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Root of the Neck

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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.
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