1、The neck(Part I)Department of human anatomy2016 Objectives:nDivision of the neck.nThe deep cervical fascia,blood vessels,nerve and lymph nodes of neck.nThe sternocleidomastoid region and its contents.nThe carotid sheath and the spatial relationships of its contents.nThe boundaries and contents of su
2、bmental and submandibular triangle.Section 1 Introduction of NeckI.Boundaries:nSuperior B:nInferior border of mandible,angle of mandible,tip of mastoid process,superior nuchal line,external occipital protuberanceI.Boundaries:nInferior B:nJugular notch,sternoclavicular joint,superior border of clavic
3、le,acromion,spinous processes of C7II.Divisions of the necknSide of the neck 固有颈部固有颈部 nAnterior region of necknLateral region of neck nSternocleidomastoid region nNape 项部项部1.Anterior region of necknSuprahyoid regionnSubmental trianglenSubmandibular trianglenInfrahyoid region nCarotid triangle nMuscu
4、lar triangle2.Lateral region of necknOccipital triangle nSupraclavicular triangle(Great supraclavicular fossa)颈部的分区颈部的分区固有颈部固有颈部项部项部颈前区颈前区胸锁乳突肌区胸锁乳突肌区颈外侧区颈外侧区舌骨上区舌骨上区舌骨下区舌骨下区颏下三角颏下三角下颌下三角下颌下三角颈动脉三角颈动脉三角肌三角肌三角枕三角枕三角锁骨上大窝锁骨上大窝斜方肌前缘斜方肌前缘胸锁乳突肌前缘胸锁乳突肌前缘胸锁乳突肌后缘胸锁乳突肌后缘舌骨舌骨III.Surface AnatomynHyoid bonenThy
5、roid cartilagenCricoid cartilagenCarotid tuberclenSternocleidomastoid nSuprasternal fossanGreater supraclaviclar fossaIV.Surface projectionnCommon carotid artery&External carotid arterynSubclavian arterynAccessory nervenBrachial plexus nExternal jugular veinnCupula of pleura&Apex of lungSection 2The
6、 superficial structures and cervical fascia.The superficial structure1.Skin nTransverse in direction.nThin and very movable.*Transverse incision is adopted on the operation of the neck.2.Superficial fascianContents nPlatysma nSuperficial veinsnCutaneous branches of cervical plexus.nCervical branch o
7、f facial nervenSuperficial lateral cervical lymph nodes(1)Superficial veinnAnterior jugular v.nExternal jugular v.(2)Cutaneous nervesnLesser occipital nervenGreet auricular nervenTransverse nerve of necknSupraclavicular nerve.The cervical fascia（3 layers）nIt lies deep to the superficial fascia and p
8、latysma,and often called deep cervical fascia.It is also called enveloping fascia or the investing fascia.nEncloses trapezius,sternocleidomastoid,posterior belly of digastric and parotid and submandibular glands.1.Superficial layer 2.Pretracheal layernEncloses viscera of neck:pharynx,larynx,trachea,
9、esophagus,thyroid gland and parathyroid glandsnCompletely surrounds thyroid gland,forming a sheath for it,and bind the gland to larynx 3.Prevertebral layernLies anterior to bodies of cervical vertebrae and prevertebral muscles.nCovers subclavian vessels and roots of brachial plexus.nExtends into upp
10、er limb as axillary sheath.nThe loose connective tissues are packed between these layers and the organs of the neck to form the spaces.The facial space1.Suprasternal space胸骨上间隙胸骨上间隙nOver the lower part of the anterior trianglenThe inversting fascia splits into two layers,which are attached to the an
11、terior and posterior margins of the upper border of the manubrium,between these two layers is a slit-like space,called the suprasternal space1.Suprasternal space胸骨上间隙胸骨上间隙nContains connective tissue,and sometimes a lymph node2.Pretracheal space气管前间隙气管前间隙nLies between pretracheal layer and cervical p
12、art of tracheanContains arteria thyroidea ima,inferior thyroid v.,unpaired thyroid venous plexus,brachiocephalic trunk and left brachiocephalic v.咽后间隙咽后间隙nLies between prevertebral layer and buccopharyngeal fascia 3.Retropharyngeal spacen椎前间隙椎前间隙nLies between prevertebral muscles,cervical part of ve
13、rtebral column and prevertebral layer.4.Prevertebral spaceSection 3The anterior region and the sternocleidomastoid regionnBoundaries nThe area occupied and covered by sternocleidomastoid.The sternocleidomastoid region.The sternocleidomastoid regionnContents:nExternal jugular veinnSuperficial lateral
14、 cervical lymph nodes nCutaneous branch of cervical plexusnAnsa cervicalis颈袢颈袢 nCarotid sheath and its contentsnSympathetic trunk in the neck1.Ansa cervicalisnUpper root form by the hypoglossal nervenLower root form by the anterior branches of the 2nd and 3rd cervical nerve.nSupply:nSternohyoid nOmo
15、hyoid nSternothyroid2.Carotid sheathnFormed by components of all three layers of deep cervical fascia.nContains:nCommon carotid artery and its branches(the internal and external carotid artery)nInternal jugular veinnVagus nerve(*The spatial relationships)3.Sympathetic trunk in the necknInclude:nSupe
16、rior cervical ganglion(梭形神经节梭形神经节)nMiddle cervical ganglionnInferior cervical ganglion(颈胸神经节颈胸神经节/星形神经节星形神经节).Suprahyoid regionnInclude:nSubmental trianglenSubmandibular triangle1.Submental trianglenBoundaries：is bounded laterally by anterior bellies of digastric,and inferiorly by the body of hyoid
17、bonenContents:nSubmental lymph nodes2.Submandibular trianglenBoundaries：Bounded by anterior and posterior bellies of digastric and lower border of the body of the mandible2.Submandibular trianglenContents:nSubmandibular glandnSubmandibular lymph nodes nSubmandibular ganglionnFacial vesselsnHypogloss
18、al nervenLingual vesselsnLingual nerve1.Remove any remaining skin in the neck region and expose the platysma.Summary of Dissection Procedure:2.Reflect the platysma superiorly to expose the superficial veins and cutaneous nerves of the neck at the surface of sternocleidomastoid.Summary of Dissection
19、Procedure:3.Cut off the originate of sternocleidomastoid and reflect it laterally to expose the structure deep to it.Summary of Dissection Procedure:4.Identify the triangles of the neck and clean the strap muscles and reflect them to expose the ansa cervicalis.Summary of Dissection Procedure:5.Open
20、the carotid sheath to expose the associated vessels and nerves.Summary of Dissection Procedure:6.Open the submental and submandibular region and expose the contents of them.Summary of Dissection Procedure:Summary:nLayers of the neck.nThe surface projection of vessels and nerve of the neck.nCutaneous branch of cervical plexus.nContents of sternocleidomastoid regionnBoundaries and contents of submental and submandibular region
