Triangle Submandibular

Submental

Borders Superior: body of mandible Anterior: anterior belly of digastric Posterior: posterior belly of digastric AND stylohyoid posteriorly Roof: skin, superficial fascia, platysma (phoenix wings), deep fascia Floor: mylohyoid muscle Superior: body of mandible Anterior: midline Posterior: anterior belly of digastric Roof: skin, superficial fascia, platysma, deep fascia Floor: mylohyoid muscle Superior: stylohyoid and posterior belly of digastric Inferior: superior belly of omohyoid Posterior: sternocleidomastoid Roof: skin, superficial fascia, platysma, deep fascia Floor: thyrohyoid, hyoglossus, constrictor pharyngeus medius/inferior

Neck Triangles (regional anatomy) ANTERIOR http://home.comcast.net/~wnor/lesson5.htm Arteries Veins Facial artery Facial vein Lingual artery

Nerves -Lingual nerve -branch of mandibular nerve (CNV3) -Submandibular ganglion -Hypoglossal nerve (CNXII)

Misc -Submandibular gland below all muscles -Hypoglossal nerve (CNXII) supplies all muscles of tongue except palatoglossus -The Submental lymph nodes -Superficial veins which form tributaries of the anterior jugular veins. -Mylohyoid muscle aids in swallowing and in depressing the mandible - Hypoglossal nerve continues to supply all muscles of the tongue except palatoglossus FLOOR Vagus nerve - contained within carotid sheath (with carotid and internal jugular vein) Internal branch of superior laryngeal nerve - supplies sensation to the epiglottis irritation causes coughing. External branch of superior laryngeal nerve- supplies cricothyroid muscle - Clinical note: Susceptible to damage during thyroidectomy as lies inferior and close to superior thyroid artery (which is ligated during thyroidectomy). Palsy results in loss of high pitch voice. MUSCLES Superficial layer sternohyoid (sh) superior belly of omohyoid (oh) Deep Layer

Carotid

After reflection of STERNOCoMtd, and internal jugular vein: -External carotid artery -Occipital artery -Facial artery -Lingual artery -Ascending pharyngeal artery -Superior thyroid artery -Internal carotid artery

SUPERFICIAL veins -common facial vein (cf) Other structures near by: -retromandibular vein (rm) -posterior auricular vein (pav) -facial vein (fv) -external jugular vein (ej) -anterior jugular vein (aj)

After reflection of STERNOCoMtd, and external jugular vein: -hypoglossal (XII) -C1 root of ansa cervicalis (C1) -C1 fibers running with hypoglossal nerve (nerve to thyrohyoid muscle (nth) -C2-C3 root of ansa cervicalis -ansa cervicalis (ac)

Muscular

Superior: superior belly of omohyoid Anterior: midline of neck Inferior: sternocleidomastoid Roof: skin, superficial fascia, platysma, deep fascia

thyroid (th) sternothyroid (st) -When the strap muscles are reflected, you are able to see the thyroid gland (tg) with its arteries (superior thyroid artery from the external carotid (sta) and the inferior thyroid artery from the thyrohyoid trunk from the subclavian (ita). POSTERIOR http://cosmos.phy.tufts.edu/~rwillson/dentgross/headneck/Triangles/Posterior%20Triangle%20of%20the%20Neck.htm Borders Arteries Veins Nerves Posterior Boundary: trapezius m. Transverse cervical artery (tc) 1. Spinal Accessory nerve (XI) Anterior Boundary: sternocleidomastoid m. crosses the upper half of the Inferior Boundary: inferior belly of triangle diagonally and, omohyoid m. passing from the deep surface Floor: Splenius Capitus m, Levator of sternocleidomastoid Scapulae m, Scalenus Medius, and a inferiorly on levator scapulae portion of Scalenus Anterior. to reach the deep surface of Roof: superficial layer of Deep Investing trapezius, innervates Fascia sternocleidomastoid and trapezius. 2. Superficial cervical cutaneous branches of Cervical plexus - formed from ventral primary rami of spinal nerves C2-C4, which emerge from posterior border of sternocleidomastoid a. Lesser Occipital (C2) follows posterior border of SCM to innervate the scalp behind and above the ear. b. Great Auricular Nerve (C2,3) - crosses superficial to SCM and innervates the skin over the parotid gland, angle of the jaw and the posterior ear c. Transverse Cervical Cutaneous Nerve of the neck (C2,3) - crosses SCM superficially and, is cutaneous for the skin of the front and side of the neck (anterior triangle).

Triangle Occipital

Structures The lower four cervical nerves (C5,C6,C7,C8) are found in the scalene gap (space between scalenus anterior and scalenus medius muscles) and they, along with the first thoracic nerve (T1), make up the brachial plexus. Cervical nerves C5, C6, join to form the superior (upper) trunk of the brachial plexus, and these nerves as well as part of the superior trunk are found in the occipital triangle.

d. Supraclavicular Nerves (C3,4) - divides into medial, intermediate, and lateral branches, which supply sensation over the shoulder(from the sternoclavicular joint to the acromion process), lateral neck and anterior upper thoracic wall. Supraclavicular Inferior Boundary: clavicle Superior Boundary: inferior belly of Omohyoid m. Anterior Boundary: sternocleidomastoid m. Floor: Splenius Capitus m, Levator Scapulae m, Scalenus Medius m, and a small portion of the Scalenus Anterior m. Roof: superficial layer of Deep Investing Fascia Components Anterior scalene muscle Suprascapular artery Subclavian artery Subclavian vein External Jugular vein Suprascapular nerve Nerve to Subclavius Brachial plexus

Region Area Anterior to Supraclavicular Triangle

Neck (regional anatomy) Features

Notes

Joints

Description/Components

Ligaments/Tendons/Features

Clinical Correlate

DIAGRAMS