Download neck topography_engl.2011

NECK.
REGIONAL ANATOMY
Neck
Boundaries
Landmarks
Regions
Neck
Landmarks
Neck
Landmarks
Organ projections
Subcutaneous layer
Platysma
V. jugularis anterior
V. jugularis externa
Pl. cervicalis
n. occipitalis minor
n. auricularis magnus
n. transversus colli
nn. supraclaviculares
Neck fascia
Lamina superficialis
- Covers entire neck
- Fascia masseterica
- Fascia parotidea
- Fascia gl. submandibularis
Lamina pretrachealis
- Between os hyoideum, strenum & clavicula, and m. omohyoideus
- Linea alba - from os hyoideum to isthmus tracheae
- Spatium interaponeuroticum suprasternale
- Arcus venosus juguli
- Recessus Gruberi - behind m. sternocleidomastoideus
Lamina prevertebralis
- Skull base - bodies Т3-Т4 (fascia
endothoracica)
- Fascia mm. longi capitis et cervicis
- Fascia mm. scaleni, m. levator scapulae
- Spatium prevertebrale – extends to proc.
transversi
Fascia endocervicalis
- Lamina visceralis – covers neck organs
- Lamina parietalis – apart from the visceral
- Vagina carotica - from lamina parietalis
- Spatium pretracheale - between the two
layers
- Extends to mediastinum superius
- Spatium retropharyngeum - between fascia
endocervicalis & lamina prevertebralis
- Extends to mediastinum posterius
Regions of the neck
Anterior region
Tr. submentale
Tr. submandibulare
Tr. musculo-viscerale
Tr. Caroticum
Sternocleidomastoid region
Lateral region
Tr. omotrapezoideum
Tr. omoclaviculare
Trigonum submandibulare
Boundaries
Basis mandibulae
M. digastricus
– venter anterior et posterior
M. mylohyoideus/m.hyoglossus
Lamina superficialis
Superficial structures
M. platysma
V. facialis
R. coli nervi facialis
Trigonum submandibulare
Gl. submandibularis – in sheath of lamina
superficialis
- Posterior process - extends to m.
pterygoideus medialis
- Anterior process – extends to gl. sublingualis
- ductus submandibularis – from the inner
surface
- lndd. submandibulares – lateral to the
capsule
Trigonum submandibulare
- A.v. facialis – give off a.v. submentalis
- N. mylohyoideus – branch of n.
mandibularis
- N. hypoglossus
- N. lingualis
- Gangl. submandibulare
- Trigonum Pirogovi – approach to a.
lingualis
- m. mylohyoideus
- tendo m. digastrici
- n. hypoglossus
Trigonum submandibulare
- A.v. facialis – give off a.v. submentalis
- N. mylohyoideus – branch of n.
mandibularis
- N. hypoglossus
- N. lingualis
- Gangl. submandibulare
- Trigonum Pirogovi – approach to a.
lingualis
- m. mylohyoideus
- tendo m. digastrici
- n. hypoglossus
Trigonum caroticum
Trigonum caroticum
Boundaries
- m. digastricus, venter
posterior
- m. omohyoideus, venter
superior
- m. sternocleidomastoideus
Trigonum caroticum
A. carotis communis – at the upper margin of
cart. thyroidea divides into:
A. carotis externa
- a. thyroidea superior, a. lingualis, a. facialis
- a. occipitalis, a. sternocleidomastoidea, a.
pharyngea ascendens
A. carotis interna
V. jugularis interna
Ansa cervicalis (С1-С3)
- Radix superior (С1,2) – anterior to a. carotis
communis
- Radix inferior (С2,3) – lateral to v. jugularis
interna
Variations in the bifurcation of
a. carotis communis
Trigonum caroticum - cont.
N. vagus – in the groove btw a. carotis
comm. & v. jugularis interna
N. laryngeus superior
- In the upper part, medial to a. carotis externa et
interna
- Enters the larynx thru membr. thyrohyoidea
with a. laryngea superior
N. hypoglossus - beneath venter posterior m.
digastrici
- Crosses lateral to a. carotis externa et
interna
- enters trig. submandibulare between vent.
post. m. digastrici & m. hyoglossus
Plexus cervicalis (С1-С4) – over the deep
cervical muscles
Truncus sympaticus - behind lamina
prevertebralis
Truncus sympaticus - behind lamina
prevertebralis
- behind a. carotis communis/interna
close to n. vagus
- gangl. cervicale superior - over m.
longus colli (C2-3)
- ganl. cervicale medius – at the levbel of
a. thyroidea inferior (C6)
- gangl. сervicale inferior (С7 head of І rib)
- Innervates upper limb arteries & a.
vertebralis
- Contact with cupula pleurae, d.
thoracicus (on the left side), a. subclavia,
a. vertebralis
Regio infrahyoidea
Boundaries
- Os hyoideum, sternum, m.
sternocleidomastoideus
Content
Lamina pretrachealis
Muscles
а) M. sternohyoideus, m. thyrohyoideus,
m. sternothyroideus & m. omohyoideus
- depress os hyoideum and larynx in
swallowing.
b) M. cricothyroideus
-straightens the vocal folds
Regio infrahyoidea
Vessels
- V. jugularis anterior
- Arcus venosus juguli - in spatium
suprasternale
- A.v. thyroidea superior
- V. thyroidea inferior
Lymph nodes
- Lndd. prelaryngeales
- Lndd. pretracheales
- Lndd. paratracheales
Organs
а) Endocrine system
- Gl. Thyroidea
- Gll. Parathyroideae
b) Respiratory system
- Larynx - C4-C6
- Trachea - C6-Th4
c) Digestive system
- Pharynx - basis cranii - C6
- Esophagus - C6 - Th11
Regio infrahyoidea.
Larynx, trachea, gl. thyroidea
Root of the neck
Transitional area btw neck and thorax. Opens in apertura
thoracica superior. Bounded:
First ribs - laterally
manubrium sterni - anteriorly
Body of Т1 - posteriorly
Topographic structures
Spatium antescalenum
Spatium interscalenum
Trigonum scalenovertebrale
Midline structures
Thymus – upper poles
Gl. Thyroidea (lobus dexter/sinister)
Gll. parathyroideae (inferiores)
Vv. thyroideae inferiores (plexus venosus)
Trachea (pars cervicalis)
Esophagus (pars cervicalis)
M. longus coli
Midline structures
Root of neck
Spatium antescalenum
Boundaries - mm. sternocleidomastoideus, sternohyoideus,
sternothyroideus anteriorly and m. scalenus anterior
posteriorly.
Content
- angulus venosus juguli
- v. jugularis interna
- v. subclavia
- ductus thoracicus/ductus lymphaticus dexter
- a. suprascapularis
- a. cervicalis superficialis
- n. phrenicus (C3-5)
- ndd. lymphaticae, around
- v. jugularis interna
- a. transversa cervicis
Spatium antescalenum
Spatium antescalenum (right)
Spatium interscalenum
Boundaries – three-wall slit btw m. scalenus
anterior anteriorly, m. scalenus medius posteriorly
and first rib (sulcus a. subclaviae) below.
Content
- a. subclavia (middle, interscalenous part), gives
off
- truncus costocervicalis
- a. cervicalis profunda – for neck muscles
- a. intercostalis suprema - for І & ІІ costal interspaces
- pl. brachialis - truncus superior, medius and
inferior.
Trigonum scalenovertebrale
Boundaries - m. scalenus anterior laterally, m. longus coli and neck
vertebrae medially and cupula pleurae below. The apex coincides with
the transverse process of С6.
Content
- a. subclavia, prescalenous part
- a. vertebralis
- truncus thyrocervicalis
- a. thyroidea inferior
- a. cervicalis ascendens
- a. cervicalis superficialis
- a. suprascapularis
- a. thoracica interna
- ductus thoracicus
- n. vagus
- n. laryngeus recurrens
- truncus sympaticus - ganglion inferior/stellatum
- ansa subclavia
Trigonum scalenovertebrale
Ductus thoracicus