TOPOGRAPHICAL ANATOMY OF THE NECK

Václav Báča, David KachlíkTereza 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 REGIO CERVICALIS ANTERIORANTERIOR

TRIGONUM CERVICALE TRIGONUM CERVICALE ANTERIUSANTERIUS

BORDERS:

CRANIAL:

lower

mandibular

border

LATERAL:ventral

border

of

m. sternocleidomastoideus

CONTENT:

trigonum

submandibulare

trigonum

submentale

trigonum

caroticum

trigonum

musculare

(omotracheale)

TRIGONUM SUBMANDIBULARETRIGONUM SUBMANDIBULAREBORDERS:

CRANIAL:lower

mandibular

border

MEDIAL:venter

ant. m. digastrici

LATERAL:venter

post. m. digastrici

BOTTOM:m. mylohyoideus

and

m. hyoglossus

CONTENT:glandula

submandibularis

vasa

facialia

(+ their

branches)

ductus

submandibularis

nervus lingualis

ganglion submandibulare

arteria

lingualis

nervus hypoglossus

nodi

lymphoidei

submandibulares

TRIGONUM CAROTICUMTRIGONUM CAROTICUM ((MalgaigneMalgaigne))

BORDERS:

CRANIAL:venter

post. m. digastrici

CAUDAL:venter

sup. m. omohyoidei

LATERAL:m. sternocleidomastoideus

CONTENT:

nervus hypoglossus

(running as arcus n. XIIventrally of the blood vessels) + v. comitans

n. hypoglossi

truncus

sympathicus

+ ganglion cervicale

superius

n. accessorius

nodi

lymphoidei

cervicales

profundi

glandula

thyroidea

in vagina carotica:

arteria

carotis

communis

–

branching

at

the

level

of

C4 (med.)

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:

CRANIAL:corpus ossis

hyoidei

CAUDAL: incisura

jugularis

sterni

LATERO-CRANIAL:vent. sup. m. omohyoidei

LATERO-CAUDAL: m. sternocleidomastiodeus

CONTENT:

larynx

→ trachea

glandula

thyroidea

+ itsvessels

and

nerves

musculus

sternothyroideusmusculus

sternohyoideus

musculus

thyrohyoideus

arcus

venosus

juguli

TRIGONUM SUBMENTALEBORDERS:

LATERAL:ventera

ant. mm. digastricorum

VENTRO-CRANIAL:corpus mandibulae

CAUDAL:corpus ossis

hyoidei

BOTTOM:mm. mylohyoidei

CONTENT:

vasa

submentalia

nodi

lymphoidei

submentales

nervi mylohyoidei

TRIGONUM A. LINGUALISTRIGONUM A. LINGUALIS

((trigonumtrigonum PirogoviPirogovi))

BORDERS:

CRANIAL:n. hypoglossus

VENTRAL:dorsal

border

of

m. mylohyoideus

CAUDAL:venter

post. m. digastrici

BOTTOM:m. hyoglossus

CONTENT:

arteria

lingualis

(ligation)

vena

lingualis

ANGULUS BANGULUS BÉÉCLARDICLARDIBORDERS:

CRANIAL:venter

post. m. digastrici

m. stylohyoideus

CAUDAL:cornu

majus

ossis

hyoidei

CONTENT:

arteria

lingualis

(ligation)

REGIO REGIO STERNOCLEIDOMASTOIDEASTERNOCLEIDOMASTOIDEA

FOSSA SUPRACLAVICULARIS FOSSA SUPRACLAVICULARIS MINORMINOR

BORDERS:

MEDIAL+LATERAL:beginnigs

of

m. sternocleidomastoideus

CAUDAL:clavicula

CONTENT:

cupula

pleurae

projectsin the

depth

REGIO CERVICALIS LATERALISREGIO CERVICALIS LATERALISBORDERS:

CRANIAL:proc. mastoideus

VENTRAL:dorsal

border

of

m. sternocleidomastoideus

DORSAL:ventral

border

of

m. trapezius

CAUDAL:clavicula

CONTENT:

trigonum

omotrapezium

trigonum

omoclaviculare

TRIGONUM OMOCLAVICULARETRIGONUM OMOCLAVICULARE correspondscorresponds to to superficialsuperficial FossaFossa supraclavicularissupraclavicularis majormajor

BORDERS:

CRANIAL:venter

inf. m. omohyoidei

CAUDAL:clavicula

VENTRAL:dorsal

border

of

m.

sternocleidomastoideus

CONTENT:

vasa

subclavia

angulus

venosus

(+ estuary

of

ductus

thoracicus

(left) / ductus

lymphaticus

dx. + its

tributaries)

plexus

brachialis

nodi

lymphoidei

supraclaviculares

(Virchow-Troisier)

nervus phrenicus

arteria

cervicalis

ascendens

+ vena

vertebralis

anterior

arteria

transversa

cervicis

(or only its branch r.superficialis)

vasa

suprascapularia

nervi supraclaviculares

vena

jugularis

externa

TRIGONUM OMOTRAPEZIUMTRIGONUM OMOTRAPEZIUM

BORDERS:

VENTRAL:dorsal

border

of

m.

sternocleidomastoideus

DORSAL:ventral

border

of

m. trapezius

CAUDAL:venter

inf. m.omohyoidei

CONTENT:

vena

jugularis

externa

(+ its

tributaries,e.g. vv. transversae

colli)

arteria

transversa

colli

(+ its

branches)

arteria

cervicalis

ascendents

+ venavertebralis

anterior

+ nervus phrenicus

vasa

cervicalia

profunda

arteria

transversa

cervicis

(or only itsbranches)

punctum nervosum

+ its

branches

nervus accessorius

pars

supraclavicularis

plexus

brachialis

nodi

lymphoidei

cervicales

...AND IN DEPTH...AND IN DEPTH

TRIGONUM SCALENOVERTEBRALE (in the depth of trig. omoclaviculare)

BORDERS:

DORSAL:m. longus

colli

LATERAL:m. scalenus

ant.

CAUDAL:cupula

pleurae

MEDIAL:trachea, esophagus, glandula

thyroidea

VENTRAL:m. sternocleidomastoideus

CONTENT:arteria

subclavia

(pars

intrascalenica)

plexus

brachialis

truncus

sympathicus

(ggl. stellatum) + ansa

subclavia

nervi cardiaci

cervicales

ductus

thoracicus

(on the left sideonly)!

FISSURA SCALENORUM 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 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 LAIMERITRIGONUM LAIMERIBORDERS:

CRANIAL:pars

(m.) cricopharyngea

m.

constrictoris

pharyngis

inferioris

CAUDAL:superior oblique

fibres

of

longitudinal

oesophageal

musclelayer

BOTTOM:circular

oesophageal

muscle

layer

CONTENT:

weakened

wall

–

possiblesite

of

pulse diverticle

occurence