Anatomy

The neck is separated from the face and head above by the mandible in front and the skull (occipital bone) behind. Below, it becomes the thorax at the clavicles and the first rib. It is neatly separated into anterior and posterior triangles by the sternocleidomastoid muscle (Figure 28.1). It is further subdivided into other triangles (Figure 28.2).

The main structures in the midline of the neck are the pharynx and oesophagus, and the larynx and trachea. These form part of a combined upper aero-digestive tract connecting the nose and mouth above to the lungs and the stomach and gastrointestinal tract below. The main vascular supply of the head and brain – the carotid arteries and the jugular veins – run in the neck lateral to the midline in the carotid sheath which lies beneath the sternocleidomastoid muscle. The vagus nerve (the tenth cranial nerve) also runs in the carotid sheath with the major vessels from the brain to the chest. The thyroid and the parathyroid glands are found lower in the anterior neck, with the major salivary glands (parotid, submandibular and sublingual glands) in the upper neck. The neck also contains the lower cranial nerves and the phrenic nerve which arises from cervical nerves 3–5 and innervates the diaphragm.

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