Term
| What structures lie in the median (midline) region of the neck? |
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Definition
•The following structures lie in the anterior median (midline) region of the neck •Symphysis menti •Mylohoid muscle & mylohyoid raphe •Anterior bellies of digastric muscles •Submental lymph nodes •Anterior jugular veins •Hyoid bone •Thyrohyoid membrane •Thyroid cartilage •Cricothyroid ligament •Cricothyroid muscle •Cricoid cartilage •Tracheal rings •Isthmus of thyroid gland •Space of Burns (suprasternal space) |
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Term
At what level is the hyoid bone located?
A
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Definition
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Term
| Where is thyroid cartilage located? |
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Definition
•Thyroid cartilage (C4 & C5 level) •Note: the upper border lies at the intervertebral disc between C3 & C4 –The common carotid artery bifurcates into the internal and external carotid arteries at this level |
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Term
| Where do you find the cricoid cartilage? |
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Definition
•Cricoid cartilage (C6 level), Trachea & esophagus begin here |
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Term
| Where is the upper border of the thyroid cartilage? |
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Definition
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Term
| Where is the angle of the thyroid cartilage located? |
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Definition
| At the level of Adam's apple (C4) |
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Term
| Where is the isthmus of the thyroid gland located? |
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Definition
•Isthmus of Thyroid gland (in front of 2, 3 & 4th tracheal rings) –Trachea begins at C6 |
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Term
| What is C6 and important landmark of? |
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Definition
•C6 – events: Cricoid cartilage lies –Trachea begins –Esophagus begins –Middle cervical sympathetic ganglion –Vertebral artery enters foramen transversarium of C6 –Inferior thyroid artery changes its course –Carotid tubercle on transverse process of C6 vertebra (contributions are C5, C6) –Upper trunk of brachial plexus –Jugulo-omohyoid lymph node |
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Term
| Where does the posterior triangle of the neck lie? |
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Definition
| It lies posterior to the sternocleidomastoid muscle and on the side of the neck |
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Term
| What is the anterior boundary of the posterior triangle of the neck? |
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Definition
| It is formed by the posterior border of the sternocleidomastoid muscle |
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Term
| What is the posterior boundary of the posterior triangle of the neck? |
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Definition
| The anterior border of the trapezius muscle |
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Term
| What structures make up the apex of the posterior triangle of the neck? |
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Definition
| The apex is formed at the point at which the trapezius and sternocleidomastoid muscles meet |
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Term
| What forms the base of the posterior triangle of the neck? |
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Definition
| The middle 1/3 of the clavicle |
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Term
| What forms the roof of the posterior triangle of the neck? |
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Definition
| Skin, superficial fascia, platysma and investing cervical fascia of neck |
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Term
| What forms the floor of the posterior triangle of the neck? |
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Definition
Superiorly to inferiorly: Splenius Capitus Levator scapulae Scalenus medius (Above 3 are covered by preverterbral fascia) 1st rib 1st digitation of serratus anterior |
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Term
| Where is the nerve point of the neck (punctum nervosum, Erb's point) located? |
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Definition
| At the junction of the upper 1/3 with the lower 2/3 of the posterior part of the SCM |
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Term
| What nerves emerge at the nerve point of the neck? |
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Definition
Accessory nerve Lesser Occipital nerve Sensory branches of C3 and C4 Greater auricular nerve Transverse cutaneous nerve of neck Supraclavicular nerves |
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Term
| What are the subdivisions of the posterior triangle of the neck? |
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Definition
| The posterior triangle of the neck is crossed at its lower region by the inferior belly of the omohyoid muscle which divides into the larger occipital triangle and the supraclavicular triange. |
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Term
| What is the only true content of the posterior triangle (i.e. what lies between the roof, the investing cervical fascia and the prevertebral fascia)? |
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Definition
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Term
| What nerves are present in the posterior triangle of the neck? |
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Definition
•spinal part of accessory nerve •it is accompanied by the sensory branches from the roots of C3 and C4 •Great auricular nerve •Lesser occipital nerve •Transverse cervical nerve (transverse cutaneous nerve of neck) •Supraclavicular nerves •Trunks of the brachial plexus •Nerve to serratus anterior •Dorsal scapular nerve •Suprascapular nerve •Nerve to subclavius |
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Term
| What arteries are present in the posterior triangle of the neck? |
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Definition
–Third part of the subclavian artery –Suprascapular artery –Transverse cervical artery –Occipital artery |
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Term
| What are the veins of the posterior triangle of the neck? |
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Definition
External jugular veins and its 3 tributaries: suprascapular vein, anterior jugular vein, transverse cervical vein Subclavian vein |
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Term
| What is the muscle of the posterior triangle of neck? |
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Definition
| Inferior belly of the omohyoid muscle |
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Term
•What are the lymph nodes of the posterior triangle? |
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Definition
• 5. Lymph nodes of the posterior triangle: •Lymph nodes are situated along the external jugular vein. These are called the superficial cervical lymph nodes. These nodes extend laterally along the spinal part of the accessory nerve. These nodes might get matted in tuberculosis or enlarged and malignant in cancer. In such case when nodes are being removed, a great care has to be exercised to retain the accessory nerve. |
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Term
•What is the greater supraclavicular fossa? |
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Definition
•The depression over the supraclavicular triangle is called the greater supraclavicular fossa. |
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Term
How do you control major bleeding in the upper limb? |
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Definition
•The third part of the subclavian artery can be compressed against the first rib in the greater supraclavicular fossa. This is the way the bleeding is controlled when a major vessel bleeds in the upper limb. |
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Term
What is cervical plexus block? |
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Definition
•Cervical plexus block: For regional anesthesia along the posterior border of sternocleidomastoid at the junction of upper & middle third |
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Term
•What is the supraclavicular brachial plexus block? |
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Definition
Supraclavicular brachial plexus block: superior to the midpoint of the clavicle. |
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Term
•Where can a central line be placed? |
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Definition
•Subclavian vein puncture for central line placement –(parenteral fluids & medications) |
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Term
•What happens in lesion of the accessory nerve? |
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Definition
•Lesion of Accessory nerve in the posterior triangle: drooping of the shoulder and inability to elevate and retract the shoulder and abduction above 90º |
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Term
•How is the external jugular vein formed? |
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Definition
•It is formed by the union of the posterior division of the retromandibular vein with the posterior auricular vein. |
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Term
| What are the triburies of the subclavian vein? |
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Definition
| The subclavian vein has only one tributary: the external jugular vein |
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Term
•What is the anterior triangle and what are its boundaries? |
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Definition
•The Anterior Triangle •It lies in front of the SCM (sternocleidomastoid) •Its boundaries are: •Anterior: the midline of the neck •Posterior: the anterior border of the SCM •Base: superiorly - by the base of the mandible and line drawn from the angle of mandible to mastoid process •Apex: is directed downwards towards the manubrium sterni |
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Term
•What smaller triangle comprise the anterior triangle? |
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Definition
•It is divided into the following triangles: •The submental triangle: Only half of this triangle is included in the corresponding anterior triangle •The digastric triangle: this is also called as the submandibular triangle •The carotid triangle: (Where carotid arteries and internal jugular vein lie) •The muscular triangle: (Mainly formed by the muscles and thyroid gland lies in this triangle) |
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Term
•What are the boundaries of the submental triangle? |
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Definition
•The submental triangle (suprahyoid): •The boundaries: •Base is formed by the hyoid bone •Apex is formed by the symphysis menti •On either side it is bounded by the anterior bellies of digastric muscles •Roof is formed by the following: •The skin •Superficial fascia •Investing layer of deep cervical fascia •Floor is formed by the mylohyoid muscle |
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Term
•What are the contents of the submental triangle? |
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Definition
Contents: commencement of the anterior jugular veins and submental lymph nodes |
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Term
•What are the boundaries of the digastric triangle? |
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Definition
•The digastric triangle: •It is also called “submandibular triangle” •Boundaries: •Base is superior. It is formed by the lower border of the mandible and line drawn from it to the mastoid process •Anteroinferiorly it is bounded by the anterior belly of digastric •Posteroinferiorly it is bounded by the posterior belly of digastric and stylohyoid muscle •Apex is formed by the intermediate tendon of digastric muscle at the hyoid bone •Roof is formed by the following: •Skin •Superficial fascia •Platysma •Cervical and Marginal mandibular branches of facial nerve •Superficial group of submandibular lymph nodes •Investing layer of deep cervical fascia •Floor of the triangle is formed by: •Mylohyoid muscle •Hyoglossus muscle •Middle constrictor muscle of the pharynx |
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Term
| What forms the roof of the digastric triangle? |
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Definition
•Skin •Superficial fascia •Platysma •Cervical and Marginal mandibular branches of facial nerve •Superficial group of submandibular lymph nodes •Investing layer of deep cervical fascia |
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Term
| What forms the floor of the digastric triangle? |
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Definition
•Mylohyoid muscle •Hyoglossus muscle •Middle constrictor muscle of the pharynx |
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Term
•What are the contents of the digastric triangle? |
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Definition
•Contents of the triangle are: •Facial vein •Submandibular gland •Deep group of submandibular lymph nodes •Facial artery •(Note: the Facial artery deeply grooves the posterior border of the submandibular gland and later lies between the gland and mandible before it winds around the lower border of the body of the mandible. Facial vein lies superficial to the submandibular gland) •Submental vessels •Nerve to mylohyoid •Mylohyoid vessels •Hypoglossal nerve •Veins accompanying hypoglossal nerve |
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Term
•What are the boundaries of the carotid triangle? |
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Definition
•The boundaries are: •Anterosuperior: the posterior belly of digastric and stylohyoid muscles •Anteroinferior: superior belly of omohyoid •Posteroinferior: the anterior border of the lower part of the SCM •Roof is formed by: •The skin •Superficial fascia •Platysma •Transverse cervical nerve (Transverse cutaneous nerve of neck) •Investing layer of cervical fascia •Floor is formed by: •Thyrohyoid muscle (anterior) •Hyoglossus •Middle constrictor of pharynx (posterior) |
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Term
•What are the contents of the carotid triangle? |
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Definition
•Contents: •Carotid sheath •Common carotid artery divides at the level of the upper border of the thyroid cartilage (disc between C3 & C4 vertebrae) into external and internal carotid arteries. •Internal jugular vein with its tributaries lies in this triangle. •Vagus nerve •Pharyngeal branches of vagus •Superior laryngeal branch of vagus which divides into internal and external laryngeal nerves •Accessory nerve •Hypoglossal nerve •Ansa cervicalis •Common facial vein •Cervical part of the sympathetic trunk- lies behind the carotid sheath •Deep cervical lymph nodes- lie along the carotid sheath •Internal carotid artery •External carotid artery and 5 out of its 8 branches- •Ascending pharyngeal artery (arises on the medial side) •Superior thyroid artery {from the front of the artery & runs down with the external laryngeal N) •Lingual artery (arise from the front of the artery) •Facial artery (from the front of the artery) •Occipital artery arises from the posterior aspect of the artery and runs along the lower border of the posterior belly of digastric muscle |
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Term
•What are the boundaries of the muscular triangle? |
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Definition
•Muscular triangle: •Posterosuperior: sup. Belly of omohyoid •Posteroinferior: sternocleidomastoid •Anterior: midline of neck •Roof: skin, S,F, investing layer of deep cervical fascia •Floor: sternohyoid and sternothyroid muscles and deep to them, thyroid gland covered by pretracheal fascia |
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Term
| What are the tributaries of the external jugular vein? |
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Definition
SAT: Suprascapular vein Anterior jugular vein Transverse cervical vien |
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