Download Neck

Pharynx
 Larynx
 Esophagus
 Trachea
 Salivary glands
 Thyroid gland
 Cervical lymph
nodes

Funnel shaped
 12 cm long muscular
tube
 Opening for respiratory
and digestive organs
 Base of skull extend
inferior to esophagus
 3 sections:

 Nasopharynx
 Oropharynx
 laryngopharynx
1.Pharynx
2. Epiglottis
3. Larynx
4. Esophagus

Nasopharynx
› Superior- nasal cavity
› Passage of air from
nasal cavity to larynx
› Boundary
 posterior- clivus/ upper
cervical spine
 Inferior- soft palate- uvula
 Lateral wall- post/inf
nasal conchae
 Opeining of eustachian
tube- middle ear
recurrence of nasopharyngeal
carcinoma in the right nasopharynx

Oropharynx
› Posterior oral cavity
› Soft palate  Hyoid
› Separated from larynx
by epiglottis
› Lymphoid tissuepalatine & lingual
tonsils
› Valleculae- pouch like
openings
 (foreign objects can
lodge)
Planning procedure for the
two lateral opposing 6 MV
asymmetrical fields for the
treatment of the
oropharyngeal region. The
isocenter is positioned
between vertebrae C5 and C6

Laryngopharynx
› From
oropharynxbetween hyoid
bone and
esophagus/lary
nx
› @ the cricoid
cartilage it
becomes the
esophagus
› Piriform sinusesdepressions that
divert food from
larynx
Recap of Anatomy
1.
2.
3.
4.
5.
Corpus Callosum
Sphenoid sinus
4 th Vent
Oropharynx
Spinal Cord




Bony skeleton- “voice box”
Surround and protect vocal cords
Laryngopharynxtrachea
› Beginning of respiratory
pathway
Three of the cartilages that make
up the larynx are:
 Thyroid
 epiglottis
 Cricoid- ring @ base of
larynx on which other
cartilages rest-junction of
larynx/trachea and
beginning of esophagus.
 Thyroid is the longest and
most superior
 Anterior lamina of the
thyroid cartilage= “Adam’s
Apple”
 Posterior to the Adam’s
apple is the epiglottisduring swallowing the
epiglottis folds back over
the larynx to prevent solids
from entering the
respiratory tract.
acute epiglottitis
MR imaging, larynx. T1weighted axial slice above
Image 2 showing the epiglottis
Axial CT scan of a T4 laryngeal tumor
with extensive cartilage destruction




Laryngopharynx to cardiac orifice
of stomach
Posterior to cricoid cartilage and
descends though thoracic cavity
›
between trachea and
anterior
longitudinal ligament of
vertebrae
Opening in diaphragm=
esophageal hiatus
2 sphincters
› Esophageal- @ entranceprevents air
› Cardiac- @ prevents reflux from
stomach
What is the condition that
happens
to the esophagus when
Portal
Hypertension is present???
Airway
 Extend from larynx
lungs

ANTERIOR to
esophagus
 T5 –trachea
bifurcates into the
right and left
mainstem
bronchi…….CARINA


Produce and empty saliva
into the oral cavity by ducts
Begin the digestion process

3 large paired glands:

› 1. parotid- largest-
anterior to auricle
› 2. submandibularborder post half of
mandible- to hyoid bone
› 3. sublingual- smallest, lie
under the tongue
Adenoid cystic carcinoma of the
parotid
enlarged left submandibular gland
abscesses.
CT scan shows a large mucous
retention cyst arising from the
sublingual gland (ranula)
How do we prevent it???
MMR shot…..
Endocrine gland
 Located @ level of cricoid
cartilage
 Two lobes joined together
by an isthmus
 Excretes hormones
 Thyroxine (T4)- body
growth/ metabolism
 Triiodothyronine (T3)growth/ metabolism
 Calcitonin- < blood
calcium to promote
bone formation

 Controlled by the
parathyroid glandsposterior surface of
thyroid lobes (4 total)
adenocarcinoma
>1/3 of the body’s total
nodes
 About 75 on each side
of the neck
 Lymph vessels carry fluid
from interstitial spaces
to the regional lymph
nodes that filter the
lymph fluid- before
emptying into the
venous blood supply

central necrosis within a left cervical
lymph node metastasis
Normal
Images of cervical Lymph
Nodes
adenopathy
The neck is divided by
sternocleidomastoid
(SCM) into anterior and
posterior triangles
 Originates on the sternum
and clavicle and inserts
on the mastoid tip of
temporal bone
 Turns the head and flexes
the neck

Muscles of the throat
 Suprahyoid and
infrahyoid

› Infrahyoid muscles are
called Strap muscles
› They look like ribbons
extending inferiorly on the
anterior neck

Trapezius

Splenius capitis

Levator scapulae

Anterior, middle
and posterior
scalene
4.2 cm left supraclavicular mass posterior to the
sternocleidomastoid muscle and lateral to the carotid
sheath
Vertebral body Is not involved.
Brachial plexus. Lesions coming from the cervico-brachial plexus are
expected to be found in a more paraspinal location.
Vertebral artery and vein Are not involved.
Prevertebral and paraspinal musculature. The lesion is clearly arising from the
left paraspinal musculature.
Carotid arteries
 Rt CCA- arise from
brachiocephalic artery
posterior to
sternoclavicular joint
 Lt CCA- arises directly
from AO arch
 Medial to internal
jugular and bifurcate
into internal and
external carotid at level
of thyroid cartilage (C3C4)

Branch of the
subclavian artery
and ascend though
the transverse
formina of C6-C1
 Arteries enter
foramen magnum
and join to form the
BASILAR artery

(A) Axial computed tomographic (CT) angiogram shows the course of the right
vertebral artery. (B) Corresponding coronally reformatted CT angiogram shows the
course and morphology of the right vertebral artery. The complexity of the fracture
(arrow) is also visible. (C) Axial CT angiogram through C2 shows the course of the
left vertebral artery. (D) Corresponding oblique coronally reformatted CT
angiogram shows the course and morphology of the left vertebral artery
Internal jugular veins
drain blood from brain
 Largest vascular
structures of the neck
 Unite with the subclavian
vein to form
brachiocephalic vein
 Rt is larger than the Lt
 Lateral to common
carotids
