- Hangman's Fracture
- Caused by hyperextension of the neck
- Often results in increased space surrounding spinal cord
- However, can still result in serious SC injuries
- Teardrop Fracture
- Caused by hyperflexion and/or compression of the neck
- Most severe C-spine fracture
- Almost always causing nerve damage
- Branches
- Vertebral
- Internal Thoracic
- Thyrocervical trunk
- Inferior thyroid
- Suprascapular
- Transverse cervical
- Costocervical trunk
- Superior intercostal
- Deep cervical
- Dorsal scapular
- Clinical Correlation
- Thoracic Outlet syndrome
- Caused by compression of subclavian artery or vein
- 1-10 people with a cervical rib develop TOS
- Hypertrophy of scalene muscles
- Symptoms
- Pain numbness tingling – compression of brachial plexus
- Swelling, cyanosis, fatigue
- Caused by compression of subclavian artery or vein
- Thoracic Outlet syndrome
The Thyroid and Parathyroid glands
- Thyroid
- Located in the anterior neck, spanning C5-and T1
- 2-lobed endocrine gland – which are connected by an isthmus.
- Posterior to sternohyoid and sternothyroid muscles
- Inferior to thyroid cartilage of the larynx.
- Produces T3 (triodothyonine) and T4 (thyroxine)
- Controlled by TSH release from pituitary gland
- Contains ultimobranchial bodies (C cells)
- Produce calcitonin
- Blood Supply
- Superior thyroid artery
- Branch off of the external carotid artery
- Inferior thyroid artery
- Branch off of the thyrocervical trunk
- Superior thyroid artery
- Parathyroid
- Produces parathyroid hormone (PTH)
- Calcium and phosphate homeostasis
- Posterior aspects of the lateral lobes of the thyroid
- Superior and inferior parathyroid glands
- Have different embryological origins
- Produces parathyroid hormone (PTH)
- Clinical Correlations
- Hyperthyroidism
- Increased T3/T4 production
- Can be caused my multiple things
- Graves Disease (autoimmune)
- Hyper-functioning thyroid gland
- Thyroiditis
- Pituitary disorder
- Symptoms
- Enlarged thyroid gland
- Sudden weight loss/increased appetite
- Sensitivity to heat
- Trouble sleeping
- Hypothyroidism
- Decreased T3/T4 production
- Causes
- Hashimoto’s Thyroiditis (autoimmune)
- Iodine deficiency
- Pituitary disorder
- Symptoms
- Depression/memory impairment
- Sudden weight gain
- Sensitivity to cold
- Fatigue
- Hyperthyroidism
Triangles of
the Neck
Subdivision |
Boundaries |
Contents |
Mandibular symphysis, anterior belly of digastric, body of hyoid |
Submental lymph nodes, tributaries forming anterior jugular vein |
|
Lower border of mandible, anterior belly of digastric, posterior belly of digastric |
Submandibular gland and lymph nodes, hypoglossal nerve, mylohyoid nerve, facial artery and vein |
|
Posterior belly of digastric, superior belly of omohyoid, anterior border of sternocleidomastoid muscle |
Tributaries to common facial v. Cervical branch of facial nerve, common carotid, internal/external carotid. Vagus, accessory, hypoglossal, ansa cervicalis |
|
Midline of neck, superior belly of omohyoid, anterior border of SCM |
Sternohyoid, omohyoid, sternothyroid, thyrohyoid, thyroid and parathyroid glands, pharynx |
|
Sternocleidomastoid, clavicle, trapezoid |
Accessory nerve, roots of brachial plexus, suprascapular nerve, cutaneous branches of cervical plexus, phrenic nerve, occipital artery, part of subclavian |
Muscles of
the Neck
Muscle |
Origin |
Insertion |
Innervation |
Function |
Base of styloid process |
Lateral area of body of hyoid process |
Facial nerve |
Pulls hyoid bone upward |
|
Digastric fossa on lower inside of mandible |
Tendon between 2 bellies |
V3 nerve to mylohyoid |
Opens mouth by lowering mandible, raises hyoid |
|
Mastoid notch on medial mastoid process |
Tendon between 2 bellies |
Facial nerve |
Pulls hyoid bone upward and back |
|
Mylohyoid line on mandible |
Body of hyoid bone |
Mylohyoid nerve from V3 |
Support and elevation of floor and mouth, elevation of hyoid |
|
Inferior mental spine on inner surface of mandible |
Anterior surface of body of hyoid bone |
Branch from anterior ramus of C1, carried on hypoglossal |
Fixed mandible elevates and pulls hyoid forward vis-versa for hyoid fixed |
|
Posterior aspect of sternoclavicular joint and manubrium |
Body of hyoid bone |
Ansa cervicalis |
Depresses hyoid after swallowing |
|
Medial to suprescapular notch |
Hyoid bone |
Ansa cervicalis |
Depresses and fixes hyoid bone |
|
Oblique line on lamina of thyroid cartilage |
Greater horn of hyoid |
C1 carried by hypoglossal |
Depresses hyoid, raises larynx |
|
Posterior surface of manubrium of sternum |
Oblique line on lamina of thyroid cartilage |
Ansa cervicalis |
Draws larynx downward |
|
Sternum and clavicle |
Superior nuchal line and lateral surface of Mastoid process |
Accessory nerve |
Tilt head toward shoulder, draw head forward |
|
Transverse processes of C2-C7 |
Upper surfaces of ribs 1 and 2 |
C4-C7 |
Elevation of ribs 1 and 2 |
Muscles of
the Pharynx
Muscle |
Origin |
Insertion |
Innervation |
Function |
Pterygomandibular raphe and adjacent bone on mandible, pterygoid hamulus |
Vagus n. |
Constriction of pharynx |
||
Pharyngeal Raphe |
Greater horn of hyoid bone, adjacent margins of lesser horn and stylohyoid ligament |
Vagus n. |
Constriction of pharynx |
|
Pharyngeal Raphe |
Cricoid cartilage, oblique line of thyroid cartilage |
Vagus n. |
Constriction of pharynx |
|
Medial side of styloid process |
Pharyngeal wall |
Glossopharyngeal n. |
Elevation of pharynx |
|
Inferior part of eustachian tube |
Pharyngeal wall |
Vagus n. |
Elevation of pharynx |
|
Upper surface of soft palate |
Pharyngeal wall |
Vagus n. |
Elevation of pharynx |
Intrinsic
muscles of the larynx
Muscle |
Origin |
Insertion |
Innervation |
Function |
Anterolateral aspect of arch of cricoid cartilage |
Inferior horn of thyroid cartilage, inferior margin of thyroid cartilage |
External branch of superior laryngeal (Vagus) |
Forward and downward rotation of the thyroid cartilage at the cricothyroid joint |
|
Oval depression on posterior surface of lamina of cricoid cartilage |
Posterior surface of muscular process of arytenoid cartilage |
Recurrent laryngeal n. (Vagus) |
Primary abductors of vocal folds. Most important skeletal muscle in the
entire universe. |
|
Superior surface of arch of cricoid cartilage |
Anterior surface of arytenoid cartilage |
Recurrent laryngeal n. (Vagus) |
Internal rotation of arytenoid cartilage, adduction of vocal folds |
|
Lateral border of posterior surface of arytenoid cartilage |
Lateral border of posterior surface of opposite arytenoid cartilage |
Recurrent laryngeal n. (Vagus) |
Adduction of arytenoid cartilages |
|
Posterior surface of muscular process of arytenoid cartilage |
Posterior apex of adjacent arytenoid cartilage, ary-epiglottic fold |
Recurrent laryngeal n. (Vagus) |
Sphincter of laryngeal inlet |
|
Thyroid angle and adjacent cricothyroid ligament |
Anterolateral surface of arytenoid cartilage, aryepiglotic fold, lateral margin of epiglottis |
Recurrent laryngeal n. (Vagus) |
Sphincter of vestibule and laryngeal inlet |
|
Lateral surface of vocal process of arytenoid cartilage |
Vocal ligament and thyroid angle |
Recurrent laryngeal n. (Vagus) |
Tension in vocal folds |
Muscles of
the Tongue
Muscle |
Origin |
Insertion |
Innervation |
Function |
Superior mental spines |
Body of hyoid, entire length of tongue |
Hypoglossal n. |
Protrudes tongue, depresses center of tongue |
|
Greater horn and body of hyoid bone |
Lateral surface of tongue |
Hypoglossal n. |
Depresses tongue |
|
Styloid process (anterolateral) |
Lateral surface of tongue |
Hypoglossal n. |
Elevates and retracts tongue |
|
Inferior surface of palatine aponeurosis |
Lateral surface of tongue |
Vagus n. |
Depresses palate, moves palatoglossal fold toward midline, elevates back of the tongue |