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WINDSOR UNIVERSITY SCHOOL OF MEDICINE

DEPARTMENT OF ANATOMY. Dr. SREEKANTH THOTA. Neck. WINDSOR UNIVERSITY SCHOOL OF MEDICINE. Neck. The neck is a tube providing continuity from the head to the trunk.

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WINDSOR UNIVERSITY SCHOOL OF MEDICINE

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  1. DEPARTMENT OF ANATOMY Dr. SREEKANTH THOTA Neck WINDSOR UNIVERSITYSCHOOL OF MEDICINE

  2. Neck • The neck is a tube providing continuity from the head to the trunk. • It extends anteriorly from the lower border of the mandible to the upper surface of the manubrium of sternum, and posteriorly from the superior nuchal line on the occipital bone of the skull to the intervertebral disc between the CVII and TI vertebrae.

  3. Objectives • 1. To study Compartments of the neck. • 2. Fascia and Fascial spaces of the neck • 3. Anterior triangle of the neck • 4. Posterior triangle of the neck • 5. Bones of the Neck • 6. Vasculatur of the neck • 7. Nerves of the neck. • 8. Lymphatics of the neck

  4. Compartments of the neck • Within the tube four compartments provide longitudinal organization • 1. visceral compartment is anterior and contains parts of the digestive and respiratory systems, and several endocrine glands • 2. vertebral compartment is posterior and contains the cervical vertebrae, spinal cord, cervical nerves, and muscles associated with the vertebral column • 3. Two vascular compartments are lateral and contain the major blood vessels and the vagus nerve [X].

  5. Fascia • Superficial fascia: contains a thin sheet of muscle (the platysma) • Deep cervical fascia: organized into several distinct layers • 1. Investing layer • 2. Prevertebral layer • 3. Pretracheal layer • 4. Carotid sheath

  6. Fascial spaces • Between the fascial layers in the neck are spaces that may provide a conduit for the spread of infections from the neck to the mediastinum. • 1. Pretracheal space: passes between the neck and the anterior part of the superior mediastinum • 2. Retropharyngeal space : extends from the base of the skull to the upper part of the posterior mediastinum

  7. Triangles of the neck • For descriptive purposes the neck is divided into anterior and posterior triangles • 1.The anterior triangle of the neck is outlined by the anterior border of the sternocleidomastoid muscle laterally, the inferior border of the mandible superiorly, and the midline of the neck medially. • 2. boundaries of the posterior triangleare the posterior border of the sternocleidomastoid muscle, the anterior border of the trapezius muscle, and the middle one-third of the clavicle

  8. Submental Triangle Submandibular Triangle Anterior Triangle Carotid Triangle Posterior Triangle • Anterior Triangle subdivided into smaller triangles by • Digastric muscle • Omohyoid muscle

  9. Anterior triangle of the neck • Subdivided into four smaller triangles • 1. Submandibular triangle: outlined by the inferior border of the mandible superiorly and the anterior and posterior bellies of the digastric muscle inferiorly • 2. Submental triangle: outlined by the hyoid bone inferiorly, the anterior belly of the digastric muscle laterally, and the midline

  10. 3.Muscular triangle: outlined by the hyoid bone superiorly, the superior belly of the omohyoid muscle, and the anterior border of the sternocleidomastoid muscle laterally, and the midline • 4.Carotid triangleis outlined by the superior belly of the omohyoid muscle anteroinferiorly, the stylohyoid muscle and posterior belly of the digastric superiorly, and the anterior border of the sternocleidomastoid muscle posteriorly.

  11. Contents of ant triangle

  12. Posterior triangle of the neck

  13. Bones of the Neck • The skeleton of the neck is formed by the cervical vertebrae and hyoid bone

  14. Cervical Vertebrae • Seven cervical vertebrae form the cervical region of the vertebral column, which encloses the spinal cord and meninges.

  15. C1 vertebrae or atlas • Ring-like, kidney-shaped bone lacking a spinous process or body and consisting of two lateral masses connected by anterior and posterior arches. • Its concave superior articular facets receive the occipital condyles.

  16. C2 vertebrae or axis • Peg-like dens (odontoid process) projects superiorly from its body

  17. Four typical cervical vertebrae (3rd to 6th) • Spinous processes are short and bifid. • Transverse processes of all cervical vertebrae (typical or atypical) include transverse foramina for the vertebral vessel(except for C7, the vertebral artery).

  18. C7 vertebra or vertebra prominens • So-named because of its long spinous process, which is not bifid. • Its transverse processes are large, but its transverse foramina are small.

  19. HYOID BONE • Anterior neck C3 • Suspended from the styloid process of the temporal bone by the stylohyoid ligament • Serves as an attachment for suprahyoid and infrahyoid muscles and the investing deep fascia • It serves as a prop to keep the airway open

  20. Important Muscles of Neck

  21. Superficial Muscles of the Neck • 1. Sternocleidomastoid Muscle • Origin:Sternal head: anterior surface of manubrium of sternumClavicular head: superior surface of medial third of clavicle • Insertion :Lateral surface of mastoid process of temporal bone and lateral half of superior nuchal line • N. supply:Spinal accessory nerve (CN XI, motor) • Action:Two muscles acting together extend head and flex neck; one muscle rotates head to opposite side

  22. Congenital Torticollis • Torticollis is a contraction of the cervical muscles that produces twisting of the neck and slanting of the head. • The lesion, like a normal unilateral SCM contraction, causes the head to tilt toward, and the face to turn away from, the affected side

  23. Spasmodic Torticollis • Cervical dystonia commonly known as spasmodic torticollis, usually begins in adulthood. • Characteristics of this disorder are sustained turning, tilting, flexing, or extending of the neck .

  24. Muscles • The muscles in the anterior triangle of the neck can be grouped according to their location relative to the hyoid bone: • 1. Muscles superior to the hyoid are classified as suprahyoid muscles. • 2. Muscles inferior to the hyoid are infrahyoid muscles.

  25. Suprahyoid muscles • Digastric (post belly by facial nerve, ant belly by n. to mylohyoid from V3) • Stylohyoid • Styloid process to hyoid bone(facial) • Geniohyoid • Inferior mental spine (on back of symphysismenti) to hyoid bone( c1 via hypoglossal) • Mylohyoid • Mandible to hyoid bone(n. to mylohyoid from V3 also ant. belly of digastric)

  26. Infrahyoid Muscles Strap muscles • Sternothyroid • Sternum to thyroid cartilage • Sternohyoid • Sternum to hyoid bone • Thyrohyoid • Thyroid cartilage to hyoid bone (hypoglossal) • Omohyoid • Superior border of scapula to hyoid bone

  27. Action of Supra & Infrahyoid Muscles

  28. Scalene Muscles • Anterior, middle, and posterior scalene muscles • Attach to transverse processes of cervical vertebrae and to rib 1 and 2 • Action • Elevation of rib I and II

  29. Subclavian artery Common carotid artery ICA ECA Arteries of the Neck

  30. Subclavian • Arises from • Right side- brachiocephalic trunk • Left side- arch of aorta • Arches laterally over cervical pleura and apex of lung and grooves on 1strib between anterior and middle scalene muscles • Divided into three parts in relation to anterior scalene muscle • Becomes axillary artery at lateral border of 1st rib

  31. First part of Subclavian artery • The first part extends from the origin of the artery to the anterior scalene muscle. • 1. Vertebral artery • 2. Thyrocervical trunk • 3. Internal thoracic artery • Thyrocervical trunk • Inferior thyroid artery • Transverse cervical artery • Suprascapular artery

  32. Second part of the subclavian artery. • Costocervical trunk • 1. Deep cervical artery • 2. Supreme intercostal artery

  33. Arises from Brachiocephalic trunk on right Arch of aorta on left Divides into internal & external carotid arteries At superior border of thyroid cartilage (C4) Common carotid artery

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