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Neck
| Question | Answer |
|---|---|
| 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
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