Neck Flashcards

(114 cards)

1
Q

What 2 things form the superior boundary of the neck?

A

Inferior border of the mandible

Pericraniocervical line

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2
Q

What 4 things form the inferior boundary of the neck?

A

Manubrium
Clavicle
Acromion
Line passing from the acromion to the spinous process of C7

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3
Q

What are the 3 borders of the anterior triangle of the neck?

A

Midline (median sagittal plane)
SCM
Mandible

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4
Q

What are the 4 borders of the posterior triangle of the neck?

A

SCM (posterior border)
Trapezius (anterior border)
Mastoid process of the temporal bone
Clavicle (middle 1/3rd)

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5
Q

What is the function of the suprahyoid muscles?

A

Elevate the hyoid

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6
Q

What is the function of the infrahyoid muscles?

A

Depress the hyoid

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7
Q

What are the 3 main suprahyoid muscles?

A

Digastric
Stylohyoid
Mylohyoid

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8
Q

What is the innervation of the anterior belly of the digastric?

A

CN Vc

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9
Q

What is the innervation of the posterior belly of the digastric?

A

CN VII

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10
Q

What is the innervation of the stylohyoid?

A

CN VII

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11
Q

What is the innervation of the mylohyoid?

A

CN Vc

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12
Q

What are the 4 main infrahyoid muscles?

A

Omohyoid
Sternohyoid
Sternothyroid
Thyrohyoid

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13
Q

What is the innervation of the infrahyoid muscles?

A

Ansa Cervicalis - a loop from the cervical plexus (C1-C3)

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14
Q

In which surgery may the ansa cervicalis be cut?

A

Carotid endarterectomy

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15
Q

What are the 4 triangles of the anterior triangle?

A

Submandibular triangle
Submental triangle
Carotid triangle
Muscular triangle

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16
Q

What are the 2 borders of the submandibular triangle?

A

Mandible
Digastric

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17
Q

What are the 3 borders of the submental triangle?

A

Midline
Hyoid bone
Anterior belly of digastric

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18
Q

What are the 3 borders of the carotid triangle?

A

SCM
Superior belly of omohyoid
Posterior belly of digastric

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19
Q

What are the 3 borders of the muscular triangle?

A

Superior belly of omohyoid
SCM
Midline

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20
Q

What are the 2 triangles of the posterior triangle?

A

Occipital triangle
Supraclavicular triangle

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21
Q

The posterior triangle is subdivided by which structure?

A

Inferior belly of omohyoid

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22
Q

What are the 3 borders of the occipital triangle?

A

SCM
Trapezius
Inferior belly of omohyoid

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23
Q

What are the 3 borders of the supraclavicular triangle?

A

SCM
Clavicle
Inferior belly of omohyoid

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24
Q

What forms the floor of the posterior triangle?

A

Prevertebral fascia

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25
The prevertebral fascia overlays which 3 muscles?
Splenius capitis Levator scapulae Scalenus
26
Where does the brachial plexus emerge from within the neck?
Between anterior + middle scalene muscles
27
Explain how to palpate the brachial plexus where it emerges between the scalenes.
Place fingers behind the lateral edge of the SCM at the level of the cricoid cartilage (C6). The anterior scalene lies just deep and lateral to the SCM
28
What is the innervation of levator scapulae?
Dorsal scapula nerve Anterior rami of C3 + C4
29
What is the innervation of erector spinae?
Posterior rami of spinal nerves
30
Which artery passes through the suboccipital triangle?
Vertebral artery
31
The platysma is surrounded by which fascia?
Superficial cervical fascia
32
What is the innervation of platysma?
Cervical branch of CN VII
33
What are the 4 main layers of the deep cervical fascia?
Investing layer Prevertebral layer Pretracheal layer Carotid sheaths
34
Which fascial layer encloses the SCM and trapezius?
Investing fascia
35
What are the superior attachment points of the investing fascia?
External occipital protuberance Superior nuchal line
36
Posterior to the oesophagus, the pretracheal fascia is referred to as what?
Buccopharyngeal fascia
37
What are the 3 structures within the carotid sheath?
Common carotid artery Internal jugular vein Vagus nerve
38
Which 3 structures does the prevertebral fascia surround as it becomes the axillary sheath?
Brachial plexus Axillary artery Axillary vein
39
The axillary sheath is formed from which fascia?
Prevertebral fascia
40
What are the 5 main spaces of the neck?
Visceral space Pretracheal space Prevertebral space Retropharyngeal space Danger space
41
The visceral space of the neck communicates between what?
Base of the skull to fibrous pericardium (superior mediastinum)
42
Infections of the oral cavity can potentially spread into the superior mediastinum through what?
Visceral space
43
The prevertebral space of the neck communicates between what?
Base of the skull to coccyx
44
The danger space of the neck communicates between what?
Base of the skull to posterior mediastinum, potentially to the diaphragm
45
The retropharyngeal space of the neck communicates between what?
Base of the skull to the superior mediastinum
46
Which pathology can cause anterior displacement of the pharynx + larynx?
Retropharyngeal abscess
47
The superficial cervical nodes run along which vessel?
External jugular vein
48
The deep cervical nodes run along which vessel?
Internal jugular vein
49
What are the 5 groups of superficial lymph nodes around the head?
Submental Submandibular Pre-auricular / parotid Posterior auricular / mastoid Occipital nodes
50
Which head lymph node groups drain into the superficial cervical nodes?
Occipital Posterior auricular / mastoid
51
Which head lymph node groups drain into the deep cervical nodes?
Pre-auricular / parotid Submandibular Submental
52
The deep cervical nodes are divided into upper and lower groups by what?
Where the intermediate tendon of the omohyoid crosses the common carotid artery + the internal jugular vein
53
What is the location of the jugulodigastric node?
Where the posterior belly of digastric crosses the internal jugular vein
54
The jugulodigastric node mainly receives lymph from what organ?
Tonsils
55
The jugulo-omohyoid node mainly receives lymph from what organ?
Tongue
56
What is the main function of neck levels?
Evaluate lymph node spread of head + neck tumours
57
What are the 6 neck levels?
I - submental + submandibular II - upper internal jugular chain III - middle internal jugular chain IV - lower internal jugular chain V - posterior triangle VI - anterior compartment
58
What are pharyngeal arches?
Interconnecting loops of tissue formed by mesoderm covered in ectoderm + endoderm
59
What are pharyngeal pouches?
Internal indentations between the pharyngeal arches
60
What are pharyngeal clefts (grooves)?
External indentations between the pharyngeal arches
61
List the 11 structures that arise from the 1st pharyngeal arch. Which artery is the 1st pharyngeal arch associated with? Which nerve is the 1st pharyngeal arch associated with?
Maxilla Zygoma Mandible Sphenomandibular ligament Malleus Incus Muscles of mastication Mylohyoid Anterior belly of digastric Tensor veli palatini Tensor tympani Maxillary artery CN V
62
List the 9 structures that arise from the 2nd pharyngeal arch. Which 2 arteries is the 2nd pharyngeal arch associated with? Which nerve is the 2nd pharyngeal arch associated with?
Stapes Stapedius Posterior belly of digastric Stylohyoid Stylohyoid ligament Styloid process Upper body + lesser horn of hyoid bone Muscles of facial expression Platysma Stapedial artery (regresses before birth) Hyoid artery CN VII
63
List the 2 structures that arise from the 3rd pharyngeal arch. Which 2 arteries is the 3rd pharyngeal arch associated with? Which nerve is the 3rd pharyngeal arch associated with?
Lower body + greater horn of hyoid bone Stylopharyngeus Common carotid artery Proximal portion of internal carotid artery CN IX
64
List the 6 structures that arise from the 4th pharyngeal arch. Which 2 arteries is the 4th pharyngeal arch associated with? Which nerve is the 4th pharyngeal arch associated with?
Thyroid cartilage Corniculate cartilage Cuneiform cartilage Pharyngeal constrictors Levator veli palatini Cricothyroid Proximal portion of the right subclavian artery Aortic arch Superior laryngeal branch of CN X
65
Which structures arise from the 6th pharyngeal arch. Which 2 arteries is the 6th pharyngeal arch associated with? Which nerve is the 6th pharyngeal arch associated with?
Intrinsic muscles of larynx (except cricothyroid) Proximal portion of the pulmonary arteries Ductus arteriosus Recurrent laryngeal branch of CN X
66
The 1st pharyngeal pouch forms what?
Middle ear Eustachian tube
67
The 2nd pharyngeal pouch forms what?
Palatine tonsils
68
The 3rd pharyngeal pouch forms what?
Inferior parathyroid gland Thymus
69
The 4th pharyngeal pouch forms what?
Superior parathyroid gland Parafollicular C cells
70
Which location does the common carotid artery bifurcate?
Superior edge of thyroid cartilage (C4)
71
What are the 8 branches of the external carotid artery?
Superior thyroid artery Lingual artery Facial artery Maxillary artery Superficial temporal artery Posterior auricular artery Occipital artery Ascending pharyngeal artery
72
Which structure near the carotid bifurcation detects changes in blood pressure?
Carotid sinus
73
Which structure near the carotid bifurcation detects changes in blood chemistry?
Carotid body
74
What is the innervation of the carotid sinus + body?
Hering's nerve (branch of CN IX)
75
Which CN passes next to the occipital artery?
CN XII
76
What are the 4 main branches of the subclavian artery?
Vertebral artery Internal thoracic artery Thyrocervical trunk Costocervical trunk
77
The internal jugular vein exits the skull via what?
Jugular foramen
78
Where is the nerve point of the neck?
Posterior border of the middle 1/3rd of SCM
79
Describe the location of CN XI in the posterior triangle.
Emerges from under SCM 3.1 - 9.8cm below the mastoid tip Passes deep to trapezius 1.3 - 9.8cm above the insertion of trapezius into the clavicle
80
List 3 neck / shoulder symptoms of a damaged CN XI.
Weakness of shrugging ipsilateral shoulder + scapula winging Weakness of turning head to contralateral side (if damaged prior to SCM) Long term - scoliosis, trapezius wasting and fasciculations
81
What are the 4 main branches of the cervical plexus?
Lesser occipital nerve Greater auricular nerve Transverse cervical nerve Supraclavicular nerves
82
Which ganglion is compressed with a pancoast tumour?
Stellate ganglion (C7-C8)
83
The thyroid gland begins its development from which structure?
Foramen caecum
84
The thyroglossal duct moves during swallowing and tongue protrusion because it is attached to what?
Hyoid bone
85
The inferior thyroid artery is a branch of which artery?
Thyrocervical trunk
86
The inferior thyroid vein drains into what?
Brachiocephalic vein
87
A Zenker's diverticulum forms in which structure?
Killian's triangle
88
The cervical plexus is formed by which nerves?
Anterior rami of C1 - C4
89
Damage to the facial nerve where it innervates platysma will cause what symptom?
Drooping of the lower lip
90
Where in the neck can the carotid pulse be palpated?
Anterior border of SCM at the level of the superior border of the thyroid cartilage
91
Which 2 CN's carry information from the carotid body + sinus to the CNS?
CN IX + X
92
List 3 reasons why the right IJV is preferred to the left for catheterization.
Direct route to SVC Right IJV is wider Avoids thoracic duct
93
What is the function of the posterior cricoarytenoid muscles?
Abducts vocal folds
94
What is the function of the lateral cricoarytenoid muscles?
Adducts vocal folds
95
Unilateral damage to the recurrent laryngeal nerve will cause what symptom?
Hoarse voice
96
Bilateral damage to the recurrent laryngeal nerves will cause what symptom?
Breathlessness
97
Damage to the superior laryngeal nerve will cause what symptom?
Weak voice
98
The superior thyroid artery is a branch of what?
External carotid artery
99
The inferior thyroid artery is a branch of what?
Thyrocervical trunk - subclavian artery
100
What artery supplies the parathyroid glands?
Inferior thyroid artery
101
Which duct is found on the parotid gland?
Stensen's duct
102
Surgery on the parotid gland may damage which nerve?
Auriculotemporal nerve of CN V
103
Frey's syndrome is caused by damage to which nerve?
Auriculotemporal nerve
104
Via which nerves can cervical neck pathologies refer pain to the ear?
Greater auricular nerve Anterior rami of C2 + C3
105
Via which nerves can cervical neck pathologies refer pain to the back of the neck / scalp (occipital headache)?
Posterior rami of C2 + C3
106
List 3 causes of Erb's palsy.
Fall onto shoulder Traumatic birth - traction on infant's head Motorbike or contact sports injury
107
What are the roots of Erb's palsy?
C5 - C6
108
Which deformity is seen in Erb's palsy?
Waiter's tip deformity
109
What action causes Klumpke's palsy?
Excessive abduction of the arm
110
What are the roots of Klumpke's palsy?
C8 - T1
111
Which deformity is seen in Klumpke's palsy?
Claw hand deformity
112
What is the key symptom of hypoglossal nerve damage?
Ipsilateral tongue weakness
113
Through which holes in the cervical vertebrae does the vertebral artery pass?
Transverse foramina
114
Why can injury to the external jugular vein result in a venous air embolus?
Intravascular pressure is lower than atmospheric pressure