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Questions and Answers
Which nerve innervates the platysma muscle?
Which nerve innervates the platysma muscle?
- Anterior rami of C5-C6
- Brachial plexus
- Accessory nerve (CN XI)
- Cervical branch of facial nerve (CN VII) (correct)
What is the primary action of the sternocleidomastoid muscle?
What is the primary action of the sternocleidomastoid muscle?
- Elevation of the first rib
- Flexion of the neck on the same side (correct)
- Lateral rotation of the neck
- Flexion of the neck on the opposite side
Which of the following muscles originates from the transverse processes of C3-C6?
Which of the following muscles originates from the transverse processes of C3-C6?
- Longus colli
- Sternohyoid
- Digastric
- Anterior scalene (correct)
Which muscle is NOT part of the infrahyoid muscles?
Which muscle is NOT part of the infrahyoid muscles?
What is the innervation of the middle scalene muscle?
What is the innervation of the middle scalene muscle?
Which of the following muscles is part of the deep layer of posterior muscles?
Which of the following muscles is part of the deep layer of posterior muscles?
The scalene muscles assist primarily in which function?
The scalene muscles assist primarily in which function?
What is the primary action of the platysma muscle?
What is the primary action of the platysma muscle?
What is the primary action of the scalene muscles?
What is the primary action of the scalene muscles?
Which muscle is responsible for the rotation and retraction of the scapula?
Which muscle is responsible for the rotation and retraction of the scapula?
What forms the boundaries of the anterior triangle of the neck?
What forms the boundaries of the anterior triangle of the neck?
Which structure is NOT found in the submandibular triangle?
Which structure is NOT found in the submandibular triangle?
What is the roof of the submental triangle composed of?
What is the roof of the submental triangle composed of?
Which triangle is unpaired among the subdivisions of the anterior triangle?
Which triangle is unpaired among the subdivisions of the anterior triangle?
Which nerve innervates the trapezius muscle?
Which nerve innervates the trapezius muscle?
What muscle is responsible for elevation of the second rib?
What muscle is responsible for elevation of the second rib?
Which muscle is contained within the investing layer of the deep cervical fascia?
Which muscle is contained within the investing layer of the deep cervical fascia?
What structure blends with the pre-tracheal layer laterally in the neck?
What structure blends with the pre-tracheal layer laterally in the neck?
The axillary sheath is derived from which layer of the deep cervical fascia?
The axillary sheath is derived from which layer of the deep cervical fascia?
Which structure is NOT found within the carotid sheath?
Which structure is NOT found within the carotid sheath?
What is the upper attachment point of the pre-vertebral layer?
What is the upper attachment point of the pre-vertebral layer?
Which of the following is a component of the superficial fascia in the neck?
Which of the following is a component of the superficial fascia in the neck?
Which neck muscle group is NOT classified as part of the posterior group?
Which neck muscle group is NOT classified as part of the posterior group?
Which of the following structures is located anterior to the pre-vertebral layer?
Which of the following structures is located anterior to the pre-vertebral layer?
What defines the anterior boundary of the carotid triangle?
What defines the anterior boundary of the carotid triangle?
Which nerves are included in the structures of the muscular triangle?
Which nerves are included in the structures of the muscular triangle?
Which artery is NOT found in the carotid triangle?
Which artery is NOT found in the carotid triangle?
What structure forms the floor of the carotid triangle?
What structure forms the floor of the carotid triangle?
In the posterior triangle, which muscle is located at the posterior boundary?
In the posterior triangle, which muscle is located at the posterior boundary?
Which vein does NOT drain into the internal jugular vein in the carotid triangle?
Which vein does NOT drain into the internal jugular vein in the carotid triangle?
What is the main function of the hypoglossal nerve in relation to the muscular triangle?
What is the main function of the hypoglossal nerve in relation to the muscular triangle?
Which structure forms the roof of the posterior triangle?
Which structure forms the roof of the posterior triangle?
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Study Notes
Neck Anatomy
- The neck is the region between the lower margin of the mandible and superior nuchal line of the occipital bone above, and the upper border of the clavicle and suprasternal notch below
- Superficial fascia in the neck is comprised of the Platysma muscle, cutaneous nerves, superficial veins, and superficial lymph nodes.
- Deep cervical fascia in the neck consists of the investing layer, pre-tracheal layer, pre-vertebral layer, and carotid sheath.
Investing Layer
- Attachments:
- Anterior: Symphysis menti, hyoid bone
- Posterior: Ligamentum nuchae, spine of C7 vertebra
- Superior: Lower border of mandible, mastoid process, external occipital protuberance
- Inferior: Spine of scapula, clavicle, sternum
- Contents:
- Sternocleidomastoid
- Trapezius
- Submandibular gland
- Parotid gland
- Supraclavicular space
- Suprasternal space
Pre-Tracheal Layer
- Attachments:
- Superior: Hyoid bone, cricoid cartilage, thyroid cartilage
- Inferior: Into thorax, blends with pericardium and arch of aorta
- Lateral: Blends with carotid sheath
- Contents:
- Thyroid gland
- Parathyroid gland
Pre-Vertebral Layer
- Attachments:
- Superior: Base of the skull
- Inferior: Body of 3rd and 4th thoracic vertebra
- Anterior: Separated from pharynx by retropharyngeal space
- Lateral: Trapezius, investing layer
- Contents:
- Cervical and brachial plexus behind it
- Axillary sheath derives from this layer
Carotid Sheath
- A condensation of deep fascia
- Blends in front with the pre-tracheal layer and behind with the pre-vertebral layer
- Contents:
- Common and Internal carotid arteries
- Internal jugular vein
- Vagus nerve
- Deep cervical lymph nodes
Neck Muscles
- Neck muscles are divided into three groups: anterior, lateral, and posterior
- Primarily responsible for movement of the head in all directions
Anterior Neck Muscles
- Superficial Muscles:
- Platysma
- Sternocleidomastoid
- Suprahyoid Muscles:
- Digastric
- Mylohyoid
- Geniohyoid
- Stylohyoid
- Infrahyoid Muscles:
- Sternohyoid
- Sternothyroid
- Thyrohyoid
- Omohyoid
- Anterior Vertebral Muscles:
- Rectus capitis
- Longus capitis
- Longus colli
Lateral (Vertebral) Neck Muscles
- Scalene Muscles:
- Anterior scalene
- Middle scalene
- Posterior scalene
- Collectively, they form part of the posterior triangle of the neck
- These muscles are accessory muscles of respiration
Posterior Neck Muscles
- Superficial Layer:
- Trapezius
- Splenius capitis
- Splenius cervicis
- Deep Layer:
- Cervical transversospinales muscles (semispinalis capitis, semispinalis cervicis)
- Deepest Layer:
- Suboccipital muscles (rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior, obliquus capitis superior)
Platysma
- A broad sheet arising from the fascia covering the upper parts of the pectoralis major and deltoid
- Fibers cross the clavicle, ascend obliquely and medially along the side of the neck
- Inserts into the mandible, skin of the lower face, lower lip, and corners of the mouth
- Innervation: Cervical branch of facial nerve (CN VII)
- Action: Facial expression
Sternocleidomastoid
- Origin:
- Clavicular head: Medial third of the clavicle
- Sternal head: Manubrium of sternum
- Insertion: Mastoid process
- Innervation: Accessory nerve (CN XI)
- Action: Flexion of the neck on the same side (ipsilateral) and lateral rotation of the head to the opposite side
Scalene Muscles
- Three paired muscles (anterior, middle, and posterior) located lateral to the neck
- They form part of the posterior triangle floor of the neck
- These muscles are accessory muscles of respiration
- Anterior scalene:
- Origin: Transverse processes of C3-C6
- Insertion: Scalene tubercle, on the inner border of the first rib
- Innervation: Anterior rami of C5-C6
- Action: Elevation of the first rib
- Middle scalene:
- Origin: Transverse processes of C2-C7, largest
- Insertion: Scalene tubercle of the first rib
- Innervation: Anterior rami of C3-C8
- Action: Elevation of the first rib
- Posterior scalene:
- Origin: Transverse processes of C5-C7
- Insertion: Second rib
- Innervation: Anterior rami of C6-C8
- Action: Elevation of the second rib
Trapezius
- Origin: Medial one-third of the superior nuchal line, external occipital protuberance, spinous processes of vertebrae C7-T12
- Insertion: Posterior border of the lateral one-third of the clavicle, acromion process, and spine of scapula
- Innervation: Accessory nerve (CN XI)
- Action: Rotation, retraction, elevation, and depression of the scapula
Neck Triangles
- The sternocleidomastoid divides the neck into two major triangles: the anterior triangle and the posterior triangle
- Each triangle contains subdivisions
- They are important due to their numerous contents, including glands, nerves, vessels, and lymph nodes
Anterior Triangle
- Boundaries:
- Anterior border of the sternocleidomastoid muscle
- Midline of the neck
- Inferior border of the mandible
- Roof:
- Skin
- Superficial fascia and platysma muscle
- Investing layer of deep cervical fascia
Subdivisions of the Anterior Triangle
- Submental Triangle:
- Borders:
- Body of hyoid
- Anterior digastric on right
- Anterior digastric on left
- Floor:
- Mylohyoid
- Roof:
- Skin
- Superficial fascia with platysma
- Deep cervical fascia
- Unpaired
- Content:
- Anterior jugular vein
- Submental lymph nodes
- Borders:
- Submandibular Triangle:
- Borders:
- Inferior border of the mandible
- Posterior digastric
- Anterior digastric
- Floor:
- Hyoglossus
- Mylohyoid
- Middle constrictor
- Roof:
- Skin
- Superficial fascia with platysma
- Deep cervical fascia
- Paired
- Contents:
- Arteries:
- Facial
- Sublingual
- Submental
- Veins:
- Same as arteries
- Nerves:
- Mylohyoid and hypoglossal
- Structures:
- Submandibular gland
- Inferior portion of the parotid gland
- Submandibular lymph nodes
- Arteries:
- Borders:
- Carotid Triangle:
- Named because parts of all three carotid arteries are located within it
- Borders:
- Anterior border of the sternocleidomastoid
- Posterior digastric
- Superior omohyoid
- Floor:
- Hyoglossus
- Thyrohyoid
- Middle constrictor
- Inferior constrictor
- Roof:
- Skin
- Superficial fascia with platysma
- Deep cervical fascia
- Paired
- Contents:
- Arteries:
- Common carotid (with carotid body)
- Internal carotid (with carotid sinus)
- Superior thyroid (with superior superior thyroid
- Lingual
- Facial
- Ascending pharyngeal
- Occipital
- Vein:
- Internal jugular vein
- Common facial vein
- Lingual vein
- Superior thyroid vein
- Middle thyroid vein
- Nerves:
- Vagus
- External laryngeal
- Internal laryngeal
- Spinal accessory
- Hypoglossal
- Ansa cervicalis
- Sympathetic trunk
- Vagus
- Structures:
- Larynx
- Thyroid
- Arteries:
- Muscular Triangle:
- Borders:
- Anterior border of the sternocleidomastoid
- Superior omohyoid
- Midline
- Floor:
- Sternohyoid
- Sternothyroid
- Roof:
- Skin
- Superficial fascia with platysma
- Deep cervical fascia
- Paired
- Contents:
- Arteries:
- Superior thyroid
- Veins:
- Inferior thyroid
- Anterior jugular
- Nerves:
- Ansa cervicalis
- Structures:
- Strap Muscles: Sternohyoid, Sternothyroid, Thyrohyoid
- Thyroid gland
- Parathyroid gland
- Larynx
- Trachea
- Esophagus
- Arteries:
- Borders:
Posterior Triangle
- Boundaries:
- Anteriorly: SCM
- Posteriorly: Trapezius
- Inferiorly: Clavicle
- Apex: Occipital bone
- Roof:
- Skin
- Superficial fascia
- Platysma muscle
- Investing layer of the deep cervical fascia
- Floor:
- Formed from these muscles, from above downwards:
- Splenius capitis
- Levator scapulae
- Posterior scalene
- Middle scalene
- Anterior scalene
- Formed from these muscles, from above downwards:
- Muscles:
- Trapezius
Subdivisions of the Posterior Triangle
- Divided into two smaller triangles by the inferior belly of the Omohyoid muscle
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