Anatomia de Cabeza y Cuello

Neck, Part 1
With Dr. Craig Canby
D G MUSIC, gonzalesmoreno.160@gmail.com
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Triangles of the Neck
Two Major Triangles
Anterior
Paulsen and Waschke, Atlas

D G MUSIC, of Human Anatomy, 15th edition, Elsevier GmbH 2011
gonzalesmoreno.160@gmail.com
Triangles of the Neck
Two Major Triangles
Posterior
Anterior

Anterior Triangle
Subdivisons
Submandibular triangle
Digastric,
posterior belly
Mandible
Digastric,
anterior belly

Anterior Triangle
Subdivisons
Submandibular triangle
• Contents
• Submandibular gland
• Lymph nodes
• Facial artery and vein

Anterior Triangle
Subdivisons
Submental triangle
Digastric,
anterior belly
Midline
Hyoid bone

Anterior Triangle
Subdivisons
Submental triangle
• Contents
• Submental lymph
nodes

Anterior Triangle
Subdivisons
Carotid triangle
Digastric,
posterior belly
Sterno-
cleidomastoid
Omohyoid,
superior belly

Anterior Triangle
Subdivisons
Carotid triangle
• Contents
• Common carotid artery
• Internal and external carotid

arteries
• Internal jugular vein
• Vagus nerve
• Hypoglossal nerve

Anterior triangle
Clinical relevance
• Common carotid and internal carotid
arteries
• Conventional carotid
endarterectomy surgically
exposes the common and internal
carotid arteries to remove
atherosclerotic lesions
Common carotid artery
Internal carotid artery
Anterior triangle
Clinical relevance
• Internal jugular vein
• A site for insertion of a central line

instead of subclavian vein
Common carotid artery
Internal carotid artery
Anterior Triangle
Subdivisons
Muscular triangle
Hyoid bone
Omohyoid,
superior belly
Sterno-
cleidomastoid

Anterior Triangle
Subdivisons
Muscular triangle
• Contents
• Infrahyoid muscles
• Pharynx
• Thyroid gland
• Parathyroid glands

Posterior Triangle
Contents
• External jugular vein
• Subclavian vein
• Transverse cervical and suprascapular

veins
• Subclavian artery

Posterior Triangle
Contents
• Accessory nerve
• Cervical plexus
• Phrenic nerve
• Trunks of brachial plexus

Posterior Triangle
Clinical relevance
• External jugular vein
• Subclavian vein
• Cervical plexus

Posterior Triangle
Clinical relevance
External jugular vein
• Superficial location makes it

vulnerable to being severed
• Lumen is held open by

investing fascia resulting in External jugular
an air embolism vein
Posterior Triangle
Clinical relevance
Subclavian vein
• A site of access for a

central line
• Puncture of subclavian
artery and pneumothorax
are two potential
complications
Right subclavian vein
Posterior Triangle
Clinical relevance
Cervical plexus
• Cervical plexus nerve block

used to anesthetize neck
region
• Anesthetic is injected over

the posterior border of
sternocleidomastoid muscle Cervical plexus
at the junction of its superior
and middle thirds.
Posterior Triangle
Subdivisons
Occipital triangle
Omoclavicular
triangle

Cervical Compartments
Vertical Organization
Visceral
Vascular
(CCA and IJV)
Vascular
(CCA and IJV)
Vertebral

Cervical Fascia
Superficial and Deep
• Superficial fascia
contains the
platysma muscle
that runs over the Superficial
sternocleidomastoid
muscle.
• Deep fascia is
divided into several
distinct layers.

Cervical Fascia
Deep Fascial Layers

Cervical Fascia
Deep Fascial Layers
Investing deep fascial layer

contains sternocleidomastoid
and trapezius muscles.
Investing

Cervical Fascia
Deep Fascial Layers
Pretracheal contains visceral neck region.

Pretracheal
Investing

Cervical Fascia
Deep Fascial Layers
Carotid sheath contains vascular neck

region and 4 major structures:
Pretracheal
1. Common carotid artery
and internal carotid artery
2. Internal jugular vein Carotid

sheath
3. CNX vagus nerve
4. Deep cervical Investing

lymph nodes

Cervical Fascia
Deep Fascial Layers
Prevertebral encloses the vertebral

neck region (including vertebra, spinal
cord and associated muscles). Pretracheal
Carotid
sheath
Investing
Prevertebral

Fascial Spaces
Three Spaces

Fascial Spaces
Three Spaces
Pretracheal space is area anterior

Pretracheal
to the trachea.
space
Retropharyngeal
space
Space within
prevertebral
layer
Fascial Spaces
Infections
• Infections in the pretracheal
space may extend inferiorly Pretracheal
into the anterior space
mediastinum.
• If invasion occurs,
cancer can spread into
Retropharyngeal
these potential
fascial spaces. space
• Retropharyngeal space
can spread down and
infect the posterior Space within
mediastinum.
prevertebral
Abscesses can form in
layer
this space.
Surgical Access to Trachea
Approaches
Coniotomy can also be called
cricothyrotomy or simply crike.
Coniotomy
Upper
tracheotomy
Lower
tracheotomy

Coniotomy
• Horizontal incision of cricothyroid
membrane
• Immediately inferior to vocal folds
Cricothyroid
incision

Tracheotomy
• Upper is above isthmus of
thyroid gland.
• Lower is below isthmus of

thyroid gland.
Upper
tracheotomy
Lower
tracheotomy

Summary
Neck Part 1
• The neck is divided two major triangles
with the anterior containing major vascular,
respiratory and digestive structures and
the posterior harboring muscles of the
vertebral column and neural elements.
• The neck is organized into four vertical

compartments by the deep cervical fascia:
visceral, vascular (right and left), and
vertebral.
• Infections of the fascial spaces may spread

into the mediastinum.
• Surgical access to the airway may be

obtained by a coniotomy or tracheostomy.
Attribution
The images used in this presentation were

sourced from:
Paulsen and Waschke:

Atlas of Human Anatomy, 15th edition,
Elsevier GmbH 2011
This document is a property of: D G MUSIC
Note: This document is copyright protected. It may not be copied, reproduced, used, or
distributed in any way without the written authorization of Lecturio GmbH.

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Neck, Part 1

With Dr. Craig Canby

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

• Facial artery and vein

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

• Common carotid artery

• Internal and external carotid

• Internal jugular vein

Paulsen and Waschke, Atlas

Common carotid artery

Internal carotid artery

• A site for insertion of a central line

Common carotid artery

Internal carotid artery

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

• External jugular vein

• Transverse cervical and suprascapular

Paulsen and Waschke, Atlas

• Trunks of brachial plexus

Paulsen and Waschke, Atlas

• External jugular vein

Paulsen and Waschke, Atlas

External jugular vein

• Superficial location makes it

• Lumen is held open by

• A site of access for a

Right subclavian vein

• Cervical plexus nerve block

• Anesthetic is injected over

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

Investing deep fascial layer

Paulsen and Waschke, Atlas

Pretracheal contains visceral neck region.

Paulsen and Waschke, Atlas

Carotid sheath contains vascular neck

2. Internal jugular vein Carotid

4. Deep cervical Investing

Paulsen and Waschke, Atlas

Prevertebral encloses the vertebral

Paulsen and Waschke, Atlas

Paulsen and Waschke, Atlas

Pretracheal space is area anterior

Paulsen and Waschke, Atlas

• Immediately inferior to vocal folds

Paulsen and Waschke, Atlas

• Lower is below isthmus of

Paulsen and Waschke, Atlas

• The neck is organized into four vertical

• Infections of the fascial spaces may spread

• Surgical access to the airway may be

The images used in this presentation were

Paulsen and Waschke:

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