Triangles of the Neck
anterior, sternocleidomastoid, and posterior
Posterior triangle boundaries
anterior: sternocleidomastoidposterior: trapeziusinferior: clavicle
Posterior Triangle Contents
roots and trunks of brachial plexus, subclavian artery, cervical plexus, scalene muscles, levator scapulae, splenius capitits muscle
Splenius capitis _____ the head and unilaterally __________ it to one side
extends, rotates
Semispinalis Capitis _____ the head
extends
Anterior pre vertebral muscles
rectus capitis anterior, longus colli, anterior scalene, longus capitis
Anterior pre vertebral muscles ____ the neck
flex
Rectus capitis anterior and longus capitis flex at
alanto-occipital joint
Scalenes are from____ to _____
cervical transverse processes to first and second ribs
Scalenes ___ and ____ neck or _____ upper two ribs
flex and rotate, elevate
The scalenes are innervated by
cervical nerves
Rectus capitis anterior is the base of
occipital bone to anterior lateral atlas
Origin of Longus Colli
C5-T3 transverse porcesses vertebral bodies
Insertion of longus colli
C1 anterior tubercle, C2-3 bodies and transverse process
Longus capitis is ______ to _________
occipital bone to C3-C6 transverse processes
Cervical plexus is the ____ and ____ nerves to much of the neck and upper shoulder regions from the cervical spinal cord
cutaneous and motor
Nerves of the cervical plexus
CNXII, superior root of ansa cervicalis, transverse cervical, inferior root of Sansa cervicalis, phrenic, greater auricular, lesser occipital, supraclavicular
Greater auricular is cutaneous to skin near
external acoustic meatus, concha, auricle
Lesser occipital is cutaneous to
lateral occipital region
Supraclavicular is cutaneous to
supraclavicular, shoulder, upper thoracic regions
Transverse cervical is cutaneous to
anterior neck
Phrenic nerve is motor to ______
motor
Phrenic nerve is sensory to ____
anterior mediatstinum, parietal pleura, somatic pericardium, upper abdomen
The ansa cervicalis innervates most of the ____________ EXCEPT _____
infrahyoid muscles, thyrohyoid muscles
sternocleidomastoid region contents
sternocleidomastoid, carotid artery, jugular vein, vagus nerve, jugular lymph nodes
The sternocleidomastoid is from ______
mastoid process
Sternocleidomastoid is _____ and a _____ head
sternal, clavicular
When contracted bilaterally the sternocleidomastoid ____ the head
flexes
Posterior fibers of the sternocleidomastoid have been found to ____ the neck
extend
Unilaterally the sternocleidomastoid bends the neck to
one side
sternocleidomastoid is innervated by
CN XI
anterior triangle boundaries
anterior: median line of neckposterior: sternocleidomastoidsuperior: mandible
anterior triangle contents
submandibular triangle, submental triangle, carotid triangle, muscular triangle
Muscles of the anterior triangle
thyroid gland and parathyroid glands, recurrent laryngeal nerve, larynx, trachea, infrahyoid strap muscles
Borders of the muscular triangle of the anterior neck
medial: midlinesuperior: hyoid boneposterior: superior belly omohyoid, inferior SCM
Superficial muscular triangle is covered by
skin, fascia, platysma
Hyoid muscles all attach to the
hyoid bone
Hyoid muscles assist in
mastication and swallowing
Hyoid muscles are divided into
infrahyoid and supra hyoid
Infrahyoid muscles ___ the hyoid
lower
Nerves to the infrahyoid muscles
ansa cervicales C1 to C3
Infrahyoid muscles
sternohyoid, sternothyoid, thryohyoid, omohyoid
Sternohyoid action
depresses hyoid
Sternothyoid action
depresses thyroid
Thyrohyoid action
elevate thyroid, depress hyoid
Omohyoid action
depresses thyroid and larynx
Hyoid bone is attachment for
tongue, mouth, pharynx, strap muscles
hyoid bone increases range of
tongue, mouth, pharyngeal movements
The hyoid is the only bone that doesn't _____ with other bone
articulate
Thyroid gland function
secretes hormones responsible for basal metabolic rate
Thyroid gland innervation:
sympathetics from middle and inferior cervical ganglia
Thyroid artery is supplied by
superior thyroid artery from external carotid, inferior thyroid artery from thyrocervical trunk
parathyroid glands function
secrete parathormone, regulation of blood calcium ion, phosphate ion concentration
parathyroid supply
inferior thyroid arteries
How many parathyroid glands
2-6
Recurrent laryngeal nerve is branch of
vagus nerve
Recurrent laryngeal nerve loops around
subclavian artery on right, aortic arch on left
recurrent laryngeal nerve travels between
esophagus and trachea
Recurrent laryngeal nerve innervates
most larynx muscles
Submandibular triangular of the anterior neck contents
submandibular gland, facial artery, facial vein, hypoglossal nerve, submandibular lymph nodes, stylohyoid muscle
Borders of submandibular triangle
superior: mandibleanterior: anterior belly digastricposterior: posterior belly digastric
Submandibular gland function
secretes saliva
Submandibular gland innervation
parasympathetics from facial nerve that travel on mandibular branch of trigeminal nerve
Submandibular gland supply
facial artery
Suprahyoid muscles
mylohyoid, anterior belly of digastric, geniohyoid, posterior belly of digastric, stylohyoid
Geniohyoid action
elevated hyoid during swallowing
Stylohyoid action
elevated hyoid during swallowing
Posterior belly of digastric action
opens the jaw, elevates hyoid
Submental triangle contents
submental lymph nodes, mylohyoid muscle, mylohyoid nerve
Borders of submental triangle
sides: anterior diagastricsposterior: hyoid
Attachment of mylohyoid
mylohyoid line of mandible, body of hyoid bone
HYpoglossal nerve innervates most
tongue muscles
C1 fibers hitchhike along ____ then leave it to
CN XII, form superior root of ansa cervicalis and innervate thyrohyoid and geniohyoid muscle
Accessory nerve exits skull via
jugular foramen
Accessory nerve innervates
sternocleidomastoid muscle, trapezius muscle
Carotid triangle and sheath contents
common carotid artery, external and internal branches, internal jugular vein, vagus nerve, carotid body and sinus, hypoglossal nerve, accessory nerve, ansa cervicalis, the superior laryngeal nerve
Borders of the carotid triangle and sheath
posterior: SCMinferior: superior belly omohyoidsuperior: posterior belly digastric
Vagus nerve gives off branches to
pharyngeal plexus and a superior laryngeal branch
Superior laryngeal branch has an internal branch that is sensory to
superior aspect of the laryngeal muscosa
Superior laryngeal branch has an external branch that is motor to the
circothyroid muscle
The vagus nerve further innervates part of the _____ and is motor to the muscle in the ____ and ____ a=
epiglottis , palate and larynx
The vagus nerve is parasympathetic motor to
thoracic organs and much of the abdominal viscera
Parts of the common carotid artery
external carotid, internal carotid, common carotid
External carotid artery supplies
face, oral and nasal cavities, scalp, pharynx, etc.
Branches of the external carotid artery
superficial temporal, maxillary, facial, lingual posterior auricular, occipital, superior thyroid
External carotid artery posterior branches
superficial temporal, posterior auricular, occipital
Superficial temporal artery supplies the
temporal region
Posterior auricular artery supplies the
external ear and the scalp behind it, meninges
Occipital artery supplies the
sternocleidomastoid and deep muscles of the neck, gives of stylomastoid artery to supply facial nerve
External carotid artery anterior branches
maxillary, facial, lingual, superior thyroid
Maxillary artery supplies
muscles of mastication, TMJ, nasal cavity, etc.
Facial artery supplies the
face
Lingual artery supplies
oral cavity and tongue
Superior thyroid artery supplies
larynx and thyroid gland
Ascending pharyngeal artery supplies
oropharynx, nasopharynx, middle ear, skull base, hypoglossal canal, mutiple cranial nerves
Carotid body chemoreceptor monitors
blood O2 and CO2 levels
Carotid body innervated mainly by
CN IX
Carotid body located at the
bifurcation of the carotid
Carotid sinus baroreceptor monitors
changes in arterial blood pressure
Carotid sinus innervated by
CN IX
Carotid sinus located at
base of internal carotid artery
Internal carotid artery supplies
brain, eye, pituitary gland
ophthalmic artery supplies the
eye and orbit
Basilar artery anastomoses with
vertebral artery
Jugular venous system consists of
facial, common facial, pterygoid plexus, external jugular, internal jugular
Internal jugular drains
brain, face, and neck
External jugular drains
external head and deep face
Facial veins drains the
face
Pterygoid plexus communicates with
cavernous sinus and maxillary vein
Zone 1
between clavicle/suprasternal notch and cricoid cartilage
Zone 1 thoracic outlet structures
common carotid, vertebral/subclavian arteries, trachea, esophagus, thoracic duct, thymus
Zone 2
between cricoid cartilage and angle of mandible
Zone 2 thoracic outlet structures
internal/external carotids, jugular veins, pharynx, larynx, esophagus, recurrent laryngeal nerve, spinal cord, trachea, thyroid, parathyroids
Zone 3
between angle of mandible skull base
Zone 3 thoracic outlet structures
extra cranial carotid/vertebral parties, superior jugular veins
Neck fracture
fracture of a cervical vertebra, shallow water dive, hanging, serve blow to neck
Whiplash
injuries related to sudden disruption of neck, car accidents, fall
Goiter
enlarged thyroid compensate for poor hormone production
Thyroid palpation
move being patient, use left hand to push trachea to right, put hand between triage and sternocleidomastoid, have patient sip a glass of water, thyroid moves up with swallow. Normal thyroid is not palpable
Brachial cyst
cystic mass between SCM and pharynx, failed obliteration of 2nd brachial cleft
Patent thyroglassal duct
duct fails to atrophy, connects tongue to thyroid, cyst gets fluid filled
Carotid body tumor
tumor formed by chemoreceptor cells
Carotid stenosis
narrowing of carotid lumen, athersosclerosis-inflammatory plaque, emboli-plaque breaks off and travels to brain, stroke
Tracheostomy/tracheotomy
surgical procedure to open direct airway by making incision through trachea, -ostomy is actually making the opening
Lymphatic draining
the deep chain of lymph nodes receive most of the lymph from the head and neck including submental and submandibular nodes and parapotid nodes. Lymph from the tongue, face, and other head regions drain directly into the deep cervical nodes
Selective neck dissection
surgery for lymph node metastasis, remove nodes from one side
Radial neck dissection
surgery for lymph node metastasis, remove nodes from one side, removal of all node groups I-V