Head And Neck Ii

Front 1

what are the borders of the anterior triangle?

what are the four divisions of the anterior triangle?

Back 1

median line, anterior SCM, inferior mandible

submental triangle
submandibular triangle
carotid triangle
muscular (omotracheal) triangle

Front 2

what are the skeletal components located in the ant triangle?

Back 2

mandible
hyoid
thyroid cart
cricoid cart
tracheal rings
manubrium
clavicle

Front 3

what are the suprahyoid mm? what do they do?

Back 3

elevate hyoid

mylohyoid
genihyoid
stylohyoid
digastric
hyoglossus

Front 4

what are the infrahyoid mm? what do they do?

Back 4

depress the hyoid

sternohyoid
omohyoid (superior is ant triangle, inferior is in post tri)
Sternothyyroid
thyrohyoid

Front 5

what is deep sternothyroid/thyrohyoid or sternohyoid/omohyoid?

Back 5

deep: sternothyroid and thyrohyoid

Front 6

what veins are in the anterior triangle?

Back 6

anterior jugular: runs on sternohyoid, drains to EJV
external jugular: superficial, on SCM
internal jugular: in carotid sheath, lateral to artery

Front 7

anterior jug v

Back 7

in ant triangle

superficial, runs on sternohyoid. drains to EJV

Front 8

EJV

Back 8

on SCM, superficial

EJV and AJV dump into the subclavian

Front 9

IJV

Back 9

in carotid sheath, lateral to A

receives blood from:
1. Facial v @ hyoid
2. superior/middle thyroid vv

**joins the subclavian to form the brachiocephalic

Front 10

Branches of External Carotid A. easy as 1 2 3

Back 10

1. medial branch
ascending pharyngeal
2. posteior branches
post auricular
occipital
3. anterior branches
superior thyroid
lingual
fascial

Front 11

from where do the common carotid a originate

Back 11

R: brachiocephalic trunk

L: aorta

Front 12

what do the common carotids brinch into

Back 12

External carotid: a bit anterior, stays out of the skill and supplies neck face oral cavity scalp, continues as maxillary A (lots of neck branches!)

Internal carotid: runs in carotid sheath, supplies brain, eye (NO branches in neck)

Front 13

where do common carotid a's bifurcate

Back 13

superior margin of thyroid cartilage

Front 14

what are the carotid bodies and carotid sinus? What CN?

Back 14

body: chemoreceptor (CO2, O2) at the bifurcation

sinus: swelling at bifurcation of internal carotid, baroreceptor for BP

**Both have their signals carried by CN IX glossopharyngeal

Front 15

name the 6 major branches of the external carotid (1, 2, 3)

Back 15

R: common from brachio, L common from aorta, branch at superior margin of thyroid cart into internal/external. internal in carotid sheath, NO branches

external branches: (from inferior)
Superior thyroid: anterior
ascending pharyngeal: medial
lingual: anterior
fascial: anterior
occipital: post
post auricular: post

Front 16

Ascending Pharyngeal A

Back 16

only middle branch off external carotid
hard to find, supplies pharnyx, meninges, pervertebral mm,
originates near bifircation, is right btwn internal/external and dives deep

Front 17

Occipital A

Back 17

one of 1 post branches (post auricular is other)

inferior to post auricular, supplies post scalp, near mastoid

seperated from occipital by inferior belly of digastric

Front 18

Posterior Auricular A

Back 18

posterior branch of external carotid (other branch is occipital)

superior to occipital

seperated by occipital by post belly of digastric

btwn mastoid and EAM

Front 19

what vessels are seperated by post belly of digastric

Back 19

occipital a
post auricular a

**the two post branches off of external carotid

Front 20

superior thyroid a

Back 20

anterior branch of external carotid (so are lingual and facial)

supplies thyroid and larynx

Front 21

facial A

Back 21

anterior branch of external carotid (so are lingual and superior thyroid)

external to mandible, deep to angle

gives rise to palentine and tonsillar branches

Front 22

lingual A

Back 22

anterior branch of external carotid (same with facial a and superior thyroid a)

deep to hypoglossal N (CN XII): controls tongue

supplies hyoglossus, stylohyoid

**hyoglossus seperates lingual a and hypoglossal N

Front 23

what does the hyoglossus mm seperate

Back 23

hypoglossus N (CN XII) (superficial)
Lingual A (Deep)

Front 24

transverse cervical N

Back 24

in ant triangle
c2-c3
deep to EJV
supplies anterior Neck


**recall with cervical plexus, deep N do motor, superficial do sensory

Front 25

Hypoglossal N

Back 25

CN XII
motor to tongue
deep to post belly of digastrisc
hypoglossal N is superficial to hyoglossus and lingual A is deep to hypolglossus
travels inferior to mandible
btwn external carotid and IJV

Front 26

Vagus N

Back 26

CN X
travels in carotid sheath btwn IJV and ICA
travels straight down the lateral neck along common carotid a
**gives R/L recurrent laryngeal N as branches


**R vagus: anterior to subclavian (gets hooked here)
**L Vagus: post to SC joint, btwn subclavian and common carotid

Front 27

The mneumonics
1. names of CN
2. function of CN
S:sensory
M: motor
B: both

Back 27

Oh Oh Oh To Touch And Feel A Good Vagina and Hymen

2. Some Say Money Matters But My Brother Says Big Brains Matter Most

Front 28

ansa cervalis

Back 28

C1-C3
loop

Front 29

tell me about the L and R recurrent laryngeals

Back 29

R: hooks under brachiocephalic medial to carotid

L: hooks under aorta

They run along side of the trachea deep to the thyroid gland (often seen from post diagram)

**innervate larynx

**branch of vagus

Front 30

along what vessel do the superficial cervical and deep cervical lymph nodes lie

Back 30

Superficial: EJV
Deep: IJV (in carotid sheath)

Front 31

thyroid gland

Back 31

Viscera in the ant triangle (muscular, omotracheal, division)
Endocrine organ
Deep to infrahyoid mm (sternohyoid, sternothyroid, thyrohyoid)
C5-T1
2 arteries and 3 veins

tough fibrous capsule, invested by visceral portion of pretracheal deep cervical fascia

Front 32

what is the pyrimadal lobe of the thyroid?
what is abarrent thyroid tissue?

Back 32

tissue along remnant of thyroglossal duct
Abarrent: detached tissue along path of thyroglossal duct (anywhere btwn tongue and thyroid)

Front 33

what are the 2 arteries that supply the thyroid, where do they come from

Back 33

Superior Thyroid A: external carotid (recall the three anterior branches, facial, sup thyroid, lingual)

Inferior Thyroid A: thyrocervical trunk

IMA: abarrent, 10%, from brachiocephalic trunk directly and travels midline across trachea and up to the thyroid (C5-T1)

Front 34

explain the venous drainage of the thyroid

Back 34

3 veins
Superior
Middle
Inferior Thyroid veins

*sup/mid drain to internal jugular
*inferior drains to brachiocephalic

Front 35

if there is an A coming off of the brachocephalic what is it? what about a vein

Back 35

A: abarrent IMA artery

V: normal, inferior thyroid V

Front 36

Lymph drainage from thyroid

Back 36

prelaryngeal, pretracheal, paratracheal then to... superior deep cervical or inferior deep cervical

Front 37

how does abarrent thryoid tissue come to be?

Back 37

in development the thyroid seperates from the post tongue and descends into the neck, there is a connection called the thyroglossal duct with usually degenerates, sometimes is doesnt and you get abarrent thyroid

Front 38

what can be damaged in a tracheotomy

Back 38

IMA A if present
recurrent laryngeal N (L hooks on arota)
inferior thyroid A

Front 39

nerves to the thyroid

Back 39

sympathetics, vasoconstriction to squeezze out secrections
*all three cervical ganglia (sup/mid/inf cervical ganglia)
*secromotor function is controlled hormonally

Front 40

what structures can be compressed by a goiter

Back 40

Thyroid enlargement due to lack of Iodine

trachea
esophagous
recurrent laryngeals

Front 41

what are symptoms of graves disease

hypothyroidism

Back 41

Graves (hyperthyroidism): can get a goiter, overactive thyroid, weight loss, tremors, exopthalmous, depression

Hypothyroidism: decreased thyroid activity, weight gain, sleepy

Front 42

where are the parathyroid glands? how many are there? what is their supply?

Back 42

external to the tough capsule on the thyroid, post surface of thyroid
4, two superior & 2 inferior
endocrine
share same vasculature as thyroid

Front 43

what are the prevertebral mm that flex the head

Back 43

longis capitis: superior, attaches to head
longus colli: right along ant surface of vert
anterior scalene: from transverse process of C3-C6 to rib 1, innervated by C3/4-C6 spinal nerves

**not in the muscular part of pretracheal fascia, those are the sternohyoid and sternothyroid. within paravetebral fascia

Front 44

what is the orgin, insertion, and innervation of the anterior scalene?

**SUPER IMPORTANT LANDMARK

Back 44

Origin: transverse process of C3-C6
Insert: rib 1
Innervation: C3/4-C6 spinal N

Front 45

Lateral neck flexors? fascia?

Back 45

Middle Scalene: transverse process to rib one, innervated by cervical spinal nerved

Posterior Scalene: transverse process rib 2, C7-C8

**in the prevertebral fascia

Front 46

recall, what thoracic structure makes it all the way into the root of the neck

Back 46

lungs, apex

Level of T1 but superior to AC joint

Front 47

which side has the brachiocephalic trunk?

Back 47

right (**remember r recurrent laryngeal gets stuck here)

Front 48

what artery is in the scalene gap?
what N runs along it?

Back 48

subclavian, continues as axillary through cervicoaxillary canal
CN X Vagus

Front 49

what pulse is taken near the clavicle in the post triangle

Back 49

subclavian

Front 50

what are the branches of the subclavian a

medial to ant scalene (3)
lateral to ant scalene (1)

Back 50

medial to anterior scalene:
1. vertrbral
2. internal thoracic
3. tthyrocervical

Lateral to anterior scalene:
1. costocervical trunk

Front 51

subclavian, external jug, ant jug, ant scalene. relationship

Back 51

the ext and ant jugular empty into the subclavian anterior to the anterior scalene

Front 52

what is the venous angle? what is it formed by? what dumps into it?

Back 52

the venous angle is where the IJV and subclavian V join to form the brachiocephalic vein

**thoracic duct dumps into the left brachiocephalic V

**SVC is formed when the R and L brachiocephalic V merge

Front 53

what are the prevertebral mm that flex the head

Back 53

longis capitis: superior, attaches to head
longus colli: right along ant surface of vert
anterior scalene: from transverse process of C3-C6 to rib 1, innervated by C3/4-C6 spinal nerves

**not in the muscular part of pretracheal fascia, those are the sternohyoid and sternothyroid. within paravetebral fascia

Front 54

what is the orgin, insertion, and innervation of the anterior scalene?

**SUPER IMPORTANT LANDMARK

Back 54

Origin: transverse process of C3-C6
Insert: rib 1
Innervation: C3/4-C6 spinal N

Front 55

Lateral neck flexors? fascia?

Back 55

Middle Scalene: transverse process to rib one, innervated by cervical spinal nerved

Posterior Scalene: transverse process rib 2, C7-C8

**in the prevertebral fascia

Front 56

recall, what thoracic structure makes it all the way into the root of the neck

Back 56

lungs, apex

Level of T1 but superior to AC joint

Front 57

which side has the brachiocephalic trunk?

Back 57

right (**remember r recurrent laryngeal gets stuck here)

Front 58

what artery is in the scalene gap?
what N runs along it?

Back 58

subclavian, continues as axillary through cervicoaxillary canal
CN X Vagus

Front 59

what pulse is taken near the clavicle in the post triangle

Back 59

subclavian

Front 60

what are the branches of the subclavian a

medial to ant scalene (3)
lateral to ant scalene (1)

Back 60

medial to anterior scalene:
1. vertrbral
2. internal thoracic
3. tthyrocervical

Lateral to anterior scalene:
1. costocervical trunk

Front 61

subclavian, external jug, ant jug, ant scalene. relationship

Back 61

the ext and ant jugular empty into the subclavian anterior to the anterior scalene

Front 62

what is the venous angle? what is it formed by? what dumps into it?

Back 62

the venous angle is where the IJV and subclavian V join to form the brachiocephalic vein

**thoracic duct dumps into the left brachiocephalic V

**SVC is formed when the R and L brachiocephalic V merge

Front 63

what are the sentinal nodes

Back 63

just above the clavicle

**inferior deep cervical LN

Front 64

the recurrent laryngeals are a branch of what CN

Back 64

X vagus!

Front 65

thoracic outlet syndrome:

Back 65

impingement btwn clavicle and Rib 1, pinches subclavian a/v, brachial plexus

**hypertrophy of ant scalene can cause impingement

mm weakness, tingling, coolness of skin, ischemia, destension of superficial vv

Front 66

phrenic N and vagus N

Back 66

vagus is more medial and is squashed btwn IJV and CCA (what happens in vegas stays)


phrenic is more lateral and runs on anterior scalene

Front 67

phrenic N

Back 67

c3,4,5
on surface of anterior scalene, outside of carotid sheath, within prevertrbral fascia
enters thorax btwn subclavian a/v courses around the heart

Front 68

where does the sympathetic trunk lie in relation to the carotid sheath? what is missing from the sympathetic trunk in the neck?
what are the named ganglia

Back 68

post to carotid sheath
NO white rami communicans

Superior
Middle
Inferior/stellate

**stellate gang is formed when inferior cervical fuses with superior thoracic

Front 69

name the three sympathetic ganglia in the neck

Back 69

superior cervical: C1/C2
middle cervical: anterior of inferior thyroid a (inf thyroid from thyrocervical)
inferior cervical: posterior to the origin of vertebral a (from subclavian)

**stellate gang if superior thoracic joins with inferior cervical

**nerve supply to the thyroid receives stuff from all three ganglia

Front 70

what N courses along subclavian?

Back 70

brachial plexus, scalene gap, cervicoaxillary canal