The neck (from Old French col, from Latin collum) is the region of the body that connects the head to the thorax.

The neck is delimited in front by the throat, behind by the nape of the neck, below by the collarbones and above by the mandible.

At the level of the throat, the neck is crossed by the upper parts of the digestive system, the pharynx and the esophagus, and by the upper parts of the respiratory system, the larynx and the trachea. There are also four glands in the neck:

• The thyroid, located on the anterior face of the trachea, it secretes two thyroid hormones which act on the metabolism.
• Parathyroids are small glands located on the posterior surface of the thyroid, they secrete a hormone that acts on the level of calcium in the blood.
• The salivary glands which are represented by the parotid (located in front of the ears) and the submandibular (located under the jaw).
• The platysma muscle, it covers the front of the neck and allows movement of the mouth and tension of the skin of the neck.
• The sternocleidomastoid muscle, it is stretched on the sides of the neck between the sternum and the collarbone and the temporal bone. It allows flexion, tilting and rotation of the head.

Posteriorly, the nape of the neck consists of the seven cervical vertebrae of the spine, numbered from C1 to C7. They provide strength and mobility to the neck. The first two vertebrae, called the atlas (C1) and axis (C2), have a different morphology from the other vertebrae which gives them an important role in the mobility of the neck. The atlas articulates with the occipital bone of the head, which allows us to tilt our head in assent. The axis (C2) has a pivot function which allows the rotation of the atlas, and therefore of the head. The articulation between C1 and C2 allows the lateral head to rotate as a sign of denial.

Neck muscles

Many muscles cover the neck, they are attached to the skull, cervical vertebrae and collarbones. They allow mobility of the head and are for the most part in the form of a strap. We find among others:

Blood supply and nervous elements

The neck is crossed on each side by a common carotid artery which divides into the external and internal carotids, a vertebral artery and by two jugular veins (internal and external).

Many nerves travel through the neck, in particular the vagus (or pneumogastric nerve, a role in digestion and heart rate), phrenic (innervation of the diaphragm) and spinal (mobility and sensitivity of the limbs) nerves.

The main role of the neck is the support and mobility of the head thanks to its bone and muscle structure.

Due to all the structures it contains, it also has an important role in digestion, respiration, phonation and metabolism.

Cervicalgies. Neck pain can have many origins. They are, for example, attributable to:

• Muscle tension and stiffness: prolonged muscle contractions in the shoulders and back of the neck which can become painful. They usually result from maintaining a position for several hours or poor posture.
• Whiplash: It is commonly called whiplash (movement of the head forward, then backward). It can occur at the time of a car accident or a strong impact while playing a sport.
• Torticollis: involuntary muscle contraction of one of the muscles of the neck. It results in a strong pain in the neck as well as a blockage of movements. The person is found to be “stuck”.
• Cervical osteoarthritis: wear and tear of the cartilage located at the joints of the cervical vertebrae. This pathology mainly concerns people over the age of 50 and causes pain, headaches (headaches), stiffness of the neck. It is a chronic disease that progresses gradually over several years.

Herniated disc : the herniated disc corresponds to the protrusion of a portion of an intervertebral disc. These discs give flexibility to the column and serve as shock absorbers in the event of an impact. A herniated disc occurs when a disc weakens, cracks, or ruptures and part of the gelatinous nucleus erupts. It can affect any area of ​​the spine. In the case of the neck, we speak of a herniated cervical disc.

Inflammation

Angina: infection in the throat, and more specifically in the tonsils. It can extend to the entire pharynx. Angina is caused either by a virus – this is the most common case – or by bacteria and is characterized by a severe sore throat.

Laryngitis: inflammation of the larynx, especially in the vocal cords. Talking then becomes painful. There are two types of laryngitis: acute laryngitis and chronic laryngitis, and there are differences between child and adult laryngitis.

Pharyngitis: inflammation of the pharynx, most often due to a mild infection, caused by a virus or bacteria. When the inflammation also affects the nasal mucous membranes, it is called nasopharyngitis.

Cyst: A cyst is a cavity that contains a fluid or semi-solid substance that forms in an organ or tissue. The vast majority of cysts are not cancerous. In the neck, the most common is the cyst of the thyroglossal tract (3) (nearly 70% of congenital anomalies in this area). Of embryonic origin, it is the consequence of abnormal development of the thyroid during the first weeks of pregnancy. In 50% of cases it occurs before the age of 20. Infection is usually its main complication.

Lymphadenopathy (lymph nodes): most often, this is a lymph node that swells in response to an infection, such as a simple cold for example. However, there are many other possible causes of “swelling” occurring in the neck or throat. It is therefore advisable to consult your doctor in the slightest doubt in order to determine the origin.

Pathologies of the thyroid gland

Goiter: refers to an increase in the size of the thyroid gland. It is common, especially in women. Goiter in itself is not a disease. It can be present in a wide variety of diseases.

Thyroid nodule: It is not uncommon for a small mass to form in the thyroid gland, for reasons that are still often unknown. It is given the name of thyroid nodule.

Thyroid cancer: Thyroid cancer is a rather rare cancer. There are 4000 new cases in France per year (for 40 breast cancers). It concerns women at 000%. This cancer is often detected at an early stage. The treatment is then very effective with a cure in 75% of cases.

Hypothyroidism: consequence of insufficient hormone production by the thyroid gland. The people most affected by this condition are women after 50 years.

Hyperthyroidism: refers to an abnormally high production of hormones by the thyroid gland. It is less common than hypothyroidism. In people with hyperthyroidism, their metabolism works faster. They may feel nervous, have frequent bowel movements, shake and lose weight, for example.

Neck pain affects 10-20% of the adult population. To relieve and prevent these problems, it is possible to indulge in a few daily exercises that can quickly become habits.

For certain pathologies, such as laryngitis, certain recommendations can prevent you from becoming ill. For others, a diet rich in iodine will prevent deficiency, which is a risk factor for thyroid nodule for example. On the other hand, for other pathologies such as thyroid cancer or goiter, there is no means of prevention.

Medical imaging :

• Cervical ultrasound: a medical imaging technique based on the use of ultrasound, inaudible sound waves, which make it possible to “visualize” the interior of the body. Examination to confirm the presence of a cyst, for example, or thyroid cancer (measurement of the gland, presence of nodules, etc.).
• Scanner: A diagnostic imaging technique that involves “scanning” a given region of the body to create cross-sectional images using an X-ray beam. The term “scanner” is actually the name of the medical device, but it is commonly used to refer to the exam. We also speak of computed tomography or computed tomography. It can be used to determine the size of a cyst or the presence of a tumor for example.
• MRI (magnetic resonance imaging): medical examination for diagnostic purposes carried out using a large cylindrical device in which a magnetic field and radio waves are produced to generate very precise images, in 2D or 3D, of parts of the body (here neck and its internal parts). MRI provides detailed images of the cervical spine, nerves and surrounding tissue. It can be used to diagnose a trauma to the spine, a cervical hernia or a tumor of the spine for example.

Laryngoscopy: a test performed by a doctor to look at the back of the throat, larynx and vocal cords using an endoscope (a thin, tube-like instrument with a light source and a lens). It is carried out to seek for example the causes of pain in the throat, bleeding or to diagnose cancer.

Exploratory cervicotomy: surgical intervention which consists of opening the neck in order to remove a cyst or a lymph node whose nature is not known or for the search for a diagnosis.

Thyroid-stimulating hormone (TSH) assay: TSH assay is the best indicator for evaluating thyroid disease. It is used to diagnose hypo- or hyperthyroidism, to monitor thyroid pathology or is performed in people with goiter.

Parathyroid hormone (PTH) dosage: Parathyroid hormone (secreted by the parathyroid glands) plays a major role in regulating calcium in the body. A dosage is recommended in case of hypercalcemia (too high level of calcium in the blood or kidney stones for example.

The “giraffe boy” (7) is how a 15-year-old Chinese boy is nicknamed, who has the longest stroke in the world with 10 cervical vertebrae instead of 7. This is the consequence of a malformation that causes in boys pain and difficulty walking (compression of the nerves in the neck).

The giraffe, with its long neck, is the tallest land mammal. Being able to reach 5,30 m for males and 4,30 m for females, a giraffe however has the same number of cervical vertebrae as mammals, that is to say 7, which measures approximately 40 cm each (8) .