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Areas and triangles of the neck
Last reviewed: 23.04.2024
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The upper border of the neck is held (right and left) from the chin at the base and posterior edge of the mandible branch to the temporomandibular joint, continue posteriorly through the apex of the mastoid process of the temporal bone along the upper nasal line to the outer projection of the occipital bone.
The lower border of the neck extends from each side of the jugular carve of the sternum along the upper edge of the clavicle to the apex of the acromion and further to the spinous process of the VII cervical vertebra.
Taking into account the relief of the skin on the neck, due to the position of the deeper muscles, internal organs, the following areas of the neck are distinguished in the anterior regions: anterior, sternocleidomastoid (right and left) and lateral (right and left), and posterior.
The anterior region of the neck, or the front triangle of the neck (regio cervicalis anterior, s.trigonum cervicale anterius), on the sides is limited by the sternocleidomastoid muscles. At the top of the triangle forms the lower jaw, and its apex reaches the jugular notch of the sternum handle.
In the anterior region of the neck, in turn, the medial triangle of the neck is distinguished on each side , bounded from the front by the median line, from above by the mandible and from behind by the anterior edge of the sternocleidomastoid muscle. A conditional horizontal plane, drawn through the body and large horns of the hyoid bone, divides the middle region of the neck (anterior triangle) into two regions: the upper supra-lingual (regio suprahyoidea) and the lower sub-lingual (regio unfrahyoidea). In the sub-lingual region of the neck, on each side, two triangles are distinguished: somnolent and muscular (scapular-tracheal).
The sleep triangle (trigonum caroticum) is bounded from above by the posterior abdomen of the digastric muscle, from behind - by the anterior edge of the sternocleidomastoid muscle, in front and from below - by the superior abdomen of the scapular-hyoid muscle. Within this triangle, the cervical branch of the facial nerve, the upper branch of the transverse nerve of the neck, and the anterior jugular vein are located above the surface plate of the cervical fascia. Deeper, beneath the superficial plate of the cervical fascia, there is a common carotid artery, an internal jugular vein and behind them a vagus nerve, enclosed in the vagina of the vascular-neural bundle common to them. Here lie deep lateral cervical lymph nodes. Within the carotid triangle at the level of the hyoid bone, the common carotid artery is divided into the inner and outer carotids. From the latter depart its branches: the upper thyroid, lingual, facial, occipital, posterior auricle, ascending pharyngeal artery and sternocleidomastoid branches, directed to the corresponding organs. Here, anterior to the vagina of the neurovascular bundle, is the upper root of the sublingual nerve, deeper and lower - the laryngeal nerve (branch of the vagus nerve), and deeper on the prenatal plate of the cervical fascia, - the sympathetic trunk.
The muscular (scapular-tracheal) triangle (trigonum musculare, s. Omotracheale) is bounded posteriorly and from below by the anterior edge of the sternocleidomastoid muscle, from above and laterally by the upper abdomen of the scapula and the medial-anterior median line. Within this triangle, directly above the jugular notch of the tracheal sternum, is covered only by the skin and fused superficial and pre-tracheal plates of the cervical fascia. Approximately 1 cm away from the median line is the anterior jugular vein that extends into the supragranular interfascial cell space.
In the supra-lingual region, three triangles are distinguished: sub-chin (unpaired) and paired - submandibular and lingual.
The subglobular triangle (trigonum submentale) is bordered on the sides by the anterior abdominal muscles of the abdominal muscles, and its base is the hyoid bone. The vertex of the triangle is facing upward, to the chin awn. The right and left mandibular-hyoid muscles join the triangle bottom. In the region of this triangle are the chin lymph nodes.
The submandibular triangle (trigonum submandibulare) is formed at the top by the body of the lower jaw, at the bottom - by the anterior and posterior abdominal muscles of the digastric muscle. Here is the same-named (submaxibus) salivary gland. In this triangle penetrate the cervical branch of the facial nerve and the branching of the transverse nerve of the neck. Here, the facial artery and vein are superficially located, and behind the submaxillary gland is the submandibular vein. Within the submaxillary triangle below the lower jaw are the same lymph nodes.
The language triangle (Pirogov's triangle) is small, but very important for surgery, located within the submandibular triangle. Within the lingual triangle is a lingual artery, access to which is possible at this place of the neck. At the front, the lingual triangle is organically bound by the posterior margin of the maxillofacial muscle, behind and below is the posterior abdomen of the digastric muscle, and above the hypoglossal nerve.
In the lateral region of the neck, the scapular-clavicular and shovel-trapezoidal triangles are distinguished.
The scapular-clavicular triangle (trigonum omoclaviculare) is located above the middle third clavicle. Bottom, it is limited to the clavicle, from above - the lower abdomen of the scapular-hyoid muscle, in front - the posterior edge of the sternocleidomastoid muscle. In the area of this triangle, the terminal (third) part of the subclavian artery is determined, the subclavian part of the brachial plexus, between the trunks of which passes the transverse artery of the neck, and above the plexus is the suprapular and superficial cervical artery. A subclavian vein, firmly fused with the fascia of the subclavian muscle and the plates of the cervical fascia, lies in front of the subclavian artery, in front of the anterior staircase (in the progenitoral interval).
A shovel-trapezoidal triangle (trigonum omotrapezoideum) is formed by the anterior margin of the trapezius muscle, the lower abdomen of the scapula and the posterior margin of the sternocleidomastoid muscle. An additional nerve passes here, a cervical and brachial plexus forms between the staircases, a small occipital, great occipital and other nerves form from the cervical plexus.
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