Fascial layers of the neck

Question 1

what is the fascia?

Answer 1

a layer of fibrous tissue that surrounds muscles, vessels and nerves

Question 2

what do the fascia layers in the neck act to do?

Answer 2

support and compartmentalise the structures present

Question 3

where does the superficial cervical fascia lie?

Answer 3

between the dermis and deep cervical fascia

Question 4

what does the superficial cervical fascia contain?

Answer 4

neurovascular supply to the skin
superficial veins (e.g. external jugular vein)
superficial lymph nodes
fat
platysma muscle

Question 5

how is double chin created in obese individuals?

Answer 5

extra fat is deposited in the superficial fascia

Question 6

where is the platysma muscle situated?

Answer 6

on anterior aspect of neck

Question 7

origin of platysma?

Answer 7

has 2 heads (L + R)

originate from fascia of pectorlis major and deltoid

Question 8

where do the 2 heads of the platsyma muscle meet?

Answer 8

fibres from the 2 heads cross the clavicle

meet in the midline, fusing with muscles of the face

Question 9

what is the motor innervation to the platysma muscle via?

Answer 9

cervical branch of the facial nerve

Question 10

what is the layers of the deep fascia? (superficial to deep)

Answer 10

investing
pre-tracheal
pre-vertebral

Question 11

describe the investing layer (location)?

Answer 11

surrounds all the structures in the neck

where it meets the trapezius + SCM muscles, splits into 2, completely surrounding them

Question 12

what are the attachments of the investing fascia?

Answer 12

thought of like a tube: has superior, anterior, inferior and posterior attachments

Question 13

what is the superior attachment of the investing fascia?

Answer 13

attaches to the external occipital protuberance (back of skull) and superior nuchal line (line across external occipital protuberance

Question 14

what is the anterior attachment of the investing fascia?

Answer 14

hyoid bone

Question 15

what is the inferior attachment of the investing fascia?

Answer 15

attaches to the spine and acromion of the scapula, clavicle and manubrium of the sternum

Question 16

what is the posterior attachment of the investing fascia?

Answer 16

along ligamentum nuchae (continuation of supraspinous ligament)

Question 17

where is the pretracheal layer of fascia situated?

Answer 17

anteriorly in the neck

Question 18

where does the pretracheal fascia span?

Answer 18

between the hyoid bone and the thorax - where it fuses with the pericardium

Question 19

what does the pretracheal fascia enclose?

Answer 19

trachea
oesophagus
thyroid gland
infrahyoid muscles

Question 20

how can the pretracheal fascia be divided anatomically?

Answer 20

into 2 parts:
muscular
visceral

Question 21

what does the muscular part of the pretracheal fascia enclose?

Answer 21

the infrahyoid muscles

muscular part encloses muscles

Question 22

what does the visceral part of the pretracheal fascia enclose?

Answer 22

thyroid gland, trachea, oesophagus

visceral around structures

Question 23

what is the posterior aspect of the visceral fascia formed by?

Answer 23

contributions from the buccopharyngeal fascia

Question 24

what is the buccopharyngeal fascia?

Answer 24

fascial covering of the pharynx

Question 25

what does the prevertebral fascia surround?

Answer 25

the vertebral column and its associated muscles (scalene, prevertebral and deep muscles of the back)

Question 26

what are the attachments of the prevertebral fascia?

Answer 26

antero/posterior | superio/inferior axes

Question 27

what is the superior attachment of the prevertebral fascia?

Answer 27

base of skull

Question 28

what is the anterior attachment of the prevertebral fascia?

Answer 28

transverse processes and vertebral bodies of the vertebral column

Question 29

what is the posterior attachment of the prevertebral fascia?

Answer 29

attaches along the ligamentum nuchae (continuation of supraspinous ligament)

Question 30

what is the inferior attachment of the prevertebral fascia?

Answer 30

fuses with endothoracic fascia of ribcage

Question 31

what forms the floor of the posterior triangle of the neck?

Answer 31

anterolateral portion of prevertebral fascia

Question 32

what does the prevertebral fascia also surround?

Answer 32

brachial plexus and subclavian artery as they leave the neck | forms the axillary sheath

Question 33

what are the carotid sheaths?

Answer 33

paired structures which enclose important vessels and nerves

Question 34

what forms the carotid sheaths?

Answer 34

contributions from all 3 deep cervical fascias (investing, pretracheal, prevertebral)

Question 35

what are the contents of the carotid sheath?

Answer 35

common carotid artery internal jugular vein vagus nerve cervical lymph nodes

Question 36

what happens to the common carotid artery within the carotid sheath?

Answer 36

bifurcates into internal and external carotid arteries

Question 37

clinical: how is the carotid fascia organised? where does it travel?

Answer 37

organised into a column runs from *base of skull* to *thoracic mediastinum* (spread of infection)

Question 38

clinical: how does neck fascia affect spread of infection?

Answer 38

compartmentalise structures within the neck layers of tough fascia define where infection can spread e.g. superficial skin abscess is prevented from spreading further into the neck by investing fascia

Question 39

clinical: where do infections posterior to the prevertebral fascia spread?

Answer 39

can erode through the prevertebral fascia, and drain into the retropharyngeal space

Question 40

what is the retropharyngeal space?

Answer 40

a space bewteen the pretracheal and prevertebral fascial layers

Question 41

clinical: where does the retropharyngeal space extend? what does this mean?

Answer 41

into the thorax, infection can spread to mediastinal contents

Question 42

clinical: where do infections between the investing fascia and visceral part of pretracheal fascia spread? causing?

Answer 42

spread inferiorly into the chest, causing infection of anterior mediastinum