Superficial Structures of Neck: Cervical Region Flashcards
Sternocleidomastoid (SCM)
divides each side of the neck into anterior and posterior triangles.
ACTION: Unilateral contraction to tilt the head to same side (laterally flexes the neck) and rotates the head so face is turned superiorly toward the opposite side.
Sternocleidomastoid (SCM)
ORIGIN: from the anterior surface of the manubrium sterni and the superior surface medial 1/3 of clavicle.
INSERTION: into the mastoid process and lateral part of the superior nuchal line of occipital bone.
NERVE: M = spinal root of accessory nerve (CN11)
S = C2 and C3 nerves (pain and
proprioception)
Trapezius
large, flat triangular muscle that covers the posterolateral aspect of the neck.
ACTION: descending (superior) fibers elevate the pectoral girdle, the transverse fibers retract the scapula, ascending inferior fibers depress shoulder.
Trapezius
ORIGIN: from the medial 1/3 of the superior nuchal line, external occipital protuberance, nuchal ligament and the Sp of C7-T12.
INSERTION: the lateral 1/3 of the clavicle, acromion of scapula and spine of scapula.
NERVE: M = spinal root of accessory nerve (CN11)
S = C2 and C3 nerves (pain and proprioception
Anterior Border of the Posterior Triangle
posterior border of SCM
Posterior Border of the Posterior Triangle
anterior border of trapezius
Inferior Border of the Posterior Triangle
middle 1/3 of the clavicle
Apex of the Posterior Triangle
where SCM and trapezius meet on the superior nuchal line of occipital bone
Roof of the Posterior Triangle
formed by the platysma and investing layer of deep cervical fascia.
Floor of the Posterior Triangle
From top down: splenius capitis, levator scapulae, scalenus medius, scalenus posterior and scalenus anterior.
2 Subdivisions of the Posterior Triangle
- Occipital triangle
2. Omoclavicular or supraclavicular or subclavian triangle
Muscle dividing the Posterior Triangle into 2
Inferior belly of omohyoid
Occipital Triangle
so called b/c the occipital artery appears in the apex
- the most important nerve crossing this triangle is the spinal accessory nerve.
Arteries of the Lateral Cervical Region
- lateral branches of the thyrocervical trunk
- 3rd part of the subclavian artery
- part of the occipital artery
Thyrocervical trunk is a branch of…..
subclavian artery
2 branches of thyrocervical trunk
- suprascapular artery
2. cervicodorsal trunk (transverse cervical artery)
Cervicodorsal (transverse cervical artery) trunk terminal branches
- ascending cervical artery
2. inferior thyroid artery
Suprascapular artery
posterior to the clavicle, accompanies the suprascapular nerve and supplies the muscles on the posterior aspect of the scapula.
2 branches of transverse cervical artery
- superficial branch
2. deep branch AKA dorsal scapular artery
Superficial branch of the transverse cervical artery passes deep to the trapezius and runs with….
spinal accessory nerve (CNXI)
Dorsal scapular artery runs with…
dorsal scapular nerve and runs deep to the levator scapulae and rhomboid muscles, supplying them.
Occipital artery is a branch of…
external carotid artery, enters the posterior triangle at its apex and ascends over the head to supply the posterior half of the scalp.
3rd part of the subclavian artery supplies…
the upper limb and lies deep to the subclavian vein
4 veins in the lateral cervical region
- external jugular vein
- retromandibular vein
- subclavian vein
- brachiocephalic vein
What vein drains most of the scalp and the side of the face
External Jugular Vein
2 veins that come together to form the External Jugular Vein
- posterior auricular vein
2. posterior division of retromandibular vein
What vein crosses the SCM obliquely, deep to the platysma and pierces the investing layer of the deep cervical fascia and terminates into the subclavian vein.
External Jugular Vein
The major venous channel draining the upper limb
Subclavian Vein
The subclavian vein and the internal jugular vein unite to form what?
brachiocephalic vein
7 Nerves of the Lateral Cervical Region
- Spinal Accessory Nerve
- Ventral Rami (roots) of the Brachial Plexus
- Suprascapular Nerve
- Roots of Cervical Plexus
- Cutaneous Branches of Cervical Plexus
- Deep Motor Branches of Cervical Plexus
- Phrenic Nerve
4 Branches of the Cervical Plexus
- Lesser Occipital Nerve
- Great Auricular Nerve
- Transverse Cervical (cutaneous) Nerve
- Supraclavicular Nerve
What Nerve passes deep to the SCM and enters the posterior triangle and passes to the anterior border of the trapezius.
Spinal Accessory Nerve (CN11)
2 muscles supplied by the Spinal Accessory Nerve (CN11)
SCM and Trapezius
Brachial Plexus Roots appear between what 2 Muscles
- Anterior Scalene Muscle
2. Middle Scalene Muscle
What nerve arises from the superior (upper) trunk of the brachial plexus?
Suprascapular Nerve (C5,C6)
2 muscles supplied by the Suprascapular Nerve
- Supraspinatus
- Infraspinatus
Also supplies articular branches to the glenohumeral joint
What Nerve supplies the skin of the neck and scalp?
Lesser Occipital Nerve (ventral ramus of C2)
What Nerve ascends vertically across the SCM and supplies the skin over and the sheath surrounding the parotid gland, the mastoid process, both surfaces of the auricle and an area of skin exteding from the angle of the mandible to the mastoid process?
Great Auricular Nerve (ventral rami of C2 and C3)
What Nerve curves around the middle of the posterior border of the SCM and supplies the skin covering the anterior cervical region (anterior triangle)?
Transverse Cervical Nerve (ventral rami of C2 and C3)
What Nerve emerges as a common trunk under the cover of the SCM and sends small branches to the skin of the neck and supplies the skin over the shoulder?
Supraclavicular Nerves (ventral rami of C3 and C4)
2 nerves that are deep motor branches of the cervical plexus and include branches arising from the roots?
- Dorsal Scapular Nerve
2. Long Thoracic Nerve
Which Nerve originates chiefly from C4 nerve, but receives contributions from the C3 and C5 nerves, contains motor, sensory and sympathetic nerve fibers.
Phrenic Nerve
What muscle does the phrenic nerve run on?
Anterior Scalene Muscle
What nerve is the sole motor supply of the diaphragm and sensory supply to its central part?
Phrenic Nerve
What lies along the external jugular vein, superficial to the SCM?
Superficial Cervical Lymph Nodes
What forms a chain along the course of the internal jugular vein and is embedded in the fascia of the carotid sheath?
Deep Cervical Lymph Nodes
Abnormal tonicity of the cervical muscles, usually begins in the adulthood, may involve any bilateral combination of lateral neck muscles, especial the SCM and trapezius.
Spasmodic Torticollis
Drooping of the shoulder is an obvious sign of??
Spinal Accessory Nerve Lesion
What nerve is vulnerable to injury in fractures of the middle third of the clavicle and results in loss of lateral rotation of the humerus at the glenohumeral joint?
Suprascapular Nerve
(The relaxed limb rotates medially into the waiter’s tip position and the ability to initiate abduction of the limb is also affected.)
