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137 Cards in this Set
- Front
- Back
What joints make up the craniovertebral joint?
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AO (atlanto-occipital) & AA (atlanto-axial)
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______ bear the weight of the skull on the atlas & have CONCAVE tubercles.
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2 lateral masses
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There are kidney-shaped ____ on the atlas for reception of the occipital condyle.
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articular facets
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The articular facets of the atlas together with the occiptial condyle form ____.
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AO joint
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The _____ join the lateral masses of the atlas. They have tubercles as well.
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anterior & posterior bony arches
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The anterior tubercle serves as the attachment for ____ & _____.
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Anterior Longitudinal Ligament & longus colli (uppermost attachment)
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The _____ of the atlas has a distinct groove for the Vertebral Artery.
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posterior arch
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Vertebral artery passes thru _____ foramen of atlas, & then bends medially & lies in groove before it _____.
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transverse foramen
ascends through the foramen magnum |
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The ____ of the atlas projects farther than any other cervical vertebrae.
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transverse processes
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The 'wide' projection of the transverse processes of the atlas has what advantage?
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increased mechanical advantage to some of the muscles that attach there
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The ____ aspect of the lateral mass is the part with the tubercle.
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medial
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The _______ runs from one lateral mass to the other.
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transverse ligament of the atlas
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The anterior arch of atlas has a facet on its posterior aspect for articulation w/____.
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dens
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C-__ is the strongest of all vertebrae.
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C2--axis
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The dens of the axis articulates with ____.
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anterior arch of the atlas (via anterior articular facet)
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The Tens has a facet posteriorly for ____, which runs from _________.
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transverse ligament
side-to-side (medial tubercles of lateral masses) |
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The superior articular facets (large) articulate with _____.
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inferior articular processes of the atlas
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The articulation of the sup. art. facets of axis w/inf. art. process of atlas forms _____.
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lateral AA joint (atlanto-axial)
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The articulation of the dens w/anterior arch of the atlas forms the _____ joint.
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median AA joint
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Describe the spinous process of the axis.
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bifid & strong
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What kind of joints are the AO joints?
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ellipsiod synovial
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Movement of one of the AO joints involves movement of the other, so considered to form ____.
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part of an elliptical surface
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What are the 2 axes that the ellipsiod joints (AO) move about?
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transverse axis
anterior-posterior axis |
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The transverse axis formed by the AO joints allows ____.
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flexion & extension ('yes')
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The anterior-posterior axis of the AO joint allows what movement?
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lateral flexino (tilting head to the side)
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Whast are the 3 AA (atlanto-axial) joints?
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2 lateral; one medial
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The two lateral AA joints are _____ joints, while the median is a ____ joint.
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lateral-gliding synovial joints
median-pivot joint |
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THe lateal AA joint surfaces are ____ (what shape?).
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flat & planar (hence the gliding motion)
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As you turn your head, the lateral AA joints glide, one _____ & one ____.
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forward & backward
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The dens has _____ cavities (lined with _____) anterior & posterior to it.
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synovial cavities (synovial membrane)
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The synovial cavities on front & back of dens allow for ________.
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rotation/PIVOTING
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When you shake your head 'no', ______ rotates around the dens-a ____ pivot.
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the skull & atlas rotate around dens, a stationary pivot
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The AO joint has a ____ capsule, which is loose & lined by a ____ membrane.
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fibrious capsule, synovial membrane
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The anterior atlanto-occipital membrane stretches b/tw ____ & ____.
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anterior arch of atlas & anterior margin of foramen magnum
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The AO membrane is located between _____ joints.
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AO
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The lateral AA joints are rather loose, & b/tw them you can see _____.
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ALL (it attaches to anterior tubrecle of the atlas)
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The posterior AO membrane stretches from ____ to ___.
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posterior arch of atlas to posterior margin of foramen magnum
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What structures pierce the posterior AO membrane?
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vertebral artery
sub-occipital nerve |
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The posteror AO membrane blends with _____ laterally.
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capsule of the AO joint
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The tectorial membrane is a continuation of ____ & is anterior to _____ (surrounding spinal cord).
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posterior longitudinal ligament
dura mater |
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The tectorial membrane runs from ___ to ___.
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axis to base of occipital bone
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What are the ligaments running deep to the tectorial membrane?
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transverse ligament of atlas + sup. & inf. longitudinal bands = cruciate ligament;
alar ligaments |
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What side of the dens does the transverse ligament cover?
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back
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The superior longitudinal & inferior longitudinal bands extend up & down from ____.
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transverse ligament
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The superior longitudinal band attaches to ____ & the inferior attaches to ____.
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basilar part of occipital bone
body of axis |
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The cruciate (cruciform) ligament is formed by what 3 structures?
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The superior longitudinal & inferior longitudinal bands;
transverse ligament |
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The alar ligaments are ___ (where in location?) to cruciate ligament.
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anterior ('deep' from posterior view)
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The alar ligaments run superiolaterally from _____ to ____.
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lateral margin of dens to medial margin of occipital condyle
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The alar ligaments are strong and sometims called ___ ligaments. Why?
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"check"-they check/limit the amount of rotation of your head
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The small apical ligament of the dens extends from ___ to ___.
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tip of dens to margin of foramen magnum
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Upon cutting one alar ligament, there is a __º increase in lateral rotation.
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30
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Diving accidents can be the culprits of a ____ fracture.
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Jefferson
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What is a Jefferson fracture?
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compressive forces passed through occipital condyle into atlas
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What happens to the lateral masses in a Jefferson fracture?
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they are displaced laterally, which fractures one or both of the bony arches
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The ____ can be ruptured if the force of a Jefferson fracture is great enough.
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transverse ligament of the atlas
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What could happen if the transverse ligament of the atlas ruptured?
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dens may impinge on spinal cord & cause grave daño o muerte
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A hangman's fracture results of ____ of head ON neck.
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hyperextension
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Hyperextension of head on neck fractures ____ of the axis.
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pars interarticularis (b/tw sup. & inf. articular procecces)
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About 40% of axial fractures involve ____.
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the dens
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The dens is usually fractured at its ____ (body or base?). Why is result?
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base
blood supply cut off & avascular necrosis occurs |
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Which is better--fracture of body or base of dens?
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body--the 2 fragments still have their own blood supply
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Rupture of the transverse ligament of atlas can cause ___ displacement of atlas.
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anterior
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There is some leeway for anterior displacement of atlas b/c _____.
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about 1/3 of it is occupied by soft tissue, meninges, & CSF
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What is Steele's Rule of 3rds?
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can displace atlas up to 1/3 diam. of ring & s.c. may not be smashed b/c 1/3=dens, 1/3 =s.c., 1/3=soft tissue, etc.
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What are the 4 muscles on each side of the prevertebral region ?
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longus colli (longus cervicis); longus capitis; rectus capitus anterior & lateralis
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The longus colli originates from ____ & attaches into ___.
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upper T & lower C vertebrae
C vertebrae (more superiorly) |
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The highest extent of the longus colli attaches into the _______.
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anterior tubercle of the atlas
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The longus capitis arises from ___ & inserts into ____.
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arises-cervical vertebrae
inserts-basilar part of occipital bone |
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The rectus capitus anterior runs from ____ to ____.
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lateral mass of atlas to basilar part of occipital bone
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The rectus capitus lateralis runs from ____ to ____.
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transverse process of atlas to jugular process of occipial bone
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The scalene muscles are sometimes considered ___, sometimes _____.
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lateral vertebral,
prevertebral |
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The scalenes all originate from _____.
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transverse process of cervical vertebrae
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What is the insertion point?
anterior scalene: middle scalene: posterior scalene: |
ant-scalene tubercle of rib 1
mid-upper surface of rib 1 post-outer margin of rib 2 |
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The scalene & prevertebral muscles are innervated by _____.
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ventral rami of cervical nerves
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What muscles flex the neck?
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longus colli-bilaterally
scalene muscles-bilaterally SCM |
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The scalenes (bilaterally) can _____ if the neck is fixed, and are hence _____.
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elevate the first 2 ribs
muscles of inspiration |
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If the scalenes contract unilaterally, you get _____.
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lateral flexion of the neck (intertransverse also does this)
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____ & ____ muscles are responsible for flexion of the head.
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Longus capitis & rectus capitis anterior
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The SCM & supra/infrahyoid muscles can pull down on hyoid & ____, causing ____.
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mandible
indirect flexion of AO joint |
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Which muscles are responsible for extension of the head?
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rectus capitis posterior major & minor
suprior oblique, trapezius |
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Lateral flexion (tilting of head from side to side) is caused by _______.
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rectus capitus lateralis
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Turning head left or right is caused by _____.
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SCM contraction on opposite side
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Which muscles cause rotation to the same side?
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rectus capitis posterior major; splenius capitis; longissimus capitis; inferior oblique
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What gives mechanical advantage to the inferior oblique to cause lat. rotation?
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the transverse process of the atlas extending so far laterally
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What structures run anterior to anterior scalene?
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phrenic nerve, suprascapular & trans. cervical aa., inf. thyroid a. (& asc. cervical branch), subclavian vein
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Which arteries clamp phrenic nerve down to ant. scalene?
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suprascapular & transverse cervical
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What structures are posterior to anterior scalene?
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2nd part of subclavian; brachial plexus (runs b/tw anterior & middle)
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What forms the interscalene triangle?
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anterior & middle scalene, along with rib 1
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What might compromise the triangle & cause lower trunk of brach. plexus or subclav. artery to become compressed?
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cervical rib (recuces size of triangle)
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The investing fascia is the most 'superficial' and ENCLOSES _____.
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SCM & trapezius muscles
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The investing layer of cervical fascial is a ___ layer on front & side of neck.
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single
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The investing layer of deep cervical fascia forms the ____ of the posterior triangle (b/tw SCM & trapez.)
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ROOF
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The prevertebral fascia covers prevertebral muscles & extends ___ to cover ___.
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laterally-scalene muscles
posteriorly-complete tubular investment for prevert. m. & musc. on back of neck |
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The ____ fascia surrounds the cervical viscera & is divided into 2 components. What?
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VISCERAL
pretracheal & buccopharyngeal |
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The pretracheal fascia forms a sheath for _____.
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thyroid gland
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The buccopharyngeal layer of fascia covers _____ & ____ (superior) & ____ (inferior).
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buccinator & pharyngeal muscles-higher
back of esophagus-lower |
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Where is the retropharyngeal space found?
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behind pharynx/esophagus; bounded anteriorly by buccopharyngeal fascia & post. by prevert. fascia
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The retropharyngeal space is filled with __, which allows ___ of pharynx & esophagus (when swallowing).
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loose areolar tissue
expansion upon swallowing |
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The ____ binds the retropharyngeal space on either side.
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carotid sheath
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Which layers of fascia contribute to carotid sheath?
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investing; prevertebral; visceral
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The carotid sheath encompasses ___, ____, & ____.
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CNX, IJA, CCA
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The retropharyngeal space extends from ___ to ___ (superiorly to inferiorly).
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base of skull
behind heart into posterior mediastinum |
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What is clinical significance of inferior border retropharyngeal space?
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infection can spread to mediastinum (in chest)
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The buccinator & 3 constrictor muscles of pharynx are covered in ____.
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buccopharyngeal fascia
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The lateral pharyngeal space is ___ filled & has which 2 muscles in it?
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fat-filled
styloglossus, stylopharyngeus |
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The lateral pharyngeal space lies lateral to ___, medial to ____.
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lateral-pharynx
medial-pterygoid muscles & parotid gland |
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The lateral pharyngeal space is continuous with the _____.
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retropharyngeal space
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A common site for infection, the lateral pharyngeal space houses ___, ___, & ____.
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base of Tongue, palatine Tonsils, Teeth (3Ts)
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CN ___ descends, loops forward, & is closely related w/vagus.
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XII
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CN ___ wraps around the stylopharyngeus.
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IX
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CN __ runs inferolaterally & enters deep side of SCM.
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XI
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CN ____ descends in the carotid sheath b/tw IJV laterally & ___ medially.
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X
internal carotid medially |
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CN ___ crosses both carotid arteries & innervates ____.
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XII;
tongue muscles |
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The sympathetic trunk lies ___ to carotid sheath & contents.
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(just) posterior
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The cervical part of the sympathetic trunk has __ ganglia. What?
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3-4;
superior, middle, inferior, & sometimes vertebral (b/w middle & stellate) |
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The ___ ganglia from cervical part of symp. trunk are usually fused (_% of time) with _____.
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inferior
80% 1st thoracic |
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The fusing of inferior cervical ganglion w/ 1st thoracic ganglion is called ___ ganglion.
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stellate ganglion/cervicothoracic)
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The cervical part of symp. trunk consists 1º of ____ fibers that have entered trunk in ____ region.
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PRESYNAPTIC SYMPATHETIC
upper thoraic region |
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The presynaptic cell bodies lie in ___.
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lateal horn of upper thoracic spinal cord
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After presynaptic cell bodies enter sympathetic trunk, they synapse ___ (where?).
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in any of the 3-4 ganglia
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After synapsing in cervical ganglia, postsynap. symp fibers will go to ___ & ___.
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head & neck
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The postsynap. symp. fibers will go to head & neck 2 ways: ___ & ___.
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gray rami comunicantes
post. symp fibers traveling along blood vessels |
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The grey rami comunicantes connect ___ & ____.
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cervical ganglia w/ cervical spinal nerves
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There are ___ cervical ganglia but ___ cervical nerves.
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3-4
8 |
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All spinal nerves have a ______.
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grey ramus
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The SUPERIOR cervical ganglion sends gray rami to which cervical nerves?
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upper 4 cervical nerves
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The MIDDLE cervical ganglion sends gray rami to which cervical nerves?
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usually C5-C6
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The INFERIOR cervical ganglion sends gray rami to which cervical nerves?
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C7-C8
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_____ results in 3-4 instead of 7-8 ganglia.
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Fusion of ganglia during development (hence you may have some variation)
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The ____ is a major nerve coming off sup. cerv. ganglion & traveling along ICA.
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internal carotid nerve (it forms a plexus around the artery, up into the skull)
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THe ___ forms a pluxus around the ECA & its branches.
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external carotid nerve
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The ___ forms a plexus around the vertebral artery.
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vertebral nerve
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Which arteries have sympathetic plexi of nerves around them?
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ECA, ICA, VA
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The sympathetic fibers travel along arteries & branches to innervate ____.
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smooth muscle & glands in head and neck (including blood vessels themselves)
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Horner's syndrome is caused by lesions of ____ .
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sympathetic trunk causing sympathetic supply to head & neck to be cut off
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The ICA plexus is responsible for ___ & ___ in Horner's syndrome. Why?
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PTOSIS-superior tarsal
MIOSIS-dilator pupillae |
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The ECA plexus is responsible for ___ & ___ in Horner's syndrome.
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VASODILATION (inc. temp, redness of skin & face)
ANHIDROSIS (lack of sweating) |