Cervical Fascia Flashcards
What’s the origin and insertion of the platysma?
Origin: from the fascia covering pectoralis major and deltoid
Insertion: lower border of the mandible and blends with the muscle at the angle of the mouth.
Talk about the posterior and anterior insertion of the investing layer of the deep fascia.
Posteriorly, the fascia is attached to ligamentum nuchae and spine of C7 and then splits to surround the trapezius muscle and then forms the roof of the posterior triangle
Anteriorly and laterally the fascia splits again to surround the sternomastoid muscle and then forms the roof of the anterior triangle and blends with the corresponding fascia from the other side at the symphysis menti, body of hyoid, and manubrium sterni
Talk about the superior and inferior insertion of the investing layer of the deep fascia.
Superiorly, the fascia is attached to the superior nuchal line, the mastoid process and the lower border of the mandible. It splits between the angle of the mandible and the mastoid process to enclose the parotid gland forming the parotid fascia. The superficial part of it is attached to the zygomatic arch and the deep part is attached to the styloid process and tympanic plate.
Inferiorly the fascia is attached to the acromion, the clavicle and the manubrium.
What’s in the suprasternal space?
Lower ends of anterior jugular veins, jugular arch, sternal head of sternomastoid and some lymph nodes.
What are the structures that pierce the general investing fascia?
External jugular vein
Anterior facial vein
All cutaneous branches of cervical plexus.
Talk about the prevertebral fascia.
It covers the prevertebral muscles and extends from the base of the skull to the third thoracic vertebra, it covers the scalenus anterior muscle and the muscles forming the floor of the posterior triangle (scalenus medius, levator scapulae and splenius capitis)
What’s the origin of the axillary fascia?
The prevertebral fascia.
What’s the pretracheal fascia?
It’s a deep fascia that lies in front and on the sides of the trachea, it splits to envelop the thyroid gland connecting it to the arch of cricoid and the oblique line of thyroid cartilage.
Laterally it blends with the carotid sheath
Inferiorly it invests the inferior thyroid veins and is continuous with the fibrous pericardium.
Why does the thyroid gland move with the movement of the larynx?
Because the pretracheal fascia invests the thyroid gland and attaches it to the oblique line of thyroid and arch or cricoid cartilages.
What are the attachments of the carotid sheath?
Above it’s attached to the tympanic plate and petrous part of temporal bone
Anteriorly it’s continuous with the pretracheal fascia and posteriorly with the prevertebral fascia.
What are the contents of the carotid sheath?
Internal jugular vein laterally, common and internal carotid arteries medially, in the middle the lower four cranial nerves (above the level of the posterior belly of digastric) or the vagus nerve only (below), the sympathetic chain is embedded in the posterior wall and the ansa cervicalis in the anterior wall.
Mention the anterior, posterior and medial relations of the carotid sheath.
Anteriorly: sternomastoid muscle and infrahyoid muscles
Superior and middle thyroid veins
Thyroid lobe
Posteriorly: cervical vertebrae, inferior thyroid artery and vertebral artery.
Medially: larynx pharynx trachea esophagus with the RLN in between
