Muscles and root of the neck The muscles of cervical region are classified into 3 groups: 1-Superficial muscles

Platysma , SCM , Trapezius 2-Hyoid related muscles Supra Hyoid Muscle , Infra Hyoid Muscle 3-Cervical vertebral muscles Ant,Lat,Post.vertebral muscle

Superficial muscles y The Platysma Muscle -Platysma means flat -Its the muscle of facial expression -Its Located in the fatty layer -the origin of platysma is classified inferiorly

All the muscles in the face that are that are related to facial expression are innervated by the 7th cranial nerve (facial nerve) this nerve provide motor innervations to all the muscles of facial expression. The platysma is located in the neck ,but it considered part from muscles of facial expression ,so its innervated by the branch of facial nerve which called cervical branch Its Attachment : Sup. Attachment Inf.Attachment Its Action : Draws mouth corner inferiorly and draws skin of the neck superiorly y SCM muscle Inferior border of body of the mandible and the angle of the mouth Delto pectoral deep fascia

has a sterna and calvicle head and it descend all the way to lateral surface of mastoid process and o the lateral part of the superior nuchal lines Its origin : Manubrium (sternal head) Med.1/3 of clavicle (clavicle head) - The SCM separates the antero-lateral aspect of the neck inti anterior and posterior triangle and it separate the neck into superficial and deep part . so (anything outside the SCM is in the superficial and anything deep to the muscle is in the deep part in the neck ) - The jugular vein outside the SCM is the EJV while the one is deep to SCM is the IJV Its insertion : mastoid processes of temporal bone and lateral part of the superior nuchal line Note: the occipital bone posteriorly has two lines , one sup. And one inf. Nuchal line , these lines arise because of the muscular attachment . (the sup.nuchal line is made by the attachment os SCM laterally and the attachment of trapezius medially ) Its innervations : Spinal part of 11 - The reference muscles (SCM and trapezius) are innervated by cranial nerve number 11 - For the SCM the innervations is particularly from the spinal branch of accessory nerve Its Action: Single turns head super laterally to opposite side Both flex the neck Trapezius muscle -its a reference muscle because its located in the posterior part of the neck ( anything overlyed by this muscle is part of the trapezius aspect of the neck ) - The trapezius muscle is divided into 3 parts : 1- The middle part : is at the level of scapula when it contracts it reflects the scapula ,bringing both scapula together 2- The superior part : above the scapula and its function to elevates the scapula 3- The inferior part : below the scapula and its function to depresses the scapula Its origin :

Med.1/3 of sup.nuchal line EOP (the prominence of the back of your head) Nuchal ligament (its in middle of the neck posteriorly) Spinous processes (C7-T12) Its insertion : Lat.1/3 of clavicle Acromion Spine of scapula Its innervation: Cranial nerve number 11 (accessory nerve)

Hyoid Related Muscles y Suprahyoid muscles 1- Geniohyoid muscle : arise from mandible anteriorly -the mandible in the middle has two genoid tubercles or also called mental spins (sup. And inf. Mental spines) from the inferior mental spine there is a muscle that goes all the way down to the hyoid bone called geniohyoid muscle -from sup.mental spine to the tongue there is a muscle called genioglusus muscle -geniohyoid muscle is more in the oral cavity than in the neck so its not considered a part of muscles in the neck . -under the geniohyoid muscle there is a flat muscle sheat which called mylohyoid muscle . 2- Mylohyoid muscle : floor of the mouth .anything above the the mylohyiod you are in the oral cavity and anything below the mylohyoid you are in the neck region . -mylo refers to the molars teeth -the mylohyiod extend from the molars on both sides all the way to the middle where it meets with the body of the hyoid bone - inside the mandible there is a linear elevation called the mylohyiod line which demarcates the attachment of the mylohyiod muscle -innervation to the mylohyiod is from the nerve to mylohyiod and it comes from the inferior dental nerve (inferior alveolar nerve) before it goes into the mandible through the mandibular foramen it sends a small branch to thr mylohyiod muscle so its called nerve to mylohyiod

3-stylohyiod :is from the styloid process of the temporal bone all the way down into the hyoid bone 4-Digastric muscles (2 bellies):the two bellies are attached to each other by tendon called intermediate tendon -the posterior belly is attached to the medial surface of the mastoid process (on the medial surface of mastoid process there is the SCM attached) -the anterior belly arise from the mandible -the digestive fossa is on the mandible (where the anterior belly arise from) this is below the mylohyiod line anteriorly -the intermediate tendon is above the hyoid bone but not attached to it ,the tendon is attached to the hyoid bone through a facial sling (part of deep fascia) this facial sling goes from the body and greater horn of hyoid bone all the way around the intermediate tendon and turns back to the hyoid bone ,by this the tendon is fixed close to the hyoid bone but not attached to it directly -when the anterior belly contracts the tendon moves anteriorly ,when the posterior belly contracts the tendon moves posteriorly -depending on the muscle closer to the belly ,this will determine from where its innervations will be -when the 4 suprahyiod muscles contracts they help in in elevating the hyoid bone -stylohyiod and post.belly of the digastrics are innervated by the cervical branch of 7th cranial nerve (facial nerve) which also innervates the platysma -the hyoid bone is attached inferiorly to the larynx so these 4 muscles also help in elevating the larynx. Infrahyiod muscles

1-sternohyiod 2-sternothyroid 3-omohyiod 4-thyrohyiod -Infrahyiod muscles are called strap muscles because the run is a strap fasion these 4 muscles are in two layers ,2 superficial and 2 deep .the two anterior ones (the superficial) are the sternohyiod arising from the manubrium of the sternum and medial end of the clavicle all the way up to the body of hyoid bone and the omohyiod omohyiod :omo means shoulder Omohyiod goes to the sup.border of the scapula posteriorly ,it has 2 bodies ,the superior belly which descend down from the body of the hyoid bone all the way to the intermediate tendon .another facial loop will come from

the clavicle and cover the tendon and fixes the tendon to the clavicle through a facial sling . -the inferior belly arise and goes inferiorly and posteriorly from the clavicle (to where the facial sling attaches the intermediate tendon)to the scapula . -the omohyiod is lateral to sternohyiod -the two deep muscles are the sternothyroid ,going from the sternum all the way to the thyroid cartilage(adams apple) -thyroid means shield like -the thyroid gland is inferior to the thyroid cartilage -the thyroid cartilage is shielding behind it the larynx and the thyrohyiod muscle -when the sternothyriod contracts it pulls the thyroid cartilage wgich pulls the thyrohyiod muscle and therefore pull thr hyoid muscle inferiorly so these two muscles works together indirectly -behind the sternohyiod there is the sternothyriod and the thyrohyiod muscles . -the thyrohyiod muscle is the shoretest muscle of all the these 4 muscles and innervated by C1 via hypoglusal nerve -Ansa means loop -ansa cervical is a loop of nervous fibers formed by c1,c2,c3 (in the neck) C1 gives a branch that goes and descend anteriorly this is called anterior branch of ansa cervical ,c2 and c3 each of them give a branch both join together to form the posterior part of ansa cervical -these two parts (anterior and posterior )of ansa cervical unite together inferiorly forming a loop ,this loop is ansa cervical . -the thyrohyiod muscle innervations comes from c1 directly without getting into the loop -the ansa cervical innervates the infrahyiod muscles except thyrohyiod muscle -Cervical vertebral muscles The vertebral muscles just you have to know the names of these vertebral muscles . Cervical vertebral muscles is classified into 3 groups around V.C : Anterior , Lateral , Posterior Anterior cervical vertebral muscles 1-Longus Capitis (Capitis means head) 2-Longus Cervicis (Cervicis means attaches to the cervical vertebrae) , its also called longus colli

It has (longus colli) sup.and inf.oblique and vertical Lateral Group (Scalene muscles) Scalene means unequal triangle Scalenous anterior is attached to first rib Scalenous medius ia attached to first rib Scalene posterior descends more into the second rib -when the scalene contracts they bend the neck to the same side that they contracy (left to the left and rt to the rt) -when scalene anterior attaches to the first rib it forms a tubercle on the first rib (internal border) which is one of the reasons why the first rib is a typical -there is a space located between scalenous anterior and medius which is called scalene hiatus(hiatus means passage way) and its inferiorly to the first rib -the scalene hiatus allow the main blood supply to the upper limb .subclavian artery from the thoracic to the upper limb and allows the brachial plexus from the neck to the upper limb -scalene hiatus boundaries : Ant scalene anterior Post scalene medius Inf first rib -anterior structures of scalene anterior are exposed -relations to Sc.Ant : anterior subclavian vein and phrenic nerve Inennervation:cervical spinal nerve Action : elevatation of ribs , bending cervical spine(neck) The contents of scalene hiatus : trunks of brachial plexus and subclavian artery Posterior cervical vertebral muscles 1-levator scapulae (posterolat.corner) 2-splenius capitis and cervicis (splenius means bandage) 3-semispinalis capitis (capitis means attaches to the skull) (semispinalis passing along the spine ) 4-rectus capitis pos.major and minor 5-sup. And inf. Obliques of the head If you cut the semispinalis (the deepest muscle)you will reach into a fossa below the occipital bone forming triangular area Supoccipital region below the occipital bone The trapezius muscle covers all the posterior group The rectus capitis posterior minor is from posterior tubercle of atlas to inferior nuchal line

The rectus capitis posterior major is from the spine process of axis to the inferior nuchal line The space between the two nuchal lines there is the spleneous and semispinalis The inferior oblique is from the spinous process of axis to the transeverse process of atlas The superior oblique from the transverse process of the atlas to the area on occipital bone between sup. And inf. Nuchal lines Suboccipital triangle: Its boundaries : Medially rectus capitis posterior major Inf. Inferior oblique Laterally superior oblique Its contents : The vertebral artery ,which passes in the transverse foramen of the cervical vertebrae then passes through foramen magnum to enter the skull ,and the occipital nerve which innervates the 4 muscles in the occipital area -the supoccipital nerve is the posterior branch of c1 -the anterior branch of c1 goes to the thyrohyiod and the geniohyiod muscles (motor innervations) The root of the neck : The area of the neck that lies immediately above the superior thoracic opening (its the junction between the thorax and the neck) -the boundaries of the thoracic opening are manubrium , first rib,andT1 -contents of the root of the neck 1-lower portions of scalene muscles(3 muscles) 2-subclavian artery and vein 3-thoracic duct (lymph vessels extends from thorax to drain into left brachiocephalis vein) 4-roots and trunks of brachial plexus 5-phrenic nerve (passes anterior to scalene anterior) from roots of c3,c4,c5 spinal nerves -thoracic duct is the largest lymph vessel in your body .

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