‫ אזור הפרוטיד ושרירי הבעה‬.1
Muscles in the parotid region
muscles of mastication
Masseter
Temporal
Lateral and medial pterygoid
innervated by the
mandibular division
(V3) of CN V
A.D.A.M
(Occipitofrontalis)
)Corrugator supercilli)
(Levator labii superioris alaeque
nasi)
(Depressor anguli oris)
Muscles of facial expression
Buccinator
Pterygomandibular raphe
Zygomaticus major and zygomaticus minor
Orbicularis oris
Orbicularis oculi
Levator labii superioris
Under it we may find the infraorbital branch of the maxillary division of the trigeminal nerve (V2)
(Depressor labii inferioris)
(Procerus)
(Mentalis)
(Depressor septi nasi)
Risorius, Platysma, Nasalis (Transverse + Alar)
Blood vessels in the parotid region
External carotid artery
Superficial temporal artery.
superficial *
deep
Maxillary artery
Facial artery
...‫הופך ל‬
Transverse facial artery
*deep to the gland but superficial to the
masseter
Inf/sup labial, Lateral Nasal, Angular
Maxillary and Superficial temporal veins
Retromandibular vein
posterior
anterior
Posterior
auricular
vein
Facial
vein
EJV
IJV
Nerves in the parotid region
Facial nerve (CN VII)*
* emerges from the skull through the stylomastoid foramen
Posterior auricular nerve
5 main branches: Temporal, Zygomatic, Buccal, Mandibular, Cervical
The mandibular division (V3) of the trigeminal nerve through the foramen ovale
*travels deeper to the gland, on the surface of the buccinator
Buccal branch*
(The Maxillary division (V2) of the trigeminal nerve
muscle, piercing it (but not supplying it)
Zygomatic, Infraorbital, Branch to Pterygopalatine ganglion)
The parotid gland
Parotid duct (Stensen's duct)
pierces the buccinator muscle and open in the cheek
Note that the parotid duct runs just inferior and parallel to the transverse facial artery
(Accessory parotid gland)
‫ הצוואר‬2-3
Large cervical muscles
Platysma Innervated by the cervical branch of C.N. VII
Sternocleidomastoid (SCM)* Innervated by C.N. XI
Trapezius Innervated by C.N. XI
*The external jugular vein is external to it.
The internal jugular vein is internal to it
Contents of the posterior triangle
Muscles (‫(מלמעלה למטה‬:
Splenius capitis
Levator scapulae
Posterior scalene
Middle scalene
Anterior scalene
The "bandage" of the head (SPLeNium = ‫)אספלנית‬
Brachial plexus lies anterior to it
Phrenic nerve emerges and lies anterior to it
Brachial plexus and subclavian artery are posterior to it, lying on
the first rib
Arteries
Subclavian artery*
Thyrocervical trunk
(First branch) Suprascapular artery
(Second branch) Transverse cervical artery
Occipital artery From the external carotid!
Passes deep to the hypoglossal nerve (C.N. XII) but superficial to C.N.'s IX, X, XI, the sympathetic trunk and the internal
carotid.
Veins
Subclavian vein
External jugular vein
Transverse cervical vein
Suprascapular vein
Anterior jugular vein
*Its branches include:
the vertebral artery,
the internal thoracic artery,
the thyrocervical and the
costocervical trunks
posterior triangle ‫מיקומו של העורק ביחס למבנים ב‬
The artery
Subclavian
Anterior
scalene
posterior
Phrenic
nerve
posterior
Brachial
plexus
anterior
Suprascapular
anterior
anterior
through
Transverse
cervical artery
anterior
anterior
anterior or
through
anterior
jugular
suprascapular
Nerves
EJV
Brachial plexus
Suprascapular nerve
Accessory nerve Emerges from underneath the SCM
1/3 the way down from its top after supplying it.
Emerge at the nerve
point of the neck. The
posterior branches of
cervical plexuss located
on the levator scapulae
and middle scalene, deep
to the SCM
‫התפצלויות הורידים‬
posterior - ‫ב‬
triangle
transverse
cervical
IJV
Subclavian
brachiocephalic
Greater auricular nerve
Lesser occipital nerve
Transverse cervical nerve
Supraclavicular nerves
Phrenic nerve
(Lymph: superficial cervical lymph nodes lie along the EJV)
Noticefrom superficial to deep:
subclavian vein,
then anterior scalene and
phrenic nerve,
then subclavian artery
Contents of the anterior triangle
The two muscles dividing the anterior triangle are:
Digastric muscle Anterior/posterior belly, Omohyoid muscle superior/inferior belly
Submandibular triangle
Submental triangle
Muscles: Mylohyoid, Hyoglossus, Stylohyoid,
Middle pharyngeal constrictor
Vessels:
Facial artery
Muscles: the two mylohyoid muscles meet
here at the median fibrous raphe.
Deeper to it are the geniohyoid and the
genioglossus muscles
(Tonsillar artery, Ascending palatine artery)
Submental artery
Facial vein
Submental vein
(Others: submental lymph nodes)
(Lingual artery)
Muscular triangle
Muscles: `strap muscles`
Sternohyoid,
Sternothyroid,
Thyrohyoid
Nerves: Hypoglossal nerve
Nerve to mylohyoid (branch of the inferior alveolar nerve)
Others: Submandibular gland, Submandibular duct
(Submandibular lymph nodes)
(omohyoid)
Vessels:
Inferior thyroid veins
Anterior jugular vein
Carotid triangle
Muscles: Anterior scalene
Vessels:
(Communicating jugular vein)
(Thyroid ima artery)
lingual
external
carotid
internal
carotid
carotid
sinus
Nerves:
Transverse cervical nerve, Right and
left recurrent laryngeal nerves
ascending
pharyngeal
The root of the neck and cervical
viscera
superior
thyroid
1.
carotid
body
common
carotid artery
superior
laryngeal
2.
From thyrocervical trunk: Inferior thyroid artery
Ascending cervical artery
Common carotid
Internal jugular vein carotid
sheath
Vagus nerve
3.
4.
5.
6.
7.
Nerves: Vagus nerve, Ansa cervicalis,
Sympathetic trunk,
Others: Deep cervical lymph nodes
7.
The division of the right brachiocephalic trunk to the
right common carotid and the right subclavian is
behind the sternoclavicular joint. It is also the site
where the IJV joins the subclavian vein to become the
brachiocephalic vein.
The vertebral artery leaves the 1st part of the
subclavian artery (=medial to the anterior scalene),
passing backwards between the scalenes and the
prevertebral muscles.
The thyrocervical trunk
The costocervical trunk: superior intercostals, deep
cervical artery
The dorsal scapular artery
The vagus nerves descend more medially into the
thorax than the phrenics.
The sympathetic trunk:
The inferior/medial/superior cervical ganglion
Thyroid gland
(isthmus, cricoid cartilage, Thyroid cartilage)
Parathyroid glands