Regions of the head and neck

Neurocranial portion

With the exception of the auricular region, which includes the external ear, the names of the regions of the neurocranial portion of the head correspond to the underlying bones or bony features, and they are the frontal, parietal, occipital, temporal and mastoid regions. The remaining eight regions of the head belong to the face and are grouped as viscerocranial.

Viscerocranial portion

This portion includes the facial region, which is divided into five bilateral and three median regions, and are named according to related superficial features (oral and buccal regions), deep soft tissue formations (parotid region), and skeletal features (orbital, infraorbital, nasal, zygomatic, and mental regions). The five bilateral regions are the orbital, infraorbital, buccal, parotid and zygomatic regions.

The three median regions are named according to features or structures lying along the midline of the body and are the nasal, oral and mental regions.

The following is a brief description of some of these head regions:

Orbital region

This is a bilateral region named according to the bony cavity, the orbit. It includes the bony cavity (eye socket), soft tissues and organs, like the eyeball, extraocular muscles, eyelids, glabella, eyebrow, lacrimal glands and bulbar conjunctiva.

Temporal region

This is a region of the neurocranial portion of the head and includes the temporal and infratemporal fossae, superior and inferior to the zygomatic arch, respectively.

Oral region

This is a median region of the face or viscerocranial portion of the head and includes the oral cavity, teeth, gingivae, tongue, palate, and the region of the palatine tonsils.

Nasal region

The nasal region is a median region named after the nose, and thus includes this part of the respiratory tract which is also an olfactory organ. Hence the nasal region contains structures that are important for smelling and breathing.

Auricular region

As mentioned earlier, this is the only region of the neurocranial portion that is not named after the cranial bone. It includes the external ear which is composed of the shell-like auricle or pinna and the external acoustic meatus or canal, both of which function to collect and conduct sound, respectively, to the tympanic membrane.

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Anterior cervical region

The anterior cervical region or anterior triangle of the neck has an anterior boundary, formed by the median line of the neck, a posterior boundary, formed by the anterior border of the SCM, a superior boundary, formed by the inferior border of the mandible, an apex, located at the jugular notch in the manubrium, a roof formed by subcutaneous tissue containing the platysma muscle, and a floor, formed by the pharynx , larynx and the thyroid gland.

For a more precise localization of structures, the anterior cervical region is subdivided by the digastrics and omohyoid muscles into four smaller triangles, the unpaired submental triangle and three small paired triangles: submandibular, carotid, and muscular (omotracheal).

Submental triangle

The submental triangle, inferior to the chin, is an unpaired suprahyoid area bounded inferiorly by the body of the hyoid and laterally by the right and left anterior bellies of the digastric muscle. It has a floor which is formed by the two mylohyoid muscles which meet in a median fibrous raphe. The apex of the submental triangle is at the mandibular symphysis, the site of the union of the halves of the mandible during infancy. Its base is formed by the hyoid, and the triangle contains several small submental lymph nodes and small veins that unite to form the anterior jugular vein.

Submandibular triangle

The submandibular triangle is a glandular area between the inferior border of the mandible and the anterior and posterior bellies of the digastric muscle. The floor of his triangle is formed by the mylohyoid and hypoglossus muscles and the middle constrictor muscle of the pharynx. The submandibular gland nearly fills this triangle.

Carotid triangle

The carotid triangle is a vascular area bounded by the superior belly of the Omohyoid, the posterior belly of the digastrics, and the anterior border of the SCM. This triangle is important because the common carotid artery ascends into it. Its pulse can be auscultated or palpated by compressing it lightly against the transverse processes of the cervical vertebrae. At the level of the superior border of the thyroid cartilage, the common carotid artery divides into the internal and external carotid arteries. Also located within the carotid triangle are the carotid sinus and carotid body.

Muscular triangle

The muscular triangle is bounded by the superior belly of the omohyoid muscle, the anterior border of the SCM, and the median plane of the neck. This triangle contains the infrahyoid muscles and viscera, for example, the thyroid and parathyroid glands.

Sternocleidomastoid region

The sternocleidomastoid muscle (SCM) is a key muscular landmark in the neck because it visibly divides each side of the neck into the anterior and lateral cervical regions (figure). The region between these triangular regions, corresponding to the area of this broad, strap-like muscle, is the sternocleidomastoid region of the neck. The SCM has two heads: the rounded tendon of the sternal head which attaches to the manubrium, and the thick fleshy clavicular head which attaches to the superior surface of the medial third of the clavicle. These two heads are separated inferiorly by a space, visible superficially as a small triangular depression, the lesser supraclavicular fossa.

Lateral cervical region

The lateral cervical region constitutes the posterior triangle of the neck, and it is bounded by the posterior border of the SCM anteriorly, anterior border of the trapezius posteriorly, inferiorly by the middle third of the clavicle between the trapezius and the SCM, and superiorly by an apex where the SCM and trapezius meet on the superior nuchal line of the occipital bone. It is also bounded by a roof formed by the investing layer of deep cervical fascia, and by a floor formed by muscles covered by the prevertebral layer of deep cervical fascia. This region contains the platysma which is a superficial muscle, amongst other structures and muscles.

For a more precise localization of structures, the posterior triangle of the neck is divided into a larger occipital triangle superiorly and a small omoclavicular triangle inferiorly by the inferior belly of the omohyoid muscle.

The occipital triangle is so called because the occipital artery appears in its apex. The most important nerve crossing this triangle is the spinal accessory nerve (CN XI). The omoclavicular (subclavian) triangle is indicated on the surface of the neck by the supraclavicular fossa. The inferior part of the external jugular vein crosses this triangle superficially, while the subclavian artery lies deep in it. These vessels are separated by the investing layer of deep cervical fascia. Because the third part of the subclavian artery is located in this region, the omoclavicular triangle is often called the subclavian triangle.

Posterior cervical region

The region posterior to the anterior borders of (i.e., corresponding to the area of) the trapezius is the posterior cervical region. Its main content is the trapezius muscle which runs down to the posterolateral aspect of the trunk. The sub-occipital triangle or region lies deep to the posterior cervical region.