Regions of the Neck: Anterior Region

Cross section of the neck at the level of the thyroid gland (MRI scan,

courtesy of Prof. Heuck, Munich).

Anterior region of the neck. Sternocleidomastoid muscles and left clavicle have been removed. Thyroid gland in

relation to trachea, larynx, and vessels of the neck is shown.

177

Anterior region of the neck and thoracic cavity. Both clavicles, sternum, and ribs have been

removed. Main veins are colored in blue.

Anterior region of the neck (schematic drawing). Regional anatomy

of the thyroid gland with related blood vessels.

1 Submandibular gland

2 Cervical branch of facial

nerve (n. VII)

3 Cervical plexus

4 Middle supraclavicular

nerves

5 Ansa cervicalis

6 Brachial plexus

7 Internal jugular vein

8 Phrenic nerve

9 Clavicle

10 Common carotid artery

11 Sternoclavicular articulation

with articular disc

12 Manubrium of sternum

13 Hyoid bone

14 External jugular vein

15 Thyroid cartilage

16 Cricothyroid muscle

17 Thyroid gland

18 Subclavius muscle

19 Recurrent laryngeal nerve

20 Trachea

21 Vagus nerve (n. X)

22 Subclavian vein

23 Middle pectoral nerve

24 Esophagus

25 Body of cervical vertebra

26 Spinal cord

27 Sternocleidomastoid muscle

28 Vertebral artery

29 Transverse process of

cervical vertebra

30 Spinous process of

cervical vertebra

31 Trapezius muscle

32 Inferior thyroid vein

33 Left brachiocephalic vein

34 Superior lobe of left lung

35 Internal thoracic artery

36 Superior vena cava

37 Superior thyroid artery

38 Inferior thyroid artery

39 Thyrocervical trunk

40 Subclavian artery

41 Aortic arch

Regions of the Neck: Anterior Region

178 Regions of the Neck: Lateral Region

1 Parotid gland and great

auricular nerve

2 Lesser occipital nerve

3 Internal and external

jugular veins

4 Retromandibular vein and

external carotid artery

5 Transverse cervical nerve

with communicating branch

to cervical branch

of facial nerve

6 Trapezius muscle and

superficial lamina of

cervical fascia

7 Lateral supraclavicular nerves

8 Middle supraclavicular nerves

9 Pectoralis major muscle

10 Buccal branch of facial

nerve and masseter muscle

11 Facial artery and vein

and mandibular branch

of facial nerve

12 Cervical branch of facial

nerve and submandibular

gland

13 Thyroid cartilage

14 Omohyoid muscle

15 Sternohyoid muscle

16 Sternocleidomastoid

muscle

17 Medial supraclavicular

nerves

18 Mandibular branch

of facial nerve

19 Cervical branch of facial

nerve with communicating

branch to transverse

cervical nerve

Cutaneous branches of cervical plexus. Erb’s point is indicated

by an arrowhead (schematic drawing).

Lateral region of the neck with posterior and carotid triangles. Superficial dissection.

Regions of the Neck: Lateral Region 179

Lateral region of the neck with posterior and carotid triangles. Superficial dissection. The superficial lamina

of cervical fascia has been removed to display the cutaneous branches of the cervical plexus and subcutaneous veins.

1 Lesser occipital nerve

2 Internal jugular vein

3 Splenius capitis muscle

4 Great auricular nerve

5 Submandibular nodes

6 Internal carotid artery and vagus nerve

7 Accessory nerve

8 Muscular branches of cervical plexus

9 External jugular vein

10 Posterior supraclavicular nerves

11 Middle supraclavicular nerves

12 Suprascapular artery

13 Pretracheal lamina of fascia of neck

14 Clavicle

15 Parotid gland

16 Mandible

17 Cervical branch of facial nerve

18 Submandibular gland

19 External carotid artery

20 Superior thyroid artery

21 Transverse cervical nerve

22 Superior root of ansa cervicalis

23 Anterior jugular vein

24 Omohyoid muscle

25 Sternohyoid muscle

26 Sternocleidomastoid muscle

27 Intermediate tendon of omohyoid muscle

180 Regions of the Neck: Lateral Region

Neck, superficial dissection (lateral aspect). Sternocleidomastoid muscle has been cut and reflected to display the pre tracheal

lamina of the cervical fascia.

1 Sternocleidomastoid muscle (reflected) and

branch of accessory nerve

2 Facial artery

3 External carotid artery and superior thyroid artery

4 Internal jugular vein

5 Deep cervical lymph nodes and external jugular vein

6 Omohyoid muscle and pretracheal lamina of cervical fascia

7 Anterior jugular vein

8 Pectoralis major muscle

9 Great auricular nerve

10 Lesser occipital nerve

11 Splenius capitis and levator scapulae muscles

12 Trapezius muscle

13 Scalenus medius muscle and brachial plexus

14 Posterior supraclavicular nerves

15 Middle supraclavicular nerve

16 Clavicle and anterior supraclavicular nerves

17 Sternocleidomastoid muscle (reflected)

181

12

Regions of the Neck: Lateral Region

Neck, deep dissection (lateral aspect). The internal jugular vein has been reflected to expose the carotid artery and vagus nerve.

1 Stylohyoid muscle

2 Facial artery and mylohyoid muscle

3 Anterior belly of digastric muscle

4 Internal jugular vein, hypoglossal nerve,

and superficial cervical lymph nodes

5 Superior thyroid artery and vein and inferior pharyngeal

constrictor muscle

6 Thyroid cartilage and vagus nerve

7 Ansa cervicalis, omohyoid muscle, and common carotid artery

8 Right superior thyroid artery

9 Scalenus anterior muscle

10 Sternothyroid muscle and inferior thyroid artery

11 Muscular branches of ansa cervicalis to the infrahyoid muscles

12 Inferior thyroid vein

13 Posterior belly of digastric muscle

14 Sternocleidomastoid muscle and lesser occipital nerve

15 Accessory nerve

16 Splenius capitis muscle

17 Cervical plexus

18 Scalenus posterior muscle

19 Levator scapulae muscle

20 Posterior supraclavicular nerves

21 Phrenic nerve

22 Middle supraclavicular nerve

23 Brachial plexus

24 Anterior supraclavicular nerves

25 Sternocleidomastoid muscle

182 Regions of the Neck: Lateral Region

Neck, deeper dissection (lateral aspect). Ansa cervicalis. The cervical fascia and the clavicle are partly removed. Ansa cervicalis and

infrahyoid muscles are displayed.

1 Masseter muscle

2 Mylohyoid muscle and facial artery

3 External carotid artery and

anterior belly of digastric muscle

4 Hypoglossal nerve

5 Thyrohyoid muscle

6 Superior thyroid artery and vein and

inferior pharyngeal constrictor muscle

7 Omohyoid muscle (superior belly)

8 Ansa cervicalis, thyroid gland, and

internal jugular vein

9 Sternothyroid muscle

10 Sternohyoid muscle

11 Thoracic duct

12 Pectoralis minor muscle

13 Pectoralis major muscle

14 Posterior belly of digastric muscle

15 Sternocleidomastoid muscle and lesser

occipital nerve

16 Splenius capitis muscle

17 Superficial cervical lymph nodes and

accessory nerve

18 Cervical plexus

19 Scalenus medius muscle

20 Levator scapulae muscle

21 Scalenus posterior muscle

22 Brachial plexus

23 Transverse cervical artery and

clavicle

24 Subclavius muscle

25 Subclavian artery and vein

26 Thoraco-acromial artery

27 Cephalic vein

Regions of the Neck: Lateral Region 183

1 Facial artery and mandible

2 Submental artery

3 Mylohyoid muscle and nerve

4 Hypoglossal nerve

(lingual branches)

5 Thyrohyoid branch of hypoglossal

nerve (n. XII)

6 Anterior belly of digastric muscle

7 Hyoid bone

8 Omohyoid branch of hypoglossal

nerve (n. XII)

9 Omohyoid muscle and superior

thyroid artery

10 Ansa cervicalis

11 Posterior belly of digastric muscle

12 Hypoglossal nerve (n. XII)

13 Vagus nerve (n. X)

14 Internal carotid artery

15 Superior root of ansa cervicalis

16 External carotid artery

17 Cervical plexus

18 Common carotid artery

19 Facial artery and vein

20 Omohyoid muscle

21 Internal jugular vein

22 Sternohyoid and sternothyroid

muscles

23 Clavicle

24 Superficial temporal artery and vein

25 Occipital artery

26 Spinal nerves (C3 and C4)

27 Spinal processes of cervical

vertebrae (C4 and C5)

28 Scapula

Neck with submandibular region (lateral aspect). Hypoglossal nerve (n. XII). Mandible

slightly elevated. Arrow = superior cervical ganglion.

Nerves and vessels of the neck (lateral aspect).

The ansa cervicalis with connection to the spinal nerves is

depicted.

24

25

26

27

10

28

12

19

16

18

20

21

22

23

184 Regions of the Neck: Lateral Region

Neck, deeper dissection (lateral aspect). Clavicle partly removed to show the slit between the scalenus muscles. Internal jugular vein

removed.

1 Masseter muscle

2 Mylohyoid muscle and facial artery

3 Anterior belly of digastric muscle

4 Hypoglossal nerve

5 Sternohyoid muscle

6 Omohyoid muscle, superior thyroid artery

and vein

7 Sternothyroid muscle, thyroid cartilage,

and pyramidal lobe of thyroid gland

8 Common carotid artery and sympathetic

trunk

9 Ansa cervicalis

10 Phrenic nerve, ascending cervical artery, and

anterior scalenus muscle

11 Inferior thyroid artery, vagus nerve, and

internal jugular vein (cut)

12 Thyroid gland and unpaired inferior thyroid

venous plexus

13 Thoracic duct and left subclavian trunk

14 Subclavius muscle (reflected)

15 Sternocleidomastoid muscle (reflected)

16 Posterior belly of digastric muscle

17 Superior cervical ganglion and splenius

muscle

18 Lesser occipital nerve

19 Internal carotid artery and branch of the

glossopharyngeal nerve to the carotid body

20 External carotid artery

21 Cervical plexus and accessory nerve

22 Inferior root of ansa cervicalis

23 Supraclavicular nerve

24 Levator scapulae muscle

25 Scalenus medius muscle and clavicle

26 Transverse cervical artery, brachial

plexus, and scalenus posterior muscle

27 Subclavian artery and vein

28 Thoraco-acromial artery and pectoralis

minor muscle

29 Pectoralis major muscle

Regions of the Neck: Lateral Region 185

Neck, deepest dissection (antero-lateral aspect). Thyroid gland reflected to expose the esophagus and the recurrent laryngeal nerve.

1 Superior cervical ganglion of sympathetic trunk and posterior

belly of digastric muscle

1a Anterior belly of digastric muscle

2 Facial artery and common carotid artery (reflected anteriorly)

3 Ascending cervical artery and longus colli muscle

4 Omohyoid muscle and superior thyroid artery

5 Sympathetic trunk and sternohyoid muscle

6 Middle cervical ganglion and inferior pharyngeal constrictor

muscle

7 Scalenus anterior muscle and phrenic nerve

8 Thyroid gland and inferior thyroid artery

9 Vagus nerve and esophagus

10 Stellate ganglion

11 Recurrent laryngeal nerve and trachea

12 Common carotid artery and cervical cardiac branch of vagus

nerve

13 Sternocleidomastoid muscle and accessory nerve

14 Splenius capitis muscle

15 Lesser occipital nerve, longus capitis muscle, and cervical plexus

16 Phrenic nerve, scalenus posterior muscle, and levator scapulae

muscle

17 Supraclavicular nerves and scalenus medius muscle

18 Brachial plexus and pectoralis major muscle (clavicular head)

19 Transverse cervical artery and clavicle

20 Subclavian artery

21 Thoraco-acromial artery and pectoralis minor muscle

22 First rib, accessory phrenic nerve, and subclavian vein

23 Internal jugular vein, thoracic duct, and subclavius muscle

1

2

1a

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

186

1

2

3

4

5

6

7

8

9

10

11

12

25

24

23

22

21

20

19

18

17

16

15

14

13

Cervical and Brachial Plexuses

Neck and arm, deepest dissection (antero-lateral aspect). Cervical and brachial plexuses and their relation to the blood vessels are

shown. Note the location and content of scalene triangle. Sternocleidomastoid muscle and clavicle have been removed; the internal jugular

vein was divided to display the roots of cervical and brachial plexuses.

1 Lesser occipital nerve

2 Great auricular nerve

3 Cutaneous branches of cervical plexus

4 Supraclavicular nerve

5 Suprascapular nerve and artery

6 Brachial plexus

7 Median nerve (with two roots) and musculocutaneous nerve

8 Axillary artery

9 Axillary vein

10 Medial brachial cutaneous nerve

11 Ulnar nerve

12 Thoracodorsal nerve

13 Parotid gland and facial nerve (cervical branch)

14 Cervical plexus

15 Submandibular gland

16 Superior thyroid artery

17 Common carotid artery dividing in internal and external

carotid artery and superior root of ansa cervicalis

18 Omohyoid muscle and cervical branch of facial nerve

joining the transverse cervical nerve (C2, C3)

19 Sternohyoid muscle

20 Transverse cervical nerve and sternothyroid muscle

21 Common carotid artery and vagus nerve

22 Phrenic nerve and scalenus anterior muscle

23 Internal jugular vein

24 Intercostobrachial nerves

25 Long thoracic nerve

187