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Triangles Of The
Neck
Divisions Created By Muscles
Presented By,
Arya V Devi
Introduction
Anterolaterally
the neck appears
as a quadrilateral
area
It is limited
• Above by the lower border of the
bod...
•This quadrilateral space is
divided by the
Sternocleidomastoid muscle
into two main triangles
•The Sternocleidomastoid
mu...
Anterior Triangle
Boundaries
Anterior border of the
SCM muscle
Midline of the neck
Inferior border of the
mandible
Roof
Sk...
Posterior triangle
Boundaries
Anteriorly: The
Sternocleidomastoid musc
posteriorly:The Trapezius
muscle.
Inferiorly:The Cl...
Subdivisions
Anterior Triangle
• Digastric/submandibular
• Submental
• Muscular
• Carotid triangles
Posterior Triangle
• O...
Anterior Triangle
Contents Of The Anterior Triangle
Vessels
• Carotid system
• Internal jugular vein
Nerves
• Cranial nerves
7,9,10,11,12
• ...
Submandibular Triangle
Submandibular Triangle
Superiorly
• Mastoid & mandible
Posteriorly
• Stylohyoid
• Posterior belly of digastric
Anteriorly
...
Submandibular Triangle
Roof
• Platysma
• Facial vein (fv)
• Cervical branch of facial nerve (cbf)
Removal of the superfici...
Contents Of The Submandibular Triangle
Facial
artery
Lingual nerve
and
submandibula
r ganglion
• The lingual nerve and
sub...
Submental Triangle
Unpaired triangle
Submental Triangle
Formed by the :
Anterior midline of neck
Hyoid bone
Anterior belly of digastric
muscle
Located between ...
Carotid Triangle
Carotid Triangle
Boundaries of the carotid
triangle are:
posterior belly of digastric muscle (pbd)
superior belly of the o...
Carotid Triangle
Deepest aspect of
the carotid
triangle
The muscles, at
this level, are the
middle and lower
pharyngeal
co...
Contents Of Carotid Triangle
Veins
• Common facial vein
• Near by:
• Retromandibular vein
• Posterior auricular vein
(pav)...
Muscular Triangle
Muscular Triangle
Boundaries
• Mid line of neck
• Superior belly of omohyoid
• Sternomastoid
The muscles forming and withi...
Muscular Triangle
When the strap muscles are reflected,
you can see the thyroid gland with its
arteries (superior and infe...
Table of Muscles
Muscle Origin Insertion Nerve supply
Sternohyoid Sternum Hyoid Ansa
Omohyoid Suprascapular notch Hyoid An...
Clinical Considerations
The cricothyroid ligament and membrane are
frequently pierced in emergency situations to open the
...
Posterior Triangle
Boundaries of Posterior Triangle
Boundaries of Posterior Triangle
Anteri
orly
• Sternocleidomastoid
Poster
iorly
• Anterior edge of trapezius
Inferi
orly
•...
Nerves And
Plexuses
• Spinal acessory
nerve.
• Branches of
Cervical plexus
• Roots and trunks
of brachial plexus
Vessels
•...
Clinical Significance Of The Posterior Triangle
The Accessory Nerve may be damaged, while
taking lymph node biopsy.
The Ex...
Lower and smaller
division of the posterior
triangle
It corresponds in the living neck
with the lower part of a deep,
prom...
Boundaries
Borders
• It shares the
same
boundaries
• Except that
superiorly it is
limited by
omohyoid
Floor
• The first ri...
Contents
The
suprascapular
vessels
Brachial plexus
Third part of the
subclavian artery
Subclavian veins
The external
jugul...
Occipital triangle
Upper and larger part of the posterior triangle
Boundaries
Shares the same
borders
Except that
inferiorly by the
inferior belly of
omohyoid
Borders
Semispinalis
capitis
O...
Boundaries
Platysma
Superficial and
deep fasciae
Skin
Roof
Spleniuscapitis
Levator
scapulae
Scaleni medius
Floor
Contents
Cutaneous and muscular branches of the
cervical plexus
Uppermost part of the brachial plexus
Transverse cervical ...
That’s it!!!

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Triangles of the neck

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Triangles of the neck

  1. 1. Triangles Of The Neck Divisions Created By Muscles Presented By, Arya V Devi
  2. 2. Introduction Anterolaterally the neck appears as a quadrilateral area It is limited • Above by the lower border of the body of the mandible ,and an imaginary line drawn from the angle of the mandible to the mastoid process. • Below , by the upper border of the clavicle. • Medially ,by the midline of the neck. • Posteriorly , by the anterior border of the trapezius muscle .
  3. 3. •This quadrilateral space is divided by the Sternocleidomastoid muscle into two main triangles •The Sternocleidomastoid muscle passes obliquely upwards and backwards from its site of origin at the clavicle and sternum to its point of insertion on the mastoid process and the occipital bone •The triangle in front of this muscle is the anterior triangle and the one behind it is the posterior triangle
  4. 4. Anterior Triangle Boundaries Anterior border of the SCM muscle Midline of the neck Inferior border of the mandible Roof Skin Superfacial fascia Platysma muscle Investing layer of deep cervical fascia
  5. 5. Posterior triangle Boundaries Anteriorly: The Sternocleidomastoid musc posteriorly:The Trapezius muscle. Inferiorly:The Clavicle The apex: occipital bone Roof Skin Superficial fascia Platysma muscle Investing layer of the deep cervical fascia Floor Splenius Capitis Levator scapulae Posterior scalene Middle scalene Anterior scalene
  6. 6. Subdivisions Anterior Triangle • Digastric/submandibular • Submental • Muscular • Carotid triangles Posterior Triangle • Occipital triangle • Subclavian triangle
  7. 7. Anterior Triangle
  8. 8. Contents Of The Anterior Triangle Vessels • Carotid system • Internal jugular vein Nerves • Cranial nerves 7,9,10,11,12 • Cervical plexus Muscles • Suprahyoid muscles: (digastric , mylohyoid,stylohyoid,g eniohyoid ) • Infrahyoid muscles: (sternohyoid,sternoth yroid,thyrohyoid, omohyoid )
  9. 9. Submandibular Triangle
  10. 10. Submandibular Triangle Superiorly • Mastoid & mandible Posteriorly • Stylohyoid • Posterior belly of digastric Anteriorly • Anterior belly of digastric
  11. 11. Submandibular Triangle Roof • Platysma • Facial vein (fv) • Cervical branch of facial nerve (cbf) Removal of the superficial structures displays the submandibular salivary gland itself.
  12. 12. Contents Of The Submandibular Triangle Facial artery Lingual nerve and submandibula r ganglion • The lingual nerve and submandibular duct pass through a gap between the hypoglossal (hg) and mylohyoid (mh) muscles Submandibul ar duct Lingual artery • The lingual artery passes deep to the hyoglossus muscle Hypoglossal nerve
  13. 13. Submental Triangle Unpaired triangle
  14. 14. Submental Triangle Formed by the : Anterior midline of neck Hyoid bone Anterior belly of digastric muscle Located between the two anterior digastric muscles Structures Submental lymph node- drain the floor of the mouth. Mylohyoid muscle (mh) arise from the body of the hyoid bone and insert into the mylohyoid line of the inside of the mandible.
  15. 15. Carotid Triangle
  16. 16. Carotid Triangle Boundaries of the carotid triangle are: posterior belly of digastric muscle (pbd) superior belly of the omohyoid muscle (so) anterior border of sternomastoid muscle (st) Roof: skin superficial fascia platysma
  17. 17. Carotid Triangle Deepest aspect of the carotid triangle The muscles, at this level, are the middle and lower pharyngeal constrictors Floor Superior laryngeal nerve, a branch of the vagus its 2 terminal branches Internal laryngeal (ilb--sensory to upper part of the larynx) External laryngeal (elb--motor to the cricoid muscle) Structures seen passing through
  18. 18. Contents Of Carotid Triangle Veins • Common facial vein • Near by: • Retromandibular vein • Posterior auricular vein (pav) • Facial vein (fv) • External jugular vein • Anterior jugular vein Arteries • Facial • Lingual • Occipital • Common carotid • External carotid • Internal carotid • Superior thyroid Nerves • Hypoglossal (XII) • C1 root of ansa cervicalis (C1) • C1 fibers running with hypoglossal nerve (nerve to thyrohyoid muscle (nth) • C2-C3 root of ansa cervicalis • Ansa cervicalis (ac)
  19. 19. Muscular Triangle
  20. 20. Muscular Triangle Boundaries • Mid line of neck • Superior belly of omohyoid • Sternomastoid The muscles forming and within the triangle • Superficial layer • Sternohyoid (sh) • Superior belly of omohyoid (oh) • Deep layer • Thyroid (th) • Sternothyroid (st) Strap Muscles
  21. 21. Muscular Triangle When the strap muscles are reflected, you can see the thyroid gland with its arteries (superior and inferior thyroid artery) If the thyroid gland is reflected laterally, the structures making up the larynx and trachea are seen: thyrohyoid membrane (thm) thyroid cartilage (Adam's apple)(tc) cricothyroid membrane and ligament (ctm) cricoid cartilage (cc) tracheal rings (tr)
  22. 22. Table of Muscles Muscle Origin Insertion Nerve supply Sternohyoid Sternum Hyoid Ansa Omohyoid Suprascapular notch Hyoid Ansa Sternothyroid Below sternohyoid on manubrium Thyroid cartilage oblique line Ansa Thyrohyoid Thyroid cartilage oblique line Hyoid C1-C2 (ansa) Anterior belly digastric Intermediate tendon Inner surface of mandile Trigeminal nerve Posterior belly Digastric Medial aspect of the mastoid process -Intermediate tendon- Facial nerve Mylohyoid Mylohyoid line of mandible Hyoid bone Trigeminal nerve Hyoglossus Hyoid bone Lateral side of tongue Hypoglossal Stylohyoid Styloid process Hyoid Facial nerve
  23. 23. Clinical Considerations The cricothyroid ligament and membrane are frequently pierced in emergency situations to open the airway. It has been known that an empty ball-point pen or a hollow stem has been used in the field to save lives, where an air passage has been closed above this region.
  24. 24. Posterior Triangle
  25. 25. Boundaries of Posterior Triangle
  26. 26. Boundaries of Posterior Triangle Anteri orly • Sternocleidomastoid Poster iorly • Anterior edge of trapezius Inferi orly • Middle third of the clavicle Apex • Between the attachments of sternocleidomastoid and trapezius to the occiput and is often blunted, so that the 'triangle' becomes quadrilateral Roof • Investing layer of the deep cervical fascia Floor • Prevertebral fascia overlying splenius capitis, levator scapulae and the scalene muscles
  27. 27. Nerves And Plexuses • Spinal acessory nerve. • Branches of Cervical plexus • Roots and trunks of brachial plexus Vessels • Subclavian artery • Transverse Cervical artery • Suprascapular artery • External jugular vein (terminal part) Lymph Nodes • Occipital • Supraclavicular Muscles • Inferior belly of Omohyoid muscle Contents of the posterior triangle
  28. 28. Clinical Significance Of The Posterior Triangle The Accessory Nerve may be damaged, while taking lymph node biopsy. The External Jugular Vein is present in a superficial location here and this makes it vulnerable to injury.
  29. 29. Lower and smaller division of the posterior triangle It corresponds in the living neck with the lower part of a deep, prominent hollow, namely, the greater supraclavicular fossa Its size varies with the extent of the clavicular attachments of sternocleidomastoid and trapezius and also the level of the inferior belly of omohyoid Subclavian Triangle
  30. 30. Boundaries Borders • It shares the same boundaries • Except that superiorly it is limited by omohyoid Floor • The first rib, • Scalenus medius • The first slip of serratus anterior Roof • Supraclavicular nerves • Platysma • Superficial and deep fasciae • Skin
  31. 31. Contents The suprascapular vessels Brachial plexus Third part of the subclavian artery Subclavian veins The external jugular vein The nerve to subclavius The triangle contains some lymph nodes.
  32. 32. Occipital triangle Upper and larger part of the posterior triangle
  33. 33. Boundaries Shares the same borders Except that inferiorly by the inferior belly of omohyoid Borders Semispinalis capitis Occasionally appears at the apex Posteriorly
  34. 34. Boundaries Platysma Superficial and deep fasciae Skin Roof Spleniuscapitis Levator scapulae Scaleni medius Floor
  35. 35. Contents Cutaneous and muscular branches of the cervical plexus Uppermost part of the brachial plexus Transverse cervical vessels Spinal accessory nerve Supraclavicular nerves Lymph nodes
  36. 36. That’s it!!! 

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