the neck - imulimul.pl/system/files/neck part i rev.pdfthroat. this results in ... innervates most...

THENECKPARTI

BONESANDJOINTSOFTHENECKMUSCLESOFTHENECK–SCM

CAROTIDTRIANGLEENDOCRINELAYEROFTHECERVICALVISCERA

Theneckhasfourmajorcompartments,whichareenclosedbyanoutermusculofascialcollar:•  Thevertebralcompartmentcontainsthecervicalvertebraeand

associatedposturalmuscles.•  Thevisceralcompartmentcontainsimportantglands(thyroid,

parathyroid,andthymus),andpartsoftherespiratoryanddigesRvetractsthatpassbetweentheheadandthorax.

•  Thetwovascularcompartments,oneoneachside,containthemajorbloodvesselsandthevagusnerve.

THENECKTHENECK

TheanteriorporRonoftheneckcontainsthemajorvisceralstructuresbetweentheheadandthethorax:•  pharynx•  larynx•  trachea•  esophagus•  thyroidandparathyroidglands

THENECKTHENECK

Theskeletonoftheneckisformedby:•  thecervicalvertebrae,•  hyoidbone,•  manubriumofthesternum,•  clavicles

THENECKTHENECK–THECERVICALVERTEBRAE

Thesevencervicalvertebraehavetransverseforamina(forthevertebralarteriestopassthrough)withintheir

transverseprocesses

THECERVICALVERTEBRAETHENECK–THECERVICALVERTEBRAE

VERTEBRALARTERIESThesevesselsentertheforamentransversarium

ofthe6thcervicalvertebra,emergingabovethe1st

cervicalvertebratoenterthesuboccipitaltriangle

ThemostdisRncRvefeatureofeachcervicalvertebraistheovalforamentransversarium(transverseforamen)inthe

transverseprocess.

Thereare7cervicalvertebrae:•  the4typicalcervicalvertebraeC3–C6•  the3atypicalcervicalvertebrae(C1,C2,andC7)

THENECK–THECERVICALVERTEBRAE

THECERVICALVERTEBRAE

ThefourtypicalcervicalvertebraeC3–C6havethefollowingcharacterisRcs:•  Thevertebralbodyissmallandlongerfromsidetosidethan

anteroposteriorly;thesuperiorsurfaceisconcave,andtheinferiorsurfaceisconvex.

•  Thevertebralforamenislargeandtriangular.•  Thetransverseprocessesofallcervicalvertebrae(typicalor

atypical)includeforaminatransversariaforthevertebralvessels(thevertebralveinsand,exceptforvertebraC7,thevertebralarteries).

•  Theirspinousprocessesareshortandbifid.

Thevertebralarteriesandtheiraccompanyingveinspassthroughthetransverseforamina,exceptthoseinC7,whichtransmitonlysmallaccessoryveins.



Thefirst(C1,atlas),second(C2,axis)andseventh(C7,vertebraprominens)cervicalvertebraeareatypical.VertebraeC3–C6arethetypicalcervicalvertebrae.

Therearethreeatypicalcervicalvertebrae(C1,C2,andC7):•  TheC1vertebraoratlas:aring-like,kidney-shapedbonelackinga

spinousprocessorbodyandconsisRngoftwolateralmassesconnectedbyanteriorandposteriorarches.ItsconcavesuperiorarRcularfacetsreceivetheoccipitalcondyles.

•  TheC2vertebraoraxis:apeg-likedens(odontoidprocess)projectssuperiorlyfromitsbody.

•  Thevertebraprominens(C7):so-namedbecauseofitslongspinousprocess,whichisnotbifid.Itstransverseprocessesarelarge,butitsforaminatransversariaaresmall.



ThehyoidisuniqueamongbonesforitsisolaPonfromtheremainderoftheskeleton.

THENECK–THEHYOIDBONE

THEHYOIDBONE

Itissuspendedfromthestyloidprocessesofthetemporalbonesbythestylohyoidligaments

andisfirmlyboundtothethyroidcarPlage.

FuncRonally,thehyoidservesasana_achment

foranteriorneckmusclesandaproptokeeptheairwayopen.

ThehyoidliesintheanteriorpartoftheneckattheleveloftheC3

vertebra.

ThebodyofthehyoidEachendofitsbodyisunitedtoagreaterhornthatprojectsposterosuperiorlyandlaterallyfromthebody.EachlesserhornisasmallbonyprojecRon.


THEHYOIDBONEC3-levelofbodyofhyoid

FRACTUREOFHYOIDBONEItoccursinpeoplewhoaremanuallystrangledbycompressionofthethroat.ThisresultsindepressionofthebodyofthehyoidontothethyroidcarPlage.InabilitytoelevatethehyoidandmoveitanteriorlybeneaththetonguemakesswallowingandmaintenanceoftheseparaRonofthealimentaryandrespiratorytractsdifficultandmayresultinaspiraPonpneumonia.

Thehyoidboneissuspendedfromthestyloidprocessesbythestylohyoidligamentsandgivesa_achmentto•  thesuprahyoidmusclesand•  theinfrahyoidmuscles.


THEHYOIDBONE

Thesuprahyoidmusclesraisethehyoidbonetowardastabilizedmandibleduringswallowing.

Thesuprahyoidregioncontains4muscles:•  Mylohyoid(V3)•  Digastric(V3+VII)•  Stylohyoid(VII)•  Geniohyoid(C1-C2)

TheinfrahyoidmusclesdepressthehyoidboneandlarynxduringswallowingandvocalizaRon.


THEHYOIDBONE

Theinfrahyoidregioncontains4musclescommonlycalledstrapmuscles:•  Omohyoid•  Sternohyoid•  Sternothyroid•  Thyrohyoid

INNERVATION:cervical

plexus(C1–C3)

Theinfrahyoidmusclesareorganizedsothat:•  sternohyoidandomohyoidliesuperficiallyand•  sternothyroidandthyrohyoidliemoredeeply


THESUPRAHYOIDANDINFRAHYOIDREGIONSThesuprahyoidregioncontains4muscles:•  Mylohyoid(V3)•  Digastric(V3+VII)•  Stylohyoid(VII)•  Geniohyoid(C1viahypoglossalnerve(CNXII))Theinfrahyoidregioncontains4musclescommonlycalledstrapmuscles:•  Omohyoid•  Sternohyoid•  Sternothyroid•  Thyrohyoid

cervicalplexus(C1–C3)

Digastric Anteriorbelly:mylohyoidnerve,V3 Posteriorbelly:facialnerve,CNVII

Mylohyoid Mylohyoidnerve,V3 Stylohyoid Facialnerve,CNVII


THEHYOIDMUSCLES

Thecervicalplexus,composedoftheventralramiofC1-C4,innervatesmostoftheneckmusclesandprovidessensory

innervaRontotheanteriorandlateralneck

THENECK–THECERVICALPLEXUS

THECERVICALPLEXUSThecervicalplexus,composedoftheventralramiofC1-C4,innervatesmostoftheneckmusclesandprovidessensory

innervaRontotheanteriorandlateralneck.

The(spinal)accessorynerve(CNXI)exitsthejugularforamenandcrossestheposteriortriangle,

innervaRngtheSCMandtrapeziusmuscles

THENECK–THECERVICALPLEXUS

THECERVICALPLEXUSAddiRonalinnervaRonincludes:•  Themylohyoidnerve(CNV3)innervatesthemylohyoidmuscle

andanteriorbellyofthedigastricmusclebeneaththechin.•  Thefacialnerve(CNVII)innervatestheplatysmamusclethrough

itscervicalbranchandposteriorbellyofthedigastricmuscle.•  Theglossopharyngealnerve(CNIX)suppliesthecaroRdbodyand

sinus(visceralsensory).•  Thevagusnerve(CNX)suppliesthelarynxthroughitssuperior

andrecurrent(inferior)laryngealnerves.•  Thehypoglossalnerve(CNXII)loopsthroughtheneckto

innervatethetongue.

ThefasciaoftheneckismulRlayeredandenclosesthemuscles,glands,andneurovascularstructures.

TherelaRonshipsbetweenthedifferentfasciallayersdeterminehowinfecPonandcancerspreadintheneck.

THENECK–THEFACIAOFTHENECK

THEFACIAOFTHENECK

FACIAOFTHENECK•  THECERVICALSUBCUTANEOUSTISSUE•  THEPLATYSMA

•  THEDEEPCERVICALFASCIA•  THEINVESTINGLAYEROFDEEPCERVICALFASCIA•  THEPRETRACHEALLAYEROFDEEPCERVICALFASCIA•  THEPREVERTEBRALLAYEROFDEEPCERVICALFASCIA

TheneckissurroundedbythecervicalsubcutaneousPssue/thesuperficialcervicalfascia

thatliesdeeptotheskinandinveststheplatysmamuscle.


THECERVICALSUBCUTANEOUSTISSUE

ThecervicalsubcutaneousPssue/thesuperficialcervicalfascialiesbetweenthedermisoftheskinandtheinvesRnglayerofdeep

cervicalfascia

Itcontainscutaneousnerves,bloodandlymphaRcvessels,superficiallymphnodes,andvariableamountsoffat.

Anterolaterally,itcontainstheplatysma.

Theplatysmacoverstheanterolateralaspectoftheneck.Itderivedfrommesenchymeinthe2ndpharyngealarchoftheembryo,issuppliedbycervicalbranchofthefacialnerve,CNVII

Thedeepcervicalfasciaconsistsofthreefasciallayers(sheaths):•  invesPng,whichsurroundsallstructuresintheneck•  pretracheal,whichenclosesthevisceraoftheneck•  prevertebral,whichsurroundsthevertebralcolumnandthedeep

musclesassociatedwiththeback


THEDEEPCERVICALFACIA

Thedeepcervicalfasciasubdividestheneckinto•  vascular(caroPdsheath)•  vertebral•  visceralcompartments

Thisarrangementallowsmovementbetweenadjacentstructuresandcompartmentsandfacilitatesthesurgicalapproachtospecificareas.Theylimitthespreadofabscesses(collecRonsofpus)resulRngfrom

infecRons.

Themostsuperficialdeepfasciallayer.CompletelysurroundstheenRreneckdeeptotheskinandsubcutaneousRssue.


THEINVESTINGLAYEROFTHEDEEPCERVICALFACIA

TheinvesPnglayerofcervicalfasciaencirclesallstructuresoftheneckbyinvesRngthesternocleidomastoidandtrapeziusmuscles,thefascialroofsoftheanteriorandposteriorcervicaltriangles,andtheparoRdandsubmandibularsalivaryglands.

•  splitsagaintosurroundthesternocleidomastoidmuscle,


THEINVESTINGLAYEROFTHEDEEPCERVICALFACIA•  A_achingposteriorlytotheligamentumnuchae

andthespinousprocessoftheCVIIvertebra,•  thisfasciallayersplitsasitpassesforwardtoenclosethetrapezius

muscle,•  reunitesintoasinglelayerasitformstheroofoftheposterior

triangle,

•  andreunitesagaintojoinitstwinfromtheotherside.

Superiorly,theinvesRng(orsuperficial)layerofdeepcervicalfasciaa_achestothe:•  Superiornuchallinesoftheoccipitalbone•  Mastoidprocessesofthetemporalbones•  ZygomaRcarches•  Inferiorborderofthemandible•  Hyoidbone•  Spinousprocessesofthecervicalvertebrae


THEINVESTINGLAYEROFTHEDEEPCERVICALFACIA

Justinferiortoitsa_achmenttothemandible,thefasciasplitstoenclosethesubmandibulargland;Posteriortothemandible,itsplitstoformthefibrouscapsuleoftheparoRdgland.

Inferiorly,theinvesRnglayerofdeepcervicalfasciaa_achestothemanubrium,clavicles,andacromionsandspinesofthescapula.

Itislimitedtotheanteriorpartoftheneck.Itextendsinferiorlyfromthehyoidintothethorax,whereitblendswiththefibrouspericardiumcoveringtheheart.


THEPRETRACHEALLAYEROFDEEPCERVICALFASCIA

Thepretracheallayeroffasciaincludesathinmuscularpart,whichenclosestheinfrahyoidmuscles,andavisceralpart,whichenclosesthethyroidgland,trachea,andesophagus

ItisconRnuousposteriorlyandsuperiorlywiththebuccopharyngealfasciaofthepharynx.

Thebuccopharyngealfasciaextendsfromthebaseoftheskullandenvelopsthebuccinatormuscleandpharyngealconstrictors


•  THEDEEPCERVICALFASCIA•  THEINVESTINGLAYEROFDEEPCERVICALFASCIA•  THEPRETRACHEALLAYEROFDEEPCERVICALFASCIA•  THEPREVERTEBRALLAYEROFDEEPCERVICAL

FASCIA

Theprevertebrallayerofdeepcervicalfasciaformsatubularsheathforthevertebralcolumnandthemusclesassociatedwithit.


THEPREVERTEBRALLAYEROFDEEPCERVICALFASCIA

Theprevertebrallayerofdeepfasciaisfixedtothecranialbasesuperiorly.

Inferiorly,itblendswiththeendothoracicfasciaperipherally

TheprevertebralfasciainananterolateralposiRonextendsfromtheanteriorandmiddlescalenemusclestosurroundthebrachialplexusandsubclavianarteryasthesestructurespassintotheaxilla.Thisfascialextensionistheaxillarysheath

ThecaroPdsheathisacolumnoffasciathatsurroundsthecommoncaroRdartery,theinternalcaroRdartery,theinternaljugularvein,andthevagusnerveasthesestructurespassthroughtheneck

ThecaroPdsheathcontainsthe:•  CommonandinternalcaroRdarteries•  Internaljugularvein•  Vagusnerve(CNX)•  Somedeepcervicallymphnodes•  CaroRdsinusnerve•  SympatheRcnervefibers(caroRdperiarterialplexuses)


THEPREVERTEBRALLAYEROFDEEPCERVICALFASCIA

Theretropharyngealspaceisthelargestandmostimportantinterfascialspaceintheneck.

TheretropharyngealspaceisapotenPalspacethatconsistsoflooseconnecRveRssuebetweenthevisceralpartoftheprevertebrallayerofdeepcervicalfasciaandthebuccopharyngealfasciasurroundingthepharynxsuperficially.

SUPERFICIALSTRUCTURESOFTHENECK•  CERVICALREGIONS/TRIANGLESANDCONTENTS•  CUTANEOUSANDSUPERFICIALMUSCLESOFNECK•  ARTERIESINCERVICALREGION•  VEINSINCERVICALREGION•  NERVESINCERVICALREGION•  LYMPHNODESINCERVICALREGION

Theneckisdividedintofourmajorregionsbasedontheusuallyvisibleand/orpalpablebordersofthelargeandrelaRvelysuperficialSCMandtrapeziusmuscles:•  Sternocleidomastoidregion•  Posteriorcervicalregion•  Lateralcervicalregion(posteriortriangle)•  Anteriorcervicalregion(anteriortriangle)

THENECK–THECERVICALREGIONS

THECERVICALTRIANGLES

Theneckisdividedinto:•  Sternocleidomastoidregion•  Posteriorcervicalregion•  Lateralcervicalregion(posteriortriangle)•  Anteriorcervicalregion(anteriortriangle)

Theneckisdividedinto:•  Sternocleidomastoidregion•  Posteriorcervicalregion•  Lateralcervicalregion(posteriortriangle)•  Anteriorcervicalregion(anteriortriangle)


THECERVICALTRIANGLES


THESTERNOCLEIDOMASTOIDREGIONTheSCMvisiblydivideseachsideoftheneckintotheanteriorandlateralcervicalregions(anteriorandposteriortriangles).

MAINCONTENT:•  sternocleidomastoidmuscle•  superiorpartofexternaljugularvein•  greaterauricularnerve•  transversecervicalnerve

Thetwoheads(clavicleandsternal)oftheSCMareseparatedinferiorlybyaspace,visiblesuperficiallyasasmalltriangular

depression,thelessersupraclavicularfossa.


THESTERNOCLEIDOMASTOIDREGION

•  inferiorpartofinternaljugularveinMAINCONTENTOFTHELESSERSUPRACLAVICULARFOSSA

Thesuperiora_achmentoftheSCMisthemastoidprocessofthetemporalboneandthesuperiornuchallineoftheoccipitalbone.

INNERVATIONOFtheSCMs:•  Spinalaccessorynerve(CNXI,motor)•  C2andC3nerves(painandpropriocepRon)


THESTERNOCLEIDOMASTOIDREGIONAcRngbilaterally,theSCMscanflextheneck.

AcRngunilaterally,theSCMlaterallyflexestheneck(bendsthenecksideways)androtatestheheadsotheearapproachestheshoulderoftheipsilateral(same)sidewhilerotaRngtheheadsothatthechinisturnedtowardthecontralateral(opposite)sideandelevates.

TotesttheSCM:theheadisturnedtotheoppositesideagainstresistance(handagainstchin).


THEPOSTERIORCERVICALREGIONBORDERSofthesuboccipitaltriangle:•ObliquuscapiRssuperior•ObliquuscapiRsinferior•RectuscapiRsposteriormajor

•  trapeziusmuscle•  cutaneousbranchesofposteriorramiofcervicalspinalnerves

suboccipitalregionortriangleliesdeeptosuperiorpartofthisregion

MAINCONTENTS:

INNERVATIONOFTHETAPEZIUS:Spinalaccessoryn.alsoreceivessomebranchesfromC2andC3,thoughttobepropriocepRve

Ifthetrapeziusisparalyzed,theshoulderdroops


THELATERALCERVICALREGIONThelateralcervicalregion(posteriortriangle)isbounded:•  anteriorlybytheposteriorborderoftheSCM•  posteriorlybytheanteriorborderofthetrapezius•  inferiorlybythemiddlethirdoftheclaviclebetweenthetrapezius

andtheSCM•  byanapex,wheretheSCMandtrapeziusmeetonthesuperior

nuchallineoftheoccipitalbone•  byaroof,formedbytheinvesRnglayerofdeepcervicalfascia•  byafloor,formedbymusclescoveredbytheprevertebrallayerof

deepcervicalfascia


THELATERALCERVICALREGIONThelateralcervicalregionisdividedinto:•  alargeOCCIPITALTRIANGLEsuperiorlyand•  asmallOMOCLAVICULARTRIANGLEinferiorlybytheinferiorbelly

oftheomohyoid

TheOCCIPITALTRIANGLEissocalledbecausetheoccipitalarteryappearsinitsapex.Themostimportantnervecrossingtheoccipitaltriangleisthespinalaccessorynerve(CNXI).

•  partofexternaljugularvein(EJV)•  posteriorbranchesofcervicalplexusofnerves•  spinalaccessorynerve(CNXI)•  trunksofbrachialplexus•  cervicodorsaltrunk•  cervicallymphnodes

MAINCONTENTSOFTHEOCCIPITALTRIANGLE:


THELATERALCERVICALREGION

•  subclavianartery(thirdpart)•  partofsubclavianvein(someRmes)•  suprascapularartery•  supraclavicularlymphnodes

MAINCONTENTSOFTHEOMOCLAVICULAR(SUBCLAVIAN)TRIANGLE:

TheinferiorpartoftheEJVcrossesthistrianglesuperficially;thesubclavianarteryliesdeepinit


THEANTERIORCERVICALREGIONTheanteriorcervicalregion(anteriortriangle)hasthefollowing:•  ananteriorboundaryformedbythemedianlineoftheneck•  aposteriorboundaryformedbytheanteriorborderoftheSCM•  asuperiorboundaryformedbytheinferiorborderofthemandible•  anapexlocatedatthejugularnotchinthemanubrium•  aroofformedbysubcutaneousRssuecontainingtheplatysma•  afloorformedbythepharynx,larynx,andthyroidgland


THEANTERIORCERVICALREGIONTHEANTERIORCERVICALREGION(ANTERIORTRIANGLE):•  submandibular(digastric)triangle•  submentaltriangle•  caroRdtriangle•  muscular(omotracheal)triangle


THEANTERIORCERVICALREGIONTHESUBMANDIBULAR(DIGASTRIC)TRIANGLEMAINCONTENTS:•  submandibularglandalmostfillstriangle•  submandibularlymphnodes•  hypoglossalnerve•  mylohyoidnerve•  partsoffacialarteryandvein

THESUBMENTALTRIANGLEMAINCONTENTS:•  submentallymphnodesand•  smallveinsthatunitetoformanteriorjugularvein


THEANTERIORCERVICALREGIONTHECAROTIDTRIANGLEThecaroRdtriangleisavascularareaboundedby:•  thesuperiorbellyoftheomohyoid,•  theposteriorbellyofthedigastric,•  theanteriorborderoftheSCM

TheneurovascularstructuresinthecaroRdtrianglearesurroundedbythecaroPdsheath:•  thecaroPdarteriesmedially•  theIJVlaterally•  thevagusnerveposteriorly


THEANTERIORCERVICALREGIONTHECAROTIDTRIANGLEMAINCONTENTS:•  caroRdsheathcontainingcommoncaroRdarteryanditsbranches

TheneurovascularstructuresinthecaroRdtrianglearesurroundedbythecaroPdsheath:•  thecaroPdarteriesmedially•  theIJVlaterally•  thevagusnerveposteriorly


THEANTERIORCERVICALREGIONTHECAROTIDTRIANGLEMAINCONTENTS:•  caroRdsheathcontainingcommoncaroRdarteryanditsbranches•  internaljugularveinanditstributaries•  vagusnerve•  externalcaroRdarteryandsomeofitsbranches•  hypoglossalnerveandsuperiorrootofansacervicalis•  spinalaccessorynerve(CNXI)•  thyroidgland,•  larynx,andpharynx•  deepcervicallymphnodes•  branchesofcervicalplexus


THEANTERIORCERVICALREGIONTHECAROTIDTRIANGLEThecaroRdtriangleisavascularareaboundedby:•  thesuperiorbellyoftheomohyoid,•  theposteriorbellyofthedigastric,•  theanteriorborderoftheSCM

THEMUSCULAR(OMOTRACHEAL)TRIANGLEMAINCONTENTS:•  sternothyroidandsternohyoidmuscles•  thyroidandparathyroidglands

THECUTANEOUSANDSUPERFICIALMUSCLESOFNECKPlatysma-cervicalbranchoffacialnerve(CNVII)Sternocleidomastoid(SCM)-spinalaccessorynerve(CNXI,motor);C2andC3nerves(painandpropriocepRon)Trapezius-spinalaccessorynerve(CNXI;motor);C2andC3nerves(painandpropriocepRon)

THENECK–THEMUSCLESOFTHENECK

THEMUSCLESINLATERALCERVICALREGION•  spleniuscapiRs•  levatorscapulae•  anteriorscalene•  middlescalene•  posteriorscalene

Thesuprahyoidregioncontains4muscles:•  Mylohyoid-nervetomylohyoid,CNV3•  Digastric-anteriorbellyCNV3;posteriorbellyCNVII•  Stylohyoid-CNVII•  Geniohyoid–C1viahypoglossalnerveCNXIITheinfrahyoidregioncontains4musclescommonlycalledstrapmuscles:•  Omohyoid-C1–C3byabranchofansacervicalis•  Sternohyoid-C1–C3byabranchofansacervicalis•  Sternothyroid-C2andC3byabranchofansacervicalis•  Thyrohyoid-C1viahypoglossalnerve(CNXII)

THENECK–THEMUSCLESOFTHENECK

THEMUSCLESINANTERIORCERVICALREGION

THENECK–THEARTERIESOFTHENECK

THELATERALCERVICALREGIONThearteriesinthelateralcervicalregioninclude:•  thelateralbranchesofthethyrocervicaltrunk•  thethirdpartofthesubclavianartery•  partoftheoccipitalartery

Thethirdpartofthesubclavianarterysuppliesbloodtotheupperlimb.Itishiddenintheinferiorpartofthelateralcervicalregion,posterosuperiortothesubclavianvein.

Thethirdpartofthearteryisthelongestandmostsuperficialpart.Itliesonthe1strib,anditspulsaRonscanbefeltbyapplyingdeeppressureintheomoclaviculartriangle.


THEANTERIORCERVICALREGIONThecommoncaroPdarterydividesinto:•  theinternalcaroRdartery•  theexternalcaroRdartery

ThecaroPdsinus,aslightdilaRonoftheproximalpartoftheinternalcaroRdartery.Innervatedprincipallybytheglossopharyngealnerve(CNIX)throughthecaroRdsinusnerveaswellasbythevagusnerve(CNX),itisabaroreceptor(pressoreceptor)thatreactstochangesinarterialbloodpressure.

ThecaroPdbody:asmall,reddishbrownovoidmassofRssueinlifethatliesonthemedial(deep)sideofthebifurcaRonofthecommoncaroRdartery.SuppliedmainlybythecaroRdsinusnerve(CNIX)andbyCNX,itisachemoreceptorthatmonitorsthelevelofoxygenintheblood

•  C3-C4JUNCTION•  SUPERIORBORDEROF

THYROIDCARTILAGE


THEANTERIORCERVICALREGIONSuperiorly,thecommoncaroPdisreplaced

bytheinternalcaroPdartery.

TheinternalcaroPdarteryhasNOBRANCHESintheneck.TheexternalcaroRdhasseveral.

TherightcommoncaroPdarterybeginsatthebifurcaRonofthebrachiocephalictrunk.Therightsubclavianarteryistheotherbranchofthisbrachiocephalictrunk.

Fromthearchoftheaorta,theleccommoncaroPdarteryascendsintotheneck.


THEANTERIORCERVICALREGIONTheinternalcaroPdarteriesaredirectconRnuaRonsofthecommoncaroRdssuperiortotheoriginoftheexternalcaroRdartery,atthelevelofthesuperiorborderofthethyroidcarRlage.

C3-C4JUNCTIONlevelofupperborderofthyroidcarRlageandbifurcaRonofcommon

caroRdartery.

TheexternalcaroPdarteriessupplymoststructuresexternaltothecranium.TheorbitandthepartoftheforeheadandscalpsuppliedbythesupraorbitalarteryarethemajorexcepRons.


THEANTERIORCERVICALREGIONTheexternalcaroPdarteries-sixarteriesarisefromtheexternalcaroRdartery:•  ascendingpharyngealartery•  occipitalartery•  posteriorauricularartery•  superiorthyroidartery•  lingualartery•  facialartery•  maxillaryartery(T)•  superficialtemporala.(T)

Theinferiorthyroidisabranchof

thesubclavianartery.


THEANTERIORCERVICALREGIONTheascendingpharyngealarterysendsbranchestothepharynx,prevertebralmuscles,middleear,andcranialmeninges.

Theoccipitalarteryendsbydividingintonumerousbranchesintheposteriorpartofthescalp.Theposteriorauriculararterysuppliestheadjacentmuscles;paroRdgland;facialnerve;andstructuresinthetemporalbone,auricle,andscalp.Thesuperiorthyroidarterygivesoffbranchestothyroidgland,theinfrahyoidmusclesandtheSCMandgivesrisetothesuperiorlaryngealartery,supplyingthelarynx.

Thelingualarterydividesintothedeeplingualandsublingualarteries.

TheexternalcaroPdarteriesisdividingintotwoterminalbranches:•  themaxillaryartery•  thesuperficialtemporalartery


THEANTERIORCERVICALREGIONThesubclavianartery:•  rightfromthebrachiocephalictrunk•  lecfromtheaorRcarch

Thesubclavianarterysuppliesbloodtotheupperlimb.1.  medialpart2.  posteriorpart3.  lateralpart

Thesubclavianartery–branches:1.  thyrocervicaltrunk

a.inferiorthyroidb.ascendingcervicalc.suprascapular

2.costocervicaltrunk

THENECK–THEVEINSOFTHENECK

THELATERALCERVICALREGIONTheexternaljugularvein(EJV)beginsneartheangleofthemandiblebytheunionoftheposteriordivisionoftheretromandibularveinwiththeposteriorauricularvein.

Theexternaljugularvein(EJV)descendstotheinferiorpartofthelateralcervicalregionandterminatesinthesubclavianvein

Thesubclavianveinuniteswiththeinternaljugularvein(IJV)toformthebrachiocephalicvein.

MostveinsintheanteriorcervicalregionaretributariesoftheIJV,typicallythelargestveinintheneck.

TheIJVdrainsbloodfromthebrain,anteriorface,cervicalviscera,anddeepmusclesoftheneck.

THENECK–THEVEINSOFTHENECK

THEANTERIORCERVICALREGION

TheIJVcommencesatthejugularforamenintheposteriorcranialfossaasthedirectconRnuaRonofthesigmoidsinus

FromadilaRonatitsorigin,thesuperiorbulboftheIJV,theveindescendsinthecaroRdsheath

TheinferiorendoftheIJVdilatestoformtheinferiorbulboftheIJV.ThisbulbhasabicuspidvalvethatpermitsbloodtoflowtowardtheheartwhileprevenRngbackflowintothevein.

THENECK–THEVISCERAOFTHENECK

THETHYROIDGLANDDevelopmentofthethyroidglandbeginsintheflooroftheembryonicpharynxatthesiteindicatedbyasmallpit,theforamencecum,inthedorsumofthepostnataltongue.

Thedevelopingglandrelocatesfromthetongueintotheneck,passinganteriortothehyoidandthyroidcarRlagestoreachitsfinalposiRonanterolateraltothesuperiorpartofthetrachea.

DuringthisrelocaRon,thethyroidglandisa_achedtotheforamencecumbythethyroglossalduct.


THETHYROIDGLANDThethyroidglandliesdeeptothesternothyroidandsternohyoidmuscles,locatedanteriorlyintheneckattheleveloftheC5–T1vertebrae.Itconsistsprimarilyofrightandlellobes,anterolateraltothelarynxandtrachea.

Thethyroidglandissurroundedbyathinfibrouscapsule

ThehighlyvascularthyroidglandissuppliedbythesuperiorandinferiorthyroidarteriesUsuallythefirstbranchesoftheexternalcaroRdarteries,thesuperiorthyroidarteriesdivideintoanteriorandposteriorbranchessupplyingmainlytheanterosuperioraspectofthegland.

Theinferiorthyroidarteries,thelargestbranchesofthethyrocervicaltrunksarisingfromthesubclavianarteries.


THETHYROIDGLANDThelymphaRcvesselsofthethyroidglandrunintheinterlobularconnecRveRssue

ThevesselspassiniRallytoprelaryngeal,pretracheal,andparatracheallymphnodes.

NERVESOFTHYROIDGLANDThesefibersarevasomotor,notsecretomotor.TheycauseconstricRonofbloodvessels.EndocrinesecreRonfromthethyroidglandishormonallyregulatedbythepituitarygland.


THEPARATHYROIDGLANDSThesmallfla_ened,ovalparathyroidglandsusuallylieexternaltothethyroidcapsuleonthemedialhalfoftheposteriorsurfaceofeachlobeofthethyroidgland,insideitssheath.

Mostpeoplehavefourparathyroidglands.Approximately5%ofpeoplehavemore;somehaveonlytwoglands.

the neck - imulimul.pl/system/files/neck part i rev.pdfthroat. this results in ... innervates most...

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