140 



THE HEAD AND NECK 



the pharynx and oesophagus are continuous. After excision of 

 the diverticulum, the cesophageal wound is closed horizontally 

 to avoid the formation of a stricture. 



In both of these cesophageal operations a drainage tube is 

 inserted to prevent any septic infection passing down into the 

 thorax along the carotid sheath. 



Thyreoid gland -V 



Longus colli, left border 

 Left recurrent nerve 



Common carotid artery, 

 cut 



Thyreoid cartilage 



Scalenus anterior 

 irenic nerve 

 Middle cervical ganglion 



Ascending cervical artery, cut 

 Upper trunk of brachial plexus 

 Sympathetic trunk 



irtebral vessels 

 :alenus medius 

 Inferior thyreoid artery 

 Mid. trunk of brachial plexus 

 Transverse cervical a. 



- Transverse scap. a. 

 Lower trunk of 

 brachial plexus 



..Subclavian 

 artery 



Vagus nerve 

 Left innominate vein 



Inferior cervical ganglion 



Subclavian vein 

 Thoracic duct 



Internal jugular vein, cut 



FIG. 44. The Deep Triangle of the Neck. 



(c) Ligature of the Vertebral Artery. In this operation the 

 deep triangle of the neck is more fully exposed. The vertebral 

 artery arises from the first part of the subclavian and runs 

 upwards and backwards behind the carotid sheath. It dis- 

 appears from view at the apex of the triangle by entering the 

 foramen in the transverse process of the sixth cervical vertebra. 

 Shortly before it disappears it is crossed anteriorly by the 

 inferior thyreoid artery and, on the left side, at a lower level by 

 the thoracic duct (Fig. 44). From both of these structures it 



