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The Neck by Prof. S. Malik, ProF. Wagner + Dr. Ayat

The Neck by Prof. S. Malik, ProF. Wagner + Dr. Ayat. Compartment:. 1- vertebra l ;cervical vertebrae, postural muscles. 2- viscera ;thyroid, parathyroid, larynx ,pharynx, trachea & esophagus. 3- vessels, two common carotid, two internal& external carotids+ two vagi & accessory nerves.

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The Neck by Prof. S. Malik, ProF. Wagner + Dr. Ayat

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  1. The Neck by Prof. S. Malik, ProF. Wagner+ Dr. Ayat

  2. Compartment: 1-vertebral ;cervical vertebrae, postural muscles. 2-viscera;thyroid, parathyroid, larynx ,pharynx, trachea & esophagus. 3-vessels,two common carotid, two internal& external carotids+ two vagi& accessory nerves. Three V.

  3. M.C.Qs. • The neck compartment are all the following except one • sentence is wrong ? • A-vertebral compartment. • B –visceral compartment • C-vessels compartment & trigeminal nerve. • D-vessels compartment with vagi. • .

  4. ,AnswerThe neck compartment are all the following except one sentence is wrong ?A-vertebral compartment. B –visceral compartmentC-vessels compartment & trigeminal nerve.D-vessels compartment with vagi. c vessels &trigeminal nerve

  5. M.C.Qs. • The superior boundaries of the neck including the following except one wrong ? • A-inferior boundary of the mandible • B- mastoid process • C-highest nucheal line • D-external occipital protuberance

  6. Answer • The superior boundaries of the neck including the following except one wrong ? • A-inferior boundary of the mandible • B- mastoid process • C-highest nucheal line • D-external occipital protuberance

  7. . The neck (L. collum, cervix) is the transitional area between the head superiorly and the clavicles inferiorly that joins the head to the trunk and limbs.

  8. 2. It serves as a major passage for structures passing between them. 3. In addition, several important organs with unique functions are located here: the larynx and the thyroid and parathyroid glands, for example.

  9. Skin of the neck and its contents

  10. M.C.Qs. • The innervations of the skin of neck including the following which all are correct except one is wrong? • A-greater auricular & lesser occipital nerves. • B-greater occipital& transverse cervical . • C-supraclavicular nerves &third occipital • D-transverse cervical &ophthalmic nerve

  11. Answer The innervations of the skin of neck including the following which all are correct except one is wrong? A-greater auricular & lesser occipital nerves. B-greater occipital& transverse cervical . C-supraclavicular nerves &third occipital D-transverse cervical & ophalamic nerves

  12. Superficial fascia and its contents Platysma muscle: muscle of depression of mandible& gravity +other muscles Origin: skin of pectoral region Insertion: lower border of the mandible and angle of mouse N.S: facial nerve Action: depress angle of the lips second branchialarche

  13. External jugular vein Superficial veins Begin: just behind angle of the mandible by union of posterior auricular vein and post.division of the retromandibular vein • End: drain into subclaviantributaries vein 1-Suprascapular &transverse cervical 2. ant. Jugular vein

  14. M.C..Qs.The platysma muscle the following are correct except one sentence is wrong?A-it is origin from pectoral regionb- inserted to the lower border of the mandible.C-innervated by facial nerved-it’ s action is elevation of the mandible.

  15. AnswerThe platysma muscle the following are correct except one sentence is wrong?A-it is origin from pectoral regionb- inserted to the lower border of the mandible.C-innervated by facial nerved-it’ s action is elevation of the mandible.

  16. M.C.Qs. • The external jagular vein is a vein of the neck it is uesd for intravenous infusion the following are true except one sentence? • A-it is formed by union of facial vein with anterior division of the retromandibular vein. • B-it’ s blood reach to the heart • C-The wall attached to the roof of the posterior triangle • D-the tributeries are anterior jagular vein, transverse cervical &suprscapular veins.

  17. AnswerThe external jagular vein is a vein of the neck it is uesd for intravenous infusion the following are true except one sentence?A-it is formed by union of facial vein with anterior division of the retromandibular vein.B-it’ s blood reach to the heartC-The wall attached to the roof of the posterior triangleD-the tributeries are anterior jagular vein, transverse cervical &suprscapular veins

  18. Tributaries of E.J.V and ant. J.V.

  19. M.C.Qs. • The previous picture showing the following are true except one is wrong? • A-anterior jaguar veins • B-sternomastoid muscles • C-suprahyoid muscles • D- buccinator muscles.

  20. Answer The previous picture showing the following are true except one is wrong? A-anterior jaguar veins B-sternomastoid muscles C-suprahyoid muscles D- buccinator muscles.

  21. Deep cervical fascia

  22. Important notes Layers of deep cervical fascia: investing layer, pretracheal, prevertebral and carotid sheath Investing layer of deep fascia encloses sternomastoid and trapeziusmuscles Contents of carotid sheath: CCA and ICA, IJV and vagus nerve

  23. M.C.Qs • The fascia of the neck showing the following are true except one sentence is wrong? • a- investing layer surrounding the sterrnocleidomastoid & trapezius. • b- the carotid sheath containing common carotid ,internal jugular vein & vagus nerve • c- the prevertebral fascia surrounding the prevertebral muscles. • . d- the pretracheal fascia does not ensheathing the thyroid gland .

  24. AnswerThe fascia of the neck showing the are true except one sentence is wrong? a- investing layer surrounding the sterrnocleidomastoid & trapezius. b- the carotid sheath containing common carotid ,internal jugular vein & vagus nerve c- the prevertebral fascia surrounding the prevertebral muscles.. d- the pretracheal fascia does not ensheathing the thyroid gland

  25. Major muscles of the neck Trapezius Sternomastoid muscle

  26. Recall of relevant structures Lateral muscles of the neck

  27. Sternomastoid muscle Origin : a) Sternal head: Rounded and tendinous from front of manubrium. b) Clavicular head: Thin and fleshy from upper surface of med. ⅓ of clavicle. Insertion : Mastoid process and lateral ⅓ of the superior nuchal line. Action : 1- Unilateral contraction → directs the face to opposite side. 2- Bilateral contraction → tilt the head backwards. Nerve Supply : → spinal accessory n. * Injury to the muscle leads to it contracture and shortening → Torticollis. The oblique position of the sternomastoid divides the side of the neck into anterior and posterior triangle.

  28. Sternomastoid muscle .origin, insertion, nerve supply & action

  29. A note about the scalene muscles : Scalenus anterior Scalenusmedius Scalenus posterior Origin :transverse processes of cervical vertebrae . Insertion :first and second ribs . Action : 1- Lateral flexion of neck . 2- Fixation of ribs during forced inspiration . Nerve supply : cervical and brachial plexuses . . The subclavian vein passes infront the of scalenus anterior . The subclavian artery and brachial plexus pass between scalenus anterior and scalenusmedius .

  30. Muscluar triangles of the neck

  31. POSTERIOR TRIANGLE BOUNDARIES Trapezius muscle Sternomastoid muscle clavicle

  32. POSTERIOR TRIANGLE Boundaries: - In front → Posterior border of sternomastoid m. - Behind → Anterior border of trapezius m. - Apex → Middle ⅓ of superior nuchal line. - Base → Middle ⅓ of the clavicle. Roof - Skin. - Superficial fascia. - Deep (investing) fascia of the neck. The superficial fascia of the posterior triangle contains the following : (1) Platysma m. : (a subcutaneous m.) (2) External Jugular vein (3)The cutaneous branches of the cervical plexus Floor: From upwards below : a) Splenius capitis. b) Levator scapulae. c) Scalenusmedius.

  33. Posterior triangle, roof , floor, bounderies & contentsM.C.Qs.TrueThe roof of the posterior triangle containing the following which is except one structure ? A-skinb-fascia superficial& investing cervical fascia.c- omohyoid muscle.D-platysema muscle

  34. AnswerThe roof of the posterior triangle containing the following which is correct except one structure ? A-skinb-fascia superficial& investing cervical fascia.c- omohyoid muscle.D-platysema

  35. Contents: Arteries 1- Third part of subclavian a. 2- Suprascapular a. 3- Superficial (or transverse) cervical a. 4- Occipital a. (near the apex). Veins 5- Subclavian v., receiving its only tributary, the external jugular v. Nerves 6- Roots and trunks of brachial plexus. 7- Spinal accessory n. (runs on levator scapulae). L.Ns. 8- Occipital L.N. (at the apex with the occipital a.). 9- Supraclavicular L.N. (at base with the subclavian a.). Ms. 10- Inferior belly of omohyoid .

  36. Accessory nerve (Primarily a motor nerve) • Formed from a cranial root emerging from the medulla and a spinal root arising from the superior region of the spinal cord • The spinal root passes upward into the cranium via the foramen magnum • The accessory nerve leaves the cranium via the jugular foramen and divided again into cranial root join the vagus nerve and spinal root • Cranial root: Supplies fibers to the larynx, pharynx, and soft palate • Spinal root: Innervates the trapezius and sternocleidomastoid, which move the head and neck

  37. M.C.QsThe accessory nerve showing the following are true except one sentence is wrong ?A- supply larynx& pharynx.B-soft palateC-spinal root supply sternomastoid &trapezius musclesD-anterior belly of the digastric muscle.

  38. Answer :The accessory nerve showing the following are true except one sentence is wrong ?A- supply larynx& pharynx.B-soft palateC-spinal root supply sternomastoid &trapezius musclesD-anterior belly of the digastric muscle

  39. OMOHYOID MUSCLE

  40. DIVISION OF POSTERIOR TRIANGLE Occipital triangle Supra (sub) clavicular

  41. ANTERIOR TRIANGLE

  42. ANTERIOR TRIANGLE □ Boundaries : • Anteriorly→ Middle line of the neck. • Posteriorly→ Ant. border of sternomastoid. • Base (above) → Lower border of mandible. • Apex (below) → Suprasternal notch. □ Roof: 1- Skin. 2- Superficial fascia (+ its contents). 3- Investing ( deep ) fascia. Contents of the Superficial Fascia of the Roof: a- Platysma muscle. b- Transverse cervical n. c- Anterior jugular v. : It is formed by the union of the submental veins → descends in the superficial fascia near the middle line → pierces the deep fascia above the sternum → passes deep to the sternomastoid → ends in the external jugular v. The deep parts of both anterior jugular veins are connected together by jugular arch. □ Subdivisions : 3 ½ triangles . See the table .

  43. M.C.Qs.The boundaries of the anterior triangle consisted of the following all incorrect except one sentence is correct?A-anterior border of the trapezius muscle.B—anterior border of the sternomastoid muscle.C-upper border of the mandible ;alveolar process.D-inferior belly of omohyoid muscle

  44. answerThe boundaries of the anterior triangle consisted of the following all incorrect except one sentence is correct?A-anterior border of the trapezius muscle.B—anterior border of the sternomastoid muscle.C-upper border of the mandible ;alveolar process.D-inferior belly of omohyoid muscle

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