Fascial Planes of the Neck

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Questions and Answers

Which structure is NOT typically enveloped by the pretracheal layer of the deep cervical fascia?

  • Esophagus
  • Trachea
  • Vertebral column (correct)
  • Infrahyoid muscles

What anatomical structures form the boundaries of the posterior triangle of the neck?

  • Trapezius, sternocleidomastoid, clavicle (correct)
  • Omohyoid, digastric, sternocleidomastoid
  • Sternocleidomastoid, mandible, midline
  • Mandible, hyoid bone, sternocleidomastoid

If a surgeon needs to access the retropharyngeal space, which fascial arrangement is MOST relevant to their approach?

  • Superficial cervical fascia
  • Alar fascia joining the carotid sheaths (correct)
  • Investing and pretracheal fascia
  • Prevertebral fascia enveloping vertebral column

Which of the following BEST describes the significance of the fascial planes of the neck?

<p>They compartmentalize the neck and limit the spread of infection. (C)</p>
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Which muscle is described as dividing the anterior triangle into the carotid and muscular triangles?

<p>Omohyoid (C)</p>
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A patient exhibits weakness in elevating the hyoid bone and depressing the mandible. Dysfunction of which muscle group is MOST likely?

<p>Suprahyoid muscles (D)</p>
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Which of the following structures is NOT typically found within the carotid sheath?

<p>Accessory nerve (D)</p>
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The investing layer of the deep cervical fascia completely envelops which muscles?

<p>Trapezius and sternocleidomastoid (A)</p>
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In which cervical triangle would you MOST likely find the subclavian artery?

<p>Supraclavicular triangle (B)</p>
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A patient presents with a neck infection. Which fascial layer, if compromised, would MOST likely allow the infection to spread into the mediastinum?

<p>Pretracheal fascia (A)</p>
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Which muscle is known for its broad, thin sheet-like structure in the superficial fascial plane and is sometimes referred to as the 'shaver's muscle'?

<p>Platysma (B)</p>
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Which triangle of the neck contains the submandibular gland, submandibular lymph nodes, and the hypoglossal nerve?

<p>Submandibular triangle (A)</p>
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Which of the following nerves located in the neck is NOT part of the cervical plexus?

<p>Vagus nerve (B)</p>
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What is the PRIMARY function of the infrahyoid muscles?

<p>Depress the hyoid bone (A)</p>
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Which muscle has fibers that originate along the internal surface of the mandible and insert onto the body of the hyoid bone, forming a support for the base of the tongue?

<p>Mylohyoid (A)</p>
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The carotid sinus nerve is contained within the lateral expansions of which fascial layer?

<p>Prevertebral layer (D)</p>
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Which of the following BEST describes the function of the sternocleidomastoid muscle?

<p>Flexion and ipsilateral rotation of the neck (A)</p>
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In the context of neck anatomy, what is the significance of the 'nerve point of the neck'?

<p>It is the convergence point for branches of the cervical plexus. (A)</p>
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The anterior belly of which muscle defines the submental triangle?

<p>Digastric (D)</p>
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The carotid sheath contains common and internal carotid arteries, the internal jugular vein, the vagus nerve, carotid sinus nerve and lymph nodes. What fascial layer forms the carotid sheath?

<p>Prevertebral layer (B)</p>
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Which structure is responsible for dividing the anterior triangle of the neck into the submandibular and submental triangles?

<p>Anterior belly of the digastric muscle (B)</p>
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Which of the following structures is NOT enveloped by the investing layer of deep cervical fascia?

<p>Thyroid Gland (C)</p>
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What is the PRIMARY role of the superficial cervical fascia?

<p>Enveloping the entire neck and containing the platysma (B)</p>
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Which layer of the deep cervical fascia is responsible for forming the carotid sheath?

<p>Prevertebral layer (C)</p>
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Which of the following nerves is found in the submandibular triangle?

<p>Hypoglossal nerve (B)</p>
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Which of the following is NOT a content of Occipital Triangle?

<p>Subclavian Artery (3rd part) (A)</p>
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Which of the following best describes the PRIMARY function of the prevertebral layer of the deep cervical fascia?

<p>Enveloping the vertebral column and associated muscles. (A)</p>
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A surgeon is planning a procedure that requires access to the carotid sheath. Which of the following fascial layers is MOST relevant to this surgical approach?

<p>Prevertebral layer of deep cervical fascia (C)</p>
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Which of the following muscles is located internal to the mylohyoid muscle?

<p>Geniohyoid (A)</p>
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A patient presents with difficulty in elevating the hyoid bone and depressing the mandible. Dysfunction of which muscle is MOST likely the cause?

<p>Mylohyoid (C)</p>
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Which of the following statements BEST describes the extent of the pretracheal layer of the deep cervical fascia?

<p>It extends from the hyoid bone to the fibrous pericardium. (D)</p>
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Within which cervical triangle is the submental triangle located?

<p>Anterior triangle (B)</p>
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Which of the following is NOT a component contained within the prevertebral layer's lateral expansions?

<p>External carotid artery (C)</p>
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Which muscle is known as the 'shaver's muscle' due to its broad, thin sheet-like structure in the superficial fascial plane?

<p>Platysma (A)</p>
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Which of the following muscles does NOT contribute to defining the borders of the posterior triangle of the neck?

<p>Omohyoid (A)</p>
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Which of the following best describes the anatomical relationship between the geniohyoid and mylohyoid muscles?

<p>The geniohyoid is internal (deep) to the mylohyoid. (C)</p>
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Which of the following best describes the PRIMARY function of the infrahyoid muscles as a group?

<p>Depressing the hyoid bone (B)</p>
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Given its location, what is the MOST likely role of the alar fascia in the neck?

<p>Facilitating movement of the pharynx and esophagus during swallowing (A)</p>
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Which of the following best describes the role of the digastric muscle's fibrous sling?

<p>Anchors the muscle's intertendon to the hyoid bone (C)</p>
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Which of the following best describes the location and function of the paravertebral muscles?

<p>Located primarily within the posterior triangle and stabilize the vertebral column (C)</p>
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A patient has a lesion affecting the ansa cervicalis. Which of the following muscle groups would be MOST affected by this lesion?

<p>Infrahyoid muscles (A)</p>
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Which of the following structures is contained within the carotid sheath?

<p>Common carotid artery (A)</p>
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Which statement accurately describes the clinical significance of the triangles of the neck?

<p>They assist in localizing and describing anatomical structures. (A)</p>
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The anterior triangle of the neck is defined by the sternocleidomastoid (SCM) muscle, midline of the neck, and which other structure?

<p>Mandible (D)</p>
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A patient is diagnosed with an infection that has spread to the retropharyngeal space. Which of the following best describes the anatomy that DIRECTLY allows this spread?

<p>The alar fascia defining the retropharyngeal space. (C)</p>
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A previously healthy individual is admitted to the emergency department following a penetrating trauma to the anterior triangle of the neck. Immediate surgical exploration is required. Damage to which of the following structures would be MOST life-threatening?

<p>Internal jugular vein (D)</p>
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A 55-year-old male presents with a progressively enlarging mass in the anterior triangle of his neck. Imaging reveals that the mass is located within the carotid sheath. Immunohistochemical analysis confirms the mass originates from cells that support and insulate nerve fibers. Which of the following nerves is MOST likely involved based on its anatomical location related to the mass?

<p>Vagus Nerve (B)</p>
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During a complex neck dissection, a surgical team must carefully navigate the fascial layers to minimize the risk of damaging critical neurovascular structures. Imagine a scenario where the surgeon must tranverse from the superficial subcutaneous tissue, through the investing layer and pretracheal layer, to reach the thyroid gland. Which of the following structures are they MOST at risk of inadvertently damaging after traversing the investing layer?

<p>Cervical branch of the Facial Nerve (A)</p>
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The fascial planes of the neck help to ______ the neck.

<p>compartmentalize</p>
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The superficial cervical fascia contains a thin layer of ______ connective tissue.

<p>subcutaneous</p>
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The ______ layer of the deep cervical fascia is limited to the anterior portion of the neck.

<p>pretracheal</p>
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The prevertebral layer of the deep cervical fascia envelops the ______ column and associated muscles.

<p>vertebral</p>
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The investing cervical layer is the most ______ of the deep layers.

<p>superficial</p>
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The ______ muscle is also known as the shaver's muscle.

<p>platysma</p>
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The sternocleidomastoid muscle contains ______ and clavicular heads.

<p>sternal</p>
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The trapezius muscle is a ______ muscle of the posterolateral aspect of the neck and thorax.

<p>triangular</p>
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[Blank] muscles work to elevate the hyoid bone and depress the mandible.

<p>suprahyoid</p>
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The fibers of the ______ muscle originate off a broad origin point along the internal surface of the mandible.

<p>mylohyoid</p>
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The ______ muscle is internal to the mylohyoid muscle.

<p>geniohyoid</p>
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The ______ muscle originates from the styloid process to the hyoid bone.

<p>stylohyoid</p>
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The digastric muscle's name comes from the presence of 2 muscle ______.

<p>bellies</p>
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[Blank] muscles depress the hyoid bone.

<p>infrahyoid</p>
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The ______ muscles are primarily in the posterior triangle of the neck.

<p>paravertebral</p>
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The triangles of the neck are divisions based on ______ borders.

<p>muscular</p>
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The ______ triangle is defined by the trapezius, sternocleidomastoid, and clavicle.

<p>posterior</p>
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The ______ triangle is defined by the sternocleidomastoid, mandible, and midline.

<p>anterior</p>
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The ______ muscle divides the posterior triangle into occipital and supraclavicular triangles.

<p>omohyoid</p>
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The anterior belly of the ______ muscle defines the submental triangle.

<p>digastric</p>
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The ______ triangle contains the submandibular gland, nodes, hypoglossal and mylohyoid nerves, and facial artery and vein parts.

<p>submandibular</p>
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The ______ triangle's main contents are suprahyoid muscles, nodes, and venous system to jugular vein.

<p>submental</p>
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The ______ triangle includes the carotid sheath, external carotid artery, hypoglossal nerve, and vagus nerve.

<p>carotid</p>
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The ______ triangle contains sternothyroid and sternohyoid muscles, thyroid and parathyroid glands.

<p>muscular</p>
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The neck contains ______ of the cranial nerves.

<p>3</p>
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The ______ nerve is contained in the carotid sheath of carotid triangle, between the carotid artery and internal jugular vein.

<p>vagus</p>
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The ______ nerve is found in occipital triangle; accepts branches from C2-C4.

<p>accessory</p>
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The ______ nerve is found in submandibular triangle, along with a branch of C1.

<p>hypoglossal</p>
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The cervical plexus is formed by spinal nerves ______.

<p>C1-C4</p>
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Communication between the head and the thorax/upper limbs occurs through structures that ______.

<p>neck</p>
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Within the superficial cervical fascia, the ______ muscle, also known as the 'shaver's muscle,' presents a broad, thin sheet that diffuses into the subcutaneous fascia of the thorax.

<p>platysma</p>
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Originating from a broad area on the internal surface of the mandible, fibers of the ______ muscle insert onto the body of the hyoid bone, with some blending along the midline as the median raphe.

<p>mylohyoid</p>
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Unlike other suprahyoid muscles, the ______ muscle, running anteroposteriorly from the internal surface of the mandible, uniquely sits internal to the mylohyoid muscle.

<p>geniohyoid</p>
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Distinguished by two muscle bellies, the ______ muscle extends from its origin at the mastoid process to its insertion on the mandible, anchored via an intertendon to the hyoid through a fibrous sling from the pretracheal fascia.

<p>digastric</p>
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The carotid sheath, a tubular fascial investment surrounding vessels and nerves, is a product of lateral expansions from the ______ layer and is critical to neck anatomy.

<p>prevertebral</p>
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Named for its implied directional role, the ______ muscles, are specifically positioned to counter elevation, and are essential for complex neck movements.

<p>infrahyoid</p>
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Distinguishing it from other regions, the unique organization of the neck's triangles aids in both localizing and structurally ______.

<p>describing</p>
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The superficial cervical fascia plays a critical role of enveloping the entire ______.

<p>neck</p>
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The ______ is located in the posterior triangle and accepts branches from C2-C4.

<p>accessory nerve</p>
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Extending from the base of the skull to the root of the neck, the lateral expansions originating from the prevertebral layer contain the common/internal carotid arteries, internal jugular vein, vagus nerve, carotid sinus nerve, and lymph nodes, all fundamental elements within the carotid ______.

<p>sheath</p>
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Flashcards

Superficial Cervical Fascia

Thin layer of subcutaneous connective tissue that envelops the entire neck and contains the platysma muscle.

Deep Cervical Fascia

Supports the viscera and forms the carotid sheath; divided into investing, pretracheal, and prevertebral layers.

Investing Cervical Layer

Most superficial layer of the deep cervical fascia, enveloping the trapezius and sternocleidomastoid muscles.

Prevertebral Layer

Forms the carotid sheath that contains the common/internal carotid arteries, internal jugular vein, vagus nerve, carotid sinus nerve, and lymph nodes. Joined by alar fascia, defines retropharyngeal space, allows movement of pharynx/esophagus.

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Trapezius Muscle

Triangular muscle of the posterolateral aspect of neck and thorax that elevates, retracts, and depresses the scapula depending on its fibers.

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Suprahyoid Muscles

Group of muscles that work to elevate the hyoid bone and depress the mandible.

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Triangles of the Neck

Divisions of the neck based on muscular borders, assisting in localizing and describing structures.

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Posterior Triangle

Triangle of the neck is defined by the trapezius, sternocleidomastoid, and clavicle.

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Contents of Occipital Triangle

Part of external jugular vein, posterior branches of cervical plexus, accessory nerve, trunks of brachial plexus, and transverse cervical artery

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Contents of Supraclavicular Triangle

Subclavian artery (3rd part), part of subclavian vein, suprascapular artery, and supraclavicular lymph nodes.

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Anterior Triangle

Triangle of the neck defined by the sternocleidomastoid, mandible, and midline.

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Contents of Submandibular Triangle

Submandibular gland, submandibular lymph nodes, hypoglossal nerve, mylohyoid nerve, and parts of facial artery and vein.

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Contents of Submental Triangle

Suprahyoid muscles, submental lymph nodes, and venous system to anterior jugular vein.

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Contents of Carotid Triangle

Carotid sheath and contents, external carotid artery, hypoglossal nerve, ansa cervicalis, accessory nerve, thyroid gland, larynx, pharynx, lymph nodes, and branches of cervical plexus.

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Contents of Muscular Triangle

Sternothyroid, sternohyoid muscles, thyroid and parathyroid glands.

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Overview of the Neck

Communication pathway between the head, thorax, and upper limbs, containing blood vessels, nerves, glands, lymphatics, trachea and esophagus.

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Fascial Planes Function

Compartmentalizes the neck and prevents the spread of infection.

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Pretracheal Layer

Located in the anterior portion of the neck, extending from the hyoid bone to the fibrous pericardium with which it envelops infrahyoid muscles, the trachea, and the esophagus.

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Paravertebral muscles

A muscle primarily in posterior triangle.

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Platysma

Superficial muscle of the neck; a shaver's muscle; it is a broad, thin sheet in superficial fascial plane. Diffuses into subcutaneous fascia of thorax

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Sternocleidomastoid

Contains sternal and clavicular heads; inserts on mastoid process of head; allows flexion, ipsilateral rotation of neck

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Mylohyoid muscle

Originates off broad origin point along internal surface of mandible; fibers insert onto body of hyoid bone; some fibers fuse along midline as median raphe; Forms the support the base of the tongue

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Geniohyoid muscle

Internal to mylohyoid muscle; fibers run anteroposterior from internal surface of mandible to hyoid bone

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Stylohyoid muscle

From styloid process to hyoid bone

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Digastric muscle

Name from presence of 2 muscle bellies; originates off mastoid process to insert on mandible; intertendon between bellies anchored to hyoid through fiberous sling from pretracheal fascia; because of angle of pull, elevates hyoid, depresses mandible

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Neck Divisions

Divides the neck based on muscular borders

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Nerve Point

Divides into superficial muscle and cervical branch

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Study Notes

Overview

  • The neck allows communication between the head, thorax, and upper limbs.
  • The neck contains blood vessels, nerves, glands, lymphatics, trachea, and esophagus.

Fascial Planes of the Neck

  • Fascial planes compartmentalize the neck and prevent the spread of infection.
  • Superficial cervical fascia is a thin layer of subcutaneous connective tissue that envelops the entire neck and contains the platysma.
  • Deep cervical fascia supports the viscera and forms the carotid sheath, divided into three layers: investing, pretracheal, and prevertebral.
  • Investing cervical layer is the most superficial of the deep layers, enveloping the trapezius and sternocleidomastoid.
  • The pretracheal layer is limited to the anterior portion of the neck and extends from the hyoid to the fibrous pericardium.
  • The pretracheal layer envelops the infrahyoid muscles, trachea, and esophagus.
  • The prevertebral layer envelops the vertebral column and associated muscles.
  • Lateral expansions of the prevertebral layer form the carotid sheath, extending from the base of the skull to the root of the neck.
  • The carotid sheath contains the common/internal carotid arteries, internal jugular vein, vagus nerve, carotid sinus nerve, and lymph nodes.
  • Carotid sheaths are joined by alar fascia, which defines the retropharyngeal space.
  • The retropharyngeal space allows movement of the pharynx/esophagus over the vertebral column during swallowing.

Muscles of the Neck

  • Superficial muscles include the platysma, sternocleidomastoid, and trapezius.
  • The platysma, also known as the shaver's muscle, is a broad, thin sheet in the superficial fascial plane that diffuses into the subcutaneous fascia of the thorax.
  • The sternocleidomastoid contains sternal and clavicular heads, inserts on the mastoid process of the head, and is involved in flexion and ipsilateral rotation of the neck.
  • The trapezius is a triangular muscle on the posterolateral aspect of the neck and thorax that elevates, retracts, and depresses the scapula, depending on the fibers involved.
  • Suprahyoid muscles elevate the hyoid bone and depress the mandible.
  • The mylohyoid's fibers originate off a broad origin point along the internal surface of the mandible, insert onto the body of the hyoid bone, and form support for the base of the tongue.
  • The geniohyoid muscle is internal to the mylohyoid, running anteroposterior from the internal surface of the mandible to the hyoid bone.
  • The stylohyoid runs from the styloid process to the hyoid bone.
  • The digastric has two muscle bellies, originating off the mastoid process to insert on the mandible.
  • An intertendon between the digastric bellies is anchored to the hyoid through a fibrous sling from the pretracheal fascia; its angle of pull elevates the hyoid and depresses the mandible.
  • Infrahyoid muscles depress the hyoid.
  • Paravertebral muscles are primarily in the posterior triangle.

Triangles of the Neck

  • The triangles of the neck are divisions based on muscular borders that assist in localizing and describing structures.
  • The posterior triangle is defined by the trapezius, sternocleidomastoid, and clavicle; the omohyoid divides it into the occipital and supraclavicular triangles.
  • The anterior triangle is defined by the sternocleidomastoid, mandible, and midline; the digastric muscle defines the submandibular triangle, the anterior belly of the digastric defines the submental triangle, and the omohyoid muscle divides the remainder into the carotid and muscular triangles.

Triangle Contents

  • The occipital triangle contains a part of the external jugular vein, posterior branches of the cervical plexus of nerves, accessory nerve, trunks of the brachial plexus, transverse cervical artery, and cervical lymph nodes.
  • The supraclavicular triangle contains subclavian artery (3rd part), part of subclavian vein, suprascapular artery, and supraclavicular lymph nodes.
  • The submandibular triangle contains the submandibular gland, submandibular lymph nodes, hypoglossal nerve, mylohyoid nerve, and parts of the facial artery and vein.
  • The submental triangle contains suprahyoid muscles, submental lymph nodes, and the venous system to the anterior jugular vein.
  • The carotid triangle contains the carotid sheath and contents, external carotid artery, hypoglossal nerve, ansa cervicalis, accessory nerve, thyroid gland, larynx, pharynx, lymph nodes, and branches of the cervical plexus.
  • The muscular triangle contains sternothyroid and sternohyoid muscles, thyroid gland, and parathyroid glands.

Nerves of the Neck

  • The neck contains three cranial nerves.
  • The vagus nerve is contained in the carotid sheath of the carotid triangle, between the carotid artery and internal jugular vein.
  • The accessory nerve is found in the occipital triangle and accepts branches from C2-C4.
  • The hypoglossal nerve is found in the submandibular triangle, along with a branch of C1.
  • The cervical plexus (C1 – C4) has a nerve point of the neck containing the great auricular, lesser occipital, transverse cervical, and supraclavicular nerves.
  • The cervical plexus also contains the ansa cervicalis (C1 – C3).

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