Deep Cervical Fascia: Anatomy and Clinical Significance, Study notes of Anatomy

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DEEP CERVICAL FASCIA

BY

DR.M.MD.MUSTAFA SHARIFF

DEPT OF ANATOMY

SENIOR LECTURER

SRMDC&H

DEEP CERVICAL FASCIA

• It is also called FASCIA COLLI
• The deep cervical fascia of neck is clinically very important for it forms various fascial spaces in the neck.
• It also provides capsule to the glands and invests the muscles in the region.

INVESTING LAYER

• It lies deep to the platysma and surrounds the neck like a collar.
• It forms the roof of the posterior triangle of the neck.
• It encloses the sternocleidomastoid and trapezius the two large superficial muscles of the neck on either side.

▪ Anterior and superiorly it is attached to the lower border of the mandible. ▪ Anteroinferiorly it is attached to the clavicle and manubrium sterni. Posteriorly : ▪ It is attached to the ligamentum nuchae , spine of the C 7 vertebrae, spine of scapula , acromian process of the scapula.

▪ The investing layer encloses two salivary glands namely the parotid and submandibular gland. ▪ Tracing the fascia upwards from the clavicle to the lower border of the mandible , it divides into two layers.

• Near the angle of mandible the investing layer divides into two layers to enclose the parotid gland.
• The superficial layer covers the gland and it is called as masseteric fascia.
• It is superiorly attached to the zygomatic arch.

• The deep layer of the fascia after covering the parotid gland goes towards the base of the skull.
• Between the angle of mandible and styloid process of temporal bone this fascia is thickened to form the stylomandibular ligament.

Contents of suprasternal space

• Jugular venous arch
• Anterior jugular veins
• Two heads of sternocleidomastoid muscle
• Interclavicular ligament

Clinical anatomy LUDWIGS ANGINA: o It is a triangular swelling due to infection in the submandibular region. o It is limited laterally by two halves of mandible and posteriorly by hyoid bone. o This is because of the attachments of investing layer of deep cervical fascia to the base of mandible and hyoid bone.

PRETRACHEAL FASCIA

• Superiorly it extends upto the hyoid bone.
• Inferiorly it extends into the thorax and joins the fibrous pericardium.
• Laterally it fuses with the carotid sheath and through this sheath it is continuous with the investing layer of deep cervical fascia.
• Medially it divides and encloses the thyroid gland.

• It forms the false capsule for the thyroid gland.
• The posterior capsule of the thyroid is thin and hence enlargement of the thyroid are directed posteriorly.
• The pretracheal fascia invest the infra hyoid muscles.
• This fascia is attached to the thyroid and cricoid cartilages and suspensory ligament of Berry.
• This ligament binds the thyroid gland to larynx.

PREVERTEBRAL FASCIA

• Superiorly it extends to the base of the skull.
• Inferiorly it extends into the posterior mediastinum and even extends into the abdomen.
• Hence a pus collection under this fascia may track down from the base of the skull to the abdomen.
• Laterally it extends to the carotid sheath , via it is connected to the investing layer of deep cervical fascia on the medial surface of the sternocleidomastoid muscle.

Function:

o To provide a fix base for gliding movements of pharynx, oesophagus and carotid sheath during movements of neck and during swallowing. o The abscess formed behind the prevertable fascia travel down into superior mediastinum upto T3-T4. o The abscess formed infront of prevertbral fascia to superior mediastinum and then the posterior mediastinum.