Fascia of the neck Flashcards

1
Q

How is the neck viewed in cross-section?

A

Looking from feet

up to head

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2
Q

Where does the neck begin?

A

Inferior border of mandible

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3
Q

Where does the neck end?

A

Suprasternal notch of manubrium

Upper border of clavicle

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4
Q

What structures organise the contents of the neck?

A

Cervical fascia

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5
Q

What are the types of cervical fascia?

A

Superficial cervical fascia

Deep cervical fascia

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6
Q

How many superficial cervical fascia layers are there?

A

Just one

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7
Q

Where is the superficial cervical fascia located?

A

Just deep to the skin

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8
Q

What type of tissue is the superficial cervical fascia made up of?

A

Loose connective tissue that contains lots of adipose tissue

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9
Q

What structures does the superficial cervical fascia contain?

A

Superficial veins

Cutaneous nerves

Lymph nodes

Platysma

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10
Q

What type of tissue is the deep cervical fascia made up of?

A

Dense connective tissue

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11
Q

How many deep cervical fascia layers are there?

A

Three

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12
Q

What are the deep cervical fascia layers?

A

Investing layer

Pre-tracheal fascia

Pre-vertebral fascia

Carotid sheath

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13
Q

How are the deep cervical fascia layers arranged in the neck?

A

From anterior neck, superficial to deep

  • investing layer
  • pre-tracheal fascia
  • pre-vertebral fascia
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14
Q

What does the investing layer contain?

A

Surrounds the whole neck

Splits to contain the sternocleidomastoid muscle and the trapezius muscle

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15
Q

What is the investing layer attached to?

A

Superiorly attaches to

  • inferior border of mandible
  • mastoid process
  • superior nuschal line
  • external occipital protruberance
  • nuschal ligament
  • spinous processes

Inferiorly attaches to

  • superior border of manubrium
  • superior surface of clavicle
  • acromion of scapula
  • spine of scapula
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16
Q

Where is the pre-tracheal fascia located?

A

In the anterior part of the neck

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17
Q

What are the parts of the pre-tracheal fascia? How are they arranged?

A

Muscular layer - anteriorly

Visceral layer - posteriorly

Buccopharyngeal fascia - posterior wall

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18
Q

What does the muscular layer of the pre-tracheal fascia contain?

A

Infrahyoid muscles

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19
Q

What does the visceral layer of the pre-tracheal fascia contain?

A

Thyroid gland

Trachea

Oesophagus

20
Q

What do the muscular and visceral layers of the pre-tracheal fascia attach to?

A

Superiorly
-hyoid bone

Inferiorly
-fuses with fibrous pericardium

21
Q

What does the buccopharyngeal fascia (pre-tracheal fascia) attach to?

A

Superiorly
-base of skull

Inferiorly
-diaphragm

22
Q

What forms the carotid sheaths?

A

Contributions from other three deep cervical fascia layers

23
Q

How many carotid sheaths are there?

A

Two

24
Q

Where are the carotid sheaths located?

A

Posteriorly and laterally to pre-tracheal fascia

on each side

25
Q

What does the carotid sheath contain?

A

Common carotid/internal carotid after the common carotid has bifurcated

Internal jugular vein

Vagus nerve

Cervical lymph nodes

26
Q

How are the contents of the carotid sheath arranged within it?

A

Common carotid/internal carotid is more medial

Internal jugular vein is more lateral

Vagus nerve is more posterior

27
Q

Where does the carotid sheath begin and end?

A

Arch of aorta

to base of skull

28
Q

Where is the pre-vertebral fascia located in the neck?

A

In the posterior part of the neck

29
Q

What does the pre-vertebral fascia contain?

A

Vertebrae

Pre- and para-vertebral muscles

30
Q

What does the pre-vertebral fascia attach to?

A

Base of skull
vertebral bodies, transverse processes up to T3
nuschal ligament up to T3

31
Q

What does the pre-vertebral fascia continue laterally as?

A

Axillary sheath

32
Q

What does the axillary sheath contain?

A

Axillary artery
Axillary vein

Cords of brachial plexus

33
Q

What are the advantages of the deep cervical fascia?

A

Allows structures to move over each other easily

Allows easier separation of structures during surgery

34
Q

What is the retropharyngeal space?

A

Space between

  • buccopharyngeal fascia anteriorly
  • carotid sheaths laterally
  • pre-vertebral fascia posteriorly
35
Q

What does the retropharyngeal space contain?

A

Ages 0-4
-lymph nodes

Ages 4+
-loose connective tissue

36
Q

What is an advantage of the retropharyngeal space?

A

Allows the pharynx to expand when swallowing

37
Q

What is a disadvantage of the retropharyngeal space?

A

If infection develops in it

it could spread into the posterior mediastinum

38
Q

What happens if an infection reaches the posterior mediastinum?

A

Mediastinum becomes inflamed, mediastinitis

39
Q

Why is mediastinitis a more serious condition?

A

High mortality rate

40
Q

What usually causes infection in the retropharyngeal space?

A

Infection in upper respiratory tract first

  • nasal cavity
  • nasopharynx
  • oropharynx
41
Q

What group of people is infection in the retropharyngeal space commonly seen in?

A

Children under age 5 years

42
Q

What are the signs and symptoms of an abscess in the retropharyngeal space?

A

Visible bulge

Sore throat

Difficulty swallowing

Stridor

Immobility of neck

Fever

43
Q

How do retrosternal goitres extend retrosternally in the first place?

A

Passes down along the pre-tracheal fascia

into the thorax

44
Q

What are the signs and symptoms of a retrosternal goitre?

A

Stridor

Breathlessness

Facial oedema

45
Q

What causes stridor and breathlessness with a retrosternal goitre?

A

Compression of the trachea

46
Q

What causes facial odema with a retrosternal goitre?

A

Compression of veins

obstructs venous drainage