Uthsc Gross Anatomy - Neck

Front 1

What are the boundaries of the neck?

Back 1

The superior boundary is the superior nuchal line of the cranium and the lower margin of the mandible; the inferior boundary is the jugular notch of the sternum, the clavicle, and the first rib. Also the tissue surrounding the 7 cervical vertebrae.

Front 2

What are the fascial compartments of the neck and what do they contain?

Back 2

Superficial fascia - surrounds the entire neck, contains platysma.
Deep fascia - separates the neck into compartments:
Superficial layer of deep fascia encloses trapezius and SCM.
Prevertebal layer encloses the vertebral column and surrounding muscles.
Pretracheal/visceral encloses cervical viscera, eg. thyroid, trachea.
Buccopharyngeal fascia is the posterior superior portion of pretracheal fascia.

Front 3

What is the "danger space" of the neck?

Back 3

The retropharyngeal space, which is a potential space anterior to the prevertebral fascia, but posterior to the buccopharyngeal fascia. Infections originating in the oral region can track into the pericardium.

Front 4

What the suprasternal space contain and where is it?

Back 4

Superior to the sternum; formed by a split in the investing fascia as it attaches to the manubrium. Contains the jugular arch.

Front 5

Where is the pretracheal space?

Back 5

Anterior to the thyroid cartilage and trachea, but posterior to the pretracheal fascia.

Front 6

Describe the attachments, actions, and innervation of the SCM.

Back 6

The sternocleidomastoid attaches superiorly to the mastoid process of the temporal bone and inferiorly to the manubrium of the sternum and the medial third of clavicle. It is innvervated by the spinal root of accessory nerve - C2 and C3. It flexes the neck to the ipsilateral side and turns the face to the opposite side. Also flexes the neck and draws the head forward.

Front 7

Describe the attachments, actions, and innervation of the platysma muscle.

Back 7

Attaches superiorly to the inferior border of the mandible and the skin of the lower face, and inferiorly to the fascia of the neck. It is innervated by the cervical branch of the facial nerve. It draws the corners of the mouth inferiorly and tenses the skin of the neck.

Front 8

What are the borders of the posterior triangle of the neck (lateral cervical region)?

Back 8

The trapezius muscle, the SCM, and the clavicle.

Front 9

What are the two triangles within the posterior triangle?

Back 9

The occipital triangle, which is larger and more superior, is bounded by the trapezius, the SCM, and the inferior belly of the omohyoid muscle. The floor is formed by the splenius capitis, the levator scapulae, and the scalene muscles. The inferior triangle is the supraclavicular triangle. Its boundaries are the inferior belly of the omohyoid, the clavicular head of the SCM, and the clavicle. The floor is formed by the anterior sclaene muscle.

Front 10

What are the boundaries of the anterior triangle?

Back 10

The inferior margin of the mandible, the SCM, and the anterior midline.

Front 11

What are the boundaries of the submandibular (digastric) triangle?

Back 11

The anterior belly of the digastric muscle, the posterior belly of the digastric, and the inferior margin of the mandible. The floor of the triangle is formed by the mylohyoid and hypoglossus muscles.

Front 12

What are the boundaries of the submental triangle?

Back 12

Unpaired area bounded by the anterior bellies of the left and right digastric and the hyoid bone. The floor is formed by the mylohyoid muscles.

Front 13

What are the boundaries of the carotid triangle?

Back 13

The posterior belly of the digastric, the SCM, and the superior belly of the omohyoid.

Front 14

What are the boundaries of the muscular triangle?

Back 14

The superior belly of the omohyoid, the SCM, and the midline from the sterm to the hyoid bone. The floor is formed by the infrahyoid muscles.

Front 15

What are the infrahyoid muscles?

Back 15

The sternohyoid, the sternothyroid, and the thyrohyoid.

Front 16

What is torticollis?

Back 16

A condition in which the head is flexed laterally to the affected side and rotated away from the affected side. Induced by persistent contraction or shortening of the SCM. Can be due to prenatal tumor or a neurological basis.

Front 17

What are the sensory nerves branching from the cervical plexus that appear in the posterior triangle?

Back 17

Lesser occipital (C2), Great auricular (C2-C3), Transverse cervical (C2-C3), supraclavicular (C3-C4).

Front 18

Describe the branches of the cervical plexus.

Back 18

Front 19

What major artery gives branches to supply the posterior triangle?

Back 19

The subclavian artery.

Front 20

What are the branches of the subclavian artery in the posterior triangle?

Back 20

The thyrocervical trunk, the transverse cervical artery, the suprascapular artery, the deep cervical artery, the costocervical trunk, and the occipital artery.

Front 21

What is a common variation on the branching of the transverse cervical artery from the thyrocervical trunk?

Back 21

The transverse cervical artery sometimes branches directly from the third division of the subclavian artery, and is then known as the dorsal scapular artery.

Front 22

Describe the locations of the branches of the subclavian artery in the posterior triangle.

Back 22

Front 23

Name some tributaries to the external jugular vein.

Back 23

Posterior auricular, retromandibular, transverse cervical, suprascapular, and anterior jugular vein.

Front 24

What is clinically significant about the external jugular vein?

Back 24

When venous pressure rises, the vein may be visible along its entire course, which could indicate heart failure, obstruction of the superior vena cava, enlarged supraclavicular lymph nodes, or a general increase in intrathoracic pressure. It is also frequently used to introduce catheters. The needle is inserted inferior to the clavicle and moved medially along the posterior surface until the wall of the vessel is penetrated.

Front 25

Describe the details of the sternohyoid muscle.

Back 25

It is is one of the superficial infrahyoid (strap) muscles. It attaches to the manubrium of the sternum and inserts on the body of the hyoid bone. It is innervated by the ansa cervicalis and helps to depress/stabilize the hyoid.

Front 26

Descibe the details of the omohyoid muscle.

Back 26

It is a superficial infrahyoid muscle. Its origin is the superior border of the scapula and its insertion is the inferior border of the hyoid bone. It has a superior and an inferior belly, and it is innervated by the ansa cervicalis. Depresses/stabilizes the hyoid.

Front 27

Describe the details of the sternothyroid muscle.

Back 27

It is one of the deep infrahyoid muscles and its origin is the manubrium of the sternum and its origin is the oblique line of thyroid cartilage. Its innervated by the ansa cervicalis and it depresses/stabilizes the hyoid.

Front 28

Describe the details of the thyrohyoid muscle.

Back 28

It is one of the deep infrahyoid muscles. Its origin is the oblique line of thyroid cartilage, and its insertion is the hyoid bone. It is innervated by C1 and serves to depress/stabilize the hyoid.

Front 29

What is the origin of the pyramidal lobe of the thyroid gland?

Back 29

Thyroid tissue arising from the vestige of the thyroglossal duct.

Front 30

What is the origin of the thyroid gland?

Back 30

It originates at the base of the tongue at the foramen cecum and descense anteriorly to the hyoid bone and trachea along the thyroglossal duct.

Front 31

What is the safest location for the insertion of a breathing tube?

Back 31

Inferior to the cricoid cartilage (to protect the laryngeal apparatus) and superior to the thyroid isthmus (to protect thyroid venous drainage or the artery). The trachea is usually incised at the level of the upper tracheal rings and is called a tracheostomy.

Front 32

What is a cricothyrotomy?

Back 32

An incision through the cricothyroid membrane, which is superficial and not highly vascularized. An emergency procedure to create an airway that may cause damage to the vocal folds.

Front 33

What is the carotid sheath?

Back 33

It is formed by the condensation of all three deep fascia layers and encloses the common (and/or internal) carotid artery, internal jugular vein, and the vagus nerve.

Front 34

What is the cervical plexus?

Back 34

It is formed by the anterior rami of cervical nerves C1-C4 and has both muscular and cutaneous branches.

Front 35

What are the muscular branches of the cervical plexus?

Back 35

The ansa cervicalis (C1-C3), branches of which innervate the infrahyoid muscles, and the phrenic nerve (C3-C5) which innervates the diaphragm.

Front 36

What are the main arteries of the head and neck?

Back 36

The common carotid artery and its two terminal branches, the external carotid artery and the internal carotid artery.

Front 37

What are the branches of the external carotid artery?

Back 37

Front 38

Describe the fascial compartments of the neck.

Back 38

Front 39

What are the branches of the internal carotid artery in the neck?

Back 39

There are none -- it enters the cranial cavity to supply the brain.

Front 40

What are the anterior branches of the external carotid artery (from inferior to superior)?

Back 40

The superior thyroid artery, the lingual artery, and the facial artery.

Front 41

What are the posterior branches of the external carotid artery (from inferior to superior)?

Back 41

The occipital artery and the posterior auricular artery.

Front 42

What is the medial branch of the external carotid artery?

Back 42

Ascending pharyngeal artery

Front 43

What are the terminal branches of the external carotid artery?

Back 43

The superifical temporal and the maxillary artery.

Front 44

Where are the carotid sinus and carotid body located and what is their function?

Back 44

They are located at the bifurcation of the common carotid artery. The carotid sinus is a dilation of the beginning of the internal carotid artery and the ending of the common carotid artery. It is a baroreceptor. The carotid body is a small tissue mass which is suspended on the posterior surface of the bifurcation and acts as a chemoreceptor. Both are innervated by branches of CN X and CN IX.

Front 45

What structures can be found in the submandibular triange?

Back 45

The submandibular gland, the submandibular lymph nodes, the facial artery and vein, the mylohyoid muscle, and the hypoglossal and mylohyoid nerves.

Front 46

What are the suprahyoid muscles?

Back 46

The stylohyoid, digastric, mylohyoid and geniohyoid.

Front 47

Describe the stylohyoid muscle.

Back 47

Its origin is the styloid process of the temporal bone and its insertion is the body of the hyoid bone. It is innervated by the cervical branch of CN VII and it elevates/stabilizes the hyoid bone and depresses mandible/opens mouth.

Front 48

Describe the digastric muscle.

Back 48

Has two bellies: anterior and posterior. The origin of the anterior belly is the digastric fossa of the mandible, and the origin of the posterior belly is the mastoid notch of the temporal bone. Their insertion is the intermediate tendon between the two bellies to the body of the hyoid bone. The anterior is innervated by the mylohyoid nerve, and the posterior is innervated by CN VII. It elevates/stabilizes the hyoid and depresses the mandible to open the mouth.

Front 49

Describe the mylohyoid muscle.

Back 49

It is one of the suprahyoid muscles and has its origin on the mylohyoid line of the mandible and its attachment on the body of the hyoid bone and Raphe. Its innervated by the mylohyoid nerve. Elevates/stabilizes the hyoid and depresses the mandible to open the mouth.

Front 50

Describe the geniohyoid muscle.

Back 50

It is a suprahyoid muscle which has its origin on the inferior mental spine of the mandible and inserts on the body of the hyoid. Innervated by C1. Elevates/stabilizes hyoid and depresses mandible to open mouth.

Front 51

What parts of the lung project into the root of the neck?

Back 51

The apex of the lung and the cupola of the pleura.

Front 52

What are the boundaries of the triangle of the vertebral artery?

Back 52

The anterior scalene muscle, the longus colli muscle and the first part of the subclavian artery. Located in the root of the neck.

Front 53

What are the boundaries of the interscalene triangle?

Back 53

It lies between the anterior and middle scalene muscles. The first rib forms its inferior boundary. The root of the brachial plexus and subclavian artery pass through this triangle.

Front 54

What are the three main branches of the thyrocervical trunk and where does it originate from?

Back 54

The inferior thyroid, the transverse cervical and the suprascapular arteries. It originates from the first part of the subclavian artery.

Front 55

What are the branches of the first part of the subclavian artery and where is it located?

Back 55

The first part of the subclavian artery is from the origin of the arter to the medial border of the anterior scalene muscle. The vertebral artery, the thyrocervical trunk, and the internal thoracic artery branch from this.

Front 56

Where does the costocervical trunk arise from and what does it give rise to?

Back 56

The costocervical trunk arises from the second or third part of the subclavian artery and gives rise to the deep cervical artery, which ascends through the neck, and the superior intercostal artery, which descends into the thorax.

Front 57

Where does the thoracic duct empty into?

Back 57

The thoracic duct empties into the union (venous angle) between the left internal jugular and left subclavian veins.

Front 58

The carotid sheath is a landmark for which nerves?

Back 58

The vagus nerve, within the sheath, the ansa cervicalis, which is on the anterolateral surface of the sheath, the cervical plexus and brachial plexus, which are posterolateral to the sheath, the sympathetic trunk, which is posteromedial to the sheath, and the superior and recurrent laryngeal nerves, which is medial to the sheath.