surface & radiological

Surface Markings amp Vertebral Levels

C2- Angle of Mandible C3- Hyoid Bone C4- Thyroid Notch C6- Cricoid Cartilage Trachea Esophagus begin C7- Vertebra Prominens T23- Upper border of Manubrium Suprasternal

notch T3 amp 4- Manubrium- overlies the aortic arch T5 to 8- Sternum- overlies the heart

bull Sternal Angle- T45- Approx level of 2nd pair of costal cartilages approx beginning and end of aortic arch bifurcation of trachea in to Rt amp Lt main bronchi

bull Xiphisternal joint- T9

bull Lowest part of costal margin-10th rib (the subcostal line)- passes through L3

bull Scapula superior angle- T2 spine of scapula- T3 Inferior Angle- T7Esophagus Approx length-25 cm Cervical superiorly- just below the level of cricoid

(cricopharyngeus muscle (C7))- 15 cm from incisors

Inferiorly- Thoracic inlet approx 18 cm T3 level at the level of suprasternal notch

bull Thoracic Esophagus Superiorly- level of T3 (18 cm from

incisors) Inferiorly- T10 or 11 Carina- 24-25 cm from incisors GE jn- Approx 40 cm from incisorsAJCC Classification Cervical (15-18 cm)

upper Thoracic (18-24 cm) mid Thoracic (24-32) Lower Thoracic (32-40)

bull Thorax- Lines of Orientation Midsternal Line- Lies in the Median Plane

over the sternum Midclavicular Line- Runs vertically

downward from the midpoint of the clavicle Anterior Axillary Line- Runs vertically

downwards from the anterior axillary fold Posterior Axillary Line- Runs Vertically

downwards from the posterior axillary fold

bull Midaxillary Line- Runs vertically downward from a point situated midway between the anterior and posterior folds

bull Scapular Line- Runs vertically downward on the posterior wall of the thorax passing through the inferior angle of the scapula (arms at sides)

bull Nipple (in males)-lies in the 4th intercostal space about 10 cm from midline

bull Apex Beat- in 5th intercostal space 9cm from midline (just below and medial to the nipple) Marks the lowest and outermost point at which the cardiac impulse can be palpated

bull Transpyloric Plane (of Addison)- Lies halfway between the suprasternal notch and pubis or approx one hands breadth below the xiphoid (L1 Level)

passes through the Pylorus the pancreatic neck the duodenojejunal flexure the fundus of the gall bladder the tip of the 9th costal cartilage and hila of the kidneys

Also corresponds to the level of termination of the Spinal Cord

bull Subcostal Plane- L3 Line joining the lowest point of the thoracic

cage on each side (inferior margin of the 10th rib)- passes through the origin of the inferior mesenteric artery

bull Plane of the Iliac Crests- L4 Corresponds to the level of the Aortic

bifurcation Useful landmark in performing LP

Neck

Triangles of the NeckTriangles of the Neck

The Anterior Region of the Neck

bull Has several palpable landmarks including the larynx trachea and sternal notch

bull The larynx ndash found in the middle of the neck ndash composed of multiple cartilages ndash thyroid cartilage

bull ldquoAdamrsquos applerdquo bull Inferior to the larynx are the cricoid cartilage and trachea bull Terminates at the sternal (jugular) notch of the manubrium and the

left and right clavicles

The Nuchal Region

bull The posterior neck region bull Houses the spinal cord cervical vertebrae and associated

structuresbull The bump at the lower boundary of this region is the vertebra

prominens

bull Superiorly along the midline of the neck is the ligamentum nuchae a thick ligament that runs from C7 to the nuchal lines of the skull

Left and Right Lateral Portions of the Neck

bull Contain the sternocleidomastoid muscles which partitions the neck into two clinically important triangles an anterior triangle and a posterior triangle

bull Each triangle houses important structures that run through the neck bull Triangles are further subdivided into smaller trianglesbull Anterior triangle lies anterior to the sternocleidomastoid muscle and

inferior to the mandible ndash subdivided into four smaller triangles

bull the submental submandibular carotid and muscular triangles

The Posterior Triangle

bull Lateral region of the neckbull Posterior to the sternocleidomastoid musclebull Superior to the clavicle inferiorlybull Anterior to the trapezius muscle bull Subdivided into two smaller triangles

ndash the occipital trianglendash supraclavicular triangle

Position of Nodes

1 Submental

2 Submandibular

3 Parotid tonsilar

4 Preauricular

5 Postauricular

6 Occipital

7 Anterior cervical superficial and deep

8 Supraclavicular

9 Posterior cervical

mdashNeck as seen from left anterior view

Som P M et al AJR 2000174837-844

copy2000 by American Roentgen Ray Society

bull AJCC(American Joint Committee on Cancer) classification

bull 1048723Level 1 ndashsubmental+ submandibularbull 1048723Level 2 ndashupper deep cx nodesbull 1048723Level 3 ndashmiddle deep cx nodesbull 1048723Level 4 ndashlower deep cx nodesbull 1048723Level 5 ndashspinal accessory + transverse cxbull 1048723Level 6 ndashpretracheal prelaryngeal

paratachealbull 1048723Level 7 ndashupper mediastinalnodes

Tonsils

Gluteal Region

bull The inferior border of the gluteus maximus muscle forms the gluteal fold

bull The gluteal (natal) cleft extends vertically to separate the buttocks into two prominences

bull In the inferior portion of each buttock an ischial tuberosity can be palpated these tuberosities support body weight while seated

bull The gluteus maximus muscle forms most of the inferolateral ldquofleshyrdquo part of the buttock

bull The gluteus medius muscle may be palpated only in the superolateral portion of each buttock

The Thigh

bull Many muscular and bony features are readily identified in the thigh which extends between the hip and the knee on each lower limb

bull An extremely important element of thigh surface anatomy is a region called the femoral triangle

bull The femoral triangle is a depression inferior to the groove that overlies the inguinal ligament on the anteromedial surface in the superior portion of the thigh

bull The femoral artery vein and nerve travel through this region making it an important arterial pressure point for controlling lower limb hemorrhage

Thigh and Knee

bull On the distal part of the anterior thigh are the three parts of the quadriceps femoris as they approach the knee

bull Still on the anterior side of the thigh three obvious skeletal features can be observed and palpated ndash (1) The greater trochanter is palpated on the superior

lateral surface of the thigh ndash (2) the patella is located easily within the patellar

tendon and ndash (3) the lateral and medial condyles of both the femur

and tibia are identified and palpated at each knee

Level Ia

Level Ia

CRANIAL Geniohyoid m plane tangent to basilar edge of mandible

CAUDAL Plane tangent to body of hyoid bone

ANTERIOR Symphysis menti platysma m

POSTERIOR Body of hyoid bone

LATERAL Medial edge of ant belly of digastric

MEDIAL na (midline)

Level Ib

Level Ib

CRANIAL Mylohyoid m cranial edge of submandibular gland

CAUDAL Plane through central part of hyoid bone


POSTERIOR Posterior edge of submandibular gland

LATERAL Basilar edge innerside of mandible platysma m skin

MEDIAL Lateral edge of ant belly of digastric

Level IIa

Level IIa

CRANIAL Caudal edge of lateral process of C1

CAUDAL Caudal edge of the body of hyoid bone

ANTERIOR Post edge of submandibular gland ant edge of int carotid artery post edge of post belly of digastric m

POSTERIOR Post Border of int jugular vein

LATERAL Medial edge of sternocleidomastoid

MEDIAL Medial edge of int carotid artery paraspinal (levator scapulae) m

IIA

Level IIb

Level IIb



ANTERIOR Post Border of int jugular vein

POSTERIOR Post border of the sternocleidomastoid m



IIB

Level III

III

CRANIAL Caudal edge of the body of hyoid bone

CAUDAL Caudal edge of cricoid cartilage

ANTERIOR Postero-lateral edge of the sternohyoid ant edge of sternocleidomastoid m

POSTERIOR Post edge of the sternocleidomastoid


MEDIAL Int edge of carotid artery paraspinal (scalenius) m

Level IV

Level IV

CRANIAL Caudal edge of cricoid cartilage

CAUDAL 2 cm cranial to sternoclavicular joint

ANTERIOR Anteromedial edge of sternocleido-mastoid m

POSTERIOR Post edge of the sternocleidomastoid m


MEDIAL Medial edge of internal carotid artery paraspinal (scalenius) m

Level V

Level V

CRANIAL Cranial edge of body of hyoid bone

CAUDAL CT slice encompassing the transverse cervical vesselsb

ANTERIOR Post edge of the sternocleidomastoid m

POSTERIOR Ant border of the trapezius m

LATERAL Platysma m skin

MEDIAL Paraspinal (levator scapulae splenius capitis) m

Level VI

Level VI

CRANIAL Caudal edge of body of thyroid cartilage

CAUDAL Sternal manubrium

ANTERIOR Skin platysma m

POSTERIOR Separation between trachea and esophagus

LATERAL Medial edges of thyroid gland skin and ant-medial edge of sternocleidomastoid m

MEDIAL na

Retropharyngeal nodes

Retropharyngeal

CRANIAL Base of skull

CAUDAL Cranial edge of the body of hyoid bone

ANTERIOR Fascia under the pharyngeal mucosa

POSTERIOR Prevertebral m (longus colli longus capitis)

LATERAL Medial edge of the internal carotid artery

MEDIAL Midline


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Neck

Slide 11

Triangles of the Neck


The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

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Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


bull Sternal Angle- T45- Approx level of 2nd pair of costal cartilages approx beginning and end of aortic arch bifurcation of trachea in to Rt amp Lt main bronchi

bull Xiphisternal joint- T9

bull Lowest part of costal margin-10th rib (the subcostal line)- passes through L3























Neck







The Nuchal Region



prominens










Position of Nodes

1 Submental

2 Submandibular

3 Parotid tonsilar

4 Preauricular

5 Postauricular

6 Occipital


8 Supraclavicular



Som P M et al AJR 2000174837-844





Tonsils

Gluteal Region






The Thigh





Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

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Slide 27

Slide 28

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Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI
























Neck







The Nuchal Region



prominens










Position of Nodes

1 Submental

2 Submandibular

3 Parotid tonsilar

4 Preauricular

5 Postauricular

6 Occipital


8 Supraclavicular



Som P M et al AJR 2000174837-844





Tonsils

Gluteal Region






The Thigh





Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

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Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI








The Nuchal Region



prominens










Position of Nodes

1 Submental

2 Submandibular

3 Parotid tonsilar

4 Preauricular

5 Postauricular

6 Occipital


8 Supraclavicular



Som P M et al AJR 2000174837-844





Tonsils

Gluteal Region






The Thigh





Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

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Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI










Position of Nodes

1 Submental

2 Submandibular

3 Parotid tonsilar

4 Preauricular

5 Postauricular

6 Occipital


8 Supraclavicular



Som P M et al AJR 2000174837-844





Tonsils

Gluteal Region






The Thigh





Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

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Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI



Som P M et al AJR 2000174837-844





Tonsils

Gluteal Region






The Thigh





Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

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Slide 28

Slide 29

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Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI





Tonsils

Gluteal Region






The Thigh





Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

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Slide 32

Slide 33

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Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Gluteal Region






The Thigh





Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

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Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


The Thigh





Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

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Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Thigh and Knee






Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

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Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Level Ia

Level Ia






MEDIAL na (midline)

Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

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Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Level Ib

Level Ib







Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Level IIa

Level IIa







IIA

Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Level IIb

Level IIb







IIB

Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Level III

III







Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Level IV

Level IV







Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Level V

Level V







Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


Level VI

Level VI






MEDIAL na


Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI



Retropharyngeal






MEDIAL Midline


Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Neck

Slide 11



The Nuchal Region



Position of Nodes

Slide 18

Slide 19

Slide 20

Tonsils

Gluteal Region

The Thigh

Thigh and Knee

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Level Ia

Level Ib

Level IIa

Level IIb

Level III

Level IV

Level V

Level VI


surface & radiological

Health & Medicine

lateral medial

cricoid cartilage

carotid artery

lateral process

posterior

runs verticallydownwards

sternocleidomastoidmedialmedial

femoral triangle