Triangles of the Neck: Difference between revisions

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'''Clinical Significance:'''
'''Clinical Significance:'''<ref>Al-Missri MZ, Al Khalili Y. [https://www.ncbi.nlm.nih.gov/books/NBK545296/ Anatomy, Head and Neck, Submental Triangle]. InStatPearls [Internet] 2022 Jun 4. StatPearls Publishing.</ref>
 
* Tumors and cysts develop within the submental triangle
* Abscess from odontogenic infections can spread into the submental space
* Swollen submental lymph nodes can be indicative of malignant lesions. However, lesions in this area commonly develop from a local and benign pathology of the head and neck
* The submental lymph nodes are commonly involved in the metastasis of oral cavity cancer<ref>Trivić A, Krejović-Trivić S, Milovanović J, Djukić V, Arsović N, Dimitrijević M, Petrović Z, Mikić A. [https://pubmed.ncbi.nlm.nih.gov/15756792/ Distribution of cervical metastases from carcinoma of the cervicofacial region]. Acta Chirurgica Iugoslavica. 2004 Jan 1;51(1):83-7.</ref>


== Posterior Triangle ==
== Posterior Triangle ==

Revision as of 13:10, 29 December 2022

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Description[edit | edit source]

The neck is the anatomical region that supports the head and serves as a conduit for vital structures passing to and from the torso. As a geometric region, it can be clinically divided using anatomical triangles.

[1]

The sternocleidomastoid muscle obliquely crosses the neck to form the division between the two major neck triangles: anterior triangle and posterior triangle. Both triangles are further divided into sub-triangles. [2][3]

  1. Anterior Triangle
    • Digastric/Submandibular Triangle
    • Carotid Triangle
    • Muscular Triangle
    • Submental Triangle
  2. Posterior Triangle
    • Occipital Triangle
    • Subclavian/Supraclavicular


The neck is limited[2]:

  • superiorly by the inferior border of the mandible
  • anteriorly by midline of the neck
  • inferiorly by the superior border of the clavicle
  • posteriorly by the anterior margin of the trapezius muscle.

Anterior Triangle[edit | edit source]

[4]


Borders:[2][5]

  • Superior border - inferior border of mandible
  • Medial border- midline of neck
  • Lateral border- anterior border of sternocleidomastoid muscle


The Anterior Triangle has an apex that extends to the manubrium of sternum. It is made up of three paired triangles: submandibular (digastric), carotid, and muscular (omotracheal/infrahyoid) triangles, and one unpaired triangle: submental triangle.

Submandibular/Digastric Triangle[edit | edit source]

Borders:[2][6]

  • Superior - inferior border of mandible
  • Anterior - anterior belly of digastric muscle
  • Posterior - posterior belly of digastric muscle
  • Inferior - hyoid bone

Floor: mylohyoid muscle

Contents:[2]

  • Glands and lymphatics: submandibular gland and lymph nodes, lower pole of the parotid gland.
  • Blood vessels: facial, lingual and submental arteries and veins
  • Nerves: marginal mandibular branch of the facial nerve, nerve to the mylohyoid, hypoglossal nerve (CN XII)


Clinical Significance:

Carotid Triangle[edit | edit source]

Borders:[2]

  • Superior - stylohyoid and posterior belly of digastric muscles
  • Anterior - superior belly of omohyoid muscle
  • Posterior - anterior border of sternocleidomastoid muscle

Floor: hyoglossus, thyrohyoid, and inferior and middle pharyngeal constrictor muscles


Contents:[2]

  • Arteries: common carotid and its bifurcation into internal and external carotid arteries, superior thyroid, lingual, facial, occipital, and ascending pharyngeal arteries
  • Veins: internal jugular, superior thyroid, lingual, facial, ascending pharyngeal, and occipital veins
  • Nerves: external and internal branches of the superior laryngeal nerve arising from the vagus nerve (CN X), hypoglossal nerve (CN XII).


Clinical Significance:

Muscular Triangle[edit | edit source]

Borders:[2][7]

  • Anterior- midline of neck
  • Inferoposterior- anterior margin of the sternocleidomastoid muscle
  • Posterosuperior- superior belly of the omohyoid muscle


Contents:[2]

  • Blood vessels: superior thyroid artery, anterior jugular and inferior thyroid veins
  • Lymphatics: anterior cervical, infrahyoid, prelaryngeal, thyroid, pretracheal, paratracheal lymph nodes
  • Muscles: thyrohyoid, sternothyroid, sternohyoid, omohyoid muscles
  • Nerves: ansa cervicalis (C1-3)
  • Organs: esophagus, trachea, thyroid gland, and the lower part of the larynx.

Clinical Significance:

Submental Triangle[edit | edit source]

Borders:[2]

  • Inferior - hyoid bone
  • Lateral - anterior belly of digastric muscle
  • Medial - midline of neck

Floor: mylohyoid muscle

Contents:[2]

  • submental lymph nodes
  • anterior jugular vein


Clinical Significance:[8]

  • Tumors and cysts develop within the submental triangle
  • Abscess from odontogenic infections can spread into the submental space
  • Swollen submental lymph nodes can be indicative of malignant lesions. However, lesions in this area commonly develop from a local and benign pathology of the head and neck
  • The submental lymph nodes are commonly involved in the metastasis of oral cavity cancer[9]

Posterior Triangle[edit | edit source]

[10]

Borders:[2]

  • Anterior - posterior margin of sternocleidomastoid muscle
  • Posterior - anterior margin of trapezius muscle
  • Inferior - middle one-third of clavicle


 Two subdivisions are formed within the posterior triangle: Occipital Triangle and Subclavian/Supraclavicular Triangle

Occipital Triangle[edit | edit source]

Borders:[2]

  • Anterior - posterior margin of sternocleidomastoid muscle
  • Posterior - anterior margin of trapezius muscle
  • Inferior - inferior belly of omohyoid muscle

Floor: levator scapulae, splenius capitis, and middle and posterior scalene muscles

Contents:

  • Artery: transverse cervical artery
  • Lymphatics: accessory lymph nodes and inferior deep lateral cervical lymph nodes
  • Nerves: accessory nerve (CN XI), cutaneous and muscular branches of the cervical plexus, upper most part of brachial plexus, supraclavicular nerves


Clinical Significance:

Subclavian/Supraclavicular/Omoclavicular Triangle[edit | edit source]

Borders: [2]

  • Superior - inferior belly of omohyoid muscle
  • Anterior -  posterior edge of sternocleidomastoid muscle
  • Inferior - clavicle


Contents: [2]

  • Blood vessels: subclavian artery and vein
  • Nerves: brachial plexus trunks and nerve to subclavius muscle
  • Lymphatics: supraclavicular lymph nodes


Clinical Significance:

References[edit | edit source]

  1. ↑ 5MinuteSchool. TRIANGLES OF THE NECK ANATOMY MADE EASY - EXPLAINED in 3 MINUTES!! CERVICAL TRIANGLES. Available from: https://www.youtube.com/watch?v=CUvmlf3Wxng [last accessed 05/11/2020]
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 Kikuta S, Iwanaga J, Kusukawa J, Tubbs RS. Triangles of the neck: a review with clinical/surgical applications. Anatomy & Cell Biology. 2019 Jun 1;52(2):120-7.
  3. ↑ Kohan EJ, Wirth GA. Anatomy of the neck. Clinics in plastic surgery. 2014 Jan 1;41(1):1-6.
  4. ↑ Anatomy Knowledge. The Anterior Triangle of the Neck - Boundaries x Subdivisions | Anatomy Tutorial. Available from: https://www.youtube.com/watch?v=YOgE2pmXfZg [last accessed 10/06/2020]
  5. ↑ Stathakios J, Carron MA. Anatomy, Head and Neck, Neck Triangle. InStatPearls [Internet] 2021 Jul 31. StatPearls Publishing.
  6. ↑ Casale J, Varacallo M. Anatomy, Head and Neck, Submandibular Triangle. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2022. PMID: 30521254.
  7. ↑ Standring S. Gray's anatomy: the anatomical basis of clinical practice. 41st ed. London: Elsevier Health Sciences; 2015.
  8. ↑ Al-Missri MZ, Al Khalili Y. Anatomy, Head and Neck, Submental Triangle. InStatPearls [Internet] 2022 Jun 4. StatPearls Publishing.
  9. ↑ Trivić A, Krejović-Trivić S, Milovanović J, Djukić V, Arsović N, Dimitrijević M, Petrović Z, Mikić A. Distribution of cervical metastases from carcinoma of the cervicofacial region. Acta Chirurgica Iugoslavica. 2004 Jan 1;51(1):83-7.
  10. ↑ Anatomy Knowledge. The Posterior Triangle of the Neck - Boundaries & Content - Head & Neck Anatomy. Available from: https://www.youtube.com/watch?v=UoVIk4tvX_w [last accessed 16/09/2019]
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