Deep Cervical Fascia: Deep Investing Fascia

Question 1

Deep investing fascia

Answer 1

Surrounds whole neck and splits to envelope trapezius and sternomastoid

Question 2

Relations posterior relations

Answer 2

1. Posterior
2. Lateral
3. Anterior
4. Superior
5. Inferior

Question 3

Posterior

Answer 3

1. Continuous with Ligamentum nuchae and C7 spine
2. Splits to surround trapezius
3. Form posterior triangle roof

Question 4

Lateral and anterior

Answer 4

1. Splits again to surround sternomastoid
2. Roofs anterior triangle
3. Becomes continuous with corresponding fascia of opposite side
4. In middle, it is attached to
   - smphysis menti
   - hyoid body
   - manubrium sterni

Question 5

Superior

Answer 5

1. Attached to
   - external occipital protuberance
   - superior nuchal line
   - mastoid process
   - mandible lower border
2. Between mandible angle and mastoid process, it splits to cover parotid gland forming parotid fascia
3. Superficial layer is fixed to zygomatic arch and deep layer to styloid process and tympanic plate
4. Part of parotid fascia from styloid process to mandible angle is thickened forming stylomandibular ligament

Question 6

Inferior

Answer 6

1. Attached to:
   - acromion
   - clavicle
   - manubrium
2. Short distance above sternum, it splits into 2 layers enclosing Supra-sternal space which contains:
   - lower end of anterior jugular veins
   - jugular arch connecting both anterior jugular veins
   - sternal head sternomastoid
   - some lymph nodes

Question 7

Structures piercing investing fascia

Answer 7

1. EJV: pierces it 1 inch above clavicle
2. Anterior facial vein: pierces it 1 finger below mandible
3. All cervical plexus cutaneous branches