PART 16 — NECK

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Study use: Rapid revision of neck triangles, congenital neck masses, carotid-body tumor, cervical lymph nodes, neck-dissection anatomy, congenital musculoskeletal conditions, thoracic-outlet links, and penetrating-neck trauma. Management points are intentionally concise and should be interpreted with age, airway status, vascularity, imaging, tissue diagnosis, and clinical severity.

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Priority Guide: 🔴 Core / Must Know | 🟠 Important | 🟡 Additional

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🎯 High-Yield Overview

• SCM divides the neck into anterior and posterior triangles; motor supply → CN XI.
• Posterior-triangle surgery can injure the spinal accessory nerve → shoulder droop + weak shrug.
• Midline neck mass moving with swallowing and tongue protrusion → thyroglossal duct cyst → Sistrunk procedure with central hyoid removal.
• Lateral cystic mass along anterior SCM in a young patient → classic second branchial cleft cyst.
• Child + soft posterior-triangle multiloculated/transilluminant mass → cystic hygroma / lymphatic malformation.
• Pulsatile upper-neck mass at carotid bifurcation + Fontaine sign + Lyre sign → carotid-body paraganglioma; avoid blind biopsy.
• Virchow node = left supraclavicular node; gastric/abdominal malignancy is the classic association.
• Radical neck dissection → levels I–V + SCM + SAN + IJV; modified radical preserves one or more nonlymphatic structures.
• Torticollis → head tilts toward affected SCM, chin rotates away; Klippel–Feil → fused cervical vertebrae; Sprengel → elevated scapula.
• Penetrating wound violating platysma + hard signs/instability → airway/operative action; stable symptomatic patient → CTA-based evaluation.

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RED FLAGS: Stridor, drooling, respiratory distress, rapidly expanding hematoma, major active bleeding, neurologic deficit, or deep-neck sepsis requires urgent airway/vascular assessment. A persistent hard/fixed or cystic lateral neck mass in an adult requires malignancy evaluation rather than assuming a benign congenital cyst.

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1. NECK TRIANGLES, SCM & KEY SURGICAL ANATOMY

2. NECK-MASS APPROACH & ADULT SAFETY RULE

3. CONGENITAL NECK MASSES — THYROGLOSSAL, BRANCHIAL & LYMPHATIC

4. CAROTID BODY TUMOR & CAROTID SINUS vs BODY

5. CERVICAL LYMPH NODES, VIRCHOW, TB & LYMPHOMA