Head and Neck Anatomy: Arteries, Nerves, Muscles & Glands

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Subclavian artery: Neck artery; right side arises from the brachiocephalic trunk, left from the aortic arch. Branches: vertebral, internal thoracic, thyrocervical trunk. Passes between the anterior and middle scalene muscles.

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Common carotid artery: Right: brachiocephalic trunk; left: aortic arch. Bifurcates at about C4 into internal and external carotid arteries. Innervation: sympathetic/vagal fibers in the carotid sheath.

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External carotid artery: Origin: common carotid bifurcation (about C4). Branches (proximal to distal): superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular, maxillary, superficial temporal. Supplies the face, scalp, neck, and thyroid.

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Superior thyroid artery: Origin: external carotid (first branch). Supplies thyroid gland and larynx. Exam tagged.

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Facial artery: Origin: external carotid. Runs deep to the posterior belly of the digastric and stylohyoid, through the submandibular gland, and over the mandible. Supplies face and submandibular region. Exam tagged.

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Submental artery: Origin: facial artery in the submandibular triangle. Supplies the submental region, mylohyoid, and anterior digastric.

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Lingual artery: Origin: external carotid. Runs deep to the hyoglossus. Supplies the tongue. Exam tagged.

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Internal carotid artery: Origin: common carotid bifurcation (about C4). Enters the carotid canal in the petrous temporal bone. Supplies the brain and eye. Foramen: carotid canal (petrous temporal bone).

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Vertebral artery: Origin: first branch of subclavian artery. Enters transverse foramina of C6 to C1, then ascends through the foramen magnum to supply the brain. Foramina: transverse foramina C6-C1; foramen magnum.

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Internal thoracic artery: Origin: subclavian artery. Descends behind the costal cartilages along the inner chest wall.

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Thyrocervical trunk: Origin: subclavian artery. Branches: inferior thyroid, suprascapular, transverse cervical, ascending cervical.

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Transverse cervical artery: Origin: thyrocervical trunk. Supplies the trapezius and levator scapulae.

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Suprascapular artery: Origin: thyrocervical trunk. Passes over the suprascapular notch to supply the supraspinatus and infraspinatus. Foramen: suprascapular notch (under the transverse scapular ligament).

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Internal jugular vein: Origin: sigmoid sinus at the jugular foramen. Descends in the carotid sheath and joins the subclavian vein to form the brachiocephalic vein. Receives the common facial vein. Foramen: jugular foramen.

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Common facial vein: Origin: union of the facial and retromandibular veins. Drains into the internal jugular vein.

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Facial vein: Origin: angular vein at the medial eye. Passes superficial to the submandibular gland and joins the retromandibular vein to form the common facial vein.

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Ansa cervicalis: Nerve Loop formed by C1 (superior root, joins CN XII) and C2-C3 (inferior root). Innervates the sternohyoid, sternothyroid, and omohyoid.

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Vagus nerve (CN X): Origin: medulla (dorsal motor nucleus and nucleus ambiguus). Exits the skull through the jugular foramen. Innervates the pharynx, larynx, thoracic, and abdominal viscera. Foramen: jugular foramen.

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Superior laryngeal nerve: Origin: vagus nerve at the inferior ganglion. Divides into an internal branch (sensory above the vocal folds, passing through the thyrohyoid membrane) and an external branch (motor to the cricothyroid). Foramen: thyrohyoid membrane.

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Internal laryngeal nerve: Origin: superior laryngeal nerve. Sensory to the laryngeal mucosa above the vocal folds. Passes through the thyrohyoid membrane with the superior laryngeal artery. Foramen: thyrohyoid membrane.

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External laryngeal nerve: Origin: superior laryngeal nerve (CN X). Innervates the cricothyroid. Exam tagged in the lecture outline.

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Recurrent laryngeal nerve: Origin: vagus. Right: loops under the subclavian artery; left: loops under the aortic arch. Ascends in the tracheoesophageal groove. Innervates all intrinsic laryngeal muscles except the cricothyroid.

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Nerve to the mylohyoid (CN V3): Origin: mandibular division (V3) via the inferior alveolar branch. Innervates the mylohyoid and anterior belly of the digastric. Foramen: foramen ovale (V3 exits here).

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Hypoglossal nerve (CN XII): Origin: medulla (hypoglossal nucleus). Exits through the hypoglossal canal at the occipital condyle. Innervates all intrinsic and most extrinsic tongue muscles. Foramen: hypoglossal canal.

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Nerve to the thyrohyoid: Origin: C1 fibers traveling with CN XII. Innervates the thyrohyoid and geniohyoid. Foramen: hypoglossal canal (with CN XII).

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Sternocleidomastoid (SCM): Origin: manubrium and medial clavicle. Insertion: mastoid process and superior nuchal line. Innervation: spinal accessory nerve (CN XI), with C2-C3 proprioception. Foramen: jugular foramen (CN XI spinal part exits here).

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Sternohyoid: Origin: posterior manubrium and medial clavicle. Insertion: body of the hyoid. Innervation: ansa cervicalis (C1-C3).

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Sternothyroid: Origin: posterior manubrium and first costal cartilage. Insertion: oblique line of the thyroid lamina. Innervation: ansa cervicalis (C1-C3).

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Cricothyroid: Origin: anterior arch of the cricoid. Insertion: inferior horn and lamina of the thyroid cartilage. Innervation: external laryngeal nerve (CN X). Only laryngeal muscle in the anterior neck.

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Thyrohyoid: Origin: oblique line of the thyroid lamina. Insertion: greater horn of the hyoid. Innervation: nerve to thyrohyoid (C1 via CN XII).

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Mylohyoid: Origin: mylohyoid line of the mandible. Insertion: median raphe and body of the hyoid. Innervation: nerve to mylohyoid (CN V3). Forms the floor of the submandibular triangle.

Identify this structure: B

Anterior digastric: Origin: digastric fossa of the mandible. Insertion: intermediate tendon (anchored to the hyoid by a fascial sling). Innervation: nerve to mylohyoid (CN V3).

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Posterior digastric: Origin: mastoid notch of the temporal bone. Insertion: intermediate tendon. Innervation: CN VII (posterior belly branch). Foramen: stylomastoid foramen (CN VII exits here). Active during chewing and swallowing.

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Omohyoid: Origin: inferior belly from the superior border of the scapula; superior belly from the intermediate tendon. Insertion: body of the hyoid. Innervation: ansa cervicalis (C1-C3).

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Stylohyoid: Origin: styloid process of the temporal bone. Insertion: greater horn and body of the hyoid. Innervation: CN VII (stylohyoid branch). Foramen: stylomastoid foramen (CN VII exits here).

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Hyoglossus: Origin: greater horn of the hyoid. Insertion: side of the tongue. Innervation: hypoglossal nerve (CN XII).

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Thyroid gland: (endocrine gland). Arterial supply: superior and inferior thyroid arteries. Innervation: sympathetic and parasympathetic fibers. .

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Parotid gland: (Salivory gland) Duct: Stensen's duct, opening opposite the upper second molar. Innervation: CN IX (parasympathetic via otic ganglion); CN VII (facial nerve passes through it). Foramen: stylomastoid foramen region (CN VII runs through the gland).

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Submandibular gland: (salivary gland). Duct: Wharton's duct, opening at the sublingual papilla. Innervation: CN VII (parasympathetic via submandibular ganglion, chorda tympani).

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Hyoid bone: (bone). Attachments: suprahyoid and infrahyoid muscles. No direct bony articulation.

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Thyroid cartilage: Attachments: thyrohyoid membrane, cricothyroid, sternothyroid, thyrohyoid.

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Laryngeal prominence: (anterior projection of the thyroid lamina). Palpable in the midline of the neck.

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Cricoid cartilage: (cartilage). Attachments: cricothyroid, posterior cricoarytenoid, and the cricotracheal ligament. I

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Cricothyroid membrane/ligament: (membrane). Spans from the cricoid to the thyroid cartilage. Used for emergency airway access (cricothyrotomy).

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Cervical plexus: Origin: ventral rami C1-C4. Predominantly cutaneous; also innervates the phrenic nerve and ansa cervicalis contributions. Foramen: intervertebral foramina C1-C4.

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Supraclavicular nerves: Origin: cervical plexus (C3-C4). Innervates skin over the clavicle and shoulder.

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Transverse cervical nerve: Origin: cervical plexus (C2-C3). Innervates the anterior neck skin.

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Great auricular nerve: Origin: cervical plexus (C2-C3). Innervates the skin over the parotid gland and earlobe.

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Lesser occipital nerve: Origin: cervical plexus (C2). Innervates the skin of the posterolateral scalp and neck.

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Phrenic nerve: Origin: cervical plexus (C3-C5). Innervates the diaphragm.

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Brachial plexus (ventral rami): Origin: ventral rami C5-T1. Passes through the posterior triangle and scalene triangle between the anterior and middle scalenes. Foramina: intervertebral foramina C5-T1.

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Spinal accessory nerve (CN XI): Origin: spinal part from the accessory nucleus (C1-C5/6). Cranial part from the medulla. Enters the foramen magnum and exits the jugular foramen. Innervates the SCM and trapezius. Foramen: jugular foramen.

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Trapezius: Origin: occipital bone (superior nuchal line), ligamentum nuchae, spinous processes of C7-T12. Insertion: lateral clavicle, acromion, and spine of the scapula. Innervation: CN XI and C3-C4 proprioception.

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Anterior scalene: Origin: anterior tubercles of the C3-C6 transverse processes. Insertion: scalene tubercle of the first rib. Innervation: ventral rami C4-C6. The phrenic nerve runs directly on the anterior scalene muscle. It forms from C3-C5, descends across the anterior surface of anterior scalene. Subclavian artery passes behind it.

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Middle scalene: Origin: posterior tubercles of C2-C7 transverse processes. Insertion: first rib (posterior to the subclavian groove). Innervation: ventral rami C3-C8.

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Posterior scalene: Origin: posterior tubercles of C5-C7 transverse processes. Insertion: outer surface of the second rib. Innervation: ventral rami C6-C8.

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Levator scapulae: Origin: posterior tubercles of C1-C4 transverse processes. Insertion: superior angle of the scapula. Innervation: dorsal scapular nerve (C5) and C3-C4.

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Splenius (capitis-yellow/cervicis-red): Origin: ligamentum nuchae and spinous processes C7-T3 (capitis); T3-T6 (cervicis). Insertion: mastoid process and superior nuchal line (capitis); posterior tubercles of C1-C3 transverse processes (cervicis). Innervation: dorsal rami of cervical nerves.