Deep structures of the neck: Root of the neck

The neck has both superficial and deep structures. But before you stick your neck out and try to guess what the deep structures are, we will just tell you. The deep structures consist of paravertebral muscles and the viscera extending through the superior thoracic aperture at the root of the neck.

When looking at the root of the neck specifically, it joins the neck and thorax, and acts like a passageway for neurovascular structures going from the thorax to the head or upper limb and vice versa.

It’s located on the cervical side of the superior thoracic aperture, which is formed laterally by the first pair of ribs and their costal cartilages, anteriorly by the manubrium of the sternum and posteriorly by the body of T1 vertebra.

The root of the neck contains neurovascular structures like the brachiocephalic trunk and the subclavian arteries, as well as veins such as the external and anterior jugular veins and the subclavian vein, and nerves such as the vagus nerve, phrenic nerves and the sympathetic trunks.

Let’s look at the arteries first. The brachiocephalic trunk is the largest branch of the aorta which arises in the midline from the beginning of the arch of aorta, posterior to the sternal manubrium.

It’s covered anteriorly by the right sternohyoid and sternothyroid muscles and passes superolaterally to the right and bifurcates posterior to the sternoclavicular joint into the right common carotid artery and right subclavian artery. Now, the right and left subclavian arteries supply each upper limb and also send branches to the neck and brain.