Fascial layers of the neck Flashcards

1
Q

what is the fascia?

A

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

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2
Q

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

A

support and compartmentalise the structures present

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3
Q

where does the superficial cervical fascia lie?

A

between the dermis and deep cervical fascia

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4
Q

what does the superficial cervical fascia contain?

A
neurovascular supply to the skin
superficial veins (e.g. external jugular vein)
superficial lymph nodes
fat
platysma muscle
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5
Q

how is double chin created in obese individuals?

A

extra fat is deposited in the superficial fascia

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6
Q

where is the platysma muscle situated?

A

on anterior aspect of neck

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7
Q

origin of platysma?

A

has 2 heads (L + R)

originate from fascia of pectorlis major and deltoid

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8
Q

where do the 2 heads of the platsyma muscle meet?

A

fibres from the 2 heads cross the clavicle

meet in the midline, fusing with muscles of the face

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9
Q

what is the motor innervation to the platysma muscle via?

A

cervical branch of the facial nerve

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10
Q

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

A

investing
pre-tracheal
pre-vertebral

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11
Q

describe the investing layer (location)?

A

surrounds all the structures in the neck

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

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12
Q

what are the attachments of the investing fascia?

A

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

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13
Q

what is the superior attachment of the investing fascia?

A

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

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14
Q

what is the anterior attachment of the investing fascia?

A

hyoid bone

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15
Q

what is the inferior attachment of the investing fascia?

A

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

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16
Q

what is the posterior attachment of the investing fascia?

A

along ligamentum nuchae (continuation of supraspinous ligament)

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17
Q

where is the pretracheal layer of fascia situated?

A

anteriorly in the neck

18
Q

where does the pretracheal fascia span?

A

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

19
Q

what does the pretracheal fascia enclose?

A

trachea
oesophagus
thyroid gland
infrahyoid muscles

20
Q

how can the pretracheal fascia be divided anatomically?

A

into 2 parts:
muscular
visceral

21
Q

what does the muscular part of the pretracheal fascia enclose?

A

the infrahyoid muscles

muscular part encloses muscles

22
Q

what does the visceral part of the pretracheal fascia enclose?

A

thyroid gland, trachea, oesophagus

visceral around structures

23
Q

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

A

contributions from the buccopharyngeal fascia

24
Q

what is the buccopharyngeal fascia?

A

fascial covering of the pharynx

25
Q

what does the prevertebral fascia surround?

A

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

26
Q

what are the attachments of the prevertebral fascia?

A

antero/posterior

superio/inferior axes

27
Q

what is the superior attachment of the prevertebral fascia?

A

base of skull

28
Q

what is the anterior attachment of the prevertebral fascia?

A

transverse processes and vertebral bodies of the vertebral column

29
Q

what is the posterior attachment of the prevertebral fascia?

A

attaches along the ligamentum nuchae (continuation of supraspinous ligament)

30
Q

what is the inferior attachment of the prevertebral fascia?

A

fuses with endothoracic fascia of ribcage

31
Q

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

A

anterolateral portion of prevertebral fascia

32
Q

what does the prevertebral fascia also surround?

A

brachial plexus and subclavian artery as they leave the neck

forms the axillary sheath

33
Q

what are the carotid sheaths?

A

paired structures which enclose important vessels and nerves

34
Q

what forms the carotid sheaths?

A

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

35
Q

what are the contents of the carotid sheath?

A

common carotid artery
internal jugular vein
vagus nerve
cervical lymph nodes

36
Q

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

A

bifurcates into internal and external carotid arteries

37
Q

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

A

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

38
Q

clinical: how does neck fascia affect spread of infection?

A

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

39
Q

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

A

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

40
Q

what is the retropharyngeal space?

A

a space bewteen the pretracheal and prevertebral fascial layers

41
Q

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

A

into the thorax, infection can spread to mediastinal contents

42
Q

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

A

spread inferiorly into the chest, causing infection of anterior mediastinum