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Lecture Notes - Larynx and Neck |
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The Lab Overview, a narrated PowerPoint presentation, is available on the web (password protected).
- Bony landmarks and Surface Anatomy
- Cranial base
- Foramen magnum
- Jugular foramen
- Carotid canal
- Occipital condyles
- Hypoglossal canal
- Styloid process
- Pharyngeal tubercle
- Mastoid process
- Mandible
- Mental protuberance
- Angle
- Hyoid bone
- Thyroid cartilage, laryngeal prominence
- Cricoid cartilage
- Trachea
- Jugular notch
- First rib
- Grooves for subclavian artery and vein
- Cervical triangles:
- Anterior - Sternocleidomastoid, trapezius, mandible and midline
- Muscular - midline, sup. belly omohyoid, sternocleidomastoid
- Carotid - post. belly digastric, sup. belly omohyoid, sternocleidomastoid
- Submandibular - ant. and post. bellies of digastric, body of mandible
- Submental - both ant. bellies of digastrics, hyoid bone
- Posterior - Trapezius, sternocleidomastoid, clavicle
- Subclavian (Omoclavicular) - inf. belly omohyoid, clavicle, sternocleidomast.
- Occipital - trapezius, sternocleidomastoid, inf. belly omohyoid
- Organization of fascial layers:
- Superficial - subcutaneous tissue - contains platysma muscle and cutaneous veins and nerves
- Deep cervical fascia:
- Superficial (investing) layer of deep cervical fascia - encloses trapezius and sternocleidomastoid.
- Infrahyoid (muscular) fascia - deep to sup. layer of deep, encloses infrahyoid (strap) muscles
- Carotid sheath - encloses carotid arteries, int. jugular v. and vagus n.
- Visceral fascia - encloses trachea, esophagus & thyroid
- Pretracheal - anterior, encloses thyroid and parathyroids
- Buccopharyngeal - back of pharynx
- Retropharyngeal space - interfascial plane between visceral and prevertebral
- Prevertebral fascia - encloses vertebral column and associated. m. (scalenes, etc.) roots of brachial and cervical plexi, sympathetic trunk.
- Muscles:
- Platysma: subcutaneous, muscle of facial expression
- Sternocleidomastoid and trapezius muscles
- Infrahyoid (strap): act on larynx and pharynx
- Omohyoid (superior & inferior bellies)
- Sternohyoid
- Sternothyroid
- Thyrohyoid
- Scalene muscles & Interscalene Triangle
- Anterior scalene
- Middle scalene
- Posterior scalene
- Cricothyroid (laryngeal muscle)
- Nerves:
- Cervical plexus:
- Roots (C1-4)
- Sensory (cutaneous): all emerge from posterior border of sternocleidomastoid m.
- Lesser occipital
- Great auricular
- Transverse cervical
- Supraclavicular
- Motor branches
- Ansa cervicalis
- Phrenic
- Cervical branch of facial n. (CN VII) to platysma
- Vagus nerve (X) branches
- External branch of superior laryngeal n. to cricothyroid
- Internal branch of superior laryngeal n. goes to interior of larynx
- Recurrent laryngeal (right and left)
- Hypoglossal nerve (XII) - motor to tongue
- Accessory (XI)
- Cervical sympathetic trunk
- Superior cervical ganglion
- Middle cervical ganglion
- Carotid nn. (internal & external, plexus)
- Brachial plexus
- Roots (C5-T1)
- Dorsal scapular n.
- Long thoracic n.
- Trunks
- Suprascapular n.
- Blood Vessels:
- Superficial veins
- External jugular
- Anterior jugular
- Communicating
- Jugular venous arch
- Deep veins
- Internal jugular v. - in carotid sheath
- Subclavian
- Common & external carotid arteries
- Superior thyroid a.
- Subclavian artery (3 parts)
- 1st part (3 branches)
- Vertebral
- Thyrocervical trunk
- Inferior thyroid
- Transverse cervical
- Suprascapular
- Internal thoracic
- 2nd part (1 branch)
- Costocervical trunk
- 3rd part (1 branch)
- Dorsal scapular (variable origin)
- Lymphatics:
- Deep cervical lymph nodes
- Jugular trunk
- Thoracic duct
- Thyroid gland: endocrine glands control general metabolism, secrete thyroxin
- Right and left lobes
- Isthmus - connection between lobes
- Pyramidal lobe
- Parathyroid glands - endocrine glands, spatially related to thyroid gland (NOT functionally)
- Cross section of the neck
- Carotid sheath, cervical sympathetic trunk, cranial nerves exiting skull base
- Pharynx
- Definition and functions
- Interior of pharynx (pharyngeal cavity)
- Nasopharynx
- Oropharynx
- Laryngopharynx:
- laryngeal inlet
- piriform recesses
- Musculature of pharynx:
- Constrictors: superior, middle, inferior
- Nerve and arterial supply
- Larynx
- Definition and functions
- Interior of larynx (laryngeal cavity):
- laryngeal inlet
- vestibule
- vestibular folds
- ventricles
- infraglottis
- Quadrangular membrane, conus elasticus
- Glottis, vocal folds, rima glottidis
- Cartilages, membranes, joints
- Intrinsic muscles of larynx
- Nerve and arterial supply
- Clinical Terms:
- Goiter - enlargement of thyroid gland
- Tracheostomy - creation of an airway in the trachea, usually an elective procedure
- Cricothyrotomy - creation of an emergency airway between thyroid an cricoid cartilages
- Thyroidectomy - removal of thyroid
- Thyroglossal duct cyst - a cyst along the tract of descent of the thyroid gland
- Torticollis - torsion or twisting of the neck and elevation of the chin due to shortening of sternocleidomastoid m.