NECK. 



561 



NECK. Gr. T^a^jjXoj; Lat. collum, cer- 

 vix; Fr. le cou ; Ital. il collo ; Ger. der Hals. 

 This word denotes that contracted, ribless por- 

 tion of the trunk or column of support, which, 

 in vertebrate animals, immediately sustains the 

 head. Disease and accidental lesions so fre- 

 quently submit it to surgical examinations and 

 operative treatment, that familiar acquaintance 

 with its intricate anatomy is of indispensable 

 necessity to the practitioner. 



The order which I shall adopt in the ensuing 

 article is, first, to describe fully and in order 

 the muscles and fasciae of the neck, and sub- 

 sequently the various regions into which it may 

 be divided with the parts contained in them ; 

 the earlier portion giving, as it were, a mere 

 skeleton view or diagram of the anatomy; the 

 latter presenting the organs in their more natural, 

 or regional arrangement, and treating of them 

 in their living relations to disease, casualty, 

 and surgical operation. I should recommend 

 the student of this important part to pursue a 

 similar plan; first, namely, thoroughly to im- 

 press on his mind those relatively firm and fixed 

 textures which admit of practical use as land- 

 marks, and not, till this task is completed and 

 these anatomical boundary lines are vividly and 

 individually before him, to fill up his sketch 

 with important organs, or perplex his mind 

 with their surgical relations. 



I. THE MUSCLI.S. 



The muscles of the posterior region of the 

 neck and those of the shoulder having been 

 described in a previous article (see BACK), the 

 remainder may be considered in three classes 



1. those which most nearly cleave to the 

 vertebra, are attached to their processes, and 

 principally affect their motions; 2. those, 

 chiefly in or near the median plane, which 

 belong to the cervical portions of the respiratory 

 and digestive apparatus, to the pharynx, larynx, 

 tongue, and os hyoides ; 3. the superficial 

 muscles of the side of the neck, the sterno- 

 cleido-mastoideus, and the platysma myoides. 

 The first class includes 1. anttrioriy, the 

 longus colli and rectus capitis anticus major; 



2. laterally, the scalenus anticus, scalenus pos- 

 ticus, and inter-trans versales, with which may 

 be reckoned the rectus capitis lateralis and 

 rectus capitis anticus minor. 



1. Anterior vertebral muscles. M. longus 

 colli ( Pre-dorso-atloidien : Chauss.) is a thin 

 elongated muscle, which occupies an extent in 

 the pre-vertebral region, corresponding to the 

 three upper dorsal and to all the cervical ver- 

 tebrae. In form it is triangular, having its 

 base at the bodies of these vertebrae, and its 

 truncated apex at the middle transverse pro- 

 cesses of the cervical region, and consists of 

 three distinct, though united, parts, which would 

 be represented by the three sides of such a 

 triangle. One portion, the largest, is nearly ver- 

 tical, next to the median line, and a direct 

 flexor of the spine : it originates from the bodies 

 of the three upper dorsal and four lower cer- 

 vical vertebra;, as also from the intervening 

 fibre-cartilages, and, ascending, is inserted by 

 two slips into the anterior surface of the bodies 



VOL. III. 



of the second and third vertebrae. The second 

 part is directed trom the transverse processes of 

 the third, fourth, and fifth cervical vertebrae, at 

 which it arisesby tendinous slips, upward and 

 inward to be inserted into the anterior tubercle 

 of the atlas, and it so continues to that bone the 

 previous insertion of the muscle. The remain- 

 ing part detaches itself from the main body of 

 the muscle at the bottom of the neck, and 

 ascends obliquely outward, to infix itself by 

 small tendons at the anterior tubercles of the 

 transverse processes of the third and fourth 

 cervical vertebrae. The muscle may, in short, 

 be described as passing from the bodies of the 

 three upper dorsal and four lower to those of 

 the three remaining cervical vertebrae, receiving 

 above an oblique reinforcement from the middle 

 transverse processes of the neck, to which it 

 has likewise below detached slips of insertion. 

 M. rectus capitis anticus major (Grand- 

 trachelo-basilaire : Dumas) lies closely on the 

 vertebrae in the upper part of the neck, to the 

 outside of the preceding muscle. It is an 

 elongated, but thickish, muscle, arising by ten- 

 dinous slips from the anterior tubercles of the 

 transverse processes of the third, fourth, and 

 fifth cervical vertebrae. These become fleshy, 

 unite as they ascend, and are inserted into the 

 under surface of the basilar process of the 

 occipital bone, beside the median line, and just 

 behind the spine, which attaches the raphe 

 of the pharynx. Its inner edge overlaps the 

 longus colli. These muscles correspond ante- 

 riorly to the great vessels of the neck, to the 

 nerves which accompany them, and to the 

 cervical portions of the respiratory and diges- 

 tive tubes, but are separated by their own dense 

 fascia from immediate relation to these parts. 

 Their deep surface is in intimate connection 

 with all the vertebrae and intervertebral discs, to 

 which they correspond. Their action is incon- 

 siderable ; the rectus will slightly rotate and 

 bend the head to its own side, or in conjunction 

 with its fellow directly flex it. The longus colli, 

 cooperating with its fellow, bends the cervical 

 spine; or, acting singly, can slightly rotate by 

 its higher fibres toward, by its lower fibres 

 away from, the side on which the contraction 

 occurs. 



2. Lateral vertebral muscles. The inter- 

 transversales colli are almost described by their 

 name. They form, on each side, a double 

 series of small square muscles, occupying the 

 spaces between the adjoining transverse pro- 

 cesses, which afford them attachment by both 

 borders of their surface. Arising from the lips, 

 which the channelled upper surfaceof each trans- 

 verse process presents, they ascend in each space 

 to the borders of the process immediately above, 

 and are there inserted. Between the inter- 

 transversales antici and postici the spinal nerves 

 of the region emerge, and the vertebral artery 

 ascends. 



Strictly analogous to these are the two small 

 muscles which pass to the occiput from the 

 transverse process of the atlas, the rectus ca- 

 pitis lateralis and rectus capitis anticus minor. 

 The former would represent a posterior, the 

 latter an anterior inter-transversal is. The former 



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