Download - neck triangles
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TRIANGLES OF NECK
TO LOCATE STRUCTURES IN NECK ON PATIENT OR IN PRACTICAL EXAM MOST USEFUL LANDMARKIS STERNOCLEIDOMASTOID MUSCLE
OUTLINE
I. TRIANGLES OFNECK
II. DEEPSTRUCTURES OFNECK
STERNOCLEIDO-MASTOID
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Triangles of Neck –for description neck is divided into anterior & posterior triangles bySternocleidomastoidmusclePosterior
triangleAnterior triangle
SternocleidomastoidMuscle
I. TRIANGLES OF NECK
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1. Boundaries
Superficial cover - superficial fascia, platysmaand Investing Layer
Deep - (floor) Prevertebrallayer of fascia
Clavicle
A. POSTERIOR TRIANGLE
PosteriorTrapezius
Anterior -SternocleidomastoidMuscle
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Superficial -branches of cervical plexus
Trans Cerv. n.
External Jugular VeinSupra-
clavicular nerves
Occipital artery
Great Auricular n.
Lesser occipital n.
Accessory n. (XI)
B. CONTENTS OF POSTERIOR TRIANGLE
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Note: Accessory n. -divides post. triangle into 'Carefree' -superior 'Careful' -inferior Phrenic
nerveBrachial plexus roots & trunks
POSTERIOR TRIANGLE - deeper, saw throughclavicle Nose
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note: Subclavian vein is not in post triangle
Nose
Phrenic n.Brachial plexus roots & trunks
Transverse (superf.) Cervical A.
Suprascapular A.
Subclavian a.Subclavian vein
POSTERIOR TRIANGLE - deeper
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1. Boundaries-ant. - midline of neckpost. - sternocleido-mastoid superior - mandible (lower margin).
Subdivided to smaller triangles (not required)
Midline of neck
SternocleidomastoidMuscle
B. ANTERIOR TRIANGLE OF NECK
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In Carotid sheath:Int. and Common Carotid A., Int. Jug. V., Vagus N.
Follow dissection to all branches of Ext. carotid
- cut through sternocleido-mastoid 2” above sternum
Hypoglossal n. XII & ansa cervicalis
2. CONTENTS OF ANTERIOR TRIANGLE OF NECK
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Two Lateral Lobes - below & on sides thyroid cartilage
Lateral Lobe
A. THYROID GLAND
Lateral Lobe
II. DEEP STRUCTURES OF NECK
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THYROID GLAND
Right lateral lobe
Left lateral lobe
Isthmus- located below cricoid cartilage
Pyramidal lobe-when present often attached to hyoid bone by fibrous strand
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very vascular-arteries accompanied by nerves
a) Sup. Thyroid artery &Sup. Laryngeal n.
b) Inf. Thyroid artery & Recurrent laryngeal n.
Note: In thyroid surgery care taken not to damage Recurrent Laryngeal Nerve
THYROID GLAND - ARTERIAL SUPPLY
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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
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PARATHYROID GLANDS
- 4 small bodies (2 on each side) located posterior to or within Thyroid gland
Superior parathyroid gland
Inferior parathyroid gland
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Sympathetic trunk- deep to (not in) Carotid Sheath
Ant to vertebrae
Not confuse with Vagus X
SYMPATHETIC CHAIN
Note: sympatheticsto most of headare from SuperiorCervical Ganglion
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FOLLOWS LEFT MARGIN OF ESOPHAGUS
DRAINS TO LEFT BRACHIOCEPHALIC V.
AT JUNCTION OF SUBCLAVIAN AND INT. JUGULAR VEINS
THORACIC DUCT
SUBCLAVIAN V.
INT. JUGULAR V.
THORACIC DUCT
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1) Completely Skin Neck
2) Skip p. 175 see: Prosection Cutaneousnerves
Do Post. Triangle
3) Cut through clavicle if not already done
4) Cut through sternocleidomastoid 2” (5cm) above sternum p. 178
GUIDE TO DISSECTION
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Superficial fascia:
- connective tissue below dermis - completely surrounds neck -thin and hard to demonstrate - contains Platysma & Superficial veins
FASCIA OF NECK
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Superficial -branches of cervical plexus
Trans Cerv. n.
External Jugular VeinSupra-
clavicular nerves
Occipital artery
Great Auricular n.
Lesser occipital n.
Accessory n. (XI)
POSTERIOR TRIANGLE - CONTENTS
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Accessory n.-divides post. triangle into Carefree-superior Careful-inferior Phrenic
nerveBrachial plexus roots & trunks
POSTERIOR TRIANGLE - deeper, saw throughclavicle Nose
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note: Subclavian vein is not in post triangle
Nose
Phrenic n.Brachial plexus roots & trunks
Transverse (superf.) Cervical A.
Suprascapular A.
Subclavian a.Subclavian vein
POSTERIOR TRIANGLE - deeper
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Carotid sheath contents Int. and Common Carotid A., Int. Jug. V., Vagus N.
Follow dissection to all branches of ext. carotid
-cut through sternocleidomastoid 2” above sternum
Hypoglossal n. XII & ansa cervicalis
ANTERIOR TRIANGLE OF NECK - CONTENTS
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Superficial temporal-scalp & temporalis
Post auricular- post. ear & scalp
Occipital- post. scalp
Ascending pharyngeal-pharynx
Lingual- tongue
Superior thyroid- br. is Sup laryngeal
Maxillary
EXTERNAL CAROTID ARTERY
Facial
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PROSECTION OFANTERIORNECK
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2) STERNOHYOID O- Manubrium & clavicle
1) OMOHYOID intermediate tendon to clavicle, rib 1; Sup. belly to hyoid
4) THYROHYOID - O -thyroid cartilage; also elevates larynx
3) STERNOTHYROID --O - manubrium I -thyroid cartilage; also depresses larynx
INFRAHYOID MUSCLES - all depress hyoid
deeperNOSE
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very vascular-arteries accompanied by nerves
Sup. Thyroid artery &Sup. Laryngeal n.
Inf. Thyroid artery & Recurrent laryngeal n.
Note: in thyroid surgery care taken not to damage Recurrent Laryngeal Nerve
THYROID GLAND - ARTERIAL SUPPLY
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PROSECTION: DEEPDISSECTION OFNECK