Triangles of the neck and misc Flashcards
What is found at the Vertebral level of C3-C4
Body of the hyoid bond
Upper margin of the thyroid cartilage
Bifurcation of common carotid artery
What is found at the vertebral levels of C5 and C6
Arch of cricord cartilage
Superior end of the esophagus and trachea
What makes up the borders of the Posterior triangle
Sternocleidomastoid (anteriorly)
Trapezius (posteriorly)
Clavicle (inferiorly)
What is considered the floor of the Posterior triangle?
Floor is covered by prevertebral layer of deep fascia
Semispinalis capitis M
Splenius Capitus M
Levator Scapulae M
Posterior, middle, and anterior Scalene Muscles
What are the Arteries that run in the Posterior triangle
Subclavian A Thyrocervical Trunk Transverse cervical A Dorsal scapular A Suprascapular A Part of the occipital A
Relationships of the Posterior Triangle: Transverse cervical artery
runs superficially and laterally across the phrenic nerve and anterior scalene muscle
Relationships of the Posterior Triangle: suprascapular A
Passes inferolaterally across the anterior scalene muscle and phrenic nerve
travels with the suprascapular N
Relationships of the Posterior Triangle: External Jugular Vein
Begins inferior to the angle of the mandible by the joining of the retromandibular V and the posterior auricular vein
EJV will then drain into the subclavian V
Relationships of the Posterior Triangle: subclavian V
the subclavian V is anterior to the anterior scalene m and then will join with the internal jugular V to form the brachiocephalic vein
What are the 4 cutaneous branches of the Posterior triangle and where do they emerge from
Lesser occipital N
Great Auricular N
Transverse cervical N
Suprascapular N
come from the cervical plexus and emerge around the middle of the posterior SCM this is called the nerve point of the neck or Erbs point
what does the Lesser occipital nerve innervate cutaneously
skin of neck and scalp posterior to the auricle
What does the Great auricular nerve innervate cutaneously
Skin and sheath over parotid gland, mastoid process, auricle and angle of mandible
What does the suprascapular nerve innervate cutaneously
skin over the clavicle and over the shoulder
Nerves located in the Posterior Triangle
Lesser occipital N Great Auricular N Transverse cervical N Suprascapular N Spinal Accessory (XI) Phrenic N Roots of brachial plexus Ansa cervicalis: in fascia of carotid sheath
Torticollis
contraction or shortening of Sternocleidomastoid m that causes the head to tilt toward and the face to turn away from the affected side
due to spinal accessory nerve damage, usually at Erbs point
Sub triangles of the Posterior triangle
Occipital triangle
Omoclavicular (subclavian) triangle
split by the Inferior belly of the omohyoid muscle
Borders of the anterior Triangle
Midline of the neck (medially)
Sternocleidomastoid (laterally)
Lower border of mandible (superiorly)
Muscles of the anterior triangle: Suprahyoid muscles
Elevate hyoid and larynx
Mylohyoid
stylohyoid
Diagastric Muscles (anterior and posterior)
Gleniohyoid Muscle
Muscles of the anterior Triangle: Infrahyoid Muscles
Depress hyoid and larynx
Sternohyoid
Omohyoid Muscle
Sternothyroid M
Thyrohyoid muscle
Branches of the External Carotid Artery
Superior Thyroid A Lingual A Facial A Ascending pharyngeal A Occipital A Posterior Auricular A Maxillary A Superficial temporal A
What are the four subdivisions of the Anterior triangle
Submandibular (diagastric) triangle
Submental Triangle
Carotid Triangle
Muscular Triangle
Submandibular Triangle: Borders
Inferior border of the mandible
anterior belly of digastric M
Posterior belly of Diagastric Belly
Submandibular Triangle: Floor
Mylohyoid Muscle
Hypoglossus m
middle pharyngeal constrictor M
Submandibular Triangle Contents
Submandibular gland submandibular lymph nodes hypoglossal N (CN XII): lays on the hyoglossus M Nerve to mylohyoid Parts of Facial N and A
Submental Triangle: Borders, and floor
Body of Hyoid
Right and left anterior belly of diagastric M
Mylohyoid Muscles
Submental Triangle Contents
Submental lymph nodes
small veins that unite to form the anterior jugular vein
Muscular Triangle Borders
Superior belly of Omohyoid
Sternocleidomastoid M
and median plane of the neck
Muscles contained in the Muscular triangle
Sternohyoid M
Sternothyroid M
Thyrohyoid M
Muscular triangle Contents
THyroid gland, parathyroid gland larynx trachea esophogus
Common carotid
Superior thyroid a
Inferior thyroid A
Anterior jugular V Thyroid Veins (superior, middle, and inferior)
Ansa cervicalis N
Eternal Laryngeal N
Recurrent laryngeal N
Carotid triangle borders
Superior belly omohyoid
posterior belly of digastric
Sternocleidomastoid M
Carotid triangle floor
Thyrohyoid M
Hyoglossus M
Middle and inferior constrictor muscles of the pharynx
Carotid triangle contents
Carotid Sheath Branches of the external carotid A Internal and external laryngeal nerves hypoglossal nerve (CN XII) Spinal accessory N (CN XI) ansa cervicalis Nerve
Carotid Triangle Vasculature: External carotid branches
Superior thyroid a ( gives fise to the superior laryngeal a and supplies the thyroid)
Ascending pharyngeal a ( only medial branch and medial to Internal carotid A)
Lingual a (anterior to middle pharyngeal constrictor, deep to hypoglossal nerve, stylohyoid m. and the posterior belly of digastric, disappears deep to hyoglossus m.)
Facial a ( gives rise to ascending palatine artery and tonsillary a, fond deep to submandibular gland and angle of the mandible (pulse point)
Occipital a ( passes superficial to ICA and hypoglossal n
Posterior auricular a ( ascends between external acoustic meatus and mastoid process)
finally terminates into the maxillary artery and the superficial temporal a
Carotid Sinus
Baroreceptor
measures blood pressure
innervated by carotid sinus nerve
-contains nerves from both Vagus (X) and Glossopharyngeal (IX)
Carotid Body
Chemoreceptor
measures oxygen levels
Innervated by carotid sinus nerve
-contains branches from both Vagus (X) and glossopharyngeal (IX)
What are the contents of the carotid sheath
Carotid arteries (medial) Internal Jugular Vein (Lateral) Vagus Nerve (Posterior) Ansa Cervcalis (anterior or embedded in sheath)
What three CN give rise in the carotid Triangle
Vagus (X)
-gives rise to pharyngeal branch
-superior laryngeal branch ( then divides into internal and external)
carotid body branch
Spinal Accessory Nerve (XI)
Hypoglosseal Nerve (XII)
Thoracic Inlet/outlent
inlet: anatomists refrence to superior thoracic aperture where food and air may enter
outlet: Clinician reference to superior thoracic aperture where arteries and nerves emerge
Contents of THoracic inlet/outlent
APEX of LUNG subclavian artery and vein brachial plexus Vagus N Phrenic N Thoracic duct Right lymphatic duct sympathetic chain Trachea Esophagus
Phrenic Nerve
C3-4-5
Right and a left
Sole motor supply to the diaghragm
Arises from the neck so that despite spinal cord injuries still can breathe
lies superficial to the anterior scalene
Cervical Plexus
C1-C4
superficial branches: sensory
Deep branches: Motor
Cervical Plexus: Great Auricular N
C2-C3 sensory
Cervical Plexus: Lesser Occipital Nerve
C2 sensory
Cervical Plexus: Supraclavicular Nerves
C3-C4 sensory
Cervical Plexus: Transverse Cervical Nerve
C2-C3 sensory
Cervical Plexus: Meningeal Nerve
C1-C2 sensory
to floor of posterior cranial fossa
Cervical Plexus: Anas cervicalis
superior branch: C1-C2
Inferior branch: C2-C3
Motor
Cervical Plexus: Phrenic Nerve
C3-C4-C5
Motor
Superior Cervical ganglion
Located at C1 and C2
sympathetics
Middle Cervical Ganglion
Located at C6 at the level of the cricord cartilage
smallest of the 3 and may be absent
sympathetics
Inferior cervical Ganglion
In 80 percent of people the inferior cervical ganglion fuses with the 1st thoracic ganglion and is termed the stellate (cervicothoracic) ganglion
located anterior to transverse process of C7
Platysma
Muscle of fascial expression
innervated by the facial N (VII)
Found in the Superficial Fascia along with cutaneous nerves blood and lymphatic vessels superficial lymph nodes and fat
Deep Cervical Fascia: Investing Layer
most superficial
surrounds the entire neck
encloses the Trapezius and SCM muscles
Encloses the parotid gland and the submandibular gland
Deep Cervical Fascia: Pretracheal layer
located only in the anterior region of the neck
Blend with the fibrous pericardium of the heart (mediastium)
Muscular layer (infrahyoid muscles)
Buccopharyngeal fascia and a visceral layer
Deep Cervical Fascia: Prevertebral Layer
Encloses the vertebral column and associated muscles
Extends laterally as the axillary sheath into the arm
Extends from the cranial base to the mediastinum
Retropharyngeal space
Posterior to pharynx
bound by the buccopharyngeal fascia anteriorly, and the prevertebral fascia posteriorly and the carotid sheath laterally
Retropharyngeal abscess develops secondary to lymphatic drainage or spread of upper respiratory or oral infections
Causes difficulty in swallowing and speaking and can be life threatening
Five groups of superficial lymph nodes and what do they drain?
Occipital: drain posterior scalp and neck
Mastoid: (retro-auricular/posterior auricular) drain posterolateral half of scalp
Pre auricular and parotid: drain anterior auricular, anterolateral scalp and upper half of face
Submandibular: follows facial artery and drains part of gingivae teeth and tongue, upper lip and lateral lower lip
Submental: drains center part of lower lip, chin, floor of mouth, tip of tongue and lower incisor teeth
Superficial cervical Lymphnodes
Collection of nodes alon the external jugular vein
recieve lymph from the posterior and posterolateral regions of the scalp
will drain into deep cervical nodes
Deep cervical Lymph nodes
Collection of nodes along internal jugular vein
upper and lower deep cervical nodes
Jugulodigastric
most superior node in the upper deep cervical node
located at C3-C4 near posterior belly of diagastric node
Jugulo-omohyoid
associated with lower deep cervical nodes
located at the C6 inferior to tendon of omohyoid M
