Term
|
Definition
O: 1.Tendinous head of sternum
2.Muscular head at clavicle
I: Mastoid process
N:Motor- Accessory Nerve (CNXI)
Sensory/Proprioception-C2 fibers
F: Very powerful flexor of Neck, and Lateral flexion and rotation to the opposite side |
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Term
What causes Torticollis?
What is Wry Neck? |
|
Definition
1. damage occurs when forceps were used to extract the child at the level of the SCM
2. Spasms in the SCM; head is somewhat flexed laterally and rotated to the opposite side |
|
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Term
| How is a central line administered? |
|
Definition
-placed into the Internal Jugular Vein (IJV) or Subclavian Vein
-SCM is a landmark fo rthe IJV b/c it lies directly superficial to the vein.
1. Have person lying down
2. Follow the medial border of the clavicular head of the SCM
3. Aim the needle down towards the nipple inserting needle directly into the IJV |
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Term
|
Definition
O: Scapula
I: Hyoid bone
-2 bellies: Inferior (in posterior triangle, runs from scapula to clavicle)
Superior (runs from clavicle to hyoid bone)
N: Ansa Cervicalis- loop of fibers from the Cervical plexus (C1-3)
F: Depress Hyoid bone and hold it in place (steadying), this action aids in swallowing |
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Term
| What are the borders in the Occipital triange? What structures can be found here? |
|
Definition
Anterior border: SCM
Inferior border: Inferior belly of Omohyoid
Posterior border: Trapezius
1. Subclavian Artery and Vein
2. The Brachial Plexus |
|
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Term
| what are the Boundries of the Posterior Triangle? |
|
Definition
Anterior: SCM
Inferior: Clavicle
Posterior: Trapezius |
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Term
|
Definition
-Found in the superficial fascia of the neck, fibers begin laterally and travel medially and insert onto the muscle fibers arund the lower lip)
-Considered a muscle of Facial Expression
-Derived from the 2nd Pharyngeal Arch
-N: Motor- Facial Nerve (CNVII)
Sensory (cutaneous)- All branches of Cervical Plexus (ventral rami of spinal nerve (C2-4) |
|
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Term
| What nerves are found at the posterior border of the SCM? |
|
Definition
1. Lesser Occipital Nerve: most superior of these nerves, comes from the posterior border of the SCM and up over the SCM
-Provides sensory innervarion in hat area just behind the ear
2. Great Auricular Nerve: comes across the SCM superficially to arrive at the area just behind the ear
-comes from loop of fibers b/t C2-3
3. Transverse Cervical (transverse Colli): cross the SCM superfically and provide sensory innervation at the Anterior triangle
-Comes from a loop of fibers b/t C2-3
4. Supraclavicular Nerve: Come out of the posterior triangle above the clavicle
-3: medial, intermediate, and lateral |
|
|
Term
| What are the Superficial Veins in the Superficial fascia? |
|
Definition
1. Posterior Auricular Vein- drains area just behind the ear
2. Retromandibular Vein- drains area from the posterior part of the jaw
3. External Jugular Vein- where both PAV and RV join; drain down thru posterior triangle
4. Subclavian Vein- where EJV drains into |
|
|
Term
| What is the Clinical relevance of the EJV? |
|
Definition
-indication of poor cardiac output
-blood flowing from heart is "stalling" and it backs up into the venous system
-patient holds breath, delineation of the EJV, also notice PULSATIONS in the VEIN |
|
|
Term
| What are the 4 Diff. Layers of Fascia? |
|
Definition
1. Investing Layer: Wraps around everything, attached to spinous processes, invests into trapezius, forms roof of the Posterior Triange, invests SCM.
2. Prevertebral Layer: Encircles the vertebral column (spinal cord and muscles involved in Extension/Flexion of the Neck); forms Axillary Sheath
3. Pretracheal Layer: Anterioryly located, surrounds visceral tube (trachea and esophagus) and Thyroid Gland
4. Carotid Sheath: made by a condensation of Fascia from other 3 layers, found antero-laterally, contains
-Laterally(internal Jugular Vein),
-Medially (Internal Carotid Artery),
-Posteriorly (Vagus Nerve)
-Deep Cervical Nodes |
|
|
Term
| What is the roof and floor of the posterior triangle? |
|
Definition
roof: investing layer of deep cervical fascia
Floor: prevertebral muscles and fascia
-splenius capitius, levator scapulae, Scalenes |
|
|
Term
| How many Cervical Vertebrae are there? |
|
Definition
|
|
Term
| What is the name of the 1st cervical vertebrae and what is unique about it? |
|
Definition
Atlas: holds up skull via articulation with the occipital condyles
-has no body, no spinous process
-instead has andterior arch w/ anterior tubercle, and posterior arch w/ posterior tubercle
-transverse process with a hole (foramen transversarium)
-action occurs at the alanto-occipital joint for flexion/extension of neck (shaking head yes) |
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|
Term
| What is the foramen transversarium? where is it found? |
|
Definition
Cervical vertebrae have a hole in the transverse processes that allow the vertebral artery to provide blood to structures inside the skull
in alteast 1st 6 cervical vertebrae |
|
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Term
| what is the name of the second cervial vertebra, and what makes it unique? |
|
Definition
Axis: action is at the atlanto-axial joint and allows for rotation (shaking head no)
*body for C1 cervical vertebrae is actuall on C2 called (Dens, or Odontoid process), it sticks up so there is NO FLEXION; ONLY ROTATION
*mostly in cauastions, spinous process is a BIFID-Spinous process in the cervical vertebrae |
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Term
| What are the characteristics of the 3rd-6th cervical vertebrae? |
|
Definition
Typical cervical vertebra
-have bodies, pedicles, laminae, transverse processes, and foramen transversarium
-anterior and posterior tubercles
-groove b/t ant. and post. tubercle in vertebra indicates the EXIT of Ventral Rami from the vertebral column (behind the vertebral artery)
*C7 cervical vertebra is unique b/c it has a very long spinous process (Vertebra Prominens) |
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Term
|
Definition
Anterior Scalene: takes origin from Ant. tubercles of C3-6 vertebra, inserts on 1st rib.
Middle Scalene: LARGEST, origin from Post. tubercles of ALL cervical vertebrae (maybe not C1), inserts on 1st rib
Posterior Scalene: comes out behind the middle scalene, takes origin from the Post. tubercle of 4th -6th cervical vertebra and inserts on 2nd rib
*Function: Flexion of Neck and aid in respiration |
|
|
Term
| Where are the roots of the brachial plexus found in the neck? |
|
Definition
| between the anterior and middle scalenes |
|
|
Term
| What is found in the occipital triangle? |
|
Definition
-Occipital artery (branch of external carotid artery)-very superior aspect of this triangle
-CN XI- comes out of jugular foramen and will be deep to the SCM, then travels through the roof of the posterior triangle of the neck to eventually supply the trapezius |
|
|
Term
| What can be found in the subclavian triangle? |
|
Definition
1. Subclavian Artery: comes up right behind the sternoclavicular joint, travel over and pass posterior to the anterior scalene and runs over through thte posterior triangle of the neck
-2 branches:
Suprascapular Artery: more inferior branch
Transverse Cervical Artery: more superior also has 2 branches (Superficial-trapezius; Deep branch-rhomboids and levator scapulae) |
|
|
Term
| What 2 nerves come out of the middle scalene? |
|
Definition
Dorsal Scapular Nerve (C5)- runs more horizontally across the boddy to supply the rhomboids and levator scapulae
Long Thoracic Nerve- runs more vertically across the body to bass behind the structures in the breachial plexus to ultimately supply the serratus anterior |
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|
Term
| What nerve runs alng the anterior scalene? |
|
Definition
Phrenic Nerve: runs across vertically and heads into the thorax to supply the diaphragm; origins from C3-5
provides major motor innervation for the diaphragm and loss of this nerve results in difficulty breathing
"C3-4-5 keeps the diaphragm alive" |
|
|
Term
| What veins are found around the anterior scalene? |
|
Definition
Subclavian Vein
-posterior to the anterior scalene
External Jugular Vein
-formed by the junction of the retromandibular and posterior auricular veins and
-is anterior to the anterior scalene
-only named branch that empties into the subclavian in this area of the neck |
|
|
Term
| What is the innervation of the Scalenes? |
|
Definition
ventral rami of the spinal nerves as they come out.
Anterior Scalene: lower ventral rami (3-6)
Middle Scalene: ALL VENTRAL RAMI OF CERVICAL SPINAL NERVES
Posterior Scalene: Venteral Rami (6-8) |
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|
Term
| What are the boundries of the Anterior triangle of the Neck? |
|
Definition
1. Mandible
2. Cervical Midline
3. SCM |
|
|
Term
| What are the borders of the Submandibular Triangle? |
|
Definition
1. Mandible
2. Ant. and Post. bellies of Digastric
AKA "digastric Triangle"
*located right beneath mandible |
|
|
Term
| What are the boundries of the Submental Triangle? |
|
Definition
1. Ant. belly of the digastrics
2. Hyoid bone
3. Cervical Midline
*located right below the mandible symphisis |
|
|
Term
| What are the boundries of the Carotid Triangle? |
|
Definition
1. SCM
2. Sup. belly of Omohyoid
3. Post. Belly of Digastric |
|
|
Term
| What are the boundries of the Muscular triangle? |
|
Definition
1. SCM
2. Sup. belly of the Omohyoid
3. Cervical Midline |
|
|
Term
| What are the 4 smaller triangles of the anterior triangle? |
|
Definition
1. Submandibular
2. Submental
3. Carotid
4. Muscular |
|
|
Term
|
Definition
*level of 3rd cervical vertebra*
-no articulation w/ any other bone
-suspended in neck by muscles only
-major landmark in neck |
|
|
Term
| going from superior to inferior, what is are the structures of the laryngeal cartilages? |
|
Definition
1. Thyrohyoid Membrane
2. Laryngeal Prominence
3. Cricothyroid Ligament
4. Cricoid Cartilage |
|
|
Term
| What is anatomically and clinically significant about the laryngeal prominence/thyroid cartilage? |
|
Definition
-at level C4-5
-Bifurcation of Comon Carotid Artery into Internal and External Carotid
-Physicians use stethoscope and listen for a BRUIE (gurgling) due to Ca deposits at the bifurcation as a result of plaque buidup from ATHEROSCLEROSIS |
|
|
Term
| What is anatomically important about the Cricoid cartilage? |
|
Definition
-At level C6
1. Pharynx is continuous with Esophagus
2. Larynx continuous w/ Trachea
3. Middle Cervical Sympathetic Ganglion |
|
|
Term
| What are the 2 endocrine glands found in the cervical midline? |
|
Definition
1. Thyroid (pinkish)
2. Parathyroid (yellowish) |
|
|
Term
|
Definition
-at level of 2nd and 4th tracheal rings
-2 lateral lobes connected by the isthmus
-May have a Pyramidal Lobe that goes up the front of the trachea and cricoid cartilage
*DEVO: starts at base of tongue andmigrates into neck |
|
|
Term
|
Definition
-Posterior Surface of the Thyroid Gland
-2 superior and 2 inferior |
|
|
Term
| What are the 2 hormones of the Thyroid Gland? |
|
Definition
1. Thyroid Hormone: regulates basal metabolic rate
2. Calcitonin: Lowers the blood calcium levels |
|
|
Term
| What is the Hormone of the Parathyroid Gland? |
|
Definition
Parathyroid Hormone: elevates blod Ca levels
*Important to maintain Ca in a very relatively narrow range, too high makes muscles go into tetany and we die |
|
|
Term
| What do the Infrahyoid Muscles have in common? |
|
Definition
-origin inferior to the hyoid bone, insert on the hyoid
-relatively flat and ribbon like "strap muscles"
-common action: depress the hyoid bone/pull hyoid bone inferiorly |
|
|
Term
| What are the Infrahyoid Muscles? |
|
Definition
1. Sup. Belly of Omohyoid
2. Sternohyoid (superficial)
3. Sternothyroid (deep)
4. Thyrohyoid (deep)
* innervated by Ansa Cervacalis C1-3; except Thyrohyoid (Nerve to Thyrohyoid) |
|
|
Term
| What to the Suprahyoid muscles have in common? |
|
Definition
-origin superior (anterior/posterior) to hyoid bone and insert into the bone
-act to elevate the hyoid; anterior pull=protraction, posterior pull=retraction |
|
|
Term
| What are the Suprahyoid muscles? |
|
Definition
1. Ant./Post. Belly of Digastric
2. Mylohyoid
3. Geniohyoid
4. Stylohyoid |
|
|
Term
| Anterior Belly of Digastric |
|
Definition
O: Mandible
I: Hyoid bone
N: Nerve to Myloyoid; Trigeminal Nerve (1st pharyngeal arch)
F: Elevate Hyoid Bone |
|
|
Term
| Posterior Belly of Digastric |
|
Definition
O: Mastoid Process of Temporal bone
I: Common tendon on hyoid bone
N: Facial Nerve (2nd Pharyngeal Arch)
F: Elevate Hyoid bone |
|
|
Term
|
Definition
-floor of oral cavity
N: Nerve to the Mylohyoid (trigeminal nerve)
F: Elevate Hyoid bone |
|
|
Term
|
Definition
-superior to mylohyoid
N: Nerve to Geniohyoid |
|
|
Term
|
Definition
O: styloid process
I: body of Hyoid
N: Facial Nerve (2nd pharyngeal arch)
F: elevate hyoid |
|
|
Term
| What are the Contents of the Carotid Sheath? |
|
Definition
1. Common Carotid (medially)
2. Internal Jugular Vein (laterally)
3. CN X (Vagus)
4. Deep Cervical Lymphnodes |
|
|
Term
| What arteries does the Common Carotid branch off of on the left and right sides? |
|
Definition
Left: direct branch of Aorta
Right: branch off of Brachiocephalic
*artery found behinde the sternalclavicular joint |
|
|
Term
| Where do the internal and external carotid arteries supply blood to? |
|
Definition
Internal-not branched til skull. supply brain and structures in orbit
External-highly branched. supply neck and external feature in fae and up into scalp |
|
|
Term
| What physiolgically important structures are found at the bifurcation of the common carotid and what do they do? |
|
Definition
Carotid body: medial surface; tuft of capillarioes w/ chemoreceptors that sencse O2 and Co2 levels
Carotid Sinus: a dilation of vessels b/t distal end of Common Carotid and proximal end of Internal Carotid. In wall of this sinus are Baroreceptors that sense and increase in Pressure.
*both are innervated by Glossopharyngeal Nerve (CN IX) |
|
|
Term
| What reflexes are controlled by the Carotid sinus and body? |
|
Definition
Sinus: Increase in pressure of sinus tells brain to bring about unconsciousness (VAGUS)
Body: Decrease in O2 is sensed and tells body to increase depth and repetition of breathing (VAGUS), if O2 were too high, then you would pass out
*Sensory: Glossopharyngeal
Motor: VAGUS |
|
|
Term
| What are the 8 branches of the External Carotid? |
|
Definition
1. Superior Thyoid A. (thyroid gland and strap muscles)
2. Ascending Pharyngeal (pharynx, travels w/ nerve to Carotid Sinus)
3. Lingual (tongue)
4. Occipital (with lingual but posterior; posterior neck and scalp
5. Facial (all structures in face)
6. Posterior Auricular (Scalp behind ear and ear)
7. Maxilary (Deep face)
8. Superficial Temporal (lateral face and rest of scalp) |
|
|
Term
|
Definition
-exits skull though Hypoglossal Canal
-between the occipital and lingual artery
-at level of hyoid bone |
|
|
Term
|
Definition
-no cutaneous distribution
-travels w/ Hypoglossal over the Thyrohyoid
-Nerve to Thyrohyoid
-also the Superior Root of the Ansa Cervicalis |
|
|
Term
| What are the 2 branches of the Superior Laryngeal Nerve (runs w/ Superior Thyroid Artery)? |
|
Definition
External Laryngeal Nerve- innervates Cricothyroid
Internal Laryngeal Nerve (assoc. w/ superior laryngeal artery)- pierce Thyrohyoid membrane; sensory for all of larynx down to vocal cords
*responsible for Cough Reflex |
|
|
Term
| What are the branches of the Subclavian Artery? |
|
Definition
1. Thyrocervical Trunk (suprascapular, transverse cervical to posterior triangle in neck)
2. Inferior Thyroid Artery (blood to posterior thyroid and parathyroid gland)
*much anastomosis b/t Superior and Inferior Thyroid arteries |
|
|
Term
| what is the Thyroidea Ima? |
|
Definition
| branch of aorta that goes to thyroid gland (not always present) |
|
|
Term
| What is the Venous Drainage of the Neck? |
|
Definition
1. Superior Thyroid Gland and Middle Thyroid Vein drain to IJV
2. Inferior Thyroid Veins forma plexus that drain into the brachiocephalic (not IJV) |
|
|
Term
| Where is a tracheotomy performed? |
|
Definition
| -Superior to Thyroid Gland above 2nd tracheal ring (b/t cricoid cartilage and 1st tracheal ring; may also be done be/t the cricoid catilage and the thyroid cartilage) |
|
|
Term
| What structures are found in the submandibular Triangle? |
|
Definition
1. Hyoglossus
2. Mylohyoid
3. Digastric
4. Stylohyoid
5. Middle Constrictor (pharyngeal constrictor)
6. Lingual
7. Facial
8. Submental
9. CNXII
10. Nerve to mylohyoid
11. Facial |
|
|
Term
|
Definition
-muslce of the tongue
-Running from the hyoid bone up into the tongue |
|
|
Term
|
Definition
| -branch of the facial artery |
|
|
Term
| Name the lymph nodes of the head and neck. |
|
Definition
1. Buccal nodes (drain lymph in medial aspect of face)
2. Parotid nodes (lateral face)
3. Submental nodes (submental triangle)
4. Submandibular nodes (submandibular triangle)
5. Mastoid nodes (aka posterior auricular nodes)
6. Superficial cervical nodes (deep to SCM in Carotid Sheath)
*Collectively form Jugular Trunk |
|
|
Term
| What is the flow of the Lymph in the head and neck? |
|
Definition
-Buccal Nodes (medial face) to Submandibular Nodes or Deep Nodes
-things in midline will drain in the Submental nodes (drain into Deep Cervical nodes)
-Parotid nodes (drain lateral scalp and face and deep face
-Mastoid nodes (drain superficial or deep) |
|
|
Term
| What is the ventral root of C2 called? |
|
Definition
|
|
Term
| What 2 nerves come from the loop between C2 and C3? |
|
Definition
1. Great Auricular
2. Transverse Cervical (colli) |
|
|
Term
| What nerve comes from the loop of fibers between C3 and C4? |
|
Definition
|
|
Term
| Where do sympathetics from cervical spinal nerves in the head and neck come from? |
|
Definition
| Thorax, pass posterior to carotid sheath |
|
|
Term
| What are the 3 ganglion that are associated w/ the cervical region? |
|
Definition
-Stellate (cervico-thoracic ganglion)- fusion of the inferior cervical gangion w/ 1st thoracic gangilon
-Middle Cervical Ganglion- level C6, gray rami from C5-6
-Superior Cervical Ganglion- level C1-4, Largest, gray rami from C1-4 here |
|
|
Term
| Sympathetics are distributed in the head and neck by arteries, which arteries and have sympathetics from the Superior Cervical Ganglion? |
|
Definition
By Arteries:
-nerve fibers that come from the Superior Cervical Ganglion come up and rid on Internal Carotid and form nerve plexus.
-branches from Superior Cervical Ganglion come over to External Carotid Artery (all postganglionic)
-Superior Cervcial Cardiac Nerve: another branch of Superior Cervical Ganglion, runs w/ Subclavian (right) and Common Carotid (left) |
|
|
Term
| Sympathetics are distributed in the head and neck by arteries, which arteries and have sympathetics from the Middle Cervical Ganglion? |
|
Definition
| -@ level C6, Inferior Thyroid Artery branches have Middle Cervical Cardiac nerve that rides down to Cardiac plexus |
|
|
Term
| What is the Ansa Subclavius? |
|
Definition
| Loop around Subclavian Artery, actually Preganglionic sympathetic that are on their way up to the superior and middle cervical ganglion (anterior) |
|
|
Term
| What are the Branches of the Subclavian Artery? |
|
Definition
-Divided into 3 parts by Anterior Scalene
1. Vertebral Artery: blood to brain
2. Internal Thoracic: decend into thorax
3. Thyrocervical Trunk:
-Suprascapular, Transverse Cervical, Inferior Thyroid (blood to thyroid)
4. Phrenic Artery (Ascending Cervical Artery-branch fo Inferior Thyroid Artery)
5. Costocervical Trunk:
-Deep Cervical (ascending branch), blood to muscles along vertebral column, anastomosis w/ branch of occipital
-Supreme Intercostal (descending branch, down into thorax and provides posterior intercostals for 1st 2 intercostalis arteries. |
|
|
Term
| What structures pass Anterior to Subclavian Artery? |
|
Definition
1. Phrenic nerve
2. Vagus
3. Ansa Subclavius
4. Subclavian Vein
5. Thoracic Duct |
|
|
Term
| What artery does the Recurrent Laryngeal Nerve of the Vagus wrap around? |
|
Definition
Right-Subclavian
Left-Aortic Arch |
|
|
Term
| Where is the Thoracic duct and what is its function? |
|
Definition
Come up and loop around and join the junction of the Subclavian Vein and Internal Jugular Vein.
-Brings all the lymph from below the diaphragm and mediastinum
-Empties lymph back into circulation at the Inferior Vena Cava |
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