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platysma is a muscle of facial expression as it is derived of the 2nd pharyngeal arch
the platysma is innervated by CN VII facial nerve; it's the nerve of the 2nd arch
platysma action? moves lower lip and corners of mouth down; tense skin of inferior face and neck
what muscle eliminates skin sagging and double-chin of non congenital etiology? platysma muscle
The investing layer of the neck contains 3 (technically 4) compartments prevertebral fascia, pretracheal fascia, carotid sheath (2)
the investing layer surrounds the what type of fascia? deep cervical fascia
what prevents the spread of infection in the neck? investing layer of deep fascia of the neck
where would neck infection between the deep fascia and the pretracheal fascia stop? what condition could it cause? manubrium, mediastinitis (affect anterior mediatstinum)
hyoid bone located at what cervical vertebrae level? C3 level
thyroid cartilage located at what cervical vertebrae level? C4-5 level
cricoid cartilage located at what cervical vertebrae level? C6 level
unilateral contraction of the SCM will rotate head contralateral/ipsilateral contralateral side
bilateral contraction of the SCM will cause what? helps you in what condition? draw head forward; helps in forced respiration like in COPD patients
motor component of SCM is innervated by which nerve? XI
proprioceptive fibers of SCM is innervated by what? anterior ramus of C2
what is spasmodic torticollis? adult-onset lesion of the SCM when you wake up and can't move your neck! off and on
what is the SCM lesion condition called in a newborn/kid? congenital torticollis (wry neck)
borders of the posterior triangle of the neck? anterior: SCM, posterior: trapezius, inferior: middle 1/3 of clavicle
inferior belly of the omohyoid muscle divides which two triangles? occipital triangle and omoclavicular/subclavian triangle
what is the roof and floor of the posterior triangle? investing layer of deep cervical fascia; prevertebral fascia
prevetebral fascia covers what muscles above? splenius capitis and levator scapulae muscles
prevertebral fascia covers what muscles below? anterior, middle, and posterior scalenes below
what are the contents of the posterior triangle? external jugular vein, cutaneous nerves (lesser occipital, great auricular, transverse cervical, supraclavicular nerves)
what could an infection posterior to prevertebral layer of deep cervical fascia cause? a swelling deep to SCM. Perforation may cause retropharyngeal abscess with dysphagia & dysarthria
dysphagia and dysarthria may be caused by an infection where? posterior to prevertebral layer of deep cervical fascia
Rupture esophagus, trachea or bronchus may cause pneumomedia-stinum
axillary vein becomes -> subclavian vein -> passes anterior/posterior to anterior scalene muscle to join the _____________ vein to form the _______ vein axillary vein becomes -> subclavian vein -> passes anterior to anterior scalene muscle to join the _internal jugular vein____________ vein to form the _____brachiocephalic_____vein
what vein is used for central line access to the heart? subclavian vein
what vein is used for renal dialysis? subclavian vein
how can the subclavian vein be accessed? below or above the clavicle
where does the subclavian artery lie? between lateral border of anterior scalene and lateral border of 1st rib
what artery can you compress in a case of bleeding from the upper limb when the cause is unknown? subclavian artery; its compression against 1st rib
branch of thyrocervical trunk of 1st part of subclavian artery? transverse cervical artery
transverse cervical artery branches into superficial branch that is superficial to what muscle? trapezius
transverse cervical artery branches into superficial branch that is deep to what musclse? levator scapulae and rhomboid muscles
deep branch of the transverse cervical might be absent and replaced by what artery? DSN from 3rd part of subclavian artery
brachial plexus emerges from between what muscles? anterior and middle scalene muscles
brachial plexus passes through ____ canal to reach axillary region brachial plexus passes through _cervicoaxillary___ canal to reach axillary region
cervical plexus is which spinal nerves? C1-4
lesser occipital nerve? C2
great auricular nerve? C2,3
transverse cervical nerve? supplies what? C2,3, skin of triangle
supraclavicular nerves? supplies what? C3,4, skin of upper chest
ansa cervicalis is formed from what? supplies hwat? C1 and C2/3; strap muscles EXCEPT thyrohyoid muscle
what innervates the strap muscles except for the thyrohyoid muscle? ansa cervicalis
you perform a _______ before a carotid endarterectomy & neck surgery (e.g. lymph node removal) cervical plexus blockade of C2-C4
where would you inject for a cervical plexus blockade? junction of upper and middle 1/3 of posterior border of SCM
phrenic nerve (C3-5) descends along anterior surface of ___ muscle anterior scalene
suprascapular artery supplies? accompanies suprascapular nerve and supplies supraspinatus and infraspinatus m.
long thoracic nerve? supplies what? C5-7, serratus anterior
DSN pierces ____ m. to supply which muscles? C5; pierces middle scalene to supply rhomboids and levator scapulae
anterior cervical triangle boundaries? anterior border of SCM, midline of neck, inferior border of mandible, manubrium sterni
muscular triangle of neck boundaries? neck midline, SCM, superior belly of omohyoid
carotid triangle of neck boundaries? superior belly of omohyoid, posterior belly of digastric, SCM
submandibular triangle of neck boundaries? between digastric bellies and base of mandible
submental triangle of neck boundaries? between 2 anterior bellies of digastric muscle & hyoid bone
anterior jugular veins drain to __ and then each drains to ____, which may drain to ___ which is located along ant border of SCM jugular venous arch, external jugular vein, large communicating vein
the muscular triangle contains infrahyoid muscles and thyroid/parathyroid glands
infrahyoid muscles aka strap muscles superifical layer muscles are: sternohyoid, omohyoid muscle
deep layer of the infrahyoid muscles are: thyrohyoid, sternothyroid
deep to sternohyoid/sternothyroid is sternohyoid/sternothyroid deep to sternohyoid is sternothyroid
what artery supplies the thyroid gland superiorly? superior thyroid artery of the external carotid
what artery supplies the thyroid gland inferiorly? inferior thyroid artery of the thyrocervical trunk
thyroid gland is posterior to? common carotid artery, internal jugular v, vagus and recurrent laryngeal nerves
venous drainage of the thyroid gland goes through which veins? superior, middle and inferior thyroid veins?
what artery of the thyroid artery is only present in 10% of people? thyroid ima artery
what artery is responsible for voice changes? recurrent laryngeal nerve position variations in relation to inferior thyroid artery
position variation of thyroid gland? pyramidal lobe: frequently extends superiorly from the isthmus
what can cause a congenital abnormality causing ectopic thyroid tissue? when a fibrous tissue string won't pull all of the thyroid down to the trachea, so parts remain on the tongue; or the string forms a duct and connects to neck and you have a cyst on the neck
thyroid gland is located posteromedially to? trachea and esophagus
goiter can cause dyspnea and/or dysphagia by compressing__ trachea or esophagus
what is a retrosternal goiter?
what's the lowest the goiter can descend? superior: hyoid bone and inferiorly descends behind the sternum and into the chest
where are the parathyroid glands located? posterior to thyroid gland on superior and inferior poles of posterior surface of thyroid gland
how many structures of parathyroid glands exist? usally 4 (sometimes 2-8)
parathyroid gland supplied by what artery? inferior thyroid arteries
during development the parathyroid glands are derived from 3rd and 4th _____ pharyngeal arches
what are the contents (vessels) of the carotid triangle? internal jugular vein, common carotid artery (and its branches external carotid and internal carotid), branches of external carotid, deep cervical lymph nodes
what are the contents (nerves) of the carotid triangle? X,XI, XII, cervical branch of VII, ansa cervicalis
right CCA arises from ____ while the left CCA arises from ___ brachiocephalic trunk, directly from the aorta
the carotid sheath compartment contains CCA (and then ECA) with the internal jugular v. and the vagus n.
name 2 specialized organs located at the CCA bifurcation carotid sinus and carotid body
carotid sinus is located where? dilated proximal part of ICA (& often terminal part of CCA)
carotid sinus function? reflexly controls BP (baroreceptors) via afferent CN IX (carotid sinus artery) & CN X (efferent)
carotid body located where? medial deep part of CCA bifurcation
carotid body function? controls blood gases (chemoreceptor) via CN IX (afferent) nad X (efferent)
in some individuals ____ may become hypersensitive to external pressure, resulting in fainting carotid sinus
the ___ is routinely used to measure blood pressure and easily palpated deep to anterior border of SCM at level of superior border of thyroid cartilage carotid sinus
each CCA divides into internal and external carotid arteries near ____ upper border of thyroid cartilage
the internal/external carotid artery has no branches in the neck internal
this artery is a frequent site of atherosclerotic plaques that might lead to TIA and stroke internal carotid artery
this artery supplies the cerebral hemispheres and structures within orbit internal carotid artery
these 5 branches of the ECA are contained within the carotid triangle superior thyroid, lingual artery, facial artery, ascending pharyngeal, occipital artery
these 2 branches of the ECA are found outside of the carotid triangle posterior auricular a, superficial temporal a.
another name for Chassaingac's tubercle? carotid tubercle
why is Chassaingac's tubercle important? the CCA may be compressed against it to control bleeding from the branches of carotid artery
where is Chassaingac's/carotid tubercle located? on the transverse process of C6
what is the largest vein of the head and neck? internal jugular v
the sigmoid sinus, a dural venous sinus will drain into ____ internal jugular v
the internal jugular v drains within the carotid sheath lateral/medial to the carotid artery lateral
this v has 2 dilatations: superior and inferior bulbs internal jugular v
IJV may distend if venous return to the RA/LA/RV/LV of the heart is obstructed like in tension pneumothorax, cardiac tamponade, or superior vena cava syndrome & heart failure RA=right atrium
IJV: ___ and ___ measurement may provide info about heart activity as it reflects waves coming from valveless brachiocephalic and IVC height and pulsation
this v provides info about heart activity IJV
you insert a central venous cathether to access the heart through which vein? IJV
the___ are located along IJV and drain all lymph of head and neck deep cervical lymph nodes
2 groups of deep cervical lymph nodes upper/superior deep cervical nodes and lower/inferior deep cervical nodes
in relation to the carotid arteries and IJV's, the vagus nerve descends how within the carotid sheath? between and behind
ansa cervicalis supplies? infrahyoid muscles except thyrohyoid
borders of the submandibular triangle? the floor? 2 bellies of the digastric muscle, inferior border of mandible; floor is mylohyoid muscle
submandibular triangle contains.............. submandibular salivary and lymph glands, hypoglossal and mylohyoid nerves, facial and submental arteries and veins
submandibular gland is innervated by CN__ that gives secretomotor pre/postganglionic parasympathetic/sympathetic fibers from cell bodies in the submandibular ganglion CN VII, postganglionic parasympathetic
borders of the submental triangle? floor? 2 anterior bellies of the digastric muscle; floor is made of mylohyoids that fuse in midline fibrous raphe that form floor of oral cavity
submental triangle contents submental lymph nodes and veins
anterior belly of digastric muscle supplied by CN __? V
posterior belly of digastric muscle supplied by CN __? VII
both bellies of the digastric muscle insert in an _____ tendon that attaches by a sling to ____ intermediate tendon, hyoid bone
both bellies of the diagstric muscle elevate____ and depress___ hyoid, mandible
stylohyoid muscle runs parallel to ____ and is supplied by CN___ posterior belly of digastric muscle, CN VII
stylohyoid muscle action? draws hyoid bone upward and backward
boundaries of the root of the neck? body of 1st thoracic vertebra (posteriorly), manubrium sterni (anteriorly), 1st pair of ribs & costal cartilages (laterally)
this artery passes posterior to the anterior scalene m. subclavian artery
subclavian artery is divided into 3 parts by the ___ muscle anterior scalene muscle
these 3 branches are found in the 1st part of the subclavian artery vertebral artery, internal thoracic artery, thyrocervical trunk
this artery runs in transverse foramena of Cv6-Cv1 vertebral artery
4 branches of the thyrocervical trunk are inferior thyroid a (gives rise to ascending cervical artery); transverse cervical a., suprascapular artery. http://en.wikipedia.org/wiki/File:Thyrocervical_trunk.png
2nd part of the subclavian artery branches into... which gives rise to ____ costocervical trunk that branches to deep cervical artery and superior intercostal artery
3rd part of the subclavian artery MAY branch to dorsal scapular artery that replaces the deep branch of the transverse cervical artery
thoracic duct passes anterior/posterior/inferior/superior to structures of the left carotid sheath posterior
the L thoracic duct loops anteriorly & inferiorly to join the junction of____ left internal jugular v. and left subclavian v.
the left venous angle is made of left internal jugular v. and left subclavian v.
R lymphatic duct drains into the ___ which is formed by the union of the R internal jugular v., R subclavian v., and perhaps the _____ R venous angle; bronchomediastinal lymphatic trunks
inferior cervical aka stellate (cervicothoracic) sympathetic ganglion are formed from the fusion of ganglia of ______ 7th and 8th cervical spinal nerves
what forms the stellate ganglion? fusion of inferior cervical ganglion and 1st thoracic spinal nerve ganglion
another name for inferior cervical ganglia is cervicothoracic sympathetic ganglion
inferior cervical ganglia location? anterior to the neck of 1st rib and transverse process of C7, posteromedial to vertebral artery, but lateral to vertebral body
how is the stellate ganglion blockade accessed? anterior approach at C6 spine level about 2mm above the Chassaignac tubercle
when is a stellate ganglion blockade performed? acute and complex pain of head, neck and upper extremities due to herpes zoster, Regional Pain syndrome & cancer pain; vascular diseases of upper extremities
what may be performed if a pt has Regional Pain syndrome? stellate ganglion blockade
what may be perofrmed in a pt that has pain due to herpes zoster? stellate ganglion blockade
what may be performed if a pt has vascular diseases of upper extremities? stellate ganglion blockade
a pancoast tumor is located where? apical portion of the lung
what is Horner's syndrome? damage to the cervical sympathetic trunk from pancoast tumour
pancoast tumour damages neck structures such as............ lower roots of brachial plexus, cervical sympathetic trunk, phrenic and/or recurrent laryngeal nerve
Horner's syndrome symptoms are: (not on slide.......) ptosis, myosis, Anhydrosis, and rubeosis
Created by: adriennemar