Bhattacharya 1 Flashcards
The neck is a constriction that connects the structures of the head and the trunk and is surrounded by a _______.
musculofascial collar
What are the compartments that the neck is divided into by fascia?
- Vertebral compartment
- Neuro-vascular
compartment - Visceral Compartment
Consists of:
a. Pharynx
b. Larynx
c. Esophagus
d. Trachea
e. Thyroid
f. Parathyroid glands
Visceral Compartment
Superior boundary
- Mandibular symphysis
- Body and angle of the
mandible - Mastoid process
- Occipital bone
Inferior Boundary
- Superior thoracic aperture
a. Suprasternal (jugular)
notch
b. First rib (covered
anteriorly by clavicle
c. Junction between C7 and
T1
Boundaries of the posterior triangle
a. Anterior - sternocleidomastoid muscle
b. Posterior - trapezius muscle
c. Inferior - middle third of the
clavicle
Skeletal landmark of the posterior triangle
Transverse process of the cervical vertebrae
Boundaries of the anterior triangle
a. Posterior - anterior border of the sternocleidomastoid muscle
b. Anterior - midline of the neck
c. Superior - inferior border of the mandible
Skeletal and other landmarks of the anterior triangle
a. Hyoid bone
b. Thyroid cartilage
(1) Thyroid notch - V-shaped
(2) Laryngealprominence
(3) Lamina of thyroid cartilage
c. Cricoid cartilage
d. Rings of the trachea
e. Thyroid gland
Structure at C3
Hyoid bone
Structure at disk between C3 and C4
Bifurcation of the common carotid artery
Structure at C4 and C5
Thyroid cartilage
Structure at C6
- cricoid cartilage
- beginning of esophagus
- beginning of trachea
- vertebral artery enters transverse foramen
Structure at C7
- isthmus of thyroid gland
2. highest point of the thoracic duct
Superficial structures
- Skin
- Platysma muscle
- A muscle of facial expression
2. Contained within the superficial fascia
Platysma Muscle
Origin of platysma muscle
fascia covering superior part of pectoralis major muscle (over the second rib)
Insertion of the platysma muscle
perioral musculature associated with the lower lip and lower margin of the mandible
Innervation of the platysma muscle
cervical branch of the facial nerve
Cutaneous Nerves from Cervical Plexus:
a. Afferent fibers
b. Postganglionic sympathetic
fibers
Ventral rami of C1-C4
Cutaneous Nerves from Cervical Plexus: Branches
a. Supraclavicular n.
b. Transverse cervical n.
c. Great auricular n.
d. Lesser occipital n.
Formed by the union of the posterior division of the retromandibular vein and the posterior auricular vein.
External Jugular Vein
The _______ lies behind or retro to the ramus of the mandible and lies under the cover of the parotid gland. It is formed by the union of the superficial temporal vein and the maxillary vein. These two veins drain the superficial temporal region and structures deep to the face, respectively.
retromandibular vein
Near the inferior border of the mandible, the retromandibular vein divides into an anterior and a posterior division.
The posterior division joins with the posterior auricular vein, which drains the region around the ear, to form the ________.
external jugular vein
The _______crosses superficially over the sternocleidomastoid muscle and penetrates the fascia on the roof of the posterior triangle of the neck. The blood vessel passes deep to the clavicle to drain into the subclavian vein.
external jugular vein
a. The anterior division of the retromandibular vein combines with the facial vein, which drains the face, to form the common facial vein.
b. Vein passes deep to the sternocleidomastoid muscle to empty into the internal jugular vein
Common facial vein
a. Vein starts in the submental region, courses inferiorly, and travels deep to the sternocleidomastoid muscle to empty into the external jugular vein.
b. May have a communicating branch with the common facial vein
c. Anterior jugular veins communicate in the suprasternal space forming the
jugular venous arch
Anterior jugular vein
- Deep fascia that surrounds the neck
- Extent
a. Encloses trapezius muscle posteriorly
b. Forms roof of posterior cervical triangle
c. Encloses sternocleidomastoid muscle
d. Covers the anterior cervical triangle
Investing Fascia
Anterior boundaries of the posterior triangle (origin and insertion)
Sternocleidomastoid muscle Origin: sternal and clavicular heads
Insertion: mastoid process
Posterior boundaries of the posterior triangle (origin and insertion)
Trapezius muscle
Origin: external occipital protuberance
Insertion: spine of scapula and lateral third of clavicle
Inferior boundary of the posterior triangle
Middle third of the clavicle
Divided into two triangles by the inferior belly of the omohyoid muscle
- Origin: Upper border of scapula
- Insertion: hyoid bone
- Intermediate tendon passes through a fascial sling attaching it to the clavicle
Subsidiary Triangles:
- Supraclavicular triangle
- Occipital triangle
Supraclavicular triangle bounded by:
a. Clavicle
b. Inferior belly of omohyoid
c. Sternocleidomastoid
Occipital triangle bounded by:
a. Sternocleidomastoid
b. Inferior belly of omohyoid
c. Trapezius
Floor of the posterior triangle contains
- Prevertebral fascia
- Muscles of the floor
of the triangle
Muscles of the floor
of the triangle
a. Anterior scalene
b. Middle scalene
c. Posterior scalene
d. Levator scapulae
e. Others not
studied in this course
Contents of the Posterior Triangle
A. Subclavian vessels and branches
B. Transverse cervical artery
C. Suprascapular artery
D. Trunks of the brachial plexus and branches
- Branch of thyrocervical trunk of subclavian artery
- Artery generally divides into two branches
a. Superficial branch passes out of the posterior triangle underneath the trapezius muscle which it supplies.
b. Deep branch exits the triangle by passing between the posterior scalene and levator scapulae muscles and supplies the muscles of the back. - Common variations
a. Deep branch may arise separately off the second or third portion of the subclavian artery as the dorsal scapular and passes through the brachial plexus to reach the levator scapulae muscle.
b. A typical transverse cervical artery with its two branches may be present in addition to the dorsal scapular artery
c. The presence of these vessels may vary from one side of the body to the other
Transverse cervical artery
Branch of the thyrocervical trunk. Passes deep along the border of the clavicle and passes over the superior border of the scapula to reach muscles associated with the shoulder
Suprascapular artery
