General Surgery
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
What are the boundaries and contents of the posterior triangle of the neck?Boundaries − SCM, trapezius and middle third of the clavicleSubdivided into occipital and supraclavicular trianglesContents − XI nerve, nodes, occipital artery, inferior belly omohyoid, external jugular vein, suprascapular vessels, cutaneous branches of cervical plexusBeneath prevertebral fascia − brachial plexus, subclavian artery, cervical plexus and phrenic nerve
The Gallbladder (GB)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
Great auricular nerve (ventral rami of C2, C3): This branch of the cervical plexus emerges from the posterior triangle of the neck. It courses parallel to the external jugular vein, then branches to provide sensation to the skin over the parotid gland, mastoid process, and pinna. Specifically, the great auricular nerve supplies the lobule and antitragus. It sometimes acts alone to supply sensation to the tragus; other times it shares this function with the auriculotemporal nerve.4 The great auricular nerve also usually innervates the tail of the helix and the scapha. It also supplies sensation to the skin overlying the angle of the mandible. Communicates with the transverse cervical nerve, the cervical branch of the facial nerve, and the marginal mandibular nerve.5 The great auricular nerve may issue a mastoid branch that communicates with the lesser occipital nerve.
Nerve and Root Lesions
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
The lower cord of the brachial plexus passes across the posterior triangle of the neck behind the subclavian artery running between scalenus anterior and medius. If there is an extra cervical rib attached to the transverse process of C7 or a fibrous band attached to an elongated transverse process, either of these may compress the lower cord of the plexus. They may also compress the subclavian artery, producing vascular symptoms. These include Raynaud’s phenomenon with complaints of coldness and colour changes in the fingers or more severe symptoms from arterial or venous obstruction. The radial pulse may disappear in certain arm positions on the affected side and a bruit may be audible in the supraclavicular fossa. Rarely, distal emboli may affect the fingers. Neurological features include aching and pain radiating down the inner forearm to the ulnar side of the hand, associated with tingling and sometimes numbness.
Anatomical aspects of the selective infraspinatus muscle neurotization by spinal accessory nerve
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Radek Kaiser, Aneta Krajcová, Michal Makel, Gautham Ullas, Veronika Němcová
SSN arises from the upper trunk of the brachial plexus which is formed by the union of the ventral rami of the C5 and C6 and rarely from C4 root. The nerve passes across the posterior triangle of the neck parallel to the inferior belly of the omohyoid muscle and deep to the trapezius muscle. It then runs along the superior border of the scapula, passes through the suprascapular notch inferior to the superior transverse scapular ligament and enters the supraspinous fossa. It then passes beneath the supraspinatus, relatively fixed on the floor of the supraspinatus fossa, and curves around the lateral border of the spine of the scapula through the spinoglenoid notch to the infraspinous fossa. In 84%, there were no more than two motor branches to the supraspinatus muscle and in 48% the infraspinatus muscle had three or four motor branches of the same size [11]. The mean diameter of the suprascapular nerve at the suprascapular notch is 2.48 ± 0.6 mm [12].
Comparison of subomohyoid plane block and interscalene nerve block for arthroscopic shoulder surgery
Published in Egyptian Journal of Anaesthesia, 2022
Rabab S. S Mahrous, Tarek I Ismail
On the other hand, supraclavicular fossa and subomohyoid plane are close anatomical spaces, and any injection high up to the level of the clavicle can directly spread either retrograde or antegrade to the phrenic nerve, and this could explain the occurrence of phrenic nerve block in some cases in subomohyoid group [37]. Sehmbi et al. [23] during the cadaveric dye study could confirm our explanation where the suprascapular nerve beneath the inferior belly of omohyoid muscle in the posterior triangle of the neck was delineated. Ten bilateral subomohyoid suprascapular nerve injections with ultrasound guidance were carried out using a 5 mL contrast dye in five fresh cadavers. They found that following injection of only 5 ml of dye, 20% of the cases had staining of the phrenic nerve. Currently, no trials demonstrate the spread of local anesthetics from the subomohyoid plane to contiguous spaces, and future research is warranted.
Superficial location of the brachial plexus and axillary artery in relation to pectoralis minor: a case report
Published in Southern African Journal of Anaesthesia and Analgesia, 2018
K Keet, G Louw
The brachial plexus innervates all the structures of the upper limb, and originates from spinal roots C5, C6, C7, C8 and T1, which are located between the anterior and middle scalene muscles.3 The trunks arise in the posterior triangle of the neck from the union of the roots; C5 and C6 roots join to form the superior trunk, C8 and T1 unite to form the inferior trunk, while C7 continues as the middle trunk. The trunks surround the first part of the axillary artery and pass over rib one, deep to the clavicle, where they each divide into anterior and posterior divisions. All three of the posterior divisions unite posterior to the axillary artery to form the posterior cord, the anterior divisions of the superior and middle trunk form the lateral cord on the lateral side of the axillary artery, while only the anterior division of the inferior trunk gives rise to the medial cord on the medial side of the artery. The cords are therefore named according to their position relative to the second part of the axillary artery and are situated deep to the pectoralis major and minor muscles. The terminal branches of the brachial plexus arise from the cords in the region of the third part of the axillary artery, inferior to the distal border of pectoralis minor, and supply skin and muscles of the upper limb.4 The lateral cord gives rise to the musculocutaneous nerve and the lateral root of the median nerve, the medial cord gives rise to the medial root of the median nerve and the ulnar nerve, and the posterior cord divides into the radial and axillary nerves.3
Related Knowledge Centers
- Deep Cervical Fascia
- Nuchal Lines
- Occipital Bone
- Omohyoid Muscle
- Sternocleidomastoid Muscle
- Neck
- Clavicle
- Trapezius
- Occipital Triangle
- Subclavian Triangle