Deep Neck, 8 Sept 2006

Courtney Takahashi 8 September 2006 Deep Neck Anatomy What type of tissue comprises the pharyngeal arches? What is the difference between the pharyngeal clefts and pouches? What 3 components are present in every arch? Arch 1 derivatives (arch derivatives must be memorized) Arch 2 derivatives Arch 3 derivatives

Arch 4-6 (merge) derivatives

What are the derivatives of the pharyngeal clefts? What are the derivatives of the pouches?

What do the neural crest cells form? What 3 syndromes result from defects in neural crest cells? What week does the tongue start to develop? What contributions does each of the arches make to tongue formation?

How does the anterior portion of the tongue develop? How does the posterior portion of the tongue develop? What nerve provides sensory innervation to the anterior 2/3 of the tongue? What nerve provides sensory innervation to the posterior 1/3 of the tongue? What cranial nerve provides motor innervation to the tongue? What cranial nerve provides special sensory information to the tongue? What tissue is the secondary palate formed

Mesoderm line by ectoderm and endoderm Clefts are external and pouches are internal Nerve, artery, cartilage Maxilla, Mandible Muscles of mastication CN V Styloid process, Lesser Cornu CN VII mm Facial expression Greater Cornu CN IX Greater horn Stylopharyngeus Thyroid, cricoid cart CN X Pharyngeal constrictors Laryngeal muscles Ext. auditory meatus Tympanic membrane Cleft 2 becomes overgrown Cleft 3-5 merge and disappear Pouch 1: Auditory tube Pouch 2: Palatine tonsil Pouch 3: Parathyroid gland (inferior) and thymus Pouch 4: Parathyroid glad (superior) and UB body Neural folds and resulting rhombomeres Migrates to face and populates facial prominences Carry Hox code and provide spatial information Pierre Robin, Digeorge, Treacher Collins syndromes Week 4 1st arch – lateral lingual swelling (LLS) and tuberculum impair (T1) 2-4  hypobranchial eminence 4th  epiglottal swelling LLS overgrows T1 and makes anterior 2/3 of tongue Arch 3 overgrows 2,4 and forms posterior 1/3 of tongue CN V CN IX CN XII CN VII Endodermal derivative

from? How does it form? What is the position of the thyroid gland? What is the nerve supply to the thyroid? What are the main arteries to the thyroid? What are the main veins to the thyroid? What is the function of the parathyroid glands? What is the main consequence of removal? Nerve supply to parathyroids?

Invagination of the foramen cecum. Thyroglossal duct grows caudally but eventually degenerates Deep the sternohyoid and sternothyroid, surrounded by pretracheal fascia Sympathetic innervation from the cervical ganglia Superior and inferior thyroid arteries Superior, middle, and inferior veins Calcium regulation Tetany Cervical sympathetic ganglia

Identify: • Thoracocervical junction / superior thoracic aperature • Brachiocephalic trunk with subclavian and common carotid arteries (right side) • Aortic arch with independent CC and SC branches (left side) • Vertebral artery • Internal thoracic artery • Thyrocervical trunk with inferior thyroid, suprascapular, transverse cervical branches • Internal thoracic artery • Costocervical trunk • Deep cervical artery • Supreme intercostal artery • Dorsal scapular artery (3rd part of subclavian artery) • Internal jugular vein that receives external and anterior jugular veins • Subclavian veins as they join internal jugular and form branchiocephalic veins • Vagus nerve • Recurrent laryngeal nerve (inferior laryngeal) • Superior laryngeal nerve • Cardiac plexus • Phrenic nerve • Sympathetic trunks / 3 cervical ganglia • Superficial cervical lymph nodes (follow external jugular) • Deep cervical lymph nodes (follow internal jugular and receive from tongue, mouth, larynx, pharynx) • Thoracic duct • Thyroid gland • Superior thyroid artery • Inferior thyroid artery • Thyroid ima • Superior thyroid vein • Middle thyroid vein • Inferior thyroid vein • Parathyroid glands • Isthmus of the thyroid • Brachiocephalic vein • Splenius capitus • Levator scapulae • Anterior, middle, posterior scalene muscles • Roots of the brachial plexus