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Superficial Neck and Triangles
N/A
15
Medical
Professional
09/11/2010

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Term
Platysma
Definition
1)Located in Superficial Fascia
2)Origin: Inferior border of the mandible, and superficial fascia of the lower face
3)Insertion: Superficial fascia that covers the upper thorax and deltoid muscle
4)Function: Pulls the angle of mouth downward, tightens and pulls the skin of the neck upward
5)Neck wounds require the platysma to be sutured with skin to enhance healing and prevent large scar formation
Term
Cervical (Deep) Fasica
Definition
Comprised of the 1)investing, 2)pretracheal and 3)prevertebral layers
Term
Investing Layer
Definition
most superifical of three layers
- encloses the SCM and Trapezius
- attaches superiorly to the superior nuchal Line, ZYGOMATIC ARCH, mastoid process, mandible, and hyoid bone
- forms capsule for the parotid and submandibular gland
- attaches inferiorly to the manubrium, clavicle, acromion and spine of scapula
- continues with the ligamentum nuchae
Term
Pretracheal Layer
Definition
- extends from the hyoid bone to the middle mediastinum where it continues with the fibrous pericardium
- encloses the infrahyoid muscles, thyroid gland, trachea and esophagus
continues with the buccopharyngeal fascia (most outer layer)
- contributes to the formation of the carotid sheath
- forms the fascial sheaths that surrounds the intermediate tendons of the digastric and omohyoid muscles
Term
Carotid Sheath *not so important*
Definition
-Mainly formed by the pretracheal fascia, though it blends with all layers of the cervical fascia
-Crosses by the intermediate tendon of the omohyoid
-Extends from the base of the cranium to the root of the neck
-Contains the common carotid artery, internal jugular vein & vagus nerve
-Communicates through the pretracheal fascia with the posterior mediastinum
-Pierced by the ansa cervicalis
Term
Prevertebral Layer
Definition
-forms a sheath that covers the prevertebral and lateral VERTEBRAL (SCALENE) muscles
-blends with the endothoracic fascia and anterior longitudinal ligament
***WANTS US TO REMEMBER***-constitutes the posterior boundary of the retropharyngeal space that continues with the posterior mediastinum
Term
Hyoid Bone
Definition
- A U- shaped bone suspended by the stylohyoid ligament
- Consists of a body, greater and lesser cornua (horns)
- Connects to the thyroid cartilage via the thyrohyoid membrane
- Gives attachment to geniohyoid, stylohyoid, mylohyoid, sternohyoid, thyrohyoid, middle pharyngeal constrictor *don't need to memorize, anything with 'hyoid' name*
Term
Cervical Muscles
Definition
*1)Sternocleidomastoid
2)Trapezius
*3)Suprahyoid muscles
*4)Infrahyoid muscles
5)Occipital muscles
6)Suboccipital muscles
Term
Sternocleidomastoid
Definition
-Divides the neck into anterior and posterior (lateral) triangles
1)Origin: manubrium (sternal head) and medial third of clavicle (clavicular head) separated by the lesser supraclavicular fossa (access to IJV)*Don't need to know this!*
2)Insertion: mastoid process and superior nuchal line
3)Function: *lateral flexion of the neck and rotation of the face upward and contralaterally.*[Major Function] Bilateral contraction produces extension of the neck at the atlanto-occipital joint, flexion of the cervical vertebrae, and flexion of upper cervical and extension of the lower cervical vertebrae. Elevates the manubrium and clavicle when the cervical vertebrae are fixed
Term
Torticollis (Wryneck)
Definition
1)Spasmodic contracture of the SCM that produces twisting of the neck and slanting of the head away from the affected side
2)Results commonly from fibroma (fibromatosis colli) pre- or postnatally
3)Excessive pull on the head infant during delivery may damage the SCM and produces torticollis
4)Children with chronic trochlear nerve palsy may develop compensatory torticollis as a result of constant bending of the neck
5)Dystonia involving the cervical muscles also produces torticollis
6)Irritation of the spinal accessory nerve may also result in torticollis
Term
Triangles of the Neck
Definition
Posterior Triangle
a)Anterior boundary: Posterior border of the SCM
b)Posterior boundary: Anterior border of the trapezius muscle
c)Base: Middle third of the clavicle
d)Apex: Occipital bone
e)Floor: splenius capitis, levator scapulae, middle and posterior scalene muscles, accessory nerve, trunks of the brachial plexus, subclavian and transverse cervical arteries
-Divided by the inferior belly omohyoid muscle into smaller subclavian (supraclavicular) and occipital triangles
Term
Suprahyoid Muscles
Definition
Stylohyoid
a)Origin: styloid process(*NOT IMPORTANT AS NAME IS SELF-EXPLANATORY*, just know it is SUPERIOR to digastric)
b)Insertion: body of hyoid
c)Function: Elevation of the hyoid and elongation of the mouth floor

Digastric
a)Origin: digastric fossa of mandible (anterior belly), mastoid notch (posterior belly)*KNOW it has two bellies*
b)Insertion: body and greater horn of hyoid
c)Function: Depresses the mandible and opens the mouth, and elevates the hyoid bone

Mylohyoid
a)Origin: mylohyoid line
b)Insertion: body of hyoid bone via raphe
c)Function: elevates the hyoid, floor of the mouth

Geniohyoid
a)Origin: inferior mental spine (AKA: Geniohyoid tubercle)
b)Insertion: body of hyoid
c)Function: shortens floor of the mouth by pulling the hyoid bone anteriorly and upward, widens the pharynx *No one going to ask this*
Term
Infrahyoid Muscles
Definition
Omohyoid
a)Origin: superior border of scapula near suprascapular notch
b)Insertion: inferior border of body of hyoid
c)Function: depresses, retracts and stabilized the hyoid

Sternohyoid *need to know for surgical intervention*
a)Origin: manubrium and medial end of clavicle
b)Insertion: body of hyoid
c)Function: depresses the hyoid

Sternothyroid *nothing special about it*
a)Origin: posterior surface of manubrium
b)Insertion: oblique line of thyroid lamina
c)Function: depresses, retracts and stabilized the hyoid

Thyrohyoid *innervation is different from all other infrahyoid muscles*
a)Origin: oblique line of thyroid lamina
b)Insertion: hyoid bone
c)Function: elevates the larynx & depresses the hyoid
Term
Cervical Triangles
Definition
A.Posterior Triangle
a)Anterior boundary: Posterior border of the SCM
b)Posterior boundary: Anterior border of the trapezius muscle
c)Base: Middle third of the clavicle
d)Apex: Occipital bone
e)Floor: splenius capitis, levator scapulae, middle and posterior scalene muscles
-Divided by the inferior belly omohyoid muscle into smaller subclavian (supraclavicular) and occipital triangles

B.Anterior Triangle
a)Anterior boundary: median line of the neck
b)Posterior boundary: anterior border of SCM
c)Superior boundary (base): inferior border of the mandible
d)Apex: Jugular notch of the manubrium
e)Roof: superficial fascia containing the platysma
f)Floor: pharynx, larynx and thyroid gland
-divides into smaller submental and submandibular triangles via the digastric muscle, and into the carotid, and muscular triangles via the omohyoid muscle
Term
Anterior Triangle Subdivisions
Definition
*WILL NOT ASK ABOUT BOUNDARIES*
A. Submental triangle
a)Inferior boundary (base): body of the hyoid
b)Lateral boundaries: anterior bellies of digastric muscle
c)Apex: symphysis menti
d)Floor: mylohyoid muscles

B. Submandibular triangle
a)Superior boundary (base): inferior border of mandible
b)Anterior Boundary: anterior belly of digastric
c)Posterior boundary: posterior belly of digastric and stylohyoid muscle
d)Apex: Hyoid bone
e)Floor; mylohyoid and hyoglossus

C. Carotid Triangle
a)Anterior and superior boundary: b)Posterior belly of digastric
c)Anterior and inferior boundary: d)Superior belly of the omohyoid
e)Posterior boundary: SCM
f)Contents: common carotid, carotid body and sinus
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