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Wednesday, August 4, 2010

Anatomy: The Neck, anatomy, Posterior Triangle of the Neck

Arteries of the Posterior Triangle of the Neck

The third part of the subclavian artery. The subclavian artery has 3 parts - separated by the scalenus anterior in thirds - the last third is the part between the scalenus anterior and the clavicle. It is a fingerbreath superior to the clavicle.

File:Gray808.png

The transverse cervical artery arises from the thyrocervical trunk - a branch of the subclavian artery. The transverse cervical artery runs superficially and laterally across the posterior triangle, 2 to 3 cm superior to the clavicle.

The Suprascapular artery from the branch of the thyrocervical trunk - runs posterior to the clavical to the muscles around the scapula.


Artery: Transverse cervical artery
Thyrocervical trunk.png
Superficial dissection of the right side of the neck, showing the carotid and subclavian arteries. Transverse cervical artery is labeled, branching from the thyrocervical_trunk.
Superficial and deep branches.png
Superficial and deep branches from the transverse cervical artery.
Latinarteria transversa cervicis, arteria transversa colli
Gray'ssubject #148 82
SuppliesTrapezius
Sternocleidomastoid
SourceThyrocervical trunk   
BranchesSuperficial branch
Deep branch
VeinTransverse cervical veins
Occipital artery is a branch of the external carotid artery enters the apex of the posterior triangle before ascending to the occipital area. 
File:Gray508.png

Nerves in the posterior triangle. The Accessory nerve (CN XI) that divides the posterior triangle into a superior and inferior parts. The Accessory nerve is a motor nerve consisting of spinal (C1 to C5) and cranial roots. The spinal roots travel superiorly and enter the posterior cranial fossa through the foramen magnum. Here they join the cranial roots of the accessory nerve from the Medulla. Both combined roots leave the skull through the jugular foramen.

The Spinal roots separates immediately and supplies the Sternocleidomastoid muscle and the trapezius muscle.

Lesions to the Accessory Muscle are rare. The Accessory Nerve may be damaged by Traumatic injury, tumours to the base of the skull, fractures involving the jugular foramen, and neck lacerations. Presents with weakness in turning the head to the OPPOSITE site against resistance. Unilateral paralysis of the trapezius muscle is evident by the patients inability to elevate and retract the shoulder, and is unable to lift the arm above the horizontal level. Drooping of the shoulder is obvious.


The Accessory Nerve function can also be functionally impaired by inflamed lymph nodes in the neck. During surgical dissection of the neck lymph nodes care should be taken to isolate and preserve the  Accessory Nerve. 


Nerve: Accessory nerve
Plan of upper portions of glossopharyngealvagus, and accessory nerves.
Inferior view of the human brain, with the cranial nerves labelled.
Latinnervus accessorius
Gray'ssubject #206 913
Innervatessternocleidomastoid muscletrapezius muscle
MeSHAccessory+Nerve

The Cervical Plexus


, Anterior triangle, Arteries, Carotid Artery, Carotid Body, , Hyoid Muscles, Muscles, Neck, Nerves, , Posterior triangle, raised JVP, , XI

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