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96 Cards in this Set

  • Front
  • Back
where is the only complete ring in the trachea?
cricoid cartilage
what level is the hyoid bone at?
c3
what level is the thyroid cartilage at?
c4
what level is the cricoid cartilage at?
c6
what is the laryngeal prominence formed by?
by the thyroid cartilage (of larynx), from 2 plates (laminae)
adam's apple
platysma
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
SCM
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
congenital torticollis
wryneck. contraction of SCM from fibrosis, gets shorter. can be torn during birth
when would the external jugular v increase in size?
cardiac failure, opera singer
what is the course of the external jugular vein?
crosses SCM in the superficial fascia, pierces fascia of post triangle and into subclavian

drains most of scalp and face on same side
what are the nerves seen in post triangle, emerging post to SCM?
less occipital
great auricular
transverse colli (trans. cervical)
supraclavicular (medial, intermediate, and lateral)
(accessory is also seen)
which nerve travels w/ the external jugular vein?
great auricular
branches to skin post to ear, ear, lower side of face, neck
where does the transverse colli n course?
anteriorly, pierces platysma, to skin over ant triangle
where do the supraclavicular nn course?
skin over ant chest and shoulder
medial: sternoclavicular joint
lateral: acromioclavicular joint
what are the boundaries of the post tri?
ant: SCM post border
post: trap ant border
inf: middle 1/3 clavicle
what is found in the floor of the post tri?
(6) splenius capitus, levator scapulae, scalenus ant med and post, and some semispinalis capitus
what do you find laying on top of the levator scapulae?
accessory nerve
scalenus anterior
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
what lies on top of the anterior scalene?
phrenic n
what vessel goes to all 3 scalenes?
asc br of inf thyroid a
what is pierced by the dorsal scapular n (n to rhomboids)?
scalenus medius
scalenus medius
o: C1-C7 transverse process
i: sup. surface of 1st rib
n: C3-C7 ventral rami
act.: elevate 1st rib in inspiration
scalenus posterior
o: C4-C6 transverse process
i: sup border of 2nd rib
n: C5-C7 ventral rami
act: elevate 2nd rib in inspiration
what is the first part of the subclavian a? what is there?
part that is medial to ant scalene. vertebral a is found here.
where is the 2nd part of the subclavian a?
post to ant scalene
where is 3rd part of subclavian a?
late to ant scalene
what are the main aa in the post triangle? from where do they arise?
trasnverse cervical a
suprascapular a
both off thyrocervical trunk of subclavian a
what is the course of the transverse cervical a?
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
what is course of suprascapular a?
courses lat and post/inf to transverse cervical a, ant to phrenic n and ant scalene.

supplies mm around scapula.
CNXI
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
dorsal scapular n
'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
what are the branches of the cervical plexus and what do they arise from?
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
what is the course and source of the cervical plexus?
(post tri)
Lies deep to Int. Jugular vein and SCM - immediately deep to XI
formed by ventral rami of C1-C4
what is the course and source of the brachail plexus?
Roots and Trunks seen between Scalenus Ant. and Medius.
from ventral Rami of C5 - T1
what are the subdivisions of the post tri?
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
what are the boundaries of the ant tri?
anteromedian line of neck
inferior border of mandible
anterior border of SCM
apex is at jugular notch
what are the suprahyoid mm?
(4) mylohyoid, geniohyoid, digastric, stylohyoid
what are the infrahyoid mm?
(4) sternohyoid, omohyoid, sternothyroid, thyrohyoid
mylohyoid
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
geniohyoid
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
digastric
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
CN XII
hypoglossal - motor
swallowing, speech
geniohyoid
CN VII
facial - S&M
facial expression, taste from ant 2/3 of ton, glands (not parotid)
post belly digastric, stylohyoid
CN V
trigeminal - S&M
mastication
branch goes to mylohyoid
stylohyoid
o: styloid process of temporal bone
i: body of hyoid bone
n. Branch of VII (Facial)
act.: raises hyoid during swallowing
what is the general structure of the ansa cervicalis?
C1 - superior root -branches to supply geniohyoid an dthyrohyoid
C2, C3 - inferior root
these join to form loop
loop supplies omohyoid, sternohyoid, sternothyroid
strap muscles
the infrahyoid mm. ribbon-like

(sternohyoid, omonyoid, sternothyroid, thyrohyoid)
sternohyoid
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
omohyoid
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
sternothyroid
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
thyrohyoid
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
the ___ separates the ___ gland into internal and external components
mylohyoid, submandibular
what are the division of the ant tri?
(4) submandibular, carotid, muscular, submental
submandibular tri
(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)
carotid tri
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
what is contained in the carotid sheath?
common and internal carotid a
vagus nerve (X)
internal jugular vein

ansa lies on top of sheath
what does the carotid sinus do?
responds to chane in art pressure
is at origin of int carotid

(blocking -> syncope)
what does the carotid body do?
chemoreceptor (inc CO2 or dec O2)
at bifurcation
what are the branches of the external carotid artery?
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
what is the relation of the vagus in the carotid sheath?
vagus is btwn and post to carotid and jug
muscular triangle
Boundaries: superior belly of Omohyoid Muscle
Anterior SCM
Midline of neck
Contents:
Infrahyoid muscles
thyroid gland
submental triangle
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.
which is more anterior: external carotid a, internal carotid a?
ext
which is more ant: carotid a, jugual v?
carotid
what are the boundaries of the superior thoracic aperture?
lateral 1st pair of ribs and costal cartilage
anterior manubrium
posterior body of 1st thoracic vertebra
which side is the brachiocephalic trunk located off aorta?
R
which side is the common carotid located off aorta?
L
which side is the subclavian located off aort?
L
what is the course of the vertebral artery?
is in 1st part of subclavian
ascends thru foramen transversarium of C1-6
enters skull via foramen magnum
L and R form basilar a
what are the branches of the thyrocervical trunk?
inferior thyroid (ant to ant scal), transverse cervical, suprascapular
internal thoracic artery
branch off of subclavian
goes inferiorly, gives ant intercostal a. to 1st 6 intercostal spaces
what are the branches of the costocervical trunk?
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)
where does the ant jugular drain?
ext jug v
where does the ext jugular drain?
subclavian v
what separates the subclavian a from the subclavian v?
ant scal
an aneurysm in the ___ will put pressure on the ___
3rd part of subclavian a, brachial plexus
subclavian steal syndrome
blockage proximal to vert a., neg press steals blood from oppp side up vert a thru circle of willis. reversed blood flow
what does the right recurrent laryngeal nerve loop around?
subclavian a
loops upward bwn esophagus and trachea to larynx
what does the left recurrent laryngeal nerve loop around?
arch of aorta
what is the course of the vagus?
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.
phrenic n
ventral roots c3-5
sole innervation to diaphhragm
travels on ant surface of ant scal
where is the sympathetic chain located?
in fascia of post carotid sheath at level of 1st rib
inferior cervical ganglion
near vertebral artery
often combines with 1st thoracic ganglion = Stellate Ganglion
Some post-ganglionic fibers go to heart
middle cervical ganglion
Small
Anterior aspect of Inferior Thyroid Art.
post-ganglionic fibers go to heart and thyroid gland
superior cervical ganglion
Large
superior termination of the sympathetic chain
level of Atlas C2
post-ganglionic fibers enter cranial cavity to smooth
muscle/glands
thoracic duct
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
where do you find the thyroid gland?
on the trachea
lobes cover rings 2-4 of trachea
covered w/ pretracheal fascia
what supplies the thyroid w/ blood?
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.
what veins go from thyroid gland?
(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.
what innervates thyroid?
branches of sympathetic chain and vagus
parathyroid glands
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
what is location of esophagus?
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
what are the fascial planes?
(4)
enveloping fascia, prevertebral fascia, carotid sheath, pretracheal fascia
enveloping fascia
(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
prevertebral fascia
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
pretracheal fascia
Anterior part of the neck
surrounds the thyroid, esophagus and trachea
blends with the carotid sheath laterally

holds thyroid to trachea, holds parathyroid