Posterior Triangle Of The Neck
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Questions and Answers
- 1.
A muscular patient who regularly lifts weights presents with pain and weakness in his right upper limb that has been slowly developing over time. His limb is cool and there is an obvious vascular insufficiency in his upper extremity. Subsequent tests show that a large vessel passing between the anterior and middle scalene muscles is being occluded by hypertrophy (enlargement) of the muscles due to the excercise. The artery involved is the:
- axillary
- brachial
- brachiocephalic
- subclavian
- suprascapular
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
D. DExplanation
The correct answer is d. The patient's symptoms, including pain, weakness, and vascular insufficiency in the right upper limb, suggest that there is an occlusion of a large vessel in the upper extremity. The description of the vessel passing between the anterior and middle scalene muscles indicates that it is the subclavian artery that is being occluded. This is likely due to hypertrophy of the muscles caused by the patient's regular weightlifting exercise. Therefore, the artery involved in this case is the subclavian artery.Rate this question:
- 2.
In repairing a damaged right subclavian artery, the surgeon notices and protects a large nerve passing around to the posterior surface of the artery. This nerve, which does not encircle the subclavian on the left side, is the:
- Phrenic
- Vagus
- Recurrent laryngeal
- Sympathetic trunk
- Ansa cervicalis
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
The correct answer is the recurrent laryngeal nerve. The question states that the nerve passes around to the posterior surface of the artery, indicating that it is a nerve that is closely associated with the subclavian artery. The phrenic nerve is not specifically mentioned in the question and does not have a close association with the subclavian artery. The vagus nerve does not encircle the subclavian artery on either side. The sympathetic trunk and ansa cervicalis are not specifically mentioned in the question and do not have a close association with the subclavian artery. Therefore, the most appropriate answer is the recurrent laryngeal nerve.Rate this question:
- 3.
A stab wound just above the left clavicle, lateral to the sternocleidomastoid muscle, may be life-threatening because of the possibility of injury to the:
- Brachial plexus
- Internal jugular vein
- Axillary artery
- Subclavian artery
- Thoracic duct
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
D. DExplanation
A stab wound just above the left clavicle, lateral to the sternocleidomastoid muscle, may be life-threatening because of the possibility of injury to the subclavian artery. The subclavian artery is a major blood vessel that supplies blood to the upper limbs, head, and neck. Injury to this artery can cause severe bleeding and potentially lead to life-threatening hemorrhage.Rate this question:
- 4.
A 27-year-old man who is a professional weight lifter comes to his physician complaining of recent weakness in his left arm and frequent tingling in his hand and fingers during exercise sessions which subsides with rest. He is diagnosed as having vasuclar insufficiency due to scalenus anticus syndrome and as a remedy it is decided to transect the anterior scalene muscle where it inserts on the first rib. During surgery, which structure in contact with the anterior surface of the muscle must the surgeon be careful of sparing?
- Inferior trunk of the brachial plexus
- Long thoracic nerve
- Phrenic nerve
- Sympathetic trunk
- Vagus nerve
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
During surgery to transect the anterior scalene muscle, the surgeon must be careful to spare the phrenic nerve, which is in contact with the anterior surface of the muscle. The phrenic nerve innervates the diaphragm, and damaging it could lead to respiratory complications.Rate this question:
- 5.
A 60-year-old man with a previous history of right carotid endarterectomy, comes to his physician complaining of light-headedness and dizziness whenever he uses his right hand vigorously. He is diagnosed as having subclavian steal syndrome due to an atherosclerotic plaque at the point where his subclavian artery branches from the brachiocephalic trunk. The cerebral insufficiency is the result of blood being stolen from which artery?
- External carotid
- Internal carotid
- Middle cerebral
- Thyrocervical trunk
- Vertebral
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
E. EExplanation
The correct answer is e) Vertebral. Subclavian steal syndrome occurs when there is a blockage or narrowing in the subclavian artery, leading to a reversal of blood flow in the vertebral artery. In this case, the atherosclerotic plaque in the subclavian artery is causing blood to be "stolen" from the vertebral artery, resulting in cerebral insufficiency and the symptoms of light-headedness and dizziness.Rate this question:
- 6.
A first year resident attempts to insert a central venous catheter into the heart by a subclavicular approach to the subclavian vein. Following the attempt, it is noted that the patient has difficulty breathing. What nervous structure lying immediately deep to the subclavian vein, as it crosses the anterior scalene muscle, may have been injured?
- External branch of the superior laryngeal nerve
- Phrenic nerve
- Recurrent laryngeal nerve
- Sympathetic trunk
- Vagus nerve
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The phrenic nerve is the nervous structure lying immediately deep to the subclavian vein as it crosses the anterior scalene muscle. Injury to the phrenic nerve can result in difficulty breathing, which is consistent with the patient's symptoms.Rate this question:
- 7.
Which statement is true of the internal jugular vein?
- It drains all of the thyroid gland on that side of the body
- It drains into the external jugular vein
- It is accompanied by the deep cervical chain of lymph nodes
- It lies deep to the prevertebral fascia
- It passes superficial to the sternocleidomastoid muscle
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
The internal jugular vein is accompanied by the deep cervical chain of lymph nodes.Rate this question:
- 8.
Which structure lies immediately anterior to the right anterior scalene muscle at its costal attachment?
- Subclavian artery
- Subclavian vein
- Thoracic duct
- Thyrocervical trunk
- Vagus nerve
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The structure that lies immediately anterior to the right anterior scalene muscle at its costal attachment is the subclavian vein.Rate this question:
- 9.
An abscess was surgically removed from the middle of the posterior triangle on the right side. During recovery the patient noticed that her shoulder drooped and she could no longer raise her right hand above her head to brush her hair. Which nerve has been cut?
- Accessory (XI)
- Ansa cervicalis
- Facial (VII)
- Hypoglossal (XII)
- Suprascapular
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
A. AExplanation
The correct answer is the Accessory (XI) nerve. The Accessory nerve innervates the trapezius and sternocleidomastoid muscles, which are responsible for shoulder movement and head rotation. Damage to this nerve can result in weakness or paralysis of these muscles, leading to shoulder drooping and difficulty raising the arm above the head.Rate this question:
- 10.
A surgeon doing a deep cervical lymph node dissection may encounter these structures upon the anterior surface of the anterior scalene muscle EXCEPT:
- Phrenic nerve
- Subclavian vein
- Middle trunk of the brachial plexus
- Transverse cervical artery
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
C. CExplanation
During a deep cervical lymph node dissection, the surgeon may encounter the phrenic nerve, subclavian vein, and transverse cervical artery upon the anterior surface of the anterior scalene muscle. However, the middle trunk of the brachial plexus is not typically found in this location.Rate this question:
- 11.
The middle cervical sympathetic ganglion, recurrent laryngeal nerve, and parathyroid glands are all closely related with which blood vessel?
- Inferior thyroid artery
- Inferior thyroid vein
- Superior thyroid artery
- Superior thyroid vein
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
A. AExplanation
The middle cervical sympathetic ganglion, recurrent laryngeal nerve, and parathyroid glands are all closely related to the inferior thyroid artery.Rate this question:
- 12.
During surgical procedures of the neck, structures within the carotid sheath can be retracted (pulled aside) as a unit. Which of the following structures would remain in place when the carotid sheath is retracted?
- common carotid artery
- cervical sympathetic trunk
- internal jugular vein
- internal carotid artery
- vagus nerve
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
When the carotid sheath is retracted during surgical procedures of the neck, the structures within it are pulled aside as a unit. The cervical sympathetic trunk, which is a part of the sympathetic nervous system, would remain in place when the carotid sheath is retracted. The other structures within the carotid sheath, such as the common carotid artery, internal jugular vein, internal carotid artery, and vagus nerve, would be pulled aside along with the carotid sheath.Rate this question:
- 13.
Which of the following nerves is derived from the dorsal primary rami of spinal nerves?
- great auricular
- greater occipital
- lesser occipital
- phrenic
- supraclavicular
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The greater occipital nerve is derived from the dorsal primary rami of spinal nerves.Rate this question:
- 14.
Which of the following hyoid muscles is an important landmark in both the anterior and posterior triangles of the neck?
- geniohyoid
- mylohyoid
- omohyoid
- sternohyoid
- stylohyoid
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
The omohyoid muscle is an important landmark in both the anterior and posterior triangles of the neck. It is a long, thin muscle that runs from the superior border of the scapula to the hyoid bone. Its superior belly forms the posterior border of the anterior triangle, while its inferior belly forms the anterior border of the posterior triangle. This muscle helps to divide the neck into these two triangles and is used as a reference point for anatomical landmarks in the neck.Rate this question:
- 15.
Which of the following structures is not seen in the posterior triangle of the neck:
- Spinal accessory nerve
- Transverse cervical artery
- Middle trunk of brachial plexus
- Superior belly of omohyoid
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
D. DExplanation
The superior belly of omohyoid is not seen in the posterior triangle of the neck. The posterior triangle of the neck is an anatomical region bounded by the sternocleidomastoid muscle, trapezius muscle, and clavicle. It contains several structures, including the spinal accessory nerve, transverse cervical artery, and middle trunk of the brachial plexus. However, the superior belly of the omohyoid muscle is not located in this region.Rate this question:
- 16.
The following nerves are found in the posterior triangle of the neck a. lesser occipital nerve b. recurrent laryngeal nerve c. spinal accessory nerve d. all of the above e. only a and c
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
E. EExplanation
The correct answer is e) only a and c. The lesser occipital nerve and spinal accessory nerve are both found in the posterior triangle of the neck. The recurrent laryngeal nerve, on the other hand, is not found in the posterior triangle of the neck.Rate this question:
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- 17.
This (these) muscle(s) receive(s) motor fibers derived from the cervical plexus a. respiratory diaphragm b. levator scapulae c. omohyoid d. all of the above e. a and b only
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
D. DExplanation
The correct answer is d. All of the above. The respiratory diaphragm, levator scapulae, and omohyoid muscles all receive motor fibers derived from the cervical plexus.Rate this question:
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- 18.
The phrenic nerve: a. is part of the cervical plexus b. is derived from spinal segments C3, C4, and C5 c. lies on the anterior scalene muscle d. a and b only e. a, b, and c
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
E. EExplanation
The phrenic nerve is part of the cervical plexus, is derived from spinal segments C3, C4, and C5, and lies on the anterior scalene muscle. Therefore, the correct answer is e, which includes all of these statements.Rate this question:
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- 19.
The periosteum of the skull is called: a. arachnoid b. leptomeninx c. pia matter d. pericranium e. epicranius
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
D. DExplanation
The periosteum is a dense fibrous membrane that covers the outer surface of bones. In the case of the skull, the periosteum is called pericranium. Therefore, the correct answer is d.Rate this question:
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- 20.
The vertebral artery: a. does not pass through the foramen transversium of the 1st cervical vertebrae b. is found deep in the occipital triangle c. is a branch of the maxillary artery d. enters the vertebral foramen at the C6 level e. does not have any branches
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The correct answer is b. The vertebral artery is found deep in the occipital triangle. This means that it is located in the region formed by the posterior belly of the digastric muscle, the superior belly of the omohyoid muscle, and the sternocleidomastoid muscle. It is important to note that the vertebral artery does not pass through the foramen transversium of the 1st cervical vertebrae, which is mentioned in option a. Option c is incorrect because the vertebral artery is not a branch of the maxillary artery. Option d is also incorrect because the vertebral artery enters the vertebral foramen at the C6 level. Option e is incorrect because the vertebral artery does have branches.Rate this question:
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- 21.
The following structures on the left side of the root of the neck usually pass between the subclavian artery and the subclavian vein (or brachiocephalic vein): a. anterior scalene b. phrenic nerve c. vagus nerve d. all of the above e. both a and b but not c
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
D. DExplanation
The correct answer is d because all of the structures listed (anterior scalene, phrenic nerve, and vagus nerve) pass between the subclavian artery and the subclavian vein (or brachiocephalic vein).Rate this question:
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- 22.
On the right side of the root of the neck the costocervical trunk usually arises from the a. first part of the subclavian artery b. second part of the subclavian artery c. third part of the subclavian artery d. brachiocephalic artery e. arch of the aorta
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The costocervical trunk usually arises from the second part of the subclavian artery.Rate this question:
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- 23.
On the left side of the root of the neck the thoracic duct turns laterally to pass between these two structures: a. phrenic nerve and the prevertebral fascia b. anterior and middle scalene muscles c. anterior primary rami of C8 and T1 d. vagus nerve and common carotid artery e. common carotid artery and vertebral artery
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
E. EExplanation
The correct answer is e. The thoracic duct turns laterally to pass between the common carotid artery and vertebral artery on the left side of the root of the neck. This is an important anatomical landmark to be aware of when considering the lymphatic drainage in this region. The thoracic duct is the main channel for lymphatic drainage from the lower half of the body and the left side of the upper half of the body, so its course and relationship with other structures are significant.Rate this question:
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- 24.
In the root of the neck the subclavian artery and subclavian vein are separated by the : a. anterior scalene muscle b. trunks of the brachial plexus c. middle scalene muscle d. all the above e. a and b not c
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
A. AExplanation
The subclavian artery and subclavian vein in the root of the neck are separated by the anterior scalene muscle.Rate this question:
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- 25.
.The spinal accessory nerve passes through the posterior cervical triangle: a. superficial to the platysma muscle b. in the superficial cervical fascia c. between the investing fascia and the prevertebral fascia d. within the carotid sheath e. deep to the prevertebral fascia
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
The correct answer is c. The spinal accessory nerve passes between the investing fascia and the prevertebral fascia. This means that it is located between the layers of fascia that surround the neck muscles. This positioning allows the nerve to travel through the posterior cervical triangle, which is a region of the neck.Rate this question:
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- 26.
Which of the following muscles cannot be found in the floor of the posterior triangle of the neck? a. scalenus medius b. scalenus anterior c. teres minor d. levator scapulae
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
C. CExplanation
The correct answer is c. Teres minor. This muscle is not found in the floor of the posterior triangle of the neck. The muscles that can be found in the floor of the posterior triangle of the neck are scalenus medius, scalenus anterior, and levator scapulae. Teres minor is actually a muscle of the shoulder.Rate this question:
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- 27.
With regard to the spinal accessory nerve, choose the best statement: a. no fibers of this nerve branch from it before it crosses the posterior triangle of the neck b. the spinal accessory nerve is strictly a sensory nerve c. the spinal accessory nerve enters the cranial cavity through the foramen magnum d. the spinal accessory nerve enters the cranial cavity through the foramen rotundum
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
C. CExplanation
The correct statement is c. The spinal accessory nerve enters the cranial cavity through the foramen magnum. This is the correct answer because the spinal accessory nerve, also known as cranial nerve XI, is a motor nerve that originates from the spinal cord and enters the cranial cavity through the foramen magnum. It then exits the skull through the jugular foramen and innervates the trapezius and sternocleidomastoid muscles.Rate this question:
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Mar 21, 2023Quiz Edited by
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Jun 04, 2013Quiz Created by
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