Sem 4 Week 11 Lecture 1

Front 1

neck

Back 1

tube between head and trunk

Front 2

Anteriorly,neck extends from

Back 2

Lower border of mandible to manubrium.

Front 3

Posteriorly,necks extends from

Back 3

Superior nucheal line on occipital bone down to C7-T1 disc.

Front 4

Superficial fascia of neck is special for 2 reasons.Name them.

Back 4

-Anteriorly,it contains a thin sheet of muscle-platysma which runs up to blend with muscles of face(supplied by facial nerve-cervical branch)
-has important veins anteriorly--> External jugular + Anterior jugular

Front 5

Ant. Jugular vein empty into

Back 5

External Jugular vein

Front 6

External Jugular vein

Back 6

-more laterally
-starts at angle of jaw & runs down vertically on SCM
-drains lots of superficial structures.

Front 7

Ant. jugular vein is

Back 7

On either side of midline

Front 8

Trachea is always open due to

Back 8

U-shaped cartilage rings

Front 9

Neck is divided into

Back 9

4 longitudinal compartments(each contained in a sleeve of fascia)

Front 10

Visceral cpt is

Back 10

Anterior

Front 11

Visceral cpt contains

Back 11

-Thyroid & parathyroid glands
-thymus(till adolesc.)
-Trachea
-Oesophagus

Front 12

Vascular cpt is

Back 12

LAteral

Front 13

Posteriorly is the

Back 13

Vertebral cpt

Front 14

Vertebral cpt of neck contains

Back 14

-Cervical vertebrae
-postural muscles assoc. with cervical spine.

Front 15

After superficial fascia,first layer of deep fascia is

Back 15

Investing layer of deep fascia

Front 16

Investing layer of deep fascia splits to

Back 16

Enclose 2 important muscles: SCM ant. and trapezius post.

Front 17

Surrounding visceral cpt is

Back 17

Pre-tracheal fascia

Front 18

Pre-tracheal fascia is divided into :

Back 18

-Pre tracheal fascia ANTERIORLY
-buccopharyngeal fascia POSTERIORLY

Front 19

WHat surrounds vertebral cpt?

Back 19

-Prevertebral fascia

Front 20

All layers of fascia have

Back 20

Spaces in between-->any infections which get into spaces might spread into spaces down to thorax.

Front 21

Carotid sheath

Back 21

-Carotid artery MEDIALLY
-Int. Jugular vein
-Vagus nerve

Front 22

Into which 2 main regions is neck div?

Back 22

-Anterior triangle( infront of SCM ,below inferior margin of mandible)
-Posterior triangle(behind SCM +infront of trapezium + above middle 1/3 of clavicle

Front 23

Carotid artery bifurcates at

Back 23

C3/C4(same level of thyroid cartilage)

Front 24

Carotid a.

Back 24

branch of aorta

Front 25

Internal carotid a. has

Back 25

NO branches in neck.(however contains carotid sinus & carotid body)

Front 26

External carotid artery

Back 26

-ascends in ant. triangle
-heads towards parotid gland
-ascending,in front of ICA
-give 6 branches during ascent

Front 27

What are the 3 branches of ECA that are in front?

Back 27

-Superior thyroid artery
-Lingual artery(floor of mouth + tongue)
-Facial artery(winds over inf. border of mandible)

Front 28

What are 2 branches of ECA at the back?

Back 28

-Post. auricular artery(behind ear)
-Occipital artery(behind skull)

Front 29

What is the medial branch of ECA ?

Back 29

Ascending pharyngeal artery(ascends with deep structures of pharynx)

Front 30

Structures that come out of jugular foramen or hypoglosseal canal come

Back 30

Straight at top of ANTERIOR triangle.(CN 9,10,11 + 12)

Front 31

IJV

Back 31

-Lateral in carotid sheath
-has all tributaries that corresponds to branches of ECA

Front 32

Vagus nerve

Back 32

-descends with IJV and carotid system,right into thorax.

Front 33

Somatic sensory fibres of CN 10

Back 33

Mucous membranes of larynx

Front 34

Branchial motor fibres of vagus nerve

Back 34

-Muscles of pharynx,larynx,soft palate

Front 35

Accessory nerve

Back 35

Goes backward into POSTERIOR triangle-->crosses post. triangle and supplies SCM and trapezius

Front 36

Test for CN 11

Back 36

Shrug shoulders

Front 37

Hypoglossal nerve

Back 37

-Motor supply to tongue,except palatoglossus
-if damaged,tongue deviated to affected side
-passes between carotid artery & jugular vein.

Front 38

Thyroid gland

Back 38

-2 lobes between upper border of thyroid cartilage above + 6th tracheal ring below
-isthmus between 2nd and 3rd tracheal rings
-enclosed by pretracheal fascia
-part of visceral cpt

Front 39

Thyroid moves up and down on swallowing because

Back 39

pretracheal fascia moves up and down with swallowing

Front 40

If there is lump in neck which does not move up and down on swallowing,

Back 40

lump is NOT inside pretracheal fascia.

Front 41

Isthmus stuck to

Back 41

Tracheal rings 2,3,4.

Front 42

Pre tracheal fascia extends to

Back 42

Hyoid bone(attaches to it)

Front 43

Thyroid gland is found

Back 43

-deep to strap muscles
-lateral to trachea/oesophagus
-overlap carotid sheath

Front 44

What happens in 50 % of cases with thyroid gland?

Back 44

-Extrapyramidal lobe that ascends from isthmus to left(pyramidal lobe)--> remnant of hypoglossal duct

Front 45

Thyroid is

Back 45

Outgrowth of embryonic pharynx

Front 46

Embryonic pharynx

Back 46

migrates to front of trachea

Front 47

Path of migration marked

Back 47

by thyroglossal duct

Front 48

Recurrent laryngeal nerve sits in

Back 48

Groove between trachea and oesophagus

Front 49

R.L.N embedded in

Back 49

-Fascia of lobes of thyroid gland from behind.

Front 50

Site of dev. of thyroid gland

Back 50

Foramen caecum

Front 51

Enlargement of thyroid gland

Back 51

-Compress trachea & oesophagus--> difficulty swallowing
-invade R.L.N on one side--> hoarse voice
-compress IJV--> engorged veins above pt of obstruction

Front 52

Thyroid gland

Back 52

Most vascular gland in body

Front 53

Parathyroid glands(peasize)

Back 53

-2 pairs on posterior aspect of each lobe of thyroid gland--> 2 superior and 2 inferior

Front 54

Blood supply of thyroid

Back 54

-Paired superior thyroid a.(1st branch of ECA)
-paired inferior thyroid a.(branch of subclavian a)
-branches anastomose vertically and across midline

Front 55

Occasionally,in 10 % of cases,

Back 55

Single thyroid a. passes along isthmus--IMA artery

Front 56

Veins of thryoid gland

Back 56

-3 pairs of veins(superior,middle and inferior thyroid )

Front 57

Cervical plexus

Back 57

from ventral rami of C2,C3,C4(under SCM)
-superficial(cutaneous) branches to skin
-Deep branches

Front 58

Deep branches of cervical plexus called

Back 58

Ansa cervicalis(motor to strap muscles of neck-attach to hyoid)

Front 59

Rami of brachial plexus

Back 59

Pass between scalenus medius and anterior

Front 60

Phrenic nerve

Back 60

C3,C4,C5

Front 61

Subclavian system supplies

Back 61

-upper limb
-almost 1/2 brain
-most of spinal cord(vertebral a)
-part of thoracic wall

Front 62

Brachial plexus travels along with

Back 62

Axillary artery

Front 63

Main branches of subclavian system in neck

Back 63

-Vertebral(normally 1st branch)--> passes in triangle between longus colli & scalenus anterior.
-Thyrocervical trunk(gives off inferior thyroid a. to thyroid gland)

Front 64

Superficial nodes drain into

Back 64

Deep nodes

Front 65

Name the 2 groups of Superficial cervical nodes.

Back 65

-Horizontal(junction of head & neck)
-Vertical(along external jugular vein)

Front 66

Horizontal superficial cervical nodes consist of

Back 66

-Submental
-Submandibular
-Parotid
-Post. auricular
-Occipital

Front 67

Deep cervical is along

Back 67

Int. Jugular vein

Front 68

Deep cervical is made up of

Back 68

-Upper group(ANT triangle)
-Lower group(POST. triangle)

Front 69

Upper group consists of

Back 69

Jugulo-digastric(JD) or tonsillar node --> drains palatine tonsils.

Front 70

Lower group consists of

Back 70

Supraclavicular nodes-final sentinel node.(JO)

Front 71

Name the 3 deep muscles of neck

Back 71

-Levator scapuli
-Scalenus medius
-Scalenus anterior

Front 72

Scalenus medius

Back 72

Accessory muscle of respiration-fixed to 1st ribs

Front 73

Subclavian vein

Back 73

-in front of scalene muscles

Front 74

Subclavian artery

Back 74

behind scalene muscles.

Front 75

Roots of brachial plexus

Back 75

Above scalenes

Front 76

Posterior triangle

Back 76

-floor made up of series of obliquely orientated muscles from cervical vertebrae to pectoral girdle.

Front 77

Post triangle

Back 77

-Scalene medius and anterior

Front 78

Roots of brachial in

Back 78

Inferior part of post triangle(between clavicle and ribs into upper limb)

Front 79

Subclavian artery passes between

Back 79

Scalene medius and anterior

Front 80

Above subclavian artery,

Back 80

roots and trunks of brachial plexus emerge.

Front 81

All muscles in ant. triangle relate to

Back 81

hyoid bone(strap muscle)

Front 82

Infrahyoid muscles

Back 82

-Strap muscles
-down from hyoid bone to pectoral girdle
-depressed hyoid bone or larynx

Front 83

Suprahyoid muscles

Back 83

-Floor of mouth
-pull up hyoid bone for swallowing/phonation

Front 84

Ant. vertebral(strap muscles)

Back 84

- lie between investing fascia nad pretracheal fascia.
-act to steady or move hyoid bone & larynx
-innervated by ant. rami of cervical nerves

Front 85

Contents of Post. triangle

Back 85

-Accessory nerve
-Subclavian a.,v.,brachial plexus
-Cervical plexus

Front 86

CN 11

Back 86

-supplies boundaries of post triangle
-through jugular foramen into top of ant. triangle
-passes beneath SCM
-runs across floor of post triangle on levator scapula(disappears beneath trapezius)

Front 87

CN 11 supplies

Back 87

SCM and trapezius

Front 88

Cervical plexus

Back 88

-Ventral rami of C1-C4
-underneath SCM
-phrenic nerve branch(runs vertically down on scalenus anterior to head into thorax)
-cutaneous branches of cervical plexus

Front 89

Cutaneous branches of cervical plexus

Back 89

-Span from back of SCM supplying cutaneous supply to back of scalp and neck.