6. Cervical Region

Front 1

What 5 structures are superficial in the cervical region?

Back 1

1. External jugular vein
2. Cutaneous nerves
3. Platysma muscle
4. Sternocleidomastoidmuscle
5. Trapezius muscle

Front 2

What 4 cutaneous cervical nerves can be seen superficially? What are their cervical roots?

Back 2

-Transverse cervical (C2/C3)
-Great auricular (C2/C3)
-Supraclavicular nerves (C3/C4)
-Lesser Occipital nerve (C2/C3)

Front 3

What innervates the platysma?

Back 3

CN VII - facial

Front 4

What is the 'laryngeal prominence'? What cervical level?

Back 4

Adams apple - C4/C5

Front 5

What cervical level is the hyoid bone?

Back 5

About c3

Front 6

What is the cricoid cartilage?

Back 6

The first complete ring of the trachea; just below the thyroid cartilage

Front 7

What forms the external jugular vein?

Back 7

-Posterior auricular vein
-Retromandibular vein
-Come together to form EJV

Front 8

What is a useful feature of the EJV?

Back 8

-Its prominence can suggest intrathoracic pressure, tumors, or congestive heart failure.

Front 9

What type of nerves are the cutaneous cervical nerves?

Back 9

Sensory

Front 10

In what region does the transverse cervical nerve receive sensory info?

Back 10

Anterior triangle; curves around from the mid-posterior StrnCMst border then crosses over it. Deep to the platysma

Front 11

Where does the Great Auricular Nerve recieve sensory info from?

Back 11

-Skin over parotid gland
-Backside of the ear
-Skin from mandibular angle to mastoid process

Front 12

Where does the lesser occipital nerve provide innervation?

Back 12

-Neck skin
-Scalp behind the ear

Front 13

Where do the supraclavicular nerves innervate?

Back 13

Small branches spread across the neck skin and shoulder (it emerges as one trunk from SCM)

Front 14

What is the platysma also called?

Back 14

The shaving muscle

Front 15

What is the function of the platysma?

Back 15

Assists in mastication; but inervated by CN VII (not V3!)

Front 16

How is the platysma classified (w/ ref to grouping)?

Back 16

As a muscle of facial expression.

Front 17

What innervates the SCM (sternocleidomastoid)?

Back 17

The spinal accessory n. CN XI

Front 18

What is the origin/insertion of SCM?

Back 18

Origin: mastoid process of temporal bone
Insertions: sternal manubrium + clavicle

Front 19

How does the SCM act when contr.
-Alone
-Both sides

Back 19

Alone: turns head to opposite side
Together: flexion

Front 20

What does CN XI also innervate?

Back 20

Trapezius

Front 21

What is the proper name for the strap muscles of the neck?

Back 21

Infrahyoid muscles

Front 22

What are the strap muscles in general; what is their function?

Back 22

Ribbon like muscles that assist in Speech, Swallowing, and Stability of Hyoid bone and Thyroid cartilage.

Front 23

What are all of the strap muscles innervated by?

Back 23

Ansa cervicalis (C1-C3)

Front 24

List the 4 strap muscles:

Back 24

-Omohyoid
-Sternohyoid
-Sternothyroid
-Thyrohyoid

Front 25

Omohyoid:
-origin
-insertion

Back 25

Origin = shoulder
Insertion = hyoid bone

Front 26

What vascular structure is just beneath the omohyoid?

Back 26

Common carotid

Front 27

What strap muscle is most medial?

Back 27

Sternohyoid

Front 28

What strap muscle lies beneath sternohyoid?

Back 28

Sternothyroid

Front 29

What lies just above sternothyroid?

Back 29

Thryohyoid

Front 30

Sternohyoid:
-origin
-insertion

Back 30

origin = sternum
insertion = hyoid bone

Front 31

Sternothyroid:
-origin
-insertion

Back 31

origin = manubrium (post border)
insertion = thyroid cartilage

Front 32

Thyrohyoid:
-origin
-insertion

Back 32

origin = thyroid cartilage
insertion = hyoid bone

Front 33

What exactly innervates the Thyrohyoid muscle?

Back 33

C1 thru Hypoglossal nerve

Front 34

What is the main function of the thyrohyoid muscle?

Back 34

To close the laryngeal orifice during swallowing - prevents food from entering the larynx.

Front 35

what are the roots of the cervical plexus?

Back 35

C1-C5

Front 36

What do the cervical nerves do?

Back 36

Provide sensry and motor innervation to the NECK.

Front 37

What are the sensory nerves of the cervical plexus?

Back 37

-Lesser occipital
-Greater auricular
-Transverse cervical
-Supraclavicular

Front 38

What are the motor nerves of the cervical plexus?

Back 38

-Ansa cervicalis
-Phrenic
-Spinal accessory

Front 39

What are the roots of ansa cervicalis?

Back 39

C1-C3

Front 40

What does ansa run with?

Back 40

hypoglossal nerve; lies within carotid sheath.

Front 41

what does the ansa cervicalis innervate?

Back 41

strap muscles - motor

Front 42

What are the nerve roots of the phrenic nerve, and what muscle does it lay right next to?

Back 42

C3,4,5 keep diaphragm alive..
-lays next to anterior scalene muscle.

Front 43

what cervical nerve roots does the accesory nerve CN XI pick up?

Back 43

C2,3,4

Front 44

What is the Posterior Triangle divided into?

Back 44

1. Occipital triangle
2. Supraclavicular triangle

Front 45

What are the borders of the posterior triangle overall?

Back 45

Ant: Sternocleidomastoid
Post: Trapezius
Inferior: mid 1/3 clavicle

Front 46

What structures lie within the posterior triangle?

Back 46

1. External jugular v.
2. Occipital artery (apex)
3. Spinal accessory n.
4. Portion of Subclavian artery

Front 47

Structure separating Ant/Post triangles:

Back 47

Sternocleidomastoid

Front 48

Where in posterior triangle is:
-Safe area
-No man's land

Back 48

Safe = above posterior omohyoid belly; few important structures
Danger = below post omohyoid belly - watch out!

Front 49

What is in No man's land of the posterior triangle?

Back 49

-Brachial plexus
-Cervical plexus
-Subclavian artery/vein
-Thyrocervical trunk

Front 50

Anterior triangle borders:

Back 50

-Midline of neck
-Inferior mandible border
-Anterior SCM border

Front 51

2 triangles within Anterior tri:

Back 51

-Carotid
-Muscular

Front 52

Carotid triangle borders:

Back 52

-Omohyoid superior belly
-Digastric posterior belly
-SCM anterior border

Front 53

Important structures in Carotid triangle:

Back 53

-Carotid sheath (includes sinus)
-Ansa cervicalis
-Hypoglossal nerve

Front 54

What is a bruit?

Back 54

Turbulent sound resulting from bloodflow through artery at faster rate than normal.

Front 55

What will a Bruit heard in the carotid triangle indicate?

Back 55

Arteriosclerosis

Front 56

Muscular triangle borders:

Back 56

-Omohyoid Superior belly
-Midline of neck
-Anterior SCM border

Front 57

Important structures in the Muscular Triangle:

Back 57

Strap muscles + Thyroid gland and cartilage

Front 58

What will a Bruit heard in the Muscular triangle indicate?

Back 58

Hyperthyroidism

Front 59

3 Main branches of the Aortic Arch:

Back 59

RIGHT: Brachiocephalic trunk

LEFT: Subclavian a. + Common Carotid a.

Front 60

What nerve is blocked in a lip laceration? Why?

Back 60

Infraorbital - to prevent swelling and make sutures easier

Front 61

Temporal Arteritis

Back 61

Pathological thicken/hardening of Superfic. Temporal artery due to autoimmune inflammation of the vessel lining

Front 62

Symptoms associated with Temporal arteritis:

Back 62

-Pain in palpating temporal area
-Unilateral vsion loss
Common in 60-70 yr olds mostly

Front 63

3 Sections of Subclavian A:

Back 63

1. Medial to Anterior Scalene
2. Behind Anterior scalene
3. Lateral to Ant. scalene

Front 64

Branches of Section 1:

Back 64

-Vertebral
-Thyrocervical trunk

Front 65

Vertebral artery supplies:

Back 65

Circle of Willis

Front 66

Subclavian Steal Syndrome:

Back 66

-Occlusion of Subclavian between Common Carotid/Vertebral branchs
-Diminished bloodflow to arm

Front 67

What is a symptom of subclavian steal syndrome?

Back 67

When pt lifts arm, faints

Front 68

Reason for fainting when lifting arm in Subcl. Steal Syndrome:

Back 68

Blood flows up ICA -> Circle of Willis -> down Vertebral
to supply subclavian on other side of occlusion.
-Insufficient blood to brain

Front 69

Vessel commonly used for bypass:

Back 69

Internal thoracic

Front 70

EJV is formed by:

Back 70

-Retromandibular
-Posterior auricular

Front 71

Swollen Nodes in Ant triangle:

Swollen Nodes in Post & Ant triangles:

Back 71

Ant = Bacterial (Strep)

Both = Viral (mono)

Front 72

What 4 arteries anastomose around the scapula?

Back 72

-Transverse cervical
-Suprascapular
-Subscapular
-Circumflex Scapular

Front 73

What are the deep muscles in the cervical region?

Back 73

-Longus Capitus
-Longus colli

Front 74

Where are the o/i of longus capitis?

Back 74

O = Bodies and Transverse processes of cervical vertebrae
I = occipital bone of skull

Front 75

What innervates longus capitis and colli?

Back 75

Cervical nerves

Front 76

What is the action of longus capitis and colli together?

Back 76

Flexion of neck

Front 77

Action of Scalenes:

Back 77

Accessory muscles of breathing

Front 78

O and I of Scalenes:

Back 78

O = cervical vertebrae transverse processes

I = 1st and 2nd ribs

Front 79

4 Structures Surround Anterior Scalene Muscle:

Back 79

Subclavian vein = anterior
Subclavian artery = posterior
Brachial plexus = posterior
Phrenic nerve = along belly

Front 80

Stellate ganglion:

Back 80

Coalescence of Inferior cervical ganglion with 1st Thoracic ganglion - occasional.