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deep cervical
· superficial cervical fascia is also called cervical subcutaneous tissue. It is a layer of fatty
connective tissue in between the investing layer of deep cervical fascia and dermis of the^ skin.
It contains blood vessels , lymphatic vessels , lymph nodes. Anterolaterally it has the platysma.
· Deep cervical fascia : also called fascia colli , it has the following layers :
a. Investing layer :
· it lies deep into the platysma, and surrounds the neck like a collar. It forms roof
of anterior
and posterior triangle.
· Superiorly (horizontal extent) :
1) External^ occipital protuberence
2) Nuchal^ lines
3) Mastoid^ process , styloid process
4) External^ acoustic^ meatus , tympanic plate
5) Base^ of mandible
· Between the mastoid process and base of the mandible , the fascia splits to enclose the parotid
gland.
· superficial lamina is thick and dense and attaches to the zygomatic arch. -PaROTID fascia
· Deep Lamina is thin and attaches to styloid process , tympanic plate and base of mandible
· Between styloid process and angle of mandible the fascia thickens to form stylomandibular ligame
- it (^) which (^) separates the
parotid gland from^ the^ submandibular^ gland.
· At the base of the mandible it encloses the submandibular gland.
· inferiorly (vertical extent) :
1) spine of scapula
2) Acromion^ process
3) clavicle
4) manubrium
· the fascia splits to enclose suprasternal and supraclavicular spaces
· Posteriorly : 1) ligamentum nuchae
2)Spine of 7th^ cervical^ vertebra
· anteriorly : 1) Hyoid bone
2)symphysis menti
· other features : &
d. Suprasternal space :^ 1) Jugular venous arch
Space of Burns 2) lymph node
3) sternal head of sternocleidomastoid
4) interclavicular^ ligament
b SUPRaClaviCULAR space :^ 1) External jugular vein
2) supraclavicular nerves
· fascia thickens twice to form : 1) stylomandibular ligament
2) Partidomassetric^ fascia
· covers- 2 muscles : Trapezius + sternocidomastoid
2 spaces : Suprasternal + supraclavicular
2 glands :^ Parotid + submandibular
2 facial slings :^ inferior body of amohyoid +^ intermediate tendon^ of diagastric
· it forms
pulleys for^ the^ attachment^ of tendon^ of^ diagastric and^ omonyoid
· applied anatomy : 2. Parotid swelling can be very painful
b. While excising submandibular gland , we should be careful about the
external carotid artery as it can slip from stylomandibular ligament
and cause severe bleeding.
c. Division of external jugular vein in supraclavicular space can cause air
embolism (^).
b. Pretracheal fascia :
· superiorly : 1) Hyoid bone (medially
- Oblique line^ of thyroid cartilage (laterally
3) cricoid cartilage (more laterally)
· inferiorly : it encloses inferior thyroid veins , passes behind brachiocephalic veins and
finally
blends with arch (^) of aorta and fibrous (^) pericardium.
· on either side : it forms the carotid sheath and fuses with deep fascia of sternoceidomastoid.
· features : a. Posterior layer of thyroid capsule is thick , it extends a ligament called suspens
- ory ligament which attaches to the cricoid (^) cartilage or the (^) thyroid gland. It
prevents the^ gland^ from^ sinking^ into^ the^ mediastinum.
b. Fascia^ provides a slippery surface for movement of trachea during swallowing
· Relations : 1. The ansa cervicalis lies embedded in the anterior wall
of carotid
sheath .
2. The^ cervical^ sympathetic chain^ lies^ behind^ the^ sheath.
- It is^ overlapped (^) by the anterior border^ of sternocleidomastoid.
d. Buccopharyngeal fascia^ :^ it covers the^ constrictor muscles externally and^ extends supe
- efficially to buccinator muscle (^) and attaches to the pharyngeal tubercle.
· Retropharyngeal space lies posterior to fascia.
· Alar Fascia is an (^) ancillary layer that divides (^) retropharyngeal space in (^2)
parts
· the (^) posterior space between alar (^) and (^) prevertebral fascia is called 'dangerous
area of neck!
e. PHARYNGOBASILAR Fascia^ :^ it is^ especially thickened between the (^) upper (^) part of superior constrictor^ muscle^ and^ base^ of shull.^ Lies^ deep in^ pharyngeal
muscles.