Neck Region
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![Page 1: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/1.jpg)
Neck Region
PA 481
![Page 2: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/2.jpg)
Anterior Surface
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Triangles at Surface
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Hyoid
1. C3 level2. Suprahyoid muscles3. Infrahyoid muscles
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Vertebral Column
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Intervertebral disc
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VertebraParts
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C1 & C2
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Cervical Vertebra
![Page 10: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/10.jpg)
Typical Cervical Vertebra
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Spinal Cord
• Receives and generates signals to body through the spinal nerves
![Page 12: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/12.jpg)
Cord in Spinal Canal
Dorsal Root Ganglion
Denticulate Ligament
Posterior Median Sulcus
Posterior Root
Anterior Root
Spinal Nerve
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Spinal Cord (X.S.)
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Spinal Cord (x.s.)
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Spinal Nerve Anatomy
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Functional Arrangement of SC
Ascending and descending pathways
![Page 18: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/18.jpg)
Ascending Pathways
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Descending Pathways
![Page 20: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/20.jpg)
Cervical Plexus
Serves neck and diaphragm
![Page 21: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/21.jpg)
Brachial Plexus and pectoral nerves
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Brachial Plexus
Innervates most of the arm and someof the body wall.
![Page 23: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/23.jpg)
Spinal Cord Segments
• 4 segments: Cervical, Thoracic, Lumbar, and Sacral (only 1 coccygeal nerve)
• 31 pairs of spinal nerves
![Page 24: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/24.jpg)
Cervical Segment
![Page 25: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/25.jpg)
Neck Fascia
Prevertebral fascia
Alar fascia
Pretracheal fasciaInvesting fascia
Superficial fascia
![Page 26: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/26.jpg)
Platysma
![Page 27: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/27.jpg)
SCM
Trapezius
SCM and Trapezius
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Cervical Triangles
Posterior Triangle Anterior Triangle
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Posterior Triangle
Supraclavicular triangle
Occipital triangle
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Superficial and Deep Posterior Triangle
Platysma
Nerve Point of Neck
Ext. jugular v.
SCM
Accessory n.
Prevertebral fascia
Brachial plexus
Scalenes
Phrenic n.
Splenius
Levator scapulae
![Page 31: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/31.jpg)
Supraclavicular Triangle
Brachial Plexus
Subclavian vessels
SCM
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Anterior Triangles
SubmentalCarotid
Submandibular
Muscular
![Page 33: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/33.jpg)
Muscular Triangle
![Page 34: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/34.jpg)
Muscles of Triangle
Sternohyoid
Sternothyroid
Thyrohyoid
Thyroid
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Thyroid Location
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Accessory Thyroid gland
Accessory thyroid along thyroglossal duct
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Pyramidal lobe(50% of people have this lobe structure)
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Thyroid Follicle
(follicular cells thyroxine)
Parafollicular cells calcitonin
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T3 & T4 Formation and Secretion
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T3 & T4
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Control of Thyroxine Secretion
Short loop
Long loop
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Thyroid Malfunction
• Hypothyroidism• Endemic goiters –due to iodine
deffeicency
• Cretinism – thyroxine in child results in growth (dwarf) and severe mental retardation
• Myxedema – thyroxine in adult, leads to swelling of tissues plus other symptoms
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Cretinism
![Page 44: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/44.jpg)
Thyroid Malfunction• Hyperthyroidism
• Toxic goiters (Graves disease) –Ab may stimulate thyroid without negative feedback control
• Exophthalmos –symptom present in many hyperthyroid patients
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Parathyroid Location
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Parathyroid
![Page 47: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/47.jpg)
PTH Actions• Stimulates resorption of
bone Ca+ 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
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Thyroid cartilage
Cricoid cartilage
Epiglottis
Arytenoid cartilage
Laryngeal Cartilages
Hyoid
(posterior)
(anterior)
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Voice Box
Vocal fold
Vestibular fold
Ventricle
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CN X: supply to laryngeal muscles
Recurrent Laryngeal n.(motor to all other laryngeal muscles) –left side goes under aortic arch
External Laryngeal n.(motor to inf. Pharnygeal constrictor and the cricohyoid)
Internal Laryngeal n.(sensory & autonomic)
Inf. Vagal ganglion
![Page 51: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/51.jpg)
Submental Triangle
Digastric
Mylohyoid
-contains submental lymph nodes
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Carotid Triangle
Digastric (posterior belly)
SCM
Ansa cervicalis
Common carotid a.
Internal carotid a.
External carotid a.
IJV
Omohyoid
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Ext. Carotid Branches
Common CarotidIJV
Int. carotid
Ext. carotid
Sup. Thyroid
FacialLingual
Occipital Post. Auricular
Maxillary
Superficial Temporal
Asc. Pharyngeal (not show)Ansa cervicalis
Hypoglossal n.
![Page 54: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/54.jpg)
External carotid (isolated)
Occipital
Post. Auricular
Superficial Temporal
Maxillary
Sup. Thyroid
Facial
Lingual
Asc. Pharyngeal
Note: Internal carotid has NO branches before cranium generally. (8% of population, the internal gives rise to asc. pharyngeal a..)
Important branches:Maxillary gives rise to: -Middle Meningeal a. that supplies meninges and calvaria; enters through f. spinosum (rupture leads to epidural hemotoma)-Infraorbital a. may form anastamoses with supraorbital a (a branch of opthalmic from Int. carotid.) this can lead to an alternative path for blood if carotids blocked)
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![Page 57: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/57.jpg)
Carotid bodies
![Page 58: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/58.jpg)
Sensors increase firing rate as BP falls
![Page 59: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/59.jpg)
![Page 60: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/60.jpg)
IJVSup. Bulb of IJV
Inf. Bulb of IJV
IJV
FacialSup. Thyroid
![Page 61: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/61.jpg)
Lymph nodes of neck
Deep Cervical Lymph nodes(most located in carotid sheath)
![Page 62: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/62.jpg)
Submandibular TriangleSubmandibular glands
Digastrics
![Page 63: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/63.jpg)
Submandibular Lymph nodes
![Page 64: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/64.jpg)
PharynxFunction: deglutitionMucosa: Str. SquamousMuscularis: Skeletal
![Page 65: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/65.jpg)
Oro- and nasopharynxPharyngeal tonsil
Pharyngeal recess
Palatine bone
Soft palate
Uvula
Lingual Tonsil
Tubal tonsils (small holes)Pharyngotympanic (Eustachian) tube
Salpingopharyngeal fold
Tonsillar cleftPalatoglossal arch
Palatopharyngeal arch
![Page 66: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/66.jpg)
Longitudinal pharyngeal muscles
Palatopharyngeus
![Page 67: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/67.jpg)
Tonsils
PharyngealTonsil
![Page 68: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/68.jpg)
Pharyngeal Constrictors
Superior
Middle
Inferior
![Page 69: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/69.jpg)
Peristalsis
![Page 70: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/70.jpg)
Deglutition (Swallowing)
![Page 71: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/71.jpg)
Fluid Drinking
![Page 72: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/72.jpg)
Deglutition (cont’d)
![Page 73: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/73.jpg)
Deglutition (cont’d)
![Page 74: Neck Region](https://reader035.fdocuments.net/reader035/viewer/2022062309/56813718550346895d9ea5f4/html5/thumbnails/74.jpg)
Laryngopharynx
Epiglottis
Piriform recess