SITUS COLLI

Tri Indah Winarni

Dept of Anatomy Faculty of Medicine
Diponegoro University
Nervus cutaneus:
1. N.Trigeminus
2. Plexus cervicalis
(r.anterior n.cervicalis)
3. Ramus posterior n.
cervivalis
MEDULLA SPINALIS
 CERVICAL LYMPH NODES
• Superficial cervical lymph nodes (~ external
jugular vein): occipital, retroauricular, parotid,
submentale, submandibulare
– Afferent: superficial tissue (skin)
– Efferent: deep cervical lymph
• Deep cervical lymph nodes (along the internal
jugular vein)
– Superior: Jugulo-digastric nodes
• Afferent: tongue, tonsil, nasopharynx
• Efferent: jugulo-omohyoid nodes, jugular trunk  vein
– Inferior: Jugulo-omohyoid nodes
• Afferent: tongue, thyroid
• Efferent: jugular trunk  vein
Metastasis of malignancy
TRIGONUM COLLI
 Principles of Movement

• Attachment:
– Origin (stable)
– Insertion (movable)
• Type of Joint (Synovial=movable)
• The position of longitudinal muscle axis
against the anatomical axis
• Results of contraction: movable part will
move toward stable part
• M. Sternocleidomastoideus
– Insertion: manubrium sterni-1/3 medial
clavicula
– Origin: Processus mastoideus
– Action: Rotation/lateroflexi skull, dorsofleksi
– Innervation: N.XI
• M. Trapezius (pars ascenden)
– Origin: Linea nuchae-protuberantia occipitalis
externa
– Insertion: Spina scapulae-acromion
– Action: Elevate scapulae
– Innervation: N.XI
 SUPRAHYOID MUSCLE
I= movable

Joint?

Branchial Arch I and II

Innervate: N. V3, VII, Ansa cervicalis
O=stable
Action: Elevate os hyoid 
deglutition
• M. Digastricus
– Venter posterior (N.VII): Incisura mastoidea –
intermediate tendo
– Venter anterior (N.V3): Intermediate tendo -
fossa digastrica mandibulae
• M. Stylohyoid (N.VII): processus
styloideus  cornus majus os hyoid
• M. Mylohyoid (N.V3): Linea mylohyoidea
mandibulae  raphe mediana
• M. Geniohyoid (Ansa cervicalis): Spina
mentalis  corpus hyoideus
INFRAHYOID MUSCLE
INNERVATION: Ansa Cervicalis
Function: Depressor os hyoid
Covered by fascia colli media
Action: Deglutition
• M. Omohyoid
– Venter Inferior – Origin: Margo superior scapula
– Venter superior – Insertion: Corpus ossis hyoid
– Intermediate tendon
– Action: Depressed os hyoid
• M. Sternohyoid
– Origin: Manubrium sterni
– Insertion: Os hyoid
– Action: Depressed os hyoid
• M. Sternothyroid
– Origin: Manubrium sterni-cart costae I
– Insertion: Linea obliqua lamina thyroidea
– Action: Depressed cart thyroidea
• M. Thyrohyoid
– Origin: Linea obliqua lamina thyroidea
– Insertion: Cornu majus os hyoid
– Action: Depressed os hyoid and elevate cart thyroidea
 ARCUS
BRANCHIALIS
ARCH BRANCHIAL DERIVATES
MASTICATION MUSCLE – BRANCHIAL ARCH I - N. V3

M. Temporalis: Fossa temporalis os

parietalis  processus coronoideus
mandibulae
M. Masseter: processus zygomaticus
 tuberositas masseterica ramus
mandibula
 MUSCLES OF FACIAL EXPRESSION
• Innervation: N. Facialis (N.VII)
• Derivative: Branchial Arch II
Originated from CORNU
LATERALIS MEDULLA
SPINALIS TH 1-2 distributed
to smooth muscle in the
head and neck (Glands etc)
A. CAROTIS EXTERNA
• Arising in carotid triangle:
• Superior thyroid artery (arise
from anterior aspect)
• Ascending pharyngeal artery
(arise from medial deep aspect)
• Lingual artery (arise from
anterior aspect)
• Facial artery (arise from anterior
aspect)
• Occipital artery (arise from
posterior aspect)
• Posterior auricular artery (arise
from posterior aspect)
• Terminal branches:
• Maxillary artery
• Superficial temporal artery
THYROID GLAND

Attention for surgeon

during thyroidectomy
 MUSCLES OF PALATE

Branchial Arch IV derivates

Innervate by r.r pharyngea N. X (vagus) except m.
Tensor velli palatini (by N.V3)
 TONGUE
• MUSCLES:
– Extrinsic
– Intrinsic
• VASCULAR SYSTEM
• INNERVATION:
– Sensoric supply
– Special visceral afferent (gustatoric)
– Motor supply
 EXTRINSIK TONGUE MUSCLES
Innervate: N. XII, except
m. Palatoglossus (N.X)
M. Styloglossus
M. Hyoglossus
M. Genioglossus
M. Palatoglossus
Function: speech,
deglutition and to help
mastication

FUNCTION??
INTRINSIK MUSCLE??
 Extrinsic and Intrinsic Muscles
• Extrinsic muscle
– Genioglossus: chin to tongue
• sticks out the tongue
• presses against the teeth or alveolar ridge
• pulls the tongue tip back
• troughs the tongue
– Styloglossus: styloid process behind ear to
tongue
• pulls the tongue upward and back
– Palatoglossus: palate to tongue
• pulls the tongue back to grove the tongue
– Hyoglossus:hyoid bone to tongue
• retracts or depresses the tongue
• elevates the hyoid bone
• Intrinsic muscles:
– Inferior and Superior Longitudinal Muscle:
• go the length of the tongue
• moves tip up and down
– Transverse Muscle:
• go across the tongue
• narrows and lengthens the tongue
– Vertical Muscle:
• go up and down in the tongue
• flattens and depresses the tongue
Schematic action of the tongue
DEGLUTITION PROCESS
Innervation of the tongue
 CRANIAL NERVES
in
HEAD & NECK REGION
 CRANIAL NERVES OF HEAD & NECK

• N. V (Trigeminalis) • Sensorik to head

• Motor to arch branch I (mast)
• N. VII (Facialis) • Motor to arch branch II
• Parasympatis to salivary
• N. IX (Glossopharyngeus)• Motor to m.stylopharyngeus
• Parasympatis to parotis
• N. X (Vagus) gland
• Motor to arch branch IV & VI
• N. XII ( Hypoglossus) • Sensorik to superior larynx
• Motor to glossus
Mixed Cranial Nerve: Trigeminal & Facial Nerves
Parasympathetic nerves of Salivary secretion
N. VII & N. IX
Originated from CORNU
LATERALIS MEDULLA
SPINALIS TH 1-2 distributed
to smooth muscle in the
head and neck (Glands etc)
A. CAROTIS EXTERNA • Arising in carotid
triangle:
• Superior thyroid artery (arise
from anterior aspect)
• Ascending pharyngeal artery
(arise from
medial(deep)aspect)
• Lingual artery (arise from
anterior aspect)
• Facial artery (arise from
anterior aspect)
• Occipital artery (arise from
posterior aspect)
• Posterior auricular artery
(arise from posterior
aspect)
• Terminal branches:
• Maxillary artery
• Superficial temporal artery