Deep Neck

Question 1

Venous System of the Upper Thorax

Answer 1

Question 2

What joins systemic venous circulation at Venous Angle?

Answer 2

• Right lymphatic duct at right venous angle
• Thoracic lymphatic duct at left venous angle

Question 3

Branches of External Carotid Artery

Answer 3

1. Superior Thoracic Artery
2. Lingual Artery
3. Facial Artery
4. Ascending pharyngeal
5. Posterior Auricular
6. Occipital
7. Superior temporal
8. Maxillary

Question 4

Tissues at Carotid Bifurcation

Answer 4

1. Carotid Body - O2 Chemoreceptor
2. Carotid Sinus - Baroreceptor for changes in arterial pressure

• Innervated by Glossopharyngeal nerve (CN IX) via visceral sensory fibers

Question 5

Divisions of Subclavian Artery (and to what structure)

Answer 5

1. Medial part
2. Posterior part
3. Lateral part

relative to anterior scalene

Question 6

Branches from parts of Subclavian Artery

Answer 6

1. Medial Part
   
   1. Vertebral Artery
   2. Internal Thoracic Artery
   3. Thyrocervical Trunk
      
      1. Inferior Thrydoid artery
      2. Ascending Cervical artery
      3. Transverse Cervical artery
      4. Suprascapular artery
2. Posterior part
   
   1. Costocervical trunk
3. Lateral Part
   
   1. Dorsal scapular artery

Question 7

Scalene Muscles

Answer 7

1. Anterior Scalene
2. Middle Scalene
3. Posterior Scalene

• innervated by **brachial plexus **

Question 8

Scalene Muscle Anatomical Relationships

Answer 8

1. Brachial Plexus and Subclavian artery pass between middle and anterior scalenes
2. Subclavian vein is anterior to the anterior scalene
3. Phrenic nerve is anterior to the anterior scalene

Question 9

Thyroid Gland

Answer 9

• makes **T3, T4, Calcitonin **
• 2 lobes join at isthmus
• Pyramidal lobe superiorly
• ○ Blood Supply
  * * Superior Thyroid ** - 1st branch of external carotid
  * *Inferior Thyroid** - branch of thyrocervical trunk

Question 10

Thyroid Gland Drainage

Answer 10

1. Superior Thyroid Vein - Drain to IJV
2. MIddle Thyroid Vein - drian to IJV
3. Inferior Thyroid vein - drain to brachiocephalic vein

Question 11

Parathyroid Glands

Answer 11

• 4
• develop from **3rd & 4th pharyngeal pouches **
• secrete Parathyroid hormone
• vascularized by **superior & inferior thyroid arteries **

Question 12

Nerves of Deep Neck

Answer 12

1. Phrenic Nerve
2. Vagus Nerve (CN X)
3. Phrenic Nerve
   
   1. behind carotid sheath

Question 13

Vagus Nerve Branches

Answer 13

Question 14

Three main cervical Ganglia of Sympathetic Trunk

Answer 14

1. Superior
2. Middle
3. Inferior

• most preganglionics synpase at **superior ganglion **
• follow major blood vessles down as **carotid plexus **

Question 15

Suboccipital Triangle Contents

Answer 15

1. Vertebral artery
2. Suboccipital Nerve

Question 16

Boundaries of Suboccipital Triangle, role, and innervation

Answer 16

1. Rectus Capitis Posterior Major/Minor
2. Obliquus capitis superior
3. Obliquus capitis inferior

• Primarily **postural/proprioception **
• innervated by suboccipital nerve

Question 17

Nerves associated with suboccipital triangle

Answer 17

1. Suboccipital nerve
   
   1. Dorsal ramus of CN 1
2. Greater occipital nerve
   
   1. Dorsal ramus of CN 2
   2. Cutaneous innervation to posterior head
3. least occipital nerve
   
   1. Dorsal ramus of CN 3
   2. Cutaneous to posterior head & neck

Question 18

Sensory innervation of head and neck - Sources

Answer 18

• Sensroy branches of cervical plexus (ventral rami C2-C4) - cutaneous innervation to anterior & lateral neck
• Dorsal rami of cervical nerves (greater & lesser occipital) - cutaneous to posterior neck/scalp