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Posterior Triangle of the Neck Dr. Zeenat Zaidi The Neck The region of the body that lies between: The region of the body that lies between:  The lower.

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Presentation on theme: "Posterior Triangle of the Neck Dr. Zeenat Zaidi The Neck The region of the body that lies between: The region of the body that lies between:  The lower."— Presentation transcript:

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2 Posterior Triangle of the Neck Dr. Zeenat Zaidi

3 The Neck The region of the body that lies between: The region of the body that lies between:  The lower border of mandible &  The suprasternal notch and the upper border of the clavicle

4 Skin The natural lines of cleavage are constant and run almost horizontally around the neck (an incision along a cleavage line heals as a narrow scar) The natural lines of cleavage are constant and run almost horizontally around the neck (an incision along a cleavage line heals as a narrow scar)

5 Superficial Fascia Thin layer of connective tissue Thin layer of connective tissue Encloses platysma Encloses platysma Contains: Contains: »cutaneous nerves »superficial veins »superficial lymph nodes

6 Cutaneous Nerves Back of the neck: Back of the neck: Greater occipital: branch of the posterior ramus of the C2 (C1 has no cutaneous branch)Greater occipital: branch of the posterior ramus of the C2 (C1 has no cutaneous branch) Front & side of neck: Anterior rami of C2-C4 through branches of cervical plexus Front & side of neck: Anterior rami of C2-C4 through branches of cervical plexus Lesser occipital C2Lesser occipital C2 Great auricular C2-3Great auricular C2-3 Transverse cutaneous C2-3Transverse cutaneous C2-3 Supraclavicular C3-4Supraclavicular C3-4

7 Superficial Veins External Jugular External Jugular Anterior Jugular Anterior Jugular  Formation  Course & relations  Termination  Tributaries

8 Platysma Origin: Deep fascia covering pectoralis major and deltoid muscles Origin: Deep fascia covering pectoralis major and deltoid muscles Insertion: Insertion: Lower margin of the body of mandibleLower margin of the body of mandible Some fibers blending with the muscle at the angle of the mouth (risoreus)Some fibers blending with the muscle at the angle of the mouth (risoreus) Below the chin, fibers interdigitate with the fibers of the opposite muscleBelow the chin, fibers interdigitate with the fibers of the opposite muscle Nerve Supply: Cervical branch of the facial nerve Action: Depresses mandible, draws down the lower lip and the angle of mouth

9 Superficial Lymph Nodes

10 Deep Cervical Fascia

11 Triangles of the Neck

12 Sternocleidomastoid Origin: Upper part of manubrium & medial third of clavicle Origin: Upper part of manubrium & medial third of clavicle Insertion: Mastoid process & lateral part of superior nuchal line Insertion: Mastoid process & lateral part of superior nuchal line Nerve supply: Spinal part of accessory nerve (motor) & ventral rami of C2-3 (proprioceptive) Nerve supply: Spinal part of accessory nerve (motor) & ventral rami of C2-3 (proprioceptive) Action: Action: Both muscles acting together extend head at atlanto-occipital joint, and flex cervical part of vertebral columnBoth muscles acting together extend head at atlanto-occipital joint, and flex cervical part of vertebral column Contraction of one muscle moves the face to the opposite sideContraction of one muscle moves the face to the opposite side

13 Boundaries Anterior: Posterior border of sternocleidomastoid Anterior: Posterior border of sternocleidomastoid Posterior: Anterior border of trapezius Posterior: Anterior border of trapezius Inferior: Middle third of clavicle Inferior: Middle third of clavicle Roof: skin, superficial fascia, platysma, investing layer of deep fascia Roof: skin, superficial fascia, platysma, investing layer of deep fascia Floor: muscles covered by prevertebral fascia Floor: muscles covered by prevertebral fascia

14 Muscular Floor of the Posterior Triangle From above downward:  Semispinalis capitis  Splenius capitis  Levator scapulae  Scalenus medius  Scalenus anterior may or may not be present

15 Subdivision of the Posterior Triangle Subdivided by the inferior belly of omohyoid muscle, into: Subdivided by the inferior belly of omohyoid muscle, into:  Large occipital triangle above  Small supraclavicular triangle below

16 Omohyoid Muscle Two bellies: Superior & Inferior joined by intermediate tendon Two bellies: Superior & Inferior joined by intermediate tendon Attachement: Superior belly to inferior border of hyoid bone, Inferior belly to superior border of scapula & suprascapular ligament Attachement: Superior belly to inferior border of hyoid bone, Inferior belly to superior border of scapula & suprascapular ligament The Intermediate tendon lies deep to sternocleidomastoid, connected to clavicle & the first rib by a loop of deep fascia The Intermediate tendon lies deep to sternocleidomastoid, connected to clavicle & the first rib by a loop of deep fascia Nerve supply: Ansa cervicalis (C1,2,3) Nerve supply: Ansa cervicalis (C1,2,3) Superior belly Intermediate tendon Inferior belly Action: Depresses the hyoid bone

17 Contents Arteries: Arteries:  Subclavian (3 rd part)  Superficial cervical & suprascapular (branches of thyrocervical trunk, a branch of 1 st part of subclavian artery  Occipital, a branch of external carotid artery

18 Veins: Veins: External jugular vein External jugular vein  Formation  Termination  Tributaries

19 Nerves: Nerves:  Branches of cervical plexus  Spinal part of accessory nerve  Brachial plexus

20 Clinical Notes Torticollis (wry neck): Torticollis (wry neck):  Congenital: due to excessive stretching of sternocleidomastoid muscle during labor.  Spasmodic: usually psychogenic Injury to spinal part of accessory nerve Injury to spinal part of accessory nerve Injury to brachial plexus Injury to brachial plexus Pleura & Lung injuries in the root of neck Pleura & Lung injuries in the root of neck Injury to nerve to platysma Injury to nerve to platysma

21 Thank You & Good Luck


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