Root of the Neck
M1 – Anatomy Root of the Neck
Dr. Jeff Dupree
1
Summary of Anterior Cervical Triangle
Boundaries: Mandible, SCM, midline
Divided into 4 triangles: Muscular, carotid, submandibular, submental
Muscular: infrahyoid muscles innervated by ansa cervicalis EXCEPT thyrohyoid (C1)
Carotid: carotid sheath, ansa cervicalis, branches of ext. carotid, hypoglossal n., deep cervical lymph nodes
Submandibular: submandibular gland, suprahyoid muscles
Submental: crosses midline, submental lymph nodes
2 Summary of Posterior Cervical Triangle
2 triangles: occipital supraclavicular
Occipital: 4 cutaneous nerves lesser occipital, great auricular, transverse cervical, supraclavicular
spinal accessory
3
4 Nerves of the Muscular Triangle
5
Boundaries of Root of Neck Anterior: manubrium of sternum Lateral: 1st rib Posterior: body of 1st thoracic vertebra
6 Anterior to Anterior Scalene M.
7
Posterior to Anterior Scalene M.
8 Muscles of the root of the neck
Longus colli
Scalenes anterior middle
posterior
9
Arteries of the Root of Neck
Brachiocephalic trunk (right side)
Common carotid
Subclavian
10 Blood Supply for Root of Neck
Common carotid a.
Subclavian a. -3 parts
11
Subclavian Artery Three parts: 1st part: origin to medial border of Anterior Scalene 2nd part: behind Anterior Scalene 3rd part: lateral edge of Ant. Scalene to 1st rib
Branches of 1st part: -vertebral -internal thoracic -thyrocervical trunk
Branches of 2nd part: -costocervical trunk
Branch of 3rd part: -dorsal scapular 12 13
Relationship between Ant. Scalene and Subclavian Branches
Vertebral Thyrocervical Costocervical Int. Thoracic (not seen)
14 Subclavian Artery Internal thoracic
Vertebral
Thyrocervical trunk: transverse cervical suprascapular inferior thyroid ascending cervical
Costocervical trunk: deep cervical superior (supreme) intercostal the superior/highest/supreme intercostal artery are all accepted names for this artery; the confusion concerns the veins of the same names; the supreme intercostal vein drains the first intercostal space and then empties into the brachiocephalic while the superior/highest intercostal vein drains the 2nd intercostal space 15
Thyrocervical
16 Costocervical
17
Venous drainage of Root of Neck
Brachiocephalic vv
Internal jugular v.
Subclavian v.
Thyroid vv.
18 Cervical Sympathetic Trunk and Ganglia
-lies on the longus colli m.
-ganglia -superior (C2) -middle (C6) -inferior (C7, behind subclavian)
-inferior and middle are connected by ansa subclavia
-vertebral ganglion
-Stellate ganglion 19
Nerves in the Root of the Neck
Phrenic
Vagus
Brachial plexus
20 Thyroid Gland
21
Thyroid Gland
-3 lobes + isthmus (2nd-3rd tracheal ring)
-pyramidal lobe- remnant of thyroglossal duct
-inf./sup. thyroid a
-inf/mid/sup thyroid v
-regulates metabolism
-thyroidea ima
22 Parathyroid Glands
-posterior surface
-4 glands
-blood supply from inferior thyroid a
-regulate Ca+
23
Esophagus
-continuous with pharynx -posterior to trachea
Trachea
-below larynx -c-shaped cartilage -covered ant. infrahyoid m isthmus of thyroid inferior thyroid v pretracheal nodes tracheostomy 24 25
Thoracic Duct
-enters neck to left of midline
-union of internal jug and left subclavian
26 27