Superficial structures of Neck: Cervical Regions Flashcards
Lateral region of neck
Anterior: Posterior border of SCM
Posterior: Anterior border traapezius
Superior: Merging of SCM and trap
Inferior: clavicle (between SCM and trapezius)
roof: investing layer of deep cervical fascia
platysma
floor: muscles covered by prevertebral layer of deep cervical fascia
anterior region of neck
anterior: median line of neck
posterior: anterior border of SCM
superior: inferior border of mandible
inferior: superior sternum
roof: subcutaneous tissue
platysma
floor: pharynx, larynx, thyroid gland
platysma origin
inferior border of mandible, skin and subcutaneous tissue of lower face
platysma insertion
fascia covering superior parts of pectoralis major and deltoid muscles
platysma innervation
cervical branch of facial nerve (CN VII)
platysma action
draws corners of mouth inferiorly and widens it: sadness and fright
draws skin of neck superiorly when teeth are clenched: tension
Sternocleidomastoid (SCM) origin
lateral surface if mastoid process of temporal bone and lateral half of superior nuchal line
SCM insertion
sternal head: anterior surface of manubrium of sternum
clavicular head: superior surface of medial third of clavicle
SCM innervation
spinal accessory nerve (CN XI (motor))
C2, C3: pain and proprioception
SCM action
unilateral contraction: lateral flexion of neck and rotates it so face is turned superiorly to opposite
bilateral contraction: extends neck at a-o joints; flexes cervical vertebrae so chin approaches manubrium; extends superior cervical vertebrae while flexing inferior vertebrae so chin is thrust forwar while head kept level
with cervical vertebrae fixed: may elevate manubrium and medial end of clavicles, assisting pump handle action of deep respiration
spinal accessory nerve
CN XI
passes deep to SCM, supplying it
enters lateral cervical region at or inferior ti junction of superior and middle thirds of posterior border of SCM
passes posteroinferiorly running on levator scapulae from which it is separated by prevertebral layer of fascia
disappears deep to anterior border of trapezius then enters muscle
brachial plexus
roots: anterior rami of C5- C8 and T1 appear between anterior and middle scalene musce
5 rami to 3 trunks (superior middle, inferior)
descend inferolaterally through lateral cervical region
passes through 1st rib, clavicle, and superior border of scapula (cortico axillary canal) to enter axilla, innervating upper limbs
suprascapular nerve
arises from superior trunk brachial plexus
runs across lateral cervical region to supply supraspinatus and infraspinatus
also articular branches to glenohumeral joint
cervical plexus
anterior rami C1-C4
anteromedial to levator scapulae and middle scalene muscle, deep to SCM
superficial branches-> posterior-> cutaneous
deep: anteromedially: motor
nerve point of neck
middle of posterior border o SCM
cutaneous branches of cervical plexus emerge, supply skin of anterolateral neck, superolateral thoracic wall and scalp between auricle and eop
branches of cervical plexus from nerve loop between anterior rami of C2 and C3
lesser occipital nerve: C2: skin of neck and scalp posterosuperior to auricle
great auricular nerve: C2 and C3: ascending vertically across SCM onto parotid gland, where divides and supplies skin and sheath of gland, posterior aspect of auricle, and angle of mandible and mastoid process
transverse cervical nerv: C2, C3: skin covering anterior cervical region, nerve curves around middle of posterior border of SCM and passers anteriorly and horizontally across it, deep to EJV and platysma
supraclavicular nerves
C3 and C4
arise from loop of cervical plexus between C3 and C4 anterior rami
supply skin of shoulder
branches of dorsal scapular nerve, long thoracic nerve (supplies serratus anterior)
phrenic nerves
from C4, but contributions from C3, C5
motor, sensory, and sympathetic nerve fibers
motor supply to diaphragm and sensation
mediastinal pleura and pericardium
anterior scalene muscle at level of superior border of thyroid cartilage
external jugular vein
EJV
begins near angle of mandible crosses SCM obliquely, descends to inferior part of lateral cervical region and continues as subclavian vein
accessory phrenic nerve
lateral to main one
subclavian vein
cant read
brachiocephalic vein
cant read
suprascapular artery
arises from cervicodorsal trunk or directly from subclavian artery
inferomedially across anterior scalene muscle and phrenic nerve
passes posterior to clavicle to supply muscles on posterior aspect of scapula
occipital artery
branch of external cervical
supplies posterior half of scalp
anterior scalene origin
anterior tubercles of transverse processes C3-C6
anterior scalene insertion
`1st rib
anterior scalene innervation
cervical spinal nerves c4-c6
anterior scalene action
flexes neck laterally, elevates 1st rib during forced inspiration
middle scalene origin
post5erior tubercles of transverse processes of C4-C7
middle scalene insertion
superior surface of 1st rib, posterior to groove for subclavian artery
middle scalene innervation
anterior rami of cervical spinal nerves
middle scalene action
flexes neck laterally
elevates 1st rib during forced respiration
posterior scalene origin
posterior tubercles of transverse processes of C4- C6
posterior scalene insertion
external border of second rib
posterior scalene innervation
anterior rami of cervical spinal nerves C7 and C8
posterior scalene action
flexes neck laterally, elevates 2nd rib during forced inspiration
muscles of floor of triangle
middle scalene, posterior scale, levator scapulae splenius capitis
