1. Structure of the Neck and Cervical Spine Flashcards
Neck anterior and inferior boundaries?
Importance?
Superior boundary: Base of skull & inferior border of mandible
Inferior boundary: Top of sternum, clavicle, acromion (anterior) & C7 (posterior)
Houses critical structures:
Serves as conduit for structures passing between head/thorax & head/upper limb
Boundaries of the anterior triangle of the neck?
Bounded by inferior border of mandible, anterior border of SCM & midline of neck (head-thorax connection; superior thoracic aperture [thoracic inlet])
Boundaries of the posterior triangle of the neck?
Posterior triangles: Bounded by posterior border of SCM, middle 3rd of clavicle & anterior border of trapezius (head/neck-upper limb connection; axillary inlet at base)
2 triangles of neck?
Anterior and posterior
2 region of the neck and their contents?
cervical region
Sternocleidomastoid region: SCM, nerves (great auricular, transverse cervical), external jugular vein (superior part)
Posterior cervical region: Trapezius, nerves (cutaneous branches of posterior rami of cervical spinal nerves)
What are the neck compartments?
Visceral
Vertebral
2 x vascular
Viceral compartment of neck, contents?
Contains parts of respiratory system, digestive system & endocrine glands
Vertebral neck compartment, contents?
Contains cervical vertebrae, spinal cord, muscles & cervical nerves
2 vascular compartments of the neck, contents?
On either side of visceral compartment
Contains blood vessels & nerves (CN X)
The compartments (vertical columns) of the neck are surrounded by ______!
The compartments (vertical columns) of the neck are surrounded by fascia!
Role of fascia in neck?
- Provides containment (varying rigidity) of muscles & viscera
- Provides slipperiness that allow structures to slide over each other (expansion/contraction, up/down)
- Serves as conduit for passage of neurovascular structures
Layers of the deep cervical fascia of the neck
1: Investing fascia (hugs muscles e..g SCM, trapezius) also called musculofascial collar
2. Pretracheal (ant to trachea)
3. Prevertebral
4. Carotid sheath (contains vascular compartment)
Superfical fascia layers?
cervical subcutaneous tissue and platysma muscle
Superficial neck fascia connects to..
- Continuous with superficial fascia of thorax
* Connects to mandible & facial muscles
Role of investing fascia? (part of deep fascia)
Encloses what structures?
- Surrounds neck completely except for superficial layer, same as deep fascia of limbs
- Encloses (‘invests’) SCM, trapezius & infrahyoid muscles
- Encloses (‘invests’) parotid & submandibular glands
What vessels pierces through the investing deep fascia of the neck?
External and anterior jugular veins and nerves
inc cervical plexus
Attachments of the investing fascia?
- Posterior: Ligamentum nuchae & C7 spinous process; surrounds trapezius
- Anterior: Hyoid bone; surrounds infrahyoid & SCM
- Superior: External occipital protuberance & superior nuchal line
- Inferior: Spine of scapula, acromion, clavicle, manubrium (see suprasternal space)
- Lateral: Mastoid process & zygomatic arch
The pretracheal fascia (as part of the deep neck fascia:
- Surrounds what?
- Attachments?
- Posteriorly called?
- Lateral relation?
- Anteriorly separates what?
- Pierced by which vessels?
- Surrounds viscera as visceral part (trachea, oesophagus & thyroid gland)
- Extends from hyoid bone to upper thoracic cavity (blends with fibrous pericardium & aortic arch)
- Posteriorly it is called buccopharyngeal fascia (runs from base of skull to thoracic cavity)
- Laterally fuses with carotid sheath (extends to C7)
- Anteriorly, it separates infrahyoid muscles from the trachea & thyroid glands (muscular part)
- Pierced by thyroid vessels
The prevertebral fascia (as part of the deep neck fascia:
- Surrounds what?
- Attachments?
- Pierced by which vessels?
- Relation to first rib?
- Surrounds vertebral column (including cervical nerves), pre- & post-vertebral muscles (scalenes, longus colli, longus capitus, deep cervical muscles)
- Pierced by cutaneous branches of cervical plexus
- Fixed to the cranial base (superior), blends with endothoracic fascia (inferior), blends with anterior longitudinal ligament at T3/4 (posterior)
- Prevertebral fascia extends laterally over the first rib to surround axillary vessels & brachial plexus as the axillary sheath
Prevertebral fascia of the deep fascia of the neck, attachments?
• Posterior: Along superior nuchal line to external
occipital protuberance
• Anterior: Attaches to basilar part of occipital
bone, area of jugular foramen & carotid canal
• Lateral: Mastoid process
Extends: from base of skull to superior mediastinum…
Neck deep fascia: carotid sheath-
Surrounds?
Juxtaposed to?
Runs from?
- Surrounds major vasculature (CCA, int CA, part ext CA, int JV) & CN X), other nerves, some cervical lymph nodes
- Juxtaposed to all other deep fascial types, receives contributions from each
- Runs from foramen of carotid canal to aortic arch
Where is the pretracheal space?
Between investing layer and pretracheal fascia. Area extends between neck and superior mediastrinum
Where is ‘True’ retropharyngeal space: ?
Between buccopharyngeal fascia & superficial prevertebral fascia (alar fascia); area extends between base of skull & superior mediastinum
Where is Danger (alar) space/fascial space?
Within prevertebral layer (alar fascia & deep prevertebral layer); covers anterior surface of transverse processes & bodies of cervical
vertebrae; area extends from base of skull through posterior mediastinum to diaphragm
