1. Superficial and lateral muscles of the neck

4. 1- Platysma - in the subcutauous tissue - thickness is few millimeter - external jugular vein - cutanous nerve of neck deep to it. - tense the skin releasing pressure on superficial vein - men use this muscle when shaving their neck

5. 2- Sternocleidomastoid (SCM): - is key muscle (landmark) in neck - has two head : * sternal head * clavicular head - attach to : * mastaid process * superior nuchial line. - innervated by : * spinal root of accessory n. (motor) * C2,C3,(pain, and proprioception). - acting by tilt head to one side i.e laterally flexes neck and rotate it so face is turned superiorly toward opposite side. - acting together two muscle flex the neck so chin is thrust forward.

8. Trapezius:- - cover posterolateral aspect of neck and thorax. it is superficial muscle of back. - its superior attachment is to:- - medial 1,3 of superior nuchial line. - external occipital protuberance. - ligamentum nuchae. - spinous process of C7-T3 vert. - lumber and sacral spinous process. - its inferior attachment is to:- - lateral 1,3 of clavicle. - acromion, and spine of scapula

9. - its innervation by :- Of accessory nerve (motor) and C3,C4 nerve ( pain,proprioception). - its main action is:- - elevation, rctraction, rotates, scapula. - superior fiber ----- elevate scapula. Middle fiber ----- retract scapula. Inferior fiber ----- depress scapula. Torticollis :- Flexion deformity of neck: - congenital - spasmodic

10. Triangles of the neck:- Divided by SCM muscle into:- Anterior, Posterior T. * Posterior T. :- Anterior ----- post. Border of SCM Posterior ----- Ant. Border of trapezius. Inferiorly ------ middle 1,3 of clavicle between SCM and (base) trapezius. Apex ----- where SCM and trapezius meet on superior nuchial line. Roof ----- *skin. *superficial fascia. * platysma. * investing layer of deep cervical fascia

11. Floor ----- * prevertebral fascia. * semispinalis capitis. * splenius capitis. * levator scapula. * scalenus medius, posterior, small part of scalenus anterior. * muscles covered by the prevertebral layer of deep cervical fascia.

17. * Post. T. divided in to:- - supraclavicular (subclavian) T. - occipital T.. by inferior belly of omohyaid muscle. * Occipital T. (superior large):- - part of external jugular vein. - accessory nerve. - posterior branches. - cervical plexus. - trunk of brachial plexus. - transverse cervical artery. - cervical L.N. - occipital a. in its apex. * Supraclavicular T. (small) inferior subclavian T. - subclavian a. - part of subclavian vein. - suprascapular a. - supraclavicular L.N.

18. Contents of post. T.:- - Arteries:- - subclavian a. (3 rd part) - transverse cervical a.(Superficial,deep) - suprascapular a. - occipital a. - Veins:- - external jugular vein.(EJV)* ----subclavian v. Receive ------ transverse cervical v. Suprascupular Anterior jugularv. * (EJV):- is usually visible above clavicle for only a short distance. when venous plessure rise vein become prominent this seen in:- - heart failure. - obst. Of superior vena cava by tumor cells. - enlarged supraclaviular L.N. - increased intrathorasic pressure.s.

19. Nerves: 1- accessory nerve. 2- ventral rami (root of brachial plexus) 3- ventral rami of cervical plexus.

20. * cutanous branches of cervical plexus are(nerve point of neck) 1- lesser accipital nerve(C2) - posterior to auricle 2- Great auricular nerve ( C2, C3) - paratid gland - post. Aspect of auricle - angle of mandible 3- Transverse cervical nerve (C2,C3) - cross SCM supply - anterior D. deep to platysma 4- Supraclavicular nerve (C3,C4) - common trunk, supply skin over neck and skin over shoulder

21. Lymph node in post. D - superficial cervical L.N. EJV - Deep cervical L.N. IJV * Supra clavicular L.N. which enlarged in carciuoma of brest T.B., Hodgchin's disease * occipital L.N.