Neck Anatomy and Physiology Lecture

              the plexus unites to form the vertebral vein which emerges at the foramen in the transverse process of the sixth cervical vertebra whence it passes downward in front of the vertebral artery and behind the internal jugular vein and terminates in the innominate vein near its origin passing in front of the first portion of the subclavian artery. It is provided with a pair of valves at its termination. It receives tributaries as follows: the veins from the neighboring muscles, the dorsi spinalis veins, the deep cervical and at times the first pair of intercostal veins. When there is a posterior condyloid foramen present it communicates with the lateral sinus by a branch which passes through the foramen. The superficial vessels of the neck can be outlined quite easily and when the pulsation of the deeper vessels is abnormally hard it can be seen, while a pulsation of the more superficial veins can be seen in some of the organic diseases of the heart. In �sore throat� and tonsillitis these veins are liable to become enlarged and distended. � NERVES. -- The nerves supplying the cutaneous area of the neck are the superficial cervical branch of the cervical plexus, which contains filaments of the second and third cervical nerves and in the lower part of its extent by the suprasternal branch which conveys twigs of the third and fourth cervical nerves. The lateral part of the neck receives filaments from the second, third and fourth cervical nerves by the great auricular, small occipital, and supraclavicular branches of the cervical plexus, and posteriorly the skin of the neck is supplied by the small occipital nerve and by the internal branches of the posterior primary divisions of the cervical nerves from the second to the sixth. // The vagus and phrenic nerves are in relation with the superficial structures constituting the front of the neck. // The spinal nerves in the neck are the cervical plexus of nerves which is formed of the anterior divisions of the upper four cervical nerves all of which communicate with the sympathetic nerve. This plexus lies under the sternomastoid muscle opposite the upper four cervical vertebrae and rests upon the levator anguli scapulae and the scalenus medius muscles. It is divided into a superficial and a deep set of branches, the superficial branches all run to and supply the skin and subcutaneous structures. To enumerate them they are the great auricular, the small occipital, the superficial cervical, the supra-sternal, the supra-clavicular and the supra-acromial. The branches composing the deep set are the phrenic, the communicans hypoglossi, the communicating and the muscular, the internal branches and external branches. The brachial plexus of nerves which is formed by the union of the anterior branches of the lower four cervical nerves as they emerge from the spinal [sp: column] between the anterior and middle scalene muscles, and a large portion of the anterior branch of the first thoracic nerve; there is also a small anterior branch from the fourth cervical and one from the second thoracic which enter into the formation of the plexus. These branches form cords from which branches are given off. The anterior branches of the fifth and sixth cervical unite to form an upper cord. The anterior branch of the seventh cervical nerve continues distinct as the middle cord and the anterior branches of the eighth cervical and first thoracic unite to form the lower cord. These three trunks accompany the subclavian artery