Neck Fascia (173-183)

Question 1

Name the fascial layers of the neck?;

Answer 1

Superfical layers:
-Superfical cervical fascia (between the dermis and the deep cervical fascia, blend with Platysma)

Deep layers:
- Investing layer of deep cervical fascia (surrounds all the structures in the neck, when meets Sternocleidomastoid & trapezius splits into two to surround),
- Pre-tracheal layer (is situated in the anterior neck, surround trachea, oesophagus, thyroid, infrahyoid muscles)
- Pre-vertebral layer (surround vertebral column & assoicated muscles)
- Carotid sheath (either side of neck between pre-vertebral and pre-tracheal layers)

Question 2

What structures are contained within the pre-tracheal fascia?;

Answer 2

Trachea, oesophagus, thyroid gland, infrahydoid muscles

Question 3

What structres are contained within the pre-vertebral fascia?
What structures are contained within Carotid sheath?;

Answer 3

Vertebral column (Vertebral arteries, spinal cord, vertebrae.), scalene muscles, prevertebral muscles, depp muscles of back.

(Carotid sheath- common carotid, internal jugular vein, Vagus nerve)

Question 4

What are the boundaries of the retropharyngeal space?;

Answer 4

Sits behind the pharynx

Anterior- pre-tracheal fascia.
Posterior- pre-vertebral fascia (Alar fascia).
Lateral- carotid sheath
Superior-base of skull
Inferior- posterior mediastinum

Question 5

What are the boundaries of the anterior triangle of the neck?;

Answer 5

Superiorly- mandible (inferior border). Lateralally- Sternocleidomastoid (anterior border). Medially- sagittal line down the midline of neck.

Question 6

What are the boundary of the posterior triangle of the neck?;

Answer 6

Anterior- Sternocleidomastoid (posterior border). Posterior- trapezius muscle (anterior border). Inferior- middle 1/3rd of clavicle.

Question 7

What are the sub-triangles of the neck and their boundaries?;

Answer 7

ANTERIOR TRIANGLES:
1. Carotid triangle (Superior- posterior belly of digastric, Lateral-sternocleidomastoid, Anterior/Inferior- superior belly of omohyoid muscle).
2. Submental triangle (Inferiorly-hyoid bone, Medially-midline of neck, Laterally- anterior belly of digastric).
3. Submandibular triangle (Superiorly-mandible, Anteriorly- anterior belly of digastric muscle, Posteriorly/Inferiorly- posterior belly of digastric muscle).
4. Muscular triangle (Superiorly- hyoid bone, Medially- midline of neck, Supero-laterally- superior belly of omohyoid muscle, Infero-laterally- sternocleidomastoid muscle).

POSTERIOR TRIANGLES:
occipital & subclavian triangles
Separated by inferior belly of omyhoid muscle

Question 8

What are the anterior branches arising from the external carotid artery?;

Answer 8

SALFOPMS (Some Angry Ladies Fighting Over PMS).
S- superior thyroid artery, (anterior branch)
A - ascending pharyngeal, (medial/deep branch)
L - Lingual artery, (anterior branch)
F - Facial artery, (anterior branch)
O - Occipital artery, (posterior branch)
P - Posterior auricular artery, (posterior branch)
M - Maxillary artery, (terminal branch)
S - Supericial temporal artery (terminal branch)

Question 9

How many levels of lymph nodes are there in the neck?;

Answer 9

7

Question 10

Where are neck level V and level VI lymph nodes located?;

Answer 10

V- posterior neck. VI- midline of neck

Question 11

What structures may be sacrified in a radial neck dissection?;

Answer 11

Sternocleidoomastoid, accessory nerve and internal jugular vein.