Neck Region PA 481 Anterior Surface Triangles at Surface Hyoid 1. C3 level 2. Suprahyoid muscles 3. Infrahyoid muscles Vertebral Column Intervertebral disc Vertebra Parts C1 & C2 Cervical Vertebra Typical Cervical Vertebra Spinal Cord • Receives and generates signals to body through the spinal nerves Cord in Spinal Canal Posterior Median Sulcus Posterior Root Denticulate Ligament Dorsal Root Ganglion Anterior Root Spinal Nerve Spinal Cord (X.S.) Spinal Cord (x.s.) Spinal Nerve Anatomy Functional Arrangement of SC Ascending and descending pathways Ascending Pathways Descending Pathways Cervical Plexus Serves neck and diaphragm Brachial Plexus and pectoral nerves Brachial Plexus Innervates most of the arm and some of the body wall. Spinal Cord Segments • 4 segments: Cervical, Thoracic, Lumbar, and Sacral (only 1 coccygeal nerve) • 31 pairs of spinal nerves Cervical Segment Neck Fascia Superficial fascia Prevertebral fascia Alar fascia Pretracheal fascia Investing fascia Platysma SCM and Trapezius SCM Trapezius Cervical Triangles Posterior Triangle Anterior Triangle Posterior Triangle Occipital triangle Supraclavicular triangle Superficial and Deep Posterior Triangle Ext. jugular v. SCM Splenius Levator scapulae Accessory n. Nerve Point of Neck Phrenic n. Prevertebral fascia Platysma Scalenes Brachial plexus Supraclavicular Triangle Brachial Plexus SCM Subclavian vessels Anterior Triangles Submandibular Submental Carotid Muscular Muscular Triangle Muscles of Triangle Thyrohyoid Sternothyroid Thyroid Sternohyoid Thyroid Location Accessory Thyroid gland Accessory thyroid along thyroglossal duct Pyramidal lobe (50% of people have this lobe structure) Thyroid Follicle (follicular cells thyroxine) Parafollicular cells calcitonin T3 & T4 Formation and Secretion T3 & T4 Control of Thyroxine Secretion Short loop Long loop Thyroid Malfunction • Hypothyroidism • Endemic goiters –due to iodine deffeicency • Cretinism –i thyroxine in child results in igrowth (dwarf) and severe mental retardation • Myxedema –i thyroxine in adult, leads to swelling of tissues plus other symptoms Cretinism Thyroid Malfunction • Hyperthyroidism • Toxic goiters (Graves disease) –Ab may stimulate thyroid without negative feedback control • Exophthalmos –symptom present in many hyperthyroid patients Parathyroid Location Parathyroid PTH Actions • Stimulates resorption of bone hCa+ and PO4- in blood • Stimulates Ca+ absorption in intestine (active Vit. D3 necessary for Ca+ absorption) • Stimulates Ca+ reabsorption and PO4- excretion in kidney • Stimulates Vit. D3 formation (skin) and activation (kidney) • Vital for life Laryngeal Cartilages Hyoid Epiglottis (anterior) Arytenoid cartilage Thyroid cartilage Cricoid cartilage (posterior) Voice Box Vestibular fold Ventricle Vocal fold CN X: supply to laryngeal muscles Inf. Vagal ganglion Internal Laryngeal n. (sensory & autonomic) External Laryngeal n. (motor to inf. Pharnygeal constrictor and the cricohyoid) Recurrent Laryngeal n. (motor to all other laryngeal muscles) Digastric Mylohyoid Submental Triangle -contains submental lymph nodes Carotid Triangle Digastric (posterior belly) External carotid a. Internal carotid a. Common carotid a. Ansa cervicalis SCM IJV Omohyoid Ext. Carotid Branches Hypoglossal n. Occipital Post. Auricular Int. carotid Superficial Temporal Maxillary Ext. carotid Facial Lingual Sup. Thyroid IJV Common Carotid Ansa cervicalis Asc. Pharyngeal (not show) External carotid (isolated) Superficial Temporal Post. Auricular Maxillary Occipital Facial Lingual Asc. Pharyngeal Sup. Thyroid Note: Internal carotid has NO neck branches. Carotid bodies IJV Sup. Bulb of IJV Facial Sup. Thyroid Inf. Bulb of IJV IJV Lymph nodes of neck Deep Cervical Lymph nodes (most located in carotid sheath) Submandibular Triangle Submandibular glands Digastrics Submandibular Lymph nodes Pharynx Function: deglutition Mucosa: Str. Squamous Muscularis: Skeletal Oro- and nasopharynx Pharyngeal tonsil Pharyngotympanic (Eustachian) tube Tubal tonsils (small holes) Pharyngeal recess Palatine bone Salpingopharyngeal fold Soft palate Uvula Palatoglossal arch Tonsillar cleft Palatopharyngeal arch Lingual Tonsil Longitudinal pharyngeal muscles Palatopharyngeus Tonsils Pharyngeal Tonsil Pharyngeal Constrictors Superior Middle Inferior Peristalsis Deglutition (Swallowing) Fluid Drinking Deglutition (cont’d) Deglutition (cont’d) Laryngopharynx Epiglottis Piriform recess