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• Root of the neck


  The area of the neck immediately above the inlet into the thorax

  
• Muscles of the root of the neck

  • Scalenus Anterior Muscle
  • Scalenus Medius Muscle

  
• Thoracic duct


  Begins in the abdomen at the upper end of the cisterna chyli, enters the thorax through the aortic opening in the diaphragm, ascends upward, inclining gradually to the left, passes upward along the left margin of the esophagus, turns laterally behind the carotid sheath, turns downward and drains into the beginning of the left brachiocephalic vein

  
• Main nerves of the neck

  • Cervical Plexus
  • Brachial Plexus
• Brachial plexus


  Formed in the posterior triangle of the neck by the union of the anterior rami of the 5th, 6th, 7th, and 8th cervical and the first thoracic spinal nerves, divided into roots, trunks, divisions, and cords

  
• Veins of the head and neck

  • Veins of the brain, venous sinuses, diploic veins, and emissary veins
  • Veins of the scalp, face, and neck

  
• Veins of the brain

  Thin walled and have no valves, consist of the cerebral veins, the cerebellar veins, and the veins of the brainstem, drain into the neighboring venous sinuses

  
• Venous sinuses


  Situated between the periosteal and the meningeal layer of the dura mater, have thick, fibrous walls, but possess no valves, receive tributaries from the brain, the skull bones, the orbit, and the internal ear

  
• Venous sinuses


  • Superior and inferior sagittal sinuses
  • Straight sinus
  • Transverse sinuses
  • Sigmoid sinuses
  • Occipital sinus
  • Cavernous sinuses
  • Superior and inferior petrosal sinuses
• Diploic veins


  Occupy channels within the bones of the vault of the skull
• Emissary veins


  Valveless veins that pass through the skull bones, connect the veins of the scalp to the venous sinuses

  
• Veins of the scalp, face, and neck

  • Facial Vein
  • Superficial Temporal Vein
  • Maxillary Vein
  • Retromandibular Vein
  • External Jugular Vein
  • Anterior Jugular Vein
  • Internal Jugular Vein
  • Subclavian Vein

  
• Facial vein


  Formed at the medial angle of the eye by the union of the supraorbital and supratrochlear veins, connected through the ophthalmic veins with the cavernous sinus, descends down the face with the facial artery, joined by the anterior division of the retromandibular vein, drains into the internal jugular vein

  
• Superficial temporal vein


  Formed on the side of the scalp, follows the superficial temporal artery and the auriculotemporal nerve, enters the parotid Salivary gland, joins the maxillary vein to form the retromandibular vein

  
• Maxillary vein


  Formed in the infratemporal fossa from the pterygoid venous plexus, joins the superficial temporal vein to form the retromandibular vein

  
• Retromandibular vein


  Formed by the union of the superficial temporal and the maxillary veins, divides into an anterior branch that joins the facial vein, and a posterior branch that joins the posterior auricular vein to form the external jugular vein

  
• External jugular vein


  Formed behind the angle of the jaw by the union of the posterior auricular vein with the posterior division of the retromandibular vein, descends across the sternocleidomastoid muscle and beneath the platysma muscle, drains into the subclavian vein behind the middle of the clavicle

  
• Anterior jugular vein


  Descends in the front of the neck close to the midline, joined to the opposite vein by the jugular arch, joins the external jugular vein deep to the sternocleidomastoid muscle

  
• Internal jugular vein


  A large vein that receives blood from the brain, face, and neck, starts as a continuation of the sigmoid sinus, leaves the skull through the jugular foramen, descends through the neck in the carotid sheath lateral to the vagus nerve and the internal and common carotid arteries, ends by joining the subclavian vein behind the medial end of the clavicle to form the brachiocephalic vein

  
• Tributaries of the internal jugular vein

  • Inferior petrosal sinus
  • Facial vein
  • Pharyngeal veins
  • Lingual vein
  • Superior thyroid vein
  • Middle thyroid vein

  
• Subclavian vein


  Continuation of the axillary vein at the outer border of the 1st rib, joins the internal jugular vein to form the brachiocephalic vein, receives the external jugular vein, often receives the thoracic duct on the left side and the right lymphatic duct on the right
• Relations of the subclavian vein

  • Anteriorly: The clavicle
  • Posteriorly: The scalenus anterior muscle and the phrenic nerve
  • Inferiorly: The upper surface of the 1st rib

  
• Lymph drainage of the head and neck

  • Regional nodes
  • Deep cervical nodes

  
• Regional lymph nodes


  • Occipital nodes
  • Retroauricular (mastoid) nodes
  • Parotid nodes
  • Buccal (facial) nodes
  • Submandibular nodes
  • Submental nodes
  • Anterior cervical nodes
  • Superficial cervical nodes
  • Retropharyngeal nodes
  • Laryngeal nodes
  • Tracheal (paratracheal) nodes

  
• Deep cervical nodes


  Form a vertical chain along the course of the internal jugular vein within the carotid sheath, receive lymph from all the groups of regional nodes, the jugulodigastric node is mainly concerned with drainage of the tonsil and the tongue, the juguloomohyoid node is mainly associated with drainage of the tongue, the efferent lymph vessels from the deep cervical lymph nodes join to form the jugular trunk, which drains into the thoracic duct or the right lymphatic duct