(sub—mandibular) triangle is bound by the anterior and posterior bellies of the digastric muscle and the inferi or border of the body of the mandible. It contains the submandibu—lar salivary gland. Submental triangle is bound by the anterior belly of the digastric muscle, the hyoid bone, and the midline of the neck. It contains the submental lymph nodes.
16. Neck. Root, fascies of the neck
Root of neck: This area communicates with the superior medi astinum through the thoracic inlet. Structures of the region include the following: subclavian artery and vein. The subclavian artery passes poste rior to the scalenus anterior muscle, and the vein passes ante rior to it. Branches of the artery include: vertebral artery; thyrocervical trunk, which gives rise to the inferior thyroid, the transverse cervical, and the suprascapular arteries; Internal thoracic artery.
Phrenic nerve is a branch of the cervical plexus, which arises from C3, C4, and C5. It is the sole motor nerve to the diaphragm. It crosses the anterior scalene muscle from lateral to medial to enter the thoracic inlet.
Recurrent laryngeal nerve is a branch of the vagus nerve. This mixed nerve conveys sensory information from the laryngeal; mucosa below the level of the vocal folds and provides motor innervation to all the intrinsic muscles of the larynx except the cricothyroid muscle.
Thoracic duct terminates at the junction of the left subcla—vian and the left internal jugular veins. On the right side of the body, the right lymphatic duct terminates in a similar fashion.
Fascias of the neck: Superficial investing fascia encloses the platysma, a muscle of facial expression, which has migrated to the neck.
Deep investing fascia surrounds the trapezius and ster—noclei – domastoid muscles.
Retropharyngeal (visceral) fascia surrounds the pharynx.
Prevertebral fascia invests the prevertebral muscles of the nee (i. e., longus colli, longus capitis). This layer gives rise to a derivative known as the alar fascia.
The major muscle groups and their innervations. A simple method of organizing the muscles of the neck is based on two basic principles: (1) The muscles may be arranged in group according to their functions; and (2) all muscles in a group share common innervation with one exception in each group.
Group 1: Muscles of the tongue. All intrinsic muscles plus all but one of the extrinsic muscles (i. e., those containing the suffix, glossus) of the tongue are supplied by CN XII. The one exception is palatoglossus, which is supplied by CN X.
Group 2: Muscles of the larynx. All but one of the intrinsic muscles of the larynx are supplied by the recurrent la—ryngeal branch of the vagus nerve. The sole exception is the cricothyroid muscle, which is supplied by the external laryngeal branch of the vagus.
Group 3: Muscles of the pharynx. All but one of the longitudinal and circular muscles of the pharynx are supplied by CNs X and XI (cranial portion). The sole exception is the stylopharyngeus muscle, which is supplied by CN IX.
Group 4: Muscles of the soft palate. All but one of the muscles of the palate are supplied by CNs X and XI (cranial portion). The sole exception is the tensor veli palatini, which is supplied CN V3.
Group 5: Infrahyoid muscles. All but one of the infrahyo—id muscles are supplied by the ansa cervicalis of the cervical olexus (C1, C2, and C3). The exception is the thy—rohyoid, which is supplied by a branch of C1. (This branch of C1 also supplies the geniohyoid muscle).
New words
neck – шея
cervical – цервикальный
vertebrae – позвоночник
cricoid cartilage – перстневидный хрящ гортани
scapulae – лопатка
scalene – лестничная мышца
brachial plexus – плечевое сплетение
vagus nerve – блуждающий нерв
hypoglossal nerve – подъязычный нерв
laryngeal branches – гортанные ветви
17. Thoracic wall
There are 12 thoracic vertebrae. Each rib articulates with the body of the numerically corresponding vertebra and the one below it. Sternum: the manubrium articulates with the clavicle and the first rib. It meets the body of the sternum at the sternal angel an important clinical landmark.
The body articulates directly with ribs 2–7; it articulates interiorly with the xiphoid process.
Ribs and costal cartilages: there are 12 pairs of ribs, which are attached posteriorly to thoracic vertebrae.
Ribs 1–7 attach directly to the sternum by costal cartilages.
Ribs 8—10 attach to the costal cartilage of the rib above. Ribs 11 and 12 have no anterior attachments. The costal groove is located along the inferior border of each rib and provides protection for the intercostal nerve artery, and vein.
There are 11 pairs of external intercostal muscles.
These muscles fill the intercostal spaces from the tubercles of ribs posteriorly to the costochondral junctions anteriorly. There are 11 pairs of internal intercostal muscles.
These muscles fill the intercostal spaces anteriorly from the sternum to the angles of the ribs posteriorly.
Innermost intercostal muscles: the deep layers of the internal intercostal muscles are the innermost intercostal muscles.
Subcostalis portion: Fibers extend from the inner surface of the angle of one rib to the rib that is inferior to it.
Internal thoracic vessels, branches of the subclavian arteries, run anterior to these fibers. Intercostal structures
Intercostal nerves: there are 12 pairs of thoracic nerves, 11 intercostal pairs, and 1 subcostal pair.
Intercostal nerves are the ventral primary rami of thoracic spinal nerves. These nerves supply the skin and musculature of the thoracic and abdominal walls.
Intercostal arteries: there are 12 pairs of posterior and anterior arteries, 11 intercostal pairs, and 1 subcostal pair. Anterior intercostal arteries.
Pairs 1–6 are derived from the internal thoracic arteries.
Pairs 7–9 are derived from the musculophrenic arteries.
Posterior intercostal arteries: the first two pairs arise from the superior intercostal artery, a branch of the costo—cervical trunk of the subcla vian artery.
Nine pairs of intercostal and one pair of subcostal arter ies arise from the thoracic aorta.
Intercostal veins: Anterior branches of the intercostal veins drain to the internal thoracic and musculophrenic veins.
Posterior branches drain to the azygos system of veins.
Lymphatic drainage of intercostal spaces: anterior drainage is to the internal thoracic (parasternal) nodes.
Posterior drainage is to the paraaortic nodes of the po—ste rior mediastinum.
New words
thoracic – грудной
wall – стенка
clavicle – ключица
xiphisternal – грудинный
groove – углубление
intercostal – межреберный
subcostal – подкостный
transversus – поперечный
musculophrenic – мышечный грудобрюшной
paraaortic – парааортальный
