dpt anatomy - head & neck 2

torticollis

twisted neck caused by SCM tightness

platysma attachment

• inferior border of mandible

• skin

• subcutaneous tissue of lower face

TO

• fascia covering superior parts of pectoralis major and deltoid

platysma innervation

cervical branch of facial nerve

platysma action

• draws corner of mouth inferiorly

• widens corner of mouth in expressions of sadness and fright

• draws skin of neck superiorly when teeth are clenched tight

sternocleidomastoid attachment

• lateral surface of mastoid process

• lateral half of superior nuchal line

TO

• anterior surface of manubrium of sternum (sternal head)

• superior surface of medial third of clavicle (clavicular head)

sternocleidomastoid innervation

• spinal accessory nerve (motor)

• C3/4 ventral rami (proprioception)

sternocleidomastoid action

unilaterally

• ipsilateral side bending

• contralateral rotation

bilaterally

• extend neck at O/A joint

• flex lower cervical vertebrae

what’s one important thing in anterior triangle of neck

carotid triangle

borders of posterior triangle

• anterior - posterior border of SCM

• posterior - anterior border of trapezius

• inferior - middle 1/3 of clavicle

• base - clavicle

• apex - superior nuchal line between SCM and trapezius

• roof (most superficial) - deep fascia, superficial fascia, platysma, superficial veins, cutaneous nerves, skin

• floor (deepest): anterior, posterior, and middle scalene

external jugular vein crosses ___

SCM

veins in posterior triangle of neck

• external jugular vein

• subclavian vein

arteries in posterior triangle

• transverse cervical artery

• suprascapular artery

• occipital artery

• subclavian artery (3rd part)

nerves in the posterior triangle of neck

• accessory nerve (CN XI) - deep to SCM

• cervical plexus (C1-4) ventral rami - deep to internal jugular vein and SCM

• supraclavicular part of brachial plexus

cutaneous branches of cervical plexus emerge at

middle of posterior border of SCM at “nerve point’

cutaneous branches of cervical plexus

• lesser occipital nerve (C2, C3)

• greater auricular nerve (C2, C3)

• transverse cervical nerve (C2, C3)

• supraclavicular nerve (C3, C4)

• phrenic nerve (C3, C4, C5)

what does greater auricular nerve (C2, C3) innervate

skin around ear

what does supraclavicular nerve (C3, C4) innervate

skin across clavicle and shoulder

what does phrenic nerve (C3, C4, C5) innervate

diaphragm

muscles in posterior triangle (superior to inferior)

• splenius capitis

• levator scapulae

• scalenus medius

• scalenus posterior

• scalenus anterior

• omohyoid

levator scapulae attachment

• posterior tubercles of transverse processes C1-C4

• superior part of medial border of scapula

levator scapulae innervation

dorsal scapular nerve (C4/5)

levator scapulae action

• elevate scapula

• downward rotation of scapula and tilts glenoid cavity inferiorly

scalenus anterior attachment

• C3-C6 transverse processes

TO

• scalene tubercle of 1st rib

scalenus anterior innervation

ventral rami cervical spinal nerve C4-C6

scalenus anterior action

• flex head

• elevate 1st rib during forced inspiration

scalenus medius attachment

• C2-C6 transverse processes

TO

• 1st rib

scalenus medius innervation

ventral rami cervical spinal nerves

scalenus medius action

• neck side bending

• elevate 1st rib during forced inspiration

scalenus posterior attachment

• C4-C6 transverse processes

TO

• 2nd rib

scalenus posterior innervation

ventral rami cervical spinal nerves

scalenus posterior action

• neck side bending

• elevates 2nd rib during forced inspiration

omohyoid attachment

• superior border of scapula

TO

• inferior border of hyoid

omohyoid innervation

ventral rami of spinal nerve C1-C3 (cervical plexus)

omohyoid action

depress, retracts, and steadies hyoid bone

borders of anterior triangle of neck

• anterior border: anteromedian line of neck

• superior border: inferior border of mandible

• posterior border: anterior border of SCM

• apex: jugular notch

• base: inferior border of mandible

• floor: pharynx, larynx, thyroid gland, and deeper prevertebral muscles

contents of the anterior triangle

• suprahyoids

• infrahyoids

• thyroid/parathyroid

• arteries/veins

• nerves

• lymph nodes

all work on hyoid bone and involved in sawllowing