Triangles Of The Neck Ii

Front 1

What nerves are in the carotid triangle?

Back 1

i. IX-XI

Front 2

How does the glossopharyngeal nerve exit the cranial cavity?

Back 2

i. Through jugular foramen

Front 3

Between what two structures does CN IX descend?

Back 3

i. IJV
ii. ICA

Front 4

Deep to what structure does CN IX descend? And then forwards between which two structures?

Back 4

i. Deep to styloid process
ii. Forward between ECA and ICA

Front 5

What are the motor/sensory branches of CN IX in the anterior triangle?

Back 5

i. Motor to stylopharyngeus
ii. Sensory to pharynx

Front 6

a. Between what two structures does CN X exit the cranial cavity?

Back 6

i. CN IX and CN XI

Front 7

b. What is the course of CN X? What structures are medial/lateral to it?

Back 7

i. Descends in carotid sheath
ii. Medial to IJV
iii. Posterior to ICA and CCA

Front 8

c. What are the branches of CN X in the anterior triangle?

Back 8

i. Carotid body
ii. Laryngeal branch
iii. Cardiac branch

Front 9

a. What is the course of CN XI? What structures surround it?

Back 9

i. Medial to IJV in carotid sheath
ii. Between IJV and ICA
iii. Passes lateral to IJV to pass downwards and backwards

Front 10

b. Under what muscle does CN XI disappear after passing over the IJV?

Back 10

i. Trapezius

Front 11

a. Through what space does the hypoglossal nerve exit the cranial cavity?

Back 11

i. Hypoglossal canal

Front 12

b. What is the course of the hypoglossal (CN XII) nerve after leaving the cranial cavity?

Back 12

i. Medial to IJV and ICA
ii. Outwards between IJV and ICA
iii. Hooks around occipital artery
iv. Deep to posterior belly of digastric
v. Deep to mylohyoid

Front 13

c. What does the hypoglossal nerve innervate?

Back 13

i. Tongue

Front 14

i. What spinal segments contribute to the ansa cervicalis?

Back 14

1. C1-C3

Front 15

ii. What does the ansa cervicalis innervate?

Back 15

1. Infrahyoid muscles, except thyrohyoid

Front 16

iii. What spinal segments constitute the superior root of the ansa cervicalis?

Back 16

1. C1

Front 17

iv. What is the course of the superior root of the ansa cervicalis?

Back 17

1. Between IJV and ICA then between IJV and CCA

Front 18

v. What nerves does the superior root of the ansa cervicalis join?

Back 18

1. XII→ then descends from XII

Front 19

i. What spinal segments constitute the inferior branch of the ansa cervicalis? From where does it branch?

Back 19

1. C2-C3
2. Direct branch off of the cervical plexus

Front 20

ii. What does the inferior branch of the ansa cervicalis supply?

Back 20

1. Lower parts of sternohyoid and sternothyroid
2. Inferior belly of omohyoid

Front 21

b. What muscles are superficial to the thyroid?

Back 21

i. Sternohyoid
ii. Sternothyroid
iii. Omohyoid

Front 22

a. What covers the exterior of the thyroid?

Back 22

i. Pretracheal fascia

Front 23

d. What developmental landmark indicates the site of the thyroid’s origin?

Back 23

i. Foramen cecum

Front 24

e. What is the thyroglossal duct?

Back 24

i. It marks the passage of the thyroid during development

Front 25

f. What are the consequences of arrested thyroid migration?

Back 25

i. Cyst/fistula
ii. Aberrant thyroid tissue

Front 26

i. What structure accompanies the superior thyroid artery?

Back 26

1. External laryngeal nerve

Front 27

ii. What are the two branches of the superior thyroid artery?

Back 27

1. Anterior glandular branch
2. Posterior glandular branch

Front 28

iii. What is the origin of the inferior thyroid artery?

Back 28

1. Thyrocervical trunk

Front 29

iv. What structure accompanies the inferior thyroid artery?

Back 29

1. Recurrent laryngeal nerve

Front 30

v. What are the terminal branches of the inferior thyroid artery?

Back 30

1. Inferior branch
2. Ascending branch

Front 31

vi. What does the ascending branch of the inferior thyroid artery supply?

Back 31

1. Parathyroid glands

Front 32

vii. Where is the origin of the thyroida ima artery?

Back 32

1. Arch of aorta or brachiocephalic trunk

Front 33

viii. What does the thyroida ima artery supply?

Back 33

1. Isthmus of thyroid

Front 34

i. Into what vein does the superior thyroid vein flow? What does it drain?

Back 34

1. IJV
2. Area supplied by superior thyroid vein

Front 35

ii. Into what vein does the middle thyroid vein flow? What does it drain?

Back 35

1. IJV
2. Majority of gland (not drained by superior thyroid vein)

Front 36

iii. Into what vein does the inferior thyroid vein flow? What does it drain?

Back 36

1. Left innominate vein
2. Drains the isthmus

Front 37

i. What are the indications for a thyroidectomy?

Back 37

1. Goiter or malignancies

Front 38

ii. What are some precautions for a thyroidectomy?

Back 38

1. Preserve parathyroid glands
2. Avoid RLN and superior laryngeal nerve
3. Avoid sympathetic trunk

Front 39

iii. What is myxedema?

Back 39

1. Atrophy of the thyroid
2. Decreased secretion

Front 40

iv. What is thyrotoxicosis?

Back 40

1. Grave’s disease
2. Increased secretion

Front 41

v. What is a multinodular goiter?

Back 41

1. Most common
2. Surgical excision for tx

Front 42

vi. What is another name for autoimmune thyroiditis?

Back 42

1. Hashimoto’s disease

Front 43

a. Where are the parathyroid glands located?

Back 43

i. Posterior surface of thyroid
ii. Between carotid bifurcation to mediastinum

Front 44

b. What is the arterial supply of the parathyroid gland?

Back 44

i. Inferior thyroid artery

Front 45

a. What structures make up the floor of the posterior triangle?

Back 45

i. Scalene muscles
ii. Levator scapulae
iii. Splenius capitis

Front 46

b. What structures make up the roof of the posterior triangle?

Back 46

i. Skin
ii. Platysma fascia

Front 47

c. What structures pierce the roof of the posterior triangle?

Back 47

i. External jugular vein
ii. Supraclavicular nerves

Front 48

a. Where is the origin of the external jugular vein? What structures join to form it?

Back 48

i. Near angle of mandible
ii. Retromandibular vein and posterior auricular vein

Front 49

b. What muscle does the EJV cross in the roof of the posterior triangle?

Back 49

i. Sternocleidomastoid

Front 50

c. Where does the EJV terminate?

Back 50

i. Subclavian vein

Front 51

d. What are tributaries of the EJV?

Back 51

i. Suprascapular vein
ii. Transverse cervical vein
iii. Anterior jugular vein

Front 52

a. What is the innervation of the sternocleidomastoid?

Back 52

i. CN XI
ii. C2-C4

Front 53

b. What is the function of the sternocleidomastoid?

Back 53

i. Tilt head to one side or draw head forward (together)

Front 54

c. Where does the sternal head of the SCM insert?

Back 54

i. Lateral ½ of superior nuchal line

Front 55

d. Where does the clavicular head of the SCM insert?

Back 55

i. Mastoid process

Front 56

a. What are the attachments of the trapezius?

Back 56

i. Origin→ C7-T12 spinous processes, superior nuchal line
ii. Insertion→ Clavicle, acromion, spine

Front 57

b. What is the innervation of the trapezius?

Back 57

i. CN XI
ii. C3-C4→ proprioception

Front 58

c. What is the function of the trapezius?

Back 58

i. Rotating the scapula

Front 59

a. What is the origin of the splenius capitis?

Back 59

i. SP C7-T4

Front 60

b. What is the insertion of the splenius capitis?

Back 60

i. Mastoid process
ii. Superior nuchal line

Front 61

c. What is the innervation of the splenius capitis?

Back 61

i. Middle cervical nerves

Front 62

a. What are the attachments of the levator scapulae?

Back 62

i. Origin→ TP of C1-C4
ii. Insertion→ Scapula

Front 63

b. What is the innervation of the levator scapulae?

Back 63

i. Dorsal scapular nerve→ C4-C5

Front 64

a. What are the attachments of the posterior scalene?

Back 64

i. Origin→ posterior tubercles of C4-C6 TP
ii. Insertion→ Upper surface of rib 2

Front 65

b. What is the innervation of the posterior scalene?

Back 65

i. C5-C7

Front 66

a. What are the attachments of the middle scalene?

Back 66

i. Origin→ TP C2-C7
ii. Insertion→ Upper surface of rib 1

Front 67

b. What is the innervation of the middle scalene?

Back 67

i. C3-C7

Front 68

a. What are the attachments of the anterior scalene?

Back 68

i. Origin→ anterior tubercles of TP C3-C6
ii. Insertion→ scalene tubercle and upper surface of rib 1

Front 69

b. What is the innervation of the anterior scalene?

Back 69

i. C4-C7

Front 70

a. What is the innervation of the omohyoid?

Back 70

i. Ansa cervicalis

Front 71

a. What causes torticollis?

Back 71

i. Breech delivery
ii. Interference with arterial supply or venous occlusion→ muscle necrosis

Front 72

b. What is the clinical presentation of torticollis?

Back 72

i. Child unable to straighten head
ii. Head is drawn towards affected SCM and chin towards opposite side
iii. Facial asymmetry with shortening of skull and face on affected side

Front 73

c. What will radiographs of torticollis show?

Back 73

i. Contralateral convex scoliosis→ C7-T1
ii. Ipsilateral compensatory convex scoliosis→ T6-T12

Front 74

a. What is the examination for whiplash like?

Back 74

i. Intense pain in neck immediately after
ii. Next few days→ increased pain
iii. Later→ Decreased intensity of pain with rigid head, neck movement if very painful

Front 75

b. What will palpation of whiplash show?

Back 75

i. Local tenderness over TP C4-C5

Front 76

c. What will radiographs of whiplash show?

Back 76

i. Normal cervical lordosis
ii. Absence of fracture of cervical vertebrae