Anatomy Exam 3, Lecture 2 (Fozi)

Front 1

Do all mammals have the same amount of cervical vertebrae?

Back 1

Yes, seven cervical vertebrae

Front 2

What does the neck do (general)

Back 2

Supports the head and moves the head in space, If you can't move your neck, you can't move your head

Front 3

The neck is a ____________ between the head and the body

Back 3

conduit (transition area)

Front 4

The root of the neck is a junction between the _________ and the _________

Back 4

neck and the thorax

Front 5

What does the cervical plexus do?

Back 5

It supplies sensory and motor fibers to much of the neck

Front 6

Part of the cervical is the ansa cervicalis. Ansa means ________. What does it do?

Back 6

Loop

-provides general motor innervation to the three strap muscles of the anterior neck

Front 7

Which bones are considered part of the neck (sometimes because muscles are attached to them)?

Back 7

-occipital
-temporal
-mandible
-cervical vertebrae
-manubrium of sternum
-clavicle
-hyoid bone

Front 8

Which cartilages are part of the neck?

Back 8

-Thyroid
-Cricoid
-Tracheal rings (beginning of them, they go down into the lungs)

Front 9

What is considered osteology?

Back 9

Bone and cartilage

Front 10

People with down syndrome tend to not be born with this:

What does this mean?

Back 10

The transverse ligament of the atlas

There is more potential for subluxation at the C1, C2 Joint

Front 11

When the Atlas articulates with the dens of the axis, what is the ligament involved?

Back 11

The transverse ligament of the atlas

Front 12

C7 is also known as the _________ __________. why?

Back 12

Vertebra prominens- it has a long spinous process and acts as a transition point (easy surface anatomy to find)

Front 13

What is the cartilage that is considered the Adam's apple?

Back 13

Thyroid cartilage

Front 14

Just underneath (inferior to) the thyroid cartilage is the __________ cartilage.

Back 14

Cricoid

Front 15

The head is the domain of the __1__________ nerves and the rest of the body is the domain of the ____2_____ nerves, and the neck has: ___3____

Back 15

1. cranial

2. spinal
3. both (the neck is part body, part head)

Front 16

The neck has multiple layers of fascia. What are they?

Back 16

1. Superficial fascia
2. Deep fascia

(multiple layers of deep)

Front 17

The superficial layer of fascia is thin, and contains:

Back 17

-Fat
-Subcutaneous connective tissue
-Cutaneous nerves, blood, and lymph vessels
-Platysma muscle

Front 18

The platysma muscle is your ___________ muscle

Back 18

Grimace

Front 19

Where does the platysma originate?

Where does it insert?

Back 19

O: Deltopectoral fascia (deep thick fascia)

I: mandible, lower lip, and other facial muscles that are associated with the lower part of the face

Front 20

The platysma is innervated by:

Back 20

The facial nerve (CN VII) (for facial expression)

Front 21

What is the function of the Platysma?

Back 21

draws the skin of the neck superiorly, and corners of the mouth inferiorly

Front 22

There are three layers of deep fascia in the neck. What are they?

Back 22

1. Investing (the most superficial of the deep)
2. Pretracheal (all around the organs)
3. Prevertebral (around vertebral body and all the musculature surrounding that vertebral body)

Front 23

What are two terms that refer to the neck?

Back 23

Cervical and Nuchal

Front 24

The cervical portion of the neck actually refers to all of the:

Back 24

Organs

Front 25

The nuchal portion of the neck is:

Back 25

The more stable, musculoskeletal portion that is posterior

Front 26

What do the deep layers of fascia provide?

Back 26

-natural cleavage planes
-limits spread of infection
-allows structures to slide

Front 27

The investing layer of fascial surrounds ___________________ and encloses:

Back 27

The entire neck

-encloses the trapezius, and the sternocleidomastoid

Front 28

The pretracheal fascia surrounds ____________________ and also expands and goes around:

Back 28

all of the anterior organs (esophagus, trachea, thyroid) and also expands and goes around the infrahyoid strap muscles

Front 29

What is the deepest layer of fascia?

Back 29

Prevertebral fascia

Front 30

The prevertebral fascia encloses:

Back 30

The muscles that are closest to the vertebral bodies: Prevertebral muscles (scalenes, longus coli, longus capitis, etc) , axillary vessels, and brachial plexus

Front 31

What are the nerves that exit between the anterior scalene and the middle scalene?

Back 31

the brachial plexus

Front 32

The roots of the brachial plexus are found in the neck and they exit between the _____________ and ______________

Back 32

anterior scalene and middle scalene

Front 33

What is found between the pretracheal and prevertebral fascial sheets?

Back 33

The retropharyngeal space

Front 34

The retropharyngeal space allows for the ______1_____________, contains the _____2__________
and opens into the:

Back 34

1. movement of viscera
2. sympathetic truck

Opens into the superior mediastinum (thoracic space where the heart resides)

Front 35

Why is the retropharyngeal space known as the danger space?

Back 35

because if infection were to get there, it could travel superiorly, and more importantly inferiorly, into the space where the heart resides.

This really does happen

Front 36

The carotid sheath is a mixture of fascia layers from all of the deep layers of fascia, and contains:

Back 36

-common carotid artery (medial)
-Internal jugular vein (lateral)
-Vagus nerve (CNX) (and sympathetic fibers)

Front 37

Right behind the carotid sheath is the _______ _________, and so the carotid sheath opens up into the _____________ as well

Back 37

1. Sympathetic trunk

2. mediastinum (arch of aorta found here)

Front 38

What is a potential pathway for infection into the thorax or cranium?

Back 38

The retropharyngeal space

Front 39

What makes up the lateral cervical region?

Back 39

The sternocleidomastoid, the trapezius( the main 2 muscles), and the clavicle

Front 40

What are the actions of the sternocleidomastoid?

Back 40

Unilaterally: Flex your neck to the same side, rotate your face to the opposite side

Bilaterally: Neck flexion

Front 41

What are the actions of the trapezius?

Back 41

-Scapular rotation
-Scapular adduction
-Scapular elevation

Front 42

The trapezius and the sternocleidomastoid are both innervated by:

Back 42

CN XI (accessory nerve)

Front 43

What are the muscles that make up the lateral cervical region?

Back 43

The trapezius, the sternocleidomostaid, and the clavicle make up the borders and then you have:
-Scalenes (anterior, middle, and posterior)
-Levator scapulae
-Splenius
-Omohyoid (inferior belly)

Front 44

The scalenes originate _____________1_____________ and insert into ________________2_________

Back 44

O: Transverse process of cervical vertebrae
I: ribs 1 and 2

Front 45

Scalenes are innervated by :

Back 45

Cervical spinal nerves (C4-C7 anterior rami)

Front 46

What is the action of the scalenes?

Back 46

They elevate the first two ribs (and neck flexion and rotation)

Front 47

The omohyoid originates________O________ and inserts on the ______I________

Back 47

O: Scapula
I: Hyoid bone

Front 48

The omohyoid is innervated by: 1

And its action is to: 2

Back 48

1. A branch of the ansa cervicalis

2. depress the hyoid

Front 49

The deep flexors of the head and neck are the:

Back 49

Longus colli and longus capitis mm

Front 50

What is the main nerve found in the lateral cervical region?

Back 50

The accessory nerve

Front 51

Does the accessory nerve have anterior branches?

Back 51

No, it just provides support for the other nerves

Front 52

The cervical plexus takes origin from which spinal nerves?

Back 52

C1-C4

Front 53

Are all of the nerves in the cervical plexus mixed spinal nerves?

Back 53

No, C2, C3, and C4 are mixed spinal nerves and have both motor and sensory, but C1 is purely motor

Front 54

Is there a C1 Dermatome?

Back 54

No, because there are no sensory fibers in C1

Front 55

The cervical plexus provides cutaneous innervation to:

Back 55

The skin of scalp, the neck, and the external ear

Front 56

Are any of the cranial nerves part of or "hitchhiking" on the cervical plexus?

Back 56

no, CN XII and CN XI (hypoglossal and accessory) are nearby and have structures from the cervical plexus attached to them, but they are not part of it at all (they're just sort of "hanging on")

Front 57

Where is the nerve point of the neck and what do you see here?

Back 57

deep to the platysma behind the sternocleidomastoid like a third of the way down,

This is where you see a lot of the sensory nerves exiting the cervical plexus and going to the superficial structures of the neck (skin)

Front 58

does the Trigeminal nerve innervate the corner of the jaw?

Back 58

No, it is a C2 area, the greater auricular

Front 59

What is a common site for an injection of anesthetics? (Nerve block)

Back 59

The nerve point of the neck

Front 60

C3,4, and 5 keeps the diaphragm alive applies to what nerve?

Back 60

The phrenic nerve

Front 61

The phrenic nerve is always riding on top of which muscle?

Back 61

The anterior scalene

Front 62

The roots of the brachial plexus can be found in the:

The trunks and divisions of the brachial plexus can be found in:

Back 62

The scalene gap- roots

Posterior triangle- trunks and divisions

Front 63

The right reccurent Laryngeal N is right next to the _____________ going up to the larynx

Back 63

Trachea

Front 64

The subclavian artery is divided into three parts. What are they are what are the relationships?

Back 64

- Medial - medial to anterior scalene
-Deep- deep to anterior scalene
-Lateral part, lateral to anterior scalene

Front 65

What structures are found within the scalene gap?

Back 65

The brachial plexus, and the subclavian artery

Front 66

If you were have any sort of compression from the scalene mm, which structures could you compress?

Back 66

Brachial plexus and subclavian artery

Front 67

The right subclavian artery branches off of:

Back 67

The brachiocephalic trunk

Front 68

What travels through the transverse foramena of the cervical vertebrae

Back 68

The vertebral artery

Front 69

Veins form distally and all go towards:

Back 69

The heart

Front 70

The external jugular vein is found right on top of the:

Back 70

Sternocleidomastoid

Front 71

The external jugular vein crosses the sternocleidomastoid and drains into the:

Back 71

Subclavian vein

Front 72

What are the causes of Thoracic Outlet Syndrome (TOS) ?

Back 72

-cervical rib (real thing)
-drooping shoulders
-repetitive activity (like stocking shelves)
(or massive musculature- body building)

Front 73

What occurs in Thoracic Outlet Syndrome (TOS)?

Back 73

Swelling of the scalene mm will compress nerves or vessels onto the first rib

Front 74

What are the two types of Thoracic outlet syndrome?

Back 74

-Neurogenic TOS
-Arterial TOS

As the scalenes swell (this tends to be a body builder thing), you can have a neurogenic or arterial TOS because it is compressing all of the nerves and vessels

Front 75

Anterior cervical region is also called:

Back 75

The anterior triangle

Front 76

What are the boundaries of the anterior cervical region (anterior triangle)?

Back 76

The sternocleidomastoid + Mandible + midline of neck

Front 77

What is the most important landmark of your anterior cervical region?

Back 77

The hyoid bone

Front 78

Muscles attach to the hyoid bone both superiorly and inferiorly, and they are called:

Back 78

Suprahyoid "strap" muscles and infrahyoid "strap" muscles, respectively

Front 79

The suprahyoid muscles _____1_______ the hyoid bone, while the infrahyoid muscles ______2_____ the hyoid bone

Back 79

1. Elevate

2. Depress

Front 80

The suprahyoid muscles and infrahyoid muscles elevating and depressing the hyoid bone relates to:

Back 80

The pitch of your voice because if you raise your larynx, you have a higher voice and if you lower your larynx, you have a lower pitch of voice

Front 81

What are the suprahyoid muscles? What do they do?

Back 81

-Anterior and posterior digastric

-mylohyoid

-geniohyoid

-stylohyoid

They all elevate the hyoid bone

Front 82

Which muscle makes up the flood of your mouth?

Back 82

The mylohyoid

Front 83

What are the actions of the geniohyoid?

Back 83

It elevates the hyoid bone and lowers the mandible down and inward

Front 84

The tendon of the Stylohyoid is split by the:

Back 84

Posterior digastric

Front 85

What is the origin of the stylohyoid muscle?

Back 85

The styloid process

Front 86

The actions of the Anterior belly of the digastric muscle are:

Back 86

Lowers mandible, elevates hyoid bone

Front 87

What are the infrahyoid muscles and what is the common action of all of them?

Back 87

-omohyoid (fixes hyoid)
-thyrohyoid (can also raise larynx)
-sternothyroid (draws larynx downward)
-sternohyoid (When the hyoid is fixed, can also elevate the hyoid)

they all depress the hyoid bone

Front 88

The strap muscles of the infrahyoid muscles are:

Back 88

omohyoid, sternohyoid, sternothyroid

Front 89

The mylohyoid and anterior belly of the digastric both receive motor innervation from what nerve?

Why do they receive the same innervation?

Back 89

Cranial nerve V3 (division of the trigeminal nerve)

because they are in the same area

Front 90

What is the foramen that CN V3 exits though?

Back 90

Foramen ovale (has to travel a long way to innervate anterior belly of digastric and mylohyoid

Front 91

The facial nerve (CN VII) provides somatic motor innervation to:

Back 91

-stylohyoid
-posterior belly of digastric
-Platysma

Front 92

What is a visceral afferent component of the glossopharyngeal nerve (CN IX)?

Back 92

Monitor Blood pressure and blood gasses

Front 93

Glossopharyngeal nerve brings sensory innervation from:

Back 93

-Carotid body and sinus
-pharynx
-Posterior 1/3 of tongue

Also does the afferent limb of gag reflex

Front 94

The vagus leaves the cranium through which foramen?

Back 94

Jugular

Front 95

Which nerve brings sensory and motor innervation to viscera, the soft palate, and the larynx?

Back 95

CN X- the Vagus nerve

Front 96

The _____________ nerve brings somatic motor innervation to almost all the muscles of the tongue (all but one of them)

Back 96

Hypoglossal (CN XII)

Front 97

The Hypoglossal Nerve (CN XII) exits the cranium though the:

Back 97

Hypoglossal canal

Front 98

The ________ nerve dives underneath the mylohyoid going into the tongue, deep to the posterior belly digastric and stylohyoid pair

Back 98

Hypoglossal (CN XII)

Front 99

The cervical plexus is deep to the ___________ muscle

Back 99

Sternocleidomastoid

Front 100

The ansa cervicalis portion of the cervical plexus sits right on top of (superficial to) ______________________

Back 100

the carotid sheath and its contents (Common carotid artery, vagus nerve, and internal jugular vein)

Front 101

What are two branches of the cervical plexus that move superiorly next to each other?

Back 101

-Greater auricular nerve
-lesser occipital nerve

Front 102

The ansa cervicalis innervates the:

Back 102

Infrahyoid strap muscles:
-omohyoid
-sternothyroid
-sternohyoid

Front 103

The transverse cervical nerve (C2-C3) supplies:

Back 103

skin over the anterior triangle (anytime you are touching the front of your neck, that is transverse cervical nerve)

Front 104

The supraclavicular nerve (C3 and C4) supplies skin over:

Back 104

-base of neck
-clavicle
-top of shoulder

Front 105

The sympathetic chain in the head and neck has three rather large ganglia. What are they called?

Back 105

-Superior cervical ganglion
-Middle cervical ganglion
-Inferior cervical ganglion (AKA stellate or star)

Front 106

Why is the inferior cervical ganglion sometimes called the stellate or start ganglion?

Back 106

Because often times this inferior cervical ganglion will fuse with the T1 sympathetic ganglion

Front 107

The sympathetic chain is _____________ to the carotid sheath

Back 107

Medial

Front 108

Once the synapse occurs in the superior cervical ganglion, post synaptic ganglionic fibers do what?

Back 108

They leave the ganglion and jump on the blood vessels and travel along the blood vessels to their target organ

Front 109

If you are sweating on your upper lip, sweat glands are turned on by sympathetics, so what happens?

Back 109

That first sympathetic neuron has synapsed here in the superior cervical ganglion, and then, its post ganglionic fibers literally jump out of the superior cervical ganglion and travel on blood vessels to make it to the upper lip to make you sweat on your upper lip (turn on the sweat glands)

Front 110

In the head, sympathetic fibers travel on:

Back 110

blood vessels

Front 111

You will have a carotid plexus on both the internal carotid artery and external carotid artery (internal and external carotid plexus). Are these fibers on them preganglionic or postganglionic?

Back 111

All postganglionic

Front 112

In the nick, sympathetic fibers also travel on:

Back 112

cervical spinal nerves

Front 113

Does the internal carotid artery have any branches in the neck?

Back 113

No, its just keeps going up to the brain (enters through the carotid canal)

Front 114

All of the branches for the neck and face come off of the _______________ carotid artery

Back 114

external

Front 115

What are the branches of the external carotid artery in order and where do they go?

Back 115

-Superior Thyroid Artery--> Thyroid gland
-Lingual Artery--> Tongue
-Facial Artery--> Face (continues to branch)
-Occipital Artery--> occipital region, scalp
-Posterior auricular A--> Posterior ear, scalp
Terminal branches:
-Superficial temporal artery
-Maxillary artery

Front 116

The superficial temporal artery and the maxillary artery are the terminal branches of the external carotid artery. Do either of them continue to branch, or do they end?

Back 116

The maxillary artery continues to branch, and goes deep behind the face and provides branches to the oral cavity

Front 117

Your brain, deep neck, and your face all drain directly into:

Back 117

Internal jugular vein

Front 118

There is both a ____________ and _________ pattern of venous drainage

Back 118

superficial and deep

Front 119

How do you get the lymphatics into the venous system?

Back 119

The left internal jugular vein and the left subclavian vain form the venous angle, and the thoracic duct gets the lymphatics into the venous system from there

Front 120

Is the thyroid located on the thyroid cartilage?

Back 120

No, the thyroid is located inferiorly to the thyroid cartilage

Front 121

Anything that is superficial has a superficial:

Back 121

Lymph node

Front 122

What type of cancer is the quickest and easiest to metastasize in the lymphatics?

Back 122

melanoma

Front 123

all of the superficial cervical nodes drain into the deep cervical lymph nodes, which are associated with the

Back 123

internal jugular vein

Front 124

On the left side for the lymphatics, the deep nodes drain into the:

Back 124

Thoracic duct

Front 125

On the right side for lymphatics, the deep nodes drain into the:

Back 125

Right jugular trunk