THE NECK

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THE NECK

• Superficial and Deep

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Pathways of the Spread of Infection
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The Cervical Fascia Layers

• Superficial Fascia
• Deep Fascia
• Superficial (Investing Layer
• Middle Layer
• Muscular Portion
• Visceral Portion
• Deep (Prevertebral) Layer

• Alar Fascia
• Carotid Sheath
• Retropharyngeal (Danger) Space

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The Jugular Venous System
Occipital Posterior Auricular Superficial
Temporal Maxillary Retromandibular ( also
drains into the external
jugular) Facial External Jugular Anterior
Jugular Internal Jugular
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Lymphatics of the Head and Neck

• Occipital Nodes
• Posterior Auricular Nodes
• Preauricular Nodes
• Parotid Nodes
• Jugulodigastric Node
• Superficial Cervical Nodes

• Facial Nodes
• Submental Nodes
• Submandibular Nodes
• Deep Cervical Nodes
• Thoracic or Right Lymphatic Duct

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The Cervical Triangles and Their Contents

• Posterior Triangle
• Occipital Triangle
• superficial cervical nerves
• spinal accessory nerve
• occipital a. v.
• posterior portion of external jugular vein
• Subclavian Triangle (Supraclavicular or Minor
  Vascular Triangle)
• subclavian artery and vein (and branches)
• supraclaviculr nerves

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• Anterior Triangle
• Submandibular Triangle
• Submandibular gland
• Submandibular lymph node
• Facial a. v.
• Lingual a. v.
• Hypoglossal nerve
• Carotid (Major Vascular) Triangle
• Common carotid a.
• Internal carotid a.
• External carotid a.
• Lingual a. v.
• Facial a. v.
• Internal jugular v.
• Vagus n.
• Hypoglossal n.

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• Anterior Triangle (cont)
• Submental Triangle
• Submental a. v.
• Mylohyoid n.
• Submental lymph node
• Muscular (Visceral) Triangle
• Infrahyoid muscles
• Larynx
• Thyroid Gland
• Trachea
• Superior and Inferior Thyroid a. v.
• Superior Laryngeal n.
• Recurrent Laryngeal n.

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Suboccipital Triangle

• Muscles
• Rectus Capitus Posterior Major
• Rectus Capitus Posterior Minor
• Obliqus Capitus Superior
• Obliqus Capitus Inferior
• Contents
• Vertebral A. V.
• Suboccipital N. (posterior rami of C1, only motor)

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Muscles of the Neck

• Anterior Group
• Sternocleidomastoid
• Suprahyoid Muscles
• Digastric
• Stylohyoid
• Mylohyoid
• Geniohyoid
• Hyoglossus
• Infrahyoid Muscles
• Sternohyoid
• Sternothyroid
• Omohyoid
• Thyrohyoid

• Posterior Group
• Trapezius
• Splenius Capitus
• Semispinalis Capitus
• Longissimus Capitus
• Scalenus Anterior, Middle and Posterior

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Cervical Nerve Plexus

• Superficial Portion (All Sensory )
• Lesser Occipital N.
• Great Auricular N.
• Transverse Cervical N
• Supraclavicular Nerves
• Deep Portion (Ansa Cervicalis) All Motor
• Branches of C1 - C4 which innervate the
  geniohyoid, and all infrahyoid muscles.

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Deep Structures of the Neck

• The Cervical Spine and Associated Structures

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Deep Muscles of the Neck

• Scalenus Anterior, Middle and Posterior
• Longus capitus, Colli

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Nerves of the Deep Neck

• Posterior Rami
• C1- Muscular Only to Suboccipital Muscles
• Greater Occipital (C2,C3) Sensory to scalp
• Third Occipital, Sensory to scalp
• Muscles innervated by posterior motor rami of
  C2-C8

• Spinal Accessory N. XI
• Roots and Trunks of Brachial Plexus
• Phrenic Nerve
• Vagus Nerve X
• Hypoglossal XII
• Sympathetic Trunk

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Subclavian Arterial Branches to the Neck
Vertebral Thyrocervical Trunk Suprascapular Tran
verse Cervical Inferior Thyroid Ascending
Cervical Costocervical Trunk Superior
Intercostal Deep Cervical
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Branches of the Carotid Artery

• Internal Carotid
• External Carotid
• Superior Thyroid
• Middle Thyroid
• Lingual
• Facial
• Submental
• Ascending Pharyngeal
• Occipital
• Posterior Auricular

• Maxillary
• Superficial Temporal

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Characteristics of Cervical Vertebrae

• Typical
• Tranverse Foramen
• Bifid Spine
• Atypical
• C1 (Atlas)
• It has no body
• Posterior Tubercle but no spine
• C2 (Axis)
• Superior portion of the body is odontoid process
• C7 has a blunted Spine

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Ligaments of the Craniovertebral Joint

• Anterior Longitudinal Ligament - becomes the
  anterior atlanto-occipital membrane.
• Posterior Longitudinal Ligament - becomes the
  tectorial membrane.
• Supraspinous Ligaments - becomes the posterior
  atalanto-occipital membrane.
• Cruciate Ligament - The transverse portion of
  this ligament actually is a articulation for the
  posterior surface of the odontoid process.
• Apical Ligament
• Alar Ligaments

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