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61 Cards in this Set
- Front
- Back
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Hyoid Bone
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Plapate superior to laryngeal prominence (C3 level)
Suspended via multiple attachments of muscles (no articulation with other bones) Landmarks- greater and lesser horns, body |
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Thyroid Cartilage
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Hyaline cartilage, laryngeal prominence (Adam's Apple), Thyroid notch
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Cricoid Cartilage
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Hyaline cartilage, articulates with thyroid cartilage,
Only complete ring to circle the airway Border between larynx and trachea |
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Jugular (suprasternal) notch
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fossa between sternal heads of SCM
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Transverse Process of C-1
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palpate inferior to mastoid process
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Supraclavicular fossa
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depression overlying the supraclavicular triangle
pressure point of subclavian artery (pulse just posterior to clavicle- junction of medial and middle third of clavicle) |
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Thyroid Gland
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Thyroid is deep to infrahyoid muscles,
2 lobes & isthmus (lobes are anterolateral to trachea and larynx, isthmus anterior to trachea Functions: metabolism, growth, temperature regulation, sympathetic activity, secretes T3&T4 and calcitonin |
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Parathyroid glands
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four small glands located in each lobe of the thyroid gland,
Critical role in maintaining calcium and phosphate balance |
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Pharynx
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pass food to esophagus and conduct air to larynx/trachea
Three sections 1. Nasopharynx- superior to soft palate and posterior to nasal cavity 2. Oropharynx- soft palate to tip of epiglotis 3. Laryngopharynx- epiglottis to cricoid cartilage Two layers of muscles- outer circular layer (constrictors), inner longitudinal layer - both innervated by CN 10 Swallowing and epiglottis- during swallowing the epiglottis will move posteriorly to close off the trachea (laryngeal inlet), this allows the food (bolus) to slide over the epiglottis as it descends to the esophagus |
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Larynx
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connects pharynx to the trachea
voice production via complex mechanism consisting of cartilage, ligaments and small laryngeal muscles CN10 gives two branches that supply the larynx 1. superior laryngeal branch- internal/external laryngeal nerves, 2. recurrent laryngeal nerve (all intrinsic laryngeal muscles except one) becomes inferior laryngeal nerve Lesions of this nerve causes paralysis of vocal folds |
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Trachea
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begins at inferior larynx (inferior to cricoid cartilage) and descends to sternal angle (bifurcates into R/L primary bronchi)
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Esophagus
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muscular tube that is continuous with the laryngopharynx, descends through superior mediastinum and then posterior mediastinum, pierces diaphragm and enters stomach
1st third is voluntary/striated muscles- transitions to involuntary smooth muscle in the lowest third |
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Cervical Lymph nodes
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palpation to identify abnormal nodes
located throughout neck Superficial- drain superficial structures and then drain into deep cervical lymph nodes Deep- follow IJV and are located deep to SCM, drain into R/L brachiocephalic veins |
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Thoracic Duct and Right lymphatic Duct
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drain into left and right IJVs and subclavians as they merge into the brachiocephalic vein
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Superficial Cervical Fascia
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thin layer of subcutaneous connective tissue, contains plasma muscle
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Investing layer of deep cervical fascia
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most superficial of deep cervical fascia layers, invests SCM and Traps "Four Corners"
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Prevertebral Fascia
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Contains scalenes and prevertebral muscles, posterior muscles of neck (except Trap) and cervical vertebral column
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Pretracheal Fascia
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Muscular fascia invests suprahyoid and infrahyoid muscles
Visceral fascia infests larynx, trachea and thyroid gland |
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Carotid Sheath
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Contains CCA, ICA, IJV and CN 10
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Retropharyngeal Space
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Between buccopharyngeal fascia and pre-vertebral fascia, potential site for swelling, trauma and infection
Ex- abscess between muscular and visceral pretracheal fascia can spread inferiorly to thorax |
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Platysma
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Superficial muscle of the neck
Inf: fascia and skin over pectoralis major & deltoid muscles Sup: inferior border of mandible and skin of lower face N: CN7- cervical branch (facial n) A: tenses skin of neck, depresses angle of mouth, weak mandible depressor |
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Sternocleidomastoid (SCM)
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Superficial Muscle
Inf: sternal head- anterior menubrium, clavicular head- medial 1/3 clavicle Sup: mastoid process of temporal bone (lateral surface), lateral 1/2 superior nuchal line of occipital bone N: CN11 (accessory nerve) A: unilaterally- ipsilateral lateral flexion and rotation to opposite side (with face turned upward), bilaterally- flexes neck |
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Sternohyoid
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Infrahyoid muscle
Inf: posterior surface of manubrium and medial clavicle Sup: body of hyoid N: ansa cervicalis A: depresses hyoid |
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Thyrohyoid
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Infrahyoid muscle
Inf: oblique line of thyroid cartilage Sup: body and greater horn of hyoid N: (VPR) CI via CNXII (hypoglossal nerve) A: depresses hyoid and elevates thyroid cartilage |
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Sternothyroid
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infrahyoid muscle
Inf: posterior manubrium of sternum Sup: oblique line of thyroid cartilage N: ansa cervicalis A: depresses the thyroid cartilage (larynx) |
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Omohyoid
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Infrahyoid muscle (2 bellies with intermediate tendon and fascial sling to clavicle)
O: inferior belly- superior border scapula (near suprascapular notch), superior belly- intermediate tendon I: inferior belly- intermediate tendon (inferior border hyoid), superior belly- body of hyoid N: ansa cervicalis A: depresses, retracts and stabilizes hyoid |
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Mylohyoid
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Suprahyoid muscle, floor of mouth
Sup: mylohyoid line of mandible Inf: raphe and body of hyoid N: mylohyoid n (branch of V3 CN5) A: elevates hyoid and tongue during speech and swallowing (deglutition) |
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Geniohyoid
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Suprahyoid muscle
Sup: inferior mental spine of mandible Inf: body of hyoid N: branch of C1 via CN 12 (hypoglossal nerve) A: pulls hyoid anterosuperiorly (widens pharynx during degultition) |
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Stylohyoid
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Suprahyoid muscle
Sup: styloid process of temporal bone Inf: body of hyoid N: CN7 (facial nerve- cervical branch) A: elevates and retracts hyoid (elongates floor of mouth) |
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Digastric
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Suprahyoid muscle
O: Anterior belly- digastric fossa of mandible, Posterior belly- mastoid notch of temporal bone I: intermediate tendon to hyoid (body & greater horns) N: anterior- mylohyoid n, posterior- CN7 A: depresses mandible, elevates hyoid |
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Scalene anterior
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Sup: transverse processes C3-6
Inf: 1st rib (scalene tubercle) N: VPR of adjacent cervical nerves A: lateral flexion of cervical spine, also assists in rotating neck to opposite side |
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Scalenus Medius
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Sup: transverse processes C2-7
Inf: superior surface 1st rib (posterior to subclavian groove) N: VPR of adjacent cervical nerves A: lateral flexion of cervical spine, elevates 1st rib (accessory muscle of inspiration) |
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Scalenus posterior
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Sup: transverse processes C4-6
Inf: outer surface 2nd rib N: VPR of adjacent cervical nerves A: lateral flexion of the cervical spine, elevates 2nd rib (accessory muscle of inspiration) |
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Longus coli
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Inf: vertebral bodies C5-T3 and transverse processes C3-5
Sup: body C2-4, transverse processes C5-6 and anterior tubercle of atlas N: VPR of cervical nerves A: flexes head and neck |
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Longus capitus
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Inf: anterior tubercules transverse processses 3-6
Sup: base of skull N: VPR of cervical nerves A: flexes head and neck |
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Rectus capitus anterior
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Inf: lateral mass of atlas
Sup: base of skull anterior to occipital condyle N: VPR of cervical nerves A: flexes head |
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Rectus capitus lateralis
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Inf: transverse process of atlas
Sup: jugular process of occipital bone N: VPR of cervical nerves A: flexes head |
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Posterior Triangle
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Clinical: EJV crosses in an oblique direction across the posterior triangle, IJV is deep to SCM, IJV is difficult to palpate (observe through overlying soft tissue)- between sternal and clavicular attachments of SCM, postrior to lower SCM and anterior to upper SCM. EJV is less reliable in detecting abnormal cardiovascular pressure.
Boundaries: posterior border of SCM, anterior border of trapezius, superior border of clavicle Contents: EJV, transverse cervical artery, subclavian artery, suprascapular artery, trunks of brachial plexus, CN11, cutaneous branches of cervical plexus, inferior belly of omohyoid, floor is middle & posterior scalenes and levator scapula and splenius capitis, cervical and suprclavicular lymph nodes Split by inf belly of omohyoid into occipital triangle and supraclavicular triangle |
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Anterior Triangle
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Boundaries: anterior border of SCM, midline of neck, mandible
Contains: hyoid muscles, arteries, veins, nerves, lymph nodes and viscera Splits into: submandibular, submental, carotid and muscular triangles |
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Submandibular triangle
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Borders: anterior and posterior bellies of digastric, mandible
Contents: submandibular gland/duct/lymph nodes, CN12 (hypoglossal nerve) |
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Carotid Triangle
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Borders: superior belly of omohyoid, posterior belly of digastric, anterior border of SCM
Contents: CCA, ECA, IJV, CN10, CN11, CN12, superior root of ansa cervicalis, branches of cervical plexus, thyroid larynx and pharynx Clinically- IJV is used for cardiac catheterization, CCA branches here so carotid body and sinus are located here as well |
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Muscular triangle
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Borders- superior belly of omohyoid, anterior border of SCM, median plane of neck (midline)
Contents- infrahyoid muscles, thyroid and parathyroid glands, thyroid and cricoid cartilages |
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Submental triangle
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Borders- right and left anterior belly of digastric muscle, hyoid bone
Contents- submental lymph nodes |
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Cervical Plexus- Sensory Branches
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1. Lesser occipital nerve (C2)- ascends posterior to SCM and posterior to ear, supplies posterior skull
2. greater auricular nerve (C2-3)- ascends anterior to SCM and anterior to ear, supplies anterior to ear 3. transverse cervical nerve (C2-3)- crosses SCM (posterior to anterior), innervates the skin of the anterior triangle 4. Suprclavicular nerve (C3-4)- descends posterior to SCM, divides into three branches (anterior, middle and posterior) |
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Cervical Plexus- Motor Branches
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1. Phrenic Nerve (C3-5)- descends in the fascia along the anterior surface of anterior scalene (runs between SCM and anterior scalene), motor supply to diaphragm
2. Ansa cervicalis- a nerve loop, superior (C1-2) and inferior (C2-3), innervates infrahyoid muscles (except thyrohyoid) |
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Brachial Plexus
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exits between anterior and middle scalene, dorsal scapular nerve exits through belly of middle scalene, long thoracic nerve exits through the belly of middle scalene
Clinically- potential site for entrapment/referred pain |
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Right vs Left Arterial pathways
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Left side- CCA and subclavian arise directly from aortic arch
Right side- CCA and subclavian arise from brachiocephalic trunk from aortic arch |
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Common Carotid Artery
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ascends within carotid sheath (with IJV and CN10), bifurcates into ICA and ECA around the superior thyroid cartilage
at bifurcation- carotid sinus (baroreceptor) and carotid body (chemoreceptor) |
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Internal Carotid Artery
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carotid sinus (baroreceptor-sense pressure changes) is in swelling at origin of ICA
No branches in the neck Ascends up carotid canal of temporal bone to supply brain |
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External carotid artery
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gives of 8 branches as it ascends in the neck: superior thyroid, lingual, facial, ascending pharyngeal, occipitla, posterior auricular, maxillary, superfical temporal
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Vertebral artery
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ascends via transverse foramen of C1-6, enters cranial cavity via foramen magnum, in cervical region branches supply spinal cord, inside cranial cavity R/L merge to form basilar artery to supply brainstem and cerebellum
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Thyrocervical trunk
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arise from subclavian, branches into inferior thyroid artery, transverse cervical artery, suprascapular artery
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Internal thoracic artery
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arises from subclavian, descends in thorax posterior to upper six costal cartilages
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Costocervical trunk
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arise from subclavian artery, 2 branches- one ascends (deep cervical) and one descends (superior intercostal)
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Dorsal scapular artery
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really a branch of thyrocervical trunk
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Anterior jugular vein
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descends anterior neck, eventually is deep to SCM and drains into EJV
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External Jugular Vein
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superficial to SCM, ends in subclavian vein (may end in IJV) then drains into brachiocephalic
distention with increased cardiovascular pressures |
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Internal jugular vein
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begins as it exits the cranial cavity via the jugular foramen, descends in carotid sheath deep to SCM, ends in brachiocephalic veins
site for cardiac catheterization, distention with increased cardiovascular pressure |
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Subclavian vein
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drains upper extremity and into brachiocephalic vein
site for central line placement right subclavian is for cardiac catheterization |
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Brachiocephalic vein
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inferior thyroid vein, internal jugular vein, subclavian vein, anterior jugular vein- all drain into this
left thoracic duct, right lymphatic duct as well |
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Superior vena cava
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R/L brachiocephalic veins drain into SVA, SVA descends to heart (right atrium)
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