Neck triangles

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triangles of neck

triangles of neck

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  • 1. TRIANGLES OF NECK OUTLINE I. TRIANGLES OF NECK II. DEEP STRUCTURES OF NECKSTERNOCLEIDO-MASTOID TO LOCATE STRUCTURES IN NECK ON PATIENT OR IN PRACTICAL EXAM MOST USEFUL LANDMARK IS STERNOCLEIDOMASTOID MUSCLE
  • 2. I. TRIANGLES OF NECK Sternocleidomastoid Muscle Triangles of Neck – for description neck is divided into anterior & posterior triangles by SternocleidomastoidPosterior muscletriangle Anterior triangle
  • 3. A. POSTERIOR TRIANGLE Anterior - Sternocleidomastoid 1. Boundaries Muscle Superficial cover - superficialPosterior fascia, platysmaTrapezius and Investing Layer Deep - (floor) Prevertebral layer of fascia Clavicle
  • 4. B. CONTENTS OF POSTERIOR TRIANGLE Occipital artery Superficial - Great branches of Auricular n. cervical Lesser plexus occipital n. Trans Cerv. n. Accessory n. (XI) External Jugular VeinSupra-clavicularnerves
  • 5. POSTERIOR TRIANGLE - deeper, saw through clavicle Nose Note: Accessory n. - divides post. triangle into Carefree - superior Careful - inferior Phrenic nerveBrachialplexusroots &trunks
  • 6. POSTERIOR TRIANGLE - deeperBrachialplexus roots & Phrenic n.trunksTransverse Nose(superf.)Cervical A.SuprascapularA. SubclavianSubclavian a. vein note: Subclavian vein is not in post triangle
  • 7. B. ANTERIOR TRIANGLE OF NECKSternocleidomastoidMuscle 1. Boundaries- ant. - midline of neck post. - sternocleido- mastoid superior - mandible (lower margin). Midline Subdivided to of neck smaller triangles (not required)
  • 8. 2. CONTENTS OF ANTERIOR TRIANGLE OF NECKIn Carotidsheath: - cut through Int. and sternocleido-Common mastoid 2”Carotid A., aboveInt. Jug. V., sternumVagus N.Followdissection Hypoglossalto all n. XII & ansabranches of cervicalisExt. carotid
  • 9. II. DEEP STRUCTURES OF NECK A. THYROID GLAND Two Lateral Lobes - below & on sides thyroid cartilageLateral Lobe Lateral Lobe
  • 10. THYROID GLAND Right Left Pyramidal lobe- lateral when present often lateral lobe attached to hyoid lobe bone by fibrous strandIsthmus- locatedbelowcricoidcartilage
  • 11. THYROID GLAND - ARTERIAL SUPPLY a) Sup.very Thyroidvascular- artery &arteries Sup.accompanied Laryngeal n.by nerves b) Inf. Thyroid artery & Recurrent laryngeal n.Note: In thyroid surgery care taken not to damageRecurrent Laryngeal Nerve
  • 12. THYROID GLAND - LOTS OF VEINS 1) Sup. Thyroid vein follows Sup. Thyroid artery 2) Middle Thyroid vein - to Int Jugular 3) Inf. Thyroid vein - Both sides join at midline -> L. Brachiocephalic Vein
  • 13. PARATHYROID GLANDS - 4 small bodies (2 on each side)Superior locatedparathyroid posteriorgland to orInferior withinparathyroid Thyroidgland gland
  • 14. SYMPATHETIC CHAINAnt tovertebrae SympatheticNot trunk- deep toconfuse (not in)with Carotid SheathVagus X Note: sympathetics to most of head are from Superior Cervical Ganglion
  • 15. THORACIC DUCT INT. JUGULAR V. THORACIC DUCT SUBCLAVIAN V. DRAINS TO LEFT BRACHIOCEPHALICFOLLOWS LEFT V.MARGIN OFESOPHAGUS AT JUNCTION OF SUBCLAVIAN AND INT. JUGULAR VEINS
  • 16. GUIDE TO DISSECTION 1) Completely Skin Neck 2) Skip p. 175 see: Prosection Cutaneous nerves Do Post. Triangle 3) Cut through clavicle if not already done 4) Cut through sternocleidomastoid 2” (5cm) above sternum p. 178
  • 17. FASCIA OF NECKSuperficial fascia:- connectivetissue belowdermis- completelysurrounds neck -thin and hard todemonstrate- containsPlatysma &Superficial veins
  • 18. POSTERIOR TRIANGLE - CONTENTS Occipital artery Superficial - Great branches of Auricular n. cervical Lesser plexus occipital n. Trans Cerv. n. Accessory n. (XI) External Jugular VeinSupra-clavicularnerves
  • 19. POSTERIOR TRIANGLE - deeper, saw through clavicle Nose Accessory n.- divides post. triangle into Carefree- superior Careful- inferior Phrenic nerveBrachialplexusroots &trunks
  • 20. POSTERIOR TRIANGLE - deeperBrachialplexus roots & Phrenic n.trunksTransverse Nose(superf.)Cervical A.SuprascapularA. SubclavianSubclavian a. vein note: Subclavian vein is not in post triangle
  • 21. ANTERIOR TRIANGLE OF NECK - CONTENTS -cut throughCarotid sheath sternocleidocontents mastoid 2”Int. and aboveCommon sternumCarotid A.,Int. Jug. V.,Vagus N. Hypoglossal n. XII & ansaFollow cervicalisdissection to allbranches of ext.carotid
  • 22. EXTERNAL CAROTID ARTERYSuperficial temporal- Maxillaryscalp & temporalisPost auricular- post. ear &scalp Facial Occipital- post. scalp Ascending pharyngeal- pharynx Lingual- tongue Superior thyroid- br. is Sup laryngeal
  • 23. PROSECTIONOFANTERIORNECK
  • 24. INFRAHYOID MUSCLES - all depress hyoid NOSE deeper2) STERNOHYOID 4) THYROHYOID - O -O- Manubrium & thyroid cartilage; alsoclavicle elevates larynx1) OMOHYOID 3) STERNOTHYROID --intermediate O - manubrium I -tendon to thyroid cartilage; alsoclavicle, rib 1; depresses larynxSup. belly tohyoid
  • 25. THYROID GLAND - ARTERIAL SUPPLY Sup. Thyroidvery artery &vascular- Sup.arteries Laryngeal n.accompaniedby nerves Inf. Thyroid artery & Recurrent laryngeal n.Note: in thyroid surgery care taken not to damageRecurrent Laryngeal Nerve
  • 26. PROSECTION:DEEPDISSECTION OFNECK