Study Guide - Anterior Triangle of Neck

1. What are the boundaries of the anterior triangle? The midline, the SMC and the mandible.
2. How many smaller triangles is the anterior divided up into? What are their names and
boundaries? 4. The muscular triangle: midline, hyoid bone, superior belly of omohyoid muscle
and SCM. Carotid triangle: posterior belly of digastric muscle, SCM, superior belly of omohyoid
and hyoid bone. Submandibular triangle: mandible, anterior and posterior bellies of digastric
muscles. Submental triangle: hyoid bone, anterior bellies of digastrics muscles.
3. Which muscle of facial expression covers the anterior triangle superficially? Platysma

Muscular Triangle

4. What are the main contents of the muscular triangle? Omohyoid muscle, sternohyoid muscle,
sternothyroid, muscle, thyrohyoid muscle, anterior jugular vein, thyroid gland and parathyroid
glands, recurrent laryngeal nerves, trachea and larynx.
5. Name the four strap muscles. What kind of fascia surrounds them? Omohyoid, sternohyoid,
sternothyroid and thyrohyoid. Embedded in investing fascia of neck.
6. Which strap muscles are in the superficial layer? Omohyoid (medial) and sternohyoid (lateral)
Which are in the deep layer? Sternothyroid (inferior) and thyrohyoid (superior)
7. What is the general function of the strap muscles? Depress the hyoid bone during swallowing
and speaking. What is the general pattern of their
innervation? Which strap muscle is the exception to the general innervation pattern? All
innervated by ansa cervicalis except for thyrohyoid which is innervated by ventral rami of C1 via
the hypoglossal nerve.
8. What is the general function of the thyroid gland & what are its major parts? Endocrine gland
which secretes hormones responsible for determining basal metabolic rate. It is composed of a
right and left lobe connected by an isthmus, and sometimes a pyramidal lobe is present. Which
lobe is oftern variable (may or may not be present)? Pyramidal.
9. What arteries supply the thyroid gland? Superior thyroid artery (branch of external carotid)
and inferior thyroid (branch of thyrocervical trunk of subclavian artery) What veins drain the
thyroid gland? Superior thyroid vein and middle thyroid vein (drains to internal jugular), inferior
thyroid vein (drains into R and L brachiocephalic veins)
10. What is the general function and location of the parathyroid glands? Secrete the hormone
parathormone, which is involved in regulating blood calcium ion and phosphate ion
concentration. Located on the posterior surface of each thyroid lobe. How many are there? 2 (but
can be 2-6) glands on each side.
11. What is the relationship of the recurrent laryngeal nerve to the esophagus and trachea? It
ascends superiorly towards the larynx in a groove formed by the larynx and trachea.
12. What general structures does the recurrent laryngeal nerve innervates? The larynx
13. Describe the relationships of the thyroid cartilage, cricothyroid membrane, cricoid cartilage
and thyroid gland to each other. The isthmus of the thyroid gland is inferior to the cricoids
cartilage. This cartilage is inferior fo the cricothyroid membrane and the thyroid cartilage.

Carotid Triangle

14. What are the general contents of the carotid triangle? Carotid sheath structures, hypoglossal
nerve (CN XII), accessory nerve (CN XI), ansa cervicalis, external carotid artery branches,
superior laryngeal nerve and its branches.
15. What is the relationship of the accessory nerve to the SCM? Spinal portion of accessory
innervates SCM and goes deep to if after passing inferiorly between posterior belly of digastrics
muscle and internal jugular vein.
16. What is the carotid sheath and what does it contain? How is the carotid sheath formed?
Formed from the investing, prevertebral and pretracheal fascias. Contains internal common
carotid artery, internal jugular vein and vagus nerve.
17. What is the relationship of the hypoglossal nerve (CN XII) to the posterior belly of the
digastric muscle? Related to inferior border of posterior belly of digastrics.
18. The fibers of which nerve hitchhike a ride along the hypoglossal and then leave to innervate
the thyrohyoid muscle? C1
19. What is the ansa cervicalis? Loop-like nerve structure formed by ventral rami of C1-C3. It is
a component of which plexus? Cervical plexus. The fibers which comprise it
come from which spinal cord levels? C1-C3 Which fibers contribute to its superior root? C1
Which contribute to its inferior root? C2 and C3
20. Which muscles are innervated by the ansa cervicalis? Sternohyoid, sternothyroid and
omohyoid.
21. What are the 5 components of the cervical plexus? Transverse cervical nerve, phrenic nerve,
supraclavicular nerves, great auricular nerve, lesser occipital nerve, ansa cervicalis.
22. Does the internal carotid artery have any branches in the neck? no
23. How many branches does the external carotid artery have (including its 2 terminal branches)?
8, 2 terminal are maxillary and superficial temporal
24. Review the relationships of the 6 non-terminal branches of the external carotid artery.
Posterior auricular – courses posteriorly along the superior margin of the posterior belly of
digastrics muscle to the region behind the ear. Occipital – courses posteriorly along the inferior
margin of the posterior belly of digastrics muscle. Ascending pharyngeal – originates near
bifurcation of internal and external carotid arteries and then ascends to the sides of the pharynx.
Facial – originates superior to lingual and courses deep to submandibular gland, over the body of
mandible, then to the angle of the eye where it ends as angular artery. Lingual – originates
superior to superior thyroid. Crossed by hypoglossal nerve as it courses deep to hypoglossal
muscle to enter oral cavity and supply tongue. Superior thyroid – originates from external carotid
and descends to supply superior pole of thyroid gland.
25. What is the carotid sinus? Baroreceptor that monitors arterial blood pressure. What is the
carotid body? Chemoreceptor that monitors blood CO 2 and O2 levels. Which nerves
innervate these structures? The body is innervated by VA fibers on CN X and the sinus by
VA fibers on CN IX.
26. What are the two terminal branches of the superior laryngeal nerve? Internal and external
laryngeal nerves. What do they innervate? Pharynx and larynx.

Submandibular Triangle

27. What are the general contents of the submandibular triangle? Submandibular gland, facial
artery and vein, CN XII (hypoglossal nerve) and submandibular lymph nodes
28. What kind of gland is the submandibular gland? Salivary It receives VE para/post
innervation from cell bodies in which special parasympathetic ganglion in the head?
Submandibular ganglion. Describe the general pathway of VE-para/pre fibers to this ganglion.
Para/pre cell bodies in the superior salivatory nucleus in the brain stem. They are carried by the
chorda tympani nerve (branch of CN VII) which joins lingual nerve (branch of V3 of CNV)
which brings them to the submandibular ganglion where they synapse. They then leave the
submandibular ganglion to the gland.
29. Which vein courses through the submandibular gland? Facial vein
30. Which muscles form the floor of the submandibular triangle? Mylohyoid and hypoglossus
31. The hypoglossal nerve passes between which two muscles as it enters into the oral cavity?
Hypoglossus and mylohyoid
32. What is the relationship of the stylohyoid muscle to the posterior belly of the digastric?
Related superiorly to the posterior belly of digastrics. Tendon splits as it attaches to hyoid bone to
allow the tendon of the posterior belly of digastric to pass through.
33. Which lymph nodes are found in the submandibular triangle? Submandibular lymph nodes
which may become enlarged and palpated when infected.

Submental Triangle

34. What are the general contents of the submental triangle? Submental lymph nodes, mylohyoid
muscle and mylohyoid nerve (branch of V3)
35. Which lymph nodes are found in the submental triangle? Submental, which may become
enlarged if there is an infection in the throat or face
36. What muscle forms the floor of the submental triangle? Mylohyoid