SHN 2014 Structures - Fredit

Structure Region Type Landmarks Notesneck mm Superficial neck.

neck

external jugular vein

cervical plexus

lesser occipital nerve

great auricular nerve

Innervates skin of shoulder.

transverse cervical nerve Skin of the anterior triangle.

bone

thyroid cartilage CT

Drains anterior triangle.

posterior auricular vein Drains area behind the area.

platysma muscle

suprascapular nerve (C5, C6) nnPass inferiorly to innervate the skin of shoulder.

There are medial, intermediate, lateral branches.

anterior triangle vv

In the SF fascia deep to platysma mm. Posterior to angle of mandible, crosses SF surface of SCM. Drains into subclavian vv.

anterior triangle

Nn – cervical plexus

Enter SF fascia near midpoint of posterior border of SCM. Cutaneous nn's to the neck.

posterior triangle


Runs parallel to posterior border of SCM.

Supplies part of scalp immediately behind ear.

anterior triangle


Crosses superficial surface of SCM, parallel to external jugular vv.

Supplies skin of lower ear, over parotid gland, and from angle of mandible to mastoid process.

supraclavicular nerveposterior triangle


Passes inferiorly with a medial, intermediate, and lateral set of branches.

anterior triangle


Passes transversely/perpendicularly across SCM.

hyoidanterior triangle

U-shaped bone betwixt floor of mouth and superior end of neck.

Serves as a central attachment for various mm's and CT about the neck.

anterior triangle

posterior branch of the retromandibular veinanterior triangle vv

The external jugular vv is formed by the joining of the posterior division of retromandibular vv and the posterior auricular vv.


Descends behind the ear along the anterior border of SCM, joins the posterior division of retromandibular vv to form the external jugular vv.

anterior jugular vein

accessory nerve (CN XI) CN

muscular triangle area

mm

mm

mm

mm


In the SF fascia near the anterior midline. Begins near hyoid bone, goes inferiorly.

posterior triangle

Crosses posterior cervical triangle. Emerges slightly superior to midpoint of posterior broder of SCM. Innervates trapezius mm.

muscular triangle

Boundaries: superolateral (superior belly of omohyoid mm), inferolateral (anterior border of SCM); medial (medial plane of neck).

Contains infrahyoid mm's, thyroid gland, parathyroid glands.

sternohyoid musclemuscular triangle

Inferior attachment to sternum, superior attachment is hyoid bone.

Depresses the hyoid bone. Innervated by anterior rami of C1 to C3 via ansa cervicalis.

omohyoid musclemuscular triangle

Superior belly is lateral to sternohyoid mm, attaches to inferior margin of hyoid bone. Inferior belly attaches to superior border of scapula near supreascapular notch.

Depresses the hyoid bone. Innervated by anterior rami of C1 to C3 via ansa cervicalis.

sternothyroid musclemuscular triangle

Inferior attachment to sternum. Superior attachment to oblique line of thyroid cartilage. Medial to superior belly of omohyoid mm.

Depress larynx. Innervated by anterior rami of C1 to C3 via ansa cervicalis.

thyrohyoid musclemuscular triangle

Inferior attachment is oblique line of thyroid cartilage. Superior attachment is hyoid bone. Posterior/lateral to the superior belly of omohyoid mm.

Elevate larynx. Fibers from anterior of C1 carried along hypoglossal nn.

nerve to the thyrohyoid muscle (C1)muscular triangle

Nn – Ansa Cervicalis Arises from Ansa Cervicalis. Innervates thyrohyoid mm.

area

gland Below the angle of mandible.

mm

mm

mm

CN

mm

area

submandibular (digastric) triangle

submandibular triangle

Boundaries: superior (inferior border of mandible), anteroinferior (anterior belly of digastric mm), posteroinferior (posterior belly of digastric mm), superficial/roof (investing layer of deep cervical fascia), deep/floor (mylohyoid and hyoglossus mm's).

Contains the submandibular gland, facial aa/vv, stylohyoid mm, parts of Hypoglossal nn (CN XII), lymph nodes.

submandibular gland

submandibular triangle Mixed serous and mucuous secretions.

anterior belly of the digastric muscle


Attaches to digastric fossa of mandible.

Innervated by mylohyoid nn (branch of mandibular division of Trigeminal; V3).

posterior belly of the digastric muscle


Posterior attachment of posterior belly is mastoid process of temporal bone.

Innervated by facial nn, CN VII. Elevate hyoid bone, depress mandible.

stylohyoid muscle


Originates from base of styloid process. Inserts to lateral area of body of hyoid bone.

Innervated by Facial nn. Pulls hyoid bone upwards in opstero-superior dierction.

hypoglossal nerve


Enters the submandibular triangle by going deep to posterior belly of digastric mm, deep to mylohyoid mm.

mylohyoid muscle


Originates from mylohyoid line on mandible, inserts to body of hyoid bone and fibers of mm from opposite side.

Innervated by mylohyoid nn from ifnerior alveolar branch of mandibular nn (V3). Support and elevation of floor of mouth; elevation of hyoid.

submental trianglesubmental triangle

An unpaired triangle that crosses midline. Right & left boundaries (anterior bellies of digastric mm's); inferior (hyoid bone); superficial (investing layer of deep cervical fascia); deep (mylohyoid mm). Contains submental lymph nodes.

carotid triangle area

external laryngeal nerve

superior laryngeal nerve

carotid sheath CT

common carotid artery

internal carotid artery

carotid triangle

Boundaries: inferomedial (superior belly of omohyoid mm), inferolateral (anterior border of SCM), superior (posterior belly of digastric mm).

Contains carotid aa's (common, infernal, external), branches of external carotid aa, part of CN XII, branches of CN X.

superior (hypoglossal) root of the ansa cervicalis

carotid triangle

Nn – Ansa Cervicalis

The superior root of ansa cervicalis travels with Hypoglossal nn.

The ansa cervicalis innervates ¾ of infrahyoid mm's: omohyoid, sternohyoid, sternothyroid mm's. Composed of mostly fibers from anterior C1.

inferior (cervical) root of the ansa cervicaliscarotid triangle

Nn – Ansa Cervicalis

Inferior root passes around lateral side of carotid sheath to join superior root to form the loop. Anterior rami of C2, C3.

internal laryngeal nerve (br. of superior laryngeal)

carotid triangle nn

Passes through the thyrohyoid membrane, courses superiorly to join external branch of superior laryngeal nn to form th superior laryngeal nn.

Gives sensory information to mucosa of larynx.

carotid triangle nn

Seen superficial to the inferior pharyngeal constrictor mm.

Arise from the superior laryngeal branch of the vagus nn.

carotid triangle nn

Made from the superiorly coursing convergence of the internal and external superior laryngeal nn's. From the vagus nn.

carotid triangle

Contains common carotid aa, internal carotid aa, internal jugular vv, and vagus nn (CN X).

carotid triangle

Aa – common carotid aa

The right side arises from the brachiocephalic trunk, the left side directly from the aortic arch.

Gives off the internal and external carotidd aa's.

carotid triangle


Arises from common carotid aa. Begins posteriorlateral to the external carotid aa, then crosses over. Enters cranial cavity through the carotid canal in the temporal bone.

Supplies the cerebral hemispheres, eyes, contents of orbits, and forehead.

external carotid artery

carotid sinus Sensory information!

carotid body

superior thyroid artery

superior laryngeal artery

lingual artery

facial artery

occipital artery

posterior auricular artery

carotid triangle


Contains six branches, each of which has an associated vv.

Gives off superior thyroid (and superior laryngeal), lingual, facial, occipital, posterior auricular, and ascending pharyngeal aa.

carotid triangle


An expansion of the common carotid aa closer to the side of the internal carotid aa.

carotid triangle


Small mass of tissue at the medial aspect of carotid bifurcation.

Contains pressoreceptors to monitor blood pressure. Innervated by CN IX and CN X.

carotid triangle

Aa – external carotid aa

From anterior surface of external carotid aa. Descends to superior pole of thyroid gland. Gives off superior laryngeal aa.

carotid triangle


Arises from the superior thyrouid aa, pierces thyrohyoid membrane alongside the internal branch of superior laryngeal nn.

carotid triangle


From the anterior surface of external carotid aa near greater horn of hyoid bone. Passes deeply into mm's of tongue.

carotid triangle


From anterior surface of external carotid aa immediately superior to lingual aa. Medial to posterior belly of digastric mm, deep to superficial part of submandibular gland. Crosses inferiro edge of mandible to enter face.

carotid triangle


From the posterior surface of external carotid aa, courses to part of scalp.

carotid triangle


Arises from posterior surface of external carotid, goes posterior to the ear to get the scalp.

internal jugular vein

common facial vein

middle thyroid vein

superior thyroid vein

CN

thyroid gland gland

inferior thyroid vein

Relatively rare artery.

gland Produce PTH.

neck root

neck root

neck root VITCD.

ascending pharygeal arterycarotid triangle


Arises from medial surface of external carotid aa near the bifurcation of common carotid aa.

carotid triangle

Vv – internal jugular vv Lateral to the common carotid aa.

Largest tributaries are common facial vv, superior thyroid vv, middle thyroid vv.

carotid triangle

Vv – internal jugular vv

carotid triangle


carotid triangle


vagus nerve (CN X)carotid triangle

carotid triangle

Located at vertibral levels CV5 to TV1. Laterally in contact with carotid sheath.

Thyroid hormone. Parathyroid glands are closely associated to the thyroid gland.

carotid triangle vv

Descend into thorax on anterior surface of trachaea.

thyroidea ima arterycarotid triangle aa

Enters thyroid gland from inferiorly, near the midline.

parathyroid glands (virtually impossible to see in a cadaver!)

carotid triangle

subclavian vein vv

Receives blood from the upper extremity and axilla, joins the braciocephalic vv to enter the SVC.

brachiocephalic vein vvReceives blood from the neck, joins the subclavian vv to enter the SVC.

subclavian artery aa

Arises from the aortic arch on the left side, from the brachiocephalic trunk on the right.

vertebral artery neck root

internal thoracic artery neck root

neck root

transverse cervical artery neck root

neck root

inferior thyroid artery neck root

cervical sympathetic trunk neck root

ascending cervical artery neck root

Aa – subclavian

Courses superiorly betwixt anterior scalene mm and longus colli mm, passes into the transverse foramen of the cervical vertebrae.

Aa – subclavian

From anteror-inferior surface of subclavian aa, goes inferiorly to the anterior thoracic wall.

thyrocervical trunkAa – subclavian

Rises from the anterosuperior surface of subclavian aa, has 3 branches: TV cervical aa, suprascapular aa, inferior thyroid aa.

Aa – subclavian – thyrocervical trunk

Crosses root of neck 2-3 cm superior to clavicle, deep to omohyoid mm. Supplies strapezius mm.

suprascapular artery


Laterally and posteriorly t othe region of suprascapular notch. In shoulder, superior to TV scapular ligament.

Supplies supraspinatus and infraspinatus mm's.


Passes medially towards thyroid gland. Usually posterior to cervical sympathetic trunk. Gives off branch, ascending certical aa.

nnGenerally anterior to inferior thyroid aa. No white rami communicantes!

aa Arises from inferior thyroid aa.

neck root

deep cervical artery neck root

neck root

dorsal scapular artery neck root

thoracic duct (on the left) neck root lymph Lymphatic drainage.

recurrent laryngeal nerves neck root

neck root C3, 4, 5 keeps the diaphragm alive.

neck root

costocervical trunkAa – subclavian

Only branch of the second part of subclavian aa. Posterior surface of second part of the subclavian aa. Gives off deep cervical aa and supreme IC aa.

Aa – subclavian – costocervical trunk Arises from the costocervical trunk.

supreme intercostal artery

Aa – subclavian – costocervical trunk Gives rise to posterior IC aa's 1 and 2.

aa

The third part of the subclavian aa's only branch. Passes betwixt superior and middle trunks of brachial plexus to get mm's of scapular region. Ascends from thorax into the neck, posterior to the esophagus at the superior thoracic aperture. Arches to the left to join venous system near junction of left subclavian vv and left internal jugular vv.

nn

Arises from the vagus nn on either side. The left one wraps about the aortic arch.

phrenic nerve nn

Crosses anterior surface of anterior scalene mm, goes into the thorax, anterior to root of lung, and innervates diaphragm.

roots of the brachial plexus (C5-T1 ant. rami)

Nn – brachia plexus

Supraclavicular portion of brachial plexus has 5 roots, 3 trunks, 6 divisions.

neck root

mm

mm

posterior scalene muscle mm

anterior scalene muscle mm

middle scalene muscle mm

skull

skull

upper, middle, and lower trunks of brachial plexus

Nn – brachia plexus

splenius capitis muscle

posterior cervical triangle

Forms part of the floor of the posterior cervical triangle. Originates from lower half of nuchal ligament. Inserts to mastoid process and skull below lateral one third of superior nuchal line.

Innervated by posterior rami of middle cervical nn's. Draw head backwards when together. Individually, draw and rotate head t othe face the same side.

levator scapulae muscle


Forms part of the floor of the posterior cervical triangle.

Innervated by C3, C4, and dorsal scapular nn (C4, C5). Elevates the scapulae.



Innervated by anterior rami of C5 to C7, elevates Rib II.


Forms part of the floor of the posterior cervical triangle. The subclavian aa and roots of brachial plexus pass betwixt middle scalene and anterior scalene mm through the interscalene triangle. The subclavian vv, TV certical aa, and suprascapular aa cross anterior surface of anterior scalene mm. Phrenic nn descends vertically across anterior surface of anterior scalene mm.

Innervated by anterior rami of C4 to C7. Elevates rib I.



Ainnervated by C3 to C7 anterior rami. Elevates rib I.

glabellaBone – frontal

On the frontal bone just superior to the nasion and betwixt the eyebrow region.

supraorbital notch or foramenBone – frontal

Notch or foramen in the ridge above the orbit.

skull The orbit's brow ridge.

skull

mental protuberance skull The bump on the anterior chin. Great place to punch someone.

mandible skull The jaw-bone.

skull

skull

mandibular notch skull

skull

head skull

neck skull

angle skull

body skull

skull

anterior nasal spine skull

superciliary archBone – frontal

mental foramenBone – mandible

Foramina towards the lateral aspect of the anterior face of the mandible.

Bone – mandibleBone – mandible

ramusBone – mandible

The anterior/inferior arranged axis of the mandible which links up to the skull proper.

coronoid processBone – mandible

The anterior process on the ramus of mandible.

Bone – mandible

A crescent notch at the superior margin of the ramus of mandible for articulation with the skull.

condylar processBone – mandible

The posterior process on the ramus of mandible.

Bone – mandible

Superiormost aspect of the condylar process.

Bone – mandible

Inferior aspect of the condylar process on the ramus of mandible.

Bone – mandible

The point of the mandible which turns from the superior/inferior axis of the ramus to the anterior/posterior angle of the body.

Bone – mandible

Anterior/posterior aspect of the mandible.

infraorbital foramenBone – maxilla

Foramen on the amxilla below the orbit.

Bone – maxilla

A ridge of the maxilla that rises up the center of the anterior nasal aperture.

alveolar process skull

frontal process skull

occipital skull Posterior bone of the skull.

parietal skull Posterior-superior bone of the skull.

superior and inferior temporal lines skull

skull

squamous part skull

mastoid process skull

skull

temporal skull

skull

skull suture

coronal suture skull suture

Bone – maxilla

Ridge along the inferior margin of the maxilla wherein sit the teeth.

Bone – maxilla

Medial edge of the maxilla along the lateral edge of the anterior nasal aperture.

Bone – occipitalBone – parietal

Bone – parietal

Ridges along the parietal bone, encapsulating the fossa of the lateral face of the skull.

sphenoidBone – sphenoid

The “butterfly” shaped bone within the skull.

Bone – temporal

Alon the center of the skull in a side-view.

Bone – temporal

Bump on the inferior-posterior margin of the temporal bone, posterior to the external acoustic meatus.

zygomatic processBone – temporal

An arch along from the temporal bone to the zygomatic bone.

Bone – temporal Infero-lateral bone of the skull.

zygomaticBone – zygomatic

A bone linking the maxilla and frontal bone to the temporal bone's zygomatic process.

squamosal suture

Suture along the superior margin of the temporal bone, superior to the squamous part of the temporal bone. A superior/inferior suture near the anterior aspect of the skull, betwixt the frontal bone and two parietal bones.

skull suture

skull suture

face

face

face glandface CT

sagittal suture

A suture along the anterior/suprior midline, running from the frontal bone back towards the occiptital bone, betwixt the two parietal bones.

lambdoid sutureA posterior suture betwixt the occipital bone and two parietal bones.

facial nerve (CN VII, and its 5 named branches on the face/neck) nn

The facial nn cuts thruogh the parotid gland in certain parts. Posterior auricular nn (posterior to ear), Temporal branch (crosses zygomatic arch), Zygomatic branch (crosses zygomatic bone), Buccal branch (crosses superficial surface of masseter), Mandbular branch (parallels inferior margin of mandible), Cervical branch (crosses angle of mandible to enter neck).

Cervical branch innervates platysma mm.

parotid duct

Crosses lateral surface of masseter mm, then turns medially to pierce buccinator mm of cheek and drain into oral vestibule lateral to second maxillary molar tooth.

parotid glandAnterior to the ear, just posterior and superficial to the angle of mandible.

Supplies serous secretions to the mouth.

buccal fat pad Anterior to the masseter mm.

face mm

face

inferior labial artery face

superior labial artery face Near angle of mouth.

angular artery facefacial vein face

face mm

face mm Lateral edge of the nose.

face mm

buccinator muscle

Runs from the lateral edge of the soft mouth tissue and lateraly, deep to the orbicularis oris and buccinator mm's. Posteriorly attaches to preygomandibular, the alveolar processes of maxilla and mandible. Anterior attachment to angle of mouth.

Compress cheek against molar teeth to keep food on occlusal surface during chewing.

buccal nerve (br. of V3) Nn – CN V

Branch of mandibular division of trigeminal nn (V3), emerges from deep to masseter.

Sensory nn to mucosa of cheek and sensory innervation to skin of cheek.

Aa – facial aa

Branch of facial aa from external carotid aa. Facial aa crosses inferior broder of mandible anterior to masseter mm. Facial aa courses inferiorly, deep to submandibular gland of neck, becomes superficial upon crossing inferior border of mandible. Near angle of mouth, facial aa gives off inferior and superior labial aa's.

Aa – facial aa

Aa – facial aa

Facial aa traces to lateral side of nose to be renamed as the angular aa.

vv Posterior to the facial aa.

orbicularis oculi muscleSurrounds the orbit with an orbital part and a palpebral (eyelid) part

Palpebral part closes eyelids gently. Orbital part closes eyelids forcefully. Both by Facial nn (CN VII).

levator labii superioris muscle

Serves to elevate upper lip. Raises upper lip and helps form nasolabial furrow. Innervated by Facial nn.

zygomaticus major muscle

Lateral attachment to zygomatic bone, medial attachment to angle of mouth.

Draws angle of mouth superiorly and posteriorly. Facial nn.

face CT The “scalp” connective tissue.

face mm Depresses angle of mouth.

face mm Forehead mm.

face mm

face mm

face mm

face mm

face mm

face

face

mental nerve face

epicranial aponeurosis (galea aponeurotica)

depressor labii inferioris muscle

A medial lower lip depressor mm. Inferior attachment to mandible and superior attachment to angle of mouth.

frontalis muscleRaises eyebrows, wrinkles forehead. Facial nn.

levator anguli oris muscle

Attaches superiorly just inferior to the infraorbital foramen, goes down to the angle of mouth.

Elevates the corner of the mouth. Facial nn.

mentalis muscle Muscle on the chin near the midline. Raises and protrudes lower lip as it wrinkles skin on chin. Facial nn.

nasalis muscleMmuscle on the nose just medial to the levator labii superioris mm.

Compresses nasal aperture and draws cartilage downward and laterally to open nostrils. Facial nn.

zygomaticus minor muscle

Leads from the zygomatic arch to a medial aspect of the mouth. Is lateral to the Nasalis mm and medial to the zygomaticus major mm. Draws the upper lip upwards. Facial nn.

depressor anguli oris muscle

A lateral depressor mm from the angle of mouth down towards the inferior margin of mandible. Lateral to the Depressor Labii Inferioris mm.

Draws corner of mouth down and laterally. Facial nn.

supraorbital nerve nn

Passes through supraorbital notch (or foramen) of frontal bone to reach skin above the eye.

Branch of opthalmic division of trigeminal nn (V1).

infraorbital nerve nn

Through infraorbital foramen of maxilla. Covered by levator labii superioris mm.

Branch of maxillary division of Trigeminal nn (V2). Sensory innervation to ifnerior eyelid, side of nose, upper lip.

nnEmerges from mental foramen, covered by depressor anguli oris mm.

Branch of mandibular division of Trigeminal nn (V3).

face

face

superficial temporal vein face

superficial temporal artery face

zygomaticofacial nerve nn

Like the zygomaticotemporal branch, passes forward at base of lateral orbital wall, leaves through small bony canal in orbital margin, opens ont oanterolateral surface of zygomatic bone and supplies the skin there.

auriculotemporal nerve nn

The zygomatic nn originates from Maxillary nn (V2), continues along lateral orbital wall, passes through canal in zygomatic bone to enter temporal fossa and passes superficially to supply skin over temple.

vv

The SF temporal vv drains down, anterior to the ear and paralleling the temporal aa, down to eventually join the internal jugular vv.

aa

External carotid aa, eventually gives rise to the superficial temporal aa and vv, which both pass anterior to the ear on their way superiorly.

SHN 2014 Structures - Fredit

Documents

Transcript of SHN 2014 Structures - Fredit