SURGICAL ANATOMY OF THE NECK. 67 



terest to the surgeon are those of the hyoid and laryn- 

 geal apparatus and the sterno-mastoids, and the hollows 

 between and behind these muscles. The first prominence 

 below the chin is the pomum Adami, which is far more 

 prominent in males than in females, and becomes devel- 

 oped at puberty ; nearly a finger's breadth above this 

 can be felt the hyoid bone, with the anterior belly of the 

 digastric muscle sweeping upward towards the chin. 

 Immediately below the thyroid cartilages, in the median 

 line, is a depression, indicating the position of the crico- 

 thyroid membrane ; next, the body of the cricoid carti- 

 lage itself; below this, the upper rings of the trachea 

 may be distinguished, and at about the third ring the 

 isthmus of the thyroid body can generally be made out, 

 more particularly in women. The position of the laryn- 

 geal apparatus during swallowing should be noticed, as 

 it is drawn upwards at the commencement of the act, 

 returning to its normal position on its completion, the 

 thyroid body being carried with it. This fact is of great 

 value in the diagnosis of tumors in the region of the 

 trachea or carotid vessels. In children the trachea is 

 more deeply placed, very small, and movable (vide 

 Trachea). 



The anterior and posterior borders of the sterno-cleido- 

 mastoidei are very evident, even when these muscles are 

 at rest, from the prominent mastoid processes to their 

 inferior attachments the sternal of which is fusiform 

 and cordlike, and the clavicular, flat and ribbon-shaped, 

 lying posterior to the former, aud variable in its extent 

 along the clavicle. The point of divergence of these 

 two sets of fibres is generally well seen, more especially, 

 however, when the muscle is in action, as in rotation of 

 the head from side to side. These points will be here- 



