Anterior Triangle of the Neck

Anterior Triangle of the Neck In

Detail
The neck is arbitrarily subdivided into two triangles by the sternocleidomastoid muscle:

• Anterior Triangle
– submental (smen)
– submandibular (sm)
– muscular-visceral
(mus)
– carotid (car)
• Posterior Triangle
Starting above the hyoid bone in the
anterior triangle, we have two small – occipital
triangles: submental and submandibular
(or digastric). We will start this study by – supraclavicular 
looking at the submandibular triangle first (omoclavicular)
then the submental.
Triangles within the Anterior
Triangle of the Neck
The Submandibular Triangle

• Boundaries
– mastoid & mandible
above
– anterior belly of
digastric anteriorly
(abd)
– posterior belly of
digastric (pbd)
– stylohyoid posteriorly
(sh)
 The superficial (roof) structures of the submandibular
region are:
• platysma
• facial vein (fv)
• cervical branch of facial nerve (cbf)
• Removal of the superficial structures displays the
submandibular salivary gland itself
CONTENTS
– facial artery (fa)
– lingual nerve and submandibular ganglion (ln)
– submandibular duct (smd)
– lingual artery (la)
– hypoglossal nerve (XII)
– the lingual nerve and submandibular duct pass through a gap between the
hypoglossal (hg) and mylohyoid (mh) muscles
– the lingual artery passes deep to the hyoglossus muscle.
 The Submental Triangle
• located between the two
anterior digastric muscles
(abd).
• Structures
– submental lymph node(s)
(ln) - drain the floor of the
mouth.
– mylohyoid muscle (mh)
arise from the body of the
hyoid bone and insert into
the mylohyoid line of the
inside of the mandible.
• aids in swallowing and in
depressing the mandible.
 The Carotid Triangle
• The boundaries of the
carotid triangle are:
– posterior belly of
digastric muscle (pbd)
– superior belly of the
omohyoid muscle (so)
– anterior border of
sternomastoid muscle
(st)

Starting from the most superficial aspects of the carotid triangle, we will
point out the items that are related to it.
Roof of the Carotid Triangle
• The first layer, under
the skin and
superficial fascia
includes the
platysma, which
forms the roof of the
carotid triangle. Note
the location of the
carotid triangle in
purple.
Veins of the Carotid Triangle
– common facial vein (cf)
(within carotid triangle)
– retromandibular vein
(rm)
– posterior auricular vein
(pav)
– facial vein (fv)
– external jugular vein (ej)
– anterior jugular vein (aj)
Nerves within the Carotid Triangle
• The nerves that enter the
carotid triangle and that
lie superficial to the
internal jugular vein,
internal and external
carotid arteries are:
– hypoglossal (XII)
– C1 root of ansa cervicalis
(C1)
– C1 fibers running with
hypoglossal nerve (nerve
to thyrohyoid muscle (nth)
– C2-C3 root of ansa
cervicalis
– ansa cervicalis (ac)
 Arteries

• cca-common carotid
artery
eca-external carotid
artery
• sta-supterior thyroid
artery
• oa-occipital artery
• la-lingual artery
• fa-facial artery
• ica-internal carotid artery
Floor of the carotid triangle
• The floor is the the deepest
aspect of the carotid triangle.
• The muscles, at this level, are
the middle and lower
pharyngeal constrictors (mpc
and ipc).
• The structures seen passing
through this level are:
– superior laryngeal nerve, a
branch of the vagus its 2
terminal branches
– internal laryngeal (ilb--sensory
to upper part of the larynx)
– external laryngeal (elb--motor
to the cricoid muscle)
 Muscular or Visceral Triangle
• The muscular triangle has the
following boundaries:
– mid line of neck (1)
– superior belly of omohyoid (2)
– sternomastoid (3)
• The muscles forming and
within the triangle are seen in
image labeled (these muscles
are often called the strap
muscles, for obvious reasons:
– superficial layer
• sternohyoid (sh)
• superior belly of omohyoid (oh)
– deep layer
• thyroid (th)
– sternothyroid (st)
 Table of Muscles
Muscle Origin Insertion Action Nerve Supply

Sternohyoid sternum hyoid ansa

Suprascapular
Omohyoid hyoid ansa
notch

Below Thyroid
Sternothyroid sternohyoid on cartilage ansa
manubrium oblique line
Thyroid
Thyrohyoid cartilage hyoid C1-C2 (ansa)
oblique line
-----
Anterior Belly Inner surface of Trigeminal
intermediate
Digastric mandile nerve
tendon------
Medial aspect
Posterior Belly -intermediate
of the mastoid Facial nerve
Digastric tendon-
process

Mylohyoid line Trigeminal

Mylohyoid Hyoid bone
of mandible nerve

Lateral side of
Hyoglossus Hyoid bone hypoglossal
tongue

Stylohyoid Styloid process hyoid Facial nerve