Head, Neck, and Neuroanatomy (THIEME Atlas of Anatomy), Latin Nomenclature (eBook)

A Head and neck regions

Right anterior view.

B Head and neck regions

Right posterior view.

C Head and neck regions

The regions of the head and neck are clinically important since they can exhibit many skin lesions, the location of which must be precisely described. This is particularly important for skin cancer given that the tissue fluid, through which the tumor cells spread, drains into different groups of lymph nodes named for their location.

D Regions of the neck (cervical regions)

a Right lateral view; b Left posterior oblique view.

These neck muscles are easily visible and palpable, making them suitable as landmarks for a topographical classification of the neck.

E Palpable bony landmarks at the head and neck

a Frontal view; b Dorsal view.

A Sequence of topics in this chapter about the head and neck

B Fascia cervicalis

Deep to the skin is the superficial cervical fascia (subcutaneous tissue) which contains the platysma muscle anterolaterally. Deep to the superficial are the following layers of fascia cervicalis:

C Superficial and inferior boundaries of the neck

Left lateral view. The following palpable structures define the superior and inferior boundaries of the neck:

• Superior boundaries: inferior border of the mandibula, tip of the proc. mastoideus, and protuberantia occipitalis externa

• Inferior boundaries: incisura jugularis, clavicula, acromion, and proc. spinosus of the C 7 vertebra.

D Relationships of the fascia cervicalis in the neck. Transverse section at the level of the C 5 vertebra

The full extent of the fascia cervicalis is best appreciated in a transverse section of the neck:

• The muscle fascia splits into three layers:

– Lamina superficialis (orange),

– Lamina pretrachealis (green), and

– Lamina prevertebralis (violet).

• There is also a neurovascular fascia, called the vagina carotica (light blue), and

• a visceral fascia (dark blue).

E Fascial relationships in the neck

a Anterior view. The cutaneous muscle of the neck, the platysma, is highly variable in its development and is subcutaneous in location, overlying the superficial cervical fascia. In the dissection shown, the platysma has been removed at the level of the inferior mandibular border on each side. The cervical fasciae form a fibrous sheet that encloses the muscles, neurovascular structures, and cervical viscera (see B for further details). These fasciae subdivide the neck into spaces, some of which are open superiorly and inferiorly for the passage of neurovascular structures. The lamina superficialis of the fascia superficialis has been removed at left center in this dissection. Just deep to the lamina superficialis is the muscular portion of the lamina pretrachealis, part of which has been removed to display the visceral portion of the lamina pretrachealis. The neurovascular structures are surrounded by a condensation of the fascia cervicalis called the vagina carotica. The deepest layer of the fascia cervicalis, called the lamina prevertebralis, is visible posteriorly on the left side. These fascia-bounded connective-tissue spaces in the neck are important clinically because they provide routes for the spread of inflammatory processes, although the inflammation may (at least initially) remain confined to the affected compartment.

b Left lateral view. This midsagittal section shows that the deepest layer of the fascia cervicalis, the lamina prevertebralis, directly overlies the columna vertebralis in the median plane and is split into two parts. With tuberculous osteomyelitis of the cervical spine, for example, a gravitation abscess may develop in the “danger space” along the lamina prevertebralis (retropharyngeal abscess). This fascia encloses muscles laterally and posteriorly (see D). The vagina carotica is...