(6) POSTERIOR TRIANGLE OF THE NECK.pdf

HEAH AND NECK Posterior triangle Professor Dr. Mohamed El fiky Professor of anatomy and Embryology Cutaneous nerves The neck are supplied by the anterior rami of C2, 3 & 4 through the cutaneous branches of cervical plexus :  Lesser occipital (C2)  Great auricular (C 2 & 3)  Transverse cervical (C...

HEAH AND NECK Posterior triangle Professor Dr. Mohamed El fiky Professor of anatomy and Embryology Cutaneous nerves The neck are supplied by the anterior rami of C2, 3 & 4 through the cutaneous branches of cervical plexus :  Lesser occipital (C2)  Great auricular (C 2 & 3)  Transverse cervical (C 2 & 3)  Supraclavicular (C 3 & 4) MOHAMED EL FIKY Superficial veins of the neck KITTIE External jugular vein Course and relations :  Begins behind the angle of mandible by the union of : Posterior auricular Posterior division of posterior facial vein.  It descends obliquely backwards across the sternomastoid  About 1 inch above the middle of the clavicle it pierces the deep fascia to   end in the subclavian vein. Tributaries 1. Posterior auricular vein. 2. Posterior division of the posterior facial vein 3. Posterior external jugular vein. 4. Transverse cervical vein. 5. Suprascapular vein. 6. Anterior jugular veins. MOHAMED EL FIKY Anterior jugular vein Begins below the chin and descends close to midline to the suprasternal notch where it joins its fellow forming jugular arch. The vein then bends sharply laterally deep to the sternomastoid to drain into the external jugular theend submental vein begin from Thereare 2 anteriorjugularveinrightandleft abovethesternumwillformjugulararchthenthe anterior jugularveindrainintoexternaljugularvein MOHAMED EL FIKY Platysma Muscle It lies in the superficial fascia of the side of the neck. Origin: From the deep fascia covering the pectoral region. Insertion: Into the lower border of the mandible. Nerve supply: Facial nerve (Cervical branch). Action: Depresses the mandible and draws down the angle of the mouth. MOHAMED EL FIKY Tticollis 1 ofsternomastoidmuscle inflammation or irritation Sternomastoid sternocleidomastoid Origin: 1  Sternal head : from the superolateral part of the front of the manubrium sierni.  Clavicular head : from the medial 1/3 of the superior surface of the clavicle. Insertion :  Lateral surface of the mastoid process.  Lateral half of the superior nuchal line. Nerve supply:  Spinal accessory (motor).  Branches from ventral rami of C2,3 (sensory, proprioceptive). Actions: flexthenecktothesamesideandelevatedtooppositeside (A) When one muscle contracts: whenthe2musclesaittogetherwillflextheneckforward T KI feel  Turns the face to the opposite side.  Tilts the head towards the shoulder. (B) When both muscles contract together : flex the neck. MOHAMED EL FIKY Mastoid Process Superior Nuchal Line Sternomastoid Muscle Clavicular Head Sternal Head MOHAMED EL FIKY so Posterior triangle Boundaries : Anterior : posterior border of sternomastoid. Posterior : anterior border of trapezius. Inferior(base) : intermediate of third of the clavicle Apex : meeting of trapeziue and sternomastoid c Roof : formed by (1) skin; (2) superficial fascia and platysma (3) deep fascia Floor : formed by the following muslces from above downwards: (1) Semispinalis capitits (2) splenius capitis. (3) levator scapula (4) Scalenus posterior. (5) scalenus medius. Division of the triangle: it is subdivided by the inferior belly of mohyoid into: head aboverelatedtothe  Occipital triangle : the larger uper part.  Supraclavicular triangle : the smaller lower part. whichmuscledivide th Fosteriortriangleintooccipital triangleandsupraclavicular triangle inferiorbellyofomohyoidmuscle MOHAMED EL FIKY Posterior Triangle of The Neck Anterior Triangle of The Neck MOHAMED EL FIKY Inferior belly of Omohyoid Muscle Occipital Triangle MOHAMED EL FIKY MOHAMED EL FIKY Itd Contents of the posterior triangle:    Nerves : Rootsandtrunksof brachial plexus. Branches of cervical plexus Spinalaccessory.  Arteries: Third part of subclavian. Trnasverse cervical. Suprascapular. Occipital. MOHAMED EL FIKY  Veins : a. Subclavian. b. Transverse cervical. c. Suprascapular. d. Lower part of the external jugular. Muslces : inferior belly of omohyoid.  Lymph nodes: Supraclavicular : along the lower part of the posterior border of the sternomastoid muscle. Occipital : at the apex of the triangle. MOHAMED EL FIKY 1- Spinal accesory nerve 2- Branches of cervical plexus 3- Roots and trunks of the brachial plexus 4- Transverse cervical artery 7- 3rd part of subclavian artery 5- Suprascapular artery 6- Subclavian vein MOHAMED EL FIKY Roots Trunks C6 Divisions C7 Cords C8 anterior Branches T1 posterior MOHAMED EL FIKY Deep part of External jugular vein MOHAMED EL FIKY Semispinalis capitis Splenius capitis Levator Scapulae Scalenus medius Scalenus posterior MOHAMED EL FIKY The floor of the triangle is covered by Deep layer of investing cervical fascia MOHAMED EL FIKY Torticollis inflammation or irritationofsterno mastoidmuscle Torticollis MOHAMED EL FIKY