Yes, it will pay off, you just have to waitThou shall not give up.meow =^..

^=
ENT 3: SUPERFICIAL NECK
Lecturer: Dr. Patrick Joseph Pardo
September 18, 2014
Notes by: Kathleen Grace N. Maniago

CA=cancer
1. Mastoid process: bone beneath ear
2. NO BONY PROTECTION pix patient massive thyroid cancer + metastasis patient is looking the
right
3. .
4. .
5. Surface Anatomy of the Neck
a. Hyoid bone
b. Thyroid cartilage-part of Adams apple
c. Cricothyroid membrane: avascular: artificial airway opening space
i. cricothyrotomy: very temporary, horizontal only, unstable, for emergency purposes
ii. tracheostomy: more permamnent , incise trachea 2-4 tracheal rings, where most of
thyroid gland situates
d. Trachea
6. .
7. Layers of the neck (very impt for cutting specialties)
a. Skin
b. Subcutaneous tissue
i. Obese: thick at least 2 in. can contribute to obstructive sleep apnea (snore loudly,
difficulty breathing)
c. Cervical fascia (one of the fascia only, In the neck there are 2 fascias: one is cervical and
the other is deep)
i. White superior cervical fascia
Yes, it will pay off, you just have to waitThou shall not give up. [2]

ii. Gray platysma
iii. Red: deep cervical fascia
8. Cervical fascia

a. Deep Middle inside red
b. Deep deep : inside yellow
1. Depp Superficial (investing) layer
2. Infrahyoid fascia(muscular portion of pretracheal fascia)
3. Carotid sheath
4. Subcutaneous tissue
5. Deep Prevertebral layer
9. Clinical Significance
a. Peritonsillar abscess can spread to potential spaces through cervical fascia w/c can further
spread to heart and lungs
b. **needed to remove the superficial, deep superficial and deep middle to ensure that youve
taken all lymph nodes in a CA patient
c. some to node picking: micro. node removed and patient will come back
10. Superficial Cervical Fascia
a. yellow part
b. whitish plane in vivo
c. FASCIAL PAD
11. Platysma
a. old patients neck folds
b. External jugular vein EJV: popping out of the neck when some one is angry
12.
a. Cosmesis: neck rejuvenation, pull platysma posteriorly and suture
b. Torticollis:when you are sleeping and your head is flexed it is difficult to extend
13. Deep Superficial CF
a. from cheekbone to coccyx
b. VERTEBRAL SPINOUS split: TRAPS, SCM AND STRAP MUSCLE
c. S. attachment: occipital protuberance, superior nuchal line & zygomatic arch
16. Deep Middle
a. Encloses:
i. thyroid gland, trachea, pharyngeal constrictor muscles and esophagus
b. Extends: (to inferior) hyoid bonesternal attachmentsfibrous pericardium
c. encloses glands in the neck (white part in the pix)
d. infxns can spread to the heart due to its connection
e. Carotid canal: caroti artery internal jugular veinand vagus nerve ass through?
17. Deep Deeeep
a. posterior to esophagus, where spine is located
18. Superfi
a. Sternocleidomastod: most superficial and palpable
b. anterior: ant triangle
c. posterior: posterior triangle
d. CN XI
19. Trapezius
a. superior nuchal LINE
Yes, it will pay off, you just have to waitThou shall not give up. [3]

b. can be harvested to cover defects in the neck
20. Triangles of the neck
21. Pix
22. Anterior triangle
23. Submandibular triangle:
a. first lymphatic drainage of the oral cavity
b. Facial artery and vein pass here
c. ANterioir and Post of Die
d. Lower border of mand
24. Submental
a. mylohyoid muscle; floor oral cavity
b. Anterioir bellies to hyoid bone
25. Carotid triangle
a. Posterior belly of digastric, Superior bely of omohyoid
b. Omohyoid: U shaped goes under SCM and reappears middle side SCM and attch to hyoid
c. bifurcation of common carotid to internal and external
i. main blood supply is in external carotid artery
ii. IJV
iii. Vagus, Hypoglossal and Ansa cervicalis nerves
d. Baroreceptors
e. ENDARTERECTOMY
f. carotid massage: low pulse or low BP
26. Muscular triangle
a. Hyoid bone, Superioir belly of omohyoid, inferioir portion of SCM
b. infrahyoid muscles:strap muscles, PHARYNX AND LARYNX
c. Surgeons bestfriend not penetrate omohyoid safe where internal jugualar vein
27. Anterior Triangle
a. Suprahyoid: Genius (C1), Style(CN7) May(5) Milo(CN5) or Die on May 7 (CN 5&7)
b. elevate hyoid bone when you swallow (pharyngeal phase of swallowing, involuntary, hyoid
retract superiorly for the bolus of food move down)
c. Infrahyoid SOST: flex the head
28. Posterior Triangle SUPRACUTE 11 12 TRANS
a. CN XI**: nick this and you cant ift your shoulders
b. CUTANEOUS BRANCHES OF CERVICAL PLEXUS
c. CNXII
d. SUPRASCAPULAR @
e. TRANSVERSE CERVICAL @
29. Retropharyngeal space most common area for neck abscesses (spread from oral cavity)
30. Nasal cavity venous plexuses no valves so infxns will always go up
31. Oral cavity spreads through spaces in cervical fascia will always go down