Unit 8 - Posterior Triangle, Root of Neck
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130 terms
Terms | Definitions |
|---|---|
 What features form the superior border of the neck? | 1) Lower border of the mandible 2) Mastoid process of skull 3) Superior nuchal line 4) External occipital protuberance |
| mental symphysis | The midline of the chin where the left and right halves of the mandible join together |
| Name the landmarks of the mandible | 1) Body of mandible 2) Mental symphysis 3) Masseter muscle (external surface of the mandible) 4) Facial artery |
| Where is the facial artery located? | Inferior border of the mandible near the anterior border of the masseter |
| What features form the inferior border of the neck? | Anteriorly: jugular/suprasternal notch, sternoclavicular joint, clavicle Posteriorly: spine of CV7 |
| Describe the features of the clavicle | 1) Medial end is large and knoblike while lateral end is flattened 2) Anteriorly, medial half is convex while lateral half is concave |
| What part of the vertebral column is the clavicle level with? | Intervertebral disc between T2 and T3 |
| Name the major landmarks of the neck | 1) Superior border (at mandible) 2) Inferior border (at clavicle and spine of CV7) 3) Hyoid bone 4) Thyroid cartilage 5) Sternocleidomastoid muscle 6) 6-8 palpable tracheal rings of cartilage |
| Location and features of the hyoid bone | 1) Unpaired and doesn't articulate with any other bone (suspended by muscles and ligaments) 2) Inferior to inferior aspect of mandible 3) Consists of central body and lesser and greater horns (cornua) on either side 4) Lies in the anterior neck at level of CV3 |
| What is the purpose of the hyoid bone? | Origin and insertion point for several muscles in the anterior neck |
| thyrohyoid membrane | Suspends larynx from the hyoid bone |
| Name the location and features of the thyroid cartilage | 1) Unpaired cartilage of the larynx 2) Consists of two laminae that join at the laryngeal prominence 3) Greater/superior and lesser/inferior horn postero-laterally on each side |
| laryngeal prominence | aka Adam's apple. Located at the midline of the thyroid cartilage where its two laminae meet and fuse |
| greater/superior horn of the thyroid cartilage | Point at which the thyroid cartilage is suspend from the hyoid bone |
| lesser/inferior horn of the thyroid cartilage | Articulates inferiorly with the cricoid cartilage |
| Location of cricoid cartilage | Level of CV6, inferior to the thyroid cartilage |
| What boundary is marked by the cricoid cartilage? | Division between larynx and trachea |
| What structures in the neck are found at the level of CV6? | 1) Junction between larynx and trachea 2) Junction of pharynx and esophagus 3) Middle cervical sympathetic ganglion 4) Vertebral artery where it first enters the transverse foramen |
| What structures form the boundaries of the posterior triangle of the neck? | Anterior: posterior border of the sternocleidomastoid muscle Posterior: anterior border of the trapezius Inferior: clavicle |
| What structures form the boundaries of the anterior triangle of the neck? | Medial: midline of the neck Lateral: anterior border of the sternocleidomastoid muscle Superior: inferior border of the mandible |
| sternocleidomastoid muscle | Separates anterior and posterior triangles of the neck |
| What nerve does the sternocleidomastoid muscle overlie? | Spinal accessory nerve, at the midpoint of the posterior border of the muscle |
| What nerves innervate the skin of the neck? | C2, C3, C4 |
| superficial cervical fascia | 1) Fascia that encircles the neck 2) Contains fat, cutaneous nerves, muscles of facial expression, and their nerves and veins |
| Name the nerves that make up the cutaneous components of the cervical plexus | 1) Lesser occipital 2) Great auricular 3) Transverse cervicals 4) Supraclaviculars |
| Root and path of the lesser occipital nerve | C2 Follows posterior border of sternocleidomastoid muscle superiorly to the head |
| What structures does the lesser occipital nerve innervate? | Skin of the neck and scalp posterosuperiorly to the auricle of the ear |
| Roots and path of the great auricular nerve | C2, C3 Climbs vertically on the surface of the sternocleidomastoid muscle |
| What structures does the great auricular nerve innervate? | 1) Skin of the parotid region and auricle 2) Skin of the angle of the mandible to the mastoid process |
| Roots and path of the transverse cervical nerves | C2, C3 1) Crosses the sternocleidomastoid horizontally 2) Joins carotid branch of the facial nerve inferior to the parotid gland |
| What structures do the transverse cervical nerves innervate? | Skin of anterior triangle of the neck |
| Roots and path of the supraclavicular nerves | C3, C4 Crosses the clavicle |
| What structures do the supraclavicular nerves innervate? | 1) Skin of the inferior half of the posterior triangle of the neck 2) Skin of the upper thoracic and deltoid regions |
| Function of the platysma muscle | 1) Facial expression 2) Covers anterior surface of the neck |
| Location of the platysma muscle | 1) Extends from fascia in the thoracic region to the inferior aspect of the mandible 2) Superficial to the external jugular veins and the trunks of the cutaneous nerves |
| What innervates the platysma muscle? | Facial nerve (cranial nerve VII) |
| What kind of nerve fibers does the cervical plexus contain? | Sensory and motor |
| Which nerves contribute to the ansa cervicalis? | Cranial nerves I-III |
| What nerves contribute to the phrenic? | Cranial nerves III-V |
| Which vessels join to form the external jugular vein? | 1) Retromandibular vein 2) Posterior auricular veins |
| What is the path of the external jugular vein? | Runs vertically across sternocleidomastoid muscle from the parotid region to the antero-inferior area of the posterior triangle? |
| What vessel does the external jugular vein drain into? | Subclavian vein |
| deep cervical fascia | 1) Encircles the neck 2) Major fascia of the neck |
| Name the parts of the deep cervical fascia | 1) Investing/anterior layer of deep cervical fascia 2) Prevertebral fascia (posterior layer of deep cervical fascia) |
| What is the role of the investing layer of deep fascia? | 1) Covers superficial and deep surface of the trapezius and sternocleidomastoid muscles (invests the muscles) 2) Forms the roof of the anterior and posterior triangles of the neck |
| What is the role of the prevertebral fascia? | Surrounds the vertebral column and the muscles closely related to it |
| What is the function of the visceral fascia? | Surrounds the viscera of the neck (pharynx, esophagus, larynx, trachea, thyroid gland) |
| What is the function of the carotid sheath? | Surrounds and contains carotid vessels, internal jugular vein, vagus nerve |
| What is the function of the middle cervical fascia? | Surrounds and contains the infrahyoid strap muscles |
| cervicoaxillary canal | 1) Bounded by muscles and fascia 2) Connects posterior triangle with the axilla |
| What structures form the roof of the posterior triangle? | Investing layer of deep cervical fascia as it attaches to 1) Adjacent borders of the trapezius and sternocleidomastoid muscles 2) Superior nuchal line 3) Clavicle |
| What structures form the floor of the posterior triangle? | Muscles covered by the prevertebral fascia 1) Splenius capitis 2) Splenius cervicis 3) Levator scapulae 4) Scalenus posterior 5) Scalenus medius 6) Scalenus anterior |
| What structures form the carpet of the posterior triangle? | Prevertebral fascia |
| What structures lie between the investing and prevertebral layers of deep fascia? | 1) Spinal accessory nerve (cranial nerve XI) 2) Inferior belly of the omohyoid muscle 3) Transverse cervical vessels 4) Cutaneous nerves from the cervical plexus |
| What structures does the spinal accessory nerve innervate? | 1) Trapezius 2) Sternocleidomastoid muscles |
| What is the spinal accessory nerve also known as? | Cranial nerve XI |
| Where is the spinal accessory nerve located? | Just beneath the investing layer of the deep cervical fascia |
| What structures lie between the carpet and floor of the posterior triangle? | 1) Dorsal scapular nerve 2) Long thoracic nerve 3) Phrenic nerve 4) Proximal portion of the brachial plexus 5) Third part of the subclavian artery |
| Root and target of innervation of the dorsal scapular nerve | C5 Rhomboids and levator scapulae |
| Roots and target of innervation of the long thoracic nerve | C5, C6, C7 Serratus anterior |
| Roots and target of innervation of the phrenic nerve | C3, C4, C5 Diaphragm |
| Origin and insertion of the sternocleidomastoid muscle | Origin: 2 heads, one on manubrium and on medial end of the calvicle Insertion: mastoid process |
| Functions of the sternocleidomastoid muscles | 1) Contraction of muscle on one side turns the head in the opposite direction 2) Contraction of both muscles action together flexes the neck 3) Accessory muscle of respiration |
| Innervation of the sternocleidomastoid muscles | Spinal accessory nerve and branches of C2 and C3 |
| How many scalene muscles are there and what are their names? | 3 1) Scalenus anterior/anterior scalene 2) Scalenus medius/middle scalene 3) Scalenus posterior/posterior scalene |
| Actions and innervations of the scalene muscles | 1) When acting together, are muscles of inspiration 2) Act on vertebral column of neck Innervation: cervical nerves |
| Which scalene muscle is a landmark in the floor of the neck? | Scalenus anterior |
| Origin and insertion of scalenus anterior | Origin: anterior tubercle of transverse processes of CV3-6 Insertion: scalene tubercle of first rib between the grooves for the subclavian vessels |
| Innervation of scalenus anterior | C5, C6, C7 |
| Where does the phrenic nerve cross the scalenus anterior muscle? | Anterior surface of the muscle deep to the prevertebral fascia, before entering the superior thoracic aperture |
| What structure crosses scalenus anterior, anterior to its insertion? | Subclavian vein |
| What structures are located between scalenus anterior and scalenus medius? | 1) Subclavian artery 2) Ventral primary rami that form the brachial plexus |
| What is the largest of the scalene muscles? | Scalenus medius |
| Origin and insertion of scalenus medius | Origin: posterior tubercle of transverse processes of CV2-7 Insertion: superior surface of the first rib immediately posterior to the brachial plexus and subclavian artery |
| Innervation of scalenus medius | C3-8 |
| What is the smallest of the scalene muscles? | Scalenus posterior |
| Origin and insertion of scalenus posterior | Origin: posterior tubercle of transverse processes of CV5-7 Insertion: second rib |
| Innervation of scalenus posterior? | C7, C8 |
| What structures do the ventral primary rami of the brachial plexus pass between when they leave the vertebral canal? | 1) Anterior and posterior tubercles of the cervical vertebrae 2) Scalenus anterior and scalenus medius |
| axillary fascia/sheath | Continuation of the prevertebral fascia |
| omohyoid muscle | 1) One of the infrahyoid muscles 2) Consists of superior and inferior bellies connected by an intermediate tendon |
| What region of the neck is the inferior belly of the omohyoid located? | Posterior triangle |
| What region of the neck is the superior belly of the omohyoid located in? | Anterior triangle |
| Where is the intermediate tendon of the omohyoid located? | Underneath the sternocleidomastoid muscle |
| Origin and insertion of omohyoid muscle | Origin: upper border of scapula Insertion: lower border of hyoid bone |
| Innervation of the omohyoid muscle | Ansa cervicalis |
| What structures lie superficial to scalenus anterior? | 1) Prevertebral fascia 2) Subclavian vein 3) Phrenic nerve 4) Transverse cervical artery 5) Suprascapular artery 6) Omohyoid muscle |
| Name the structures that lie immediately above the first rib, from anterior to posterior | 1) Subclavian vein 2) Scalenus anterior 3) Subclavian artery 4) Lower portion of brachial plexus 5) Scalenus medius |
| brachial plexis | Plexus of nerves that are formed from the ventral primary rami of C5-T1 |
| Name the parts of the brachial plexus found in the posterior triangle of the neck | 1) Ventral rami 2) Trunks 3) Divisions of the upper trunk 4) Suprascapular nerve 5) Nerve to the subclavius muscle 6) Dorsal scapular nerve 7) Long thoracic nerve 8) Phrenic nerve |
| sternoclavicular joint | Gliding joint between the medial end of the clavicle and the manubrium |
| articular disk | Divides the joint cavity into two separate spaces |
| Name the ligaments of the sternoclavicular joints | 1) Articular capsule 2) Anterior sternoclavicular ligament 3) Posterior sternoclavicular ligament 4) Interclavicular ligament 5) Costoclavicular ligament |
| What vessels does of the subclavian arteries branch off of? | Left: aortic arch Right: brachiocephalic trunk, which branches from the aorta |
| At what point does the subclavian artery become the axillary artery? | Lateral border of the first rib |
| What are the 3 sections of the subclavian artery, from proximal to distal? | 1) Before it crosses scalenus anterior 2) Where it crosses posterior to scalenus anterior 3) After it cross scalenus anterior but before it reaches the first rib |
| Name the branches of the first part of the subclavian artery | 1) Internal thoracic artery 2) Vertebral artery 3) Thyrocervical trunk |
| Where does the internal thoracic artery branch from and where does it go? | 1) Arises from the antero-inferior aspect of the subclavian artery 2) Descends posterior to the sternal end of the clavicle to enter thorax |
| Where does the vertebral artery branch from? | Arises from postero-superior aspect of the subclavian artery |
| Trace the path of the vertebral artery once it branches from the subclavian artery | 1) Enters transverse foramen of CV6 2) Ascends through succeeding transverse foramina 3) Runs along the superior aspect of the atlas 4) Enters skull via the suboccipital triangle |
| What structures does the vertebral artery supply? | Brain and the brain stem |
| Where does the thyrocervical trunk branch from? | Superior aspect of subclavian artery |
| Name the branches of the thyrocervical trunk | 1) Inferior thyroid artery 2) Suprascapular artery 3) Transverse cervical artery |
| Trace the path of the inferior thyroid artery once it branches from the thyrocervical trunk | 1) Passes superiorly along medial border of scalenus anterior to about the level of C6 2) Turns medially and branches |
| What structure does the ascending cervical artery run parallel to? | Phrenic nerve |
| What structure does the inferior laryngeal artery accompany? | Recurrent/inferior laryngeal nerve |
| Name the branches of the inferior thyroid artery | 1) Ascending cervical artery 2) Inferior laryngeal artery |
| Trace the path of the suprascapular artery once it branches from the thyrocervical trunk | 1) Passes anterior to scalenus muscle and posterior to sternocleidomastoid muscle 2) Travels behind clavicle to reach scapular notch 3) Crosses above the transverse scapular ligament |
| Trace the path of the transverse cervical artery once it branches from the thyrocervical trunk | 1) Passes between the scalenus anterior and sternocleidomastoid muscles 2) Turns posteriorly and crosses posterior triangle 2) Divides into superficial and deep branches |
| What structure does the superficial branch of the transverse cervical artery accompany? | Spinal accessory nerve, on the deep surface of the trapezius muscle |
| What structure does the deep branch of the transverse cervical artery accompany? | Dorsal scapular nerve, on the deep surface of the levator scapulae and rhomboid muscles |
| superficial cervical artery | Instead of branching off of the transverse cervical artery, the superficial branch may arise from the thyrocervical trunk separately as this artery |
| dorsal scapular artery | Instead of branching off of the transverse cervical artery, the deep branch may arise from the third party of the subclavian artery separately as this artery |
| What branches are located in the second part of the subclavian artery? | Costocervical trunk |
| What are the branches of the costocervical trunk? | 1) Deep cervical artery 2) Highest intercostal artery |
| What structures does the deep cervical artery supply? | Deep muscles on the back of the neck |
| What structures does the highest intercostal artery supply? | First two intercostal spaces |
| The third part of the subclavian artery has no branches. What is the exception to this rule? | Instead of having a deep branch of the transverse cervical artery, will have a separate branch off of the third part called the dorsal scapular artery |
| Where is the subclavian vein located? | 1) Begins at lateral border of first rib 2) Anterior to scalenus anterior muscle 3) Ends posterior to medial end of clavicle (at the sternoclavicular joint) |
| What vessels form the brachiocephalic vein? | 1) Subclavian vein 2) Internal jugular |
| Where do the subclavian and internal jugular veins join? | Poster to the medial end of the clavicle (at the sternoclavicular joint) |
| Where do the thoracic ducts drain into the venous system? | Left: junction of the subclavian and internal jugular veins Right: right subclavian vein |
| Where is the internal jugular vein located? | 1) Begins at the jugular foramen at the base of the skull 2) Within the carotid sheath, deep to the sternocleidomastoid muscle 3) Ends posterior to medial end of the clavicle (at the sternoclavicular joint) |
| What is the function of the anterior jugular vein? | Drains anterior triangle of the neck into the jugular arch |
| Location of the jugular arch | Above jugular notch of the sternum |
| What does the jugular arch empty into? | External jugular vein and internal jugular vein (to a lesser extent) |
| Where is the phrenic nerve located? | Anterior to the subclavian artery, medial to the phrenic nerve |
| Where does the right recurrent laryngeal nerve branch from? | Right vagus nerve as it passes the subclavian artery |
| Define the root of the neck | Base of cervical region that is 1) Superior to manubrium and transitions into the superior mediastinum 2) Anterior to the muscles of the prevertebral region and the scalene muscles 3) Lateral to the visceral compartment of the neck |
| Where does the superior cardiac branch arise from? | Right vagus nerve |
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