1. Neck Region PA 544 Clinical Anatomy

2. Anterior Surface

3. Triangles at Surface

4. Hyoid 1.C3 level 2.Suprahyoid muscles 3.Infrahyoid muscles

5. Vertebral Column

6. Intervertebral disc

7. Vertebra Parts

8. C1 & C2

9. Cervical Vertebra

10. Typical Cervical Vertebra

11. Spinal Cord Receives and generates signals to body through the spinal nerves

12. Cord in Spinal Canal Dorsal Root Ganglion Denticulate Ligament Posterior Median Sulcus Posterior Root Anterior Root Spinal Nerve

13. Spinal Cord (X.S.)

14. Spinal Nerve Anatomy

16. Functional Arrangement of SC Ascending and descending pathways

17. Ascending Pathways

18. Descending Pathways

19. Cervical Plexus Serves neck and diaphragm

20. Brachial Plexus and pectoral nerves

21. Brachial Plexus Innervates most of the arm and some of the body wall.

22. Spinal Cord Segments 4 segments: Cervical, Thoracic, Lumbar, and Sacral (only 1 coccygeal nerve) 31 pairs of spinal nerves

23. Cervical Segment

24. Neck Fascia Prevertebral fascia Alar fascia Pretracheal fascia Investing fascia Superficial fascia

25. Platysma

26. SCM Trapezius SCM and Trapezius

27. Cervical Triangles Posterior Triangle Anterior Triangle

28. Posterior Triangle Supraclavicular triangle Occipital triangle

29. 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

30. Supraclavicular Triangle Brachial Plexus Subclavian vessels SCM

31. Anterior Triangles Submental Carotid Submandibular Muscular

32. Muscular Triangle

33. Muscles of Triangle Sternohyoid Sternothyroid Thyrohyoid Thyroid

34. Thyroid Location

35. Accessory Thyroid gland Accessory thyroid along thyroglossal duct

36. Pyramidal lobe (50% of people have this lobe structure)

37. Thyroid Follicle (follicular cells  thyroxine) Parafollicular cells  calcitonin

38. T 3 & T 4

39. Control of Thyroxine Secretion Short loop Long loop

40. 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

41. Cretinism

42. Thyroid Malfunction Hyperthyroidism Toxic goiters (Graves disease) –Ab may stimulate thyroid without negative feedback control Exophthalmos –symptom present in many hyperthyroid patients

43. Parathyroid Location

44. PTH Actions Stimulates resorption of bone   Ca + and PO 4 - in blood Stimulates Ca + absorption in intestine (active Vit. D 3 necessary for Ca + absorption) Stimulates Ca + reabsorption and PO 4 - excretion in kidney Stimulates Vit. D 3 formation (skin) and activation (kidney) Vital for life

45. Thyroid cartilage Cricoid cartilage Epiglottis Arytenoid cartilage Laryngeal Cartilages Hyoid (posterior) (anterior)

46. Voice Box Vocal fold Vestibular fold Ventricle

47. CN X: supply to laryngeal muscles Recurrent Laryngeal n. (motor to all other laryngeal muscles) External Laryngeal n. (motor to inf. Pharnygeal constrictor and the cricohyoid) Internal Laryngeal n. (sensory & autonomic) Inf. Vagal ganglion

48. Submental Triangle Digastric Mylohyoid -contains submental lymph nodes

49. Carotid Triangle Digastric (posterior belly) SCM Ansa cervicalis Common carotid a. Internal carotid a. External carotid a. IJV Omohyoid

50. Ext. Carotid Branches Common Carotid IJV Int. carotid Ext. carotid Sup. Thyroid Facial Lingual Occipital Post. Auricular Maxillary Superficial Temporal Asc. Pharyngeal (not show) Ansa cervicalis Hypoglossal n.

51. External carotid (isolated) Occipital Post. Auricular Superficial Temporal Maxillary Sup. Thyroid Facial Lingual Asc. Pharyngeal Note: Internal carotid has NO neck branches.

53. Carotid bodies

55. IJV Sup. Bulb of IJV Inf. Bulb of IJV IJV Facial Sup. Thyroid

56. Lymph nodes of neck Deep Cervical Lymph nodes (most located in carotid sheath)

57. Submandibular Triangle Submandibular glands Digastrics

58. Submandibular Lymph nodes

59. Pharynx Function: deglutition Mucosa: Str. Squamous Muscularis: Skeletal

60. Oro- and nasopharynx Pharyngeal tonsil Pharyngeal recess Palatine bone Soft palate Uvula Lingual Tonsil Tubal tonsils (small holes) Pharyngotympanic (Eustachian) tube Salpingopharyngeal fold Tonsillar cleft Palatoglossal arch Palatopharyngeal arch

61. Longitudinal pharyngeal muscles Palatopharyngeus

62. Tonsils Pharyngeal Tonsil

63. Pharyngeal Constrictors Superior Middle Inferior

64. Peristalsis

65. Deglutition (Swallowing)

66. Fluid Drinking

67. Deglutition (cont’d)

69. Laryngopharynx Epiglottis Piriform recess