HMI104 - Neck

Where is the internal jugular vein formed from?

Dural venous sinuses

What is the function of the internal jugular vein?

Return venous blood from the brain

Where does the internal jugular vein travel from?

Travels within the carotid sheath laterally and posterior to the common carotid artery

Where does the common carotid artery ascend in and where does it bifurcate?

Ascends in carotid sheath and bifurcates at around C3 to C4

What does the internal carotid artery supply?

Brain

What does the external carotid artery supply?

Neck, head and face

What are the symphysis joints between vertebral bodies

Intervertebral discs: Annuluses fibrosis and nucleus pulposis

Why are the in vertebral discs of the cervical region smaller than other regions of the vertebral column?

Support less weight, allowing increased mobility and flexibility

Which of the divisions of the laryngopharynx facilitates the passage of air?

Anterior

Which of the divisions of the laryngopharynx facilitates the passage of food?

Posterior

Lists the contents of the carotid sheath, and list which superficial neck muscle this sheath is located beneath

Common carotid artery - medially

Internal jugular vein - laterally

Vagus nerve - posteriorly

What ligament resist extension?

Anterior longitudinal ligament

What ligament resist flexion?

Posterior longitudinal ligament, ligamentum flavum, interspinous ligament, supraspinous ligament

Location of the anterior longitudinal ligament

Anterior to vertebral bodies

Location of the posterior longitudinal ligament

Posterior to vertebral bodies

Location of ligamentum flavum

Connects laminae of adjacent vertebrae

Location of interspinous ligament

Between spinous process

Location of supraspinous ligament

Between spinous processes

Nucleus polposus

Internal gelatinous mass

Function of nucleus polposus

Deals with compression load and directs weight bearing force to outer portion of disc

Annulus fibrosus

A ring of collagen and ring of fibrocartilage

Function of annulus fibrosus

Buffers shear force when moving neck

Atypical features of C1

no vertebral body, instead of spinous process they have tubercles, no lamina

Atypical features of C2

vertebral body is large, has a dens, huge spinous process and body

Atypical features of C7

transverse foramen can be absent, transverse processes are non-byford (single), and spinous process is non-byford but huge

Why is the spinous process huge in C7?

For ligamentous attachment of the nuchal ligament

What are the bony borders of the anterior triangle

inferior border of mandible (superiorly), anterior border of sternocleidomastoid muscle (laterally) and midline of neck (medially)

What are the bony borders of the posterior triangle

posterior border of sternocleidomastoid muscle (anteriorly), anterior border of trapezium muscle (posteriorly), and middle of clavicle (inferiorly)

Describe the pathway of drainage of the internal jugular vein to the right atrium of the heart

Internal jugular vein → brachiocephalic vein → superior vena cava → right atrium

A trauma patient’s open‑mouth X‑ray shows a ring‑shaped vertebra lacking a body, with prominent lateral masses and both anterior and posterior arches. Which of these features is characteristic and unique to the C1 vertebrae?

Groove for vertebral artery

On a lateral cervical X‑ray, you observe the C2 vertebrae. Presence of which feature is most indicative of the C2 vertebrae?

Odontoid process

A CT cervical scan shows arterial blood flow in the transverse foramina of C1–C6 but not in C7’s. What explains this finding?

	Vertebral artery enters transverse foramen at C7, meaning the vertebral artery is occluded.
	Vertebral artery ascends from C6, and based on this the scan is normal
	Common carotid ascends in the transverse foramen from C6, and based on this the scan is normal
	Common carotid artery enters transverse foramen at C7, meaning the Common carotid artery is occluded.

Vertebral artery ascends from C6, and based on this the scan is normal

The vertebral foramen is relatively largest in the cervical region to accommodate which structure?

Spinal cord

A student palpating the neck feels a firm prominence at the level of C4, described in laymans terms as the 'Adam’s apple'. They are palpating a landmark on which aspect of the larynx?

Thyroid Cartilage

The vascular compartment of the neck is enclosed in a layer of fascia, known as the 'carotid sheath'. Which three structures are best described as contents of this sheath?

Common carotid artery, internal jugular vein, vagus nerve

Which important ligament has the important function of limiting anterior translation of the C1 vertebrae from the dens, stabilizing the AA joint?

Cruciform ligament of the atlas

Which structure forms the posterior border of a cervical intervertebral foramen?

Zygapophyseal (facet) joint

Which of the following ligaments of the vertebral column is most likely involved in limiting extension between vertebral segments?

Anterior longitudinal ligament

A 48-year-old office worker presents with chronic neck pain and stiffness, worse on neck flexion. MRI reveals degeneration at the C5–C6 level, with hypertrophy of a ligament contributing to mild spinal canal narrowing. Based on the location and function, which ligament is most likely involved?

Ligamentum flavum

An ultrasound locates a carotid bifurcation behind the thyroid cartilage at the level of C4. This finding is described as:

Typical (expected)

Function of epiglottis

Closes laryngeal inlet

Structures in the anterior triangle

Thyroid gland, common carotid artery, jugular notch, vagus nerve, hyoid bone, laryngeal cartilage, infrahyoid muscles

Structures in the posterior triangle

Scalene muscles, subclavian artery, subclavian vein, external jugular vein, cervical plexus, brachial plexus, phrenic nerve

Where does the vertebral arteries ascend and where do they travel afterwards

Ascend in transverse foramen of C6 - C1 before entering the foramen magnum

What does the transverse foramen allow

Permits the passage of the vertebral arteries and veins

What type of joint is the atlantoaxial joint

Synovial pivot joint, which allows for rotation

What type of joint is the uncovertebral joint

Plane synovial joint

Articular surface of uncovertebral joint

Between uncinate process of inferior vertebrae and vertebral body above

What are secondary curvatures?

Cervical and lumbar

What are primary curvatures?

Thoracic and sacrum

Difference between secondary and primary curvatures?

Secondary - develops after birth, when infants pick up their head

Primary - persists from foetal life

Function of epiglottis

Closes laryngeal inlet during swallowing so food doesn’t enter the lungs