Anat - Posterior Head And Neck

Front 1

Boundries of the neck?

Back 1

Superior boundries:
- mandible
- mastoid process
- Ionion # (superior occipital protuberence)

Inferior:
- sternum
- clavicle
- acromion of scapulae
- 7th cervicle vertebrae

Front 2

structure coursing between the head and thorax are associated with which traingle?

Back 2

anterior triangle

Front 3

structure coursing through the head/neck and upper limbs are associated with which triangle?

Back 3

posterior

Front 4

Know surface anatomy:
- hyoid bone
- cricoid cartilage
- thyroid cartilage
- thyroid membrane
- thyroid gland
- trachea

Back 4

Front 5

What are the 3 compartments of the neck?

Back 5

viseral
vertebral
vascular

Front 6

describe the viseral laminae of the neck.

Back 6

- thin layer of areolar connective tissue
-lies between dermis and skin
- contains platysma, cutaneous nerves (facial nerve, CN VII), blood vessles, lymphatic vessles
- contains varying amounts of fat
- continuous superficial facea elsewhere in the body

Front 7

Where is the external jugular vein found?

(know other superficial veins? - slide 21)?

Back 7

over the sternocleomastoid muscle

Front 8

Describe the deep cervicle faciae.

Back 8

- dense connective tissue deep to the superficial fasciae
- envelopes muscle, neurovascular structure, and certain vicera
- serves as partitions, compartmentalizes the neck
- clinical corralations - surgical cleavage plane and potential space (pathways for infections to spread)

Front 9

What are the 4 deep fasciae and where are the found?

Back 9

Investing layer:
- just deep to superficial fasciae - surrounds muscle

Prevertebral fasciae:
a) axillary sheath (around axillary vessels)
b)supraplural membrane ????

Pretracheal fasciae:
- lies anterior to the trachea

Carotid sheath:
- contains corrotid arteries, internal jugular, vegas nerve etc...

Front 10

The investing layer of the deep fasciae covers which 2 glands?

Back 10

submandibular and parotid

Front 11

Where are the points of attachment for the investing fasciae?

Superior?
Inferior?

Back 11

Superior:
- hyoid bone
- inferior margin of mandible
- zygomatic arch

Inferior:
- clavicle
- acromion
- spine of scapulae
- manubrium of sternum

Front 12

superiorly the submandibular fasciae attaches where?

Inferiorly where does it attach?

Back 12

The myohyoid bone and the inferior border of the mandible

The hyoid bone

Front 13

The submandibular node is found in which fasciae?

Back 13

the submandibular fasciae (part of investing layer)

Front 14

describe the 2 layer of the parotid fasciae (part of deep investing fasciae)

Back 14

superficial layer
- attaches to zygomatic arch superiorly
- continuous with fasciae covering SCM behind and the masseter in front

Deep parotid fasciae
- extends along medial surface of gland and attaches to the skull
- not as dense as superficial except for the Stylomandibular ligament

Front 15

What are the 2 divisions of the prevertebral membrane?

Back 15

the suprapleural membrane and the axillary sheath.

Front 16

axillary sheath (part of prevertebral division) surrounds what?

Back 16

axillary vessles and brachial plexus

Front 17

What does the carotid sheath contain?

Back 17

common corotid, internal jugular and vagus nerve

Front 18

The corotid fasciea is formed from what other fasciaes?

Back 18

the pretracheal, prevertebral, and the investing/superficial fasciea.

Front 19

the carotid sheath goes from where to where?

Back 19

base of skull to root of neck

Front 20

What is the posterior portion of the pretracheal fasciae called?

Back 20

buccopharangeal fasciae (just anterior to alar fasciae)

Front 21

What is the anterior portion of the prevertebral fasciae called?

Back 21

alar fasciae (just posterior to buccopharangeal fasciae)

Front 22

label the following fascial spaces:
Retroviseral
Retropharangeal
Danger Zone (space 4)
Prevertebral
Lateral pharangeal

Back 22

Front 23

The investing layer encompasses what?

Back 23

the entire neck and spits to surround SCM and trap. muscles

Front 24

Pretracheal layer encloses what?

Back 24

muscular portion incloses the infrahyoid muscle and the viseral portion encloses thyroid, larynx, trachea, pharynx and esophogus

Front 25

the prevertebral layer surrounds what?

Back 25

the cervical vertebral column and the associated muscles

Front 26

The corotid sheath incloses what?

Back 26

the common corotid, internal jugular and the vagus

Front 27

What are the borders of the anterior triangle?

Back 27

midline
inferior margin of mandible
anterior margin of SCM muscle

Front 28

What are the borders of the posterior triangle?

Back 28

Posterior margin of SCM
Anterior margin of trap
middle 1/3rd of clavicle

Front 29

What are the 4 minor triangles of the anterior triangle?

Back 29

muscular, submental, submandibular triangle, carotid.

Front 30

What are the minor triagles of the posterior triangle?

Back 30

supruclavicular (also called omoclavicular or subclavian) and occipital

Front 31

What are the muscles of the posterior triangle?

Back 31

-semispinalis capitus muscle
-splenus capitus
-levitator scapulae
-posterior, anterior and middle scalene muscle

Front 32

What is the major vein in the posterior triangle?

Back 32

external jugular

Front 33

What are the important arteries in the posterior triangle?

Back 33

First part of subclavian artery and its branches

Thyrocervical trunk
a) tranverse cervical artery
b) Suprascapular artery

Front 34

The superficial location of what nerve as it crosses the posterior triangle makes it suseptable to injury?

Back 34

Accesory nerve XI

Front 35

What is the hierarchy of peripheral nerves?

Back 35

Dorsal and ventral ramus form plexuses of the Cervical, brachial, lumbar and sacral which form peripheral nerves

Front 36

What makes up the cervical plexus?

Back 36

Anterior Rami of cervical nerves (C1-C4)

Front 37

What nerves make up the cervical plexus?

Back 37

Muscular (deep) branches:
- phrenic and sensory nerves
- Ansa cervicalis
- direct motor branches to the prevertebral and lateral vertebral muscles

Cutaneous (superficial branches)
- Lesser occiptial
- Greater Auricular
- Transverse cervical nerve
- Supraclavicular nerve

Front 38

What do the cutaneous branches of the cervical plexus arise from?

Back 38

Erb's point

Front 39

Brachial Plexus???

Back 39

???? slide 63

Front 40

How are the lymphatics in the neck arranged?

Back 40

Horizontal Superficial ring
Horizontal deep ring
Deep cervical (jugular) trunk
(SEE POWER POINT!!!) slides 65-71

Front 41

Why is the subclavian vein clinically important?


What other veins may be used for the same purposes?

Back 41

used for interveneous hyperalimentation, monitoring central venous pressure, obtaining central venous access and for chemotheropy, introducing intravenous pacemakers.

Internal jugular and chephalic veins

Front 42

Cervical rib and anterior scalene syndrome and hyperabduction are also preferentially called what?

Back 42

Thoracic outlet syndrome.

Front 43

in Cervical rib syndrome the anterior end of the cervical rib may articulate how?

Back 43

articulate with the sternum,
(2) articulate or fuse with the first rib,
(3) attach to the first rib by a fibrous band, or
(4) present a free end.

Front 44

What is anterior scalene syndrome?

Back 44

due to spasm or hypertrophy of anterior scalene muscle

Front 45

The symtoms of thoracic outlet syndrome are due to what?

Back 45

compression of the neurovascular
structures extending anywhere from the thoracic
outlet to the insertion of the pectoralis minor muscle.
They are characterized by neurological deficits and/or
vascular (arterial or venous) changes in the upper
extremity.

(also see handout)