Session 1 Anterior Neck

Into which vessel does the external jugular v. drain?

The EJV runs superficial to the sternocleidomastoid muscle (SCM), and drains into the
subclavian v. lateral and deep to the SCM.

Which spinal nerves comprise the cervical plexus, and what does the cervical plexus
innervate?
The cervical plexus consists of contributions from spinal nerves C1-C4. The cervical plexus
innervates the skin of the neck via the cutaneous nerves from the nerve (Erb’s) point of the
neck, the infrahyoid mm. (via ansa cervicalis & nerve to thyrohyoid), the diaphragm (via the
phrenic n.), & the geniohyoid m..

What are the innervations & actions of the sternocleidomastoid m.?

The SCM flexes the cervical spine when both muscles are involved. Unilaterally, the SCM
laterally flexes the neck & rotates the face in the contralateral direction. There are other actions
that the SCM plays a smaller role, but you are not responsible for these.

What is the significance of the names for the infrahyoid mm.?

The infrahyoid (strap) mm. are named for their attachments. Typically the distal attachment
begins the name, and the proximal attachment ends the name. For example, the sternothyroid
m. distally attaches to the sternum (specifically to the manubrium of the sternum) and
proximally attaches to the thyroid cartilage of the larynx.

What are the actions of the infrahyoid mm.?

The superficial layer of infrahyoid mm. (sternohyoid & omohyoid) stabilizes the hyoid bone &
may depress the hyoid if it is elevated. The deep layer of infrahyoid mm. (sternothyroid &
thyrohyoid) may elevate/depress the larynx or depress the hyoid.

From which spinal cord levels do the roots of ansa cervicalis arise?
Superior limb (C1)
Inferior limb (C2, C3)

What is the physical relationship between the jugular foramen & the carotid canal, and what
traverses these foramina?
The external opening of the carotid canal is anterior to the jugular foramen. These openings
convey the internal carotid a., internal jugular v., and cranial nn. IX, X, & XI. All of these elements
are found within the carotid sheath.

What is the carotid sheath, where is it located, and what does it contain?
The carotid sheath is condensation of deep cervical fascia which runs a course of intermediate
depth bilaterally along the length of the neck. Starting at the base of the cranium (surrounding
the contents of the carotid canal and jugular foramen, the carotid sheath travels deep to the
SCM, lateral to the infrahyoid mm. & viscera, and terminates around the root of the neck.

The carotid sheath’s major contents include:

● Internal jugular v. & tributaries
● Common carotid a. & brs.
● Vagus n. (CN X) & brs.

Minor contents include:

● Glossopharyngeal n. (CN IX)
● Accessory n. (CN XI)
● Deep cervical lymph nodes

The carotid sheath is associated with:

● Ansa cervicalis
● Cervical sympathetic trunk & ganglia

How might one distinguish between the external & internal carotid aa.?
The external and internal carotid aa. are terminal brs. of the common carotid a. The external
carotid a. is more anteriorly situated and has several brs. serving the neck, face, & head. The
internal carotid a. has no brs. before entering the cranium.

How does the visceral fascia of the thyroid gland relate to the muscular fascia investing the
infrahyoid mm.?
The visceral fascia of the thyroid gland & the muscular fascia investing the infrahyoid mm. are
both of the middle (pretracheal) layer of the deep cervical fascia and are in close contact with
one another.

Where is the inferior thyroid a. located, and from where does it originate?
The inferior thyroid a. is a branch of the thyrocervical trunk of the first part of the subclavian a.
It ascends from the root of the neck, crossing posterior to the common carotid a. as it ascends
to the thyroid gland.

To where does the superior vena cava drain?

The superior vena cava receives blood from the brachiocephalic vv., and delivers blood to the
right atrium of the heart.

What is the relationship between the jugular foramen & the carotid canal?
The external opening of the carotid canal is anterior to the jugular foramen. These openings
convey the internal carotid a., internal jugular v., and cranial nn. IX, X, & XI. All of these elements
are found within the carotid sheath.