Anterior and posterior triangles of the neck Flashcards
What are some important structures around the anterior and posterior triangles?
Sternocleidmastoid muscle between the triangles
clavicle- bone under triangles
Trapezius Muscle -behind posterior triangle
Inferior border of mandible- jawline
What are the 3 boundaries of the posterior triangle?
Posterior border of the sternocleidomastoid muscle (SCM)
Middle third of the clavicle
Anterior border of trapezius muscle
What are the subdivisions of the posterior triangle?
Occipital triangle (large) subclavian triangle(small) split by the OMOHYOID muscle
What is the roof and floor of the triangle made from?
The roof of the triangle is made of investing layer of cervical fascia that envelopes the sternocleidomastoid and trapezius muscles.
The floor of the triangle consists of the prevertebral layer of cervical fascia covering the splenius capitis, leavtor scapulae and scalene muscles.
What vein crosses the posterior triangle?
How is this vein clinically important?
EXTERNAL JUGULAR VEIN- crosses SCM into posterior triangle and empties into the subclavian vein
clinical importance- it may be visible if engorged
What are the contents of the posterior triangle?
External Jugular vein Subclavian artery Accessory nerve Cervical plexus of nerves Trunks of the brachial plexus Apex of the lung lymph nodes
How can you examine the pulse of the subclavian artery?
press the artery against the first rib(as it crosses the first rib) in the SUPRACLAVICULAR FOSSA at the junction of the middle and medial thirds of the clavicle
This is important pressure point to stop/obstruct the artery when there is bleeding distally in the upper limb
What is the cervical plexus of nerves?
nerve point of neck made up by anterior primary rami of the C1-C4 cervical nerves
Where is the cervical plexus of nerves located?
branches emerge at the junction of the superior and middle thirds of the posterior border of the SCM
Where are the trunks of the brachial plexus?
What do they feel like?
at the anterior inferior angle of the posterior triangle just behind the SUBCLAVIAN pulse
feel like thick cords, when finger pressure is applied patient may feel slight pain
which lymph nodes should you examine on a patient?
occipital, posterior, cervicle, supraclavicuar
What are the 3 boundaries of the anterior triangles of the neck?
Midline of the neck
inferior border of the mandible
Anterior border of the sternocleidmastoid muscle
What is the anterior triangle divided up into?
4 smaller triangles: submental triangle submandibular triangle carotid triangle muscular triangle
What covers the anterior triangle?
PLATYSMA MUSCLE in the superficial fascia
What lies beneath the deep cervical fascia?
SUPRAHYOID group of muscles and iINFRAHYOID group of muscles
What are the contents of the anterior triangle?
Hyoid bone Thyroid cartilage Cricoid cartilage Cricothyroid space Trachea and tracheal rings Suprasternal notch of manubrium Thyroid gland carotid arteries Internal jugular vein subclavain vein Lymph nodes Deep cervical lymph nodes
How can you examine the hyoid bone?
hold the GREATER HORNS of the hyoid bone between your thumb and the rest of the fingers and move the bone side to side
How can you examine the Cricoid cartilage?
Just below the lower border of the thyroid you can feel a soft tissue depression and then the anterior arch of the cricoid cartilage
Where is the cricothyroid ligament?
What is the importance of this area?
The soft tissue depression or the space between the lower border of the thyroid cartilage and the upper border of the anterior arch of the cricoid cartilage
Important site for performing emergency CRICOTHYRIODOTOMY to establish and adequate airway
Where can the trachea and tracheal rings be felt?
below the cricoid cartilage
Where can you feel the suprasternal notch of the manubrium?
Why is it important to feel for this area?
further down the trachea
Important to feel the notch to detect if it had deviated from the midline-this may indicate lung pathology or pressure changes in the pleural cavities
Where can you fell the thyroid gland?
The isthmus is felt over the 3rd and 2nd tracheal rings as a slight thickening
The lateral lobes is felt either side of the trachea
You can ask the patient to sip some water and watch the movement of the lobes of the glands upwards with the larynx
Where can you detect the common pulse of the carotid artery?
beneath the anterior border of the sternocleidmastoid muscle at the level of the upper border of the thyroid
Where in the anterior triangle is the internal jugular vein detected and easily accessible from?
midway down the anterior border of the SCM - it is easily accessible at the apex of the triangle between the sternal and clavicular heads of the SCM
Where in the anterior triangle does the subclavain vein run?
behind the medial 3rd of the clavicle - can be approached from the upper border of the clavicle just lateral to the attatchment of the clavicular head of the SCM
Where do the deep cervical lymph nodes run in the anterior triangle?
along the internal jugular vein under the cover of the SCM.
superior deep cervical nodes(jugulodigastic group)- can be felt anterior to the SCM
inferior deep cerival nodes(jugulomohyoid group)- can be felt posterior to the SCM
What should you do when feeling the cervical lymph nodes?
feel in a circular motion without lifting your fingers off the patient to ensure no lymph nodes are missed
Use both hands to feel for lymph nodes on each side simultaneously
Which 8 cervical lymph nodes to you have to feel for?
Submental nodes –inferior to the chin
Submandibular nodes –inferior to the angle of the mandible
Preauricular/parotid nodes –anterior to the ear (technically the preauricular and parotid nodes are two separate sets of nodes, but because of their close proximity, they are usually palpated at the same time.)
Postauricular nodes - posterior to the ear
Occipital nodes - base of the occipital
Superior deep cervical nodes - superior part of the sternocleidomastoid
Inferior deep cervical nodes - inferior part of the sternocleidomastoid
Supraclavicular nodes - superior to the clavicle
How do you examine the nodes?
feel for them -watch video on coursera to see where to feel for each of the glands
