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Anatomy > Unit 17 Anterior Triangle of the Neck > Flashcards

Unit 17 Anterior Triangle of the Neck Flashcards

1
Q

What are the boundaries of the anterior triangle of the neck?

A

boundaries
1. Superior (base of the triangle): inferior and posterior borders of mandible on
each side
2. posterior: anterior border of the sternocleidomastoid
3. anterior: median line of the neck

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2
Q

What are the four divisions of the anterior triangle of the neck?

A

muscular, carotid, submental and digastric or submandibular

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3
Q

What are the boundaries of the muscular division?

A

bounded by the anterior border of the
sternocleidomastoid muscle, the superior belly of the omohyoid muscle and the median line

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4
Q

What are the four “strap” muscles? What do they act on?

A

Called infrahyoid muscles: sternohyoid muscle, omohyoid muscle, sternothyroid muscle, thyrohyoid muscle; they act on the larynx and the hyoid bone

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5
Q

From where does the sternohyoid muscle arrise? Where does it insert?

A

It arrises from the thorax behind the manubrium, it inserts on the hyoid bone

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6
Q

From where does the omohyoid arise? Where does it insert?

A

It arises near the suprascapular notch and inserts on the hyoid bone

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7
Q

What is the structure of the omohyoid muscle?

A

Has superior and inferior bellies with an intermediate tendon

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8
Q

Where does the sternothyroid muscle arise? Where does it insert?

A

It arises from the posterior manubrium..below the origin of the sternohyoid muscle. It inserts on the oblique line of thryroid cartilage

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9
Q

What three muscles act as a depressor of the larynx as a whole?

A

Sternohyoid, sternothyroid, and omohyoid

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10
Q

What are the three depressors of the larynx innervated by?

A

The sternothyroid, sternohyoid, and omohyoid are all innervated by branches of the ansa cervicalis

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11
Q

What muscle opposes the depressors of the larynx, and therefore elevates the larnyx as a whole?

A

the thyrohyoid

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12
Q

From where does the thyrohyoid arise? Where does it insert?

A

arises from the oblique line of thyroid cartilage and inserts on the hyoid bone

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13
Q

What innervates the elevator of the larynx?

A

The thyrohyoid is innervated by C1 fibers that run in the hypoglossal nerve (part of the ansa cervicalis)

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14
Q

What are the boundaries of the carotid division of the anterior triangle?

A

bounded by the posterior belly of the digastric muscle, the superior
belly of the omohyoid muscle, and the anterior border of the
sternocleidomastoid muscle

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15
Q

What is found within the carotid division of the anterior triangle of the neck?

A

The division of the common carotid into the internal and external carotid arteries. At the level of the common carotid we have the carotid sheath with the internal juglar vein and vagus nerve.

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16
Q

At what level does the common carotid divide into the internal and external carotid arteries?

A

upper border of the thyroid cartilage

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17
Q

What internal carotid branches are found in the neck?

A

NONE!

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18
Q

What are the branches of the external carotid artery in the neck?

A

superior thyroid, lingual artery, facial artery, ascending pharyngeal artery, occipital artery,

terminal branches: i. maxillary artery
ii. superficial temporal artery

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19
Q

What is the first branch of the external carotid? What branches from this artery?

A

The first branch is the superior thyroid, and its first branch is the superior laryngeal artery

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20
Q

What does the superior laryngeal artery travel with, and through what structure?

A

Travels with the internal branch of the superior laryngeal NERVE through the thyrohyoid membrane

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21
Q

What is the “second”anterior branch of the external carotid artery, and where does it run?

A

the lingual artery: passes deep to the hypoglossus muscle and immediately above the hyoid bone

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22
Q

What is the “third” anterior branch of the external carotid and where does it run?

A

facial artery: may come off in common with lingual artery; passes deep to the submandibular gland before crossing external to the mandible to enter the face; in neck it gives branches

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23
Q

What are the branches of the facial artery?

A

i. glandular branches
ii. submental branch which accompanies the nerve to the mylohyoid muscle
iii. tonsilar and ascending palatine branches (not seen in this dissection)

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24
Q

What is the “first” posterior branch of the external carotid, and where does it run?

A

ascending pharyngeal artery: lies on the wall of the pharynx

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25
Q

What is the “second posterior” branch of the external carotid artery? Where does it run?

A

the occipital artery: hooks over the hypoglossal nerve, grooves
the medial surface of the mastoid process and travels with the greater occipital nerve

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26
Q

At what point does the external carotid terminate, and what does it terminate as?

A

the external carotid artery then enters the parotid gland to divide into its terminal branches

i. maxillary artery
ii. superficial temporal artery

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27
Q

What are the boundaries of the submental triangle?

A

bounded by the two anterior bellies of the digastric muscles and the hyoid bone. The only unpaired triangle in the neck.

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28
Q

What are the boundaries of the digastric triangle?

A

submandibular triangle - bounded by the two bellies of the digastric muscle and the lower border of the mandible

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29
Q

What is found in the submanibular triangle?

A

suprahyoid muscles, submandibular gland, submandibular lymph nodes, vessels

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30
Q

What are the five suprahyoid muscles?

A

digastric muscle, stylohyoid muscle, mylohyoid muscle, geniohyoid muscle, hyoglossus muscle

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31
Q

From where does the digastric muscle arise? Where does it insert?

A

(a) arises from the medial aspect of the mastoid process
forming its posterior belly
(b) intermediate tendon goes through a connective tissue
pulley which is attached to the hyoid bone and also usually passes between two parts of the stylohyoid muscle
(c) anterior belly ascends to insert on the inner surface of the mandible close to the midline

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32
Q

What nerve supplies the posterior belly of the digastric? What nerve supplies the anterior belly?

A

posterior belly is supplied by the facial nerve, and the anterior belly is supplied by the trigeminal nerve by way of the nerve to the mylohyoid muscle

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33
Q

What is the action of the digastric?

A

elevator of the larynx as a whole

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34
Q

From where does the stylohyoid muscle arise? Where does it insert?

A

(a) arises from the styloid process
(b) inserts on the hyoid bone

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35
Q

What nerve supplies the stylohyoid muscle?

A

C7 facial nerve

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36
Q

What is the action of the stylohyoid?

A

elevator of the larynx as a whole

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37
Q

From where does the mylohyoid arise? Where does it insert?

A

(a) forms the muscular floor of the mouth
(b) arises from the mylohyoid line of the mandible
(c) inserts on the hyoid bone and a connective tissue raphe
which extends from the hyoid bone to the mandible in
the midline between left and right muscles

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38
Q

What is the nerve supply to the mylohyoid?

A

trigeminal nerve

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39
Q

What is the action of the mylohyoid?

A

elevator of the larynx as a whole

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40
Q

from where does the geniohyoid arise? Where does it insert?

A

(a) situated above the mylohyoid muscle
(b) arises from the inferior genial tubercle of the mandible
(c) inserts into the body of the hyoid bone

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41
Q

What is the nerve supply to the geniohyoid?

A

(d) nerve supply - C1 and C2 through the hypoglossal
nerve

42
Q

What almost fills the submandibular triangle? What is this structures function?

A

submandibular gland - major salivary gland

43
Q

What are the two parts of the submandibular gland? Where are they located?

A

(a) superficial part of gland lies superficial to the
mylohyoid muscle and becomes folded around the free posterior border of the muscle with the deep part of the gland deep to the muscle
(b) deep part of gland lies between the mylohyoid and hyoglossus muscles

44
Q

Where does the submandibular duct arise? Where does it run? Where does it open?

A

submandibular duct arises from deep part of gland and passes forward and medially between the mylohyoid and hyoglossus muscles and opens into the oral cavity at the sublingual papilla

45
Q

Where are the submandibular lymph nodes?

A

lie on the gland and between the gland and the mandible, deep to investing fascia

46
Q

What two vessels are in the submandibular triangle?

A

facial artery, facial vein

47
Q

What branches from the facial artery in the submandibular triangle?

A

the submental artery

48
Q

Where does the facial artery travel?

A

travels in a spiral fashion along lower border of the mandible deep to the gland to reach the face, may actually travel within the gland

49
Q

Where does the facial vein run?

A

(a) passes over the gland in the subcutaneous tissue
(b) facial vein lies behind facial artery as the vessels enter
the face

50
Q

Where does the mylohyoid nerve run? What are its branches?

A

Also called trigeminal nerve: is on surface of mylohyoid muscle deep to submandibular gland and it sends branches to:

(a) mylohyoid muscle
(b) anterior belly of digastric muscle

51
Q

Where is the intermediate tendon of the digastric muscle?

A

intermediate tendon of digastric muscle on surface of hyoglossus muscle just above hyoid bone

52
Q

Where does the hypoglossus muscle run?

A

hypoglossal nerve (CN12/CNXII) runs forward on hyoglossus muscle deep to the submandibular gland, passes between mylohyoid and hyoglossus muscles

53
Q

Where is the lingual nerve in the submandibular triangle?

A

passes between mylohyoid and hyoglossus muscles

54
Q

Where is the lingual artery run in the submandibular triangle?

A

passes deep to hyoglossus muscle

55
Q

What are the venous drainage structures in the superficial structures of the head and neck?

A
  1. posterior auricular vein
    2. retromandibular vein
  2. facial vein
  3. external jugular vein
  4. common facial vein
56
Q

What is the anterior branch of the retromandibular vein?

A

maxillary vein

57
Q

What is the posterior branch of the retromandibular vein?

A

superficial temporal vein

58
Q

Where is the retromandibular vein located?

A

a. formed in the upper portion of the parotid gland deep to the neck of the mandible is formed by

b. posterior to ramus of the mandible lies in the parotid gland it lies
lateral to the external carotid artery

59
Q

What is the facial vein continuous with? What forms this structure?

A

a. continuous with the angular vein which is formed by the supratrochlear and supraorbital veins

60
Q

What are two unique features of the facial vein?

A

b. contains NO valves
c. communicates with the pterygoid plexus of veins by the deep facial vein

61
Q

What forms the external jugular vein?

A

a. formed by veins joining
(1) posterior auricular vein
(2) posterior branch of the retromandibular vein

62
Q

Where does the external jugular vein run? Where does it drain?

A

b. descends across the sternocleidomastoid muscle to empty into the
subclavian vein

63
Q

What forms the common facial vein?

A

a. formed by veins joining
(1) anterior branch of the retromandibular vein
(2) facial vein

64
Q

Where does the common facial vein drain?

A

b. empties into internal jugular vein high in neck

65
Q

What is the deep venous drainage system of the neck? Where does it arise?

A

internal jugular vein, arises from dural sinuses (sigmoid and inferior petrosal sinuses) within
the cranial cavity

66
Q

Where is the internal jugular vein located?

A

lies in the carotid sheath with the common/internal carotid artery
and vagus nerve

67
Q

Where does the internal juglar vein run?

A

as it descends from the skull it moves from posterior to lateral in
relation to the internal carotid artery

68
Q

What lymph nodes drain the head and neck?

A

facial nodes, nodes at the junction of head and neck, superficial cervical nodes - external jugular nodes, cervical nodes, final common pathway for head and neck lymph.

69
Q

Where are the facial nodes?

A

facial nodes are found along the facial vessels in the head, but most lymph vessels flow relatively vertically to nodes at the junction of head and neck

70
Q

What are the nodes at the junction of the head and neck?

A

a. submental - lie on mylohyoid muscle between the anterior bellies
of the digastric muscles
b. submandibular
(1) lie on each side of gland and along the inferior border of the mandible
(2) receive lymph from wide area including much of the deep and superficial face
c. superficial parotid - on parotid sheath
d. mastoid (retroauricular) - behind auricle on the insertion of the
sternocleidomastoid muscle
e. occipital - in area of the superior nuchal line between attachments
of trapezius and sternocleidomastoid muscles

71
Q

Where are the superficial cervical nodes?

A

lie along the external jugular vein

72
Q

What are the cervical nodes and where are they located?

A

located deep to investing fascia
a. infrahyoid - found along the superior thyroid vessels
b. prelaryngeal - found on cricothyroid ligament
c. pretracheal - found along the inferior thyroid vessels
HA - 17 -5
d. paratracheal - found along recurrent laryngeal nerves between trachea and esophagus
e. accessory - found along accessory nerve
f. transverse cervical - found along transverse cervical vessels
g. deep parotid within parotid gland tissue
h. retropharyngeal - lie on the lateral side of the retropharyngeal
space

73
Q

What composed the final pathway for lymph drainage in the head and neck?

A

superior deep cervical nodes, inferior deep cervical nodes, jugular
lymph trunk

74
Q

What are the two groups of lymph nodes in the superficial deep cervical category?

A

form a chain in the carotid sheath along the internal jugular vein
(1) jugulodigastric - prominent nodes anterior to the internal
jugular vein just below the angle of the mandible
(2) jugulomyohoid - located on omohyoid muscle as it
crosses the internal jugular vein

75
Q

Where ar ethe inferior deep cervical lymph nodes?

A

continuous with superior deep
cervical lymph nodes below the omohyoid muscle

76
Q

Where does the jugular lymph trunk drain?

A

efferent vessels from deep cervical nodes drain into jugular
lymph trunk
(1) drains into thoracic duct of left and right lymphatic
trunk on right

77
Q

What does the trigeminal nerve innervate?

A 
trigeminal nerve (CN5/CNV) - nerve to mylohyoid, which also supplies the
 anterior belly of the digastric muscle (Plates 121; 9.11, 9.14)
78
Q

What does the facial nerve innervate?

A

cervical branch of facial nerve supplies the
platysma muscle. (The stylohyoid and posterior belly of the digastric muscles are supplied by the main trunk of the facial nerve, but this cannot be seen in this dissection.) (Plates 122; 9.15)

79
Q

What does the glossopharyngeal nerve innervate?

A

supplies carotid sinus

80
Q

What are the branches of the vagus nerve? Where does the main trunk run?

A

main trunk passes through neck in the carotid sheath with the
common/internal carotid artery and internal jugular vein
(1) superior and inferior cervical cardiac nerves

(2) superior laryngeal nerve
(3) pharyngeal branch
(4) recurrent (inferior) laryngeal nerve

81
Q

What are the superior and inferior cervical cardiac nerves?

A

visceral
branches of vagus to the cardiac plexuses

82
Q

What are the two branches of the superior laryngeal nerve? Where do they run?

A

(a) external branch to cricothyroid muscle and root of the tongue
(b) internal branch
i. passes through the thyrohyoid membrane
ii. sensory to the laryngeal mucosa above the true
vocal folds
iii. important for cough reflex

83
Q

Where will you find the pharyngeal branch of the vagus nerve?

A

passes between carotid arteries

84
Q

Where will you find the recurrent inferior laryngeal nerve?

A

lies in groove
between trachea and esophagus

85
Q

Where is the accessory nerve what does it supply?

A

accessory nerve (CN11/CNXI) (Plates 126; 9.19)
a. enters deep surface of sternocleidomastoid muscle high in the neck (1) supplies that muscle
HA - 17 -6
(2) then crosses the posterior triangle of the neck to supply the
trapezius muscle

86
Q

Where will you find the hypoglossal nerve?

A

a. crosses external to both carotid arteries
b. goes deep to the mylohyoid muscle

87
Q

Where do the branches of the the hypoglosso nerve go?

A

hypoglossal nerve (CN12/CNXII), carries branches to the ansa cervicalis, thyrohyoid and geniohyoid
muscles
(1) fibers actually from C1
(2) review the cervical plexus (see HA-8-2)

88
Q

What does the ansa cervicalis innervate?

A

(1) innervation to infrahyoid muscles
(2) forms loop on anterior surface of the internal jugular vein

89
Q

What are the two roots of the ansa cervicalis?

A

descendens hypoglossi - superior root, descendens cervicalis - inferior root

90
Q

What does the superior root of the ansa cervicalis supply?

A

descendens hypoglossi - superior root
i. fibers from C1 run with hypoglossal nerve
ii. supplies thyrohyoid and geniohyoid muscles
as separate nerve
iii. root also supplies superior belly of omohyoid
muscle

91
Q

What does the inferior root of the ansa cervicalis supply?

A

descendens cervicalis - inferior root
i. fibers from C2 and C3
ii. supplies sternohyoid, sternothyroid and
inferior belly of omohyoid muscles
iii. review the cervical plexus

92
Q

What is the cervica portion of the sympathetic trunk composed of?

A

superior cervical ganglion, middle cervical ganglion, inferior cervical ganglion

93
Q

What does the superior cervical ganglion supply?

A
  • *a. internal carotid nerve and plexus
    b. superior cervical cardiac nerve
    c. communications with CN9, CN10, and CN12
    d. gray communicating rami with C1-4
    e. pharyngeal branches
    f. branches to the external carotid artery**
94
Q

What does the middle cervical ganglion supply?

A

a. middle cervical cardiac nerve
b. gray communicating rami to C5 and C6

95
Q

What does the inferior cervical ganglion supply?

A

a. inferior cervical cardiac nerve
b. gray communicating rami to C7 and C8
c. may fuse with first thoracic ganglion and form stellate ganglion
d. if vertebral ganglion not present, it gives a branch to the vertebral
artery

96
Q

What is the vertebral ganglion?

A

vertebral ganglion - if present near vertebral artery

97
Q

What is the structure of the thyroid gland?

A

a. two lateral lobes which extend usually from oblique line of thyroid cartilage down to the level of the sixth tracheal ring
b. median lobe or middle lobe is isthmus that connects the two lateral lobes
c. a pyramidal lobe may be present - extends up from isthmus

98
Q

What is the blood supply to the thyroid gland?

A

blood supply
a. superior thyroid artery - branch of external carotid artery
b. inferior thyroid artery - branch of thyrocervical trunk which is a
branch of the subclavian artery

99
Q

What is attached to the posterior surface of the thyroid gland?

A

parathyroid glands

100
Q
A

Anatomy (16 decks)

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