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6-3-04 Neck (Plate 31a) Skin Subcutaneous tissue or superficial fascia of neck a. muscles – facial expression (platysma) b. nerve supply and vessles in adipose tissue Investing layer of deep cervical fascia – invests the SCM and Trapezius Prevertebral layer of deep cervical fascia a. deep back muscles – levators, scalenes, (Why more posterior muscles – you need these to maintain erect posture) b. vertebral column and prevertebral muscles (flexors) Prevertebral space is deep to vertebral fascia Retropharyngeal space – goes to base of skull behind trachea to mediastinum where the trachea bifricates (this is a big space where you could have a lot of bleeding or have a problem with an infection spreading) Infrahyoid or strap muscles – Muscular layer of deep cervical fascia or middle layer of deep cervical fascia Visceral portion of deep cervical fascia (visceral layer)– thyroid, parathyroid, trachea, esophagus Carotid sheath – internal jugular vein, vagus nerve, internal carotid artery Sympathetic chain Skull (plate 10) Jugular foramen – glossopharyngeal nerve, vagus nerve, spinal accessory nerve, Hypoglossal canal - Hypoglossal Nerve Carotid canal – internal carotid artery and sympathetic chain Know Branches of external carotid artery and the internal carotid and cranial nerves 9-12 Plate 26 Longus collie Longus capitus Rectus capitus lateralis Rectus capitus anterior Scalenes Pharynx (plate 59, 60a, 60b, 62, 63, 64) - open space posterior to nose, mouth, and larynx Muscles of pharynx are constrictors – pharyngeal constrictors There is no proper anterior wall of the pharynx – the anterior wall is just space Choanae - connection to the nasal cavitiy and nasopharynx Pharyngela isthmus – connects nasal pharynx to oral pharynx a. nasopharynx – behind the nose, posterior to soft palate and nose (expiratory) a. torus tuberious – elevation or ridge formed by cartilage of tube (auditory or Eustachian tube) (equalize pressure) b. salpingopharyngeal muscle c. pharyngeal tonsil (when inflamed called adenoids) b. Oropharynx – Gross Anatomy 2 -1- a. Oropharyngela isthmus – communicates with oral cavity and oropharynx b. Palatine tonsil – (tonsils) lymphatic tissue, rough c. Chronic cryptic tonsilitis – constant infection of tonsils d. Lingual tonsils – posterior and inferior to tongue Epiglotitis – can close the throat if inflamed enough Superior phayrngal constrictor – origin – medial pterygoid plate, hamulus, pterygoid mandibular rraphe, tongue, mandible Middle phayrngeal constrictor Origin – hyoid bone (easiest to find for dissection) Inferior pharyngeal constrictor Origin – cricoid cartilage, thyroid cartilage SAME Insertion – median or pharyngeal rraphe FOR Innervated by pharyngeal plexus – cranial nerve 9 and 10a ALL 3 Action – constrict the pharynx Between superior and middle constrictor is the stylo pharyngeous muscle and glossopharyngeal nerve. Gross Anatomy 2 -2- Stylo-pharyngeous muscle Origin – medial aspect of styloid process Insertion – thyroid cartilage Action – elevates the pharynx (disphagia) Innervated – cranial nerve 9 (glossopharyngeal) Piriform recess has 2 things running through it and it is is located between the middle and inferior constrictors Internal branch of the superior laryngeal nerve (ALWAYS TAGGED) Superior laryngeal artery which is a branch of the superior thyroid artery Below inferior constrictor Recurrent or (inferior) laryngeal nerve (loops under subclavian artery on left under arch of aorta on right and is mainly motor to voice muscles, some sensory) and inferior laryngeal artery Plate 71 (MEMORIZE) From vagus the Superior laryngeal nerve branches into internal and external branches Plate 125, 121, 122, 124 Cranial nerve IX, X, and XI go through jugular foramen Glossopharyngeal (IX) nerve goes into Pharyngeal plexus but innervates the stylopharyngeous muscle Spinal part of the spinal accessory and cranial part both go through the foramen magnum and then down through the jugular foramen. Gross Anatomy 2 -3- Ambigous nucleus is actually the cranial part of the spinal accessory nerve Hypoglossal nerve (XII) – lateral aspect of the neck ascendens hypoglossy Sympathetic chain is next to internal carotid Plate 30b - Common carotid External – superior thyroid branches to superior laryngeal(runs with internal branch of the superior laryngeal nerve) Occipital artery and posterior auricular artery Superficial temporal and Transverse facial are terminal branches Maxillary artery Lingual artery Gross Anatomy 2 -4- Gross Anatomy 2 -5-