Triangles of the Neck II

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Questions and Answers

Which of the following arteries branches directly from the facial artery?

  • Dorsal lingual artery
  • Ascending palatine artery (correct)
  • Inferior thyroid artery
  • Recurrent laryngeal artery

What is the primary function of the superior laryngeal nerve?

  • Motor to the muscles of the larynx
  • Motor to the cricothyroid muscle (correct)
  • Sensory to the lower part of the cavity of the larynx
  • Parasympathetic fibers to the heart

Which structure does the internal jugular vein merge with to form the brachiocephalic vein?

  • External jugular vein
  • Left common carotid artery
  • Subclavian vein (correct)
  • Facial vein

What does the lingual artery NOT provide tributaries to?

<p>Auricular branch (A)</p> Signup and view all the answers

Which of the following is NOT a function of the vagus nerve in the neck?

<p>Motor to the cricothyroid muscle (A)</p> Signup and view all the answers

Which muscles are primarily supplied by the spinal part of the accessory nerve?

<p>Sternocleidomastoid and trapezius (A)</p> Signup and view all the answers

What anatomical structure does the hypoglossal nerve wind forward over?

<p>Superficial to the internal carotid, external carotid, and lingual artery (A)</p> Signup and view all the answers

Which structure lies above the posterior belly of the digastric muscle?

<p>Jugulo-digastric lymph nodes (B)</p> Signup and view all the answers

The inferior root of descendens cervicalis is associated with which spinal segments?

<p>C2 and C3 (B)</p> Signup and view all the answers

Which statement best describes the role of the hypoglossal nerve?

<p>It supplies the muscles of the tongue. (A)</p> Signup and view all the answers

Which structure forms the floor of the digastric triangle?

<p>Mylohyoid muscle (A)</p> Signup and view all the answers

What is located in the contents of the anterior part of the digastric triangle?

<p>Facial vein (B)</p> Signup and view all the answers

Which structure is found within the posterior part of the digastric triangle?

<p>External carotid artery (B)</p> Signup and view all the answers

Which muscle bounds the digastric triangle posteriorly?

<p>Stylohyoid muscle (B)</p> Signup and view all the answers

Which of the following is NOT part of the muscular triangle's structure?

<p>Posterior belly of digastric muscle (D)</p> Signup and view all the answers

Which arteries branch from the external carotid artery in the neck?

<p>Superior thyroid artery (C)</p> Signup and view all the answers

What is the function of the ansa cervicalis?

<p>Supplies infrahyoid muscles (D)</p> Signup and view all the answers

Which statement accurately describes the internal jugular vein?

<p>It ends by joining the subclavian vein to form the brachiocephalic vein. (D)</p> Signup and view all the answers

What areas does the vagus nerve provide branches to in the neck?

<p>Cardiac branches to the cardiac plexus (C)</p> Signup and view all the answers

Which structure forms the boundaries of the Digastric triangle?

<p>Lower border of the mandible and digastric muscles (C)</p> Signup and view all the answers

What is the origin of the sternocleidomastoid muscle?

<p>Sternum and medial end of the clavicle (A)</p> Signup and view all the answers

Which structure is NOT a boundary of the Carotid triangle?

<p>Ansa cervicalis (A)</p> Signup and view all the answers

Which lymph nodes drain the central part of the lower lip and the floor of the mouth?

<p>Submental lymph nodes (D)</p> Signup and view all the answers

At which level does the common carotid artery bifurcate?

<p>At the upper border of the lamina of the thyroid cartilage (A)</p> Signup and view all the answers

What nerve supplies the sternocleidomastoid muscle?

<p>Spinal accessory nerve (C)</p> Signup and view all the answers

What is the carotid tubercle primarily used for?

<p>To serve as a landmark for the common carotid artery (B)</p> Signup and view all the answers

At which vertebral level does the common carotid artery terminate?

<p>C3 and C4 (A)</p> Signup and view all the answers

Which artery is NOT a branch of the external carotid artery?

<p>Subclavian artery (D)</p> Signup and view all the answers

What are the terminal branches of the common carotid artery?

<p>Internal and external carotid arteries (B)</p> Signup and view all the answers

Where can the pulsation of the common carotid artery be palpated?

<p>Anterior to the sternocleidomastoid muscle (C)</p> Signup and view all the answers

Why is the carotid tubercle significant in surgical procedures?

<p>It serves as a landmark to avoid injury to the carotid artery. (D)</p> Signup and view all the answers

Which structure is part of the floor of the Carotid triangle?

<p>Hyoglossus muscle (C)</p> Signup and view all the answers

What function does the carotid body serve?

<p>Chemo-receptor (B)</p> Signup and view all the answers

Where can the carotid pulse be palpated?

<p>Deep to the anterior border of the sternocleidomastoid muscle (B)</p> Signup and view all the answers

What can the carotid tubercle provide leverage against?

<p>The vertebrae of the neck (C)</p> Signup and view all the answers

What is the purpose of carotid artery compression?

<p>To control hemorrhage from the head or neck (B)</p> Signup and view all the answers

Flashcards

Facial Artery

A major artery in the neck that supplies blood to the face and neck.

External Laryngeal Nerve

This nerve is a branch of the vagus nerve and controls muscles in the larynx, specifically the cricothyroid muscle.

Internal Jugular Vein

A vein in the neck that drains blood from the brain and skull.

Ansa Cervicalis

A network of nerve fibers in the neck that control muscles in the neck and shoulder.

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Common Carotid Artery

A major artery in the neck that branches into internal and external carotid arteries and supplies blood to the brain, face, and neck.

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Inferior root (Descendens cervicalis)

A branch of the hypoglossal nerve (CN XII) that descends along the neck, contributing to the innervation of infrahyoid muscles.

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Hypoglossal nerve (CN XII)

The 12th cranial nerve, responsible for innervating the muscles of the tongue, allowing for movement and speech.

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Deep cervical lymph nodes

A cluster of lymph nodes located deep in the neck, closely associated with the internal jugular vein.

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Jugulo-digastric nodes

A subset of the deep cervical lymph nodes located above the posterior belly of the digastric muscle, filtering lymph from the head and neck regions.

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Jugulo-omohyoid nodes

Another group of deep cervical lymph nodes found beneath the posterior belly of the digastric muscle, also contributing to lymphatic drainage in the neck area.

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Common Carotid Artery Bifurcation

The common carotid artery divides (bifurcates) into the internal carotid artery, which supplies the brain, and the external carotid artery, which supplies the face and neck.

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External Carotid Artery

The external carotid artery supplies blood to structures outside the skull, such as the face, neck, and scalp. Its major branches include the ascending pharyngeal artery, superior thyroid artery, lingual artery, occipital artery, superficial temporal artery, and maxillary artery.

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Carotid Sheath

The carotid sheath is a fibrous covering that encloses the common carotid artery, internal jugular vein, and vagus nerve. It helps protect and organize these structures.

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Spinal Accessory Nerve

The spinal accessory nerve (CN XI) is a cranial nerve involved in controlling neck and shoulder movements.

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Hypoglossal Nerve

The hypoglossal nerve (CN XII) controls tongue movements and sensation.

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Carotid Tubercle

The carotid tubercle is a bony bump on the transverse process of the sixth cervical vertebra (C6). It serves as a landmark for locating the common carotid artery during physical examination, compression techniques, or surgery.

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Digastric Triangle (Submandibular Triangle)

A triangular region of the neck located beneath the mandible, bounded by the posterior belly of the digastric muscle, stylohoid muscle, and anterior belly of the digastric muscle. It contains structures like the submandibular gland, facial artery, and facial vein.

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What muscles form the floor of the digastric triangle?

The floor of the digastric triangle is formed by these muscles: Mylohyoid, Hyoglossus, and Middle Constrictor.

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What structures are found in the anterior part of the digastric triangle?

The anterior portion of the digastric triangle contains structures like the submandibular gland, facial artery, facial vein, and mylohyoid vessels and nerve.

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What structures are found in the posterior part of the digastric triangle?

The posterior portion of the digastric triangle contains several important structures, including the parotid gland, external carotid artery, carotid sheath with its contents (internal carotid artery, vagus nerve, and internal jugular vein), glossopharyngeal nerve, and three muscles attached to the styloid process.

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Muscular Triangle

A triangular region of the neck located below the hyoid bone, bounded by the anterior midline of the neck, the superior belly of the omohyoid muscle, and the anterior border of the sternocleidomastoid muscle. It contains muscles involved in controlling the position of the hyoid bone.

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What is the submental triangle?

The submental triangle is a small triangular region located in the anterior neck, below the chin.

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What are the borders of the submental triangle?

The submental triangle's borders include the hyoid bone as its base, the anterior belly of the digastric muscle as its sides, and the symphysis menti as its apex.

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What are the contents of the submental triangle?

The submental triangle contains submental lymph nodes, which drain lymph from the central lower lip, floor of the mouth, and tip of the tongue. It also contains the anterior jugular vein.

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What is the sternocleidomastoid muscle?

The sternocleidomastoid muscle is a large muscle that runs from the sternum and clavicle to the mastoid process. It helps rotate and flex the head.

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What is the carotid triangle?

The carotid triangle is a triangular region on the neck, located between the posterior belly of the digastric muscle, superior belly of omohyoid, and the sternocleidomastoid muscle.

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What are the contents of the carotid triangle?

The carotid triangle includes important structures such as the common carotid artery and its branches, internal jugular vein, vagus nerve, ansa cervicalis, hypoglossal nerve, and deep cervical lymph nodes.

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What is the common carotid artery?

The common carotid artery, one of the major arteries in the neck, supplies blood to the head and neck. It arises from the arch of the aorta on the left and the brachiocephalic trunk on the right.

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What is the external carotid artery?

The external carotid artery, one of the terminal branches of the common carotid artery, supplies blood to the face and neck. It divides into the superficial temporal and maxillary arteries.

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What is the carotid sheath?

A sheath of connective tissue surrounding the common and internal carotid arteries, internal jugular vein, and vagus nerve in the neck.

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Define the Digastric Triangle.

A triangular space in the neck bounded by the lower border of the mandible, the posterior belly of the digastric muscle, and the anterior belly of the digastric muscle.

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What is the Ansa Cervicalis?

It's a nerve loop formed by the ventral rami of the C1, C2, and C3 nerves, located anterior to the carotid sheath.

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What does the internal jugular vein do?

It's a major vein in the neck, a continuation of the sigmoid sinus, that descends along with the carotid arteries and vagus nerve within the carotid sheath.

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What is the external laryngeal nerve?

A branch of the vagus nerve that supplies the cricothyroid muscle, a muscle that helps with voice production.

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Study Notes

Triangles of the Neck II

  • Objectives: The lecture covers boundaries, contents, arteries, veins, nerves, and lymphatic systems of the anterior triangle, specifically its subdivisions. Clinical importance is also addressed.

Anterior Triangle

  • Boundaries:
    • Posterior: Sternocleidomastoid muscle
    • Anterior: Midline of the neck from symphysis menti to the suprasternal notch
    • Base: The lower border of the mandible and a line connecting the angle of the mandible to the mastoid process
    • Apex: Directed downward towards the suprasternal notch

Subdivision of the Anterior Triangle

  • The superior belly of the omohyoid and posterior belly of the digastric muscles divide the anterior triangle into:
    • Digastric (Submandibular) triangle
    • Carotid triangle
    • Muscular triangle
    • Submental triangle (located at the midline)

Carotid Triangle

  • Contents:
    • Common carotid artery and its bifurcation
    • External carotid artery and its branches
    • Carotid sheath with its contents (common carotid artery, internal jugular vein, vagus nerve)
    • Ansa cervicalis (a nerve loop)
    • Spinal accessory nerve
    • Hypoglossal nerve
    • Deep cervical lymph nodes

External Carotid Artery & Its Branches

  • Branches:
    • Ascending pharyngeal artery
    • Superior thyroid artery
    • Lingual artery
    • Facial artery
    • Occipital artery
    • Posterior auricular artery
    • Maxillary artery
    • Superficial temporal artery

Carotid Sheath & its Content

  • This sheath contains:
    • Common carotid artery
    • Internal carotid artery
    • Internal jugular vein
    • Vagus nerve

Vagus Nerve in the Neck

  • Branches:
    • Superior laryngeal nerve (Internal/External)
    • Recurrent laryngeal nerve
    • Cardiac branches
    • Branches to carotid body & sinus
    • Auricular branch (Alderman's nerve)
    • Pharyngeal branch

Internal Jugular Vein (IJV) & its Tributaries

  • Formation: Continuation of the sigmoid sinus; brings venous blood from the brain and cranium.
  • Tributaries:
    • Inferior petrosal sinus
    • Pharyngeal veins
    • Common facial vein
    • Lingual vein
    • Middle & inferior thyroid veins
  • Termination: Joins with the subclavian vein to form the brachiocephalic vein

Ansa Cervicalis

  • Roots: Superior root (Descendens hypoglossi) and Inferior root (Descendens cervicalis)
  • Function: Supplies motor to infrahyoid muscles.

Spinal Accessory Nerve

  • Supplies sternocleidomastoid and trapezius muscles

Hypoglossal Nerve

  • Divides into external and internal branches; supplies muscles of the tongue
  • Relation to arteries: Passes superficial to the internal carotid, external carotid arteries, and the first part of the lingual artery.

Deep Cervical Lymph Nodes

  • Chain of nodes found in close relation to the internal jugular vein.

Digastric Triangle (Submandibular Triangle)

  • Boundaries: Base of the mandible, extending from angle of the mandible to the mastoid process, posterior belly of the digastric. And anterior belly of the digastric
  • Contents: Submandibular gland, facial vein, facial artery, mylohyoid vessels & nerve, hypoglossal nerve

Muscular Triangle

  • Boundaries: Anterior midline of the neck, body of the hyoid bone, superior belly of the omohyoid muscle, and lower part of the sternocleidomastoid muscle.
  • Contents: Sternohyoid, sternothyroid, thyrohyoid, omohyoid, Supplied by the Ansa cervicalis

Submental Triangle

  • Boundaries:
    • Apex: Symphysis menti
    • Base: Hyoid bone
    • Sides: Anterior belly of digastric
    • Floor: Mylohyoid
  • Contents:
    • Submental lymph nodes; draining central part of lower lip/mouth floor/tip of tongue
    • Anterior jugular vein

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