Lecture 1 - Root of Neck Flashcards
Root of neck is
immediately superior to superior thoracic aperture
- contains major BVs, nerves and cervical viscera
Root of Neck Boundaries: Anterior
Manubrium of sternum
Root of Neck Boundaries: Lateral
By first ribs, which slope upward as they pass posteriorly to articulate with vertebra T1
Root of Neck Boundaries: Posterior
Vertebra T1
Pleural Cavity in Root of Neck
Anteriorly, pleural cavities and apical portion of LUNGS extend into root of neck
- Cervical pleurae, apices of lung, and sympathetic trunks lie posterior to first part of subclavian arteries.
Root of Neck Vessels
Subclavian artery
Subclavian vein
Root of Neck Nerves
- Phrenic
- Vagus
- Recurrent laryngeal
- Components of Symp NS
Subclavian artery
RIGHT of BT: terminal branch
Left: direct branch of arch of aorta
Both:
- pass ANTERIOR to pleural cavity in root of neck
- lie POSTERIOR to anterior scalene muscle which divides each into 3 parts
- Become AXILLARY ARTERIES as they cross lateral border of first rib
Subclavian Artery: 3 parts
First Part: Medial to anterior scalene muscle
- vertebral artery, internal thoracic artery and thyrocervical trunk arise from first part of subclavian artery.
Second Part: Posterior to muscle
- Costocervical trunk arises from second part
Third part: lateral to muscle
- Dorsal scapular artery, often arising from third part
Vertebral artery ascends in transverse foramen of cervical vertebrae and enters
Foramen magnum
Internal thoracic artery runs
inferiorly through thoracic inlet and PARALLEL to body of sternum.
Descends on internal aspect of anterior chest wall, giving off segmented anterior intercostal branches.
thyrocervical trunk
arises as short stem and abruptly divided into 2 cervical branches and 1 thyroid branch
suprascapular artery
crosses anterior scalene muscle, enter posterior triangle and passes posteriorly to suprascapular region of back
transverse cervical artery
crosses scalenus anterior muscle to enter posterior triangle to supply lateral structures of neck
inferior thyroid artery
ascends in neck, arches MEDIALLY and DOWNWARD to enter/supply INFERIOR portion of thyroid gland
- large musclar branch from inferior thyroid artery, ASCENDING cervical artery travels STRAIGHT/ UPWARD
costocervical trunk
short branch supplies muscles of root of neck (deep cervical artery) and sends branches to upper 2 intercostal spaces (supreme intercostal artery)
Dorsal scapular artery
independent branch of 2nd or 3rd part of subclavian (may also arise as deep descending branch of transverse cervical artery)
- wraps around posterior scapula, forms anastomosis with supra scapular artery, rotator cuff muscles
DSA branch of subclavian..
dorsal scapular artery passes laterally through trunks of BRACHIAL PLEXUS, anterior to middle scalene
DSA then
runs deep to elevator scapulae and rhomboid muscles, supplies both and participates in arterial anastomoses around scapula
*arteries can be joined to each other via anstomosis (able to feed each other’s territory)
