Triangles Of The Neck 64432w
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THE TRIANGLES OF THE NECK OTPT 102:Take Home Quiz A Presentation by: Antonio, Taciana Marie Dela Cruz, Ianna Kristine Domingo, Harvey Duata, Paulo Fortea, Michelle Alyssa Go, Lilbert Go, Riezel Pamela Labarete, Rejean Ramel, Jonas Sahagun, Maria Patricia Velasco, Lovely Jane
THE TRIANGLES OF THE NECK
OBJECTIVES
Objectives
To identify the triangles of the neck
To identify the borders, subdivisions and contents of each triangle
THE TRIANGLES OF THE NECK
INTRODUCTION
Introduction
The neck is the region of the body below the mandible and above the suprasternal notch and upper border of the clavicle.
The neck contains a portion of the respiratory pathways, namely the larynx and trachea, and the digestive pathways, namely the pharynx and esophagus.
On its sides, the neck holds the arteries and veins that transport blood to the brain, as well as the vagus nerve and numerous lymph nodes.
Introduction
With many components and structures present, the neck can become difficult to study.
To better understand the anatomical components of the neck, its lateral aspect can be divided into portions defined by the following borders: a line from the border of the mandible to the mastoid process above, the upper border of the clavicle below, the middling of the neck in front, and the anterior margin of the trapezius muscle behind.
Introduction
The sternocleidomastoid muscle can be thought of as a line that divides the region defined by the borders above into two imaginary triangles.
The contents of these triangles, and other triangles that can be found within, are described in this report.
TRIANGLES OF THE NECK
THE TRIANGLES OF THE NECK
Two Major Triangles: ◦ Anterior Triangle the area anterior to the sternocleidomastoid and below the inferior border of the mandible
◦ Posterior Triangle the area posterior to the sternocleidomastoid and above the trapezius
THE STERNOCLEIDOMASTOID
Sternocleidomastoid ◦ paired muscle in the superficial layer of the anterior portion of the neck divides the neck into two triangles, anterior and posterior, to simplify the complicated area ◦ Origin: Sternal head – manubrium sterni Clavicular head – medial 2/3 of the clavicle
THE STERNOCLEIDOMASTOID ◦ Insertion Mastoid process of the temporal bone and lateral half of the superior nuchal line
◦ Action: Bilateral: Flexes the neck Single: Flexes the head and laterally rotates to the opposite side
◦ Innervation Ipsilateral accessory nerve Anterior primary rami of spinal nerves C2 and C3
THE TRIANGLES OF THE NECK
THE ANTERIOR TRIANGLE
Retrieved from http://www.trueknowledge.com/images/thumbs/180/250/1e1803e46a9642ffccf2316a8e3951b2.png
THE ANTERIOR TRIANGLE ◦ Borders: 1. 2. 3. 4.
Base: Body of the Mandible Anterior: Midline of the Neck Posterior: Sternocleidomastoid Muscle Apex: Sternum
◦ Contents: 1. Suprahyoid Muscles 2. Infrahyoid Muscles
THE ANTERIOR TRIANGLE ◦ Contents: 1. Suprahyoid Muscles: superior to the hyoid 1. 2. 3. 4.
Classifications: Stylohyoid Digastric Mylohyoid Geniohyoid
2. Infrahyoid Muscles: inferior to the hyoid 1. 2. 3. 4.
Classifications: Omohyoid Sternohyoid Thyrohyoid Sternothyroid
THE ANTERIOR TRIANGLE ◦ Subdivisions or Subtriangles:
Muscular Triangle Carotid Triangle Submental Triangle Digastric triangle
The Anterior Triangle: Subdivisions
THE MUSCULAR TRIANGLE
MUSCULAR TRIANGLE
THE ANTERIOR TRIANGLE: SUBDIVISIONS I. Muscular Triangle ◦ also known as the Inferior Carotid Artery ◦ Borders 1.
2. 3.
◦
Medial: Median line of neck from hyoid bone to the sternum Inferolateral: Anterior border of the Sternocleidomastoid muscle Superolateral: Superior belly of the Omohyoid muscle
Covering
Integument, superficial fascia, platysma, and deep cervical fascia
THE ANTERIOR TRIANGLE: SUBDIVISIONS I. Muscular Triangle ◦ Contents: 1. (muscle) The Infrahyoid muscles–Sternohyoid, Sternothyroid 2. (vessel) Common carotid artery, Internal Jugular vein, 3. (nerve) Vagus nerve 4. (glands) Thyroid, Parathyroid
The Anterior Triangle: Subdivisions
THE CAROTID TRIANGLE
Retrieved from http://home.comcast.net/~wnor/necktriangle.jpg
THE ANTERIOR TRIANGLE: SUBDIVISIONS II. Carotid Triangle ◦ Borders 1. Posterior belly of the Digastric 2. Superior belly of the Omohyoid 3. Anterior border of the sternocleidomastoid muscle
◦ contains the bifurcation of the common carotid artery
THE ANTERIOR TRIANGLE: SUBDIVISIONS II. Carotid Triangle ◦ Platysma First layer,under the skin and superficial fascia Forms the roof of the carotid triangle
◦ Common Facial Vein Second Layer, seen with the Platysma removed
◦ Middle and Lower Pharyngeal Constrictors Third layer, Lies on the floor of the Carotid Triangle
THE ANTERIOR TRIANGLE: SUBDIVISIONS II. Carotid Triangle ◦ Contents: Common Carotid Artery arises in the base of the neck from the brachiocephalic artery on the right side and directly from the arch of the aorta on the left side in the superior mediastinum of the thorax es into the base of the neck through the thoracic inlet bounded by T1 vertebral body, the sternum and first rib and ascends into the carotid triangle
THE ANTERIOR TRIANGLE: SUBDIVISIONS
II. Carotid Triangle ◦ Contents:
Internal Jugular Vein collects blood from the brain, face and neck begins after exiting the jugular foramen then es inferiorly through the carotid triangle receiving many tributaries from surrounding structures
Vagus Nerve conveys voluntary motor and sensory nerve fibers to structures in the neck, and viscero-motor fibers to thorax and abdomen enters the neck by exiting the skull through the jugular foramen lies behind and between the carotid and jugular vessels in the carotid triangle
The Anterior Triangle: Subdivisions
THE SUBMENTAL TRIANGLE
Retrieved from http://www.trueknowledge.com/images/thumbs/180/250/1e1803e46a9642ffccf2316a8e3951b2.png
THE ANTERIOR TRIANGLE: SUBDIVISIONS III. Submental Triangle ◦ also called the Suprahyoid Triangle ◦ Borders Lateral: Two Anterior Bellies of the Digastric Posterior: Body of the Hyoid bone Floor: Mylohyoid muscle (Mylohyoideus)
THE ANTERIOR TRIANGLE: SUBDIVISIONS
III. Submental Triangle ◦ Contents: 1.
Gland/s: Submental Lymph Glands drain the floor of the oral cavity, tip of the tongue and middle lower lip and central incisors
2.
Veins
Anterior Jugular veins lie in the midline, running from the submental triangle pierce the deep fascia above manubrium between the posterior border of the sternocleidomastoid muscle and the upper border of the clavicle drain into the external jugular veins in the posterior triangle of the neck
THE ANTERIOR TRIANGLE: SUBDIVISIONS III. Submental Triangle
Submental vein
4. Artery
supplies the submandibular gland and the mylohyoid muscle in addition to the skin and superficial fascia
The Anterior Triangle: Subdivisions
THE DIGASTRIC TRIANGLE
THE ANTERIOR TRIANGLE: SUBDIVISIONS IV. Digastric Triangle ◦ ◦ ◦ ◦
also known as Submandibular Triangle the most superior of the infrahyoid triangles continuous with the fossa for the parotid gland floor is formed by the mylohyoid, hyoglossus and middle constrictor muscles
THE ANTERIOR TRIANGLE: SUBDIVISIONS IV. Digastric Triangle ◦
Borders 1. 2. 3.
◦
Anterior: Anterior belly of Digastric Posterior: Posterior belly of Digastric ed by Stylohyoid muscle Superior: Lower border of Mandible
Floor
formed by the Mylohyoid, Hyoglossus and Superior Constrictor muscles of the Pharynx
THE ANTERIOR TRIANGLE: SUBDIVISIONS IV. Digastric Triangle ◦
Contents 1.
2.
3.
4.
Glands Submandibular and Parotid gland
Veins Anterior Facial and Internal Jugular vein
Arteries Facial, Submental, Internal and External Carotid, Posterior Auricular, Superficial Temporal and Lingual artery
Nerves Vagus, Glossopharyngeal, Facial and Hypoglossal nerve
THE TRIANGLES OF THE NECK
THE POSTERIOR TRIANGLE
Posterior Triangle of the Neck: Please refer to the pink-colored area in the illustration Retrived from http://.wikimedia.org/wikipedia/commons/e/e9/Posterior_triangle_of_the_neck.PNG
THE POSTERIOR TRIANGLE ◦ Subdivisions or Subtriangles: Occipital Triangle Subclavian Triangle
◦ Borders 1. Anterior: Posterior margin of the Sternocleidomastoid muscle 2. Posterior: Anterior margin of the Trapezius muscle 3. Inferior: Middle one-third of the clavicle
THE POSTERIOR TRIANGLE 4. The base of the posterior triangle:
formed by the clavicle
5.The apex of the posterior triangle:
formed in the superior nuchal line of the occipital bone wherein the sternocleidomastoid and the trapezius meet
◦ Roof (Posterior Triangle of the Neck) covered by the skin, the superficial and deep fasciæ, and by the Platysma below
◦ Floor (Posterior Triangle of the Neck) composed of the Splenius capitis, Levator Scapulae, Scalene muscles, and Omohyoid
THE POSTERIOR TRIANGLE ◦ Structures exterior to sternocleidomastoid: External jugular vein – it serves as a drainage to the scalp and face and unfills into the subclavian. Superficial cervical lymph nodes Lesser occipital nerve – es along the latter margin of the sternocleidomastoid and supplies the skin of the face and scalp posterior to the auricle. Great auricular nerve – it rises towards the parotid gland through the upper border of the sternocleidomastoid and supplies the skin inferior to the auricle. Transverse cervical nerve – it transversely es across the middle part of the posterior border of the sternocleidomastoid and supplies the skin with its branches located over the anterior triangle of the neck. Supraclavicular nerves – a single trunk divided into medial, lateral and intermediate branches which supplies the skin of the anterior part of the chest and shoulders.
THE POSTERIOR TRIANGLE ◦ Structures exterior to sternocleidomastoid: Spinal accessory nerve – it innervates the sternocleidomastoid and trapezius ◦ Structures close to the root of the neck: Brachial plexus Subclavian artery Subclavian vein ◦ Other structures found in the posterior triangle of the neck: Transverse cervical artery Suprascapular artery
The Posterior Triangle: Subdivisions
THE OCCIPITAL TRIANGLE
Retrieved from http://commons/archive/9 /93/20090520062314!Musculi_coli_ base,_my_edits_for_tringles,_Occipital_triangles.svg
THE POSTERIOR TRIANGLE: SUBDIVISIONS I. Occipital Triangle ◦ the larger division of the posterior triangle, lying above the inferior belly of the omohyoid ◦ covered by the skin, the superficial and deep fasciæ, and by the Platysma below ◦ Borders 1. 2. 3. 4. 5.
Posterior: Trapezius Muscle Anterior: Sternocleidomastoid Muscle Inferior: Omohyoid Muscle Floor: Splenius Capitus, Levator Scapulae muscle, Scalenus Medius, and a portion of Scalenus Anterior Roof: Superficial layer of Deep Investing Fascia.
THE POSTERIOR TRIANGLE: SUBDIVISIONS I. Occipital Triangle ◦
Contents: Spinal Accessory nerve (XI) crosses the upper half of the triangle diagonally and, ing from the deep surface of sternocleidomastoid inferiorly on levator scapulae to reach the deep surface of trapezius, innervates sternocleidomastoid and trapezius
Superficial cervical cutaneous branches of Cervical plexus formed from ventral primary rami of spinal nerves C2-C4, which emerge from posterior border of sternocleidomastoid
THE POSTERIOR TRIANGLE: SUBDIVISIONS I. Occipital Triangle ◦
Contents: Lesser Occipital (C2)
follows posterior border of SCM to innervate the scalp behind and above the ear.
Great Auricular Nerve (C2,3)
crosses superficial to SCM and innervates the skin over the parotid gland, angle of the jaw and the posterior ear
Transverse Cervical Cutaneous Nerve of the neck (C2,3)
crosses SCM superficially and, is cutaneous for the skin of the front and side of the neck (anterior triangle)
THE POSTERIOR TRIANGLE: SUBDIVISIONS I. Occipital Triangle ◦
Contents: Supraclavicular Nerves (C3,4)
divides into medial, intermediate, and lateral branches, which supply sensation over the shoulder(from the sternoclavicular t to the acromion process), lateral neck and anterior upper thoracic wall
Part of the occipital and parts of the transverse cervical and suprascapular arteries are also found in the occipital triangle.
The Posterior Triangle: Subdivisions
THE SUBCLAVIAN TRIANGLE
Retrieved from http://commons/0/0b/Musculi_coli_base,_my_edits_for_tringles,_Subclavian.svg
THE POSTERIOR TRIANGLE: SUBDIVISIONS II. Subclavian Triangle ◦ Borders 1. 2. 3. 4.
Inferior: Clavicle Superior: Inferior Belly of Omohyoid Muscle Anterior: Sternocleidomastoid Muscle Floor: Splenius Capitus Muscle Levator Scapulae Muscle Scalenus Medius Muscle Scalenus Anterior Muscle (only a small portion)3
5. Roof: Superficial layer of Deep Investing Fascia
THE POSTERIOR TRIANGLE: SUBDIVISIONS II. Subclavian Triangle ◦ Contents 1. Superior trunk of the brachial plexus
the union of C5 and C6 two nerves come from this trunk
2. Suprascapular through the suprascapular foramen to innervate supraspinatus and infraspinatus Suprascapular innervates supraspinatus and infraspinatus Nerve to Subclavius innervates subclavius
THE POSTERIOR TRIANGLE: SUBDIVISIONS II. Subclavian Triangle ◦ Contents 3. Middle trunk of the brachial plexus
continuation of the anterior primary division of the C7 nerve
4. Lower trunk of the brachial plexus
the anterior primary division of the C8 and T1 nerves
5. Subclavian artery
divided into 3 parts with the scalenus anterior muscle as the landmark First: Medial to Scalenus anterior muscle Second: Posterior to Scalenus anterior muscle Third: lateral to the scalenus anterior muscle
THE POSTERIOR TRIANGLE: SUBDIVISIONS
II. Subclavian Triangle ◦ Contents
6. External Jugular Vein
Retromandibular Vein union of superficial temporal and maxillary vein divides at the angle of mandible into anterior and posterior divisions Internal Jugular Vein into which common facial v. (anterior division and facial vein) drains into External Jugular Vein union of posterior division and posterior auricular vein descends across Sternocleidomastoid muscle to drain into Subclavian vein descends to the anterior angle of the posterior triangle where it enters the subclavian vein Anterior Jugular Vein from small veins below mandible descends to External Jugular vein above clavicle
THE TRIANGLES OF THE NECK
CONCLUSION/ SUMMARY
CONCLUSION/SUMMARY
The triangles of the neck are described as the anterior and posterior triangles. The anterior triangle is further subdivided into the muscular triangle, carotid triangle, submental triangle and digastric triangle. The posterior triangle is further subdivided into the occipital and subclavian triangles.
The anterior triangle is bordered by the body of the mandible, midline of the neck, sternocleidomastoid and sternum, and contains the suprahyoid and infrahyoid muscles.
CONCLUSION/SUMMARY
The muscular triangle is bordered by the median line of the neck, the anterior border of the sternocleidomastoid, and the superior border of the omohyoid muscles, and contains the infrahyoid muscles, common carotid artery, internal jugular vein, vagus nerve, and thyroid and parathyroid glands.
The carotid triangle is bordered by the posterior belly of the digastric, superior belly of the omohyoid, and anterior border of the sternocleidomastoid. It contains the platysma, common facial vein, middle and lower pharyngeal constrictors, the vagus nerve, common carotid artery and internal jugular vein.
The submental triangle is bordered by the two anterior bellies of the digastric, the body of the hyoid bone, and the mylohyoid muscle. It contains the submental lymph glands, the anterior jugular and submental veins, and arteries.
CONCLUSION/SUMMARY
The digatric triangle is bordered by the anterior belly of the digastric, the posterior belly of the digastric, and the lower border of the mandible. It contains glands, veins, arteries and nerves.
The posterior triangle is bordered by the posterior margin of the sternocleidomastoid, the anterior margin of the trapezius, the clavicle and the superior nuchal line. It contains the external jugular vein, the lymph nodes, the lesser occipital, transverse cervical, supraclavicular, spinal accessory and auricular nerves, subclavian artery and vein, transverse cervical and suprascapular arteries.
CONCLUSION/SUMMARY
The subclavian triangle is bordered by the clavicle, inferior belly of omohyoid muscle, sternocleidomastoid muscle, other muscles and fascia. It contains the superior, middle and lower trunk of the brachial plexus, suprascapular, subclavian artery, and external jugular vein.
The occipital triangle is bordered by the trapezius muscle, omohyoid muscle, sternocleidomastoid, splenius muscle, and other muscles. It contains the spinal accessory nerves, branches of the cervical plexus, lesser occipital, great auricular, transverse cervical cutaneous nerves, supraclavicular nerve and certain arteries.
CONCLUSION/SUMMARY
References: Carotid Triangle. (2004). In The Free Dictionary by Farlex. Retrieved from http://medical-dictionary.thefreedictionary.com/carotid+triangle Carotid Triangle. (n.d.). In The Anterior Triangle of the Neck. Retrieved from http://iris3.med.tufts.edu/ headneck/Triangles/Anterior%20Triangle%20of%20the%20Neck.htm Edmison, J., et al. (n.d.). Structures in Triangles of Neck. A Summary of the Curriculum of the First Two Years at the School of Medicine of Case Western Reserve University. Retrieved from http://d3jonline.tripod.com/28Head_and_Neck_Anatomy/Structures_in_Triangles_of_the_Neck.htm Gray, H. 1918. The Triangles of the Neck. In Gray's Anatomy of the Human Body (VI. Arteries). Retrieved from http://education.yahoo.com/reference/gray/subjects/subject/145
References: Gray, H. (1918). Gray's Anatomy of the Human Body. Lea and Febiger, Philadelphia, USA Gray, H. (1918). The triangles of the neck. Retrieved from http://iris3.med..tufts.edu/ headneck/Triangles/Posterior%20Triangle %20of%20the%20Neck.htm#OccipiOcc.
The Muscles and Triangles of the Neck [PPT format]. (n.d.). Retrieved from http://www.idoub.com/doc/42017062/The-Muscles-and-Triangles-of-theNeck Norman, W. (1999). Anterior triangle of the neck in detail. Retrieved from http://home.comcast.net/~wnor/lesson5.htm on June 23, 2011. Norman, W. (1999). The Carotid Triangle. In Anatomy of the Head and Neck. Retrieved from http://home.comcast.net/~wnor/lesson5.htm
References: Norman, W. (1999). Sternomastoid Region and Posterior Triangle of Neck. The Anatomy Lesson. Retrieved from http://home.comcast.net/~wnor/lesson6.htm Photius Coutsoukis. (n.d.). The triangles of the neck. Retrieved from http://www.theodora.com/anatomy/the_triangles_of_the_neck.html on June 23, 2011. Rafique, M. Anterior Triangle of Neck, Supra-hyoid & Infra-hyoid muscles [PowerPoint slides]. Retrieved from http://www.docstoc.com/docs/57150790/Anterior-Triangle-of-NeckSupra-hyoid-and-Infra-hyoid-muscles Snell, R. S. (2008). Clinical Anatomy by Regions. Lippincott Williams & Wilkins, Philadelphia, USA Tank, P. (2005). Carotid, Submandibular and Submental Triangles of the Neck. Retrieved from http://anatomy.uams.edu/anatomyhtml/anteriortriangle.html on June 23, 2011.
References: Tank, P. W. (2005). Grant's Dissector 13th ed. Lippincott Williams & Wilkins, Philadelphia, USA Tufts University Department of Anatomy and Cellular Biology Medical and Dental Gross Anatomy.(n.d). The Anterior Triangle of the Neck. Retrieved from http://iris3.med. tufts.edu/headneck/Triangles/Anterior%20Triangle%20of%20the%20Neck.htm Tufts University Department of Anatomy and Cellular Biology Medical and Dental Gross Anatomy. (n.d.). Retrieved from http://iris3.med.tufts.edu/headneck/Triangles/Posterior%20Triangle%20of%20the%20 Neck.htm
Tufts University Department of Anatomy and Cellular Biology Medical and Dental Gross Anatomy. (n.d). The Anterior Triangle of the Neck. Reyrieved from http://iris3.med.tufts.edu/headneck/Triangles/Anterior%20Triangle%20of%20the%20 Neck.htm#Submental on June 23, 2011.
References: Tufts University Department of Anatomy and Cellular Biology Medical and Dental Gross Anatomy. (n.d).The posterior triangle of the neck. Retrieved from http://iris3.med.tufts.edu/ headneck/Triangles/Posterior%20Triangle%20of%2 0the%20Neck.htm#Occipital. Willson, R., n.d, The Anterior Triangle of the Neck. Retrieved from http://iris3.med.tufts.edu/headneck/Triangles/Ante rior%20Triangle%20of%20the%20Neck.htm
THE TRIANGLES OF THE NECK
OBJECTIVES
Objectives
To identify the triangles of the neck
To identify the borders, subdivisions and contents of each triangle
THE TRIANGLES OF THE NECK
INTRODUCTION
Introduction
The neck is the region of the body below the mandible and above the suprasternal notch and upper border of the clavicle.
The neck contains a portion of the respiratory pathways, namely the larynx and trachea, and the digestive pathways, namely the pharynx and esophagus.
On its sides, the neck holds the arteries and veins that transport blood to the brain, as well as the vagus nerve and numerous lymph nodes.
Introduction
With many components and structures present, the neck can become difficult to study.
To better understand the anatomical components of the neck, its lateral aspect can be divided into portions defined by the following borders: a line from the border of the mandible to the mastoid process above, the upper border of the clavicle below, the middling of the neck in front, and the anterior margin of the trapezius muscle behind.
Introduction
The sternocleidomastoid muscle can be thought of as a line that divides the region defined by the borders above into two imaginary triangles.
The contents of these triangles, and other triangles that can be found within, are described in this report.
TRIANGLES OF THE NECK
THE TRIANGLES OF THE NECK
Two Major Triangles: ◦ Anterior Triangle the area anterior to the sternocleidomastoid and below the inferior border of the mandible
◦ Posterior Triangle the area posterior to the sternocleidomastoid and above the trapezius
THE STERNOCLEIDOMASTOID
Sternocleidomastoid ◦ paired muscle in the superficial layer of the anterior portion of the neck divides the neck into two triangles, anterior and posterior, to simplify the complicated area ◦ Origin: Sternal head – manubrium sterni Clavicular head – medial 2/3 of the clavicle
THE STERNOCLEIDOMASTOID ◦ Insertion Mastoid process of the temporal bone and lateral half of the superior nuchal line
◦ Action: Bilateral: Flexes the neck Single: Flexes the head and laterally rotates to the opposite side
◦ Innervation Ipsilateral accessory nerve Anterior primary rami of spinal nerves C2 and C3
THE TRIANGLES OF THE NECK
THE ANTERIOR TRIANGLE
Retrieved from http://www.trueknowledge.com/images/thumbs/180/250/1e1803e46a9642ffccf2316a8e3951b2.png
THE ANTERIOR TRIANGLE ◦ Borders: 1. 2. 3. 4.
Base: Body of the Mandible Anterior: Midline of the Neck Posterior: Sternocleidomastoid Muscle Apex: Sternum
◦ Contents: 1. Suprahyoid Muscles 2. Infrahyoid Muscles
THE ANTERIOR TRIANGLE ◦ Contents: 1. Suprahyoid Muscles: superior to the hyoid 1. 2. 3. 4.
Classifications: Stylohyoid Digastric Mylohyoid Geniohyoid
2. Infrahyoid Muscles: inferior to the hyoid 1. 2. 3. 4.
Classifications: Omohyoid Sternohyoid Thyrohyoid Sternothyroid
THE ANTERIOR TRIANGLE ◦ Subdivisions or Subtriangles:
Muscular Triangle Carotid Triangle Submental Triangle Digastric triangle
The Anterior Triangle: Subdivisions
THE MUSCULAR TRIANGLE
MUSCULAR TRIANGLE
THE ANTERIOR TRIANGLE: SUBDIVISIONS I. Muscular Triangle ◦ also known as the Inferior Carotid Artery ◦ Borders 1.
2. 3.
◦
Medial: Median line of neck from hyoid bone to the sternum Inferolateral: Anterior border of the Sternocleidomastoid muscle Superolateral: Superior belly of the Omohyoid muscle
Covering
Integument, superficial fascia, platysma, and deep cervical fascia
THE ANTERIOR TRIANGLE: SUBDIVISIONS I. Muscular Triangle ◦ Contents: 1. (muscle) The Infrahyoid muscles–Sternohyoid, Sternothyroid 2. (vessel) Common carotid artery, Internal Jugular vein, 3. (nerve) Vagus nerve 4. (glands) Thyroid, Parathyroid
The Anterior Triangle: Subdivisions
THE CAROTID TRIANGLE
Retrieved from http://home.comcast.net/~wnor/necktriangle.jpg
THE ANTERIOR TRIANGLE: SUBDIVISIONS II. Carotid Triangle ◦ Borders 1. Posterior belly of the Digastric 2. Superior belly of the Omohyoid 3. Anterior border of the sternocleidomastoid muscle
◦ contains the bifurcation of the common carotid artery
THE ANTERIOR TRIANGLE: SUBDIVISIONS II. Carotid Triangle ◦ Platysma First layer,under the skin and superficial fascia Forms the roof of the carotid triangle
◦ Common Facial Vein Second Layer, seen with the Platysma removed
◦ Middle and Lower Pharyngeal Constrictors Third layer, Lies on the floor of the Carotid Triangle
THE ANTERIOR TRIANGLE: SUBDIVISIONS II. Carotid Triangle ◦ Contents: Common Carotid Artery arises in the base of the neck from the brachiocephalic artery on the right side and directly from the arch of the aorta on the left side in the superior mediastinum of the thorax es into the base of the neck through the thoracic inlet bounded by T1 vertebral body, the sternum and first rib and ascends into the carotid triangle
THE ANTERIOR TRIANGLE: SUBDIVISIONS
II. Carotid Triangle ◦ Contents:
Internal Jugular Vein collects blood from the brain, face and neck begins after exiting the jugular foramen then es inferiorly through the carotid triangle receiving many tributaries from surrounding structures
Vagus Nerve conveys voluntary motor and sensory nerve fibers to structures in the neck, and viscero-motor fibers to thorax and abdomen enters the neck by exiting the skull through the jugular foramen lies behind and between the carotid and jugular vessels in the carotid triangle
The Anterior Triangle: Subdivisions
THE SUBMENTAL TRIANGLE
Retrieved from http://www.trueknowledge.com/images/thumbs/180/250/1e1803e46a9642ffccf2316a8e3951b2.png
THE ANTERIOR TRIANGLE: SUBDIVISIONS III. Submental Triangle ◦ also called the Suprahyoid Triangle ◦ Borders Lateral: Two Anterior Bellies of the Digastric Posterior: Body of the Hyoid bone Floor: Mylohyoid muscle (Mylohyoideus)
THE ANTERIOR TRIANGLE: SUBDIVISIONS
III. Submental Triangle ◦ Contents: 1.
Gland/s: Submental Lymph Glands drain the floor of the oral cavity, tip of the tongue and middle lower lip and central incisors
2.
Veins
Anterior Jugular veins lie in the midline, running from the submental triangle pierce the deep fascia above manubrium between the posterior border of the sternocleidomastoid muscle and the upper border of the clavicle drain into the external jugular veins in the posterior triangle of the neck
THE ANTERIOR TRIANGLE: SUBDIVISIONS III. Submental Triangle
Submental vein
4. Artery
supplies the submandibular gland and the mylohyoid muscle in addition to the skin and superficial fascia
The Anterior Triangle: Subdivisions
THE DIGASTRIC TRIANGLE
THE ANTERIOR TRIANGLE: SUBDIVISIONS IV. Digastric Triangle ◦ ◦ ◦ ◦
also known as Submandibular Triangle the most superior of the infrahyoid triangles continuous with the fossa for the parotid gland floor is formed by the mylohyoid, hyoglossus and middle constrictor muscles
THE ANTERIOR TRIANGLE: SUBDIVISIONS IV. Digastric Triangle ◦
Borders 1. 2. 3.
◦
Anterior: Anterior belly of Digastric Posterior: Posterior belly of Digastric ed by Stylohyoid muscle Superior: Lower border of Mandible
Floor
formed by the Mylohyoid, Hyoglossus and Superior Constrictor muscles of the Pharynx
THE ANTERIOR TRIANGLE: SUBDIVISIONS IV. Digastric Triangle ◦
Contents 1.
2.
3.
4.
Glands Submandibular and Parotid gland
Veins Anterior Facial and Internal Jugular vein
Arteries Facial, Submental, Internal and External Carotid, Posterior Auricular, Superficial Temporal and Lingual artery
Nerves Vagus, Glossopharyngeal, Facial and Hypoglossal nerve
THE TRIANGLES OF THE NECK
THE POSTERIOR TRIANGLE
Posterior Triangle of the Neck: Please refer to the pink-colored area in the illustration Retrived from http://.wikimedia.org/wikipedia/commons/e/e9/Posterior_triangle_of_the_neck.PNG
THE POSTERIOR TRIANGLE ◦ Subdivisions or Subtriangles: Occipital Triangle Subclavian Triangle
◦ Borders 1. Anterior: Posterior margin of the Sternocleidomastoid muscle 2. Posterior: Anterior margin of the Trapezius muscle 3. Inferior: Middle one-third of the clavicle
THE POSTERIOR TRIANGLE 4. The base of the posterior triangle:
formed by the clavicle
5.The apex of the posterior triangle:
formed in the superior nuchal line of the occipital bone wherein the sternocleidomastoid and the trapezius meet
◦ Roof (Posterior Triangle of the Neck) covered by the skin, the superficial and deep fasciæ, and by the Platysma below
◦ Floor (Posterior Triangle of the Neck) composed of the Splenius capitis, Levator Scapulae, Scalene muscles, and Omohyoid
THE POSTERIOR TRIANGLE ◦ Structures exterior to sternocleidomastoid: External jugular vein – it serves as a drainage to the scalp and face and unfills into the subclavian. Superficial cervical lymph nodes Lesser occipital nerve – es along the latter margin of the sternocleidomastoid and supplies the skin of the face and scalp posterior to the auricle. Great auricular nerve – it rises towards the parotid gland through the upper border of the sternocleidomastoid and supplies the skin inferior to the auricle. Transverse cervical nerve – it transversely es across the middle part of the posterior border of the sternocleidomastoid and supplies the skin with its branches located over the anterior triangle of the neck. Supraclavicular nerves – a single trunk divided into medial, lateral and intermediate branches which supplies the skin of the anterior part of the chest and shoulders.
THE POSTERIOR TRIANGLE ◦ Structures exterior to sternocleidomastoid: Spinal accessory nerve – it innervates the sternocleidomastoid and trapezius ◦ Structures close to the root of the neck: Brachial plexus Subclavian artery Subclavian vein ◦ Other structures found in the posterior triangle of the neck: Transverse cervical artery Suprascapular artery
The Posterior Triangle: Subdivisions
THE OCCIPITAL TRIANGLE
Retrieved from http://commons/archive/9 /93/20090520062314!Musculi_coli_ base,_my_edits_for_tringles,_Occipital_triangles.svg
THE POSTERIOR TRIANGLE: SUBDIVISIONS I. Occipital Triangle ◦ the larger division of the posterior triangle, lying above the inferior belly of the omohyoid ◦ covered by the skin, the superficial and deep fasciæ, and by the Platysma below ◦ Borders 1. 2. 3. 4. 5.
Posterior: Trapezius Muscle Anterior: Sternocleidomastoid Muscle Inferior: Omohyoid Muscle Floor: Splenius Capitus, Levator Scapulae muscle, Scalenus Medius, and a portion of Scalenus Anterior Roof: Superficial layer of Deep Investing Fascia.
THE POSTERIOR TRIANGLE: SUBDIVISIONS I. Occipital Triangle ◦
Contents: Spinal Accessory nerve (XI) crosses the upper half of the triangle diagonally and, ing from the deep surface of sternocleidomastoid inferiorly on levator scapulae to reach the deep surface of trapezius, innervates sternocleidomastoid and trapezius
Superficial cervical cutaneous branches of Cervical plexus formed from ventral primary rami of spinal nerves C2-C4, which emerge from posterior border of sternocleidomastoid
THE POSTERIOR TRIANGLE: SUBDIVISIONS I. Occipital Triangle ◦
Contents: Lesser Occipital (C2)
follows posterior border of SCM to innervate the scalp behind and above the ear.
Great Auricular Nerve (C2,3)
crosses superficial to SCM and innervates the skin over the parotid gland, angle of the jaw and the posterior ear
Transverse Cervical Cutaneous Nerve of the neck (C2,3)
crosses SCM superficially and, is cutaneous for the skin of the front and side of the neck (anterior triangle)
THE POSTERIOR TRIANGLE: SUBDIVISIONS I. Occipital Triangle ◦
Contents: Supraclavicular Nerves (C3,4)
divides into medial, intermediate, and lateral branches, which supply sensation over the shoulder(from the sternoclavicular t to the acromion process), lateral neck and anterior upper thoracic wall
Part of the occipital and parts of the transverse cervical and suprascapular arteries are also found in the occipital triangle.
The Posterior Triangle: Subdivisions
THE SUBCLAVIAN TRIANGLE
Retrieved from http://commons/0/0b/Musculi_coli_base,_my_edits_for_tringles,_Subclavian.svg
THE POSTERIOR TRIANGLE: SUBDIVISIONS II. Subclavian Triangle ◦ Borders 1. 2. 3. 4.
Inferior: Clavicle Superior: Inferior Belly of Omohyoid Muscle Anterior: Sternocleidomastoid Muscle Floor: Splenius Capitus Muscle Levator Scapulae Muscle Scalenus Medius Muscle Scalenus Anterior Muscle (only a small portion)3
5. Roof: Superficial layer of Deep Investing Fascia
THE POSTERIOR TRIANGLE: SUBDIVISIONS II. Subclavian Triangle ◦ Contents 1. Superior trunk of the brachial plexus
the union of C5 and C6 two nerves come from this trunk
2. Suprascapular through the suprascapular foramen to innervate supraspinatus and infraspinatus Suprascapular innervates supraspinatus and infraspinatus Nerve to Subclavius innervates subclavius
THE POSTERIOR TRIANGLE: SUBDIVISIONS II. Subclavian Triangle ◦ Contents 3. Middle trunk of the brachial plexus
continuation of the anterior primary division of the C7 nerve
4. Lower trunk of the brachial plexus
the anterior primary division of the C8 and T1 nerves
5. Subclavian artery
divided into 3 parts with the scalenus anterior muscle as the landmark First: Medial to Scalenus anterior muscle Second: Posterior to Scalenus anterior muscle Third: lateral to the scalenus anterior muscle
THE POSTERIOR TRIANGLE: SUBDIVISIONS
II. Subclavian Triangle ◦ Contents
6. External Jugular Vein
Retromandibular Vein union of superficial temporal and maxillary vein divides at the angle of mandible into anterior and posterior divisions Internal Jugular Vein into which common facial v. (anterior division and facial vein) drains into External Jugular Vein union of posterior division and posterior auricular vein descends across Sternocleidomastoid muscle to drain into Subclavian vein descends to the anterior angle of the posterior triangle where it enters the subclavian vein Anterior Jugular Vein from small veins below mandible descends to External Jugular vein above clavicle
THE TRIANGLES OF THE NECK
CONCLUSION/ SUMMARY
CONCLUSION/SUMMARY
The triangles of the neck are described as the anterior and posterior triangles. The anterior triangle is further subdivided into the muscular triangle, carotid triangle, submental triangle and digastric triangle. The posterior triangle is further subdivided into the occipital and subclavian triangles.
The anterior triangle is bordered by the body of the mandible, midline of the neck, sternocleidomastoid and sternum, and contains the suprahyoid and infrahyoid muscles.
CONCLUSION/SUMMARY
The muscular triangle is bordered by the median line of the neck, the anterior border of the sternocleidomastoid, and the superior border of the omohyoid muscles, and contains the infrahyoid muscles, common carotid artery, internal jugular vein, vagus nerve, and thyroid and parathyroid glands.
The carotid triangle is bordered by the posterior belly of the digastric, superior belly of the omohyoid, and anterior border of the sternocleidomastoid. It contains the platysma, common facial vein, middle and lower pharyngeal constrictors, the vagus nerve, common carotid artery and internal jugular vein.
The submental triangle is bordered by the two anterior bellies of the digastric, the body of the hyoid bone, and the mylohyoid muscle. It contains the submental lymph glands, the anterior jugular and submental veins, and arteries.
CONCLUSION/SUMMARY
The digatric triangle is bordered by the anterior belly of the digastric, the posterior belly of the digastric, and the lower border of the mandible. It contains glands, veins, arteries and nerves.
The posterior triangle is bordered by the posterior margin of the sternocleidomastoid, the anterior margin of the trapezius, the clavicle and the superior nuchal line. It contains the external jugular vein, the lymph nodes, the lesser occipital, transverse cervical, supraclavicular, spinal accessory and auricular nerves, subclavian artery and vein, transverse cervical and suprascapular arteries.
CONCLUSION/SUMMARY
The subclavian triangle is bordered by the clavicle, inferior belly of omohyoid muscle, sternocleidomastoid muscle, other muscles and fascia. It contains the superior, middle and lower trunk of the brachial plexus, suprascapular, subclavian artery, and external jugular vein.
The occipital triangle is bordered by the trapezius muscle, omohyoid muscle, sternocleidomastoid, splenius muscle, and other muscles. It contains the spinal accessory nerves, branches of the cervical plexus, lesser occipital, great auricular, transverse cervical cutaneous nerves, supraclavicular nerve and certain arteries.
CONCLUSION/SUMMARY
References: Carotid Triangle. (2004). In The Free Dictionary by Farlex. Retrieved from http://medical-dictionary.thefreedictionary.com/carotid+triangle Carotid Triangle. (n.d.). In The Anterior Triangle of the Neck. Retrieved from http://iris3.med.tufts.edu/ headneck/Triangles/Anterior%20Triangle%20of%20the%20Neck.htm Edmison, J., et al. (n.d.). Structures in Triangles of Neck. A Summary of the Curriculum of the First Two Years at the School of Medicine of Case Western Reserve University. Retrieved from http://d3jonline.tripod.com/28Head_and_Neck_Anatomy/Structures_in_Triangles_of_the_Neck.htm Gray, H. 1918. The Triangles of the Neck. In Gray's Anatomy of the Human Body (VI. Arteries). Retrieved from http://education.yahoo.com/reference/gray/subjects/subject/145
References: Gray, H. (1918). Gray's Anatomy of the Human Body. Lea and Febiger, Philadelphia, USA Gray, H. (1918). The triangles of the neck. Retrieved from http://iris3.med..tufts.edu/ headneck/Triangles/Posterior%20Triangle %20of%20the%20Neck.htm#OccipiOcc.
The Muscles and Triangles of the Neck [PPT format]. (n.d.). Retrieved from http://www.idoub.com/doc/42017062/The-Muscles-and-Triangles-of-theNeck Norman, W. (1999). Anterior triangle of the neck in detail. Retrieved from http://home.comcast.net/~wnor/lesson5.htm on June 23, 2011. Norman, W. (1999). The Carotid Triangle. In Anatomy of the Head and Neck. Retrieved from http://home.comcast.net/~wnor/lesson5.htm
References: Norman, W. (1999). Sternomastoid Region and Posterior Triangle of Neck. The Anatomy Lesson. Retrieved from http://home.comcast.net/~wnor/lesson6.htm Photius Coutsoukis. (n.d.). The triangles of the neck. Retrieved from http://www.theodora.com/anatomy/the_triangles_of_the_neck.html on June 23, 2011. Rafique, M. Anterior Triangle of Neck, Supra-hyoid & Infra-hyoid muscles [PowerPoint slides]. Retrieved from http://www.docstoc.com/docs/57150790/Anterior-Triangle-of-NeckSupra-hyoid-and-Infra-hyoid-muscles Snell, R. S. (2008). Clinical Anatomy by Regions. Lippincott Williams & Wilkins, Philadelphia, USA Tank, P. (2005). Carotid, Submandibular and Submental Triangles of the Neck. Retrieved from http://anatomy.uams.edu/anatomyhtml/anteriortriangle.html on June 23, 2011.
References: Tank, P. W. (2005). Grant's Dissector 13th ed. Lippincott Williams & Wilkins, Philadelphia, USA Tufts University Department of Anatomy and Cellular Biology Medical and Dental Gross Anatomy.(n.d). The Anterior Triangle of the Neck. Retrieved from http://iris3.med. tufts.edu/headneck/Triangles/Anterior%20Triangle%20of%20the%20Neck.htm Tufts University Department of Anatomy and Cellular Biology Medical and Dental Gross Anatomy. (n.d.). Retrieved from http://iris3.med.tufts.edu/headneck/Triangles/Posterior%20Triangle%20of%20the%20 Neck.htm
Tufts University Department of Anatomy and Cellular Biology Medical and Dental Gross Anatomy. (n.d). The Anterior Triangle of the Neck. Reyrieved from http://iris3.med.tufts.edu/headneck/Triangles/Anterior%20Triangle%20of%20the%20 Neck.htm#Submental on June 23, 2011.
References: Tufts University Department of Anatomy and Cellular Biology Medical and Dental Gross Anatomy. (n.d).The posterior triangle of the neck. Retrieved from http://iris3.med.tufts.edu/ headneck/Triangles/Posterior%20Triangle%20of%2 0the%20Neck.htm#Occipital. Willson, R., n.d, The Anterior Triangle of the Neck. Retrieved from http://iris3.med.tufts.edu/headneck/Triangles/Ante rior%20Triangle%20of%20the%20Neck.htm
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