1386 



SUKFACE AND SUKGICAL ANATOMY. 



contains, or the result of a primary suppurative cellulitis. A tubercular abscess 

 originating in one of the retropharyngeal lymph glands (Fig. 1085) lies in front 

 of the prevertebral fascia, and points towards the posterior wall of the pharynx ; 

 abscesses secondary to disease of the cervical vertebrae lie behind the prevertebral 

 fascia, and spread laterally behind the vascular compartment ; they point behind 

 the sterno-mastoid, and should be opened through an incision at the posterior 

 border of the muscle, the surgeon keeping to the anterior aspect of the transverse 

 processes in order to avoid the structures in the vascular compartment (Chiene). 



In front of the visceral compartment is a small muscular compartment containing 

 the infra-hyoid muscles ; anterior to it again, in the region of the supra-sternal 

 notch, is the small supra-sternal compartment, containing the lower part of the 



External maxillary artery 

 Submaxillary gland 



Bifurcation of common carotid artery 



Sterno-mastoid 

 Carotid tubercle 



Apex of lung 



Brachial plexus 

 Subclavian artery 

 Acromial end of clavicle 

 Lesser tubercle of \ 

 humerns. \ 

 Tendon of biceps 

 Greater tubercle 

 of humerus 



Anterior belly of digastric 

 Hyoid bone 



Thyreoid cartilage (pomum Adami) 

 Crico-thyreoid ligament 



External jugular vein 

 Cricoid cartilage 



Isthmus of thyreoid gland 

 ^Sternal head of sterno-mastoid 

 Clavicular head of sterno-mastoi' 



Sterno-clavictilar articulatic 

 First part axillary arte: 



Coracoid process 



Tricuspid valve 



Pulmonary valve 

 Aortic valve 



Mitral valve 

 FIG. 1086 ANTERIOR ASPECT OF NECK AND SHOULDERS. 



anterior jugular veins, along with their transverse communicating branch, a little 

 fat, and one or two lymph glands. 



The vascular compartment contains the carotid vessels, and the internal jugular 

 vein, and the following nerves, viz. : the vagus, the first part of the hypoglossal, 

 the descendens hypoglossi, and the superior part of the accessory. These structures 

 are enveloped in a thin fascial tube, the carotid sheath. The sheath is sur- 

 rounded by cellular tissue in which are embedded the carotid chain of lymph 

 glands ; normally they may be readily separated from the sheath of the internal 

 jugular vein, to which, however, they become adherent when inflamed. A few 

 small lymph glands lie within the sheath. The cervical sympathetic trunk and 

 the inferior thyreoid artery lie in the cellular space between the posterior wall of 

 the carotid sheath and the prevertebral fascia ; they can be reached through an 

 incision along the posterior border of the sterno-mastoid muscle, this muscle, along 



