Neck muscles and triangles


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Neck muscles and triangles

  1. 1. The Neck 01
  2. 2. • is relatively narrow and flexible portion between the head above and the chest below• Functions: 1. transports a food tube, an air tube, and a neurovascular bundle between the head and chest. 2. the upper limbs originate from the cervical region during their embryological development, 3. passageway for the blood vessels and nerves to and from the upper limb. 02
  4. 4. A. Superior1. Anterior- lower border of the mandible2. Lateral- line between the gonion and the mastoid temporal,3. Posterior- inion and superior nuchal line 04
  5. 5. B. Inferior1. Anterior - jugular or suprasternal notch2. Lateral - superior border of the clavicle,3. Posterior- transverse line from the acromioclavicular joint to the spinous processof the 7th cervical vertebra 05
  7. 7. Contour• well-rounded in women and children and is more angular in men• natural upright position of the neck is midway between flexion and extension 07
  8. 8. Structures Palpated in the Midline body of the hyoid bone thyroid cartilage cricoid cartilage Trachea isthmus of the thyroid gland suprasternal notch 08
  9. 9. Structures Palpated Posteriorly Inion Nuchal goove Vertebra prominence Ligamentum nuchae which covers spines of C2 to C6 09
  10. 10. Structures Palpated Laterally Sternocleido-mastoid muscle Trapezius muscle External jugular veins 10
  11. 11. The Muscles and Triangles of the Neck 11
  12. 12. Regions of the Neck To facilitate the seemingly complicated area, the neck is divided into two major areas, or triangles, by the sternocleidomastoid muscle. These are: 1. anterior triangle - the area anterior to the SCM and below the inferior border of the mandible 2. posterior triangle - the area posterior to the SCM and is limited posteriorly by the trapezius muscle 12
  13. 13. Sternocleidomastoid Muscle Origin Insertion Action Nerve SupplyTwo heads: Mastoid process Bilateral: 1. SpinalSternal head – of the of the Flex the neck accesory nervemanubrium temporal bone 2. Anteriorsterni and lateral half primary rami of of the superior Single: spinal nerves C2 nuchal line. Flex the head and C3.Clavicular head and laterally- Medial 2/3 of rotate to thethe clavicle opposite side 14
  14. 14. Trapezius Muscle Origin Insertion Action Nerve SupplyExternal Fibers Contract to 1. Spinaloccipital originating from rotate and accessory nerveprotruberance, the head insert elevate thethe medial half into the lateral scapula. Its 2. Anteriorof the superior third of the cervical portion, primary rami ofnuchal line, the clavicle, and the acting the spinalligamentum remaining fibers bilaterally, can nerves C3 andnuchae, and the insert into the extend the head C4.lower cervical acromion and singly, itand all the process and can rotate thethoracic spines spine of the head and face scapula to the opposite side 15
  15. 15. The Anterior Triangle of the Neck 16
  17. 17. I. Infrahyoid Muscles Muscle Origin Insertion Action Nerve SupplyOmohyoid Inferior belly: Inferior belly: Depresses the Ansa Superior Intermediate hyoid bone cervicalis border of the tendon and larynx (APR of C1, scapula Superior C2, C3) Superior belly: belly: Lower border Intermediate of the body of tendon the hyoid boneSternohyoid Manubrium of Lower border Depresses the Ansa the sternum, of the body of hyoid bone cervicalis posterior the hyoid and larynx (APR of C1, aspect bone C2, C3) 18
  18. 18. Infrahyoid Muscles Muscle Origin Insertion Action Nerve SupplySternothyroid Manubrium of Oblique line Depresses the Ansa the sternum, of thyroid larynx cervicalis posterior cartilage (APR of C1, aspect C2, C3)Thyrohyoid Oblique line of Body and Depresses the Thyrohyoid thyroid greater horn hyoid bone branch of the cartilage of hyoid bone, hypoglossal lower border nerve 19
  19. 19. II. Suprahyoid Muscles Muscle Origin Insertion Action Nerve SupplyStylohyoid Styloid Greater horn Elevates Facial nerve process of hyoid hyoid bone boneDigastric Digastric Intermediate Raises the Facial nerve(Posterior notch of the tendon hyoid bonebelly) temporal bone at the base of the skullDigastric Intermediate Digastric Elevates the Nerve to the(anterior tendon fossa of the hyoid bone mylohyoidbelly) mandible muscle 20
  20. 20. Suprahyoid Muscles Muscle Origin Insertion Action Nerve SupplyMylohyoid Mylohyoid line Median raphe Elevates the Nerve to on the medial and body of hyoid bone, mylohyoid aspect of hyoid base of the muscle mandibular tongue, and body floor of the mouthGeniohyoid Inferior Body of hyoid Elevates hyoid APR of C1muscle border genial bone bone, tubercle of protracts the mandible hyoid bone 21
  22. 22. • Anterior - median line of the neck• Posterior – anterior border of the sternocleidomastoid muscle• Superior - inferior border of the mandible• Roof - skin, superficial fascia, platysma, and investing layer of deep cervical fascia 23
  24. 24. 1. Digastric Triangle2. Carotid triangle3. Muscular or inferior carotid triangle4. Submental triangle 25
  25. 25. 1. Digastric TriangleBoundaries:1. Superior- lower border of the mandible2. Anterior – anterior belly of the digastric3. Posterior – posterior belly of the digastric4. Floor - mylohoid and hyoglossus muscles and superior contrictor muscle of the pharynx 26
  26. 26. Structures:1. Glands – parotid and submandibular2. Arteries - Internal and external carotid, facial, submental, posterior auricular, superficial temporal and lingual.3. Veins - anterior facial and internal jugular.4. Nerves – vagus, glossopharyngeal, facial, and hypoglossal. 27
  27. 27. 2. Carotid TriangleBoundaries:1. Superior – posterior belly of the digastric2. Inferior – superior belly of omohyoid3. Posterior – anterior border of the SCM4. Floor - thyrohyoid muscle, hyoglossus muscle, and the middle and inferior constrictor muscles of the pharynx. 28
  28. 28. Structures:1. Organs – larynx and pharynx (lower part)2. Arteries - CCA, facial, occipital, acending pharyngeal, superior thyroid, and lingual.3. Veins - internal jugular, superior thyroid, lingual, facial, occipital and ascending pharyngeal.4. Nerves - vagus, accessory, hypoglossal, ansa hypoglossi, external and internal laryngeal. 29
  29. 29. 3. Muscular or Inferior Carotid TriangleBoundaries:1. Supero-posterior - superior belly of omohyoid2. Infero-posterior - anterior border of SCM3. Anterior - median line of the neck4. Floor - sternohyoid and sternothyroid 30
  30. 30. Structures:1. Organs – thyroid and parathyroid glands, trachea2. Arteries - inferior thyroid3. Veins - internal jugular4. Nerves - vagus, recurrent laryngeal, sympathetic n. 31
  31. 31. 4. Submental TriangleBoundaries:1. Lateral - two anterior bellies of the digastric2. Inferior - body of the hyoid boneStructures:1. Submental lymph glands2. Beginning of the anterior jugular vein 32
  32. 32. The Posterior Triangle of the Neck 33
  33. 33. Boundaries:1. Anterior - posterior border of the SCM.2. Posterior - anterior border of the trapezius muscle.3. Inferior - superior border of the intermediate 1/3 of trhe clavicle. 34
  34. 34. 4. Superior - meeting of the trapezius and SCM at the superior nuchal line.5. Roof - formed by the skin, superficial fascia, platysma and investing layer of the deep cervical fascia.6. Floor - formed by several muscles – semispinalis capitis, splenius capitis, levator scapulae, and scalene muscles 35
  35. 35. Muscles of thePosterior Triangle of the Neck 36
  36. 36. Muscle Origin Insertion Action NervePlatysma Superficial Inferior Stretches Facial nerve fascia of the border of tight the deltoid and the skin of the pectoral mandible, neck, regions some fibers depresses sweep the mandible upward and blend with risoriusSplenius Lower part Mastoid Bilateral: Cervicalcapitis of the process and Extends the spinal nerves ligamentum the superior head nuchae, nuchal line Individual: lower cervical Flexes the spines head laterally 37
  37. 37. Muscle Origin Insertion Action NerveLevator Transverse Superior Elevates and Dorsalscapulae processes of portion of rotates the scapular C1 to C4 the vertebral scapula nerves border of the scapulaScalenius Transverse Superior Flexes the APR of C5 toposterior processes of aspect of the neck C8 C5 and C6 second ribScalenius Transverse Superior Flexes the APR of C3Medius processes of aspect of the neck and C4 C2 to C7 first ribScalenius Transverse Scalene Participates APR of C5 toanterior processes of tubercle of in forced C8 C3 to C6 the first rib inspiration by elevating the ribs and sternum 38
  38. 38. Subdivisions of the Posterior Triangle1. Occipital Triangle2. Supraclavicular Triangle 39
  39. 39. 1. Occipital TriangleBoundaries:1. Anterior - posterior border of SCM2. Posterior - anterior border of the Trapezius M.3. Superior - meeting between the trapezius and SCM4. Inferior - superior border of the inferior belly of omohyoid 40
  40. 40. 2. Supraclavicular or Subclavian or Omoclavicular TriangleBoundaries:1. Anterior - posterior border of SCM2. Superior - inferior border of the inferior belly of omohyoid3. Inferior - superior border of the intermediate 1/3 of the clavicle 41
  41. 41. Contents of the Posterior Triangle1. Arteries - subclavian artery, transverse cervical artery, occipital artery and suprascapular artery.2. Veins - external jugular vein, anterior jugular vein, transverse cervical vein, suprascapular and subclavian veins.3. Nerves - spinal accessory nerve, cutaneous and muscular branches of the cervical plexus, ansa cervicalis and root, trunk and divisions of the brachial plelxus.4. Lymph glands - supraclavicular lymph glands, and the lateral superior deep cervical lymph glands. 42