The platysma is a muscle of fascial expression derived from which pharyngeal arch?
Second Pharyngeal Arch
What cranial nerve innervates the second pharyngeal arch?
CN VII - Facial Nerve
Name the 4 Layers of Deep Cervical Fascia
Carotid Sheath (bilateral)
Which layer of deep cervical fascia covers the viscera?
Which layer of deep cervical fascia covers the entire neck?
Which layer of deep cervical fascia prevents/limits the spread of infection?
An infection between the investing layer and the MUSCULAR part of the pretracheal fascia, surrounding the infrahyoid muscles, will spread from the neck until what structure?
An infection between the investing layer and the VISCERAL part of the pretracheal fascia will spread from the neck until what structure?
An infection of what area causes swelling deep to the SCM, developing into retropharyngeal abscess with dysphagia and dysarthria?
Posterior to prevertebral Layer
Rupture of what structures may cause pneumomediastinum?
Esophagus, Trachea, or Bronchus
The Hyoid Bone is at what cervical level?
The Thyroid Cartilage is at what cervical level?
The Cricoid Cartilage is at what cervical level?
Which muscle divides the neck into anterior and posterior triangles?
Unilaterally contraction of the right SCM turns the head in which direction?
Motor innervation to the SCM is by what nerve?
CN XI (Spinal Accesssory Nerve)
Proprioceptive innervation to the SCM is by what nerve?
Anterior Ramus of C2 [part of Ansa Cervicalis]
Proprioceptive innervation to the Trapezius is by what nerve?
Anterior Rami of C3-C4 [part of Ansa Cervicalis]
Cervical Dystonia of the SCM in the adult is called what?
What is Wry Neck?
A congenital shortening of SCM
What are the boundaries of the Posterior Cervical Triangle?
Anterior Boundary: SCM
Posterior Boundary: Trapezius
Inferior Boundary: Clavicle
What forms the roof of the posterior cervical triangle?
Investing Layer of Deep Cervical Fascia
What forms the floor of the posterior cervical triangle?
Prevertebral Fascia that covers:
Anterior, Middle, Posterior Scalenes
Name the SUPERFICIAL contents of the Posterior Triangle.
Hint: 1 Vein, 4 Nerves
1- External Jugular Vein
2- Lesser Occipital Nerve (C2)
3- Great Auricular Nerve (C2-C3)
4- Transverse Cervical Nerve (C2-C3)
5- Supraclavicular Nerve (C3-C4)
Name the DEEP contents of the Posterior Triangle
1- CN XI
2- Subclavian Vein
3- Subclavian Artery (3rd Part)
4- Transverse Cervical (Cervicodorsal) Artery
5- Suprascapular Artery
6- Brachial Plexus (Roots, Trunks, and Branches)
7- Branches of Cervical Plexus
The Subclavian Vein passes anterior to which muscle before joining the Internal Jugular Vein?
Anterior Scalene Muscle
What structures passes along anterior border of the Anterior Scalene muscle?
Phrenic Nerve (C3-C5)
Transverse Cervical Artery
The External Jugular Vein drains into what vein?
In reference to the clavicle, where can the Subclavian Vein be found?
Below proximal 1/3 of Clavicle
Which veins can be used to insert a central line (catheter) to the heart or for Renal Dialysis?
Internal Jugular Vein
Where is the Subclavian Artery found?
Above first rib, Posterior to the Anterior Scalene
During a bleed from an upper limb, which artery can be compressed to stop the bleed?
During a bleed from an upper limb, where would you compress the subclavian artery to control the bleeding?
Against first Rib in Supraclavicular Triangle
Trace the Transverse Cervical Artery back to the Subclavian Artery
Subclavian Artery --> Thyrocervical Trunk --> Transverse Cervical Artery
The Transverse Cervical Artery divides in a superficial and deep branch relative to what muscles?
Levator Scapulae and Rhomboids
The Deep Branch of the Transverse Cervical Artery may be absent and replaced by what other artery?
Dorsal Scapular Artery
The Dorsal Scapular Artery branches from which part of the Subclavian Artery?
3rd Part of the Subclavian Artery
The Suprascapular Artery and Nerve to go which muscles?
Supraspinatus and Infraspinatus
Roots of the brachial plexus emerge with the Subclavian Artery between what muscles?
Anterior and Middle Scalenes
In a Thoracic Outlet Syndrome, which trunk of the Brachial Plexus is compressed?
In Thoracic Outlet Syndrome, which artery is compressed?
The Cervical Plexus is made up of what spinal nerves?
Anterior Rami of C1-C4
The cutaneous branches of the cervical plexus are found in which triangle?
Posterior Cervical Triangle
What are the cutaneous branches of the cervical plexus (include nerve roots)?
Lesser Occipital (C2)
Great Auricular (C2-C3)
Transverse Cervical (C2-C3)
Supraclavicular Nerves (C3-C4)
What is the muscular branch of the cervical plexus?
Ansa Cervicalis (Superior Root, C1 + Inferior Root, C3)
Which Strap Muscle IS NOT innervated by the Ansa Cervicalis?
A Cervical Plexus Blockade is administered to block what spinal nerves?
What are the 4 Landmarks for identifying the nerve point of the neck to administer a cervical plexus blockade?
Posterior Border of SCM Posterior Border of the Clavicular Head
Transverse Process of C6
What is the Main Injection Site for the Cervical Plexus Blockade?
Junction of upper and middle 1/3 of Posterior Border of SCM
An Accessory Phrenic Nerve may branch from what other nerve?
Nerve to Subclavius (C5)
What "extra" nerves are found in the posterior cervical triangle?
Accessory Phrenic Nerve (Branch of Subclavian Nerve)
Long Thoracic Nerve (C5-7) to Serratus Anterior
Dorsal Scapular Nerve (C5) - Pierces middle scalene to Rhomboids and Levator Scapulae
Irritation of the Phrenic Nerve will send referred pain to the ipsilateral shoulder via which nerve?
Supraclavicular Nerve (C3-C4)
The posterior cervical triangle courses structures between the thorax/neck and the __________.
The Anterior Cervical Triangle courses structures between the head and the ________.
The Posterior Cervical Triangle is divided into what two triangles?
Supraclavicular Triangle (Subclavian Triangle)
What muscle divides the Posterior Cervical Triangle?
Inferior Belly of the Omohyoid Muscle
The external jugular vein is formed near the angle of the mandible by the union of which 2 veins?
-Posterior Division of the Retromandibular Vein
-Posterior Auricular Vein
A Venous Air Embolism may form if the External Jugular Vein is cut at what level?
Where it pierces the investing layer of deep cervical fascia.
Which lymph nodes follow the external jugular vein?
Superficial Cervical Lymph Nodes
The Superficial Cervical Lymph Nodes drain into which lymph nodes?
Deep Cervical Lymph Nodes
Which vein do the Deep Cervical Lymph Nodes follow?
Internal Jugular Vein
Which nerve supplies the skin over the angle of the mandible, the lower part of the auricle and the mastoid process?
Great Auricular Vein (C2,C3)
Which nerve supplies skin over the anterior triangle of the neck?
Transverse Cervical Nerve (C2,C3)
What is the main nerve found in the Occipital Triangle?
Accessory Nerve (CN XI)
Where are the transverse cervical artery and suprascapular artery (branches of the thyrocervical trunk) relative to the anterior scalene?
They are anterior to the anterior scalene.
Which artery supplies the trapezius?
Transverse Cervical Artery
What are Sentinel Nodes?
Supraclavicular Lymph Nodes that enlarge due to thoracic/abdominal cancers.
What vessels do Sentinel Nodes follow?
Transverse Cervical Artery and Vein
Does the Suprascapular Artery pass above or below the Superior Transverse Scapular Ligament?
What about the Suprascapular Nerve?
Suprascapular Artery - Above
Suprascapular Nerve - Below
Collateral Circulation of the Suprascapular Artery around the scapula allows for safe ligation of what artery?
Axillary Artery proximal to its subscapular branch
How does a lesion of the Suprascapular Nerve Present Clinically?
Inability to initiate abduction of arm.
Weakened lateral rotation of arm