~ 24 ~

Structure

Surface anatomy of neck

lower mandible
Jugular notch

C3
C4
C5
C6

Musculoskeletal system for National License I by Med 38 KKU

~ 25 ~

Laryngeal prominence surface landmark

quadrilateral laminae thyroid cartilage midline
Tracheal ring trachea
Hyoid bone
- body of C3
Thyroid cartilage
body of C4-5
Cricoid cartilage
body C6
Isthmus of thyroid
tracheal ring 2
C2
C7
Vertebral prominens

C6

- Junction larynx Trachea

- Junction Pharynx Esophagus
- Inferior Thyroid artery Common Carotid artery Thyroid
- Middle Cervical sympathetic ganglion inf thyroid a.(Thyrocervical trunk)
Vertebral a. Foramen Transversarium
- Recurrent laryngeal nerve Larynx
- Landmark Tracheostomy

Superficial Nerve
cutaneous nerves(plexus) 4
Sternocleidomastoid m. 1. Lesser occipital n., 2. Great
auricular n., 3. Transverse cervical n. 4. Supraclavicular n.

Musculoskeletal system for National License I by Med 38 KKU

Superficial Vein

~ 26 ~

Retromandibular

Post auricular v.
External
jugular v.

Ant jugular v.

-Exernal Jugular vein Sternocleidomastoid m.

external jugular v.

Drain Posterior Auricular v.

Retromandibular v.( facial v.)
-Anterior Jugular v. External Jugular v.
Transcervical v. Suprascapular v. External Jugular v.
-jugular vein engorgement External Jugular v.
obstruction right atrium
congestive heart failure

Superficial Lymph nodes

Superficial lymph nodes drain deep lymph nodes
Submental node drain
Submandibular node drain
Ant. Jugular node ant. Jugular v.
Ext. Jugular node ext. jugular v.
Lymph node

Musculoskeletal system for National License I by Med 38 KKU

v.

~ 27 ~

Triangle of Neck
Anterior cervical triangle
-Submental triangle

hyoid bone

-Submandibular (Digastric) triangle landmark submandibular duct

facial a.
-Muscular triangle landmark thyroidectomy and tracheostomy ( )
-Carotid triangle common carotid a. internal jugular v. landmark carotid
angiography

Musculoskeletal system for National License I by Med 38 KKU

Posterior clavicular triangle

~ 28 ~

-occipital triangle cutaneous nerve 4 nerve 11

-Omoclavicular triangle(Supraclavicular triangle) Subclavian a

Fascia of neck
-Superficial fascia (skin,fat)
-Deep fascia 5

Musculoskeletal system for National License I by Med 38 KKU

~ 29 ~

1. Investing layer Superficial deep cervical fascia

2. Prevertebral fascia Musculoskeleton compartment
3. Cervical visceral fascia pretracheal fascia buccopharyngeal fascia visceral
compartment
4. Carotid sheath Carotid a.,Vagus n.,Internal jugular v.,ansa celvicalis
5. Alar fascia Buccopharyngeal fascia Prevertebral fascia retropharyngeal space
2 Buccopharyngeal fascia True retropharygeal space Prevertebral
fascia Danger sapce

Musculoskeletal system for National License I by Med 38 KKU

~ 30 ~

Vagus N.

Vagus n.
Vagus n. Ganglion 2 Superior ganglion inferior ganglion
Superior Laryngeal n. inf ganglion 2
internal laryngeal nerve sensory supply &
vocal cord
-external laryngeal nerve superior thyroid a. inferior constrictor m.
motor supply cricothyroid
pitched sound(Monotonus voice)
** Recurrent laryngeal n. Horseness voice 2

*** Cricothyroid Ext laryngeal n (intrinsic) Recurrnet laryngeal n.

Musculoskeletal system for National License I by Med 38 KKU

Recurrent (inferior) laryngeal nerve

~ 31 ~

-motor n. intrincsic m. cricothyroid m. external laryngeal n.

-sensory n. supply vocal cord trachea
- vagus n. arch
aorta
- vagus nerve subclavian a.


(Tracheosopharygeal groove)

Internal Jugular v.
Sigmoid sinus carotid sheath

Common carotid a.
Rt. brachiocephalic trunk
sternoclavicular joint
Lt. arch of aorta superior
mediastinum
Bifurcation Thyroid cartilage
Carotid sinus
Baroreceptor bifurcation
Carotid body Bifurcation common
carotid a. chemoreceptive cell pH

Musculoskeletal system for National License I by Med 38 KKU

Lymph Node

~ 32 ~

Deep cervical Lymph nodes

internal jugular v. superior belly of omohyoid m. Superior Inferior

Superior deep cervical lymph node

1. Jugulo-digastric node posterior belly digastric
palatine submandibular retroauricular superficial cervical lymph node
2. Juguloomohyoid node intermediate tendon omohyoid



deep cervical lymph node jugular lymph trunk thoracic duct
right lymphatic duct
Inferior deep cervical nodes superior deep cervical nodes superior
belly omohyoid supraclavicular middle third
** thoracic duct Virchow's
node Signal node Sentinel node virchow's node

[Gastric Cancer]

Musculoskeletal system for National License I by Med 38 KKU

Cervical plexus

~ 33 ~

Anterior rami C1-4

1. Cutaneous n.
- lesser occipital n.
- great auricular n.
- transverse cervical
- supraclavicular
2. Muscular branches
3.Ansa Cervicalis C1-3 infrahyoid m. Thyrohyoid m.
-superior root C1
-inferior root C2-3

Musculoskeletal system for National License I by Med 38 KKU

~ 34 ~

4.Phrenic n. C3-5 Scalenus anterior

. Cervical sympathetic trunk and ganglion
- inf . cervical ganglion T1 >> Stellate ganglion
Lesion Cervical Sympathetic trunk Horner syndrome
Miosis
Ptosis
Enophthalmos
Anhydrosis

Musculoskeletal system for National License I by Med 38 KKU