Head And Neck

Head and Neck

Topographical view

Surface anatomy - neck
Hyoid
Thyroid cartilage
Cricoid cartilage
SCM muscle
Sternum
Chassaignac’s tubercles
Sternal notch

Surface anatomy - neck
Inion
Trapezius
Trasversocostal muscle group
C7 spinous process
T1 spinous process
Nuchal ligament
Post. facet joint
Suboccipital muscle
Greator occipital nerve

Bony Landmark Trails

Muscles of the Head, Neck and Face

Sternocleidomastoid
Action
Bilateral: Extends the head, assists in respiratio when the head is fixed
Unilateral: Tilts the head to the same side, rotates the head to the opposite side
Origin
Sternal head: Manubrium
Clavicular head: Medial third of the clavicle
Insertion
Mastoid process and superior nuchal line
Innervation
Acessory nerve and direct branches from the cervical plexus (C1-2)

Sternocleidomastoid
Supine
Locate the matoid process, medial clavicle and the top of the sternum
Ask pt. to raise his head very slightly off the table as you palpate SCM

Sternocleidomastoid
Palpate along the borders of the SCM
Follow it behind the earlobe and then down to the clavicle and sternum

Test for SCM

Test for SCM
Patient: Supine with elbows bent and hands beside the head, resting on table
Fixation: If the anterior abdominal muscles are weak, the examiner can provide fixation by exerting firm, downward pressure on the thorax
Test: Anterolateral neck flexion
Pressure: Against the temporal region of the head in an obliquely posterior direction

Scalene muscles
Anterior scalene
Middle scalene
Posterior scalene
Actions of scalenes muscles
Unilaterally: Laterally flex the head and neck to the same side, rotate head and enck to the opposite side
Bilaterally: Elevate the ribs during inhalation, flex the head and neck

Anterior scalene
Origin
TP of 3 rd through 6 th cervical vertebrae (ant. tubercle)
Insertion
1 st rib
Innervation
Cervical and brachial plexus (C3-6)

Middle scalene
Origin
TP of 3 rd through 7 th cervical vertebrae (post. tubercle)
Insertion
1 st rib
Innervation

Posterior scalene
Origin
TP of 5 th through 7 th cervical vertebrae (post. tubercle)
Insertion
2 nd rib
Innervation

Scalenes as a group
Supine
Cradle the head to allow for easier palpation
Place your finger pad along the ant. and lat. sides of the neck b/w SCM and trapezius

Masseter
Supine
Locate zygomatic arch and angle of the mandible
Place your fingers b/w these bony landmarks and palpate the surface of the masseter
Ask pt. to alternately clench and relax her jaw

Temporalis
Supine and locate the zygomatic arch
Place your finger pads 1 inch superior to the arch
Ask pt. to alternately clench and relax her jaw

Temporalis
To locate the insertion site of the temporalis tendon, ask pt. to open her mouth wide
Locate and explore the coronoid process

Occipitofrontralis
Frontalis fibers
supine
place fingers on the forehead
ask pt. to raise his eyebrows
Occipitalis fibers
supine or prone
locate sup. nuchal line
slide fingers 1 inch superiorly

Splenius muscles

Splenius muslces
7. Splenius cervicis
8. Splenius capitis

Splenius muscles
Action
Entire muscle; bilateral contraction extends the cervical spine and head, unilateral contraction flexes and rotates the head to the same side
Origin
Splenius cervicis: Spinous process of T3-T6 vertebrae
Splenius capitis: Spinous process of C3-T3 vertebrae
Insertion
Splenius cervicis: Transverse process of C1-2
Splenius capitis: Lateral superior nuchal line, mastoid process
Innervation
Lateral branches of dorsal rami of spinal nerves C1-6

Splenius capitis
Prone, locate the upper fibers of the trapezius
Isolate the lat. edge of the trapezius by extending pt’s head slightly
Palpate just lateral to the trapezius and follow the oblique fiber up to the mastoid process

Both splenii muscles
Supine with head rotated 45° away from the side palpating
Cradle the head with one hand while the other hand locates the lamina groove of the upper cervical vertebrae

Suboccipitalis Rectus capitis posterior major Rectus capitis post. minor Oblique capitis superior Oblique capitis inferior

Suboccipitalis
Rectus capitis posterior major
Rectus capitis posterior minor
Rectus capitis superior
Rectus capitis inferior

Rectus capitis posterior major
A: Bilateral contraction extends the head. Unilateral contraction rotates the head to the same side
O : SP of the axis
I : Inferior nuchal line of the occiput
N : Suboccipital

Rectus capitis posterior minor
O : Tubercle of the posterior arch of the atlas
I : Inferior nuchal line of the occiput
N : Suboccipital

Oblique capitis superior
A: Bilateral contraction extends the head. Unilateral contraction tilts the head to the same side and rotates it to the opposite side
O : TP of Atlas
I : Above the insertion of the rectus capitis posterior major
N : Suboccipital

Oblique capitis inferior
O : Sp of the axis
I : TP of the atlas
N : Suboccipital

Suboccipitalis
Supine position
Cradle the head in both hands
Passively extending the neck a bit
Locate sup. nuchal line and spinous process of C2
 Suboccipital span the area between these two landmarks

Suboccipitals
Prone position
Locate lat. edge of the trapezius’ upper fiber
Palpating beside the level of C1 , place one finger at the lateral edge of the trapezius
Slowly sink medially into the suboccipitalis

Test for posterolateral neck extensor

Test for posterolateral neck extensor
Splenius capitis/cervicis, semispinalis capitis/cervicis, and cervical erector muscles
Patient: Prone with elbows bent and hands overhead, resting on the table
Fixation: None necessary
Test: Posterolateral neck extension, with the face turned toward the side being tested
Pressure: Against the posterolateral aspect of the head in an anterolateral direction

Head And Neck

by jae o han

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Head And Neck

by jae o han

Accessibility

Categories

Upload Details

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3 Embeds 14

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Head And Neck Presentation Transcript

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