Lateral Cervical Region
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2 regions of the neck
- 1. Anterior Region (Anterior Triangle)
- 2. Lateral Cervical Region (Posterior/ Lateral Triangle)
What dermatones innervates the neck?
What cutaneous nerves innervate the neck?
C2-C4 branches of the cervical plexus
What is the name for the ventral rami of C2?
The Lesser Occipital Nerve
What is the name for the dorsal rami of C2?
The greater occipital nerve
- 1. Inferior border of mandible
- 2. Skin
- 3. Subcutaneous tissue of lower face
- 4. Fascia covering superior parts of pectoralis major and deltoid muscles
Cervical branch of Facial nerve (CN VII)
Actions of Platysma muscle
Draws corners of the mouth inferiorly and widens it to show expressions of sadness and fright. Draws skin of the neck superiorly when teeth are clenched.
- 1. Lateral surface of mastoid process of temporal bone
- 2. Lateral half of superior nuchal line
- 3. Anterior surface of manubrium of sternum (Sternal Head)
- 3. Superior surface of medial third of clavicle (clavicular head)
Innervation of Sternocleiodomastoid
- 1. CN XI (motor)
- 2. C2 and C3 (pain and proprioception)
Unilateral actions of the sternocleidomastoid
- 1. Laterally flexes neck
- 2. Rotates face upward to opposite side
Bilateral Actions of the sternocleidomastoid
- 1. Extends neck at Atlanto-Occipital joint
- 2. Flexes neck at cervical vertebrae
Where is the Platysma muscle?
In the superficial fascia of the neck
What are the types of deep fascia in the neck?
- 1. Investing fascia
- 2. Pretracheal fascia
- 3. Prevertebreal fascia
What is contained in the Carotoid sheath?
- 1. Common and internal Carotid artery
- 2. Vegas Nerve (CN X)
- 3. Internal Jugular vein
What are the boundaries of the posterior cervical triangle?
- 1. Posterior border of sternocleidomastoid muscle
- 2. Anterior border of trapezius
- 3. Middle 1/3 of clavicle
- 4. Floor is the prevertebral fascia
- 5. Roof is the investing fascia
- 6. Apex is the superior nuchal line
What are the regions of the posterior cervicle triangle?
- Subdivided by the inferior belly of the omohyoid muscle
- 1. Omoclavicular triangle
- 2. Occipital triangle
What muscles are in the floor of the Posterior Cervicle Triangle?
- 1. Splenius Capitus
- 2. Levatator Scapula
- 3. Posterior Scalene
- 4. Middle Scalene
- 5. Anterior Scalene
What disease indicates an inability to use one of the sternocleidomastoid muscles?
Attachments of the Omohyoid muscle
- 1. Superior belly attaches to the hyoid bone
- 2. Inferior belly attaches to the superior border of the scapula
- 3. Anchored by the clavicle
Innervation of the Omohyoid muscle
- Ansa Cervicalis
- (C1, C2 and C3)
Actions of the Omohyoid
Depresses, retracts and stabilizes hyoid bone
Name of the tendon on Omohyoid
Anterior Scalenus Attachments
- 1. Transverse processes of C3-C6
- 2. attaches distally to rib 1
Middle Scalenus Attachment
- 1. Transverse processes of C3-C6
- 2. Attaches distally to rib 1
Posterior Scalenus Attachments
- 1. Transverse processes of C5-C7
- 2. attaches distally to rib 2
Innervation of Scalene muscles
Ventral Rami of Cervical spinal nerves (C4-C8)
Actions of Scalenes
- 1. Laterally flex neck
- 2. Accessory muscle for respiration
*Important muscles in people with COPD for respiration*
Contents of Posterior Cervical Triangle
- 1. External Jugular Vein
- 2. Cervical Plexus- cutaneous branches C2-C4
- 3. Spinal Acessory Nerve (CN XI)
- 4. Transverse Cervical and Suprascapular arteries
- 5. 3rd part of Subclavian artery
- 6. Subclavian vein (inconsistent)
- 7. Occipital artery
- 8. Brachial Plexus (C5-C8 and T1) roots and trunks
- 9. Cervical lymph nodes
How superficial is the external jugular vein?
Superficial to the fascia
Which cervical spinal nerve does the transverse cervical nerve come from?
C2 and C3
Which cervical spinal nerves does the supraclavicular nerve come from?
C3 and C4
What are the names of the cutaneous branches of the cervical plexus that are found in the posterior lateral triangle?
- 1. Greater Occipital nerve
- 2. Lesser Occipital nerve
- 3. Transverse Cervical nerve
- 4. Supraclavicular nerve
Why would someone have a prominent external jugular vein?
- 1. Increased pressure on the right side of the heart due to congestive heart failure
- 2. Pulmonary edema
- 3. Superior vena cava obstruction
What blood vessels are in the Posterior Cervical Triangle?
- 1. Cervicodorsal trunk of the Transverse Cervical Artery
- 2. Suprascapular artery
- 3. Subclavian artery (3rd part)
- 4. Subclavian vein
- 5. Occipital artery (in apex)
What innevates the diaphram?
C3, C4 and C5 keep the diaphram alive
What is the Cervical Plexus?
Ventral Primary Rami of C1-C4
What is the Brachial Plexus?
Ventral Primary Rami of C5- T1
Where does the 1st part of the subclavian artery come from?
1. Comes of the aorta to the brachiocephalic trunk
What does the 1st part of the subclavian artery branch into?
- 1. Vertebral artery
- 2. Internal thoracic artery
- 3. Thyrocervical trunk
What does the Thyrocervical trunk branch into?
- 1. Inferior thyroid artery
- 2. Transverse cervical artery
- 3. Suprascapular artery
What does the second part of the subclavian artery branch into?
What does the Costocervical trunk branch into?
- 1. Deep cervical artery
- 2. Supreme intercostal artery
What does the 3rd part of the subclavian artery branch into?
sometimes the dorsal scapular artery
Where is the 1st part of the subclavian artery located?
Median to anterior scalene
Where is the 2nd part of the subclavian artery located?
deep to the anterior scalene
Where is the 3rd part of the subclavian artery located?
Lateral to anterior scalene
What makes up the upper trunks of the brachial plexus?
Ventral primary rami of C5 and C6
What makes up the middle trunks of the brachial plexus?
Ventral Primary Rami of C7
What makes up the lower trunk of the brachial plexus?
Ventral Primary Rami of C8 and T1
Where do the roots of the brachial plexus pass through in the neck?
through the interscalene triangle (between anterior and middle scalene)
Where is the interscalene triangle?
Between the anterior and middle scalene
Where do the roots of the brachial plexus go?
Through the posterior cervical triangle to get to the axilla
What is a neck stinger?
a nerve pinch injury that causes burning pain to radiate down one of the upper limbs (can cause weakness or numbness in the muscle)
What are the causes of a Neck stinger?
- 1. Stretching of the brachial plexus
- 2. Direct blow to brachial plexus
- 3. Compression to brachial plexus
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