Clinical Anatomy Head & Neck
Terms
undefined, object
copy deck
- What are the major triangular divisons of the neck?
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posterior triangle
anterior triangle - What is the structure of the posterior triangle of the neck?
- bounded by sternocleidomastoid muscle (posterior), trapezius (anterior), and the clavicle (superior)
- What structures are located in the posterior tiangle of the neck?
-
acessory nerve
cutaneous branches of servical plexus
external jugular vein
subclavian vein and artery
transverse cervical and supra scapular vessels
inferior omohyoid
roots and trunks of brachial plexus - How is the posterior triangle of the neck divided?
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occipital triangle (superior)
inferior omohyoid (border)
subclavian triangle (inferior) - What is the structure of the anterior triangle of the neck?
- bounded by sternoclediomastoid (anterior), midline of the neck, and the mandible (inferior)
- How is the anterior triangle of the neck divided?
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digastric triangle (superior)
muscular triangle (anterior)
carotid triangle (lateral) - What are the attachments of the hyoid bone?
-
geniohyoid
mylohyoid
onohyoid
sternohyoid
stylohyoid
thyrohyoid
digastric (anterior and posterior0 - What are the major nerves of the neck?
-
accesory
cervical plexus
brachial plexus - What is the structure of the accesory nerve?
-
most inferior lateral to olive on the medulla oblongata
passes through the jugular foramen - What are the functions of the accessory nerve?
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innervate sternocleidomastoid and trapezius muscles of the neck
motor nerves innervate soft palate, physrynegeal constrictors, and larynx - What is the structure of the cervical plexus?
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ventral pimary rami of C1-C4
cunaeous branches
motor branches - What and where are the cuntaneous branches of the cervical plexus?
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nerves that innervate the skin in the neck
lesser occipital nerve (C2)
great auricular nerve (C2-C3)
transverse cervical nerve (C2-C3)
supraclavicular nerve (C3-C4) - What and where are the motor branches of the cervical plexus?
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motor nerves of the neck
ansa cervicalis (C1/C2)
phrenic nerve (C3-C5)
twigs from the plexus
accessory phrenic nerve (C5) - Where does the ansa cervicalis innervate?
- innervates infrahyoid muscles except the thyrohyoid muscle
- Where do the phrenic and acessory phrenic nerves innervate?
- innervates the diaphragm (motor minor sensory)
- What is the structure of the brachial plexus?
-
ventral primary rami of C5-T1
dorsal scapular nerve (C5)
long thoracic nerve (C5-C7)
suprascapular nerve (C5-C6)
nerve to sublavius muscle (C5) - Where does the dorsal scapular nerve innervate?
- innervates levator scapulae and rhomboid muscles
- Where does the long thoracic nerve innervate?
- innvates serratus anterior
- Where does the suprascapular nerve innervate?
- innervates the supraspinatus and infraspinatus muscles
- What are the blood vessels in the neck?
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subclavin artery
common carotid arteries
veins - What is the structure of the subclavian artery?
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right-rises from the right branch of the brachiocephalic trunk
left-directly from the aortic arch on the left - What are the branches of the subclavian artery?
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vertebral artery
tyrocervical trunk
internal thoracic artery (downward)
costocervical trunk
dorsal scapular artery - What is the structure of the vertebral artery?
- first to rise from the subclavian artery that ascends the transverse foamina of vertabrae C1-C6 through the foramen magum to the cranium
- What is the structure of the tyrocervical trunk?
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second to rise from the subclavian artery
inferior thyroid artery
transverse cervical artery (laterally along scalene muscle)
suprascapular artery - What is the structure of the internal thoracic artery?
- first to fall from the subclavian artery to the sixth intercostal space as the superior epigastric artery
- What is the structure of the costocervical trunk?
- last to rise from the subclavian artery divides into the deep cervical artery and the superior intercostal artery
- What are the structures of the common carotid arteries?
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right-leftmost division of the brachicephalic trunk
left-middle artery from aortic arch - What are the viens of the neck?
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retromandibular vein
external jugular vein
internal jugular vein - What is the structure of the external jugular vein?
- formed by union of posterior auricular vein and retomandibular vein and lateral to the sternocliedomastoid muscle
- What are the suprahyoid muscles and their nerve connections?
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digastric (facial, trigeminal nerve)
mylohyoid (trigeminal nerve)
stylohyoid (facial nerve)
geniohyoid (hypoglossal nerve) - What is the structure of the internal jugular vein?
- begins at the jugular foramen and ends at the brachiocephalic veins
- What are the cervical muscles and their nerve connections?
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platysma (facial nerve)
sternocleidomastoid (spinal accesory) - What are the infrahyoid muscles and their nerve connections?
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sternohyoid (ansa cervicalis)
sternothyroid (ansa cervicalis)
thyrohyoid (hypoglossal nerve)
omohyoid (ansa cervicalis) - What are the lymphatics of the neck?
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superficial lymph nodes of the head
deep lymph nodes of the head
superficial cervical lymph nodes
deep cervical lymph nodes - From where do the superficial lymph nodes of the head drain?
- lymph vessels form the face, scalp, and ear
- From where do the deep lymph nodes of the head drain?
- lymph vessels from the middle ear, nasal caviy and paranasal sinuses, the tongue, the larynx, the pharynx, and the thyroid glands
- From where do the superficial cervical lymph nodes drain?
- lymph vessels along the external and anterior jugular veins
- From where do the deep cervical lymph nodes drain?
- recieve lymphatics from veins along the internal jugular veins, the superficial lymph nodes of the head, the deep lymph nodes of the head, and the superficial cervical lymph nodes
- What is the structure of the trachea?
-
begins at the cricoid cartilage (C6)
has 16-20 incomplete hyaline cartilaginous rings (posterior opennings) - What is the structure of the esophagus?
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begins at the cricoid cartilage level (C6) and decends between the trachea and vertebral column
ciropharyngeus muscle is closed during deglitition and emesis - What nerves and arteries innervate the esophagus?
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recurrent laryngeal nerves and sympathetic trunks
inferior thyroid arteries - What is the structure of the thyroid gland?
- endocrine gland with right and left lobes connected by an isthmus on the second and third tracheal rings
- What is the function of the thyroid gland?
- uses iodine to produce throxine and thyrocalcitonin essential for metabolism and growth
- What are the structures and functions of parathyroid glands?
- four ovid bodies that lie against the dorsum of the thyroid regulating the levels of calcium and phosphorous metabolism
- What is the structure of the sympathetic trunk of the neck?
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covered by prevertebral fascia and contains preganglionic and postganglionic sympathetic fibers and visceral afferent fibers
recieves gray rami communicantes but not white in the cervical region - What are the cervical ganglion?
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neruons of the sympathetic trunk
superior cervical ganglion
middle cervical ganglion
inferior cervical ganglion
ansa subclavia - What is the structure and function of the superior cervical ganglion?
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sympathetic ganglion anterior to the transverse processes of C1-C2
contains cell bodies of postganglionic sympathetic fibers for visceal structures of the head and neck
gives rise to internal and external carotid nerves, pharyngeal branches, and superior cervical cardiac nerve (to heart) - What is the structure and function of the middle cervical ganglion?
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sympathetic ganglion at the level of the cricoid cartilage C6
gives rise to the middle cervical cardiac nerve (sympathetic cardiac nerve) - What is the structure and function of the inferior cervical ganglion?
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sympathetic ganglion that fuses with the first thoracic ganglion at C7 to become cervicothoracic ganglion
gives rise to the inferior cervical cardiac nerve - What is the sympathetic part of the ansa subclavia?
- cord connecting the middle and inferior cervical sumpathetic ganglia
- What is the structure and funciton of the thoracic duct?
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vessel that vurves posteriorly to the left carotid artory and left jugular vein
largest lymph vessel collecting from the body, except the right upper body, and drainning into the left subclavian vein - What are the types of deep cervical fasciae?
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spuerficial layer
prevertebral layer
carotid sheath
pretracheal layer
alar fascia
buccopharyngeal fascia
pharynogobasilar fascia
retropharyngeal space - What are the lateral vertebral deep muscles of the neck and their nerve innerventions?
- anterior, middle, and posterior scalene (lower cervical C5-C8)
- What are the anterior vertebral deep muscles of the neck and their nerve innerventions?
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longus capitus (C1-C4)
longus colli (C2-C6)
anterior and lateral rectus capitis (C1-C2) - How does the tyroid gland develop?
- endoderm forms throid diverticulum in the pharynx, elongates channel downward with the thyroglossal duct
- How does the parathyroid gland develop?
- superior and inferior parathyroid glands develop as the result of proliferation of endodermal cells in the third and fourth phgaryngeal pouch
- What are the nerves of the face and scalp?
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facial nerve
trigeminal nerve - How does the facial nerve innervate the muscles of the face and scalp?
- exits the skull through the stylomastoid foramen and branches into the temporal, zygomatic, buccal, mandibular, cervical , and posterior occipital branches
- What muscles does the facial nerve innervate?
- innervates the muscles of facial expression, auricular and occipitalis muscles, the digastric posterior belly, and stylohyoid muscles
- How does the trigeminal nerve innervate the muscles of the face?
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sensory innervation
above the upper eyelid and dorsum of nose
below the level of the eyes and above the upper lip
below the lower lip - What are the three trigeminal nerves?
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opthalmic division
maxillary division
mandibular division - How and where do the opthalmic nerves innervate the face?
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innervate at the upper eyelid (supraorbital, supratrochlear, lacrimal, infratrochlear nerves)
dorsum of the nose (external nasal) - How and where do the maxillary nerves innervate the face?
- innervate below the eyes and above the upper lip (zygomaticotemporal, sygomaticofacial, infraorbital nerve)
- How and where do the mandibular nerves innervate the face?
- innervate below the lower lip (auriculotemporal, buccal, mental nerve)
- What are the blood vessels of the face and scalp?
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facial artery
superficial temporal artery
facial vein
retromandibular vein - What is the structure of the facial artery?
- arises from the external carotid artery above the hyoid bone, passes deep into the mandible and winds around the border of the mandible up and forward to the face
- What is the structure of the superficial temporal artery?
- arises behind the neck of the mandible ascends anterior to the external acoustic meatus into the scalp, gives rise to the transverse facial artery along zygomatic arch
- What is the structure of the facial vein?
- recieves tributaries from facial arteries to form a common facial vein that enters the jugular vein
- What is the structure of the retromandibular vein?
- formed by the union of the superficial temporal arteries and maxillary veins, divides into an anterior and posterior branch to the external jugular vein
- What are the layers of the scalp?
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skin
connective tissue (vessels, dense tissue)
sponeurosis epicranialis (fibrous sheet)
loose connective tissue
pericranium (periosteum) - What is the sponeurosis epicranialis?
- a fibrous sheet that covers the vault of the skull
- What nerves innervate the skull?
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supraorbital nerves
zygomaticotemporal nerves
lesser, greater, and third occipital nerves - What arteries supply the skull?
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supratrochlear and supororbital branches of the internal carotid artery
superficial temporal, posterior auricular, and occipital banches of the external carotid artery - What are the boundries of the infratemporal fossa?
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posterior surface of maxilla (anterior)
styloid process (posterior)
lateral pterygoid plate (medial)
ramus and coronoid process of mandible (lateral)
greater wing of sphenoid (roof) - What are the boundries of the temporal fossa?
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zygomatic process of the frontal bone (anterior)
temporal line (posterior)
temporal line (superior)
zygomatic arch (inferior)
parts of sphenoid bone (fllor) - What are the nerves of the infratemporal region?
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mandibular division of trigeminal nerve
otic ganglion - What is the structure of the mandibular division of the trigeminal nerve and where are the motor nuerons?
- passes through the foramen ovale and innervates the muscles of mastication, anterior digastric muscle, and the myohyloid muscle
- Where do the sensory mandibular trigeminal nerves innervate?
- innervation to the lower teeth and below the lower lip and mouth
- What branches form from the mandibular division of the trigeminal nerve?
-
meningeal branch
muscular branch (muscles of mastication)
buccal nerve (mucus membranes of cheek and gum)
auriculotemporal nerve (general somatic afferent)
lingual nerve(secretomotor, sensory tongue)
inferior alveolar nerve - What is the structure of the meningeal branch of the mandibular division of the trigeminal nerve?
- enters cranium through foramen spinosum and innervates meninges of middle cranial fossa
- What is the structure of the inferior alveolar nerve of the mandibular division of the trigeminal nerve?
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mylohyoid nerve (mylohyoid, digastric)
inferior dental branch
mental nerve
incisive branch - What is the structure of the otic ganglion?
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lies in the infratemporal fossa, recieves preganglionic paraympathetic fibers towards the glossopharyngeal nerve
contain postganglionic fibers that innervate the parotid gland - What are the divisions of the common carotid artery?
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internal carotid artery
external carotid artery - What is the structure of the internal carotid artery?
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artery with no branches in the neck, ascends with vagus nerve and internal jugular vein
enters the cranium through the carotid canal and splits in the middle cranial fossa - What is the structure of the external carotid artery?
- artery that extends from the upper border of the thyroid cartilage dividing into the maxillary and superficial temporal arteries
- What are the blood vessels of the infratemporal region?
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maxillary artery
pterygoid venous plexus
retromandibular vein - What is the structure of the maxillary artery?
-
artery that arises from the external carotid artey at the posterioor border of the ramus of the mandible
mandibular part
pterygoid part
pterygopalatine part - What is the structure of the mandibular part of the maxillary artery?
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deep auricular artery
anterior tympanic artery
middle meningeal artery
accessory meningeal artery - What is the structure of the pterygopalatine part of the maxillary artery?
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posterior-superior alveolar arteries
infraorbital artery
descending palatine artery
artery of the pterygoid canal
pharyngeal artery
sphenopalatine artery - What is the structure of the pterygoid venous plexus?
- lies on the lateral surface of the medial pterygoid muscle drains branches of maxillary arteries into maxillary vein
- What is the structure and function of the parotid gland?
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occupise retromandibular space
innervated primarily by ptic ganglion
secretes a copious watery saliva by pasasympathetic stimulatioon
procudes a viscous saliva by sympathetic stimulation - What is the structure of the temporomandibular joint?
-
combined upper gliding and lower hinge synovial joints
between madibular fossa and articular tubercle - What are the branches of the external carotid artery?
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rises from the common coarotid artery (in ascending order)
superior thryroid artery
lingual artery
occipitlal artery (sternocleidomastoid branch, descending branch)
facial artery
posterior auricular artery
maxillary artery
ascending pharyngeal artery
superficial temporal artery - What is the structure of the pterygoid part of maxillary artery?
- lies superficial to the lateral sterygoid muscle and branches
- What are the muscles of mastication?
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temporalis
masseter
lateral pterygoid
medial pterygoid - What is the action of the muscles of mastication
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temporalis (elevates, retracts)masseter (elevates, retracts)
lateral pterygoid (depresses, and protracts)
medial pterygoid (elevates, protracts) - What is the nerve of the muscles of mastication?
- trigeminal
- What are the origin and insertion points of the muscles of mastication?
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temporalis (temporal fossa, coronoid process of mandible)
masseter (lower border, lateral surface of coronoid process)
lateral pterygoid (superior head of sphenoid, neck of mandible)
medial pterygoid (tuber of maxilla, medial surface of mandible) - What are the branches of the internal carotid artery in the brain?
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ophthalmic artery
posterior communicating artery
anterior choroidal artery
anterior cerebral artery
middle cerebral artery - What are the branches of the vertebral artery of the brain?
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anterior spinal artery
posterior spinal artery
posterior-inferior cerebral artery
basilar artery - What are the branches of the basial artery?
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anterior-inferior cerebellar artery
labyrinthine artery
pontine arteries
superior cerebellar artery
posterior cerebral artery - What are the cranial nerves?
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olfactory nerves
optic nerve
oculomotor
trochlear
trigeminal (opthalmic, maxillary, mandibular)
abducences
facial
vestibulocochlear
glossopharyngeal
vagus
accessory
hypoglossal - What is the structure of the olfactory nerve?
-
arises from the upper one third of the nasal mucosa
pass through the foramina in the cribriform plate of the ethmoid bone - What is the structure of the optic nerve?
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formed by ganglion cells of retina
leaves orbit from optic canal
converges at optic chiasma (cross over)
visual cortex in brain - What is the structure of the oculomotor nerve?
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most medial nerve attachment superior to the pons
superior orbital fissue
extraocular muscles - What is the structure of the trochlear nerve?
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middle nerve coming from the superior pons
passes through the lateral wall of the caverous sinus
superior orbital fissue
superior oblique muscle - What is the structure of the trigeminal nerve?
-
most lateral nerve from superior pons
splits into opthalmic, macillary, mandibular (most lateral) - What is the structure of the abducenes nerve?
-
most medial nerve superior to the medulla oblongata
supraorbital fissure
lateral rectus muscle - What is the structure of the facial nerve?
-
posterior superior to the medulla oblongata (wraps around)
anterior auperior portion of internal acoustic meatus
facial canal in temporal bone
stylomastoid foramen
geniculate ganglion - What is the structure of the vestibulochoclear nerve?
-
vestibulo (posterior) and cohchlear (anterior inferior) portions join after internal acoustic meastus
lateral superior medulla oblongata - What is the structure of the glossopharyngeal nerve?
-
most superior lateral to olive on the medulla oblongata
passes through jugular foramen - What is the structure of the vagus nerve?
-
middle lateral to olvie nerve on medulla oblongata
passes through jugular foramen - What is the structure of the hypoglossal nerve?
-
lateral to the pyramid and medial to the olive of the medulla oblongata
passes through hypoglossal canal
mylohyoid muscles - What are the cell bodies of the olfactory nerve?
- nasal mucosa
- What are the cell bodies of the optic nerve?
- ganglion cells of retina
- What are the cell bodies of the oculomotor nerve?
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nucleus (middle superior colliculus)
Edinger-Westphal nucleus (middle superior colliculus posterior to oculomotor nucleus) - What are the cell bodies of the trochlear nerve?
- nucleus (inferior colliculus)
- What are the cell bodies of the trigeminal nerve?
-
motor nucleus (lateral middle pons)
trigeminal ganglion - What are the cell bodies of the abducences nerve?
- nucleus (posterior middle pons)
- What are the cell bodies of the facial nerve?
-
motor nucleus (facial colliculus posterior pons)
superior salivatory nucleus (edge of pons and medulla oblongata)
geniculate ganglion - What are the cell bodies of the vestibulocochlear nerve?
-
vestibular and cochlear nuclei (lateral edge of inferior pons)
vestibular ganglion
spiral ganglion - What are the cell bodies of the glossopharyngeal nerve?
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nucleus ambiguus (middle lateral medulla)
inferior salivary nucleus (medulla)
inferior ganglion
superior ganglion - What are the cell bodies of the vagus nerve?
-
nucleus ambiguus (middle lateral medulla)
dorsal nucleus (medulla)
inferior ganglion
superior ganglion - What are the cell bodies of the accesory nerve?
- spinal cord (cervical)
- What are the cell bodies of the hypoglossal nerve?
- nucleus (middle medial medulla)
- What are the chief functions of the olfacory nerves?
- smell (sensory)
- What are the chief functions of the optic nerves?
- vision (sensory)
- What are the chief functions of the oculomotor nerves?
-
nucleus-eye movements (extraocular movements, somatic motor)
Edinger-Westphal nucleus-constriction of pupil (parasympathetic) - What are the chief functions of the trochlear nerves?
- eye movements (GSE)
- What are the chief functions of the trigeminal nerves?
-
motor nucleus-muscles of mastication (SVE)
trigeminal ganglion-sensation in head (GSA) - What are the chief functions of the abducenes nerves?
- eye movement (lateral rectus, GSE)
- What are the chief functions of the facial nerves?
-
motor nucleus-facial expression (SVE)
superior salivatory nucleus-lacrimal and salivary secretion (GVE)
geniculate ganglion-(sensation from palate GVA, auricle and external meatus GSA, hearing SSA) - What are the chief functions of the vestibulocochlear nerves?
-
vestibular-equilibrium (SSA)
spiral-hearing (SSA) - What are the chief functions of the glossopharengeal nerves?
-
nucleus ambiguus-elevation of pharynx (SVE)
inferior salivary-secretion of saliva (GVE)
inferior ganglion-carotid sinus GVA, taste from posterior one-third of tongue SVA)
superior ganglion-external ear (GSA) - What are the chief functions of the vagus nerves?
-
nucleus ambiguus-muscles of pharynx (SVE)
dorsal nucleus-smooth muscles in thoracic and abdominal visceral (GVE)
infeiro ganglion-sensation in lover neck (GVA), taste on epiglottis (SVA)
susperior ganglion-auricle and external acoustic meatus (GSA) - What are the chief functions of the acessory nerves?
- sternocleidomastoid and trapezius muscles (SVE)
- What are the chief functions of the hypoglossal nerves?
- muscles of movements of the tongue (GSE)
- What is cranial nerve I?
- olfactory
- What is cranial nerve II?
- optic
- What is cranial nerve III?
- oculomotor
- What is cranial nerve IV?
- trochlear
- What is cranial nerve V?
- trigeminal
- What is cranial nerve VI?
- abducences
- What is cranial nerve VII?
- facial nerve
- What is cranial nerve VIII?
- vestibulocochlear
- What is cranial nerve IX?
- glossopharengeal
- What is cranial nerve X?
- vagus
- What is cranial nerve XI?
- acessory
- What is cranial nerve XII?
- hypoglossal
- What are the divisions of the trigeminal nerve?
-
ophthalimic division (lacrimal nerve, frontal nerve, nasociliary nerve)
maxillary division (meningeal branch, pterygopalatine nerve, posterior-superior alveolar nerve, sygomatic nerve, infraorbital nerve, branches via pterigopalatine ganglion)
mandibular division (meningeal branch, muscular branches, buccal nerve, lingual nerve, inferior alveolar nerve) - What are the branches of the facial nerve?
-
greater petrosal nerve
communicating branch
stapedial nerve
chorda tympani
muscular branches
fine communicating branch
posterior auricular nerve
terminal branches - What are the branches of the glossopharyngeal nerve?
-
tympanic nerve
communicating branch
pharyngeal branch
carotid sinus branch
tonsillar branches
motor branch
lingual branch - What are the branches of the vagus nerve?
-
meningeal branch
auricular branch
pharyngeal branch
superior, middle, and inferior cardiac branches
superior laryngeal nerve (internal, external)
recurrent laryngeal nerve