muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf ·...

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Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous stems in the neck MUDr. Veronika Němcová CSc.

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Page 1: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous stems in the neck

MUDr. Veronika Němcová CSc.

Page 2: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

SCM

TROH

Mm.scaleniLS

SC

SH

TH

ST

Dig

StyloH

Hyoglossus

Muscles of the neck

Page 3: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Neck muscles -innervation• MUSCLES • from the 1-st branchial arch V/3 – m.mylohyoideus,

m.digastricus v.a.• from the 2-nd branchial arch VII – m.stylohyoideus,

m.digastricus, m. platysma• in the superficial fascia XI - m.sternocleidomastoideus,

m.trapezius• infrahyoid ansa cervicalis profunda (C1-C3) –

m.sternohyoideus, m.sternothyroideus, m.thyrohyoideus, m.omohyoideus

• deep cervical muscles anterior branches of cervical nerves– m.scaleni, m.longus colli, m.longus capitis, m.rectus capitis ant.+lat.

Page 4: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Neck muscles layers

• 1-m.platysma• 2-m.sternocleidomastoideus,

m.trapezius• 3-mm.suprahyoidei +

mm.infrahyoidei• 4-mm.scaleni, m.longus capitis,

m.longus colli, m.rectus capitis ant., m.obliquus capitis ant.

Page 5: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

F

F.colli superficialis

F.colli media(pretrachealis)

F.colli profunda(prevertebralis)

Neck fascias

Spatium retroviscerale

Spatium suprasternale

Spatium pretracheale

Vagina carotica

Spatium paraviscerale

Page 6: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Suprahyoid and infrahyoid muscles

Page 7: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Suprahyoid and infrahyoid muscles

Page 8: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Mylohyoid and geniohyoid

Page 9: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Styloid septum muscles

posterior belly of digastricus

stylohyoid

styloglossusstylopharyngeus

prestyloid space – external carotid arteryretrostyloid space – internal carotid artery

Page 10: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

SPh

SG

S-H

DiSCM

Styloid septum muscles

crossection

Page 11: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Submandibular triangle

mandible

Digastricus - posterior belly

SH

hyoid boneDigastricus - anterior belly

Page 12: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

mylohyoid

hyoglossus

Submandibular triangle

Page 13: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

M.mylohyoideus

Gl.submandibularisA.facialis

V.facialis

A.submentalis

r.mylohyoideus

Submandibular trianglesuperficial layer

Page 14: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

TS

LF

CI CE

JI

Lingual nerve and submandibular ganglion

Submandibular duct

Arcus n.XII

Submandibular triangledeep layer

Page 15: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Lingual artery in the Beclard´s angle

Trigonum Pirogovi

Page 16: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Beclard´s angle and trig.Pirogov´s trigon

A.lingualis

Page 17: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Trigonum submandibularesuperficial layer

Nodi lymfatici cervicales profundi

Page 18: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Trigonum submandibularedeep layerrepetition

Page 19: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Regio colli anterior - muscles

Platysma

Page 20: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Internal jugular vein and omohyoid

Page 21: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Regio colli anteriorsuperficial and pretracheal fascia removed

Page 22: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Infrahyoid muscles

Page 23: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Infrahyoid and deep neck muscles

Page 24: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Deep neck muscles

Page 25: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Scalene muscles

Page 26: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Neck-deep layer

Page 27: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Anterior neck region

Page 28: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Anterior neck region – infrahyoids removed

Page 29: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Anterior neck region – infrahyoids removed

Arcus venosus juguli

v.thyroidea inferior

Ansa cervicalis

Page 30: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Head and neck regions

Trig. caroticum

Trig.submandibulare

Trig.submentale

Trigonum omoclaviculare

Trig.omotrapeziumP A

Page 31: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Head and neck region carotid triangle

Page 32: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous
Page 33: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

SCM

OH

DGvp

Trigonum caroticumborders

Page 34: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Trigonum caroticumcontent

C3-4 common carotid

External carotid artery branches:3 anterior2 -3 posterior1 medial2 terminal

internal external

Page 35: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Trigonum caroticumcontent

C3-4

A.facialis

A.lingualis (Beclard´s angle)

A.thyroidea sup.

N.XII (arcus n.hypoglossi

N.laryngeus sup(z n.vagus)

V.jugularis interna

Radix superior ansae cervicalis

A.occipitalis

A.auricularis post

External carotid artery branches:3 anterior2 -3 posterior1 medial2 terminal

Page 36: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

TS

LF

IJ IC

SPh

Dig

R.SCM

Tongue muscles

Infrahyoids

Vascular and nervous bundle of the neck

Schema of the neck muscles and vesselsarrangement

Page 37: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Platysma

Punctum nervosum(Cervical plexus – general sensory branches)

Lateral neck region

Page 38: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

V.jugularis externa

Nn.supraclaviculares

N.transversus colli

N.auricularis magnus

N.occipitalis minor

Sternocleidomastoid region –fascia colli superficialis removed

Page 39: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Plexus brachialis

Omoclavicular and omotrapezoid triangle

in the scalene fissure !

Page 40: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Krk zboku hluboká vrstvaLateral neck regiondeep layer

Truncus sympaticus(f.colli profunda)

N.vagus(vagina carotica)

N.frenicus(m.scalenus ant.)

3 vertically running nerves !!!

Page 41: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

A.vertebralis

Tr.thyreocervicalis

A.subclavia

A.transversa colli

Plexus brachialis

Page 42: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Superior thoracis aperture

vv. brachicephalicae

VCS

Plexus brachialis

a. subclavia

v. subclavia

N.frenicus

n.vagus

Tr.sympaticus

Ductus thoracicus

Page 43: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Superior thoracis aperturerepetition

Page 44: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Superior mediastinumcrossection

Page 45: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Neck crossection repetition

Page 46: Muscles and osteofascial compartments of the neck ...anat.lf1.cuni.cz/souhrny/azubz_08.pdf · Muscles and osteofascial compartments of the neck, innervation. Vascular and nervous

Sources• Petrovický et al., Anatomie I• Grim, Základy anatomie• Čihák, Anatomie I• Sobotta, Atlas anatomie člověka• Bertolini/Leutert, Atlas der Anatomie des

Menschen• Netter, Atlas • Grayś Anatomy