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