Transcript Neck
Pharynx Larynx Esophagus Trachea Salivary glands Thyroid gland Cervical lymph nodes Funnel shaped 12 cm long muscular tube Opening for respiratory and digestive organs Base of skull extend inferior to esophagus 3 sections: Nasopharynx Oropharynx laryngopharynx 1.Pharynx 2. Epiglottis 3. Larynx 4. Esophagus Nasopharynx › Superior- nasal cavity › Passage of air from nasal cavity to larynx › Boundary posterior- clivus/ upper cervical spine Inferior- soft palate- uvula Lateral wall- post/inf nasal conchae Opeining of eustachian tube- middle ear recurrence of nasopharyngeal carcinoma in the right nasopharynx Oropharynx › Posterior oral cavity › Soft palate Hyoid › Separated from larynx by epiglottis › Lymphoid tissuepalatine & lingual tonsils › Valleculae- pouch like openings (foreign objects can lodge) Planning procedure for the two lateral opposing 6 MV asymmetrical fields for the treatment of the oropharyngeal region. The isocenter is positioned between vertebrae C5 and C6 Laryngopharynx › From oropharynxbetween hyoid bone and esophagus/lary nx › @ the cricoid cartilage it becomes the esophagus › Piriform sinusesdepressions that divert food from larynx Recap of Anatomy 1. 2. 3. 4. 5. Corpus Callosum Sphenoid sinus 4 th Vent Oropharynx Spinal Cord Bony skeleton- “voice box” Surround and protect vocal cords Laryngopharynxtrachea › Beginning of respiratory pathway Three of the cartilages that make up the larynx are: Thyroid epiglottis Cricoid- ring @ base of larynx on which other cartilages rest-junction of larynx/trachea and beginning of esophagus. Thyroid is the longest and most superior Anterior lamina of the thyroid cartilage= “Adam’s Apple” Posterior to the Adam’s apple is the epiglottisduring swallowing the epiglottis folds back over the larynx to prevent solids from entering the respiratory tract. acute epiglottitis MR imaging, larynx. T1weighted axial slice above Image 2 showing the epiglottis Axial CT scan of a T4 laryngeal tumor with extensive cartilage destruction Laryngopharynx to cardiac orifice of stomach Posterior to cricoid cartilage and descends though thoracic cavity › between trachea and anterior longitudinal ligament of vertebrae Opening in diaphragm= esophageal hiatus 2 sphincters › Esophageal- @ entranceprevents air › Cardiac- @ prevents reflux from stomach What is the condition that happens to the esophagus when Portal Hypertension is present??? Airway Extend from larynx lungs ANTERIOR to esophagus T5 –trachea bifurcates into the right and left mainstem bronchi…….CARINA Produce and empty saliva into the oral cavity by ducts Begin the digestion process 3 large paired glands: › 1. parotid- largest- anterior to auricle › 2. submandibularborder post half of mandible- to hyoid bone › 3. sublingual- smallest, lie under the tongue Adenoid cystic carcinoma of the parotid enlarged left submandibular gland abscesses. CT scan shows a large mucous retention cyst arising from the sublingual gland (ranula) How do we prevent it??? MMR shot….. Endocrine gland Located @ level of cricoid cartilage Two lobes joined together by an isthmus Excretes hormones Thyroxine (T4)- body growth/ metabolism Triiodothyronine (T3)growth/ metabolism Calcitonin- < blood calcium to promote bone formation Controlled by the parathyroid glandsposterior surface of thyroid lobes (4 total) adenocarcinoma >1/3 of the body’s total nodes About 75 on each side of the neck Lymph vessels carry fluid from interstitial spaces to the regional lymph nodes that filter the lymph fluid- before emptying into the venous blood supply central necrosis within a left cervical lymph node metastasis Normal Images of cervical Lymph Nodes adenopathy The neck is divided by sternocleidomastoid (SCM) into anterior and posterior triangles Originates on the sternum and clavicle and inserts on the mastoid tip of temporal bone Turns the head and flexes the neck Muscles of the throat Suprahyoid and infrahyoid › Infrahyoid muscles are called Strap muscles › They look like ribbons extending inferiorly on the anterior neck Trapezius Splenius capitis Levator scapulae Anterior, middle and posterior scalene 4.2 cm left supraclavicular mass posterior to the sternocleidomastoid muscle and lateral to the carotid sheath Vertebral body Is not involved. Brachial plexus. Lesions coming from the cervico-brachial plexus are expected to be found in a more paraspinal location. Vertebral artery and vein Are not involved. Prevertebral and paraspinal musculature. The lesion is clearly arising from the left paraspinal musculature. Carotid arteries Rt CCA- arise from brachiocephalic artery posterior to sternoclavicular joint Lt CCA- arises directly from AO arch Medial to internal jugular and bifurcate into internal and external carotid at level of thyroid cartilage (C3C4) Branch of the subclavian artery and ascend though the transverse formina of C6-C1 Arteries enter foramen magnum and join to form the BASILAR artery (A) Axial computed tomographic (CT) angiogram shows the course of the right vertebral artery. (B) Corresponding coronally reformatted CT angiogram shows the course and morphology of the right vertebral artery. The complexity of the fracture (arrow) is also visible. (C) Axial CT angiogram through C2 shows the course of the left vertebral artery. (D) Corresponding oblique coronally reformatted CT angiogram shows the course and morphology of the left vertebral artery Internal jugular veins drain blood from brain Largest vascular structures of the neck Unite with the subclavian vein to form brachiocephalic vein Rt is larger than the Lt Lateral to common carotids