The superior cervical ganglion lies at the C2/C3 intervertebral level, while the middle cervical ganglion lies at the C6/C7 intervertebral level. The cervical ganglia are a trio of sympathetic nervous system ganglia that lie alongside the vertebral column. The neck is home to a multitude of nervous system structures. Therefore, tumor embolization from abdominal (gastric cancer) and pelvic regions (ovarian cancer) may cause enlargement of Virchow's node (sentinel node).
Virchow's node, a left suprascapular lymph node, lies near the junction of the thoracic duct and the left subclavian vein, where the lymph from most of the body drains into the systemic circulation. The supraclavicular lymph nodes are located just above the clavicle. There is also a retropharyngeal nodal plexus that drains the nasopharynx and skull base. The deep central neck is drained by lymph node chains contiguous with the mediastinal lymph nodes, responsible for draining the thyroid and peri-thyroid area and cervical trachea. These drain the vast majority of structures in the head and neck. The lateral neck lymph nodes exist in anterior and posterior chains on each side of the neck, lateral to and closely associated with the internal jugular veins. Many lymph nodes exist in the neck, with the majority located along the course of the internal jugular vein. The anterior jugular veins also anastomose with the external jugular vein, with anastomotic variances discussed in other StatPearls article topics for each vein. īlood from the face and scalp drains into the external jugular vein, which travels down the sternocleidomastoid border and drains into the subclavian vein. It eventually anastomoses with the subclavian vein to form the brachiocephalic vein. It descends within the carotid sheath and receives drainage from the facial, lingual, and superior and middle thyroid veins. The internal jugular vein is continuous with the sigmoid sinus and exits the skull via the jugular foramen. The internal carotid artery continues into the temporal bone through the carotid canal and joins the circle of Willis to supply the ophthalmic artery, anterior cerebral artery, and the middle cerebral artery. It gives off the superior thyroid artery, lingual artery, facial artery, and occipital artery. The external carotid artery exits the carotid sheath and supplies the superficial aspect of the face and parts of the neck. The common carotid bifurcates into the internal carotid and external carotid arteries at the level of the superior portion of the thyroid cartilage. The right common carotid artery originates from the brachiocephalic artery, while the left common carotid artery originates directly from the aortic arch. These are the common carotid artery, the internal carotid artery, and the internal jugular vein.
The major blood vessels of the neck are confined within the carotid sheath.
The anterior triangle is subdivided into four smaller segments (also triangles): the submental, submandibular, carotid, and muscular triangles. The posterior triangle is bordered posteriorly by the trapezius muscle, anteriorly by the sternocleidomastoid muscle, and inferiorly by the clavicle. The anterior triangle is surrounded inferiorly by the sternal notch and clavicle, laterally by the sternocleidomastoid, and medially by the trachea, thyroid, and cricoid cartilages. The neck separates into two triangles: anterior and posterior, with these divided into additional triangles and anatomic areas. It is an intricate part of the body with many different planes and compartments. It provides conduits for blood flow to the brain and head, supports the head and moves it accordingly, and transmits nervous signals from the brain to the rest of the body. It is home to the proximal esophagus, trachea, thyroid gland, and the parathyroid glands. The neck can be envisioned very simply as a pathway (or connection) between the head and the rest of the body.
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