Anatomy wk 30 - Neck and Thyroid

Where is the openings for the submandibular gland?

Each side of the phrenulum

What is the surface anomy of the internal jugular vein?

Earlobe to SCM

All branches from carotid arteries arise from which carotid?

External carotid

Which cranial nerve is affected by a tumour at the stylomastoid foramen

Facial nerve

What laryngeal muscle is the ONLY ABductor of the vocal cords and prevent asphyxiation? what is its innervation?

Posterior Cricoarytenoid. --> Inferior laryngeal (recurrent laryngeal)

What nerves provide sensation above and below vocal cords?

Recurrent laryngeal

the supra and infra hyoid muscles are also know as?

The External muscles of the larynx

^^ what is their innervation?

http://teachmeanatomy.info/neck/muscles/the-suprahyoid-muscles/

The internal carotid is situated where in relation to the external

posterolateral

what nerve supplies the uvula?

pterygopalatine ganglion

What runs through the parotid gland? what innervates it?

runs through: facial, external carotid a. innervation =Glosso

The thyroid lies deep to which muscles?

sternohyoid and sternothyroid

Where does sub mandible gland open?

phrenulum of tongue

What lymph nodes supply the thyroid?

- Deep cervical lymph nodes - Pre-laryngeal, Pre-and para-tracheal nodes - Directly to the thoracic duct

What are the borders of the submandibular triangle?

- Superiorly by the inferior border of the mandible and the mastoid process, -posteriorly by the posterior belly of digastric and stylohyoid, and - anteriorly by the anterior belly of digastric.

What does the internal branch of superior laryngeal nerve do then?

. It descends to the thyrohyoid membrane, piercing it in company with the superior laryngeal artery, and is distributed to the mucous membrane of the larynx. Of these (sensory) branches, some are distributed to the epiglottis, the base of the tongue (TASTE), and the epiglottic glands; others pass posteriorly, in the aryepiglottic fold, to supply the mucous membrane surrounding the entrance of the larynx, and the mucous lining of the larynx as inferior as the vocal folds. (SENSES FOOD IN LARYNX!)

What occurs at C6?

1. Larynx ends; trachea begins 2 Pharynx ends; esophagus begins 3. Inferior laryngeal nerve enters the larynx. 4. Vertebral a. enters the transverse Foramen of C 6

What are the major salivary glands?

1. Parotid 2. Submandibular 3. Sublingual (minor)

Name the 4 compartments within the neck. What do they contain?

1. anterior 2. lateral x 2 3. posterior

What are the layers of deep fascia in the neck?

1. investing layer (surrounds all structures in the neck) 2. Prevertebral layer (surrounds the vertebral column and the deep back muscles) 3. pre-tracheal layer (encloses the viscera of the neck) 4. the carotid sheaths

What are the veins applying the thyroid?

1. superior (drains into internal jugular) 2. Middle (drains into internal jugular) 3. Inferior (brachiocephalic)

What are the 3 arterial vessels supplying the thyroid?

1. superior (ext carotid) 2. Inferior (there cervical trunk of subclavian) 3. Ima (3%)

List 4 complications of thyroid surgery

1.Postoperative Haemorrhage 2.Recurrent Laryngeal Nerve Injury 3.External Laryngeal Nerve Injury 4.Postoperative Hypocalcaemaia

the inferior parathyroid glands originate for which pharyngeal pouch?

3rd pouch

What are the intrinsic muscles of the larynx? what is their motor innervation?

ALL= inferior laryngeal (Recurrent Laryngeal) EXCEPT criothyroid = external laryngeal (branch of superior Laryngeal) --> responsible for loud speech. CRICOTHYROID = SUPERIOR and EXTERNAL

All muscles of facial expression are innervated by___________ except ______________

All muscles of facial expression are innervated by FACIAL NERVE except MASSESTER

The thyroid gland is situated in which triangle of the neck?

Anterior triangle

How would you differentiate an enlarged submandibular gland from enlarged lymph node?

Bimanual exam. Omohydoid muscle divide submandibular into 2.

Which muscles of mastication are not supplied by the mandibular nerve?

Buccinator (buccal br of facial)

What occurs at C6

CRICOID CARTILAGE! 1. Larynx ends; trachea begins 2 Pharynx ends; esophagus begins 3. Inferior laryngeal nerve enters the larynx. 4. V ertebral a. enters the transverse Foramen of C 6

The inferior part of the carotid sheath contains?

Common carotid, internal jugular, Vagus nerve

If ALL motor innervation of vocal cords is recurrent laryngeal except for the crothyroid (what was its nerve supply again?) What is the sensory innervation in the larynx?

Cricothryoid = SUPERIOR laryngeal-->external branch Above the vocal folds the sensory innervation of the larynx is via the internal laryngeal nerve. Below the vocal folds it is the recurrent laryngeal nerve. The vocal fold itself receives dual innervation from both nerves.

What are the suprahyoid muscles?

GMDS 1. Genohyoid 2. Mylohyoid 3. Digastric 4. Stylohyoid

Inferior salivary nucleus supplies?

Glossopharangeal-->Tympanic branch--> lesser petrosal nerve--> Joins otic ganglion--> the superior salivary gland (parotid)

What structure is at C3?

Hyoid bone and bifurcation of common carotid

What is the rule of 4s with cranial nerve and the brainstem?

In the rule of 4 there are 4 rules There are 4 CN in medulla, 4 in the pons and 4 ABOVE the pons (2 in the midbrain) Midbrain = 3 and 4 (1 and 2 are not true cranial nerve) pons = CN5-8 Medulla = CN9-12

What is the innervation of the parotid gland? what structures run through it? what structures run behind it?

Innervation: Runs through: Facial n., External carotid a. Retromandibular v. Runs behind: Auriculotemporal nerve.

What are the borders of the anterior triangle? What are its contents?

It is bounded: Superiorly - Inferior border of the mandible (jawbone) Laterally - Medial border of the sternocleidomastoid Medially - Imaginary sagittal line down midline of body The anterior triangle of the neck contains muscles, nerves, arteries, veins and lymph nodes. The muscles in this part of the neck are divided as to where they lie in relation to the hyoid bone. There are four suprahyoid muscles (stylohyoid, digastric, mylohyoid, and geniohyoid) and four infrahyoid muscles (omohyoid, sternohyoid, thyrohyoid, and sternothyroid) With respect to the vasculature, the common carotid artery passes through the anterior triangle, and bifurcates within the triangle into the external and internal carotid arteries. The internal jugular vein also can be found within this area. It drains blood from the head and neck. Numerous cranial nerves are located in the anterior triangle. Some pass straight through, and others give off branches to innervate some of the other structures within the triangle. The cranial nerves in the anterior triangle are the facial [VII], glossopharyngeal [IX], vagus [X],accessory [XI], and hypoglossal [XII] nerves.

Why does a thyroid swelling move on swallowing?

It is enclosed in the pre tracheal fascia. When the hyoid moves, so does the thyroid

What are the borders of the posterior triangle? What are its contents?

Its boundaries are as follows: Anterior: Posterior border of the SCM. Posterior: Anterior border of the trapezius muscle. Inferior: Middle 1/3 of the clavicle. Veins: The external jugular vein and the subclavian vein. Nerves: The accessory nerve (CN XI) enters the posterior triangle after innervating SCM. The cervical plexus forms within the muscles of the floor of the posterior triangle. A major branch of this plexus is the phrenic nerve, which arises from the anterior divisions of spinal nerves C3-C5. It descends down the neck, within the prevertebral fascia, to innervate the diaphragm. The trunks of the brachial plexus also cross the floor of the posterior triangle. Arteries: The distal part of the subclavian artery can be located as it emerges between the anterior and middle scalene muscles. As it crosses the first rib, it becomes the axillary artery, which goes onto supply the upper limb.

Superior salivary nucleus supplies?

PART OF FACIAL nerve = the inferior salivary glands lower CN number (7) = inferior salivary glands = (sublingual and submandibular) Preganglionic parasympathetic fibers are distributed partly via the chorda tympani and lingual nerves to the submandibular ganglion,--> postganglionic fibers to the submandibular gland and sublingual gland.

Hypoglossal supplies all motor muscles of the tongue except?

Palatoglossus (vagus)

The inferior salivary nucleus supplies?

Parotid gland It is the visceral efferent component of the GLOSSOPHARNAGEAL nerve (9) --> parasympathetic input to the parotid gland for salivation. GLOSSO=PAROTO :)

What nerves are responsible for innervation of salivary glands? which does which glands?

Parotid: The parotid gland receives sensory and autonomic innervation. The autonomic innervation controls the rate of saliva production. Sensory innervation is supplied by the auriculotemporal nerve, a branch of the mandibular nerve (V3). The parasympathetic innervation to the parotid gland has a complex path. It begins with the glossopharyngeal nerve (cranial nerve IX). This nerve synapses with the otic ganglion (a collection of neuronal cell bodies). The auriculotemporal nerve then carries parasympathetic fibres from the otic ganglion to the parotid gland. Parasympathetic stimulation causes an increase in saliva production. Sympathetic innervation originates from the superior cervical ganglion, part of the paravertebral chain. Fibres from this ganglion travel along the external carotid artery to reach the parotid gland. Increased activity of the sympathetic nervous system inhibits saliva secretion, via vasoconstriction. Submandibular and sublingual: both receive parasympathetic from facial, and sympathetic from sympathetic chain

What are the infra hyoid muscles?

SOTS 1. Sternohyoid 2. Omohyoid 3. thyrohyoid 4. Sternothyroid

The phrenic nerve overlies which muscle?

Scalene anterior

What is the role of the internal laryngeal nerve? what nerve is it a branch of?

Sensation of above level of vocal cords. Branch of superior laryngeal nerve.

What are the branches of the external carotid arteries?

Some Anatomists Like Freaking Out Poor Medical Students S: superior thyroid artery A: ascending pharyngeal artery L: lingual artery F: facial artery O: occipital artery P: posterior auricular artery M: maxillary artery S: superficial temporal artery

Why muscle prevents a goiter from moving superiorly?

Sternohyoid

Label

Strap muscles = 1. supra hyoid = GMDS = elevate larynx/hyoid 2. infra hyoid muscles. = SOTS = depress larynx/hoid Role: raise and depress the hyoid bone and larynx during swallowing .

Boundaries of the carotid triangle?

The carotid triangle of the neck has the following boundaries: Superior: Posterior belly of the digastric muscle. Lateral: Medial border of the sternocleidomastoid muscle. Inferior: Superior belly of the omohyoid muscle. The main contents of the carotid triangle are the common carotid artery (which bifurcates within the carotid triangle into the external and internal carotid arteries), the internal jugular vein, and the hypoglossal and vagus nerves

What are the surface markings of the parotid gland?

The parotid gland lies inferior to the zygomatic arch, anteroinferior to the external acoustic meatus, anterior to the mastoid process, and posterior to the ramus of the mandible.

what other lump would move with protrusion of the tongue?

Thyroglossal cyst

inspiration

YOU ARE SMART YOU ARE KIND YOU ARE GORGEOUS YOU CAN DO IT

What structure demarcates the 2 lobes of the submandibular gland?

mylohyoid muscle

Will the thyroid move on protrusion of the tongue?

no.

Where is parotid duct opening

opposite 2nd upper molars

to complete a SILOGRAM: Where is the opening of the parotid duct?

opposite the crown of the second molar tooth (middle third between triages to angle of mouth)

What is the clinical significance of the delphian node?

worse prognosis