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96 Cards in this Set
- Front
- Back
where is the only complete ring in the trachea?
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cricoid cartilage
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what level is the hyoid bone at?
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c3
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what level is the thyroid cartilage at?
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c4
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what level is the cricoid cartilage at?
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c6
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what is the laryngeal prominence formed by?
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by the thyroid cartilage (of larynx), from 2 plates (laminae)
adam's apple |
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platysma
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origin: fascia and skin over deltoid and pec major
arises from superficial fascia (imbedded in it) Inserts: Inferior border of mandible and skin of lower face nerve: cervical branch of CN VII (facial) artery: a. submental branch of facial b. suprasternal branch of suprascapular off thyrocervical trunk actions: muscle of facial expression |
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SCM
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origin: a. sternal head: anterior surface of manubrium
b. Cleido = clavicular head, superior surface of medial 1/3 clavicle Insert: a. lateral surface of mastoid process of temporal bone b. lateral 1/2 of superior nuchal line of occipital bone nerves: Accessory (CN XI) and ventral ramus of C2/C3 Spinal Nucleus in C1-C6 gray in cord forms accessory, then C2 ventral ramus joins it and goes to SCM. artery: suprascapular (off of thyrocervical trunk). SCM br. of Sup. Thyroid, Occipital and Post. Auricular - all from Ext. Carotid actions: a. alone: tilts head to own side |
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congenital torticollis
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wryneck. contraction of SCM from fibrosis, gets shorter. can be torn during birth
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when would the external jugular v increase in size?
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cardiac failure, opera singer
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what is the course of the external jugular vein?
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crosses SCM in the superficial fascia, pierces fascia of post triangle and into subclavian
drains most of scalp and face on same side |
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what are the nerves seen in post triangle, emerging post to SCM?
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less occipital
great auricular transverse colli (trans. cervical) supraclavicular (medial, intermediate, and lateral) (accessory is also seen) |
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which nerve travels w/ the external jugular vein?
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great auricular
branches to skin post to ear, ear, lower side of face, neck |
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where does the transverse colli n course?
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anteriorly, pierces platysma, to skin over ant triangle
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where do the supraclavicular nn course?
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skin over ant chest and shoulder
medial: sternoclavicular joint lateral: acromioclavicular joint |
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what are the boundaries of the post tri?
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ant: SCM post border
post: trap ant border inf: middle 1/3 clavicle |
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what is found in the floor of the post tri?
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(6) splenius capitus, levator scapulae, scalenus ant med and post, and some semispinalis capitus
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what do you find laying on top of the levator scapulae?
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accessory nerve
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scalenus anterior
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o: C3-C6 transverse process
i: scalene tubercle and upper surface of 1st rib n: C4-C7 ventral rami act.: elevate 1st rib in inspiration |
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what lies on top of the anterior scalene?
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phrenic n
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what vessel goes to all 3 scalenes?
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asc br of inf thyroid a
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what is pierced by the dorsal scapular n (n to rhomboids)?
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scalenus medius
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scalenus medius
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o: C1-C7 transverse process
i: sup. surface of 1st rib n: C3-C7 ventral rami act.: elevate 1st rib in inspiration |
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scalenus posterior
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o: C4-C6 transverse process
i: sup border of 2nd rib n: C5-C7 ventral rami act: elevate 2nd rib in inspiration |
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what is the first part of the subclavian a? what is there?
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part that is medial to ant scalene. vertebral a is found here.
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where is the 2nd part of the subclavian a?
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post to ant scalene
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where is 3rd part of subclavian a?
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late to ant scalene
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what are the main aa in the post triangle? from where do they arise?
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trasnverse cervical a
suprascapular a both off thyrocervical trunk of subclavian a |
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what is the course of the transverse cervical a?
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off thyrocervical trunk, courses lateral and post to scalenes
superficial branch goes to lev scap and branches on trap deep branch to lev scap and rhomb if deep br comes off subclavian -> descending scapular a and transverse cervical -> superficial cervical a |
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what is course of suprascapular a?
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courses lat and post/inf to transverse cervical a, ant to phrenic n and ant scalene.
supplies mm around scapula. |
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CNXI
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accessory n
-found in post tri, on top of lev scap -supplies trrap and some SCM -consists of motor and spinal roots: spinal root from C1-C5 join the cranial root from medulla of brainstem to form XI spinal portion supplies the SCM and Trap |
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dorsal scapular n
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'nerve to the rhomboids' (post tri)
from ventral ramus C5 pierces scalenus medius, goes -deep to Lev. Scap. and ends deep to rhomboids innervates all 3 |
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what are the branches of the cervical plexus and what do they arise from?
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5 branches found in Post. Triangle -
a. Lesser Occipital N. C2 b. Great Auricular N. C2-C3 c. Transverse Colli N. C2-C3 d. Supraclavicular N. C3-C4 e. Phrenic N. C3-C5 (on ant. surface of ant. Scalene |
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what is the course and source of the cervical plexus?
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(post tri)
Lies deep to Int. Jugular vein and SCM - immediately deep to XI formed by ventral rami of C1-C4 |
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what is the course and source of the brachail plexus?
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Roots and Trunks seen between Scalenus Ant. and Medius.
from ventral Rami of C5 - T1 |
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what are the subdivisions of the post tri?
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split by omohyoid:
1. Supraclavicular (Omoclavicular Triangle) bordered by inf edge of inferior belly of omohyoid clavicle SCM post border 2. Occipital triangle bordered by superior edge of inferior belly of omohyoid trapezius SCM post border |
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what are the boundaries of the ant tri?
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anteromedian line of neck
inferior border of mandible anterior border of SCM apex is at jugular notch |
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what are the suprahyoid mm?
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(4) mylohyoid, geniohyoid, digastric, stylohyoid
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what are the infrahyoid mm?
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(4) sternohyoid, omohyoid, sternothyroid, thyrohyoid
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mylohyoid
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thin, flat, form a sling inferior to tongue. feel if push ton forward
o: medial aspect of mandible i: midline raphe and body of hyoid bone n: mylohyoid n, br of inferior alveolar off Mandibular Div of Trigem (V) act.: elevates hyoid, floor of mouth, tongue in swallowing and speaking |
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geniohyoid
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superior to mylohyoid, reinforces the floor of mouth
o: mandible i: body of hyoid n: ventral ramus of C1 via the Hypoglossal Nerve (XII) act: pulls hyoid anterosuperiorly during swallowing |
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digastric
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o: Ant: digastric fossa on mandible
Post: mastoid process of temporal bone i: both insert on tendon in meddle, attached to hyoid by a fibrous sling that acts as a pulley - lets tendon move anterior and posterior n: Ant: mylohyoid n. Post: facial nerve (VII) act.: together - raise hyoid during swallowing and speaking posterior action - open mouth, depress mandible |
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CN XII
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hypoglossal - motor
swallowing, speech geniohyoid |
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CN VII
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facial - S&M
facial expression, taste from ant 2/3 of ton, glands (not parotid) post belly digastric, stylohyoid |
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CN V
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trigeminal - S&M
mastication branch goes to mylohyoid |
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stylohyoid
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o: styloid process of temporal bone
i: body of hyoid bone n. Branch of VII (Facial) act.: raises hyoid during swallowing |
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what is the general structure of the ansa cervicalis?
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C1 - superior root -branches to supply geniohyoid an dthyrohyoid
C2, C3 - inferior root these join to form loop loop supplies omohyoid, sternohyoid, sternothyroid |
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strap muscles
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the infrahyoid mm. ribbon-like
(sternohyoid, omonyoid, sternothyroid, thyrohyoid) |
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sternohyoid
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superficial
o: sternal end of clavicle/manubrium i: body of hyoid n: C1-C3 from cervical plexus - ansa cervicalis act: depresses hyoid after it is raised during swallowing |
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omohyoid
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o: Inf. Belly - superior border of scapula near
suprascapular notch Sup. Belly - Intermediate tendon i: Inf. Belly - Intermediate tendon Sup. Belly - hyoid body n: C1-C3 via the ansa cervicalis act.: depresses hyoid bone |
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sternothyroid
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deep to sternohyoid, thin muscle
o: Post. surface of manubrium i: side of thyroid cartilage n: C1-C3 via ansa cervicalis act. pulls larynx inferiorly |
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thyrohyoid
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superior continuation of Sternothyroid Muscle
o: Thyroid cartilage - oblique line on side i: body of hyoid n. not ansa - C1 ventral ramus via the Hypoglossal Nerve act: elevates the larynx in swallowing |
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the ___ separates the ___ gland into internal and external components
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mylohyoid, submandibular
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what are the division of the ant tri?
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(4) submandibular, carotid, muscular, submental
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submandibular tri
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(part of ant tri) ('digastric tri')
borders: inf border of mandible, 2 bellies of digastric contents: submandibular gl, submandibular duct, CN XII (and part of c1), sylohyoid m (attached to post belly of digastric) |
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carotid tri
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borders: SCM (ant edge), sup belly omohyoid, post belly digastric
contents: common carotid a and division into int/ext carotid, branches of ext carotid a, carotid sinus, carotid body, hypoglossal n carotid sheath |
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what is contained in the carotid sheath?
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common and internal carotid a
vagus nerve (X) internal jugular vein ansa lies on top of sheath |
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what does the carotid sinus do?
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responds to chane in art pressure
is at origin of int carotid (blocking -> syncope) |
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what does the carotid body do?
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chemoreceptor (inc CO2 or dec O2)
at bifurcation |
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what are the branches of the external carotid artery?
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superior Thyroid - supplies thyroid
lingual - becomes deep lingual art in head facial - around ramus of mandible ascending pharyngeal - comes off posterior, supplies pharynx, prevertebral mm, middle ear and meninges occipital - to post part of scalp no branches of inf carotid in neck |
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what is the relation of the vagus in the carotid sheath?
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vagus is btwn and post to carotid and jug
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muscular triangle
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Boundaries: superior belly of Omohyoid Muscle
Anterior SCM Midline of neck Contents: Infrahyoid muscles thyroid gland |
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submental triangle
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Unpaired
Boundaries: Hyoid Bone inferiorly Left and Right Anterior Bellies of Digastric m. laterally Floor: - Mylohyoid Muscles Contents: Submental lymph nodes receive lymph from tip of tongue, floor of mouth Small veins that join to form Anterior Jugular Vein. |
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which is more anterior: external carotid a, internal carotid a?
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ext
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which is more ant: carotid a, jugual v?
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carotid
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what are the boundaries of the superior thoracic aperture?
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lateral 1st pair of ribs and costal cartilage
anterior manubrium posterior body of 1st thoracic vertebra |
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which side is the brachiocephalic trunk located off aorta?
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R
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which side is the common carotid located off aorta?
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L
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which side is the subclavian located off aort?
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L
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what is the course of the vertebral artery?
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is in 1st part of subclavian
ascends thru foramen transversarium of C1-6 enters skull via foramen magnum L and R form basilar a |
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what are the branches of the thyrocervical trunk?
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inferior thyroid (ant to ant scal), transverse cervical, suprascapular
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internal thoracic artery
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branch off of subclavian
goes inferiorly, gives ant intercostal a. to 1st 6 intercostal spaces |
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what are the branches of the costocervical trunk?
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branches off of subclavian a., goes sup and post over apex of pleura
divides into: -superior intercostal -deep cervical (to m in back of neck) |
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where does the ant jugular drain?
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ext jug v
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where does the ext jugular drain?
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subclavian v
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what separates the subclavian a from the subclavian v?
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ant scal
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an aneurysm in the ___ will put pressure on the ___
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3rd part of subclavian a, brachial plexus
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subclavian steal syndrome
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blockage proximal to vert a., neg press steals blood from oppp side up vert a thru circle of willis. reversed blood flow
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what does the right recurrent laryngeal nerve loop around?
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subclavian a
loops upward bwn esophagus and trachea to larynx |
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what does the left recurrent laryngeal nerve loop around?
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arch of aorta
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what is the course of the vagus?
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goes down carotid sheath post to the blood vessels
goes ant to 1st part of subclavian art (med to ant scal) R recurrent loops around subclavian and back up btwn esophagus and trachea to larynx branches in neck: pharyngeal, laryngeal (gives rise to carotid body) and cardiac branches. |
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phrenic n
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ventral roots c3-5
sole innervation to diaphhragm travels on ant surface of ant scal |
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where is the sympathetic chain located?
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in fascia of post carotid sheath at level of 1st rib
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inferior cervical ganglion
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near vertebral artery
often combines with 1st thoracic ganglion = Stellate Ganglion Some post-ganglionic fibers go to heart |
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middle cervical ganglion
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Small
Anterior aspect of Inferior Thyroid Art. post-ganglionic fibers go to heart and thyroid gland |
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superior cervical ganglion
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Large
superior termination of the sympathetic chain level of Atlas C2 post-ganglionic fibers enter cranial cavity to smooth muscle/glands |
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thoracic duct
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left side in the neck
Enters neck though superior thoracic aperture at left border of esophagus drains from entire lower body and upper left Goes more superior than its destination. Arches posterior to carotid sheath and ant. to sympathetic trunk and courses inferiorly to thyrocervical trunk and enters junction of subclavian. and int. jugular v. Right side of head, neck, upper limb and thorax drained by Right Lymphatic Duct into junction of R int. Jugular and R. Subclavian Veins |
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where do you find the thyroid gland?
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on the trachea
lobes cover rings 2-4 of trachea covered w/ pretracheal fascia |
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what supplies the thyroid w/ blood?
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superior thyroid a: 1st branch of Ext. Carotid Art.
courses inferiorly ends on anterior surface of thyroid anastomoses with superior thyroid art from other side on isthmus and sends off numerous branches inf thyroid a: 1st branch of Thyrocervical trunk off subclavian art. goes superior anterior to Ant Scalene posterior to carotid sheath ends on posterior side of thyroid. |
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what veins go from thyroid gland?
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(3 pair)
Superior thyroid Vein - drains superior into Int. Jugular V. Middle thyroid Vein - drains lateral into int. jugular v. Inferior thyroid vein - drains inferior into brachiocephalic v. |
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what innervates thyroid?
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branches of sympathetic chain and vagus
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parathyroid glands
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2 on each side, under fascia of thyroid
have their own capsule supplied by inf or sp thyroid aa drained by thyroid venous plexus innervated by br of cervical symp ganglia |
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what is location of esophagus?
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betwen trachea and ant long lig of vert col
recurrent laryngeal nn ascend btwn the trachea and esophagus in contact w/ cervical pleura on R on L, thoracic duct betwen esophagus and pleura |
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what are the fascial planes?
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(4)
enveloping fascia, prevertebral fascia, carotid sheath, pretracheal fascia |
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enveloping fascia
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(superficial layer of the deep fascia)
encircles neck (encircles SCM and trap), encloses all structures except platysma (in superf. fascia) Inferiorly: attached to the manubrium of the sternum, clavicle and acromion and spine of scapula separates over manubrium to form the suprasternal space |
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prevertebral fascia
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surrounds vertebral m. (post neck(
transverse extension from one enveloping layer to another. Anterior to the prevertebral muscles separates neck into areas post to prevertebral fascia and ant to prevertebral fascia |
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pretracheal fascia
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Anterior part of the neck
surrounds the thyroid, esophagus and trachea blends with the carotid sheath laterally holds thyroid to trachea, holds parathyroid |