Exam 2: Triangles of Neck

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  1. What can the neck be thought of as?
    • a strut for the head
    • a conduit for nerves, respiratory and dgestive organs 
  2. Which endocrine organs reside in the neck?
    • thyroid
    • parathyroid glands 
  3. What connects the back of the face into the neck?
  4. What is the airway called?
  5. Where is the trachea found?
    anterior in the inferior neck
  6. What is the part of the GI tract found in the neck?
  7. Where is the esophagus located?
    posteriorly below the larynx
  8. What is the larynx?
    the organ that separates respiratory from gustatory
  9. Where is the posterior triangle?
    lies in front of trapezius and posterior to sternomastoid muscle
  10. What forms the base of the posterior triangle?
    clavicle inferiorly
  11. What does the inferior portion of the posterior triangle supply?
    transition from neck to upper extremity so that nerves and arteries stream distally to limb under protection of clavicle
  12. Where is the anterior triangle of the neck?
    from midline of neck to anterior border of sternocleidomastoid muscle
  13. What is the superior limit of the anterior triangle?
    body of mandible
  14. What is the inferior limit of the anterior triangle?
    suprasternal notch of manubrium of the sternum
  15. How are subtriangles named?
    based on what structures reside in each subdivision
  16. Wht does the carotid triangle contain?
    branches of external carotid artery
  17. What does the muscular triangle contain?
    infrahyoid or strap muscles of neck
  18. What separates the carotid and muscular triangles?
    superior belly of omohyoid muscle
  19. Where is the submandiblular triangle?
    below mandible and is occupied by submandibular gland
  20. Where is the submental triangle?
    superior to hyoid bone and located between anterior bellies of right and left digastric mm.
  21. What is another name for the submental triangle?
    suprahyoid triangle
  22. What is found between the anterior and posterior triangle?
    carotid sheath
  23. What is between the two carotid sheaths (right and left)?
    a potential space behind the visceral tubes of the anteror triangle --the retropharyngeal space
  24. What commonly occurs in the retropharyngeal space?
    infections can travel through this space from neck to thoracic cavity
  25. What forms the cervical plexus?
    ventral rami of C1-4
  26. Which muscle does the cerical plexes orginate deep to?
    sternocleidomastoid muscle
  27. What does the cervical plexus provide?
    general sensation to neck and posterior head and motor innervation to infra-hyoid mm.
  28. What types of fibers does the cervical plexus contain?
    sensory, motor, and postganglionic sympathetic fibers
  29. Each cervical nerve (1-4) of the cervical plexus receives a gray ramus communicans from:
    superior cervical ganglion of the sympathetic trunk
  30. What do the sympathetic fibers innervate?
    sweat glands, vessel walls, etc
  31. What are the 4 major sensory branches that arise from the cervical plexus?
    • lesser occipital n.
    • great auricular n.
    • transverse cervical n.
    • supraclavicular nn.   
  32. Which cervical nerves contribute to the formation of the 4 sensory branches of the cervical plexus?
    cervical nerves 2-4
  33. Which triangle do the sensory components of the cervical plexus emerge from?
    posterior triangle of neck at midpoint of posterior border of sternocleidomastoid muscle
  34. What are the motor nerves of the cervical plexus?
    • ansa cervicalis
    • phrenic nn. 
  35. What does "ansa" mean?
    handle (loop)
  36. What are the roots of the ansa cericalis?
    superior and inferior
  37. What does the superior root of the ansa cervicalis contain?
    fibers from C1 and C2
  38. Which nerve does the proximal portion of the superior root of the ansa cervicalis run with?
    hypoglossal n. (CN XII)
  39. What fibers make up the inferior root of the ansa cervicalis?
    fibers from C2 and C3
  40. What does the ansa cervicalis provide?
    motor innervation to anterior neck "strap" muscles or infrahyoid muscles
  41. What are the infrahyoid muscles?
    • omohyoid (both bellies)
    • sternothyroid
    • sternohyoid
    • thyrohyoid
  42. Which of the infrahyoid muscles in not innervated by the ansa cervicalis?
  43. What innervates thyrohyoid?
  44. What are the boundaries of the posterior cervical triangle? 
    • posterior border of sternocleidomastoid muscle
    • anterior border oftrapezius
    • middle 1/3 of clavicle
    • inferior belly of omohyoid muscle divides triangl into omoclavicular and occipital sub-triangles
    • floor is formed by muscles    
  45. Which muscles make up the floor of the posterior triangle?
    • splenius capitus
    • levator scapulae
    • scalene muscles
  46. Which artery supplies splenius capitus?
    • deep cervical artery
    • posterior intercostal aa.  
  47. Which artery supplies the levator scapulae muscle?
    dorsal scapular artery
  48. Which scalene muscles form part of the floor of the posterior triangle?
    middle and posterior
  49. What normally hides the anterior scalene muscle?
    the SCM, but sometimes appears in the floor of the posterior triangle
  50. What is the overall function of the scalene muscles?
    inspiratory muscles and act to laterally flex neck (during unilateral contraction)
  51. What innervates the scalene muscles?
    ventral rami of C3-8
  52. What forms the interscalene triangle?
    the attachment of anterior and middle scalene muscles to first rib
  53. What is the interscalene triangle?
    a small space through which the proximal brachial plexus and subclavian artery pass on their way to the upper limb
  54. What clinical issue is caused by compression of the interscalene triangle?
    thoracic outlet syndrome
  55. What does the omohyoid muscle separate the posterior triangle into?
    superior occipital triangle and inferior praclavicular triangle
  56. Which artery supplies the omohyoid muscle?
    transverse cervical artery
  57. What type of nerves are found in the posterior triangle?
    • posteriorly directed motor nerves of cervical plexus
    • anteriorly directed sensory nerves of cervical plexus (supraclavicular nn)
    • trunks of brahial plexus
    • cranial nerve XI   
  58. What is cranial nerve XI?
    spinal accessory n.
  59. Where is the spinal accessory nerve?
    superifical structure of posterior triangle
  60. Where does the spinal accessory n. enter the posterior triangle?
    at the junction of supeiror and middle thirds of posterior border of SCM
  61. The spinal accessory n. passes postero-inferiorly, and then disappears where?
    deep to he anterior border of the trapezius between sperior 2/3 and inferior 1/3 of the muscle
  62. What is the function of the spina accessory n.?
    provides motor innervation to trapezius and sternocleidomastoid
  63. Why is the spinal accessory n. susceptible to injury?
    because ofits superficial position
  64. Which vessels cross through the posterior triangle?
    • subclavian artery
    • transverse cervical artery
    • suprascapular artery
    • occipital artery
    • external jugular vein    
  65. Which part of the posterior triangle does the subclavian artery pass through?
    the base
  66. Where is the subclavian artery headed as it passes through the base of the posterior triangle?
    the arm
  67. Which branches of the subclavian artery also cross the posterior triangle?
    • transverse cervical
    • suprascapular
  68. What is the transverse cervical artery a branch of?
    thyrocervical trunk
  69. What does the transverse cervical artery supply?
    trapezius and other structures
  70. What is the suprascapular artery a branch of?
    thyrocervical trunk
  71. What does the suprascapular artery supply?
    posterior scapular muscles
  72. What is the occipital artery a branch of?
    external carotid a.
  73. What does the occipital a. supply?
    posterior scalp
  74. Where does the external jugular vein begin?
    near the angle of the madible by the union of the retromandibular ad posterior auricular veins
  75. Where does the external jugular vein terminate?
    in the subclavian vein
  76. What are the boundaries of the anterior triangle?
    • anterior border of sternocleidomastoid muscle
    • midline of the neck
    • inferior border of the mndible
    • suprasternal notch
    • roof is platysma muscle and investing layer of deep cervical fascia    
  77. What are the muscles of the anterior triangle?
    • mylohyoid
    • geniohyoid
    • stylohyoid
    • digastric
    • sternohyoid
    • omohyoid
    • sternothyroid
    • thyrohyoid      
  78. What are the nerves of the anterior triangle?
    • ansa cervicalis
    • lesser occipital nerve, great auricular nerve, transverse cervial nerve and supraclavicular nn.
    • hypoglossal nerve
    • vagus nerve
    • cervical branch of facial n. (CN VII)
  79. What is the function of the ansa cervicalis?
    motor to infrahyoid mm.
  80. What is the function of the lesser occipital n., great auricular n., transverse cervical n., and supraclavicular nn.?
    sensory to skin on neck and around ear
  81. What cranial nerve is the hyoglossal nerve?
  82. What is the function of the hypoglossal nerve?
    motor to most mm. of tongue
  83. Where is the hyoglossal nerve?
    passes over carotid sheath and deep to posterior belly of digastric
  84. Which tongue muscle is not innervated by the hypoglossal nerve?
  85. Which cranial nerve is the vagus nerve?
  86. What is the function of the vagus nerve?
    motor and sensory in neck region
  87. What are important branches of the vagus nerve in the neck?
    • recurrent laryngeal n.
    • superior laryngeal n.  
  88. Where is the recurrnet laryngeal n. on the left?
    around aorta
  89. Where is the recurrent laryngeal n. on the right?
    around subclavian a.
  90. What structure does the recurrent laryngeal n. ascend in?
    tracheoesophageal groove
  91. What is the function of the recurrent laryngeal n.?
    supplies intrinsic mm. of larynx and sensation inferior to vocal folds as inferior laryngeal n.
  92. What are the branches of the superior laryngeal n.?
    external and internal
  93. What is the function of the external laryngeal n.?
    motor supplyto cricothyroid m.
  94. What is the function of the internal laryngeal n.?
    sensation in larynx above vocal folds
  95. What is the function of the facial n.?
    motor to platysma
  96. Which cranial nerve is the facial n.?
    CN VII
  97. What are the contents of the carotid sheath?
    • common carotid a.
    • internal jugular v.
    • vagus n.  
  98. Where does the right common crotid a. begin?
    at brachiocephalic a.
  99. Where does the left common carotid artery begin?
    aortic arch
  100. What structure does the common carotid a. ascend in?
    carotid sheath
  101. What does the common carotid artery bifurcate into?
    external and internal carotidd aa.
  102. Where does the common carotid a. bifurcate?
    at the level of the superior horn of the thyroid cartilage (in carotid triangle)
  103. What is the carotid body?
    a chemoreceptor
  104. What is the carotid sinus?
    a baroreceptor
  105. Do the internal carotid aa. have branches in the neck?
  106. What does the internal carotid a. supply?
    structures within the skull
  107. How many arteries supply the brain with blood?
  108. Do the internal carotid aa. supply the brain with blood?
  109. Where do the internal carotid aa. enter the cranium?
    through carotid canals
  110. What does the external carotid a. supply?
    structures outside of the skull
  111. What artery does the exteral cartid a. terminate as?
    maxillary a. and superficial temporal a.
  112. Where are the branches of the external carotid a.?
    both inside and outside the carotid triangle
  113. What are the branches of the external carotid a. within the carotid triangle?
    • superior thyroid a.
    • lingual a.
    • facial a.
    • ascending pharyngeal a.
    • occipital a.
    • posterior auricular a.     
  114. Where do the branches of the supeiror thyroid a. go?
    to sternocleidomastoid and infrahyoids, superior pole of thyroid gland
  115. Superior laryngeal a. is a branch of what?
    superior thyroid a.
  116. Where does the lingual artery arise?
    superior to greater horn of hyoid bone
  117. Which structures does the lingual a. travel deep to?
    • hypoglossal n. (CN XII)
    • stylohyoid m.
    • posterior belly of digastric m.
  118. Where does the lingual a. dive deep?
    deep to hyoglossus m.
  119. What is a frequent way for the lingual a. to branch instead of from the external carotid a.?
    • arise from a common trunk with facial a.
    • (sometimes off common trunk with supeior thyroid a.) 
  120. Where does the facial artery branch from?
    external carotid a. in carotid triangle
  121. Which triangle does the facial a. pass into?
    submandibular triangle
  122. The facial artery passes deep to which gland?
    submandibular gland
  123. In relationship to the submandibular gland, where does the facial v. pass?
    superficial to the gland
  124. What are branches of the facial a. in the neck?
    tonsilar ad submental branches
  125. Where does the ascending pharyngeal a. ascend in relationship to the internal carotid a.?
    deep to the internal carotid a.
  126. Which branch off the external carotid a. is the ascending pharyngeal a.?
    1st or 2nd
  127. Where can the ascending pharyngeal a. sometimes arise from?
    directly from bifurcation of common carotid a.
  128. Where do branches of the ascending pharyngeal a. go?
    pharynx, prevetebral mm., middle ear and meninges
  129. Where does the occipital a. arise?
    from posterior surface of external carotid a.
  130. Where does the occipital a. arise from the external carotid a.?
    where CN XII crosses the external carotid a. (corresponding to inferior border of posterior belly of digastric m.)
  131. Which triangles is the occipital a. found in?
    carotid triangle and posteior triangle
  132. Which CN run superficial to the occipital a.?
    CN IX, X and XI
  133. Where does the posterior auricular a. arise?
    • from posterior aspect of external carotid a.
    • at supeior border of posterior belly of digastric m. 
  134. Where does the posterior auricular a. ascend?
    posterior to external acoustic meatus
  135. What does the posterior auricular a. supply?
    adjacent musculature, facial n., parotid gland, auricle and scalp
  136. What does the internal jugular vein drain?
    brain and superficial head and neck
  137. Where does the internal juguar vein travel?
    in carotid sheath in lateral position
  138. What accompanies the internal jugular vein?
    deep cervical lymph nodes
  139. How is the internal jugular vein formed?
    by union of posterior auricular vein and posterior division of retromandibular vein
  140. How is the anterior jugular vein formed?
    by confluence of several superficial veins from submandibular region
  141. What does the anterior jugular vein drain into?
    external jugular (sometimes directly into subclavian)
  142. What are the boundaries of the submandibular triangle?
    • anterior belly of digastric m
    • posterior belly of digastric m.
    • lower border of mandible
    • floor = mylohyoid m.
  143. What are the boundaries of the submental triangle?
    • anterior belly of digastric m.
    • midline of the area
    • inferior body of hyoid bone
    • floor = mylohyoid m.   
  144. What are the contents of the submental and submandibular triangles?
    • submandibular glnad
    • cranial nn. in region
    • suprahyoid mm.
    • vessels
  145. How many salivary glands are there?
  146. Where does the submandibular gland secrete product?
    into submandibular duct
  147. What supplies autonomic innervation of the submandibular gland?
    CN VII via chorda tympani
  148. Where is the superficial lobe of the submandibular gland prominent?
    in submandibular triangle
  149. What cranial nn. are in the submental and submandibular triangles?
    • vagus
    • hypoglossal (with C1)
    • facial 
    • nerve to mylohyoid (V3)
    • glossopharyngeal    
  150. What is the function of the suprahyoid muscles?
    • act on hyoid bone
    • -stabilization
    • -elevation
    • -retraction
  151. What is an added function of the digastric muscles?
    depress mandible
  152. What are the suprahyoid muscles?
    • digastric
    • mylohyoid
    • stylohyoid
    • geniohyoid
  153. What innervates the anterior belly of the digastric m.?
    nerve to mylohyoid (branch of V3)
  154. What innervates the posterior belly of the digastric m.?
    CN VII
  155. What innervates the mylohyoid?
    nerve to mylohyoid (branch of V3)
  156. What innervates stylohyoid?
    CN VII
  157. What innervates geniohyoid?
    C1 via hyoglossal
  158. Which vessels are contained in the submental and submandibular triangles?
    parts of facial a. and v.
  159. What are the boundaries of the carotid triangle?
    • superior belly of omohyoid
    • posterior belly of digastric
    • anterior border of SCM  
  160. What are the contents of the carotid triangle?
    • carotid sheath
    • common carotid arter
    • external carotid artery and branches
    • internal jugular v.
    • Nerves
    • -vagus (CN X)
    • -superior root of ansa cervicalis
    • -spinal accessory (CN XI)
    • -branches of cervical plexus
    • thyroid gland, larynx, and pharynx
    • deep cervical lymph nodes          
  161. Which artery is in the carotid triangle?
    • common carotid artery
    • external carotid artery and branches 
  162. Which vein is in the carotid triangle?
    internal jugular vein
  163. Which nerves are in the carotid triangle?
    • vagus (CN X)
    • superior root of ansa cervicalis
    • hypoglossal (CN XII)
    • spinal accessory (CN XI)
    • branches of cervical plexus    
  164. What are the boundaries of the muscular triangle?
    • superior belly of omohyoid m.
    • anterior borer of SCM
    • median plane of neck  
  165. What are the contents of the muscular triangle?
    • infrahyoid mm.
    • throid and parathyroid glands 
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Exam 2: Triangles of Neck
review of 6/25 lecture on Triangles of Neck for Exam 2
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