viewed connectedly), it may be weli to take 
them in that relation. 
Thus, (1) a region of the median line, (2) an 
antero-inferior, (3) an antero-superior, (4) a 
tero-superior, and (5) a postero-inferior tri- 
angle, (6) a digastric, and (7) a posterior pha- 
ryngeal space, ave to be severally considered ; 
and a few preliminary remarks may be given 
_ to the tegumentary parts, which are more or 
less common to all. 
__ The skin is fine, thin, and extensible, espe- 
cially below and in front; becoming coarser 
and more adherent toward the upper part of 
the posterior triangle; it frequently presents 
me transverse wrinkling above the hyoid 
bone, which seems to depend on the platysma 
nyoides ; here, too, the follicles are larger and 
e abundant than in the other parts of 
the neck, and, in the male subject, the surface 
‘is overgrown by the beard. The subcutaneous 
cellular tissue has already been described ; in 
the upper part of the posterior triangle it be- 
comes almost inseparably confounded with the 
ical aponeurosis ; the platysma myoides lies 
yeen its layers and keeps them apart 
the greater surface of the neck; the 
; es of this muscle are absent in the lower 
1 of the anterior, and upper part of the 
ferior triangle, and at these spots the two 
Tayers of the superficial fascia fall together and 
are nearly confounded. In the deeper lamina 
this texture, subjacent to the platysma in the 
_ parts where it lies, run the superficial veins and 
| nerves. The external jugular vein commences 
: in the parotid gland, usually by radicles, which 
' = pond to the terminal branches of the ex- 
: ternal carotid artery, temporal, internal maxil- 
_ lary, and transverse facial; pierces the fascia 
Rear the angle of the jaw, and directs itself al- 
Most vertically toward the middle of the cla- 
vicle, in the deep layer of superficial fascia : 
aut at the edge of the clavicular insertion of 
_ the sterno-mastoid muscle it bends inward, 
i the aponeurosis, and discharges itself 
{ into the subclavian vein. It thus very ob- 
_ liquely crosses the sterno-cleido-mastoideus 
_ from its anterior to its posterior edge, sepa- 
tated from that muscle by its fascial sheath ; 
the auricular nerve runs upward parallel 
to its posterior border; the platysma covers 
it in its whole course with fibres which cross 
its direction ; its place of discharge into the 
subclavian vein is usually just opposite the 
Scalenus anticus, covered by fascia and by the 
Sterno-mastoid muscle. It receives superficial 
_ Occipital, superior and posterior scapular veins ; 
branches from the posterior triangle of the 
neck, and from the trapezius; it has uncertain 
irregular communication with the anterior 
jugular vein, and receives a certain, though not 
regular, branch from the internal jugular; this 
is usually given to it at the lower part of the 
parotid, or on its emergence from that gland, 
and occasionally seems to constitute its com- 
mencement. Obvious surgical inferences from 
the anatomy of this vein are: the relief that its 
communication with the internal jugular en- 
ables it to give, when opened in cases of cere- 
bral congestion; the eligibility of its line of 
NECK. 
571 
passage over the thick belly of the sterno- 
mastoid for that mode of venesection; the ne- 
cessity for dividing some fibres ¥ the platysma 
transversely to theirlength (by an \acision nearly 
in the direction of the sterno-mastoid) in order 
to obtain a clear opening and free jet of blood ; 
the need for care in this operation, but still 
more in proportion as the vein is wounded 
lower in the neck, to hinder the possibility of 
air being inspired through its cavity. 
The anterior jugular vein is an irregular sub- 
cutaneous supplement to the external: it com- 
mences in the submental region, near the hyoid 
bone; descends vertically beside the median 
line, receiving branches from the larynx, and 
sometimes from the thyroid body; on arriving 
at the sternum, or near that bone, it bends 
horizontally outward, piercing the fascia, and 
runs behind the origin of the sterno-mastoid, to 
throw itself into the subclavian vein, somewhat 
within the termination of the external jugular. 
It generally has free communications with its 
fellow and with the internal and external ju- 
gular. Its size is in inverse proportion to that 
of the external; and, in absence of this, it is 
generally a very considerable branch; it is 
sometimes single and mesial; but more usually 
two exist, which are commonly of unequal 
calibre. 
The superficial nerves are of two classes, 
being partly derived from the cervical plexus, 
partly from the portio dura. 
The cervical plexus sends its superficial 
branchings in three directions : the mastoid and 
auricular pass upward ; the anterior cervical 
runs forward ; the supra-clavicular and super- 
acromial, as their names denote, descend more 
or less obliquely. 
The muastoid, originating from the second 
cervical nerve, winds upwardly across the sple- 
nius, and almost parallel with the posterior edge 
of the sterno-mastoid, which it crosses in its 
ascent. It pierces the fascia soon after its 
origin, and becomes subcutaneous. Its distri- 
bution is entirely to the skin of the mastoid and 
occipital regions. The auricular, rising from 
the second and third cervical nerves by a trunk, 
common to it with the anterior cervical, di- 
rectly pierces the fascia, loops round the pos- 
terior edge of the sterno-mastoid, and ascends 
across its surface (the fascial sheath intervening) 
toward the angle of the jaw; where, after sup- 
plying twigs to the integuments over the pa- 
rotid gland, it divides into terminal branches, 
which are distributed to the external and in- 
ternal surfaces of the auricle and to the adjoin- 
ing integument, in a manner which need not 
be particularised in the present article. In 
crossing the sterno-mastoid it is parallel to the 
external jugular vein, and behind it. The 
anterior cervical rises in common with the last, 
and pierces the fascia in its company ; bends 
at right angles across the sterno-mastoid muscle, 
and is itself crossed by the external jugular vein. 
On arriving at the edge of the muscle, it di- 
vides into many twigs, which, traversing the 
platysma at several spots, distribute themselves 
to the skin of the anterior triangle of the neck, 
and to that of the adjacent part of the digastric 
