Neck

• Where do the efferent vessels of the deep cervical nodes drain into?

  The jugular trunk, that ultimately leads into the venous system at the junction of the internal jugular and subclavian veins

  
• Where do all of the lymph vessels in the head and neck drain into?

  Deep cervical lymph nodes

  
• What are the contents of the carotid sheath?

  
• what is the carotid sheath?

  It contains several vital neurovascular structures, including the carotid artery, jugular vein, vagus nerve, and sympathetic plexus. It extends upwards from the arch of the aorta and terminates at the skull base.

  
• What does the brachial plexus do?


  This network of nerves projects towards the armpit to supply the entirety of the upper limb
• What forms the brachial plexus?

  Anterior rami of the lower 4 cervical nerves & first thoracic nerve (C5, C6, C7, C8 & T1)
• What does the ansa cervicalis nerve innervate?

  - Omohyoid muscle

  - Sternothyroid & sternohyoid muscle
• what does the superficial groups of the cervical plexus supply?

  The superficial supply the skin of the anterior and lateral parts of the neck and the side of the head
• what does the deep groups of the cervical plexus supply?

  the deep group supplies muscles
• What are the cutaneous branches of the cervical plexus?

  
• what is the cervical plexus divided into?

  The cervical plexus may be divided into superficial and deep groups.

  
• what does the cervical plexus (C1-C4) supply

  The cervical plexus (C1-C4) supply the muscles and cutaneous region of the neck. Also form the phrenic nerve

  
• what do the anterior branches of the 8 cervical spinal nerves supply?

  The anterior rami form the cervical and brachial plexuses
• what do the posterior branches of the 8 cervical spinal nerves supply?

  the extensor muscles of the vertebral column and, except for C1, supply the skin of the posterior parts of the scalp and neck
• Describe the innervation of the neck.

  - Several structures of the neck, as well as face, receive innervation from the cranial nerves VII-XII

  
  

  - There are also 8 cervical spinal nerves which, typical of these nerves, divide into anterior and posterior branches
• Where does the interior jugular vein emerge from and where does it go?

  It emerges from base of skull & travels in carotid sheath. It receives tributaries from most of the head & neck regions
• What is the main vein of the anterior triangle?

  Internal jugular vein, draining anterior region of neck
• Where does the common carotid artery enter?

  It enters the neck within the carotid sheath and gives no branches
• Where does the common carotid artery arise from?

  Brachiocephalic artery on RHS of body & directly from the arch of aorta on LHS
• Where do all of the arteries of the anterior triangle derive from?

  Common carotid artery
• What are the main structures of interest within the anterior triangle?

  - The muscles that attach to the hyoid bone

  - Carotid arteries

  - Internal jugular vein

  - Vagus nerve

  - Elements of the respiratory & GI system

  - Thyroid & parathyroid glands
• What are the important structures of the posterior triangle?

  - accessory nerve

  - 4 superficial branches of the cervical plexus

  - external jugular vein

  
• The sternocleidomastoid muscle forms the boundary between the anterior & posterior triangles.

  TRUE/FALSE

  TRUE

  
• What are the boundaries of the posterior triangle?

  - Middle 1/3 of the clavicle

  - Anterior margin of the trapezius

  - Posterior margin of the sternocleidomastoid

  
• What are the boundaries of the anterior triangle?

  - Median vertical line of neck

  - Inferior margin of mandible

  - Anterior margin of the sternocleidomastoid muscle

  
• What do you have to determine to do a central line?

  The anterior triangle: the outer surface of the neck is divided into 4 triangles, 2 anterior & 2 posterior.

  
• Where can you insert a central line?


  In the large vessels that supply the brain & head, at the base of the neck, as they are very superficial (hence why it's also an easy pulse point)
• what is a central line?


  a catheter placed into a large vein.

  (a tube that doctors place in a large vein in the neck, chest, groin, or arm to give fluids, blood, or medications or to do medical tests quickly)

  
• Why is the neck very vulnerable to serious injury?

  the vertebrae of the neck do not attach to ribs, thus the vertebra offer little protection to the viscera & vasculature
• what muscles keep the neck straight/upright?

  post vertebral muscles
• What does contraction of the trapezius muscle do?

  Moves the scapula when the spine is fixed or vice-versa
• Where does the trapezius muscle originate?

  From the back of the head- occipital protuberance- as well as the spinous processes of the cervical vertebrae and inserts onto the lateral third of the clavicle and spine of scapula
• What does bilateral recruitment of the sternocleidomastoid do?

  Acts to either hold the head straight, so has a stabilising role, or to flex the head
• What does unilateral contraction of the sternocleidomastoid do?

  Causes the skull to rotate to the opposite side & lateral flexion to the same side
• Where does the sternocleidomastoid originate?

  Courses from the sternum and clavicles to the mastoid process of the temporal bone
• What does the deep fascia of the neck comprise?


  It comprises structures enveloped in tough membranes e.g. carotid sheath enclosing the large vessels

  - Muscles include sternocleidomastoid & the trapezius
• What is a telling sign of paralysis to the platysma muscle, from damage to the facial nerve?

  Visible droop of skin
• What is the main role of the platysma?

  Tense the skin, helping to depress the mandible or in generating some facial expressions
• What do some posterior fibres of the platysma attach to?

  Deltoid muscle
• What is the platysma?

  A flat, thin muscle that covers the entire anterior half of the neck, from the mandible to the clavicles