THE NECK FASCIA

Question 1

LAYERS OF THE NECK FROM SUPERFICIAL TO DEEP

Answer 1

1. platysma
2. investing layer/ superficial to the deep cervical fascia
3. infrahyoid fascia
4. paratracheal/visceral fascia
5. carotid fascia
6. buccopharyngeal
7. prevertebral fascia

Question 2

There are two fascias in the neck

Answer 2

1. superficial cervical fascia

2. deep cervical fascia

Question 3

deep cervical fascia

Answer 3

1. deep fascia/ investing layer
2. pretracheal fascia
3. prevertebral fascia
4. carotid sheath

Question 4

1. investing layer

Answer 4

a. it is the most superficial to all deep cervical fascia
b. surrounds all the structures in the neck
c. where it meets the trapezius and the sternocleidomastoid muscle is split, completely enclosing them

Question 5

investing layer attachments

Answer 5

1. S= external occipital protuberance and superior nuchal lines
2. A= hyoid bone
3. I= spine, clavicle, acromin of the cravicle, manubrium of the stenum
4. P= nuchal ligaments of the vertebral column

Question 6

compartment contents of investing layer

Answer 6

1. trapezius
2. sternocleidomastoid
3. parotid gland
4. submandibular gland
5. suprasternal space

Question 7

2. paratracheal/visceral fascia

Answer 7

a. found in the anterior of the neck
b. spans superiorly from the hyoid bone to the thorax inferiorly where it joins pericardium

it is divided into

1. muscular part= encloses infrahyoid muscles
2. visceral part= trachea, esophagus, thyroid gland, pharynx, larynx

the posterior aspect of this fascia has contributions from the buccal pharyngeal fascial which covers the pharynx

Question 8

3. prevertebral fascia

Answer 8

a. surrounds the vertebral column with its associated muscles, scalene muscles, prevertebral muscles, and the deep muscles oof the back.
b. The anterolateral portion of the prevertebral fascia forms the floor of the posterior triangle of the neck. It also surrounds the brachial plexus as it leaves the neck and subclavian artery as it passes through the lower neck region – in doing so, it forms the axillary sheath.

Question 9

attachments of the prevertebral fascia

Answer 9

Superior attachment – base of the skull.

Anterior attachment – transverse processes and vertebral bodies of the vertebral column.

Posterior attachment – along the nuchal ligament of the vertebral column

Inferior attachment – fusion with the endothoracic fascia of the ribcage.

Question 10

carotid sheath

Answer 10

a. paired structures on either side of the neck enclosing important next neurovascular bundle

The fascia of the carotid sheath is formed by contributions from the paratracheal, prevertebral, and investing fascia layers. The carotid artery bifurcates within the sheath into the external and internal carotid arteries.

The carotid fascia is organized into a column, which runs between the base of the skull to the thoracic mediastinum. This is of clinical importance as a pathway for the spread of infection.

Question 11

contents of the carotid sheath

Answer 11

Common carotid artery
Internal jugular vein.
Vagus nerve.
Accompanying cervical lymph nodes

Question 12

superficial cervical fascia

Answer 12

The superficial cervical fascia lies between the dermis and the deep cervical fascia. It contains numerous structures:

Neurovascular supply to the skin
Superficial veins (e.g. the external jugular vein)
Superficial lymph nodes
Fat
Platysma muscle

Question 13

platysma

Answer 13

The superficial cervical fascia blends with the ‘paper thin’ platysma muscle. The platysma is a broad superficial muscle that lies anteriorly in the neck.

It has two heads, which originate from the fascia of the pectoralis major and deltoid. The fibers from the two heads cross the clavicle, and meet in the midline, fusing with the muscles of the face. Superiorly, the platysma inserts into the inferior border of the mandible.

Innervation to the platysma is via the cervical branch of the facial nerve.