Neck

Question 1

Describe the superficial fascia of the neck (what kind of layer)

Answer 1

Subcutaneous layer of adipose connective tissue

Question 2

What are the 4 contents of the superficial fascia of the neck?

Answer 2

1-Fat (of variable amount)
2-superficial lymph nodes
3-cutaneous nerves and vessels which supply the overlying skin
4-Platysma muscle

Question 3

What are the fasciae within the deep cervical fascia?

Answer 3

Deep investing fascia
Visceral (pretracheal) Prevertebral
Alar
Carotid sheaths

Question 4

Give a description of the deep investing fascia

Answer 4

Deep to superficial fascia

Wraps around the entire circumference of the neck like a fibrous collar

Question 5

What are the contents of the deep investing fascia?

Answer 5

The entire neck and its viscera

Encloses separately the sternocleidomastoid and the trapezius

Question 6

Where does the deep investing fascia attach superiorly?

Answer 6

superiorly:
1- inferior border of the mandible
2-body of hyoid
3-zygomatic arch
4-angle of mandible
5-mastoid process
6-styloid process

Question 7

Where does the deep investing fascia attach inferiorly?

Answer 7

1-Manubrium of sternum
2-clavicles
3-spines of scapulae
4-sternocleidomastoid 
5-trapezius

Question 8

Where does the deep investing fascia attach posteriorly?

Answer 8

Ligamentum nuchae

Question 9

What is important about the deep investing fascia’s attachment to the manubrium?

Answer 9

As it descends to the manubrium, the deep investing fascia divides into anterior and posterior sheets, creating the suprasternal space.

Question 10

What does this suprasternal space contain?

Answer 10

1-areolar tissue
2-fat
3-lymph nodes
4-portions of inferior thyroid veins
5-portions of anterior jugular venous arch

Question 11

Give a description of the visceral/pretracheal fascia.

Answer 11

Deep to deep investing fascia

Forms sheath around visceral unit of neck

Question 12

What are the contents of the visceral unit of the neck?

Answer 12

• pharynx –> oesophagus at C6
• larynx –> trachea at C6
• thyroid gland

Question 13

Where does the visercal fascia arise from superiorly?

Answer 13

1-hyoid bone

2-shared attachment with pharynx to base of skull

Question 14

Where does the visceral fascia extend to inferiorly and what does it blend with?

Answer 14

-superior mediastinum

blends with pericardium of heart

Question 15

What is the retropharyngeal space?

Answer 15

a fascial space behind the pharynx through which serous infections can spread down into the posterior mediastinum. (infections of the caused by impacted wisdom teeth)

Question 16

Give a description of the prevertebral fascia.

Answer 16

Posterior to the visceral unit

Surrounds the vertebral unit

Question 17

What are the contents of the prevertebral fascia?

Answer 17

The vertebral unit

Question 18

What is contained within the vertebral unit?

Answer 18

• 7 cervical vertebrae
• cervical portion of spinal cord
• 8 paired spinal nerves
• anterior vertebral muscles (flex)
• posterior vertebral muscles (extend)
• extends laterally into axillary sheath

Question 19

What is contained within the axillary sheath?

Answer 19

The brachial plexus

The Subclavian vessels

Question 20

What are the superior attachments of the prevertebral fascia?

Answer 20

Base of the skull

Question 21

What are the inferior attachments of the prevertebral fascia?

Answer 21

-posterior portion of sheath blends with investing fascia of back muscles
anterior portion of sheath blends with anterior longitudinal ligament of thoracic verebrae

Question 22

Give a description of the Alar fascia.

Answer 22

Between the prevertebral and visceral units

Question 23

What are the contents of the alar fascia?

Answer 23

Formed by division of anterior component of prevertebral fascia to form 2 potential spaces between the two units

Question 24

What are the attachments of the alar fascia and why does it attach here?

Answer 24

Binds to transverse processes on either side to limit the space laterally

Question 25

What is so vital about the alar space and the spread of infection?

Answer 25

The alar space extends from the base of the skull to the superior medastinum so infection can travel straight to the thorax!!!!!!!!!!!

Question 26

What are the spaces (retropharyngeal and alar) between deep cervical fascia filled with?

Answer 26

Loose areolar connective tissue.

Question 27

When do potential spaces within deep cervical fascia become real spaces?

Answer 27

Only when invaded and displaced by infective material (PUS) or occasioanlly by air (SURGICAL EMPHYSEMA)

Question 28

Give a description of the bilateral carotid sheaths.

Answer 28

Lateral to the visercal unit Bilateral tubes of fasica which extend from the base of the skull to the thoracic inlet

Question 29

What is contained within the carotid sheaths?

Answer 29

``` Bilateral: Common carotid artery Internal jugular vein Vagus nerve (CN X) Deep cervical lymphnodes ```

Question 30

What are the superior attachments of the carotid sheaths?

Answer 30

The base of the skull around the: - carotid canal - jugular foramen

Question 31

What are the anterior attachments of the carotid sheaths?

Answer 31

blends with visceral fascia

Question 32

What are the posterior attachments of carotid sheaths?

Answer 32

blends with prevertebral fascia

Question 33

What are the of benefits tubes of deep cervical fascia

Answer 33

prevent spread of infection from one compartment to another

Question 34

What is formed when the anterior rami of spinal nerves intertwine?

Answer 34

A plexus

Question 35

What do the anterior rami of spinal nerves give?

Answer 35

Sensor innervation

Question 36

What spinal nerves intertwine to for the cervical plexus?

Answer 36

C2, C3 and C4

Question 37

what does the cervical plexus give sensory innervation to?

Answer 37

The neck The shoulders The corner of the face (at angle of the mandible)

Question 38

How do the sensory nerves of the cervical plexus reach the spinal cord?

Answer 38

Leave the skin and superficial fascia and pierce the deep fascia to reach the spinal cord

Question 39

What is a 'nerve point'?

Answer 39

Where the plexus goes deep

Question 40

Where is the nerve point of the neck?

Answer 40

Posterior to the middle of the sternocleidomastoid's posterior border

Question 41

Describe the platysma muscle including innveration, blood supply, origin, insertion and action

Answer 41

A thin flat muscle within superficial fascia which overlies the sternocleidomastoid. Innervated by: CN VII Supplied by:branches of the Submental artery and Suprascapular artery Originates: subcutaneous tissue of infraclavicular and supraclavicular regions Inserts: base of mandible; skin of cheek and lower lip; angle of mouth; orbicularis oris Action: Draws the corners of the mouth inferiorly and widens it (as in expressions of sadness and fright). Also draws the skin of the neck superiorly when teeth are clenched

Question 42

Where do the superficial veins of the neck lie within?

Answer 42

The superficial fascia

Question 43

What are the superficial veins of the neck all part of?

Answer 43

The jugular venous system

Question 44

Where do superficial veins of neck drain to?

Answer 44

"Deep" internal jugular veins

Question 45

What are the 3 bilateral jugular veins called?

Answer 45

External jugular Anterior jugular Superior jugular communicating

Question 46

What are the branches of each of these bilateral jugular veins?

Answer 46

Posterior auricular vein directly into external jugular Retromandibular posterior division directly into external jugular Retromandibular anterior division and facial into common facial Common facial into superficial jugular communicating Anterior jugular and superficial jugular communicating superficially cross over internal jugular to drain into external jugular

Question 47

What potential space sits more anterior to the other?

Answer 47

The retropharyngeal space sits anterior to the alar space (important in sagittal cross section )