Anterior triangle and infrahyoid and suprahyoid muscles Learning objectives

At the end of the lecture the student should be able to know: The boundaries of anterior triangle The contents of anterior triangle The divisions of anterior triangle Suprahyoid muscles Infrahyoid muscles Ansa cervicalis

Boundaries

Roof skin superficial fascia platysma investing layer of deep fascia

Crossed by cervical branches of the facial nerve transverse cut.nerve(cervical plexus)

Is subdivided by the 1- Digastric muscle 2- Superior belly of the omohyoid Into 4 triangle Submental triangle Submandibular triangle (digastric) Muscular triangle Carotid triangle Contents of anterior triangle

Contents of anterior triangle

Submental Triangle

Contains Submental LNs anterior jugular vein Digastric triangle (submandibular)

Anterior ant.belly of the digastric muscle Posterior post. Belly of DGM + stylohyiod muscle Superior lower border of the mandible

- hypoglosus muscles

Contents 1- submandubular salivary gland (superficial part) 2- facial artery (deep to the gland) 3- facial vein (superficial to the gland) 4- submandibular LNs (superficial to it) 5- hypoglossal nerve (deep to the gland and on the hyoglossus muscle)

Muscular triangle neck

contents 1-anterior jugular vein 2-infrahyoid muscles 3-

-larynx trachea-esophagus

Carotid Triangle

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middle pharyngeal constrictor m. inferior pharyngeal constrictor m. thyrohyoid m.

Digastric triangle (submandibular)

- hypoglosus muscles

Contents 1- submandubular salivary gland (superficial part) 2- facial artery (deep to the gland) 3- facial vein (superficial to the gland) 4- submandibular LNs (superficial to it) 5- hypoglossal nerve (deep to the gland and on the hyoglossus muscle) Muscular triangle

contents 1-anterior jugular vein 2-infrahyoid muscles 3-larynx trachea-esophagus

Carotid Triangle

middle pharyngeal constrictor m. inferior pharyngeal constrictor m. thyrohyoid m. Contents of carotid triangle

1- Carotid sheath and most of the branches of the ext.carotid artery

2- Ansa cervicalis in front of the carotid sheath a- the descendens hypoglossi b- the descendens cervicalis

3- Sympathetic chain embedded in its post. wall

4- Vagus nerve and hypoglossal nerves

Extrinsic Laryngeal Muscles

Three Main Purposes: 1) Fixation (primary role) 2) Elevation (move larynx up) 3) Depression (move larynx down) Two major groups of extrinsic muscles Suprahyoid & Infrahyoid Anatomical position: Suprahyoid- one of the above larynx. Infrahyoid- one of the attachments lies

attachments lies above the below the larynx.

Suprahyoid muscles

Suprahyoid Muscles: 1) Digastric 2) Geniohyoid 3) Hyoglossus 4) Mylohyoid 5) Stylohyoid Function: Raise the hyoid bone & indirectly raise the larynx. Infra-Hyoid Muscles Thyrohyoid muscle Omohyoid muscle Sternohyoid muscle Sternothyroid

Digastric muscle

Two fleshy bellies Anterior belly- originates from the inside surface of the lower border of the mandible near the symphysis and inserts into the lesser horn of the hyoid bone Posterior belly- Originate from the mastoid process of the temporal bone to the sternocleidomastoid muscle Two bellies meet and are joined by an intermediate tendon Stylohyoid muscle

AttachmentStyloid processhyoid bone Nerve supply

Mylohyoid muscle

-depresses the mandible

Geniohyoid Paired, cylindrical muscle located above the superior surface of the mylohyoid muscle Originate by means of a short tendon, from the lower part of the mental symphysis Insert into anterior surface of the hyoid Mandible fixed, this muscle pulls the hyoid bone up and forward

Hyoglossus Extrinsic muscle of the tongue Influences position of the larynx Arises from upper border of the body and greater horns of the hyoid bone Inserts into posterior and lateral regions of the tongue

Genioglossus Extrinsic tongue muscle which influences position of the larynx Originates from the mental symphysis Fibers fan out and course toward their insertion Lower fibers insert into the body of the hyoid bone Upper fibers insert into the under surface of the tongue Contraction elevates the hyoid bone and draws it forward
The Infrahyoid muscles

They lie over the thyroid gland the trachea and the larynx

Consist of 4 muscles arranged into 2 layers 1-The superficial layer 2-The deep layer

The superficial layer Sternohyoid muscle is a thin, narrow muscle attaching the hyoid bone to the sternum, serving to depress the hyoid bone. It is innervated by the ansa cervicalis. The muscle arises from the posterior border of the medial end of the clavicle, the posterior sternoclavicular ligament, and the upper and posterior part of the manubrium sterni.

Passing upward and medially, it is inserted by short tendinous fibers into the lower border of the body of the hyoid bone

Omohyoid muscle Long, narrow 2 bellied muscle Located on the anterolateral surface of the neck Inferior belly originates from the upper horn of the hyoid Prevents the neck region from collapsing during deep inspiration Prevents blood vessels of the neck from being compressed The deep layer
a sheet of longitudinal muscle fibers extend b/w the upper part of the sternum and the lower border of the hyoid bone oblique line of the thyroid cartilage divides this sheet into

1- sternothyroid 2- thyrohyoid

Sternothyroid muscle

(below) each one covers its corresponding lobe of the thyroid gland

oblique line of thyroid cartilage

Thyrohyoid muscle

Thyrohyoid muscle is a small, quadrilateral muscle appearing like an upward continuation of the Sternothyroid. It belongs to the infra-hyoid muscles group. It arises from the oblique line on the lamina of the thyroid cartilage, and is inserted into the lower border of the greater cornu of the hyoid bone. Nerve supply of infrahyoid muscles
All the infrahyoid muscles except the thyrohyoid are supplied by branches of ansa cervicalis

*Thyrohyoid m. Thyrohyoid branch from C1 (appears to arise from CN12)

Ansa cervicalis ( C1, C2 & C3 ) supplies 3 infrahyoid m. 1-omohyoid 2-sternohyoid 3-sternothyroid

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