Anatomy Superficial Head And Neck

Front 1

Where is the hyoid bone?

Back 1

anterior neck (C3) between the mandible and the thyroid cartilage

suspended from the styloid processes of the temporal bone by the stylohyoid ligaments

firmly bound to the thyroid cartilage

Front 2

What is the origin/insertion of platysma? What is it's action? Innervation?

Back 2

fascia covering the superior parts of the deltoid and pectoralis major muscles / facial muscles over chin

tenses the skin to release pressure on the superficial veins/ platysma helps to depress the mandible and draw the corners of the mouth inferiorly

cervical branch of the facial nerve

Front 3

What are the attachments of sternocleidomastoid? Actions?
Innervation?

Back 3

mastoid process of the temporal bone and the superior nuchal line of the occipital

Acting bilaterally, SCM flexes the neck. Acting unilaterally, it laterally flexes and rotates the head and neck (brings the ear towards the shoulder of the same side and turns the chin to the opposite side and superiorly)

spinal accessory nerve (CN XI) and sensory innervation from C2 and C3 nerves

Front 4

Trapezius origin? insertion? action? innervation?

Back 4

medial third of the superior nuchal line and external occipital protuberance, ligamentum nuchae and the spinous processes of C7-T12

lateral third of the clavicles, medial side of the acromion and the scapular spine

elevates, depresses and rotates the scapula depending on which part of the muscle contracts

spinal accessory nerve (CN XI) (motor) and C3-C4 nerves (pain and proprioception)

Front 5

What are the main tributaries of the external jugular vein?

Back 5

posterior external jugular
transverse cervical
suprascapular veins

Front 6

What do the anterior jugular veins drain into? What can they rain into instead? What is it called when they communicate with each other?

Back 6

subclavian vein
external jugular vein
jugular venous arch

Front 7

What forms the external jugular vein? How does it run? What does it run into?

Back 7

posterior division of the retromandibular vein and the posterior auricular vein

angle of the mandible to the mid-clavicle superficial to the SCM

at the root of the neck, it pierces the investing layer of deep fascia and enters the subclavian vein

Front 8

What are the 4 superficial nerves of the neck?

Back 8

lesser occipital nerve: derived from the anterior branch of C2; curves along the posterior edge of sternocleidomastoid (SCM) and supplies the skin behind the ear.
great auricular nerve: derived from C2-3; encircles the posterior border of SCM and ascends on the muscle with the external jugular vein to supply the skin around the ear and over the parotid gland.
transverse cervical nerves: derived from C2-3; curve around the posterior border of SCM and run anteriorly across the surface of SCM; ascending branches pierce platysma and supply the skin of the upper anterior neck; descending branches pierce platysma and are distributed to the anterolateral neck.
supraclavicular nerves: derived from C3-4; emerge from the posterior border of SCM and divide into medial, intermediate and lateral branches to supply the skin over the clavicle and superior thorax.

Front 9

What are the boundaries of the anterior triangle?

Back 9

the midline of the neck anteriorly;
the anterior border of the sternocleidomastoid posteriorly;
the inferior border of the mandible superiorly
the jugular notch of the manubrium forms the apex of the triangle inferiorly

Front 10

What are the boundaries of muscular triangle?

Back 10

the superior belly of omohyoid, posterosuperiorly
the anterior border of the SCM, posteroinferiorly
and the median plane of the neck from the hyoid bone to the sternum, medially

Front 11

What does the muscular triangle contain?

Back 11

infrahyoid muscles, viscera of the neck (thyroid, parathyroid glands), the recurrent laryngeal nerve, inferior laryngeal artery and external laryngeal nerve

Front 12

What do the strap muscles do?

Back 12

anchor the hyoid and larynx during swallowing and speaking and depress the hyoid bone

Front 13

Describe the strap muscles origin, insertion, and innervations.

Back 13

Sternohyoid – a superficial muscles, lies parallel and adjacent to the anterior midline
Origin: manubrium of sternum and medial end of clavicle
Insertion: Body of hyoid bone
Innervation: C1-3 by a branch of the ansa cervicalis
Omohyoid – lateral to sternohyoid, has 2 bellies that are united by an intermediate tendon connected to the clavicles
Origin: Superior border of the scapula
Insertion: Inferior border of hyoid
Innervation: C1-3 by a branch of the ansa cervicalis
Sternothyroid – lies under sternohyoid and covers the lateral lobe of the thyroid gland, attaching to the oblique line of the lamina of the thyroid cartilage; the thyroid cartilage sits immediately above it and limits its movement in the superior direction, so tumors or goiters cause its expansion anteriorly or inferiorly into the mediastinum
Origin: Posterior surface of the manubrium of the sternum
Insertion: Oblique line of thyroid cartilage
Innervation: C1-3 by a branch of the ansa cervicalis
Thyrohoid – the continuation of the sternothyroid from the oblique line of the thyroid cartilage to the hyoid
Origin: Oblique line of thyroid cartilage
Insertion: Inferior border of body and greater horn of hyoid
Innervation: C1 via hypoglossal nerve (CN XII)

Front 14

What is the only strap muscles not innervated by C1-3 by a branch of the ansa cervicalis?

Back 14

thyrohyoid by C1 via hypoglossal nerve (CN XII)

Front 15

What are the boundaries of the carotid triangle?

Back 15

the superior belly of the omohyoid, anteroinferiorly
the posterior belly of the digastric, superiorly
the anterior border of the sternocleidomastoid, posteriorly

Front 16

How do you palpate the common carotid?

Back 16

lightly compressing it against the transverse processes of the cervical vertebrae

Front 17

Where does the common carotid split into external and internal carotid arteries?

Back 17

superior border of the thyroid cartilage

Front 18

What are the carotid body and sinus? Include innervations

Back 18

body- a small, ovoid mass of tissue that lies on the medial side of the common carotid bifurcation. This is a chemoreceptor that monitors the level of oxygen in the blood. When oxygen levels are low, it initiates a reflex that increases the rate and depth of respiration, cardiac rate and blood pressure. The carotid body is innervated by branches of the glossopharyngeal (CN IX) and vagus (CN X) nerves.

a slight dilation of the beginning of the internal carotid artery, baroreceptor that reacts to changes in arterial blood pressure and is innervated by the glossopharyngeal nerve (CN IX)

Front 19

What nerve crosses the external and internal carotid vessels posterior to the digastric and stylohyoid muscles?

Back 19

hypoglossal nerve (CN IX)

Front 20

What structures are within carotid sheath?

Back 20

common and internal carotid artery medially
internal jugular vein laterally
vagus nerve (CN X) posteriorly
ansa cervicalis usually lies on or in the anterolateral aspect of the sheath

Front 21

What are the boundaries of the submental triangle? What is inside the submental triangle?

Back 21

the body of the hyoid bone, inferiorly
the anterior belly of the digastric muscle, laterally
the midline, medially
the floor is formed by the mylohyoid muscle; the right and left mylohyoid muscles meet in a fibrous median raphe

submental lymph nodes that drain the floor of the oral cavity, tip of the tongue and middle lower lip

Front 22

What are the boundaries of the submandibular or digastric triangle?

Back 22

the inferior border of the mandible, superiorly

the posterior belly of the digastric and stylohyoid muscles, posteroinferiorly

the anterior belly of the digastric muscle, anteroinferiorly

the floor is formed by the mylohyoid and hyoglossus muscles

Front 23

What is inside the submandibular triangle?

Back 23

This triangle is nearly filled by the submandibular gland, which is usually palpable as a soft mass between the body of the mandible and the mylohyoid muscle. The facial vein is superficial to the gland and the facial artery is deep to it. The submandibular duct passes from the deep part of this gland and parallel to the tongue to open into the oral cavity. Submandibular lymph nodes lie on each side of this gland and along the inferior border of the mandible. The submental and hyoid artery and nerves lie on the mylohyoid muscle.
 
The posterior region of the triangle contains part of the parotid gland, the external carotid artery passing deep to the stylohyoid, the internal carotid artery, internal jugular vein and vagus nerve (CN X).

Front 24

Where does the the common carotid artery arise?

Back 24

from the brachiocephalic trunk on the right side and directly from the arch of the aorta on the left side

Front 25

Where does the internal carotid enter the skull?

Back 25

carotid canals

Front 26

What does the external carotid artery split into?

Back 26

maxillary artery and superficial temporal artery

Front 27

What are the anterior, posterior, and terminating branches of the external carotid artery?

Back 27

Anterior Branches
Superior thyroid artery – most inferior of the 3 anterior branches. It arises close to the carotid bifurcation and descends anteriorly across the carotid triangle to supply the thyroid gland and some adjacent skin. Branches of the superior thyroid artery anastomose with their counterparts on the opposite side and with the inferior thyroid artery (a branch of the thyrocervical trunk). It gives off the superior laryngeal, infrahyoid, SCM and cricothyroid branches.
Lingual artery – arches superoanteriorly and passes deep to the suprahyoid muscles to enter and supply the tongue (via the deep lingual and sublingual arteries).
Facial artery – arises in common with the lingual artery or immediately superior to it. Passes superiorly under the digastric and stylohyoid muscles and the angle of the mandible, loops anteriorly and enters a deep groove in the submandibular gland; it then hooks around the middle of the inferior border of the mandible where it can be palpated and enters the face. Supplies a tonsillar branch and branches to the palate and submandibular gland.

Posterior Branches
Ascending pharyngeal artery – arises near the carotid bifurcation from the posterior surface of the external carotid and ascends on the pharynx deep (medial) to the internal carotid artery. It sends branches to the pharynx, prevertebral muscles, middle ear and cranial meninges.
Occipital artery – arises from posterior aspect of the external carotid artery, superior to the facial artery. It passes superficial to the internal carotid artery and the spinal accessory nerve (CN XI) and sends branches to the SCM, dura mater and the back of the head to supply the scalp.
Posterior auricular artery – this is a small, posterior branch that ascends posteriorly between the external acoustic meatus and the mastoid process to supply the scalp, middle ear and auricle.

Terminal Branches
Superficial temporal artery – terminal branch arising opposite the external auditory meatus. Supplies the scalp on the lateral side of the head and gives off the transverse facial artery. Divides into parietal and temporal branches.
Maxillary artery – large terminal branch and the principal artery of the deep face.

Front 28

tributaries of the internal jugular vein in the anterior triangle: (she just names them)

Back 28

facial vein - empties into the internal jugular vein opposite or just inferior to the level of the hyoid bone; it may receive the superior thyroid, lingual or sublingual veins.
lingual vein - forms a single vein from the tongue that empties into the internal jugular vein at the level of origin of the lingual artery.
pharyngeal vein - arises from the venous plexus on the pharyngeal wall and drains into the internal jugular vein at the angle of the mandible.
superior and middle thyroid veins - leave the thyroid gland to drain into the internal jugular vein.
occipital veins – highly variable veins that drain the scalp

Front 29

What are the tributaries of the vagus nerve?

Back 29

The vagus nerve (CN X) exits the skull through the jugular foramen and descends through the neck in the carotid sheath. Within this sheath, it lies posterior to the internal and common carotid arteries and medial to the internal jugular vein. It gives a number of branches in the neck that will be discussed later, and these include the following: preganglionic parasympathetic fibers
Meningeal branch(es) start from the superior vagal ganglion and are distributed to the dura mater in the posterior cranial fossa.
Auricular branch arises from the superior vagal ganglion and is joined by a branch of the glossopharyngeal nerve (CN IX). It is distributed to the skin of part of the ear and the external acoustic meatus.
A pharyngeal branch passes between the internal and external carotid vessels to the middle constrictor of the pharynx. This branch joins branches from the glossophargyneal nerve (CN IX) to form the pharyngeal plexus.
A superior laryngeal nerve passes to the side of the larynx deep to the external and internal carotid arteries. It divides into the internal and external laryngeal branches. The internal laryngeal branch provides sensory innervation to the piriform fossa of the pharynx and laryngeal mucosa above the vocal cords and is involved in the coughing reflex. The external laryngeal branch runs on the lateral larynx to innervate a single muscle, the cricothyroid.
Recurrent laryngeal branches arise outside the carotid triangle and supply all the laryngeal muscles except for cricothyroid.

Front 30

What does the glossopharngeal nerve innervate?

Back 30

the stylopharyngeus muscle, the carotid sinus and provides sensory innervations to the pharynx.

Front 31

What are the superior and inferior loop of the cervical plexus?

Back 31

superior loop formed from the descending hypoglossal nerve (CN XII) and an inferior loop from the cervical plexus

Front 32

What's in the superifical layer of neck fascia?

Back 32

fatty connective tissue with nerves, vessels and the platsyma muscle. It extends from the neck into the thorax.

Front 33

What are the 3 deep layers?

Back 33

superficial (investing) layer [blue]; a pretracheal layer; and a prevertebral layer

Front 34

What layers form the carotid sheath?

Back 34

All 3 deep layers

Front 35

Where does the investing fascia cover and go?

Back 35

the submandibular and parotid glands below the mandible and extends inferiorly to the manubrium, clavicles and scapulae

Front 36

What layer contains the suprasternal space? What is inside and how does that relate to trauma?

Back 36

Investing (superficial)

These layers enclose the sternal heads of the SCM muscles, the inferior ends of the anterior jugular veins, the jugular venous arch, fat and lymph nodes. Trauma to this space can cause severe bleeding and subsequently a large bulging above the manubrium that may extend posteriorly to the manubrium into the superior mediastinum.

Front 37

What is the superior border of the pretracheal fascia? What do they surround?

Back 37

hyoid bone
the trachea, esophagus and thyroid gland

Front 38

What does the prevertebral layer form and enclose?

Back 38

forms a tubular sheath for the vertebral column and its associated muscles (prevertebral muscles, scalene muscles and deep muscles of the back). It extends from the base of the skull to the T3 vertebra. Laterally in the lower neck, it becomes the axillary sheath that surrounds the axillary vessels and brachial plexus.

Front 39

What is the pretracheal space?

Back 39

This is the space between the investing layer of cervical fascia that covers the posterior surface of the infrahyoid muscles and the anterior layer of pretracheal fascia, which covers the anterior surface of the trachea and thyroid gland. This space passes from the neck into the anterior part of the superior mediastinum.

Front 40

What is the retropharyngeal space?

Back 40

The retropharyngeal space is the potential space of loose connective tissue between the buccopharyngeal fascia, which lies on the posterior surface of the pharynx and esophagus, and the prevertebral fascia on the anterior surface of the transverse processes and bodies of the cervical vertebrae (the alar fascia). The retropharyngeal space allows movement of the pharynx, esophagus, larynx and trachea relative to the vertebral column during swallowing. It is closed superiorly by the base of the skull and on each side by the carotid sheath, but open inferiorly to the superior part of the posterior mediastinum. This space contains the retropharyngeal lymph nodes that drain the adenoids, nasal cavities, nasopharynx and posterior ethmoid sinuses.
 
The retropharyngeal space is a route through which infections of the mouth and throat can reach the mediastinum.

Front 41

What is the fascial space of the vertebrae?

Back 41

This space is the loose fascia between the laminae of the prevertebral fascia that extends from the base of the skull to the posterior mediastinum and to the diaphragm. It lies behind the esophagus and the lower part of the pharynx. This pathway may potentially extend infections of the head and neck into the mediastinum, leading to compression of the heart or phrenic nerves and thrombosis of vessels, the trachea and the esophagus. This space may also be infected directly by posterior perforations of the esophagus or by infections of the deep cervical nodes lying adjacent to it.
 

Front 42

What is the submandibular space and Ludwig's angina?

Back 42

The submandibular space is bounded superiorly by the oral mucosa and tongue and inferiorly by the superficial layer of cervical fascia extending from the hyoid bone to the mandible. Posteriorly, the space is continuous with the lateral pharyngeal space.
 
Infections in the submandibular space are almost always from dental or periodontal origin.

Ludwig’s angina is a condition exhibiting bilateral swelling of the submandibular space and is characterized by hardness of the floor of the mouth, swelling of the neck and ensuing elevation of the oral mucosa and tongue. In a majority of cases, extraction of a lower molar tooth and subsequent infection precedes Ludwig’s angina. [The roots of the second and third molars are below the level of the mylohyoid, so infection of these teeth pass through the root and directly into the submaxillary space.] Infection here may eventually spread to the lateral pharyngeal space and the retropharyngeal space, which can compromise the airway and lead to problems opening the mouth (trismus – paralysis of the trigeminal nerve (CN V)).

Front 43

What are the boundaries of the posterior triangle?

Back 43

• the posterior border of the SCM muscle, anteriorly
• the anterior border of the trapezius muscle, posteriorly

middle third of the clavicle between SCM and trapezius, inferiorly

Front 44

What is the roof of the posterior triangle?

Back 44

investing layer of deep neck fascia

Front 45

What is the floor of the posterior triangle? What is inside this triangle?

Back 45

prevertebral layer of deep cervical fascia
From posterosuperior to anteroinferior, this layer includes splenius capitis, levator scapulae and the posterior, middle and anterior scalene muscles.

Front 46

What vein and artery are within the posterior triangle?

Back 46

external jugular vein and branches of the thyrocervical trunk

Front 47

What is and what passes through the interscalene triangle?

Back 47

space between the anterior and middle scalene muscles

subclavian artery and brachial plexus

Front 48

What divides the posterior triangle into smaller triangles? What are these 2 triangles?

Back 48

inferior belly of the omohyoid

superior occipital triangle and a smaller, inferior supraclavicular triangle

Front 49

What are the boundaries of the occipital triangle and supraclavicular triangle?

Back 49

A. Occipital Triangle
• trapezius, posteriorly
• SCM, anteriorly
• inferior belly of omohyoid, inferiorly

B. Supraclavicular (or subclavian) Triangle
• SCM, anteriorly
• clavicle, inferiorly
• inferior belly of omohyoid, superiorly

Front 50

Where does subclavian arise from on both sides?

Back 50

right: brachiocephalic
left: subclavian

Front 51

How are the subclavian artery and vein positioned compared to the subclavian muscle?

Back 51

subclavian artery is located posterior to the muscle, while the subclavian vein lies anterior

Front 52

When does the subclavian artery become the axillary?

Back 52

lateral border of the first rib

Front 53

What three main arteries come off the subclavian Medial to anterior scalene muscle?

Back 53

vertebral, internal thoracic, and thyrocervical trunk

Front 54

What artery does the internal thoracic become?

Back 54

musculophrenic

Front 55

What does the vertebral artery supply?

Back 55

cervical spinal cord and skull

Front 56

What does the thyrocervical trunk give off?

Back 56

inferior thyroid, suprascapular and transverse cervical arteries

Front 57

What does the transverse cervical anastamose with? What does it supply?

Back 57

superior thyroid artery coming from the external carotid artery

supplies the anterior scalene and longus colli muscles via an ascending cervical artery

Front 58

What is a common variation of the transverse cervical artery?

Back 58

• A common variation is for the superficial branch to originate alone from the thyrocervical trunk. In this case, it accompanies the accessory nerves on the deep side of trapezius as the superficial cervical artery. The deep branch then originates from the third part of the subclavian artery (lateral to the scalene) as the dorsal scapular artery.

Front 59

This union of the subclavian and internal jugular vein forms the _____________

Back 59

brachiocephalic vein

Front 60

What does the costocervical artery give off? What do these 2 arteries supply? What is an anomaly associated with the origin of the costocervical artery?

Back 60

superior (or supreme) intercostal artery that supplies the first two intercostal spaces and a deep cervical artery that supplies the deep musculature of the back of the neck.

On the left side, the costocervical artery may arise from the first part of the subclavian.

Front 61

What artery is posterior to the anterior scalene muscles?

Back 61

costocervical artery

Front 62

What possible artery comes off the subclavian lateral to the anterior scalene muscle?

Back 62

dorsal scapular artery

Front 63

What nerves form the cervical plexus? Where is it?

Back 63

ventral rami of C(1)2-4

on the surface of the levator scapulae and middle scalene muscles

Front 64

What 4 nerves emerge from the middle of posterior border of SCM?

Back 64

• lesser occipital nerve (C2) – skin of the neck and scalp behind the auricle
• great auricular nerve (C2-3) – skin over parotid gland, posterior aspect of auricle
• transverse cervical nerves (C2-3) – skin over anterior triangle
• supraclavicular nerves (C3-4) – skin of over the shoulder and upper pectoral region

Front 65

What does an accessory phrenic nerve come from? Where does it lie?

Back 65

This accessory phrenic nerve is usually a branch of the nerve to subclavius from the brachial plexus. When present, the accessory phrenic nerve lies lateral to the main nerve.

Front 66

What forms the cervical plexus? Where is it found?

Back 66

ventral rami of C(1)2-4 and lies on the surface of the levator scapulae and middle scalene muscles

Front 67

Which nerves haves the same origin as the phrenic nerves (C2-C4) and account for referred pain associated with pleurisy?

Back 67

supraclavicular nerves

Front 68

What innervates supraspinatus and infraspinatus and what are its roots?

Back 68

suprascapular nerve (C5-6)

Front 69

Name the deep structures of the root of the neck

Back 69

• common carotid artery
• subclavian artery and vein
• terminal portion of the thoracic duct (left side) and right lymphatic trunk (right side)
• vagus, recurrent laryngeal and phrenic nerves
• sympathetic trunk
• trunks of the brachial plexus
• esophagus and trachea
• prevertebral muscles

Front 70

What arteries come straight off the arch of the aorta?

Back 70

brachiocephalic trunk on the right side and the common carotid and subclavian arteries on the left side

Front 71

What muscles cover the brachiocephalic trunk

Back 71

sternohyoid and sternothyroid muscles

Front 72

What does the brachiocephalic trunk split into?

Back 72

right subclavian and right common carotid

Front 73

Where does the subclavian artery travel?

Back 73

ascend through the root of the neck

Front 74

What is a continuation of the axillary vein?

Back 74

subclavian vein

Front 75

What two veins form the brachiocephalic vein?

Back 75

subclavian and internal jugular veins

Front 76

The internal jugular vein is enclosed by which structure

Back 76

carotid sheath

Front 77

The structure represents the junction where the subclavian and internal jugular veins meet?

Back 77

venous angle

Front 78

Where does the thoracic duct and right lymphatic trunk drain lymph in veins?

Back 78

venous angle

Front 79

Where are the phrenic nerves found in the neck?

Back 79

formed at the lateral borders of the anterior scalene muscles from the cervical ventral rami of C3-5. They descend anterior to the anterior scalene muscles and pass under the prevertebral layer of deep cervical fascia

Front 80

What does the right recurrent laryngeal artery wrap around?

Back 80

right subclavian at T1/T2

Front 81

What travels through the tracheoesophageal groove? What do they supply?

Back 81

vagus and right recurrent laryngeal nerve
all the intrinsic muscles of the larynx except the cricothyroid
cricothyroid is supplied by external laryngeal nerve, one of the terminal branches of the superior laryngeal nerve

Front 82

The cervical sympathetic trunk has white or gray rami?

Back 82

It receives no white rami communicantes in the neck, but is associated with three cervical sympathetic ganglia by way of gray rami communicantes: superior, middle and inferior

Front 83

Which of the cervical ganglion forms a stellate ganglion?

Back 83

inferior ganglion

Front 84

Where do all sympathetics in the cervical region synapse?

Back 84

superior ganglion

Front 85

Where do branches from the superior ganglion travel?

Back 85

internal and external carotid arteries, C1-C4 spinal nerves and the upper cardiac plexus (superior cardiac nerves)

Front 86

Where is the superior ganglion?

Back 86

C1/C2 vertebrae

Front 87

Where is the middle ganglion and what does it supply?

Back 87

at the level of the cricoid cartilage or inferior thyroid artery (C6). It lies anterior to the vertebral artery, and post-ganglionic fibers pass to C5 and C6 spinal nerves, the heart (middle cardiac nerves) and the thyroid gland.

Front 88

What is the inferior ganglion around? What does it supply?

Back 88

vertebral artery
Post-ganglionic fibers pass to spinal nerves C7-T1, the heart (inferior cardiac nerves) and the vertebral artery, forming the vertebral plexus.

Front 89

The brachial plexus is between which muscles?

Back 89

anterior and middle scalene muscles with the subclavian artery

Front 90

What is the origin, insertion, action, and innervation of anterior scalene?

Back 90

• originates from the anterior tubercles of the transverse processes of C3-C6
• inserts on the scalene tubercle of the first rib
• laterally flexes and rotates the neck, elevates the first rib
• innervation is from ventral rami of C4-7

Front 91

What is the origin, insertion, action, and innervation of middle scalene?

Back 91

• originates on the posterior tubercles of the transverse processes of C2-7
• inserts on the first rib
• flexes the neck laterally, elevates the first rib during forced inspiration
• innervation is from the ventral rami of C3-7

Front 92

What is the origin, insertion, action, and innervation of posterior scalene?

Back 92

• originates on the posterior tubercles of the transverse processes of C4-6
• inserts on the second rib
• flexes neck laterally, elevates the second rib during forced inspiration
• innervation is from the ventral rami of C5-7

Front 93

What is the origin, insertion, action, and innervation of levator scapulae?

Back 93

• originates from the transverse processes of vertebrae C1-C4
• inserts on the medial border of the scapulae
• elevates the scapula
• innervation is from the dorsal scapular nerve (C4-5) and cervical spinal nerves C3-4

Front 94

What is thoracic outlet syndrome?

Back 94

compression of the components of the brachial plexus (the large cluster of nerves that pass from the neck to the arm), the subclavian artery, and/or the subclavian vein by bone, trauma, or hypertrophy of the scalene muscles

Front 95

What is the origin, insertion, action, and innervation of splenius capitis?

Back 95

• originates from the ligamentum nuchae and upper thoracic vertebrae
• inserts on the mastoid process and superior nuchal line of occipital bone
• draw the head backward or to the respective side
• innervation is from the dorsal rami of middle cervical spinal nerves

Front 96

What are the origin, insertion, action, and innervation of the anterior vertebral muscles?

Back 96

A. Longus colli
• Originates from the transverse processes of C3-5 (superior oblique part), bodies of C5-T3 (vertical part) and bodies of T1-3 (inferior oblique part)
• Inserts on the anterior tubercle of the atlas (superior oblique part), bodies of C2-4 (vertical part) and transverse processes of C5-6 (inferior oblique part)
• flexes the neck and rotates it to opposite side if the muscle acts unilaterally
• innervation is from the ventral rami of C2-6.
B. Longus capitis
• originates from transverse processes of C3-6
• inserts on basilar part of occipital bone
• flexes the head
• innervation is from the ventral rami of C1-3.
C. Rectus capitis anterior
• originates from anterior surface and transverse processes of atlas
• inserts on the base of the skull anterior to occipital condyle
• functions to stabilize and flex the head
• innervation is from ventral rami of C1 and C2
D. Rectus capitis lateralis
• originates from transverse process of atlas
• inserts on jugular process of occipital bone
• functions to stabilize and flex the head
• innervation is from ventral rami of C1 and C2

Front 97

What forms the floor of the cervical triangles?

Back 97

prevertebral (anterior and lateral vertebral) muscles

Front 98

What muscles are the floor of the posterior triangle?

Back 98

The lateral vertebral muscles are associated with the floor of the posterior triangle: splenius capitis, levator scapulae and the scalene muscles

Front 99

Where is the attachment and limit of attachment for the temporalis muscle?

Back 99

superior temporal line
inferior temporal line

Front 100

What is the fissure between the pterygoid process (in yellow) and the posterior part of the maxilla (aquamarine)? What fossa does this lead to?

Back 100

pterygomaxillary fissure
pterygopalatine fossa

Front 101

Where is the superior orbital fissure? What doe sit connect? Where is the inferior orbital fissure?

Back 101

superior orbital fissure is between the lesser and greater wings of the sphenoid.

orbit and the braincase

The inferior orbital fissure is between the greater wing of the sphenoid and the maxilla

Front 102

What is the origin of masseter?

Back 102

zygomatic arch

Front 103

What are the posterior nasal apertures leading to the nasopharynx lateral to the nassal septum?

Back 103

Choanae

Front 104

What is the hard palate made of?

Back 104

palatine processes of the maxillae and the horizontal plates of the palatine bones

Front 105

What suture is in the back of the head between the squamous occipital and the parietal bones?

Back 105

lambdoid

Front 106

Which suture is on the sides of the head between the squamous portion of the temporal bone and the parietal ?

Back 106

squamous

Front 107

Which is the most anterior suture between the frontal and the parietals? Which suture splits the body down the midline between the left and right parietals?

Back 107

coronal
sagittal

Front 108

What are fontanelles?
What are examples?

Back 108

fontanelles mark regions of unossified connective tissue

anterior, posterior, sphenoidal, and mastoid

Front 109

Why is pterion clinically important?

Back 109

Pterion is clinically important because this is a relatively thin area of the vault and the anterior branch of the middle meningeal artery runs just deep to pterion. So a fracture at pterion can tear the artery.

Front 110

cranial dysraphism

Back 110

The anterior fontanelle will very rarely fail to close, which allows for a herniation of either meninges or brain tissue

Front 111

Where is the groove for the superior sagittal sinus?
Which two aspects of the skull is it on?

Back 111

Along the internal aspect of the sagittal suture
frontal and occipital

Front 112

Anterior to the foramen magnum is the _________ of the occipital bone

Back 112

basilar part

Front 113

What kind of movement does the atlanto-occipital joint allow?

Back 113

flexion and extension

Front 114

What is an emissary vein?

Back 114

drains blood from outside the skull into a major dural sinus

Front 115

Where do you find the hypoglossal canal?

Back 115

lateral to foramen magnum

Front 116

What is an Inca bone?

Back 116

For the occipital, the more superior portion forms intramembranously while the remainder forms endochondrally. Rarely, this distinction is maintained as a suture

Front 117

What does the groove for the superior sagittal sinus turn into?

Back 117

groove for the right transverse sinus

Front 118

What does the straight sinus become?

Back 118

left transverse sinus

Front 119

How does the transverse sinuses become the internal jugular vein

Back 119

The transverse sinuses go onto the temporal as the sigmoid sinuses, and then exit as the internal jugular vein through the jugular foramen

Front 120

What is the difference between endochondral and membraneous ossification?

Back 120

endochondral involves cartilage

Front 121

Which parts of the temporal bone form intramembranously and which form endochondrally (from cartilage)?

Back 121

intramembranously (the squamous part and tympanic part) and endochondrally (the petrous part)

Front 122

Where does the chorda tympani nerve run?

Back 122

Petrotympanic fissure, between the very posterior part of the mandibular fossa (a part known as the postglenoid process, which is small in us but large in carnivores) and the tympanic part of the bone

Front 123

What does the supraorbital margin separate and what does it hold?

Back 123

"forehead" from the roof of the orbit
supraorbital nerve

Front 124

What is the one air sinus and where is it?

Back 124

frontal sinus in frontal bone

Front 125

What attaches to digastric fossa?

Back 125

anterior belly of digastric muscle

Front 126

What forms the frontonasal process?

Back 126

mesenchyme (with its ectodermal covering) stretching from the forebrain to the first pharyngeal arch

Front 127

What forms the lateral and medial nasal prominences?

Back 127

INvagination of Nasal placodes

Front 128

What is the cleft between the lateral nasal prominence and the maxillary process (in salmon here) of the first pharyngeal arch? What does it become? What does it do?

Back 128

nasolacrimal groove
nasolacrimal duct
drain tears from orbit to nasal cavity

Front 129

What forms the intermaxillary segment? What does the intermaxillary segment form?

Back 129

medial nasal processes

most of the external nose, the philtrum of the upper lip, and the primary palate

Front 130

How do you decide between anterior and posterior clefts?

Back 130

posterior according to their location relative to the incisive fossa, which lies at the junction of the primary and secondary palates. For example, anterior clefts may involve the lip, alveolar process of the maxilla, or the entire primary palate. Posterior clefts can involve just the soft palate or the entire secondary palate.

Front 131

What is the alveolar process of the maxilla and mandible?

Back 131

the part connected to teeth

Front 132

What travels through the zygomaticofacial foramen? What does that nerve become before it exits through the zygomaticotemporal foramen?

Back 132

zygomatic nerve

zygomaticofacial nerve and the zygomaticotemporal nerve

Front 133

What are Lefort fractures?

Back 133

– Fractures that involve the middle 1/3 of the face and the pterygoid processes of the sphenoid bone must be fractured

Front 134

What are the 3 types of Lefort fractures?

Back 134

LeFort I involves detachment of the palate from the face. LeFort II, or pyramidal, fractures involve the nasal and lacrimal bones, along with the maxilla. The zygomatic bone remains in place. Finally, Lefort III fractures essentially detach the midface from the cranial base. The zygomatic bones are detached at the frontal and temporal processes.

Front 135

What are the 5 layers of the SCALP?

Back 135

skin, connective tissue, aponeurosis (the galea aponeurotica or epicranial aponeurosis), loose connective tissue, and pericranium

Front 136

Why is the loose CT of SCALP loose? What layer can infection spread quickly through?

Back 136

so the frontalis and occipitalis muscle can "slip" the galea aponeurotica across the cranial vault

below galea (aponeurosis)

Front 137

How are muscles of facial expression different?

Back 137

no membraneous fascia

Front 138

Which facial muscles do arise from bone, and insert directly into skin via small slips of muscle?

Back 138

frontalis from superficial fascia over brow to the galea aponeurotica

Front 139

What is the primary function of facial muscles?

Back 139

is to dilate or constrict facial orifices

Front 140

What are facial muscles derived from? What are they innervated by?

Back 140

mesenchyme of the second pharyngeal arch,

branchiomotor fibers from the facial nerve

Front 141

What is Bell's palsy?

Back 141

paralysis of facial nerve

Front 142

What muscle is affected by Horner's Syndrome?

Back 142

the superior tarsal muscle

Front 143

What muscles are functional and nonfunctional in Bell's palsy?

Back 143

. Note that in Bell's palsy (paralysis of the facial nerve) the orbicularis oculi will be non-functional, while the levator palpebrae superioris and the superior tarsal muscle (smooth muscle innervated by the sympathetic trunk) will be functional.

Front 144

What are the cartilages of the nose? Which are extensions of another?

Back 144

septal, lateral, and alar
lateral are extensions of septal

Front 145

What passes through the parotid gland?

Back 145

facial nerve branches

Front 146

What is on the deeper border of the parotid gland?

Back 146

masseter muscle, the mastoid process, and deeper muscles of the face

Front 147

Where does the parotid duct travel?

Back 147

parotid duct extends from the anterior border of the gland, crosses the masseter muscle, then pierces the buccinator muscle

Front 148

How does the parotid gland receive innervation?

Back 148

parotid gland receives parasympathetic fibers that leave the brain with the glossopharyngeal nerve (IX). As we will discuss with cranial nerves, the glossopharyngeal nerve sends its fibers to the parotid gland via the trigeminal nerve (V3) (auriculotemporal branch)

Front 149

Sensory fibers for the skin of the face above the inferior border and angle of the mandible derive exclusively from __________________

Back 149

the trigeminal nerve (V).

Front 150

What can denervation of a facial dermatome reflect?

Back 150

a tumor or skull fracture deep in the skull that impinges on one of these divisions

Front 151

Where do ophthalmic (V1) nerves travel? What are they?

Back 151

These fibers extend throughout the forehead, with most entering the skull through the supraorbital foramen or notch. They then pass through the orbit.
Also tip of the nose

cutaneous nerves: supraorbital and supratrochlear nerves

Front 152

Where do maxillary (V2) nerves travel? What are their named nerves?

Back 152

Fibers from the middle part of the face follow the infraorbital nerve through the infraorbital foramen, passing into the infraorbital canal of the maxilla in the floor of the orbit. These fibers serve the inferior orbit, the side of the nose, and the upper lip.

Named branches include the zygomaticotemporal and zygomaticofacial nerves.

Front 153

Where does mandibular (V3) travel, what does it innervate, and what are named branches?

Back 153

V3: The mandibular division of the trigeminal nerve emerges from the mental foramen in the body of the mandible. Sensory fibers innervate the lower lip, chin, and the skin over the body of the mandible. Major branches include the buccal and mental nerves.

Front 154

Where does the facial nerve exit the skull?

Back 154

stylomastoid forame

Front 155

What are the branches of the facial nerve?

Back 155

temporal, zygomatic, buccal, marginal mandibular, and cervical branches

TO ZANZIBAR BY MOTOR CAR

Front 156

What surgery typically damages the facial nerve?

Back 156

parotidectomy

Front 157

What are the two terminal branches of external carotid artery?

Back 157

superficial temporal and maxillary arteries

Front 158

What do the supratrochlear and supraorbital arteries branch off of?

Back 158

internal carotid artery

Front 159

What arteries does the facial artery give off?

Back 159

superior and inferior labial arteries

Front 160

What gives off the transverse facial artery?

Back 160

superficial temporal artery

Front 161

What do the infraorbital and the mental arteries branch off of?

Back 161

maxillary artery

Front 162

What is the main vein of the facial region? What is the only vein not names like the artery?

Back 162

facial vein
retromandibular vein

Front 163

Where does the lymph of the face drain?

Back 163

lymph from the superficial face drains into the deep cervical chain of nodes that runs along the internal jugular vein

Front 164

What are the lymph nodes of the face?

Back 164

buccal, submandibular, submental, posterior aurical, parotid

Front 165

The "danger zone" of the scalp is recognized as which layer?

Back 165

loose CT

Front 166

An elderly man presented with severe pain beneath the left eye, radiating into the lower eyelid, lateral side of the nose and upper lip. What nerve was involved?

Back 166

infraorbital nerve is a cutaneous nerve from the maxillary division of trigeminal nerve (V2). It innervates the skin of the lateral nose, lower eyelid, upper lip and zygomatic region

Front 167

During a face lift operation on a 48-year-old woman, the plastic surgeon inadvertently cut the marginal mandibular branch of the facial nerve. Which muscles would be paralyzed?

Back 167

depressor anguli oris, mentalis

Front 168

An elderly woman complained of a severe pain, felt above the right eye radiating to the upper eyelid, side of the nose and forehead. Branches of which of the following nerves convey pain sensations from areas of the skin described?

Back 168

Ophthalmic (V1)

Front 169

Due to multiple salivary calculi (stones) in the submandibular duct, the submandibular gland of a 45-year-old individual was surgically removed. What major artery directly related to the gland was of special concern to the surgeon?

Back 169

facial artery

Front 170

To study the compensatory response of selective suprahyoid muscles in elevating the hyoid bone, an experiment was designed in which the posterior belly of the digastric and stylohyoid muscles were paralyzed by drugs. The muscular branches of which of the following nerves must be chemically interrupted to produce paralysis in both muscles?

Back 170

facial nerve (regular, no special branches)

Front 171

Which nerves provide sensory and motor innervation to buccinator?

Back 171

sensory: buccal nerve

motor: buccal branch of facial (CNVII)

Front 172

Which nerve provides cutaneous innervation to the skin of the angle of the mandible?

Back 172

Great auricular nerve

Front 173

A patient is unable to wink; what muscle is affected?

Back 173

orbicularis oculi

Front 174

Which nerves send and carry postganglionic parasympathetic fibers to the parotid gland?

Back 174

send: glossopharyngeal nerve
carry: auriculotemporal nerve (V3)

Front 175

What three structure go through the parotid gland, list them from superficial to deep?

Back 175

The facial nerve, retromandibular vein, and external carotid artery

Front 176

What nerves handles sensory innervation of the face?

Back 176

trigeminal

Front 177

What muscle handles pursing and closing of the lips?

Back 177

orbicularis oris

Front 178

What are the known branches of V3 branch of trigeminal (CN V)? What muscles do they innervate?

Back 178

buccal and mental nerves

Front 179

What muscles keeps cheeks taut?

Back 179

Buccinator muscle

Front 180

A patient is unable to move their facial expression muscles, which nerve was affected?

Back 180

facial nerve

Front 181

While recovering from multiple dental extractions, an elderly man experienced a radiating pain affecting the lower eyelid, lateral side of the nose, upper lip and over the zygomatic and temporal areas on the left side. Which nerve is involved in the patient's perception of pain?

Back 181

maxillary branch of trigeminal

Front 182

Frey's Syndrome is marked by profuse sweating over one cheek, temple, and surrounding areas of the face, precipitated by eating. The condition may be idiopathic, but often follows parotid surgery. The condition is attributable to abberant reinnervation, the redirection of autonomic fibers normally going to salivary glands being redirected to sweat glands. What is the source of the nerve fibers involved?

Back 182

auriculotemporal of V3 of trigeminal (CN V)

Front 183

The facial muscle most responsible for moving the lips both upward and laterally to produce a smile is:

Back 183

zygomaticus major

Front 184

In repairing a damaged right subclavian artery, the surgeon notices and protects a large nerve passing around to the posterior surface of the artery. This nerve, which does not encircle the subclavian on the left side, is the:

Back 184

recurrent laryngeal

Front 185

A stab wound just above the left clavicle, lateral to the sternocleidomastoid muscle, may be life-threatening because of the possibility of injury to the:

Back 185

subclavian artery

Front 186

A 27-year-old man who is a professional weight lifter comes to his physician complaining of recent weakness in his left arm and frequent tingling in his hand and fingers during exercise sessions which subsides with rest. He is diagnosed as having vasuclar insufficiency due to scalenus anticus syndrome and as a remedy it is decided to transect the anterior scalene muscle where it inserts on the first rib. During surgery, which structure in contact with the anterior surface of the muscle must the surgeon be careful of sparing?

Back 186

phrenic nerve

Front 187

Where does the phrenic nerve travel relative to the anterior scalene muscle?

Back 187

anterior surface

Front 188

A 60-year-old man with a previous history of right carotid endarterectomy, comes to his physician complaining of light-headedness and dizziness whenever he uses his right hand vigorously. He is diagnosed as having subclavian steal syndrome due to an atherosclerotic plaque at the point where his subclavian artery branches from the brachiocephalic trunk. The cerebral insufficiency is the result of blood being stolen from which artery?

Back 188

vertebral

Front 189

What 2 veins turn into brachiocephalic vein?

Back 189

internal jugular and subclavian

Front 190

Which structure lies immediately anterior to the right anterior scalene muscle at its costal attachment?

Back 190

Subclavian vein

Front 191

What structure lies anterior only to the left anterior scalene muscle?

Back 191

thoracic duct

Front 192

What are the branches of the thyrocervical trunk, from superior to inferior, medial to lateral?

Back 192

inferior thyroid (which gives off ascending cervical) artery
transverse cervical artery
suprascapular artery

Front 193

A person develops a primary tumor of the thyroid gland and, among other symptoms, drooping of the eyelid and constriction of the pupil on the right side of the eye are noted. What nerve fibers have been interrupted by the tumor?

Back 193

cervical sympathetic trunk

Front 194

The middle cervical sympathetic ganglion, recurrent laryngeal nerve, and parathyroid glands are all closely related with which blood vessel?

Back 194

inferior thyroid artery

Front 195

Which of the following hyoid muscles is an important landmark in both the anterior and posterior triangles of the neck?

Back 195

omohyoid

Front 196

What innervates platysma?

Back 196

cervical branch of facial nerve (VII)

Front 197

The layer of encircling cervical fascia that splits to enclose sternocleidomastoid and trapezius muscles is the:

Back 197

Superficial layer of deep fascia

Front 198

The triangle in which the superior branch of the ansa cervicalis separates from the hypoglossal nerve is the:

Back 198

carotid triangle

Front 199

Exploration of the tracheoesophageal groove at the level of the thyroid gland would reveal what important structure bilaterally?

Back 199

recurrent laryngeal nerve

Front 200

A 35 year old woman was diagnosed with an adenoma of the thyroid gland. This required excision of the lower pole (left lobe) of the gland and ligation of the artery supplying that region. Which of the following nerves accompanying the artery is most likely to be damaged if the surgeon is not careful? What is the artery?

Back 200

recurrent laryngeal nerve
inferior thyroid artery

Front 201

What innervates stylohyoid?

Back 201

facial nerve (CN VII)

Front 202

A 47-year-old woman is diagnosed as having a thyroid tumor. Surgery to remove the cancerous growth is undertaken. In which triangle of the neck will the surgeon make an incision to gain access to the gland?

Back 202

muscular triangle

Front 203

A 50-year-old woman is brought to the operating room for a biopsy of a suspicious looking nevus (mole) which is found along the anterior border of her sternocleidomastoid muscle at about its midlength. What nerve must be locally anesthetized for the operation to proceed without pain?

Back 203

transverse cervical nerve

Front 204

The superior belly of the omohyoid forms the anterior border of which cervical triangle?

Back 204

carotid

Front 205

A six-year-old child, whose medical history includes a rather difficult birth, has a permanently tilted head posture, with the right ear near the right shoulder and the face turned upward and to the left. Which of the following muscles was very likely damaged during birth?

Back 205

sternocleidomastoid muscle

Front 206

Any irritation of the diaphragm (e.g. infection, tumor) may create referred pain that seems (to the patient) to originate in the area atop the shoulder. This is due to the fact that the phrenic nerve shares spinal segments with what cutaneous nerve in the shoulder region?

Back 206

supraclavicular nerve

Front 207

What provides innervation to the skin behind the ear?

Back 207

lesser occipital nerve

Front 208

What nerve supplies the skin around the ear and over the parotid gland?

Back 208

great auricular nerve

Front 209

What nerve supplies the skin of the upper anterior neck; descending branches pierce platysma and are distributed to the anterolateral neck.?

Back 209

transverse cervical nerve

Front 210

What nerves to supply the skin over the clavicle and superior thorax?

Back 210

supraclavicular nerves

Front 211

What triangle is made of:
the midline of the neck anteriorly;
the anterior border of the sternocleidomastoid posteriorly;
the inferior border of the mandible superiorly

Back 211

anterior triangle

Front 212

What triangle is made of:
the superior belly of omohyoid, posterosuperiorly
the anterior border of the SCM, posteroinferiorly
and the median plane of the neck from the hyoid bone to the sternum, medially?

Back 212

muscular triangle

Front 213

What triangle is made of:
the superior belly of the omohyoid, anteroinferiorly
the posterior belly of the digastric, superiorly
the anterior border of the sternocleidomastoid, posteriorly

Back 213

carotid triangle

Front 214

What is a slight dilation of the beginning of the internal carotid artery, baroreceptor that reacts to changes in arterial blood pressure and is innervated by the glossopharyngeal nerve (CN IX)

Back 214

carotid sinus

Front 215

What is a small, ovoid mass of tissue that lies on the medial side of the common carotid bifurcation. This is a chemoreceptor that monitors the level of oxygen in the blood. When oxygen levels are low, it initiates a reflex that increases the rate and depth of respiration, cardiac rate and blood pressure. The carotid body is innervated by branches of the glossopharyngeal (CN IX) and vagus (CN X) nerves.

Back 215

carotid body

Front 216

What goes through the carotid sheathe?

Back 216

common carotid artery
internal carotid
internal jugular vein
vagus nerve
ansa cervicalis

Front 217

What is the following triangle:
the body of the hyoid bone, inferiorly
the anterior belly of the digastric muscle, laterally
the midline, medially

Back 217

submental triangle

Front 218

What triangle has lymph nodes?

Back 218

submental triangle

Front 219

What do the submental lymph nodes drain?

Back 219

floor of the oral cavity, tip of the tongue and middle lower lip

Front 220

the inferior border of the mandible, superiorly
the posterior belly of the digastric and stylohyoid muscles, posteroinferiorly
the anterior belly of the digastric muscle, anteroinferiorly
the floor is formed by the mylohyoid and hyoglossus muscles

Back 220

submandibular triangle

Front 221

What is in the posterior part of the submandibular triangle?

Back 221

part of the parotid gland, the external carotid artery passing deep to the stylohyoid, the internal carotid artery, internal jugular vein and vagus nerve (CN X).

Front 222

What is inside the suprasternal space?

Back 222

the sternal heads of the SCM muscles, the inferior ends of the anterior jugular veins, the jugular venous arch, fat and lymph nodes

Front 223

Fascial space within prevertebral layers (danger space)

Back 223

This space is the loose fascia between the laminae of the prevertebral fascia that extends from the base of the skull to the posterior mediastinum and to the diaphragm. It lies behind the esophagus and the lower part of the pharynx. This pathway may potentially extend infections of the head and neck into the mediastinum, leading to compression of the heart or phrenic nerves and thrombosis of vessels, the trachea and the esophagus. This space may also be infected directly by posterior perforations of the esophagus or by infections of the deep cervical nodes lying adjacent to it.
 

Front 224

the posterior border of the SCM muscle, anteriorly

the anterior border of the trapezius muscle, posteriorly

middle third of the clavicle between SCM and trapezius, inferiorly

Back 224

posterior trangle

Front 225

What muscles are directly in contact with prevertebral layer of deep cervical fascia?

Back 225

splenius capitis, levator scapulae and the posterior, middle and anterior scalene muscles

Front 226

What is and what travels through the interscalene triangle?

Back 226

subclavian artery and brachial plexus pass through this space

Front 227

• trapezius, posteriorly
• SCM, anteriorly
• inferior belly of omohyoid, inferiorly

Back 227

occipital triangle

Front 228

• SCM, anteriorly
• clavicle, inferiorly
• inferior belly of omohyoid, superiorly

Back 228

supraclavicular triangle

Front 229

What artery is posterior to the anterior scalene muscle and which vein is anterior to it?

Back 229

subclavian

Front 230

How does suprascapular originate?

Back 230

The suprascapular nerve (C5-6) arises from the superior trunk of the brachial plexus

Front 231

What branch of the trigeminal nerve (CN V) is infraorbital nerve?

Back 231

v2, maxillary

Front 232

Sternohyoid

Back 232

Sternohyoid – a superficial muscles, lies parallel and adjacent to the anterior midline
Origin: manubrium of sternum and medial end of clavicle
Insertion: Body of hyoid bone
Innervation: C1-3 by a branch of the ansa cervicalis

Front 233

Omohyoid

Back 233

Omohyoid – lateral to sternohyoid, has 2 bellies that are united by an intermediate tendon connected to the clavicles
Origin: Superior border of the scapula
Insertion: Inferior border of hyoid
Innervation: C1-3 by a branch of the ansa cervicalis

Front 234

Sternothyroid

Back 234

Sternothyroid – lies under sternohyoid and covers the lateral lobe of the thyroid gland, attaching to the oblique line of the lamina of the thyroid cartilage; the thyroid cartilage sits immediately above it and limits its movement in the superior direction, so tumors or goiters cause its expansion anteriorly or inferiorly into the mediastinum
Origin: Posterior surface of the manubrium of the sternum
Insertion: Oblique line of thyroid cartilage
Innervation: C1-3 by a branch of the ansa cervicalis

Front 235

thyrohyoid

Back 235

Thyrohoid – the continuation of the sternothyroid from the oblique line of the thyroid cartilage to the hyoid
Origin: Oblique line of thyroid cartilage
Insertion: Inferior border of body and greater horn of hyoid
Innervation: C1 via hypoglossal nerve (CN XII)

Front 236

What are the anterior branches of the external carotid artery?

Back 236

superior thyroid
lingual
facial

Front 237

What are the posterior branches of the external carotid artery?

Back 237

Ascending pharyngeal artery
occipital
Posterior auricular artery

Front 238

What are the terminating branches of the carotid branches?

Back 238

Superficial temporal artery
maxillary artery