Review: The Cervical Region

Cervical Region Topics

- Fascial coverings of the neck

- Muscles and Root of the neck

- Posterior Triangle of the neck - Anterior triangle the neck

Fascial Coverings of The Neck

Covering Layers of The Neck

- Skin
-Superficial Fascia Fatty layer that contains: Platysma Muscle Sup: lower border of the mandible. Inf: delto-pectoral fascia. Cutaneous N. External Jugular V. Superficial L.N.

Anterolateral Cutaneous Nerves

Arise from post. border of SCM 4 nerves: Lesser occipital n. (C2) Great auricular n. (C2,C3) innervates :lobule, skin over parotid gland, angle of the mandible. Transverse cutaneous n. (C2,C3) ant. neck from mand. to st. Supraclavicular n. (C3,C4) 3 (med., intermediate, lat.) innervations- skin over the clavicle, upper half of the shoulder (deltoid muscle) , lower half of posterior triangle.

External Jugular Vein

Starts behind angle of mandible By: Post. division of retromand. V. + Post. auricular V.
Extends: Angle mid. 1/3 of clavicle Drains into: Subclavian V. ( common) or IJV

Deep Cervical Fascia

4 Parts Investing Layer surrounds the neck Pretracheal Layer muscles & viscera Prevertebral Layer prevertebral muscles Carotid Sheath bld. vessels & nerves

Structures Enclosed by Investing Fascia

2 Muscles? SCM & Trapezius 2 Salivary glands? Parotid & Submandibular glands * Thickened between styloid & mandibular angle to form= ? Stylomandibular Lig.

Structures Enclosed by Carotid Sheath

Common carotid a. & internal carotid artery.

IJV Vagus n. (X)Parasympathetic Deep cervical L.N.

Root of The Neck

The area of the neck that lies immediately above the superior thoracic opening Boundaries for Sup. thoracic opening manubrium, first rib and T1

Contents of The Root of The Neck

1. lower portions of scalene muscles (3 muscles)
2. subclavian artery & vein (divided by scalenus ant. To 3 parts)

3. thoracic duct: lymph vessel extends from thorax to drain into left brachiocephalic vein 4. roots & trunks of brachial plexus
5. Phrenic nerve (pass anterior to scalene hiatus) from roots of C3, C4, C5 spinal nerves

Posterior Triangle of The Neck (Lateral Cervical Region)

Boundaries
Ant.: post. border of SCM Post.: ant. border of trapezius Inf.: mid. 1/3 of clavicle Roof: skin & fascia Floor: lat. & Post. vertebral muscles

Contents of post. Triangle:

4 arteries

5 veins

3 kinds of nerves:

4 cutaneous
Spinal B.P (roots & trunks)

Veins in Posterior Triangle

Occipital Vein Drainage?
3 possibilities : Vertebral artery Internal jugular vein Posterior auricular / external jugular vein

Anterior Triangle of The Neck

Anterior Triangle
Boundaries
Ant.: Imaginary Midline (mid-sagittal line) Post.: ant. border of SCM Sup.: inf. border of the mandible Inf. apex: ant. & post. meet together

Subdivisions of Ant. Triangle

By: digastric m. (both bellies) sup. Belly of omohyoid m. 4 Triangles: Submental Submandibular (Digastric) Carotid Muscular

Submandibular Triangle
Boundaries Anteromedial: ant. belly of digastric
Anterolateral: lower border of mandible Posterior: post. belly of digastric & stylohyoid m. Floor: mylohyoid & hyoglossus m.

Contents
1. Superficial part of submandibular gland
2. Facial a. & v.: deep to the gland ? 3. Hypoglossal n.: deep to the gland on hyoglossus m. 4. n. To mylohyoid: between ? & ?

5. Submandibular L.N.

Carotid Triangle
Boundaries
Sup.: post. belly of digastric Antero-inferiorly: sup. Belly of omohyoid Post.: ant. border of SCM Floor: part of hyoglossus part of thyrohyoid m. middle & inf. costrictors

Contents
Carotid sheath contents (4?) Ansa Cervicalis ant. aspect of the sheath Cervical Sympathetic chain post. aspect of the sheath Hypoglossal n. (part) ECA & some of its branches mainly ant. branches

Ansa Cervicalis

ECA
* Extent?

Branches (8):
Medially (1)

Ant. (3)
Post. (2) Terminations (2)