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Neck triangles
The document provides an outline on the triangles of the neck and deep structures of the neck. It begins by introducing the sternocleidomastoid muscle as the most useful landmark for locating neck structures. It then describes the boundaries and contents of the posterior and anterior triangles of the neck, noting key nerves, vessels, and muscles located in each. The document concludes by detailing structures such as the thyroid gland, parathyroid glands, sympathetic chain, and thoracic duct found deeper in the neck.
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Neck triangles
- 1. TRIANGLES OF NECK OUTLINE I. TRIANGLES OF NECK II. DEEP STRUCTURES OF NECK STERNOCLEIDO- MASTOID TO LOCATE STRUCTURES IN NECK ON PATIENT OR IN PRACTICAL EXAM MOST USEFUL LANDMARK IS STERNOCLEIDOMASTOID MUSCLE
- 2. I. TRIANGLES OFNECK Sternocleidomastoid Muscle Triangles of Neck – for description neck is divided into anterior & posterior triangles by Sternocleidomastoid Posterior muscle triangle Anterior triangle
- 3. A. POSTERIOR TRIANGLE Anterior - Sternocleidomastoid 1. Boundaries Muscle Superficial cover - superficial Posterior fascia, platysma Trapezius and Investing Layer Deep - (floor) Prevertebral layer of fascia Clavicle
- 4. B. CONTENTS OFPOSTERIOR TRIANGLE Occipital artery Superficial - Great branches of Auricular n. cervical Lesser plexus occipital n. Trans Cerv. n. Accessory n. (XI) External Jugular Vein Supra- clavicular nerves
- 5. POSTERIOR TRIANGLE -deeper, saw through clavicle Nose Note: Accessory n. - divides post. triangle into 'Carefree' - superior 'Careful' - inferior Phrenic nerve Brachial plexus roots & trunks
- 6. POSTERIOR TRIANGLE -deeper Brachial plexus roots & Phrenic n. trunks Transverse Nose (superf.) Cervical A. Suprascapular A. Subclavian Subclavian a. vein note: Subclavian vein is not in post triangle
- 7. B. ANTERIOR TRIANGLEOF NECK Sternocleidomastoid Muscle 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 OFANTERIOR TRIANGLE OF NECK In Carotid sheath: - cut through Int. and sternocleido- Common mastoid 2” Carotid A., above Int. Jug. V., sternum Vagus N. Follow dissection Hypoglossal to all n. XII & ansa branches of cervicalis Ext. carotid
- 9. II. DEEP STRUCTURESOF NECK A. THYROID GLAND Two Lateral Lobes - below & on sides thyroid cartilage Lateral Lobe Lateral Lobe
- 10. THYROID GLAND Right Left Pyramidal lobe- lateral when present often lateral lobe attached to hyoid lobe bone by fibrous strand Isthmus - located below cricoid cartilage
- 11. THYROID GLAND -ARTERIAL SUPPLY a) Sup. very Thyroid vascular- artery & arteries Sup. accompanied Laryngeal n. by nerves b) Inf. Thyroid artery & Recurrent laryngeal n. Note: In thyroid surgery care taken not to damage Recurrent 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 located parathyroid posterior gland to or Inferior within parathyroid Thyroid gland gland
- 14. SYMPATHETIC CHAIN Ant to vertebrae Sympathetic Not trunk- deep to confuse (not in) with Carotid Sheath Vagus 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 BRACHIOCEPHALIC FOLLOWS LEFT V. MARGIN OF ESOPHAGUS 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 NECK Superficialfascia: - connective tissue below dermis - completely surrounds neck - thin and hard to demonstrate - contains Platysma & 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 Vein Supra- clavicular nerves
- 21. POSTERIOR TRIANGLE -deeper, saw through clavicle Nose Accessory n.- divides post. triangle into Carefree- superior Careful- inferior Phrenic nerve Brachial plexus roots & trunks
- 22. POSTERIOR TRIANGLE -deeper Brachial plexus roots & Phrenic n. trunks Transverse Nose (superf.) Cervical A. Suprascapular A. Subclavian Subclavian a. vein note: Subclavian vein is not in post triangle
- 23. ANTERIOR TRIANGLE OFNECK - CONTENTS -cut through Carotid sheath sternocleido contents mastoid 2” Int. and above Common sternum Carotid A., Int. Jug. V., Vagus N. Hypoglossal n. XII & ansa Follow cervicalis dissection to all branches of ext. carotid
- 24. EXTERNAL CAROTID ARTERY Superficialtemporal- Maxillary scalp & temporalis Post auricular- post. ear & scalp Facial Occipital- post. scalp Ascending pharyngeal- pharynx Lingual- tongue Superior thyroid- br. is Sup laryngeal
- 25.
- 26. INFRAHYOID MUSCLES -all depress hyoid NOSE deeper 2) STERNOHYOID 4) THYROHYOID - O - O- Manubrium & thyroid cartilage; also clavicle elevates larynx 1) OMOHYOID 3) STERNOTHYROID -- intermediate O - manubrium I - tendon to thyroid cartilage; also clavicle, rib 1; depresses larynx Sup. belly to hyoid
- 27. THYROID GLAND -ARTERIAL SUPPLY Sup. Thyroid very artery & vascular- Sup. arteries Laryngeal n. accompanied by nerves Inf. Thyroid artery & Recurrent laryngeal n. Note: in thyroid surgery care taken not to damage Recurrent Laryngeal Nerve
- 28.