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The Muscles andThe Muscles andTriangles of the NeckTriangles of the Neck
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Regions of the NeckRegions of the Neck
To facilitate the seemingly complicated area, theTo facilitate the seemingly complicated area, theneck is divided into two major areas, orneck is divided into two major areas, ortriangles, by thetriangles, by the sternocleidomastoidsternocleidomastoidmusclemuscle. These are:. These are:
1.1. anterior triangleanterior triangle-- the area anterior to the SCM and belowthe area anterior to the SCM and belowthe inferior border of the mandible.the inferior border of the mandible.2.2. posterior triangleposterior triangle
-- the area posterior to the SCM and isthe area posterior to the SCM and islimited posteriorly by thelimited posteriorly by the trapeziustrapeziusmuscle.muscle.
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Sternocleidomastoid MuscleSternocleidomastoid Muscle
MuscleMuscle OriginOrigin InsertionInsertion ActionAction NerveNerveSupplySupply
SternocleidoSternocleido
mastoidmastoidmusclemuscle
Two heads:Two heads:
Sternal headSternal headmanubriummanubriumsternisterni
ClavicularClavicular
headhead-- Medial 2/3Medial 2/3of theof theclavicleclavicle
MastoidMastoid
process ofprocess ofthe of thethe of thetemporaltemporalbone andbone andlateral halflateral halfof theof thesuperiorsuperiornuchal line.nuchal line.
Bilateral:Bilateral:
Flex theFlex theneckneck
Single:Single:
Flex theFlex the
head andhead andlaterallylaterallyrotate to therotate to theoppositeoppositesideside
1. Spinal1. Spinal
accesoryaccesorynervenerve
2. Anterior2. Anteriorprimary ramiprimary ramiof spinalof spinal
nerves C2nerves C2and C3.and C3.
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Trapezius MuscleTrapezius MuscleMuscleMuscle OriginOrigin InsertionInsertion ActionAction NerveNerve
SupplySupplyTrapeziusTrapeziusmusclemuscle
ExternalExternaloccipitaloccipital
protruberanceprotruberance, the medial, the medialhalf of thehalf of thesuperiorsuperiornuchal line,nuchal line,thetheligamentumligamentumnuchae, andnuchae, andthe lowerthe lowercervical andcervical andall theall thethoracicthoracicspinesspines
FibersFibersoriginatingoriginating
from the headfrom the headinsert into theinsert into thelateral third oflateral third ofthe clavicle,the clavicle,and theand theremainingremainingfibers insertfibers insertinto theinto theacromionacromionprocess andprocess andspine of thespine of thescapulascapula
Contract toContract torotate androtate and
elevate theelevate thescapule. Itsscapule. Itscervicalcervicalportion, actingportion, actingbilaterally,bilaterally,can extendcan extendthe head andthe head andsingly, it cansingly, it canrotate therotate thehead and facehead and faceto theto theopposite sideopposite side
1. Spinal1. Spinalaccessoryaccessory
nervenerve
2. Anterior2. Anteriorprimary ramiprimary ramiof the spinalof the spinalnerves C3 andnerves C3 and
C4.C4.
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The Anterior TriangleThe Anterior Triangleof the Neckof the Neck
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Boundaries of the Anterior TriangleBoundaries of the Anterior Triangle
AnteriorAnterior-- median line of the neckmedian line of the neck
PosteriorPosterior anterior border of theanterior border of the
sternocleidomastoidsternocleidomastoidmusclemuscle
SuperiorSuperior-- inferior border of theinferior border of themandiblemandible
RoofRoof-- skin, superficial fascia,skin, superficial fascia,platysma, and investingplatysma, and investinglayer of deep cervicallayer of deep cervicalfasciafascia
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Muscles of theMuscles of theAnterior Triangle of the NeckAnterior Triangle of the Neck
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I. Infrahyoid MusclesI. Infrahyoid Muscles
MuscleMuscle OriginOrigin InsertionInsertion ActionAction NerveNerveSupplySupply
OmohyoidOmohyoid Inferior belly:Inferior belly:
SuperiorSuperiorborder of theborder of the
scapulascapulaSuperior belly:Superior belly:
IntermediateIntermediatetendontendon
Inferior belly:Inferior belly:
IntermediateIntermediatetendontendon
SuperiorSuperiorbelly:belly:
Lower borderLower borderof the body ofof the body ofthe hyoidthe hyoidbonebone
Depresses theDepresses thehyoid bonehyoid boneand larynxand larynx
AnsaAnsacervicaliscervicalis(APR of C1,(APR of C1,
C2, C3)C2, C3)
SternohyoidSternohyoid Manubrium ofManubrium ofthe sternum,the sternum,posteriorposterioraspectaspect
Lower borderLower borderof the body ofof the body ofthe hyoidthe hyoidbonebone
Depresses theDepresses thehyoid bonehyoid boneand larynxand larynx
AnsaAnsacervicaliscervicalis(APR of C1,(APR of C1,C2, C3)C2, C3)
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Infrahyoid MusclesInfrahyoid Muscles
MuscleMuscle OriginOrigin InsertionInsertion ActionAction NerveNerveSupplySupply
SternothyroidSternothyroid Manubrium ofManubrium ofthe sternum,the sternum,
posteriorposterioraspectaspect
Oblique line ofOblique line ofthyroidthyroid
cartilagecartilage
Depresses theDepresses thelarynxlarynx
AnsaAnsacervicaliscervicalis
(APR of C1,(APR of C1,C2, C3)C2, C3)
ThyrohyoidThyrohyoid Oblique line ofOblique line ofthyroidthyroidcartilagecartilage
Body andBody andgreater horngreater hornof hyoid bone,of hyoid bone,lower borderlower border
Depresses theDepresses thehyoid bonehyoid bone
ThyrohyoidThyrohyoidbranch of thebranch of thehypoglossalhypoglossalnervenerve
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II. Suprahyoid MusclesII. Suprahyoid Muscles
MuscleMuscle OriginOrigin InsertionInsertion ActionAction NerveNerveSupplySupply
StylohyoidStylohyoid StyloidStyloidprocessprocess
Greater hornGreater hornof hyoidof hyoidbonebone
ElevatesElevateshyoid bonehyoid bone
Facial nerveFacial nerve
DigastricDigastric
(Posterior(Posteriorbelly)belly)
DigastricDigastricnotch of thenotch of thetemporaltemporalbone at thebone at the
base of thebase of theskullskull
IntermediateIntermediatetendontendon
Raises theRaises thehyoid bonehyoid bone
Facial nerveFacial nerve
DigastricDigastric
(anterior(anteriorbelly)belly)
IntermediateIntermediatetendontendon
DigastricDigastricfossa of thefossa of themandiblemandible
Elevates theElevates thehyoid bonehyoid bone
Nerve to theNerve to themylohyoidmylohyoidmusclemuscle
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Suprahyoid MusclesSuprahyoid MusclesMuscleMuscle OriginOrigin InsertionInsertion ActionAction NerveNerve
SupplySupply
MylohyoidMylohyoid Mylohyoid lineMylohyoid lineon the medialon the medial
aspect ofaspect ofmandibularmandibularbodybody
Median rapheMedian rapheand body ofand body of
hyoidhyoid
Elevates theElevates thehyoid bone,hyoid bone,
base of thebase of thetongue, andtongue, andfloor of thefloor of themouthmouth
Nerve toNerve tomylohyoidmylohyoid
musclemuscle
GeniohyoidGeniohyoidmusclemuscle
InferiorInferiorborder genialborder genialtubercle oftubercle ofthe mandiblethe mandible
Body of hyoidBody of hyoidbonebone
Elevates hyoidElevates hyoidbone,bone,protractsprotractshyoid bonehyoid bone
APR of C1APR of C1
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Boundaries of the Anterior TriangleBoundaries of the Anterior Triangle
AnteriorAnterior-- median line of the neckmedian line of the neck
PosteriorPosterior anterior border of theanterior border of the
sternocleidomastoidsternocleidomastoidmusclemuscle
SuperiorSuperior-- inferior border of theinferior border of themandiblemandible
RoofRoof-- skin, superficial fascia,skin, superficial fascia,platysma, and investingplatysma, and investinglayer of deep cervicallayer of deep cervicalfasciafascia
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Subdivisions of theSubdivisions of the
Anterior TriangleAnterior Triangle1.1. DigastricDigastricTriangleTriangle
2.2. CarotidCarotid
triangletriangle3.3. Muscular orMuscular or
inferiorinferiorcarotidcarotid
triangletriangle4.4. SubmentalSubmental
triangletriangle
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1. Digastric Triangle1. Digastric Triangle
Boundaries:Boundaries:
1.1. SuperiorSuperior--lower border of the mandiblelower border of the mandible
2.2. AnteriorAnterior anterior belly of the digastricanterior belly of the digastric
3.3. PosteriorPosterior posterior belly of the digastricposterior belly of the digastric
4.4. FloorFloor --mylohoid and hyoglossus musclesmylohoid and hyoglossus musclesand superior contrictor muscle of theand superior contrictor muscle of thepharynxpharynx
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1. Digastric Triangle1. Digastric Triangle
Structures:Structures:1. Glands1. Glands
parotid andparotid andsubmandibularsubmandibular
2. Arteries2. Arteries
-- Internal and externalInternal and externalcarotid, facial, submental,carotid, facial, submental,posterior auricular,posterior auricular,superficial temporal andsuperficial temporal andlingual.lingual.
3. Veins3. Veins-- anterior facial andanterior facial andinternal jugular.internal jugular.
4. Nerves4. Nerves vagus,vagus,glossopharyngeal, facial,glossopharyngeal, facial,and hypoglossal.and hypoglossal.
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2. Carotid Triangle2. Carotid Triangle
Boundaries:Boundaries:1.1. SuperiorSuperior
posterior belly of theposterior belly of thedigastricdigastric
2.2. InferiorInferior
superior belly ofsuperior belly ofomohyoidomohyoid
3. Posterior3. Posterior anterior border of theanterior border of theSCMSCM
4.4. FloorFloor-- thyrohyoid muscle,thyrohyoid muscle,hyoglossus muscle, and thehyoglossus muscle, and themiddle and inferiormiddle and inferiorconstrictor muscles of theconstrictor muscles of thepharynx.pharynx.
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2. Carotid Triangle2. Carotid Triangle
Structures:Structures:1.1. OrgansOrgans
larynx and pharynx (lowerlarynx and pharynx (lowerpart)part)
2.2. ArteriesArteries-- CCA, facial, occipital,CCA, facial, occipital,
acending pharyngeal,acending pharyngeal,superior thyroid, and lingual.superior thyroid, and lingual.3.3. VeinsVeins
-- internal jugular, superiorinternal jugular, superiorthyroid, lingual, facial,thyroid, lingual, facial,occipital and ascendingoccipital and ascendingpharyngeal.pharyngeal.
4.4. NervesNerves
-- vagus, accessory,vagus, accessory,hypoglossal, ansahypoglossal, ansahypoglossi, external andhypoglossi, external andinternal laryngeal.internal laryngeal.
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3.3. Muscular or InferiorMuscular or Inferior
Carotid TriangleCarotid Triangle Boundaries:Boundaries:1.1. SuperoSupero--posteriorposterior
-- superior belly ofsuperior belly ofomohyoidomohyoid
2.2. inferoinfero--posteriorposterior-- anterior border ofanterior border ofSCMSCM
3.3. AnteriorAnterior-- median line of themedian line of theneckneck
4.4. FloorFloor-- sternohyoid andsternohyoid andsternothyroidsternothyroid
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3. Muscular or Inferior3. Muscular or Inferior
Carotid TriangleCarotid Triangle Structures:Structures:1.1. OrgansOrgans
thyroid andthyroid andparathyroid glands,parathyroid glands,
tracheatrachea2.2. ArteriesArteries
-- inferior thyroidinferior thyroid
3.3. VeinsVeins
-- internal jugularinternal jugular
4.4. NervesNerves
-- vagus, recurrentvagus, recurrentlaryngeal,laryngeal,sympathetic n.sympathetic n.
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4. Submental Triangle4. Submental Triangle
Boundaries:Boundaries:
1.1. LateralLateral
-- two anterior belliestwo anterior belliesof the digastricof the digastric
2.2. PosteriorPosterior-- body of the hyoidbody of the hyoidbonebone
Structures:Structures:
1.1. Submental lymphSubmental lymphglandsglands
2.2. Beginning of theBeginning of theanterior jugular veinanterior jugular vein
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The Posterior TriangleThe Posterior Triangle
of the Neckof the Neck
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The Posterior Triangle of the NeckThe Posterior Triangle of the Neck
Boundaries:Boundaries:
1.1. AnteriorAnterior-- posterior border of the SCM.posterior border of the SCM.
2.2. PosteriorPosterior-- anterior border of the trapeziusanterior border of the trapeziusmuscle.muscle.
3.3. InferiorInferior-- superior border of thesuperior border of theintermediate 1/3 of trhe clavicle.intermediate 1/3 of trhe clavicle.
4.4. SuperiorSuperior-- meeting of the trapezius andmeeting of the trapezius andSCM at the superior nuchal line.SCM at the superior nuchal line.
5.5. RoofRoof
-- formed by the skin, superficialformed by the skin, superficialfascia, platysma and investing layerfascia, platysma and investing layerof the deep cervical fascia.of the deep cervical fascia.
6.6. FloorFloor-- formed by several musclesformed by several muscles semispinalis capitis, apleniussemispinalis capitis, apleniuscapitis, levator scapulae, andcapitis, levator scapulae, andscalenius mediusscalenius medius
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Muscles of theMuscles of the
Posterior Triangle of the NeckPosterior Triangle of the Neck
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MuscleMuscle OriginOrigin InsertionInsertion ActionAction NerveNerve
PlatysmaPlatysma SuperficialSuperficial
fascia of thefascia of thedeltoid anddeltoid andpectoralpectoralregionsregions
InferiorInferior
border ofborder ofthethemandible,mandible,some fiberssome fiberssweepsweep
upward andupward andblend withblend withrisoriusrisorius
StretchesStretches
tight thetight theskin of theskin of theneck,neck,depressesdepressesthe mandiblethe mandible
Facial nerveFacial nerve
SpleniusSpleniuscapitiscapitis
Lower partLower partof theof theligamentumligamentumnuchae,nuchae,lowerlowercervicalcervicalspinesspines
MastoidMastoidprocess andprocess andthe superiorthe superiornuchal linenuchal line
Bilateral:Bilateral:
Extends theExtends the
headheadIndividual:Individual:
Flexes theFlexes theheadheadlaterallylaterally
CervicalCervicalspinalspinalnervesnerves
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MuscleMuscle OriginOrigin InsertionInsertion ActionAction NerveNerve
LevatorLevator
scapulaescapulae
TransverseTransverse
processes ofprocesses ofC1 to C4C1 to C4
SuperiorSuperior
portion ofportion ofthe vertebralthe vertebralborder ofborder ofthe scapulathe scapula
Elevates andElevates and
rotates therotates thescapulascapula
DorsalDorsal
scapularscapularnervesnerves
ScaleniusScaleniusposteriorposterior
TransverseTransverseprocesses ofprocesses ofC5 and C6C5 and C6
SuperiorSuperioraspect of theaspect of thesecond ribsecond rib
Flexes theFlexes theneckneck
APR of C5 toAPR of C5 toC8C8
ScaleniusScaleniusMediusMedius
TransverseTransverseprocesses ofprocesses ofC2 to C7C2 to C7
SuperiorSuperioraspect of theaspect of thefirst ribfirst rib
Flexes theFlexes theneckneck
APR of C3APR of C3and C4and C4
ScaleniusScaleniusanterioranterior TransverseTransverseprocesses ofprocesses ofC3 to C6C3 to C6
ScaleneScalenetubercle oftubercle ofthe first ribthe first rib
ParticipatesParticipatesin forcedin forcedinspirationinspirationby elevatingby elevatingthe ribs andthe ribs andsternumsternum
APR of C5 toAPR of C5 toC8C8
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Subdivisions of theSubdivisions of thePosterior TrianglePosterior Triangle
1.1. Occipital TriangleOccipital Triangle
2.2. Supraclavicular TriangleSupraclavicular Triangle
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1. Occipital Triangle1. Occipital Triangle
Boundaries:Boundaries:
1.1. AnteriorAnterior-- posterior border ofposterior border ofSCMSCM
2.2. PosteriorPosterior-- anterior border of theanterior border of theTrapezius M.Trapezius M.
3.3. SuperiorSuperior-- meeting between themeeting between thetrapezius and SCMtrapezius and SCM
4.4. InferiorInferior-- superior border of thesuperior border of theinferior belly ofinferior belly ofomohyoidomohyoid
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2. Supraclavicular or Subcalvian or2. Supraclavicular or Subcalvian orOmoclavicular TriangleOmoclavicular Triangle
Boundaries:Boundaries:
1.1. AnteriorAnterior-- posterior border ofposterior border ofSCMSCM
2.2. SuperiorSuperior-- inferior border of theinferior border of theinferior belly ofinferior belly ofomohyoidomohyoid
3.3. InferiorInferior-- superior border ofsuperior border ofthe intermediate 1/3 ofthe intermediate 1/3 ofthe claviclethe clavicle
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Contents of the Posterior TriangleContents of the Posterior Triangle
1.1. ArteriesArteries-- subclavian artery, transverse cervical artery, occipital artery andsubclavian artery, transverse cervical artery, occipital artery andsuprascapular artery.suprascapular artery.
2.2. VeinsVeins
-- external jugular vein, anterior jugular vein, transverse cervical vein,external jugular vein, anterior jugular vein, transverse cervical vein,suprascapular and subclavian veins.suprascapular and subclavian veins.
3.3. NervesNerves-- spinal accessory nerve, cutaneous and muscular branches of thespinal accessory nerve, cutaneous and muscular branches of thecervical plexus, ansa cervicalis and root, trunk and divisions of thecervical plexus, ansa cervicalis and root, trunk and divisions of thebrachial plelxus.brachial plelxus.
4.4. Lymph glandsLymph glands-- supraclavicular lymph glands, and the lateral superior deep cervicalsupraclavicular lymph glands, and the lateral superior deep cervicallymph glands.lymph glands.