Side Of The Neck Flashcards
Apex of post triangle
Mastoid process and sup nuchal line
Roof of post triangle
Roof:
- Skin and superficial fascia: containing the:
a. External jugular vein.
b. 4 cutaneous branches of the cervical plexus: lesser occipital, great auricular,
transverse cervical and supraclavicular nerves.
c. Platysma muscle.
2. Deep fascia: formed of the investing layer of the deep cervical fascia.
Floor of post triangle
Floor: muscular floor
a. 5 muscles: from above downward:
1. Semispinalis capitis may appear at the apex.
2. Splenius capitis. 3. Levator scapulae.
4. Sealenus medius.
5. Scalenus anterior may appear at the base. b. The muscles of the floor are covered by the prevertebral fascia
Content of posterior triangle
Blood Vessels: 4 arteries & 2 veins
Nerves
- The 3 part of the subclavian artery
- Suprascapular artery
- Transverse cervical artery
- Occipital artery: at the apex
- Subclavian vein.
- Termination of the external jugular vein.
Muscle: inferior belly of the omohyoid
- Spinal accessory nerve.
- Cervical plexus.
- Brachial plexus: roots & trunks.
Lymph Nodes
Arteries of post triangle
- The third part of the subclavian artery:
I descending Anr
It lies lateral border of the scalenus anterior muscle.
Branches: it gives no branches. It may give the dorsal scapular artery if the deep
branch of the transverse cervical artery is absent,
- Transverse cervical artery:
Arises from the thyrocervical trunk (from the first part of the subclavian artery); It passes in front of the scalenus anterior above the suprascapular artery.
It divides into superficial branch (to the trapezius) & deep branch (to the scapula). 3. Suprascapular artery:
⚫ Arises from the thyrocervical trunk (from the first part of the subclavian artery). It passes in front of the scalenus anterior below the transverse cervical artery.
- Occipital artery:
Arises from the external carotid artery and terminates by supplying the scalp.
It gives posterior meningeal (mastoid) artery to the dura (enters the mastoid foramen).
Veins of post triangle
Veins in the Posterior Triangle
- Subclavian vein:
It lies in front of the scalenus anterior muscle.
It ends by joining with the internal jugular vein to form the brachiocephalic vein.. •Tributaries: only the external jugular vein..
External jugular veins
It is formed by union of the posterior auricular vein and the posterior division of the
retromandibular vein. It pierces the investing layer of the cervical fascia to end in the subclavian vein.
Tributaries: transverse cervical vein, suprascapular vein and anterior jugular vein.
Transverse cervical A supplies
Trapezius by sup branch
And
Scapula by deep branch
Cervical origins of Great auricular Lesser occ G occ 3rd occ Transverse cervical And supra clavicular
Great autivular --v of c 2 and 3 Lesser occ V c2 G occ D c2 3rd occ D c3 Transverse cervical V c2.3 And supra clavicular V c3.4
C1.2.3. C2.3 C3.4 C3:6 C3.4.5
C1.2.3. Ansa cervicalis(infrahyoid ms) C2.3 Sterno mastoid C3.4 Scalene C3:6 Trapezius and levator scapulae C3.4.5 Phrenic to diaphragm
Injury to accessory nerve
As its located superficially in the investing layer of upper deep c f Cause paralysis of Trap. Drop shoulder And St mast. Inability to turn head to opposite side
Location of accessory n and cervical plexus
- parallel to levator scapulae in investing fascia
- deep to prevertibral fascia in front of scalenus medius
All about sternomastoid
Origin: by 2 heads
M: Mastoid process
Sternomastoid
- Sternal head: front of the manubrium. 2. Clavicular head: medial 1/3 of the clavicle.
Insertion:
- Lateral surface of the mastoid process 2. Lateral % of the superior nuchal line
Nerve supply:
- Spinal accessory nerve: motor. 2. Ventral rami of C2 & C3: sensory.
Action:
One muscle: rotate the head to the opposite side Two muscles: forward flexion of the neck.
clavicle
2
1: sternal head 2: clavicular head
Superficial Relations
- Skin & superficial fascia containing platysma
- External jugular vein.
- 4 Cutaneous branches of the cervical plexus:
a. Lessr occipital nerve.
c. Transverse cervical nerve.
d. Anterior supraclavicular nerve. 4. Superficial cervical lymph nodes along the external jugular vein
b. Great auricular nerve.
Deep Relations
- Muscles in the floor of the posterior triangle (splenius capitis, levator scapulae. scalenus medius & scalenus anterior) and intermediate tendon of omohyoid.
- Nerves in the posterior triangle (brachial plexus, cervical plexus, phrenic nerve, spinal accessory and vagus nerve).
- Vessels in the posterior triangle: subclavian artery & vein, suprascapular and transverse cervical arteries & internal jugular vein.
Torticollis (twisted neck; wry neck):
• Results from injury of the sternomastoid during difficult delivery with formation of hematoma that undergoes fibrosis.
⚫ Rotation of the head is due to shortening of the caused by fibrosis.
• Surgical treatment includes cutting of the sternal origin to elongate the muscle and enable the person to rotate the head.
Origin insertion n supply and action of scalene anterior
Origin:
transverse processes of C3-C6 -Insertion: scalene tubercle of the 1” rib.
Nerve supply: cervical plexus (C4-C6)
Action:
elevation of the 1” rib.
Ant relations of scalenus anterior
A -transverse cervical - supra scapular V - subclavina - int jug. N -phrenic -vagus Ms -tendon of omo - sterno m
Post relations of scalenus ant
Brachial plexus
Subclavian artery 2nd part
S.medius ms
