Subclavian veins

45
Q

What does the phrenic nerve receive contributions from

A

C3 and C5

46
Q

What is the contribution from C5 to the phrenic nerve called

A

Accessory phrenic nerve

47
Q

Where does the external jugular vein start

A

Near angle of mandible

48
Q

What is the course of the external jugular vein

A
  • Starts near angle of mandible
  • Crosses the SCM obliquely deep to the platysma
  • Pierces the investing layer of deep cervical fascia, which forms the roof of this region
49
Q

Where does the external jugular vein terminate

A

Subclavian vein

50
Q

What does the subclavian vein join and what does this become

A

IJV to form the brachiocephalic vein posterior to the medial end of the clavicle

51
Q

What is the innervation of the platysma

A

Facial nerve 7

52
Q

What is the SCM innervated by

A
  • Spinal accessory nerve

- C2 and C3 nerves

53
Q

What are the triangles in the anterior triangle

A
  • Submandibular triangle
  • Submental triangle
  • Carotid triangle
  • Muscular triangle
54
Q

Superior attachments of SCM

A
  • LAteral surface if mastoid process of temporal bone

- Lateral half of superior nuchal line

55
Q

Inferior attachments of SCM

A

Sternal head- Anterior surface of the manubrium of sternum

Clavicular head- Superior surface of medial third of clavicle

56
Q

What are the 4 suprahyoid muscles

A
  • Mylohyoid
  • Geniohyoid
  • Stylohyoid
  • Digastric muscles
57
Q

Functions of suprahyoid muscles

A

Supports the hyoid bone in providing a base from which the tongue functions and in elevating the hyoid and larynx in relation to swallowing and tone production

58
Q

What does each digastric muscle have

A

Anterior and posterior bellies joined by an intermediate tendon to slide anteriorly and posteriorly as it connects this tendon to the body and greater horn of the hyoid bone

59
Q

What is the purpose of the infrahyoid muscles

A

Anchor the hyoid, sternum, clavicle and scapula and depress the hyoid and larynx during swallowing and speaking

60
Q

What are the two planes of infrahyoid muscles

A

SUperficial plane

Deep plane

61
Q

What is the superficial plane of the infrahyoid muscles made of

A

Sternohyoid and omohyoid

62
Q

What is the deep plane of the infrahyoid muscles composed of

A

Sternothyroid and thyrohyoid

63
Q

What is the structure of the omohyoid

A

HAs two bellies united by an intermediate tendon that is connected to the clavicle by a fascial sling

64
Q

Where do the sternothyroid and sternohyoid lie in relation to each other

A

Sternothyroid lies under the sternohyoid