Anatomy: Posterior Triangle And Root Of Neck

Front 1

The left and right halves of the mandible join to form what structure?

Back 1

- mental symphysis

Front 2

What muscle is located at the external surface of the angle of the mandible? (bulges when you grind your teeth)

Back 2

- masseter muscle

Front 3

What is the artery called that is located at the inferior border of the mandible and the anterior border of the masseter muscle? What lies on top of the masseter muscle?

Back 3

- facial artery
- facial vein

Front 4

Where is the mastoid process of the skull located?

Back 4

- behind the auricle of the ear

Front 5

What does the hyoid bone articulate with?

Back 5

- Nothing!
- suspended by muscle

Front 6

Where is the hyoid bone located in respect to the mandible? At what vertebrae?

Back 6

- inferior to mandible
- CV3

Front 7

What does the hyoid bone look like?

Back 7

- single bone with a thick central body and greater and lesser horns on each side

Front 8

What connects the hyoid to the larynx?

Back 8

- thyrohyoid membrane

Front 9

What does the thyroid cartilage look like?

Back 9

- shield shape with 2 plates aligning in front
- inferior horn that interacts with the cricoid cartilage of the larynx
- superior horns that doesn't interact with anything

Front 10

What level is the thyroid cartilage at? What other structures are here?

Back 10

- CV6
- pharynx/esophagus junction
- beginning trachea
- middle cervical sympathetic ganglion
- where the vertebral artery first enters the transverse foramen

Front 11

What are the borders of the posterior triangle?

Back 11

- anterior: posterior border of sternocleidomastoid muscle
- posterior: anterior border of trapezius
- inferiorly by clavicle

Front 12

What 2 things does the sternocleidomastoid muscle separate?

Back 12

- the anterior and posterior triangles of the neck

Front 13

What is skin innervated by?

Back 13

- C2, 3, 4

Front 14

What nerves make up the cervical plexus? (nerves in superficial cervical fascia that surround the neck)

Back 14

- C1-C4 ventral primary rami

Front 15

What are the 4 nerves that make up the cervical plexus and both their names?

Back 15

- C2: lesser occipital
- C2,3: great auricular
- C2,3: transverse cervical
- C3,4: supraclavicular

Front 16

Where is the lesser occipital nerve (C2) located?

Back 16

- follows posterior border of sternocleidomastoid superior to behind the ear

Front 17

What does the lesser occipital nerve (C2) innervate?

Back 17

- skin of neck and scalp posterosuperiorly to auricle of the ear

Front 18

Where is the great auricular nerve (C2,3) located?

Back 18

- vertically on the surface of the sternocleidomastoid to in front of the ear

Front 19

What does the great auricular nerve (C2,3) innervate?

Back 19

- skin of the parotid region and auricle
- skin of angle of the mandible to the mastoid process

Front 20

Where is the transverse cervical nerves (C2,3) located?

Back 20

- cross sternocleidomastoid horizontally

Front 21

What do the transverse cervical nerves (C2,3) innervate?

Back 21

- skin of anterior triangle of the neck
- joins cervical branch of the facial nerve inferior to the parotid gland

Front 22

Where is the supraclavicular nerves (C3,4) located?

Back 22

- travels inferiorly across the clavicle

Front 23

How many branches does the supraclavicular nerves have?

Back 23

- 3: medial, lateral, intermediate

Front 24

What do the supraclavicular nerves (C3,4) innervate?

Back 24

- skin of the inferior half of the posterior triangle
- skin of the upper thoracic and deltoid regions

Front 25

Where is the platysma muscle located?

Back 25

- superficial fascia in thoracic region to the inferior aspect of the mandible
- superficial to external jugular veins and trunks of cutaneous nerves
- inferior to superficial fascia

Front 26

What is the platysma muscle innervated by?

Back 26

- facial nerve (C7)

Front 27

What is the external jugular vein formed by?

Back 27

- union of the retromandibular and posterior auricular veins

Front 28

Where is the external jugular vein located?

Back 28

- vertically across sternocleidomastoid muscle from parotid region inferiorly to the antero-inferior area of posterior triangle to drain into subclavian vein

Front 29

What are the 2 layers of deep cervical fascia?

Back 29

1) investing layer of deep cervical fascia (anterior layer)
2) prevertebral fascia (posterior layer)

Front 30

What does the investing layer of deep cervical fascia entail?

Back 30

- invests/surrounds the muscles: covers both superficial and deep trapezius and sternocleidomastoid muscles
- 'roof' of anterior and posterior triangles

Front 31

What does the prevertebral fascia surround?

Back 31

- vertebral column and the muscles closely related to it
- forms carpet of the posterior triangle

Front 32

What does visceral fascia surround?

Back 32

- viscera of the neck such as: pharynx, esophagus, larynx, trachea, and thyroid

Front 33

What does the carotid sheath surround? How many are there in the neck?

Back 33

- carotid vessels, internal jugular vein, vagus nerve
-2

Front 34

What does the middle cervical fascia surround?

Back 34

- the infrahyoid strap muscles (anterior to visceral fascia)

Front 35

The posterior triangle of the neck is a 3-D space, what forms the roof?

Back 35

- investing layer of deep cervical fascia (surrounds SEM and trapezius)

Front 36

The posterior triangle of the neck is a 3-D space, what forms the floor and carpet?

Back 36

- floor: muscles! (splenius capitis, splenius cervicis, levator scapulae, posterior/middle/anterior scalene)
- carpet: prevertebral fascia that surrounds the muscle

Front 37

What can be found between the investing and prevertebral layers of deep fascia (roof and carpet)

Back 37

- spinal accessory nerve
- inferior belly of omohyoid muscle
- transverse cervical vessels (before splits to trapezius)
- cutaneous nerves to skin (cervical plexus)

Front 38

What can be found between the carpet (prevertebral fascia) and the floor (scalene muscles)

Back 38

- dorsal scapular nerve (C5)
- long thoracic nerve (C5,6,7)
- phrenic nerve (C3,4,5)
- proximal portion of brachial plexus
-3rd part of subclavian artery

Front 39

What does the spinal accessory nerve/ cranial nerve/CN11 innervate?

Back 39

- trapezius and sternocleidomastoid

Front 40

What does the dorsal scapular nerve (C5) innervate?

Back 40

- rhomboids

Front 41

What does the long thoracic nerve (C5,6,7) innervate?

Back 41

- serratus anterior

Front 42

What does the phrenic nerve (C3,4,5) innervate?

Back 42

- diaphragm

Front 43

Where is sternocleidomastoid muscle located?

Back 43

- anterior border of posterior triangle

Front 44

Where does the sternocleidomastoid muscle originate?

Back 44

- manubrium
- medial end of clavicle

Front 45

Where does the sternocleidomastoid muscle insert?

Back 45

- mastoid process

Front 46

What is the action of the sternocleidomastoid muscle?

Back 46

- contraction of one: turns head to opposite side
- contraction both: flexes neck (look down)
- accessory muscle of respiration

Front 47

What innervates the sternocleidomastoid muscle?

Back 47

- accessory nerve (CN11)
- C2 and C3 branches

Front 48

How many muscles comprises the scalene muscles?

Back 48

- 3 (anterior/middle/posterior)

Front 49

Where are the scalene muscles located?

Back 49

- floor of the lateral neck, covered by prevertebral fascia of deep cervical fascia

Front 50

What innervates the scalene muscles/

Back 50

- cervical nerves

Front 51

What do the scalene muscles do?

Back 51

- inspiration muscles
- act on vertebral column of neck

Front 52

Where is the origin of anterior scalene?

Back 52

- anterior tubercle of transverse processes of CV3 to CV6

Front 53

Where does the anterior scalene muscles insert?

Back 53

- scalene tubercle of the first rib between the grooves for the subclavian artery and vein

Front 54

What innervates the anterior scalene?

Back 54

- C5-7

Front 55

What nerve and artery pass on the anterior surface of the anterior scalene but deep to the prevertebral fascia of deep cervical fascia

Back 55

- Phrenic nerve
- transverse cervical artery

Front 56

Which scalene muscle is the larges?

Back 56

- middle scalene

Front 57

Where is the origin of the middle scalene muscle?

Back 57

- posterior tubercle of the transverse process of CV2-7

Front 58

Where does the middle scalene muscle insert?

Back 58

- superior surface of the first rib
- posterior to brachial plexus and subclavian artery

Front 59

What innervates the middle scalene muscle?

Back 59

- C3-8

Front 60

Which scalene muscle is the smallest?

Back 60

- posterior scalene

Front 61

Where does the posterior scalene arise from?

Back 61

- posterior tubercle of transverse process of CV5-7

Front 62

Where does the posterior scalene insert?

Back 62

- 2nd rib

Front 63

What innervates the posterior scalene muscle?

Back 63

- C7-8

Front 64

Do the anterior/posterior primary rami of nerves form the brachial plexus?

Back 64

- anterior

Front 65

Which nerves form the brachial plexus?

Back 65

- C5-8, T1

Front 66

Which 2 muscles can the brachial plexus be found between?

Back 66

- anterior and middle scalene

Front 67

What larger group of muscles is the omohyoid muscles part of?

Back 67

- infrahyoid muscles

Front 68

Which part of omohyoid muscle is found in the posterior triangle?

Back 68

- inferior belly

Front 69

Which part of the omohyoid muscle is found within the anterior triangle?

Back 69

- superior belly

Front 70

What is the origin of the omohyoid muscle?

Back 70

- upper border of scapula

Front 71

Where does the omohyoid muscle insert?

Back 71

- lower border of the hyoid bone

Front 72

What innervates the omohyoid muscle?

Back 72

- ansa cervicalis

Front 73

What 2 structures are found between the anterior and middle scalene?

Back 73

- subclavian artery
- anterior primary rami that form the brachial plexus

Front 74

What structures lie on the anterior surface of the anterior scalene muscle?

Back 74

- prevertebral fascia of deep cervical fascia (covers muscles around vertebral column)
- subclavian vein
- phrenic nerve
- transverse cervical artery
- suprascapular artery
- omohyoid muscle

Front 75

Which structures can be found immediately superior to the first rib from anterior to posterior?

Back 75

- subclavian vein
- anterior scalene
- subclavian artery
- lower portion of brachial plexus
- middle scalene

Front 76

What is the root of the neck?

Back 76

- base of the cervical region
- region superior to the manubrium of the sternum into the superior mediastinum
- anterior to the scalenes and prevertebral muscles
- lateral to visceral part of neck

Front 77

Where is the sternoclavicular joint located?

Back 77

- between medial end of clavicle and manubrium (synovial joint)

Front 78

What are the ligaments of the sternoclavicular joint?

Back 78

- costoclavicular ligament
- articular capsule (over articular disc)
- anterior/posterior sternoclavicular ligaments (superior portion manubrium to clavicle)
- interclavicular ligament (superior to manubrium from right to left medial end of clavicle)

Front 79

What is the main artery of the root of the neck?

Back 79

- subclavian artery

Front 80

What does the subclavian artery branch off of on the right? on the left?

Back 80

- brachiocephalic trunk from the aortic arch
- aortic arch

Front 81

Where does the subclavian artery 'end' (changes into axillary artery)?

Back 81

- lateral border of the first rib

Front 82

What are the 4 main branches off of the subclavian artery?

Back 82

1) internal thoracic artery
2) vertebral artery
3) thyrocervical trunk
4) costocervical trunk

Front 83

Where is the internal thoracic artery located on the subclavian vein and where does it go?

Back 83

- antero-inferior aspect of subclavian
- descends posteriorly to sternal end of clavicle into thorax

Front 84

Where does the vertebral artery arise from the subclavian artery?

Back 84

- postero-superior aspect of subclavian

Front 85

Where does the vertebral artery go?

Back 85

- enters transverse foramen of CV6
- ascends
- goes into suboccipital triangle to supply brain (esp brainstem)

Front 86

Where does the thyrocervical trunk come off of the subclavian artery?

Back 86

- very short trunk on superior aspect

Front 87

How many branches come off of the thyrocervical trunk? What are they?

Back 87

-3
1) inferior thyroid artery
2) surprascapular artery
3) transverse cervical artery

Front 88

Where does the inferior thyroid artery travel?

Back 88

- superiorly along medial border of anterior scalene to CV6 (near internal jugular vein)
- then branches

Front 89

What does the inferior thyroid artery split into?

Back 89

- ascending cervical artery
- inferior laryngeal artery

Front 90

Where is the ascending cervical artery?

Back 90

- parallels phrenic nerve on the anterior surface of anterior scalene

Front 91

Where is the inferior laryngeal artery?

Back 91

- accompanies the recurrent laryngeal nerve

Front 92

Where does the suprascapular artery travel?

Back 92

- anterior to anterior scalene and behind the sternocleidomastoid
- continues behind clavicle to scapular notch and crosses above the transverse scapular ligament

Front 93

Where does the transverse cervical artery travel?

Back 93

- between anterior scalene and sternocleidomastoid
- crosses posterior triangle of neck
- divides into 2 branches

Front 94

What are the 2 branches of transverse cervical artery?

Back 94

- superficial branch
- deep branch

Front 95

Where does the superficial branch off of the transverse cervical artery travel?

Back 95

- accompanies the accessory nerve, deep to the trapezius

Front 96

Where does the deep branch of the transverse cervical artery travel?

Back 96

- accompanies the dorsal scapular nerve
- deep to levator scapulae and rhomboids

Front 97

What is special about the superficial branch of the transverse cervical artery?

Back 97

- may arise separates from the thyrocervical trunk
- then known as superficial cervical artery

Front 98

What is another places besides the transverse cervical artery can the deep branch arise from?

Back 98

- third part of the sublcavian
- then known as dorsal scapular artery

Front 99

Where does the costocervical trunk arise from?

Back 99

- posterior aspect of subclavian
- short then divides into 2 braches

Front 100

What are the 2 branches of the costocervical trunk?

Back 100

- deep cervical artery
- highest inetercostal artery

Front 101

What does the deep cervical artery off of the costocervical trunk supply?

Back 101

- the deep muscles on the back of the neck

Front 102

What does the highest inetercostal artery off of the costocervical trunk supply?

Back 102

- first 2 intercostal spaces

Front 103

Where does the subclavian vein travel?

Back 103

- begins lateral border of first rib
- passes over anterior scalene
- joins internal jugular to form braciocephalic vein

Front 104

Where does the thoracic duct drain?

Back 104

- junction of the subclavian and internal jugular veins on the LEFT side

Front 105

What is the duct called that feeds into the right subclavian vein?

Back 105

- the right lymphatic duct

Front 106

What 2 ducts feed into the right lymphatic duct?

Back 106

- subclavian trunk
- jugular trunk

Front 107

Where does the internal jugular vein travel?

Back 107

- begins at jugular foramen (base of skull)
- travels deep to sternocleidomastoid
- joins subclavian and forms brachiocephaic vein

Front 108

Where does the anterior jugular vein travel?

Back 108

- inferiorly close to midline in the anterior triangle of the neck
- joins a jugular arch which is above the jugular notch of the sternum

Front 109

What does the jugular arch empty into?

Back 109

- external jugular vein, some internal jugular vein

Front 110

Where does the vagus nerve travel on the right side?

Back 110

- anterior to subclavian artery, medial to phrenic, posterior to anterior scalene
- right recurrent laryngeal is given off and curls around subclavian artery

Front 111

Where does the vagus nerve travel on the left side?

Back 111

- root of neck anterior to subclavian, medial to phrenic, and posterior to anterior scalene
- left recurrent laryngeal given off and goes under aorta and ligamentum arteriosos

Front 112

What forms th ephrenic nerve?

Back 112

- anterior rami of C3, 4, 5

Front 113

Does the phrenic nerve run on the anterior or posterior surface of the anterior scalene muscle?

Back 113

- anterior

Front 114

What does the phrenic nerve innervate?

Back 114

- diaphragm