neck

Basic anatomy :- many structures compressed in small

area.
Neck : extend from madible -----supra sternal notch an clavicle
Skin :- line of cleavage: horizontally :
Cutaneous nerves :- posterior rami of cervical nerve C2----5
a- greater occipital : C2 posterior to occipital bone
b- lesser occipital : C2 posterior to occipital & medial to auricle
c- greater auricular : C2-3 auricle + angle of mandible + parotid
d- transverse cutaneous : C2-3 anterior and lateral of neck
e- Supra clavicular : C3-4 medial + intermediate + lateral

anterior, upper and posterior of shoulder + deltoid

f- posterior rami of C3-4-5 posterior of neck

 Superficial fascia: Invest : a- platysma muscle.

b- cutaneous nerves

c- superficial veins

d- superficial lymph nodes.

Platysma muscle. :

Origin: fascia of pectoralis major + deltoid

Insertion: lower border of mandible + mouth angle
nerve supply : cervical branch of facial nerve
Action : depress mandible + draws lower lip + angle
of mouth

 Superficial fascia :
A- External jugular vein : Begins : behind angle of mandible by posterior auricular
vein + retro mandibular vein

cross the sternocledomastoid muscle

join subclavian vein in deep fascia

Tributaries: #-posterior auricular vein

#-posterior branch of retromandibular vein

#-posterior external jugular vein (posterior of

scalp and neck)

#- transverse cervical vein

#- supra scapular vein

#- anterior jugular vein (2 form jugular arch)

 Clinical notes: Identification of the platysma .m.:- clench jaws

platysma tone and neck incisions:- carefully sutured
reduce scars.
Mouth distortion : skin lacerations over mandible may
distort shape of moth ( injury to br. of vii nerve ).
External jugular vein more enlarged and tortuous in
professional singers (kazim) increased intra thorasic p.
Vein catheterization : external jugular during inspiration.

(valves are open) mid point cricoid - clavicle.

 superficial cervical lymph node:

- along the external jugular vein

- superficial to sterno-cleidomastoid muscle
- drain from : mastoid + occipital l.n.
- drain to deep cervical l.n.

 Deep cervical fascia :

- invests : muscles, vessels and

viscera of neck
#- investing layers
#- pretracheal layer
#- prevertebral layer
#- axillary sheath
#- carotid sheath

 #- investing layers :

invests :-
- sternocleidomastoid m.

- trapezius m.

- submandibular salivary gland

thickened to form:- stylomandibular ligament

- attached to clavicle, acromion,

&sternum

#- pretracheal layer;

invests:
- thyroid gland

- infrahyoid muscle

 #- prevertebral layer :

- cover prevertebral muscles

- turns around the neck attach to

ligamentum nuchae

- form facial floor of posterior triangle

- invests : subclavian a. & brachial plexus

Retropharyngeal space : between prevertebral
fascia and pharynx
#- axillary sheath;- continuation of Prevertebral
fascia to the axilla with ax. A.
#- carotid sheath; invest : - common & int. carotid a.

- internal jugular vein

- Vagus nerve

- deep cervical lymph nodes

 Clinical notes :
Infection of the masticator and sub
mandibular spaces as extension from
dental infection to mandible
Ludwigs angina : acut. Inf. Of sub
mandibular facial space
Dumbbell or collar-stud abscess:
superficial abscess may be extension
of deep abscess.
Congenital torticollis : fibrosis of ste.
mast. M. due to dammage during labor.

Triangle of the neck

Anterior :sub mental

digastric

carotid

muscular
Digastric m.:

origin: mastoid pro.

insertion: intermediate tendon to

stylohyoid
Nerve : mandibular + VII. N.

PREPERED BY :
Prof. Dr. Talib Jawad
DEAN OF COLLEGE OF MEDICINE
DYIALA UNIVERSITY