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Neuro Exam 1 - JLJ > Triangles of the Neck and Larynx > Flashcards

Triangles of the Neck and Larynx Flashcards

1
Q

What structures are found at the level of C3-C4?

A

Body of hyoid bone, upper margin of thyroid cartilage, and bifurcation of common carotid artery

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2
Q

What structures are found at the level of C5-C6?

A

Arch of cricoid cartilage, superior end of esophagus, and superior end of trachea

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3
Q

What are the boundaries of the anterior triangle?

A

Midline of the neck, sternocleidomastoid, and lower border of mandible

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4
Q

What are the boundaries of the posterior triangle?

A

Sternocleidomastoid, trapezius, and clavicle

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5
Q

What are the different triangles of the anterior triangle?

A

Submandibular, submental, carotid, and muscular

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6
Q

What are the boundaries of the submandibular triangle?

A

Anterior/posterior belly of digastric and inferior border of mandible

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7
Q

What are the boundaries of the submental triangle?

A

Midline of the neck, anterior belly of the digastric, and body of the hyoid

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8
Q

What are the boundaries of the carotid triangle?

A

Posterior belly of digastric, superior belly of omohyoid, and sternocleidomastoid

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9
Q

What are the boundaries of the muscular triangle?

A

Body of hyoid, superior belly of omohyoid, and median plane of the neck and sternocleidomastoid

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10
Q

What makes up the floor of the posterior triangle?

A

Semispinalis capitis, splenius capitis, levator scapula, and posterior/middle/anterior scalenes

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11
Q

What are the contents of the posterior triangle?

A

Arteries: transverse cervical, suprascapular, dorsal scapular, part of occipital, and subclavian

Veins: external jugular and subclavian

Nerves: lesser occipital, great auricular, transverse cervical, suprascapular, spinal accessory, phrenic, roots of brachial plexus, and ansa cervicalis

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12
Q

What are the branches of the thyrocervical trunk?

A

Inferior thyroid, transverse cervical, dorsal scapular, and suprascapular arteries

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13
Q

Which veins join to become the external jugular vein?

A

Posterior retromandibular and posterior auricular veins, anterior to SCM

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14
Q

The subclavian vein joins with what vein to form the brachiocephalic vein?

A

Internal jugular vein

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15
Q

What nerves make up Erb’s Point?

A

Lesser occipital, great auricular, transverse cervical, and suprascapular nerves

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16
Q

The skin and sheath over the parotid gland, mastoid process, auricle, and angle of the mandible is innervated by what nerve?

A

Great auricular nerve

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17
Q

The skin over the clavicle and over the shoulder is innervated by what nerve?

A

Supraclavicular nerve

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18
Q

The skin of the neck and scalp posterior to the auricle is innervated by what nerve?

A

Lesser occipital nerve

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19
Q

The skin of the anterior cervical region is innervated by what nerve?

A

Transverse cervical nerve

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20
Q

What nerve innervates the trapezius?

A

Spinal accessory nerve (CN XI)

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21
Q

What nerve innervates the diaphragm?

A

Phrenic nerve

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22
Q

The ansa cervicalis is found in what structure?

A

Fascia of carotid sheath

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23
Q

Why is the spinal accessory nerve clinically significant?

A

Can be easily damaged due to traumas or even during simple procedures such as biopsy of a lymph node; also the most commonly cut nerve

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24
Q

What is torticollis?

A

Contraction or shortening of SCM that causes the head to tilt toward and the face to turn away from the affected side; can be associated with damage to the spinal accessory nerve

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25
Q

What are the contents of the occipital triangle?

A

Part of EJV, posterior branches of cervical plexus, spinal accessory nerve (CNXI), trunks of brachial plexus, cervicodorsal trunk, and cervical lymph node

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26
Q

What are the contents of the omoclavicular (subclavian) triangle?

A

Third part of subclavian artery, suprascapular artery, part of subclavian vein, and supraclavicular lymph nodes

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27
Q

What divides the posterior triangle into its subtriangles, the occipital and omoclavicular triangles?

A

Inferior belly of omohyoid

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28
Q

What are the suprahyoid muscles and what is their function?

A

Mylohyoid, stylohyoid, digastric, and geniohyoid muscles; elevate the hyoid and larynx

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29
Q

What are the infrahyoid muscles and what is their function?

A

Sternohyoid, omohyoid, sternothyroid, and thyrohyoid muscles; depress the hyoid and larynx

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30
Q

Where would you find the carotid sinus and carotid body and what is their function, respectively?

A

Carotid Sinus: proximal part of ICA (internal carotid artery); baroreceptor

Carotid Body: cleft between ICA and ECA; chemoreceptor

31
Q

What are the branches off the ECA?

A

Superior thyroid, lingual, facial, ascending pharyngeal, occipital, posterior auricular, maxillary, and superficial temporal arteries

32
Q

What are the contents of the submandibular triangle?

A

Submandibular gland, submandibular lymph nodes, hypoglossal nerve (CN XII), mylohyoid nerve, and parts of facial artery and vein

33
Q

What are the contents of the submental triangle?

A

Submental lymph nodes and small veins that unite to form the anterior jugular vein

34
Q

What makes up the floor of the submandibular triangle?

A

Mylohyoid, hypoglossus, and middle pharyngeal constrictor

35
Q

What makes up the floor of the submental triangle?

A

Mylohyoid muscles

36
Q

What are the muscles of the muscular triangle?

A

Sternohyoid, sternothyroid, thyrohyoid

37
Q

What are the contents of the muscular triangle?

A

Viscera: thyroid gland, parathyroid glands, larynx, trachea, esophagus

Arteries: common carotid, superior/inferior thyroids

Veins: anterior jugular, superior/middle/inferior thyroids

Nerves: ansa cervicalis, external laryngeal, recurrent laryngeal

38
Q

What makes up the floor of the carotid triangle?

A

Thyrohyoid, hypoglossus, middle/inferior constrictor muscles of the pharynx

39
Q

What is found in the carotid sheath?

A

Common and internal carotid arteries, IJV, vagus nerve, deep cervical lymph nodes, carotid sinus nerve, and sympathetic nerve fibers

40
Q

What are the contents of the carotid triangle?

A

Carotid sheath, branches of the external carotid artery, internal/external laryngeal nerves, hypoglossal nerve, spinal accessory nerve, and ansa cervicalis

41
Q

What are the branches of the vagus nerve (CNX)?

A

Pharyngeal branch, superior laryngeal branch (which branches into internal/external branches), and carotid body branch

42
Q

The superior thoracic aperture where arteries and nerves emerge is called what?

A

Thoracic outlet

43
Q

The superior thoracic aperture where food and air may enter is called what?

A

Thoracic inlet

44
Q

What are the contents of the thoracic outlet/inlet?

A

Apex of lung, subclavian artery/vein, brachial plexus, vagus nerve, phrenic nerve, thoracic duct, right lymphatic duct, sympathetic chain, trachea, and esophagus

45
Q

Why is the phrenic nerve clinically relevant?

A

It is the sole motor supply to the diaphragm, so it must be identified during thoracic surgery and preserved; because it arises from the neck, patients who suffer spinal cord injuries below the neck are still able to breathe effectively despite any paralysis of the lower limbs

46
Q

What are the nerves from the cervical plexus?

A

Meningeal nerve (C1-2), superior/inferior root of ansa cervicalis (C1-3), and phrenic nerve (C3-5)

Cervical plexus is C1-4, so phrenic nerve has roots from cervical plexus (C3-4) and brachial plexus (C5)

47
Q

What is found at the level of C1-C2?

A

Superior cervical ganglion

48
Q

What structure extends superiorly to C1 or to the base of the skull?

A

Sympathetic trunk

49
Q

What is found at the level of C6 and the cricoid cartilage?

A

Middle cervical ganglion

Smallest of 3 ganglion

50
Q

What is found anterior to the transverse process of C7? Why is this significant?

A

Inferior cervical ganglion; in 80% of people, it fuses with the 1st thoracic ganglion and is then termed the stellate (cervicothoracic) ganglion

51
Q

What are the contents of the superficial fascia, what is the function of the muscle found here, and what nerve innervates this muscle?

A

Cutaneous nerves, blood and lymph vessels, superficial lymph nodes, fat, and platysma muscle; platysma is the muscle of facial expression and is innervated by the facial nerve (CNVII)

52
Q

What are the 3 layers of the deep cervical fascia and where can you find each layer?

A

Investing Layer: most superficial, surrounds entire neck

Pretracheal Layer: located only in the anterior region of the neck and blends with fibrous pericardium of heart

Prevertebral Layer: encloses vertebral column and associated muscles, extends laterally as the axillary sheath into the arm, and extends from the cranial base to the mediastinum

53
Q

Why is the retropharyngeal space clinically significant?

A

Can get abscesses that develop secondary to lymphatic drainage or spread of upper respiratory or oral infections; when this space swells is can cause difficulty in swallowing and speaking and can be life threatening

54
Q

What structure is found at vertebral levels C5-T1?

A

Thyroid

55
Q

What structure is found at vertebral levels C3-C6?

A

Larynx

56
Q

Where would you find the laryngeal cavity?

A

Extends from laryngeal inlet, communicates with the laryngopharynx, to the inferior border of the cricoid cartilage; continuous with trachea

57
Q

Where would you find the laryngeal vestibule?

A

Between laryngeal inlet and vestibular folds

58
Q

Where would you find the laryngeal ventricle?

A

Between the vestibular and vocal folds

59
Q

Where would you find the infraglottic cavity?

A

Between vocal folds and the inferior border of the cricoid cartilage

60
Q

Where would you find the rima glottidis?

A

Space between the vocal folds

61
Q

These are known as the false vocal cords?

A

Vestibular folds

62
Q

These are known as the true vocal cords?

A

Vocal folds

63
Q

What is the innervation and function of the cricothyroid muscle?

A

External laryngeal nerve (from CN X); stretches and tenses vocal ligament

64
Q

What is the innervation and function of the thyro-arytenoid muscle?

A

Inferior laryngeal nerve (terminal part of recurrent laryngeal nerve from CN X); relaxes vocal ligament

65
Q

What is the innervation and function of the posterior crico-arytenoid muscle?

A

Inferior laryngeal nerve (terminal part of recurrent laryngeal nerve from CN X); abducts vocal folds

only ABductor

66
Q

What is the innervation and function of the lateral crico-arytenoid muscle?

A

Inferior laryngeal nerve (terminal part of recurrent laryngeal nerve from CN X); adducts vocal folds

67
Q

What is the innervation and function of the transverse and oblique arytenoid muscles?

A

Inferior laryngeal nerve (terminal part of recurrent laryngeal nerve from CN X); adducts arytenoid cartilages

68
Q

What is the innervation and function of the vocalis muscle?

A

Inferior laryngeal nerve (terminal part of recurrent laryngeal nerve from CN X); relaxes posterior vocal ligament while maintaining (or increasing) tension of the anterior part

69
Q

Above the vocal folds, the larynx is supplied by what artery and nerve? What about below the vocal folds?

A

Above: superior laryngeal artery and internal branch of superior laryngeal nerve

Below: inferior laryngeal artery and inferior laryngeal nerve

70
Q

There are 5 groups of lymph nodes that form a ring around the head and drain the face and scalp. What are the 5 groups?

A

Occipital, mastoid, pre-auricular and parotid, submandibular, and submental

71
Q

What group of lymph nodes drains to the superficial cervical lymph nodes? Deep cervical lymph nodes?

A

Superficial: occipital and mastoid

Deep: pre-auricular and parotid, submandibular, and submental

72
Q

What are the superficial and deep cervical lymph nodes?

A

Superficial: nodes along EJV; eventually drain into deep cervical nodes

Deep: nodes along IJV; divided into superior and inferior nodes; superior is called jugulodigastric and inferior is called jugulo-omohyoid

73
Q

What does the right lymphatic duct drain? Left?

A

Right: right side of head, neck, chest, and right UE

Left: literally everything else including LE

Neuro Exam 1 - JLJ (17 decks)

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