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Flashcards in Neck anatomy Deck (39):

Superior boundary of the neck

Pericraniocervical line Inferior mandible and base of the skull


Inferior boundary of the neck

Manubrium, clavicle and acromion to C7 spinous process


Suprahyoid muscles




All elevate the hyoid bone


Infrahyoid muscles

Scalene muscles (anterior, middle, posterior)

Depress the hyoid bone, supplied by ansa cervicalis (C1-C3)


Label the muscles of the anterior neck


Posterior muscles of the neck

Levator scapulae - elevates shoulders (dorsal scapula nerve, C3 and C4)

Splenius capitis, semispinalis capitis - flex and extend the neck and head (posterior rami of spinal nerves)

Suboccipital muscles: extend the head on C1, rotate the head on C2 (C1 posterior ramus)

Ligamentum nuchae - strong median ligament of the neck.


Compartments of the neck



Four comparments enclosed by an outer musculofascial collar (investing fascia)

1. Vertebral compartment (cervical vertebrae and postural muscles). Covered by prevertebral fasia

2. Visceral compartment (glands - thyroid, parathyroid, thymus). Covered by pretracheal fascia

3. Vascular compartment x 2(carotid vessels and vagus nerve). Covered by carotid sheaths


Borders of the anterior triangle of the neck

Medial: midline

Lateral: sternocleidomastoid

Superior: inferior margin of mandible


Borders of the posterior triangle

Medial: sternocleidomastoid

Lateral: trapezius

Base: clavicle


Apex: mastoid process


Subdivisions of the anterior triangle


Contents of the carotid triangle

Carotid, thyroid, facial & lingual arteries

Internal jugular & facial veins


Superior laryngeal nerve

Thyroid gland


Which landmarks would you use to locate the common carotid pulse?

Common carotid artery lies in a groove between the trachea and infrahyoid muscles.

Palpated deep to anterior border of sternocleidomastoid at the level of the thyoid cartilage


Contents of the submandibular triangle

Submandibular lymph nodes

Submandibular salivary gland

Hypoglossal nerve

Lingual artery

Facial artery & vein

Marginal mandibular branch of CN VII


Contents of submental triangle

Submental lymph nodes

Anterior jugular vein tributaries


Subdivisions of the posterior triangle

Divided by omohyoid muscles into occipital triangle and supraclavicular triangle


Fascia of the neck

Superficial fascia of the neck contains a thin sheet of muscle (platysma) which begins in the thorax and runs upwards to the mandible


Deep fascia is organised into layers.
Investing layer - completely surrounds the neck

Prevertebral layer - surrounds vertebral column and muscles (prevertebral, scalene muscles, depe muscles of the back)

Pretracheal layer - surround the trachea, oesophagus and thyroid. hyoid bone to upper thoracic cavity

Carotid sheath - surround common carotid, internal carotid, internal jugular vein, vagus nerve. Sympathetic chain lies posterior to sheath


Fascial spaces in the neck

Prevertebral space - between investing layer of the cervical fascia and pretracheal fascia. Passes between the neck and anterior part of the superior mediastinum

Retropharyngeal space - between the buccopharyngeal fascia (part of pretracheal) and prevertebral fascia. Extends from the base of the skill to upper part of the posterior mediastinum.



Retropharyngeal space

Between buccopharyngeal fascia (pretracheal) and prevertebral fascia. Extends from the base of the skull to posterior mediastinum.

Alar fascia crosses the retropharyngeal space.

Consists of loose connective tissue. Permits movement of the pharynx oesophagus and larynx during swallowing.

Major pathway for the spread of infection


Spread of infection in the neck

Investing layer of deep cervical fascia helps prevent the spread of absesses.

If an infection occurs between the investing layer and pretracheal fascia the infection does not spread beyond the manubrium.

If infection occurs between the investing fascia and the visceral part of the pretracheal fascia it can spread into the thoracic cavity anterior to the pericardium.


Buccopharyngeal fascia

Posterior part of the pretracheal fascia. Separates the pharynx and the oesophagus from the prevertebral layer.

Begins at the base of the skull and ends in the thoracic cavity.


Axillary sheath

Prevertebral fascia of the neck that extends from the anterior and middle scalene muscles to surrounds the brachial plexus and subclavian artery as they pass into the axilla.

~ In axilla, axillary sheath contains 1st part of axillary artery, axillary vein and cords of the brachial plexus.


N.B. Infection in the vertebral compartment can spread to the upper limb via the axillary sheath

Plexus block via injection is done via the axillary sheath.


Central lines

Lesser supraclavicular fossa used to access internal jugular vein - space between the origin of the two heads of sternocleidomastoid


Contents of the supraclavicular/omoclavicular triangle

Subclavian artery and vein

Supraclavicular nodes

Suprascapular nerve



Points where brachial plexus can be anaesthatised

Supraclavicular triangle

Axillary sheath

Interscalene (anterior and middle)



Floor of posterior triangle

Formed by prevertebral facia overlying muscles of the neck

Splenius capitus

Levator scapulae


Inferior belly of omohyoid


Nerves in the posterior triangle

Phrenic nerve

Brachial plexus

Acessory nerve

Doral scapular nerve

Long thoracic nerve


Superficial drainage of the neck

External jugular veins and anterior jugular veins

Exernal jugular vein is formed by post auricular and retromandibular vein. Runs from the angle of the mandible diagonally across sternocleidomastoid to the lateral point where it meets the clavicle. It then pierves the investing and enters the subclavian vein.

Anterior jugular veins are paired venous channels that drain the anterior aspect of the neck. They begin as small veins descend on either side of the midline. Each anterior vein pierces the investing facia to enter the subclavian vein. Connected by a jugular venous arch at the suprasternal notch.



Lymph nodes in the head and neck

Submental - lower lip, tip of tongue

Submandibular - lip, lateral body of tongue, nose, face

Parotid (preauricular): temporal scalp and eye

Mastoid: external acoustic meatus and pinna

Occipital: occipital scalp to vertex

Superficial cervical: runs with external jugular vein

Jugulo-digastric: tonsil, pharynx, posterior tongue

Deep cervical chain: superficial node groups
Jugulo-omohyoid: superficial node groups, central tongue

Supraclavicular: surround thoracic duct,


Describe the origin and course of the carotid arteries

Common carotid: Right common carotid - originates from the brachicephalic trunk. Left common carotid - direct branch of the arch of the aorta that pases into the neck. Both pass superiorly into the neck at the sternoclavicular joint and ascend lateral to the trachea and oesophagus within the carotid sheath. Divide into the external and internal carotid arteries at the thyroid cartilage (C3/C4 vert.)

Internal carotid arteries: ascend towards the base of the skill and enters the cranial cavity through the carotid canal. Supplies cerebral hemispheres, eyes and forehead

External carotid arteries give off branches immediately after the bifurcation to supply the neck and face.




Describe the distribution of the branches of external carotid arteries

External carotid arteries give off branches immediately after the bifurcation of the common carotid arteries

1. superior thyroid - supplies thyroid gland, larynx, muscles (TH, SCM)

2. ascending pharyngeal artery - pharyngeal constrictors, palate, tonsil, pharyngotypmanic tube

3. lingual artery - musles of the tongue, palatine tonsil, soft palate, floor of the mouth, sublingual gland

4. facial artery - structures of the face

5. occiputal artery - SCM, deep muscles of the back, scalp

6. posterior auricular artery - parotid and surrounding muscles, exernal and inner ear

7. superficial temporal artery - parotid, masseteer, temoporalis, external ear

8. maxillary artery - EAM, middle ear, mandible and maxilla (skin, gums, teeth), nasal cavity



Support and elevation of the flood of the mouth

Elevation of hyoid




Lowers mandible to open mouth, raises hyoid bone and pulls is back

Anterior belly: CN V3
Posterior belly: CN VII



Depresses and flexes hyoid bone 

Ansa cervicalis (Anterior rami C1-)



Pulls hyoid bone posterosuperiorly




Depresses hyoid bone after swallowing

Ansa cervicalis (C1-C3)



Draws larynx/thyroid cartilage downwards

Ansa cervicalis


Scalene muscles

Anterior, middle elevate rib 1

posterior elevates rib 2


Anterior rami C3-C7



Depresses hyoid bone, raises larynx when hyoid is fixed



What key structures present at the bifurcation of the common carotid?

Carotid sinus contained in the dilation of the common carotid at point of bifurcation. Contains receptors that monitor changes in bp. Innervated by glossopharyngeal nerve (CNIX)

Carotid body detect changes in pO2 and pCO2. Innervated by branches of CNIX and CNX

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