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Triangle of neck
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A brief review of triangles of neck

neck triangles

  1. 1. TRIANGLES OF NECK OUTLINE I. TRIANGLES OF NECK II. DEEP STRUCTURES OF NECKSTERNOCLEIDO-MASTOID TO LOCATE STRUCTURES IN NECK ON PATIENT OR IN PRACTICAL EXAM MOST USEFUL LANDMARK IS STERNOCLEIDOMASTOID MUSCLE
  2. 2. I. TRIANGLES OF NECK Sternocleidomastoid Muscle Triangles of Neck – for description neck is divided into anterior & posterior triangles by SternocleidomastoidPosterior muscletriangle Anterior triangle
  3. 3. A. POSTERIOR TRIANGLE Anterior - Sternocleidomastoid 1. Boundaries Muscle Superficial cover - superficialPosterior fascia, platysmaTrapezius and Investing Layer Deep - (floor) Prevertebral layer of fascia Clavicle
  4. 4. B. CONTENTS OF POSTERIOR TRIANGLE Occipital artery Superficial - Great branches of Auricular n. cervical Lesser plexus occipital n. Trans Cerv. n. Accessory n. (XI) External Jugular VeinSupra-clavicularnerves
  5. 5. POSTERIOR TRIANGLE - deeper, saw through clavicle Nose Note: Accessory n. - divides post. triangle into Carefree - superior Careful - inferior Phrenic nerveBrachialplexusroots &trunks
  6. 6. POSTERIOR TRIANGLE - deeperBrachialplexus roots & Phrenic n.trunksTransverse Nose(superf.)Cervical A.SuprascapularA. SubclavianSubclavian a. vein note: Subclavian vein is not in post triangle
  7. 7. B. ANTERIOR TRIANGLE OF NECKSternocleidomastoidMuscle 1. Boundaries- ant. - midline of neck post. - sternocleido- mastoid superior - mandible (lower margin). Midline Subdivided to of neck smaller triangles (not required)
  8. 8. 2. CONTENTS OF ANTERIOR TRIANGLE OF NECKIn Carotidsheath: - cut through Int. and sternocleido-Common mastoid 2”Carotid A., aboveInt. Jug. V., sternumVagus N.Followdissection Hypoglossalto all n. XII & ansabranches of cervicalisExt. carotid
  9. 9. II. DEEP STRUCTURES OF NECK A. THYROID GLAND Two Lateral Lobes - below & on sides thyroid cartilageLateral Lobe Lateral Lobe
  10. 10. THYROID GLAND Right Left Pyramidal lobe- lateral when present often lateral lobe attached to hyoid lobe bone by fibrous strandIsthmus- locatedbelowcricoidcartilage
  11. 11. THYROID GLAND - ARTERIAL SUPPLY a) Sup.very Thyroidvascular- artery &arteries Sup.accompanied Laryngeal n.by nerves b) Inf. Thyroid artery & Recurrent laryngeal n.Note: In thyroid surgery care taken not to damageRecurrent Laryngeal Nerve
  12. 12. THYROID GLAND - LOTS OF VEINS 1) Sup. Thyroid vein follows Sup. Thyroid artery 2) Middle Thyroid vein - to Int Jugular 3) Inf. Thyroid vein - Both sides join at midline -> L. Brachiocephalic Vein
  13. 13. PARATHYROID GLANDS - 4 small bodies (2 on each side)Superior locatedparathyroid posteriorgland to orInferior withinparathyroid Thyroidgland gland
  14. 14. SYMPATHETIC CHAINAnt tovertebrae SympatheticNot trunk- deep toconfuse (not in)with Carotid SheathVagus X Note: sympathetics to most of head are from Superior Cervical Ganglion
  15. 15. THORACIC DUCT INT. JUGULAR V. THORACIC DUCT SUBCLAVIAN V. DRAINS TO LEFT BRACHIOCEPHALICFOLLOWS LEFT V.MARGIN OFESOPHAGUS AT JUNCTION OF SUBCLAVIAN AND INT. JUGULAR VEINS
  16. 16. GUIDE TO DISSECTION 1) Completely Skin Neck 2) Skip p. 175 see: Prosection Cutaneous nerves Do Post. Triangle 3) Cut through clavicle if not already done 4) Cut through sternocleidomastoid 2” (5cm) above sternum p. 178
  17. 17. FASCIA OF NECKSuperficial fascia:- connectivetissue belowdermis- completelysurrounds neck -thin and hard todemonstrate- containsPlatysma &Superficial veins
  18. 18. POSTERIOR TRIANGLE - CONTENTS Occipital artery Superficial - Great branches of Auricular n. cervical Lesser plexus occipital n. Trans Cerv. n. Accessory n. (XI) External Jugular VeinSupra-clavicularnerves
  19. 19. POSTERIOR TRIANGLE - deeper, saw through clavicle Nose Accessory n.- divides post. triangle into Carefree- superior Careful- inferior Phrenic nerveBrachialplexusroots &trunks
  20. 20. POSTERIOR TRIANGLE - deeperBrachialplexus roots & Phrenic n.trunksTransverse Nose(superf.)Cervical A.SuprascapularA. SubclavianSubclavian a. vein note: Subclavian vein is not in post triangle
  21. 21. ANTERIOR TRIANGLE OF NECK - CONTENTS -cut throughCarotid sheath sternocleidocontents mastoid 2”Int. and aboveCommon sternumCarotid A.,Int. Jug. V.,Vagus N. Hypoglossal n. XII & ansaFollow cervicalisdissection to allbranches of ext.carotid
  22. 22. EXTERNAL CAROTID ARTERYSuperficial temporal- Maxillaryscalp & temporalisPost auricular- post. ear &scalp Facial Occipital- post. scalp Ascending pharyngeal- pharynx Lingual- tongue Superior thyroid- br. is Sup laryngeal
  23. 23. PROSECTIONOFANTERIORNECK
  24. 24. INFRAHYOID MUSCLES - all depress hyoid NOSE deeper2) STERNOHYOID 4) THYROHYOID - O -O- Manubrium & thyroid cartilage; alsoclavicle elevates larynx1) OMOHYOID 3) STERNOTHYROID --intermediate O - manubrium I -tendon to thyroid cartilage; alsoclavicle, rib 1; depresses larynxSup. belly tohyoid
  25. 25. THYROID GLAND - ARTERIAL SUPPLY Sup. Thyroidvery artery &vascular- Sup.arteries Laryngeal n.accompaniedby nerves Inf. Thyroid artery & Recurrent laryngeal n.Note: in thyroid surgery care taken not to damageRecurrent Laryngeal Nerve
  26. 26. PROSECTION:DEEPDISSECTION OFNECK
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A brief review of triangles of neck

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