The Neck

Dr:Ahmed Ibrahim Abdi(nawawi)

Anatomist
 Introduction
• The neck is the transitional area between the base of the
cranium superiorly and the clavicles inferiorly.
• The neck joins the head to the trunk and limbs, serving as
a major conduit for structures passing between them.
• It extends :
– anteriorly from the lower border of the mandible to
the upper surface of the manubrium of the sternum.
– posteriorly from the superior nuchal line on the
occipital bone of the skull to the intervertebral disc
between the CVII and TI vertebrae.
THE NECK
 The Neck
• The four compartments provide longitudinal
organization:
– The visceral compartment is anterior and contains
parts of the digestive and respiratory systems, and
several endocrine glands .
– The vertebral compartment is posterior and contains
the cervical vertebrae, spinal cord, cervical nerves,
and muscles associated with the vertebral column.
– The two vascular compartments, one on each side,
are lateral and contain the major blood vessels and
the vagus nerve [X] .
COMPARTMENTS OF THE NECK
 Fascia
• The fascia of the neck
has a number of unique
features.
• The superficial fascia in
the neck contains a thin
sheet of muscle (the
platysma) , which
begins in the superficial
fascia of the thorax,
runs upward to attach to
the mandible and blend
with the muscles on the
face, is innervated by
the cervical branch of
the facial nerve [VII]
 Fascia

• Deep to the superficial fascia, the deep cervical fascia is

organized into several Different layers.
• These include:
– an investing layer, which surrounds all structures in the
neck;
– the prevertebral layer, which surrounds the vertebral
column and the deep muscles associated with the back;
– the pretracheal layer, which encloses the viscera of the
neck; and
– the carotid sheaths, which receive a contribution from the
other three fascial layers and surround the two major
neurovascular bundles on either side of the neck.
FASCIA OF NECK, TRANSVERSE VIEW
 Fascial spaces

• Three spaces could be involved in this process :

– The first is the pretracheal space between the
investing layer of cervical fascia and the
pretracheal fascia.
– The second is the retropharyngeal space between
the buccopharyngeal fascia (and the prevertebral
fascia
– The third space is within the prevertebral layer
covering the anterior surface of the transverse
processes and bodies of the cervical vertebrae.
FASCIA O F THE NECK, SAGITTAL VIEW
 The neck
• The skeleton of the neck is formed by:
– cervical vertebrae.
– hyoid bone.
– manubrium of the sternum.
– clavicles.
• These bones are parts of the axial skeleton
except the clavicles, which are part of the
appendicular skeleton.
BONES AND CARTILAGES OF NECK
 Hyoid bone
• The mobile hyoid bone (or simply, the hyoid),
lies in the anterior part of the neck at the level
of the C3 vertebra in the angle between the
mandible and the thyroid cartilage.
• The hyoid is suspended by muscles that
connect it to the mandible, styloid processes,
thyroid cartilage, manubrium of the sternum,
and scapulae.
 Hyoid bone
The hyoid consists of: body and greater
and lesser horns.
• The body of the hyoid, its middle
part.
• Each end of its body is united to a
greater horn that projects
posterosuperiorly and laterally from
the body.
• Each lesser horn is a small bony
projection from the superior part of
the body of the hyoid near its union
with the greater horn.
• It is connected to the body of the
hyoid by fibrous tissue and
sometimes to the greater horn by a
synovial joint.
• The lesser horn projects
superoposteriorly toward the styloid
process.
 The Neck
• For descriptive purposes the neck is divided into:
– anterior
– posterior triangles.
• The boundaries o f the anterior triangle are the
anterior border of the sternocleidomastoid
muscle, the inferior border of the mandible, and
the midline of the neck.
• The boundaries of the posterior triangle are the
posterior border of the sternocleidomastoid
muscle,the anterior border of the trapezius
muscle, and the middle one-third of the clavicle.
ANTERIOR AND POSTERIOR TRIANGLES OF THE NECK
 Anterior triangle of the neck

• The anterior triangle of the neck is bounded

by the anterior border of the
sternocleidomastoid muscle laterally, the
inferior border of the mandible superiorly, and
the midline of the neck medially.
BORDERS AND SUBDIVISIONS OF THE ANTERIOR TRIANGLE OF THE NECK
 Anterior triangle of the neck
• it is further subdivided into
several smaller triangles as
follows:
• The submandibular triangle is
outlined by the inferior
border of the mandible
superiorly and the anterior
and posterior bellies of the
digastric muscle inferiorly.
• The submental triangle is
outlined by the hyoid bone
inferiorly, the anterior belly
of the digastric muscle
laterally, and the midline.
 Anterior triangle of the neck
• The muscular triangle is outlined
by the hyoid bone superiorly, the
superior belly of the omohyoid
muscle, and the anterior border
of the sternocleidomastoid
muscle laterally, and the midline.

• The carotid triangle is outlined

by the superior belly of the
omohyoid muscle
anteroinferiorly, the stylohyoid
muscle and posterior belly of the
digastric superiorly, and the
anterior border of the
sternocleidomastoid muscle
posteriorly.
 Muscles

• The muscles in the anterior triangle of the neck can

be grouped according to their location relative to
the hyoid bone:
– Muscles superior to the hyoid are classified as
suprahyoid muscles and include the stylohyoid,
digastric, mylohyoid, and geniohyoid.
– Muscles inferior to the hyoid are infrahyoid
muscles and include the omohyoid, sternohyoid,
thyrohyoid, and sternothyroid.
 Suprahyoid muscles

• The four pairs of suprahyoid muscles are

related to the submental and submandibular
triangles.
• They pass in a superior direction from the
hyoid bone to the skull or mandible and raise
the hyoid, as occurs during swallowing.
 Suprahyoid muscles

Stylohyoid
• The stylohyoid muscle
arises from the base of
the styloid process and
passes anteroinferiorly
to attach to the lateral
area of the body of the
hyoid bone .
• During swallowing it
pulls the hyoid bone
posterosuperiorly and
it is innervated by the
facial nerve [VII] .
 Digastric

• The digastric muscle has two bellies connected

by a tendon, which attaches to the body of the hyoid
bone :
– The posterior belly arises from the mastoid
notch on the medial side of the mastoid
process of the temporal bone.
– The anterior belly arises from the digastric
fossa on the lower inside of the mandible.
SUPRAHYOID MUSCLES. LATERAL VIEW
 Digastric

• the muscle has multiple actions depending on which bone is

fixed:
– When the mandible is fixed, the digastric muscle raises the hyoid
bone.
– When the hyoid bone is fixed, the digastric muscle opens the
mouth by lowering the mandible.
• Innervation of the digastric muscle is from two different cranial
nerves.
• The innervation of the posterior belly of the digastric muscle is by
the facial nerve [VII] , whereas the anterior belly of the muscle is
innervated by the mandibular division [V3] of the trigeminal
nerve [V] .
 Mylohyoid

• The mylohyoid muscle is

superior to the anterior
belly of the digastric.
• This mylohyoid muscle
supports and elevates the
floor of the mouth and
elevates the hyoid bone.
• It is innervated by the
mandibular division [V 3]
of the trigeminal nerve [V]
.
 Geniohyoid

• The geniohyoid muscle is superior to the floor of the oral

cavity.
• The geniohyoid arises from the inferior mental spine of
the mandible and passes backward and downward to
insertion the body of the hyoid bone.
• It has two functions depending on which bone is fixed:
– Fixation of the mandible elevates and pulls the hyoid bone
forward.
– Fixation of the hyoid bone pulls the mandible downward
and inward.
• The geniohyoid is innervated by a branch from the anterior
ramus of C1 carried along the hypoglossal nerve [XII] .
SUPRAHYOID MUSCLES. A. LATERAL VIEW. B. INFERIOR VIEW
END