Henry Gray (18251861). Anatomy of the Human Body. 1918.
vagus nerve, separated from the external carotid by the Styloglossus and Stylopharyngeus, and the glossopharyngeal nerve.1
The Suprahyoid Triangle is limited behind by the anterior belly of the Digastricus, in front by the middle line of the neck between the mandible and the hyoid bone; below, by the body of the hyoid bone; its floor is formed by the Mylohyoideus. It contains one or two lymph glands and some small veins; the latter unite to form the anterior jugular vein.
Posterior Triangle.The posterior triangle is bounded, in front, by the Sternocleidomastoideus; behind, by the anterior margin of the Trapezius; its base is formed by the middle third of the clavicle; its apex, by the occipital bone. The space is crossed, about 2.5 cm. above the clavicle, by the inferior belly of the Omohyoideus, which divides it into two triangles, an upper or occipital, and a lower or subclavian.
The Occipital Triangle, the larger division of the posterior triangle, is bounded, in front, by the Sternocleidomastoideus; behind, by the Trapezius; below, by the Omohyoideus. Its floor is formed from above downward by the Splenius capitis, Levator scapulæ, and the Scaleni medius and posterior. It is covered by the skin, the superficial and deep fasciæ, and by the Platysma below. The accessory nerve is directed obliquely across the space from the Sternocleidomastoideus, which it pierces, to the under surface of the Trapezius; below, the supraclavicular nerves and the transverse cervical vessels and the upper part of the brachial plexus cross the space. A chain of lymph glands is also found running along the posterior border of the Sternocleidomastoideus, from the mastoid process to the root of the neck.
The Subclavian Triangle, the smaller division of the posterior triangle, is bounded, above, by the inferior belly of the Omohyoideus; below, by the clavicle; its base is formed by the posterior border of the Sternocleidomastoideus. Its floor is formed by the first rib with the first digitation of the Serratus anterior. The size of the subclavian triangle varies with the extent of attachment of the clavicular portions of the Sternocleidomastoideus and Trapezius, and also with the height at which the Omohyoideus crosses the neck. Its height also varies according to the position of the arm, being diminished by raising the limb, on account of the ascent of the clavicle, and increased by drawing the arm downward, when that bone is depressed. This space is covered by the integument, the superficial and deep fasciæ and the Platysma, and crossed by the supraclavicular nerves. Just above the level of the clavicle, the third portion of the subclavian artery curves lateralward and downward from the lateral margin of the Scalenus anterior, across the first rib, to the axilla, and this is the situation most commonly chosen for ligaturing the vessel. Sometimes this vessel rises as high as 4 cm. above the clavicle; occasionally, it passes in front of the Scalenus anterior, or pierces the fibers of that muscle. The subclavian vein lies behind the clavicle, and is not usually seen in this space; but in some cases it rises as high as the artery, and has even been seen to pass with that vessel behind the Scalenus anterior. The brachial plexus of nerves lies above the artery, and in close contact with it. Passing transversely behind the clavicle are the transverse scapular vessels; and traversing its upper angle in the same direction, the transverse cervical artery and vein. The external jugular vein runs vertically downward behind the posterior border of the Sternocleidomastoideus, to terminate in the subclavian vein; it receives the transverse cervical and transverse scapular veins, which form a plexus in front of the artery, and occasionally a small vein which crosses the clavicle from the cephalic. The small nerve to the Subclavius also crosses this triangle about its middle, and some lymph glands are usually found in the space.
Note 1. The remark made about the inferior carotid triangle applies also to this one. The structures enumerated as contained in its posterior part lie, strictly speaking, beneath the muscles which form the posterior boundary of the triangle; but as it is very important to bear in mind their close relation to the parotid gland, all these parts are spoken of together. [back]