64. Neck. Topographic regions. Subcutaneous elements in the cervical region.

Overview

The neck is divided by the sternocleidomastoid and the trapezius into anterior, sternocleidomastoid and lateral cervical regions, which are further subdivided into triangles. This topic describes these regions, their boundaries and contents, the subcutaneous elements, the cervical fascia and the muscles of the neck.

1. Anterior cervical region (regio cervicalis anterior)
2. 1.1 Cranially: mandible
3. 1.2 Caudally: sternum – jugular notch
4. 1.3 Laterally: sternocleidomastoid
5. Sternocleidomastoid region (regio sternocleidomastoidea) – is bordered by the margins of the sternocleidomastoid
6. Lateral cervical region (regio cervicalis lateralis)
7. 3.1 Ventrally: sternocleidomastoid
8. 3.2 Dorsally: trapezius
9. 3.3 Caudally: clavicle

1. Anterior cervical region (regio cervicalis anterior)
2. 1.1 Submental triangle
3. 1.2 Submandibular triangle
4. 1.3 Carotid triangle
5. 1.4 Muscular/omotracheal triangle
6. Sternocleidomastoid region (regio sternocleidomastoidea)
7. 2.1 Lesser supraclavicular fossa
8. 2.2 Scalenovertebral triangle
9. Lateral cervical region (regio cervicalis lateralis)
10. 3.1 Omoclavicular triangle
11. 3.2 Omotrapezoid triangle

Medial (anterior) cervical region

The medial (anterior) cervical region lies between the anterior median line and the anterior border of the sternocleidomastoid. The hyoid bone divides it into the suprahyoid part (submental and submandibular triangles) and the infrahyoid part (carotid and omotracheal triangles). The midline structures lie in the visceral space: the larynx and trachea, the pharynx and oesophagus and the thyroid and parathyroid glands, with the carotid sheaths at the sides.

Boundaries

1. Cranially: body of mandible – inferior margin
2. Medially: digastric – anterior belly
3. Laterally: digastric – posterior belly
4. Bottom: mylohyoid and hyoglossus

Content S(GLG) LL HF

1. Submandibular gland
2. 1.1 Submandibular duct
3. Lingual nerve
4. Submandibular ganglion
5. Hypoglossal nerve
6. Lingual artery and vein
7. Facial artery and vein – including submental and glandular branches and tributaries
8. Submandibular lymph nodes

Boundaries

1. Cranially: digastric – posterior belly
2. Laterally: sternocleidomastoid
3. Caudally: omohyoid – superior belly

Content

Inside the carotid sheath

1. Common carotid artery – situated medially – continues as the internal carotid artery from the C4 level upward
2. Internal jugular vein – situated laterally
3. Superior root of deep ansa cervicalis – situated ventrally
4. Vagus nerve – situated dorsally

Boundaries

1. Laterally: digastric – anterior belly
2. Ventrally (cranially): mandible – body
3. Caudally: hyoid bone – body
4. Floor: mylohyoid

Content

5. Mylohyoid nerves
6. Submental arteries and veins
7. Submental lymph nodes

Boundaries

1. Cranially: hyoid bone – the body
2. Cranially and laterally: omohyoid – the superior belly
3. Caudally and laterally: sternocleidomastoid
4. Medially: anterior median line
5. Caudally: sternum – the manubrium (its jugular notch)

Content

1. Larynx / trachea (borderline at the level of C6)
2. Pharynx / oesophagus (borderline at the level of C6)
3. Thyroid gland and parathyroid glands
4. Recurrent laryngeal nerve
5. Superior laryngeal nerve