Deep cervical fascia

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Deep cervical fascia
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Section of the neck at about the level of the sixth cervical vertebra. Showing the arrangement of the fascia colli.
Anatomical terminology

The deep cervical fascia (or fascia colli in older texts) lies under cover of the platysma, and invests the muscles of the neck; it also forms sheaths for the carotid vessels, and for the structures situated in front of the vertebral column. Its attachment to the hyoid bone prevents the formation of a dewlap. [1]

Contents

The investing portion of the fascia is attached behind to the ligamentum nuchæ and to the spinous process of the seventh cervical vertebra.

The alar fascia is a portion of the deep cervical fascia.

Divisions

The deep cervical fascia is often divided into a superficial, middle, and deep layer.

The superficial layer is also known as the investing layer of deep cervical fascia. It envelops the trapezius, sternocleidomastoid, and muscles of facial expression. It also contains the submandibular and parotid salivary gland as well as the muscles of mastication (the masseter, pterygoid, and temporalis muscles).

The middle layer is also known as the pretracheal fascia. It envelopes the strap muscles (sternohyoid, sternothyroid, thyrohyoid, and omohyoid muscles). It also surrounds the pharynx, larynx, trachea, esophagus, thyroid, parathyroids, buccinators, and constrictor muscles of the pharynx.

The deep layer is also known as the prevertebral fascia. It surrounds the paraspinous muscles and cervical vertebrae. [2]

The carotid sheath is also considered a component of the deep cervical fascia.

Superior extent of the investing fascia

Above, the fascia is attached to the superior nuchal line of the occipital bone, to the mastoid process of the temporal bone, and to the whole length of the inferior border of the body of the mandible. [3]

Opposite the angle of the mandible the fascia is very strong, and binds the anterior edge of the sternocleidomastoideus firmly to that bone.

Between the mandible and the mastoid process it ensheathes the parotid gland—the layer which covers the gland extends upward under the name of the parotideomasseteric fascia and is fixed to the zygomatic arch. It also contributes to the sheath of the digastric.

At the level of the jaw, it splits to enclose the submandibular gland, with the upper leaflet inserting on the mylohyoid line just inferior to mylohyoid and the inferior leaflet inserting onto the lower margin of the jaw. The posterior portion of the upper leaflet helps separate the parotid gland from the submandibular gland where the mylohyoid is deficient while the posterior border is thickened into a strong band extending between the angle of the jaw and the temporal styloid process, forming the stylomandibular ligament. It is complemented by the pterygospinous ligament, which stretches from the upper part of the posterior border of the lateral pterygoid plate to the spinous process of the sphenoid.

It occasionally ossifies, and in such cases, between its upper border and the base of the skull, a foramen is formed which transmits the branches of the mandibular nerve to the muscles of mastication.

Inferior extent of the investing fascia

Below, the fascia is attached to the thoracic outlet (acromion, clavicle, and manubrium). In doing so, it bifurcates into two layers, superficial and deep.

The former is attached to the anterior border of the manubrium, the latter to its posterior border and to the interclavicular ligament.

Between these two layers is a slit-like interval, the suprasternal space (space of Burns); it contains a small quantity of areolar tissue, the lower portions of the anterior jugular veins and their transverse connecting branch, the sternal heads of the sternocleidomastoid, and sometimes a lymph gland.

Deeper fascial layers

The fascia which lines the deep surface of the sternocleidomastoideus gives off the following processes:

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Parotid gland animal organ

The parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the mandibular ramus, and secretes serous saliva through the parotid duct into the mouth, to facilitate mastication and swallowing and to begin the digestion of starches. There are also two other types of salivary glands; they are submandibular and sublingual glands. Sometimes accessory parotid glands are found close to the main parotid glands.

Submandibular gland

The paired submandibular glands are major salivary glands located beneath the floor of the mouth. They each weigh about 15 grams and contribute some 60–67% of unstimulated saliva secretion; on stimulation their contribution decreases in proportion as the parotid secretion rises to 50%.

Digastric muscle small muscle

The digastric muscle is a small muscle located under the jaw. The term "digastric muscle" refers to this specific muscle. However, other muscles that have two separate muscle bellies include the ligament of Treitz, omohyoid, occipitofrontalis.

External jugular vein

The external jugular vein receives the greater part of the blood from the exterior of the cranium and the deep parts of the face, being formed by the junction of the posterior division of the retromandibular vein with the posterior auricular vein.

Facial artery branch of the external carotid artery

The facial artery is a branch of the external carotid artery that supplies structures of the superficial face.

Common carotid artery One of the two arteries that supply the head and neck with blood

In anatomy, the left and right common carotid arteries (carotids) are arteries that supply the head and neck with oxygenated blood; they divide in the neck to form the external and internal carotid arteries.

Carotid sheath Anatomy of head neck region.

The carotid sheath is an anatomical term for the fibrous connective tissue that surrounds the vascular compartment of the neck. It is part of the deep cervical fascia of the neck, below the superficial cervical fascia meaning the subcutaneous adipose tissue immediately beneath the skin.

Occipital artery

The occipital artery arises from the external carotid artery opposite the facial artery. Its path is below the posterior belly of digastric to the occipital region. This artery supplies blood to the back of the scalp and sternocleidomastoid muscles, and deep muscles in the back and neck.

Superior thyroid artery artery

The superior thyroid artery arises from the external carotid artery just below the level of the greater cornu of the hyoid bone and ends in the thyroid gland.

Submandibular triangle corresponds to the region of the neck immediately beneath the body of the mandible

The submandibular triangle corresponds to the region of the neck immediately beneath the body of the mandible.

Carotid triangle portion of the anterior triangle of the neck

The carotid triangle is a portion of the anterior triangle of the neck.

Cervical lymph nodes Lymph nodes found in the neck

Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to a number of different pathological conditions including tumours, infection and inflammation.

Prevertebral fascia

The prevertebral fascia is a fascia in the neck.

Investing layer of deep cervical fascia most superficial part of the deep cervical fascia

The Investing layer of deep cervical fascia is the most superficial part of the deep cervical fascia, and it encloses the whole neck.

Pretracheal fascia

The pretracheal fascia is a portion of the structure of the human neck. It extends medially in front of the carotid vessels and assists in forming the carotid sheath.

Outline of human anatomy Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

Parapharyngeal space deep neck space near the pharynx

The parapharyngeal space, is a potential space in the head and the neck. It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area. It is also a key anatomic landmark for localizing disease processes in the surrounding spaces of the neck; the direction of its displacement indirectly reflects the site of origin for masses or infection in adjacent areas, and consequently their appropriate differential diagnosis.

Submandibular space fascial space of the head and neck

The submandibular space is a fascial space of the head and neck. It is a potential space, and is paired on either side, located on the superficial surface of the mylohyoid muscle between the anterior and posterior bellies of the digastric muscle. The space corresponds to the anatomic region termed the submandibular triangle, part of the anterior triangle of the neck.

References

This article incorporates text in the public domain from page 388 of the 20th edition of Gray's Anatomy (1918)

  1. Anatomy & Physiology, 8th Edition, McGraw-Hill Co., 2008.
  2. Lee, K.J. (2012). Essential Otolaryngology (10 ed.). McGraw Hill. pp. 559–60. ISBN   978-0-07-176-147-5.
  3. Meyers, E. S. (Errol Solomon); MacPherson, R. K. (Ronald Kenneth) (1939-01-01). The arrangement of the deep cervical fascia / by E.S. Meyers and R.K. MacPherson. Papers (University of Queensland. Dept. of Anatomy); v. 1, no. 1. Sydney: Australasian Medical Publishing.