DOCSLIB.ORG

Cervical Spine Manipulation Versus Sub-Occipital Muscle Release Technique in the Treatment of Tension Type Headaches

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Cervical Spine Manipulation Versus Sub-Occipital Muscle Release Technique in the Treatment of Tension Type Headaches COPYRIGHT AND CITATION CONSIDERATIONS FOR THIS THESIS/ DISSERTATION o Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. o NonCommercial — You may not use the material for commercial purposes. o ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. How to cite this thesis Surname, Initial(s). (2012) Title of the thesis or dissertation. PhD. (Chemistry)/ M.Sc. (Physics)/ M.A. (Philosophy)/M.Com. (Finance) etc. [Unpublished]: University of Johannesburg. Retrieved from: https://ujcontent.uj.ac.za/vital/access/manager/Index?site_name=Research%20Output (Accessed: Date). Cervical Spine Manipulation versus Sub-Occipital Muscle Release Technique in the Treatment of Tension Type Headaches A dissertation submitted to the Faculty of Health Sciences, University of Johannesburg, as partial fulfilment for the Master’s Degree in Technology, Chiropractic by Craig Ross Orr (Student Number: 201201444) Supervisor: ___________________________ Date: _________________________ Dr C.J. Hay DECLARATION I, Craig Ross Orr, declare that this dissertation is my own, unaided work. It is being submitted as partial fulfilment for the Master’s Degree in Technology, in the program of Chiropractic, at the University of Johannesburg. It has not been submitted before for any degree or examination in any other University or Technikon. ____________________________ Craig Ross Orr On this day the _______ of the month of ______________________ 2018 ii DEDICATION I would like to dedicate this to my Mother Jennifer Orr, without you this would not have been possible. Thank you for providing a solid foundation for me to grow and learn, for loving, supporting, encouraging and believing in me. You have always been my rock, through the tough times. Throughout this long journey, whenever I felt like giving up, you have given me the strength to keep going. You are the dream role model and mother that any child can ask for. Words cannot express how grateful I am for everything. I love you. To Katherine Valkenburg, over the past two years you have supported me along my journey proving me with motivation to carry on. Your love and motivation has helped dearly throughout this time. Thank you. To my special friends, Todd Page, Candice Bowes, Mathew Penny, Sebastian Moreli, Keegan and Tristan Shcut, words cannot express how grateful I am to you for everything. You are more than friends to me, you are my Family. Thank you for the unforgettable years, all the laughter, tears, good times and bad times. I love you. iv ACKNOWLEDGEMENTS To my supervisor, Dr Caroline Hay, thank you for all the guidance, effort and patience you have given through this process. Thank you. To Juliana Van Staden from Statkon, thank you so much for your assistance. I truly appreciate it. Lastly, to the thirty participants, without you this would not have been possible. Thank you. v ABSTRACT Objective: The aim of the study was to determine the efficacy of cervical spine chiropractic manipulation and muscle tension release technique of the sub occipital muscles in relieving tension-type headaches. This study was also used to determine which treatment protocol would be most effective in relieving tension-type headaches, cervical spine chiropractic manipulation, and muscle tension release technique of the sub occipital muscles or a combination of both treatment protocols. Study design: A randomized clinical study was used in this research study. Setting: University of Johannesburg, Chiropractic Day Clinic, Johannesburg, South Africa. Subjects: A total of thirty participants were used, male and female, between the ages of 18-50 years. The participants were divided into three groups, with each group consisting of ten participants. Group A received cervical spine manipulations; Group B received muscle tension release technique of the sub occipital muscles and Group C a combination of cervical spine manipulation and muscle tension release technique of the sub occipital muscles . Methods: Prior to becoming a participant, each individual was assessed according to inclusion and exclusion criteria. Thereafter participants had to read and sign relevant information and consent forms. A full case history, physical examination and cervical spine regional examination was then completed. Procedure: Subjective data was collected from the participants using the Numerical Pain Rating Scale, Headache Impact Questionnaire and the Neck Disability Index. Objective data was collected from the participants by using the Pressure Algometer. Objective and subjective data was collected prior to the 1st and 3rd treatment consultations and at the 5th final consultation. Each participant was treated four times, over a two week period. An additional 5th consultation was done to obtain objective and subjective data only. Results: Statistically significant improvements regarding the Headache Impact Questionnaire, Numerical Pain Rating Scale, Neck Disability Index and Pressure Algometer occurred in all three groups. However in terms of intergroup analysis regarding the Headache Impact Questionnaire, Numerical Pain Rating Scale, Neck Disability Index and Pressure Algometer, no statistically significant improvements occurred, meaning that no group proved to be more superior to the others. vi Conclusion: Based on the results obtained, it is suggested that cervical spine chiropractic manipulation, muscle tension release technique of the sub occipital muscles and a combination of the two treatments were effective treatment methods in relieving tension-type headaches. However, neither the cervical spine chiropractic manipulation, muscle tension release technique of the sub occipital muscles nor a combination of the two treatments was more effective in relieving tension-type headaches. Definitive conclusions could not be made in terms of intergroup analysis and therefore further research should be performed to yield more results on the comparison of all three treatment methods. vii TABLE OF CONTENTS DECLARATION........................................................................................................................................ ii AFFIDAVIT ……………………………………………………………………………………………….…….....iii DEDICATION................................................................................................................................……….iv ACKNOWLEDGEMENTS........................................................................................................................ v ABSTRACT.............................................................................................................................................. vi TABLE OF CONTENTS.......................................................................................................................... viii LIST OF FIGURES.................................................................................................................................. xii LIST OF TABLES................................................................................................................................... xiii LIST OF APPENDICES......................................................................................................................... xiv CHAPTER ONE - INTRODUCTION 1.1 Problem statement............................................................................................................................. 1 1.2 Aim of study........................................................................................................................................ 2 1.3 Benefits of study................................................................................................................................. 2 CHAPTER TWO - LITERATURE REVIEW 2.1 General overview of headaches......................................................................................................... 3 2.2 The cervical spine.............................................................................................................................. 3 2.2.1 Anatomy of the cervical spine...................................................................................................... 3 2.2.2 Intervertebral disc........................................................................................................................ 6 2.2.3 Uncovertebral joints..................................................................................................................... 7 2.2.4 Facet joints………….................................................................................................................... 7 2.2.5 Blood supply to the cervical spine .............................................................................................. 8 2.2.6 Innervation of the cervical spine.................................................................................................. 9 2.3 Skeletal muscle................................................................................................................................ 10 2.3.1 Anatomy of skeletal muscle...................................................................................................... 10 2.3.2 The muscle spindle................................................................................................................... 11 2.3.3 The Golgi tendon
Load more

Recommended publications
  • HUMAN ANATOMY: a Prosection Guide
    HUMAN ANATOMY: A Prosection Guide 3rd Edition Frank J. Daly Cover image www.kendallhunt.com Send all inquiries to: 4050 Westmark Drive Dubuque, IA 52004-1840 Copyright © 2010 by Frank J. Daly. ISBN 978-0-7575- All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the copyright owner. Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 iii GROSS ANATOMY LABORATORY PROCEDURES 1. Appropriate laboratory attire is required: Scrubs (full-length, scrub pants), close-toed shoes (no Crocs), safety glasses, and Nitrile gloves. Scrubs are available in the campus bookstore (no specific color required). NO shorts or skirts permitted, even if made from scrub material. Safety glasses for splash protection are available in the lab. Gloves will be provided; please try to limit use to ~ 1 pair/session. Long hair must be tied back, away from the face. Long necklaces should be removed. Contact Lenses are NOT advised, as they are permeable to volatile compounds and may result in injury. Students should bring their lab manual to lab sessions. 2. No food or beverages are allowed in the laboratory - EVER. Smoking and/or chewing gum is prohibited in the laboratory. 3. No cadaveric materials (or models) are EVER to be removed from the Gross Anatomy lab. This is a State and a Federal law. You WILL be prosecuted to the fullest extent of the law.
    [Show full text]
  • DEPARTMENT of ANATOMY IGMC SHIMLA Competency Based Under
    DEPARTMENT OF ANATOMY IGMC SHIMLA Competency Based Under Graduate Curriculum - 2019 Number COMPETENCY Objective The student should be able to At the end of the session student should know AN1.1 Demonstrate normal anatomical position, various a) Define and demonstrate various positions and planes planes, relation, comparison, laterality & b) Anatomical terms used for lower trunk, limbs, joint movement in our body movements, bony features, blood vessels, nerves, fascia, muscles and clinical anatomy AN1.2 Describe composition of bone and bone marrow a) Various classifications of bones b) Structure of bone AN2.1 Describe parts, blood and nerve supply of a long bone a) Parts of young bone b) Types of epiphysis c) Blood supply of bone d) Nerve supply of bone AN2.2 Enumerate laws of ossification a) Development and ossification of bones with laws of ossification b) Medico legal and anthropological aspects of bones AN2.3 Enumerate special features of a sesamoid bone a) Enumerate various sesamoid bones with their features and functions AN2.4 Describe various types of cartilage with its structure & a) Differences between bones and cartilage distribution in body b) Characteristics features of cartilage c) Types of cartilage and their distribution in body AN2.5 Describe various joints with subtypes and examples a) Various classification of joints b) Features and different types of fibrous joints with examples c) Features of primary and secondary cartilaginous joints d) Different types of synovial joints e) Structure and function of typical synovial
    [Show full text]
  • 432 Surgery Team Leaders
    3 Common Neck Swellings Done By: Reviewed By: Othman.T.AlMutairi Ghadah Alharbi COLOR GUIDE: • Females' Notes • Males' Notes • Important • Additional Outlines Common Anatomy of the Neck Neck Ranula Swellings Dermoid cyst Thyroglossal cyst Branchial cysts Laryngocele Carotid body tumor Hemangioma Cystic Hygroma Inflammatory lymphadenopathy Malignant lymphadenopathy Thyroid related abnormalities Submandibular gland related abnormalities Sjogren's syndrome 1 Anatomy of the Neck: Quadrangular area (1): A quadrangular area can be delineated on the side of the neck. This area is subdivided by an obliquely prominent sternocleidomastoid muscle into anterior and posterior cervical triangles. Anterior cervical triangle is subdivided into four smaller triangles: -Submandibular triangle: Contains the submandibular salivary gland, hypoglossal nerve, mylohyiod muscle, and facial nerve. -Carotid triangle: Contains the carotid arteries and branches, internal jugular vein, and vagus nerve. -Omotracheal triangle: Includes the infrahyoid musculature and thyroid glands with the parathyroid glands. -Submental triangle: Beneath the chin. Figure 1: Anterior cervical muscles. 2 Posterior cervical triangle: The inferior belly of the omohyoid divides it into two triangles: -Occipital triangle: The contents include the accessory nerve, supraclavicular nerves, and upper brachial plexus. -Subclavian triangle: The contents include the supraclavicular nerves, Subclavian vessels, brachial plexus, suprascapular vessels, transverse cervical vessels, external jugular vein, and the nerve to the Subclavian muscle. The main arteries in the neck are the common carotids arising differently, one on each side. On the right, the common carotid arises at the bifurcation of the brachiocephalic trunk behind the sternoclavicular joint; on the left, it arises from the highest point on arch of the aorta in the chest.
    [Show full text]
  • Surface Anatomy
    BODY ORIENTATION OUTLINE 13.1 A Regional Approach to Surface Anatomy 398 13.2 Head Region 398 13.2a Cranium 399 13 13.2b Face 399 13.3 Neck Region 399 13.4 Trunk Region 401 13.4a Thorax 401 Surface 13.4b Abdominopelvic Region 403 13.4c Back 404 13.5 Shoulder and Upper Limb Region 405 13.5a Shoulder 405 Anatomy 13.5b Axilla 405 13.5c Arm 405 13.5d Forearm 406 13.5e Hand 406 13.6 Lower Limb Region 408 13.6a Gluteal Region 408 13.6b Thigh 408 13.6c Leg 409 13.6d Foot 411 MODULE 1: BODY ORIENTATION mck78097_ch13_397-414.indd 397 2/14/11 3:28 PM 398 Chapter Thirteen Surface Anatomy magine this scenario: An unconscious patient has been brought Health-care professionals rely on four techniques when I to the emergency room. Although the patient cannot tell the ER examining surface anatomy. Using visual inspection, they directly physician what is wrong or “where it hurts,” the doctor can assess observe the structure and markings of surface features. Through some of the injuries by observing surface anatomy, including: palpation (pal-pā sh ́ ŭ n) (feeling with firm pressure or perceiving by the sense of touch), they precisely locate and identify anatomic ■ Locating pulse points to determine the patient’s heart rate and features under the skin. Using percussion (per-kush ̆ ́ŭn), they tap pulse strength firmly on specific body sites to detect resonating vibrations. And ■ Palpating the bones under the skin to determine if a via auscultation (aws-ku ̆l-tā sh ́ un), ̆ they listen to sounds emitted fracture has occurred from organs.
    [Show full text]
  • Posterior Triangle
    POSTERIOR TRIANGLE BY DR . M.MD. MUSTAFA SHARIFF DEPT OF ANATOMY SENIOR LECTURER SRMDC & H POSTERIOR TRIANGLE • This is a triangular depressed space present above the middle one third of clavicle and behind the sternocleidomastoid muscle. POSTERIOR TRIANGLE OFNECK • Boundaries • – Infront – posterior border of sternocleidomastoid muscle • Behind – anterior border of trapezius • Base – Superior surface of middle 1/3rd of clavicle • Apex – Superior nuchal line where sternocleidomastoid and trapezius muscles meet • Roof – Skin, superficial fascia (platysma), investing layer of deep cervical fascia STERNOCLEIDOMASTOID MUSCLE (SCM) Origin: • Sternal head --- manubrium • Clavicular head --- medial 1/3 of clavicle Insertion: • Mastoid process and lateral ½ of superior nuchal line Action: • When muscle of one side contracts, the head is tilted to the same side and chin is rotated to opposite side. • When muscles of both side contract the head and neck are flexed Nerve supply: • Spinal part accessory nerve , ventral rami of spinal nerves C2,C3 TRAPEZIUS MUSCLE Origin: ✓ Superior nuchal line, ext. occipital protuberance, lig. nuchae, spines of C7 – T12 Insertion: ✓ Lateral 1/3 of clavicle, acromion, spine of scapula Functions: ✓ Elevation of scapula (sup. fibers), ✓ Depression of scapula (inf. fibers), ✓ Retraction of scapula (middle fibers), ✓ Superior rotation of glenoid fossa of scapula (sup. + inferior fibers). ROOF OF THE POSTERIOR TRIANGLE • The ROOF of the posterior triangle is the platysma m. and the investing layer of deep cervical fascia. Investing layer of deep cervical fascia • The platysma is a muscle of facial expression and will be Platysma m. discussed later. Roof is pierced by : Nerves : ✓ Lesser occipital, Anterior ✓ Great auricular,Superior ✓ Transverse cutaneous nerve of the neck, Posterior ✓ Supraclavicular nerves, Inferior • The FLOOR of the post.
    [Show full text]
  • Anatomy Module 3. Muscles. Materials for Colloquium Preparation
    Section 3. Muscles 1 Trapezius muscle functions (m. trapezius): brings the scapula to the vertebral column when the scapulae are stable extends the neck, which is the motion of bending the neck straight back work as auxiliary respiratory muscles extends lumbar spine when unilateral contraction - slightly rotates face in the opposite direction 2 Functions of the latissimus dorsi muscle (m. latissimus dorsi): flexes the shoulder extends the shoulder rotates the shoulder inwards (internal rotation) adducts the arm to the body pulls up the body to the arms 3 Levator scapula functions (m. levator scapulae): takes part in breathing when the spine is fixed, levator scapulae elevates the scapula and rotates its inferior angle medially when the shoulder is fixed, levator scapula flexes to the same side the cervical spine rotates the arm inwards rotates the arm outward 4 Minor and major rhomboid muscles function: (mm. rhomboidei major et minor) take part in breathing retract the scapula, pulling it towards the vertebral column, while moving it upward bend the head to the same side as the acting muscle tilt the head in the opposite direction adducts the arm 5 Serratus posterior superior muscle function (m. serratus posterior superior): brings the ribs closer to the scapula lift the arm depresses the arm tilts the spine column to its' side elevates ribs 6 Serratus posterior inferior muscle function (m. serratus posterior inferior): elevates the ribs depresses the ribs lift the shoulder depresses the shoulder tilts the spine column to its' side 7 Latissimus dorsi muscle functions (m. latissimus dorsi): depresses lifted arm takes part in breathing (auxiliary respiratory muscle) flexes the shoulder rotates the arm outward rotates the arm inwards 8 Sources of muscle development are: sclerotome dermatome truncal myotomes gill arches mesenchyme cephalic myotomes 9 Muscle work can be: addacting overcoming ceding restraining deflecting 10 Intrinsic back muscles (autochthonous) are: minor and major rhomboid muscles (mm.
    [Show full text]
  • In the Occipital Triangle 1.(I.E., Above the Omohyoid). • Spinal Accessory Nerve
    In the occipital triangle 1.(i.e., above the omohyoid). • Spinal accessory nerve. • third and 4th cervical nerves supplying branches to levator scapulae and trapezius muscles. • Dorsal scapular nerve (C5). • 4 cutaneous branches of cervical plexus (first parts). • Superficial transverse cervical artery. • Occipital artery. In the subclavian/supraclavicular triangle (i.e., below the omohyoid) • third part of the subclavian artery. • Subclavian vein. • Terminal part of external jugular vein. • Trunks of brachial plexus. • Superficial (transverse) cervical, suprascapular and dorsal scapular arteries. • Lymph nodes. The most essential contents of posterior triangle are • : • (a) Third part of subclavian artery • (b) Brachial plexus (cervical part) • (c) Spinal accessory nerve and • (d) Lymph nodes. • All the significant contents of the posterior triangle are located deep to the fascial carpeting of the floor with the exception of spinal accessory nerve, which is located just underneath the roofing. In procedures on the posterior triangle all the structures with the exception of spinal accessory nerve are safe, supplied fascial carpeting of posterior triangle is left undamaged. • MPORTANT FEATURES OF SOME OF THE CONTENTS • Spinal accessory nerve • This nerve comes in the posterior triangle by piercing the posterior border of the sternocleidomastoid (a little above the middle of the border). In this case, it’s related to lymph nodes of the upper deep cervical chain. The nerve then crosses the posterior triangle by running downwards and laterally around and parallel to the fibres of levator scapulae muscle to evaporate below to the anterior border of trapezius (about 5-6 cm above the clavicle) and supplies trapezius muscle. In the posterior triangle it is adherent to the deep aspect of the fascial roof of the triangle.
    [Show full text]
  • A Mnemonic for Neck Triangles
    iology: C s ur hy re P n t & R y e s m e o Anatomy and Physiology: Current a t r a c n h A ISSN: 2161-0940 Research Original Article A Mnemonic for Neck Triangles Abdulrauf Badr MI* Department of Surgery, King Faisal Specialist Hospital and Research Center Jeddah, Saudi Arabia ABSTRACT Anatomical Neck Triangles are imaginary to some extent. Their significance to many surgical specialties is invaluable. Among all basic Medical sciences subjects, Anatomy is most prone to be forgotten. None of the other subjects has the amount of mnemonics described or invented compared to it. Junior years students of Medical schools need to memorize anatomy with no or very little knowledge of its clinical applications. Relatively speaking, that can be quite cumbersome for them compared to those who are already involved in surgical residency training program, when anatomy knowledge is concerned. Surgeons who specialize or exclusively work in a selected anatomic region, they become experts and famous in their field and in that particular operation, mostly because they subconsciously become oriented to that region’s anatomy. However, those who work on various anatomical areas, frequently need to refresh their anatomy knowledge. Mnemonics, therefore are helpful for various level medical professionals. The Neck represents a relatively limited transition zone or passage of various tissue structures besides great vessels and nerves between Head, Chest and Upper extremities, very much like a three-way connector. Unless the concept of Neck triangles was there, it would have been very difficult to discuss or communicate about neck related procedures.
    [Show full text]
  • Head & Neck I, II And
    1 Head & Neck I, II and III Objectives : مب من سﻻيدز الدكتور :I took these objectives from our course schedule Head & Neck I: - Neck masses (Intro, anatomy, diagnosis, differentials and examples). - Thyroid (anatomy, nodule, cancer, surgery & complications) Head & Neck II: - Salivary gland (anatomy, physio, infection, autoimmune and tumors). - Tumors of oral cavity (Intro, pre-malignant lesions, leukoplakia, malignant lesions, SCCA) Head & Neck III: - Tumors of pharynx (nasopharyngeal ca, oro & hypopharyngeal ca) - Tumors of larynx (Intro, laryngeal papillomatosis, ca larynx) Resources: F1 Doctor’s slides Done by: Maha AlGhamdi [Color index: Important | Notes | Extra] Editing File 2 *Head and Neck I & II* Part I&II are needed for your exam and real life, part 3 is needed for your exam only, unless you want to become an ENT resident. Introduction • Common clinical finding • All age groups. The younger the age the more toward inflammatory mass, the older the more toward neoplastic. • Very complex differential diagnosis • Systematic approach essential. The systematic approach we do for each single patient is: physical examination and order investigations. Anatomical Considerations NECK: • Anatomical landmarks: Angel of mandible and Clavicle and mastoid tip. The ONLY obvious landmarks in every single patient including obese. Always look for bones! • So, make sure you locate them before starting 1. Prominent your examination. landmarks • In the midline of the neck, there is a cricoid. Anything above the cricoid is called upper midline (your DDx will be B/W the carotids. • Anything below the cricoid to the Suprasternal notch, we call it lower Midline (DDX related to thyroid lobes). • Anterior Triangle Divided into: contains the carotid vessels, thyroid gland and lymph nodes - Submental triangle: bounded by both anterior bellies of digastric and hyoid bone.
    [Show full text]
  • • Carotid Triangle
    • carotid triangle The neck is divided into triangles, the two most prominent being formed as the sternocleidomastoid crosses the neck to form the anterior and posterior triangles. The anterior triangle is further subdivided by the anterior and posterior bellies of the digastrics and the superi - or belly of the omohyoid. (1) Submental triangle: (a) Boundaries: Anterior belly of digastric muscle, hyoid bone and the midline of the neck (b) Floor: Mylohyoid (c) Contents (main): Submental lymph nodes, floor of the mouth (2) Digastric (or submandibular) triangle: (a) Boundaries: Anterior and posterior bellies of digastric muscle and inferior border of the body of the mandible (b) Floor: Mylohyoid and hyoglossus (c) Contents (main): Submandibular gland (3) Carotid triangle: (a) Boundaries: Sternocleidomastoid, posterior belly of digastric and superior belly of omohyoid muscle (b) Floor: Thyrohyoid, hyoglossus, and pharyngeal constrictors (c) Contents (main): bifurcation of common carotid artery, internal jugular vein, vagus and hypoglossal nerve (4) Muscular triangle: (a) Boundaries: Superior belly of omohyoid, sternocleidomastoid and midline of the neck (b) Floor: Sternohyoid and sternothyroid (c) Contents (main): Infrahyoid muscles, thyroid and parathyroid glands The posterior triangle (lateral cervical region) is subdivided by the inferior belly of the omohyoid. (1) Occipital Triangle: (a) Boundaries: Sternocleidomastoid, trapezius, and inferior belly of omohyoid muscle (b) Floor: Splenius capitis, levator scapulae, and the middle and posterior scalenes (c) Contents (main): Accessory nerve (2) Subclavian (or supraclavicular, omoclavicular) triangle: (a) Boundaries: Sternocleidomastoid, inferior belly of omohyoid muscle and clavicle (b) Floor: 1st rib and serratus anterior (c) Contents (main): Subclavian artery and vein, brachial plexus and supraclavicular nerves.
    [Show full text]
  • Anatomy of the Neck
    2019.Spring Anatomy of the Neck Lecture Lab 2/19(二) PM 1-6 Posterior triangle , 2 Hours + 2 Hours 2/26(二) PM 1-6 Anterior triangle, 1.5 Hours + 3.5 Hours 3/ 5(二) AM 8-12 Deep structure of the neck, 1 Hour + 3 Hours 3/12(二)AM 8-12 Face and scalp, 2 Hours + 2 Hours 3/19(二) PM 1-6 Lect. + Face and scalp lab. 2 Hours 參考書: Anatomy of the Head and Neck, by George H. Paff 電子資源: Grant's Dissection Videos /Acland’s video atlas of human anatomy 賴逸儒 [email protected] Outline The Neck: neurovascular structure/ viscera The triangles of the neck • Posterior triangle • Anterior triangle Fascia and spaces of the neck Triangles of the neck - Sternocleidomastoid muscle (胸鎖乳突肌) - Posterior triangle / anterior triangle 1= SCM 5= Mandible 2= Trapezius 6= Digastric, AB 3= Clavicle 7= Digastric ,PB 4= Omohyoid, PB 8= Hyoid 9= Omohyoid, AB The fascia of the neck • Superficial fascia- between skin and deep fascia • Deep fascia Superficial cervical fascia (continuous, loose subcutaneous tissue) Skin Deep fascia (investing layer) Nerves, vessels, lymph- supply skin Fatty connective tissue (except: eyelid) Scalp <-- --> thorax, upper extremity Platysma: through the superficial Deep fascia: fascia •Investing Platysma (頸闊肌) • Broad, thin muscle Deltoid and pectoris major (skin, Inferior) Mandible, lower face Depressor muscles of mouth • Shaving, grimace • branch of facial nerve (CN. VII) Deep Cervical Fascia (muscular fascia) • Investing • Pretracheal I.F Tr • Prevertebral • Carotid sheath • Retropharyngeal space # posterior Investing Layer of Deep Cervical
    [Show full text]
  • Posterior and Anterior Triangles of the Neck
    Landmarks of the Neck M1 - Anatomy Posterior and Anterior Triangles of the Neck Jeff Dupree Sanger 9-057 828-9536 [email protected] 1 2 Landmarks of Cervical Triangles Anterior Cervical Triangle 3 4 Anterior Cervical Triangle Boundaries Anterior cervical triangle is divided into 4 smaller triangles Sup: mandible Ant: midline Muscular Lat. Post: SCM Carotid Submandibular Submental 5 6 Muscular triangle boundaries Lat/sup: sup belly of omohyoid Lat/inf: SCM Med/ant: midline 7 8 Muscles in the muscular triangle are referred to as 2 layers: infrahyoid or #1 omohyoid strap muscles sternohyoid #2 thyrohyoid Sup belly of omohyoid sternothyroid Sternohyoid Thyrohyoid Sternothyroid 9 10 Innervation of Infrahyoid/Strap Muscles Nerves of the Muscular Triangle Ansa cervicalis C1-C3 Exception: Thyrohyoid fibers directly from C1 11 12 Carotid triangle boundaries Carotid triangle Contents: Sup: post belly digastric Carotid sheath common carotid internal jugular Ant: sup belly omohyoid vagus nerve Post: SCM Ansa cervicalis (embedded in sheath) Hypoglossal nerve (XII) Arteries: Branches of ext. carotid 13 14 Contents of carotid sheath Carotid Triangle Carotid sinus Ansa cervicalis -dilatation of internal carotid frequently is embedded -innervated by CN IX within the sheath -baroreceptor that reacts to changes in blood pressure Carotid body Med: common carotid -ovoid mass positioned in the bifurcation of the carotid -innervated by CN IX Lat: internal jugular -chemoreceptor that monitors blood oxygen levels Post: vagus (CN X) 15 16 Branches of external carotid Sup. Thyroid Ascending pharyngeal Lingual Facial Occipital NOT in Carotid Triangle Post. Auricular Maxillary Superficial temporal 17 18 Nerves of Carotid Triangle 19 20 Submandibular triangle boundaries Submandibular Triangle contents Arteries: facial Sup: mandible Nerve: Post/inf: post.
    [Show full text]