129 Questions
Which of the following muscles has its origin from the body of the hyoid bone?
Sternohyoid muscle
Which muscle group is subdivided into medial or prevertebral group and lateral group?
The posterior group
What is the function of the Omohyoid muscle?
Depresses the hyoid bone
Which nerve supply all infrahyoid muscles?
Branches of the cervicalis ansa
Where does the Sternothyroid muscle insert?
Posterior surface of the manubrium of sternum
What is the function of the Sternothyroid muscle?
Depresses the hyoid bone and larynx
Where does the Thyrohyoid muscle originate?
Body and great horn of the hyoid bone
What is the function of the Thyrohyoid muscle?
Depresses the hyoid bone and elevates the larynx
Which muscle forms the lateral boundary of the submandibular triangle?
Digastric muscle
What is the name of the triangle bounded by the sternocleidomastoid muscle, omohyoid muscle, and digastric muscle?
Carotid triangle
Which nerve is found in the occipital triangle?
CN XI /external branch/
What is the name of the muscle that forms the floor of the submandibular triangle?
Mylohyoid muscle
Which structure is not found in the carotid triangle?
Submandibular gland
Which muscle forms the lateral boundary of the omotracheal triangle?
Omohyoid muscle
What is the name of the triangle that contains the thyroid gland?
Omotracheal triangle
Which nerve is found in the submandibular triangle?
CN XII
At what level does the external carotid artery pass through the parotid gland and terminate?
At the level of the upper border of the thyroid cartilage
Which nerve does the superior laryngeal artery pierce the thyrohyoid membrane with?
CN X
What is the relation of the external carotid artery to the internal jugular vein in the carotid triangle?
Medial to the internal jugular vein
Which artery supplies the middle part of the larynx?
Cricothyroid artery
What is the relation of the external carotid artery to the pharynx in the carotid triangle?
Deep to the pharynx
Which muscle is the external carotid artery deep to within the parotid gland?
Posterior belly of the digastric muscle
What is the main artery that supplies the brain and spinal cord?
Vertebral artery
How many branches does the external carotid artery give off?
Eight
Which artery supplies the thyroid gland?
Inferior thyroid artery
Which nerve does the superior thyroid artery descend with?
External laryngeal nerve
What is the main vein of the neck?
Internal jugular vein
What is the branch of the thyrocervical trunk that supplies the thyroid gland?
Inferior thyroid artery
What is the branch of the costocervical trunk that supplies the intercostal region?
Highest intercostal artery
What is the vein that is formed by the union of the internal jugular vein and the subclavian vein?
Brachiocephalic vein
Which artery is a branch of the thyrocervical trunk?
Inferior thyroid artery
What is the origin of the internal jugular vein?
Sigmoid venous sinus
What is the origin of the stylohyoid muscle?
Styloid process of the temporal bone
What is the function of the muscle that originates from the mastoid process of the temporal bone?
Turns the face superiorly towards the opposite side
What is the innervation of the mylohyoid muscle?
CN V3
What is the insertion of the muscle that originates from the mastoid process of the temporal bone?
Manubrium of the sternum
What is the function of the middle group of muscles when acting together?
Turns the face superiorly upwards
What is the origin of the muscle that inserts into the body of the hyoid bone?
Mylohyoid line on the internal aspect of the mandible
What is the innervation of the muscle that originates from the mastoid process of the temporal bone?
Cervical plexus and cervical part of CN XI
What is the function of the mylohyoid muscle?
Elevates the floor of the oral cavity
What is the pathway of lymph collected from the deep cervical nodes?
Into the jugular trunk
What is the relation of the pharynx to the alimentary and the respiratory systems?
It is a common passage for both systems
What is the branch that supplies the thyroid gland?
The branch of the thyrocervical trunk
What is the course of the pharynx?
From the base of the skull to the lower border of the cricoid cartilage
What is the length of the pharynx?
About 12 cm
What is the relationship between the external carotid artery and the internal jugular vein in the carotid triangle?
The external carotid artery is deep to the internal jugular vein
Which branch of the thyrocervical trunk supplies the thyroid gland?
Inferior thyroid artery
What is the course of the superior laryngeal artery?
It pierces the thyrohyoid membrane with the superior laryngeal nerve
What is the main vein of the neck?
Internal jugular vein
What is the relationship between the subclavian artery and the brachial plexus?
They are sometimes separate by the minor scalene muscle.
What is the course of the subclavian artery?
It runs below the first rib.
Which of the following is a branch of the neck?
Subclavian artery
What is the relation of the cranial nerves to the neck?
They are part of the nerves of the neck.
What is the organization of the lymphatic drainage of the neck?
It is organized into superficial and deep nodes.
Which cervical fascia gives off septa that can be subdivided into five parts?
Deep cervical fascia
What is the relationship between the pretracheal fascia and the investing layer of the deep cervical fascia?
The investing layer merges laterally with the pretracheal fascia
Which muscle is enclosed by the investing layer of the deep cervical fascia?
Sternocleidomastoid
What is the composition of the superficial cervical fascia?
Variable amounts of adipose tissue and the platysma muscle
How many parts can the septa of the deep cervical fascia be subdivided into?
Five
What is the level at which the internal carotid artery arises from the common carotid artery?
At the level of the upper border of the thyroid cartilage
What is the relationship between the internal carotid artery and the external carotid artery in the neck?
The internal carotid artery lies medially to the external carotid artery
What is the course of the internal carotid artery within the carotid canal?
The internal carotid artery ascends upward and then forward by the cavernous sinus
What is the relationship between the internal carotid artery and the internal jugular vein in the neck?
The internal carotid artery lies lateral to the internal jugular vein
What is the termination of the internal carotid artery?
It terminates intracranially in the middle cranial fossa, medially to the anterior clinoid process of the sphenoid bone
What is the function of the auricular nerve?
To supply the skin of the external auditory meatus and the tympanic membrane
What is the relation of the vagus nerve to the internal jugular vein in the neck?
The vagus nerve lies medially to the internal jugular vein
What is the course of the vagus nerve in the neck?
It descends through the neck and thorax to the oesophageal plexus
What is the branch of the vagus nerve that arises from the superior vagal ganglion?
Meningeal branch
What is the structure that the vagus nerve leaves the skull through?
Jugular foramen
What type of joint is the cricothyroid joint?
Plane synovial joint
What is the function of the conus elasticus?
Forms the vocal fold (true vocal cord)
What is the relation between the quadangular membrane and the aryepiglottic fold?
The quadangular membrane is a part of the aryepiglottic fold
What is the function of the thyrohyoid membrane?
Unites the upper border of the thyroid cartilage to the posterior surface of the body and the greater horns of the hyoid bone
What is the course of the cricothyroid joint?
Located between the inferior horn of the thyroid cartilage and the lateral aspect of the cricoid cartilage
What is the relation between the conus elasticus and the vocal fold?
The conus elasticus forms the vocal fold
What is the type of joint that the crico-arytenoid joint is?
Plane synovial joint
What is the function of the quadangular membrane?
Passes from the lateral margin of the epiglottis to the arytenoid cartilage
What is the relation between the thyrohyoid membrane and the hyoid bone?
The thyrohyoid membrane unites the upper border of the thyroid cartilage to the posterior surface of the body and the greater horns of the hyoid bone
What is the course of the quadangular membrane?
Passes from the lateral margin of the epiglottis to the arytenoid cartilage
What is the boundary of the Supraclavicular triangle?
Sternocleidomastoid, omohyoid and clavicle
Which of the following structures is found in the Anterior fissure of the scalene muscles?
Subclavian vein
What is the muscle that forms the posterior boundary of the Anterior fissure of the scalene muscles?
Anterior scalene muscle
Which of the following structures is found in the Supraclavicular triangle?
Subclavian artery, subclavian vein and brachial plexus
What is the boundary of the Posterior fissure of the scalene muscles?
Anteriorly - anterior scalene muscle, posteriorly - middle scalene muscle, inferiorly - first rib
What is the location of the groove for the subclavian vein?
On the first rib, anterior to the scalene tubercle
What is the relation of the internal carotid artery to the external carotid artery in the neck?
The internal carotid artery is lateral to the external carotid artery
What is the boundary of the Anterior fissure of the scalene muscles?
Anteriorly - sternocleidomastoid muscle, posteriorly - anterior scalene muscle, inferiorly - first rib
Which nerve hooks around the external carotid artery?
XII nerve
Which of the following nerves is a cutaneous branch from the cervical plexus?
All of the above
What is the branch of the external carotid artery that supplies the middle ear?
Inferior tympanic artery
What is the level at which the external carotid artery arises from the common carotid artery?
Same level as the facial artery
What is the branch of the posterior auricular artery that supplies the middle ear?
Posterior tympanic artery
What is the direction in which the external carotid artery runs?
Backwards and downwards
What is the region through which the internal carotid artery passes?
Carotid canal
What is the branch of the external carotid artery that supplies the scalp?
Occipital branch
What is the primary tributary of the sigmoid sinus?
Occipital sinus
Which vein is formed by the union of the posterior branch of the retromandibular vein and the posterior auricular vein?
External jugular vein
What is the destination of the anterior jugular vein?
Subclavian vein
What is the function of the jugular arch?
Unites the two anterior jugular veins
Which of the following veins is not a tributary of the internal jugular vein?
Thoracic duct
What is the relationship between the vertebral vein and the deep cervical vein?
They are both branches of the brachiocephalic veins
Which of the following veins drains into the subclavian vein?
All of the above
What is the primary function of the posterior auricular vein?
Drains the posterior aspect of the scalp
What is the main difference between the left and right jugular trunks?
The left jugular trunk drains into the thoracic duct.
What is the location of the deep cervical nodes in relation to the sternocleidomastoid muscle?
Deep to the sternocleidomastoid muscle.
What is the length of the pharynx?
12 cm
What is the width of the pharynx at its upper part?
1.5 cm
What is the level at which the pharynx becomes the upper part of the oesophagus?
C6
What is the function of the pharynx?
It is a common passage for the alimentary and respiratory systems.
What is the direction of the pharynx?
From the base of the skull to the lower border of the cricoid cartilage
What is the greatest width of the pharynx?
5 cm
What is the primary purpose of a cricothyrotomy?
To provide emergency air supply to the trachea and lungs
What type of muscle is found in the posterior wall of the trachea?
Unstriated muscle
Which nerve branch supplies the mucous membrane of the infraglottic portion of the larynx?
Inferior laryngeal nerve
What is the anatomical landmark at which the trachea begins?
The level of the 6th cervical vertebra
What is the purpose of a tracheostomy?
To provide ventilation to patients in bad condition using a respirator
What type of cartilage makes up the C-shaped rings of the trachea?
Hyaline cartilage
Which structure lies posterior to the trachea in the neck?
Oesophagus
What is the name of the muscle that is not supplied by the inferior laryngeal nerve?
Cricothyroid muscle
Which of the following nuclei is responsible for visceral sensory function?
Nucleus of the tractus solitarius
What is the total number of nuclei of the vagal nerve?
Four
Which type of fibers supply the heart, lungs, and the alimentary canal near to the splenic flexure?
General visceral motor fibers
What is the location of the superior parathyroid glands?
Near the middle of the lobe of the thyroid gland
What is the function of the special visceral motor fibers?
Innervate the striated muscles of the larynx, pharynx, and palate
What is the function of the general visceral sensory fibers?
Come from the mucous membrane of the palate, pharynx, larynx, heart, lungs, and the alimentary canal
What is the location of the inferior parathyroid glands?
Near the base of the thyroid lobe
How many types of fibers does the vagal nerve consist of?
Five
What is the function of the special visceral sensory fibers?
Come from the valleculae and the epiglottis
What is the total number of pairs of parathyroid glands?
Two
Study Notes
External Carotid Artery (ECA)
- Divides into two terminal branches: maxillary and superficial temporal arteries at the level of the upper border of the thyroid cartilage
- Located in the carotid triangle and within the parotid gland
- Laterally to the internal carotid artery (ICA) and medially to the CN VII and retromandibular vein
- Gives off eight branches, categorized into two groups:
- Anterior aspect:
- Superior thyroid artery
- Superior laryngeal artery
- Cricothyroid artery
- Posterior aspect:
- Vertebral artery
- Internal thoracic artery
- Thyrocervical trunk
- Costocervical trunk
- Anterior aspect:
Internal Carotid Artery (ICA)
- Supplies the greater part of the brain and the contents of the orbit
- Origin: bifurcation of the common carotid artery at the level of the upper border of the thyroid cartilage (C6)
- End: terminates intracranially in the middle cranial fossa, medially to the anterior clinoid process of the sphenoid bone
- Course: ascends to the base of the skull, first located posterolaterally to the external carotid artery, then medially to that artery
- Relations:
- Within the neck: lies within the carotid sheath with the internal jugular vein laterally and the vagus nerve behind
- In the carotid triangle: lies laterally and posteriorly to the ECA, posteriorly and medially to the sternocleidomastoid muscle, and anteriorly to the prevertebral fascia and the sympathetic trunk
Veins of the Neck
- Three main veins:
- Internal jugular vein
- External jugular vein
- Anterior jugular vein
- Internal jugular vein:
- Arises as the continuation of the sigmoid venous sinus
- Ascends through the neck and behind the medial end of the clavicle, where it is joined by the subclavian vein to form the brachiocephalic vein
- Relations:
- Laterally by the posterior belly of the digastric muscle
- Medially by the anterior belly of the digastric muscle
- Inferiorly by the mandible
- Floor: formed by the mylohyoid muscle, hyoglossus muscle, and the pharynx
Triangles of the Neck
- Anterior triangle of the neck:
- Submandibular triangle
- Carotid triangle
- Muscular triangle or omotracheal triangle
- Submental triangle
- Posterior triangle of the neck:
- Occipital triangle
- Supraclavicular triangle
- Omoclavicular triangle
- Greater supraclavicular fossa
- Relations:
- Sternocleidomastoid muscle
- Omohyoid muscle
- Digastric muscle
- Scalene muscles
Muscles of the Neck
- Suprahyoid muscles:
- Mylohyoid muscle
- Stylohyoid muscle
- Digastric muscle
- Infrahyoid muscles:
- Omohyoid muscle
- Sternohyoid muscle
- Sternothyroid muscle
- Thyrohyoid muscle
- Posterior group:
- Longus colli muscle
- Longus capitis muscle
- Rectus capitis anterior muscle
- Lateral group
Lymphatic Drainage of the Neck
- Groups of superficial nodes:
- Submandibular nodes
- Submental nodes
- Anterior cervical nodes
- Posterior cervical nodes
- Groups of deep nodes:
- Deep cervical nodes
- Jugular trunk
- Thoracic duct
- Right lymphatic duct
Pharynx
- Muscular tube extending from the base of the skull to the lower border of the cricoid cartilage of the larynx
- Subdivided into three regions:
- Nasopharynx
- Oropharynx
- Laryngopharynx
- Relations:
- Base of the skull
- Lower border of the cricoid cartilage
- Level of the 6th cervical vertebra### Emergency Therapy for Asphyxiation
- In case of object entering the larynx, emergency therapy is required to supply air to the trachea and lungs
- A large needle should be inserted into the median cricothyroid ligament, a procedure called cricothyrotomy
Inferior Laryngeal Nerve
- Inferior laryngeal nerve (nervus laryngeus inferior) is a branch from the recurrent laryngeal nerve (branch of vagal nerve)
- Supplies mucous of infraglottic portion of the larynx and all intrinsic muscles (except cricothyroid muscle)
Trachea
- Cervical portion of trachea is a tube composed of cartilages and membranes
- Maintained by a series of C-shaped rings of hyaline cartilage, incomplete posteriorly
- Posteriorly, across the gap of each cartilage, is a thin coat of unstriated muscle (trachealis), called membranous wall
- Cartilages united by fibro-elastic membranes, named anular ligaments
- Begins at the level of the 6th cervical vertebra (at the lower border of the cricoid cartilage)
- Anteriorly situated is the thyroid gland and posteriorly the trachea lies on the oesophagus
- Tracheostomy is a surgical procedure in which an opening in the trachea is made to allow patients in bad condition ventilation by respirator
Tributaries
- Sigmoid sinus (sinus sigmoideus)
- Occipital sinus (sinus occipitalis)
- Inferior petrosal sinus (sinus petrosus inferior)
- Occipital vein (vena occipitalis)
- Facial vein (vena facialis)
- Pharyngeal plexus (plexus pharyngeus)
- Lingual vein (vena lingualis)
- Superior and inferior thyroid veins (vena thyroidea superior et inferior)
- Thoracic duct (ductus thoracicus) on the left side
- Right lymphatic duct (ductus lymphaticus dexter) on the right side
External Jugular Vein
- A superficial vein formed behind the angle of the mandible by the union of the posterior branch of the retromandibular vein and the posterior auricular vein
- May enter either the internal jugular, brachiocephalic, or subclavian veins
- Tributaries:
- Posterior auricular vein (vena auricularis posterior)
- Occipital vein (vena occipitalis)
- Suprascapular vein (vena suprascapular)
- Transverse cervical vein (vena transversa colli)
Anterior Jugular Vein
- Begins below the hyoid bone to enter the external jugular or subclavian veins
- Jugular arch unites the two anterior jugular veins
Occipital Artery
- Relations:
- Arises at the same level as the facial artery
- Runs backwards across carotid sheath where the CN XII hooks around it
- Branches:
- Branches for muscles (neck and suboccipital)
- Mastoid branch
- Auricular branch
- Occipital branch
Posterior Auricular Artery
- Relations:
- Passes along the upper border of the posterior belly of the digastric
- Passes through the apical part of the parotid gland to the lateral aspect of the scalp
- Branches:
- Auricular branch
- Posterior tympanic artery - to the middle ear
- Branches to the muscles
- Stylomastoid artery
- Occipital branch
Test your knowledge of the neck muscles, their origins, insertions, functions, and innervation. Identify the muscles of the neck and their roles in movements like flexion and rotation.
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