Topographical Anatomy of the Neck

TOPOGRAPHICAL ANATOMY
OF THE NECK
Václav Báča, David Kachlík
Tereza Smržová, Martin Holek, Katarina Hubčíkova, Radek Jakša
Department of Anatomy, Third Faculty of Medicine,
Charles University in Prague
supported by grant FRVS 1101/2008/F3
REGIO CERVICALIS
ANTERIOR
TRIGONUM CERVICALE
ANTERIUS
BORDERS:
CONTENT:
CRANIAL:
trigonum submandibulare
lower mandibular border
trigonum submentale
LATERAL:
ventral border
trigonum caroticum
of m. sternocleidomastoideus
trigonum musculare (omotracheale)
TRIGONUM SUBMANDIBULARE
BORDERS:
CRANIAL:
lower mandibular border
MEDIAL:
venter ant. m. digastrici
CONTENT:
glandula submandibularis
vasa facialia (+ their branches)
ductus submandibularis
nervus lingualis
LATERAL:
venter post. m. digastrici
BOTTOM:
m. mylohyoideus and m. hyoglossus
ganglion submandibulare
arteria lingualis
nervus hypoglossus
nodi lymphoidei submandibulares
TRIGONUM CAROTICUM
(Malgaigne)
CONTENT:
BORDERS:
nervus hypoglossus (running as arcus n. XII
ventrally of the blood vessels) + v. comitans n.
hypoglossi
CRANIAL:
venter post. m. digastrici
truncus sympathicus + ganglion cervicale superius
n. accessorius
CAUDAL:
venter sup. m. omohyoidei
nodi lymphoidei cervicales profundi
LATERAL:
m. sternocleidomastoideus
arteria carotis communis – branching at the level of
C4 (med.)
glandula thyroidea in vagina carotica:
arteria carotis int.
arteria carotis ext. + its branches and their veins
vena jugularis int. + its tributaries (laterodors.)
radix sup. ansae cervicalis profundae (ventr.)
nervus vagus + nervus laryngeus sup. (dors.)
TRIGONUM MUSCULARE
(fossa suprasternalis, trigonum omotracheale)
BORDERS:
CONTENT:
CRANIAL:
corpus ossis hyoidei
larynx → trachea
CAUDAL:
incisura jugularis sterni
glandula thyroidea + its
vessels and nerves
LATERO-CRANIAL:
vent. sup. m. omohyoidei
musculus sternothyroideus
musculus sternohyoideus
musculus thyrohyoideus
LATERO-CAUDAL:
m. sternocleidomastiodeus
arcus venosus juguli
TRIGONUM SUBMENTALE
BORDERS:
CONTENT:
LATERAL:
ventera ant. mm. digastricorum
vasa submentalia
VENTRO-CRANIAL:
corpus mandibulae
nodi lymphoidei submentales
CAUDAL:
corpus ossis hyoidei
BOTTOM:
mm. mylohyoidei
nervi mylohyoidei
TRIGONUM A. LINGUALIS
(trigonum Pirogovi)
BORDERS:
CRANIAL:
n. hypoglossus
CONTENT:
VENTRAL:
dorsal border of m. mylohyoideus
arteria lingualis (ligation)
CAUDAL:
venter post. m. digastrici
BOTTOM:
m. hyoglossus
vena lingualis
ANGULUS BÉCLARDI
BORDERS:
CRANIAL:
venter post. m. digastrici
m. stylohyoideus
CAUDAL:
cornu majus ossis hyoidei
CONTENT:
arteria lingualis (ligation)
REGIO
STERNOCLEIDOMASTOIDEA
FOSSA SUPRACLAVICULARIS
MINOR
BORDERS:
MEDIAL+LATERAL:
beginnigs of m. sternocleidomastoideus
CAUDAL:
clavicula
CONTENT:
cupula pleurae projects
in the depth
REGIO CERVICALIS LATERALIS
BORDERS:
CONTENT:
CRANIAL:
proc. mastoideus
VENTRAL:
dorsal border of m. sternocleidomastoideus
trigonum omotrapezium
trigonum omoclaviculare
DORSAL:
ventral border of m. trapezius
CAUDAL:
clavicula
TRIGONUM OMOCLAVICULARE
corresponds to superficial Fossa supraclavicularis major
BORDERS:
CRANIAL:
venter inf. m. omohyoidei
CAUDAL:
clavicula
CONTENT:
vasa subclavia
angulus venosus (+ estuary of ductus thoracicus (left) /
ductus lymphaticus dx. + its tributaries)
plexus brachialis
nodi lymphoidei supraclaviculares (Virchow-Troisier)
nervus phrenicus
VENTRAL:
dorsal border of m.
sternocleidomastoideus
arteria cervicalis ascendens + vena vertebralis anterior
arteria transversa cervicis (or only its branch r.
superficialis)
vasa suprascapularia
nervi supraclaviculares
vena jugularis externa
TRIGONUM OMOTRAPEZIUM
CONTENT:
BORDERS:
VENTRAL:
dorsal border of m.
sternocleidomastoideus
DORSAL:
ventral border of m. trapezius
CAUDAL:
venter inf. m.omohyoidei
vena jugularis externa (+ its tributaries,
e.g. vv. transversae colli)
arteria transversa colli (+ its branches)
arteria cervicalis ascendents + vena
vertebralis anterior + nervus phrenicus
vasa cervicalia profunda
arteria transversa cervicis (or only its
branches)
punctum nervosum + its branches
nervus accessorius
pars supraclavicularis plexus brachialis
nodi lymphoidei cervicales
...AND IN DEPTH
TRIGONUM SCALENOVERTEBRALE
(in the depth of trig. omoclaviculare)
BORDERS:
CONTENT:
DORSAL:
arteria subclavia (pars
intrascalenica)
m. longus colli
LATERAL:
plexus brachialis
m. scalenus ant.
CAUDAL:
cupula pleurae
MEDIAL:
truncus sympathicus (ggl. stellatum)
+ ansa subclavia
nervi cardiaci cervicales
trachea, esophagus, glandula thyroidea
VENTRAL:
m. sternocleidomastoideus
ductus thoracicus (on the left side
only)!
FISSURA SCALENORUM
BORDERS:
VENTRAL:
m. scalenus anterior
DORSAL:
m. scalenus medius
CAUDAL:
clavicula
CONTENT:
arteria subclavia (subclavian vein
runs in front of m. scalenus
ant.)
arteria transversa cervicis (or
only its branch r. profundus)
plexus brachialis
TRIGONUM KILLIANI
BORDERS:
CRANIAL:
pars (m.) thyropharyngea m.
constrictoris pharyngis inferioris
CAUDAL:
pars (m.) cricopharyngea m.
constrictoris pharyngis inferioris
CONTENT:
weakened wall –
possible site of pulse
diverticle (of Zenker)
occurence
TRIGONUM LAIMERI
BORDERS:
CONTENT:
CRANIAL:
pars (m.) cricopharyngea m.
constrictoris pharyngis inferioris
CAUDAL:
superior oblique fibres of
longitudinal oesophageal muscle
layer
BOTTOM:
circular oesophageal muscle layer
weakened wall – possible
site of pulse diverticle
occurence