DEEP CERVICAL FASCIA

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deep cervical fascia
- pretracheal fascia
  - encloses and suspends thyroid gland
  - attachments
    - superiorly
      - hyoid bone in median plane
      - oblique line of thyroid cartilage laterally
      - cricoid cartilage
    - inferiorly
      - encloses inferiior thyroid veins
      - blends with arch of aorta and pericardium
    - on either side
      - forms front of carotid sheath
- buccopharyngeal fascia
  - covers superior constrictor muscle externally
  - extends on superficial aspect of buccinator muscle
- pharyngobasilar fascia
  - thickened between
  - upper border of superior constrictor
  - base of skull
- prevertebral fascia
  - lies infront of prevertebral muscles
  - attachments
    - superiorly
      - attached to base of skull
    - inferiorly
      - extends in to superior mediastinum to split in to
        
        anterior
        
        blends with buccopharyngeal fascia
        
        posterior layers
        
        attached to body of T4 vertebra
        
        also attached to anterior longitudinal ligament
    - laterally
      - lies deep to trapezius muscle
      - attached to fascia of sternocleidomastoid
    - anteriorly
      - separated from pharynx and buccopharyngeal fascia by
        
        retropharyngeal space
        
        retropharyngeal abscess
        
        lower part prevertebral fascia and buccopharyngeal fascia fuse
- other features
  - cervical plexus and brachial plexus behind this fascia
  - axillary sheath
- investing layer
  - deep to platysma
  - forms roof of posterior triangle
  - attachments
    - superiorly
      - external occipital protuberance
      - superior nuchal line
      - mastoid process, styloid process
      - external acoustic meatus , tympanic plate
      - base of mandible
      - superificial lamina
        
        splits fo form parotid fascia
    - inferiorly
      - spine of scapula
      - acromion process
      - clavicle
      - manubrium
    - anteriorly
      - symphysis menti
      - hyoid bone
  - other features
    - splits to enclose
      - muscles
        
        trapezius
        
        sternocleidomastoid
      - salivary gland
        
        submandibular
        
        while cutting this gland external carotid artery must be secured
        
        parotid gland
        
        parotid swelling are painful
      - space
        
        suprasternal
        
        containsright and left sternocleidomastoid heads
        
        jugular venous arch
        
        interclavicular ligament
        
        lymph node
        
        supraclavicular
        
        traversed by
        
        external jugular vein
        
        clinically division of vein can cause air embolism
        
        supraclavicular nerves
- carotid sheath
  - relations
    - anterior wall
      - ansa cervicalis
    - cervical sympathetic chain lies behind the sheet plastered to prevertebral fascia
    - overlapped by anterior birder of sternocleidomastoid
  - content
    - common or internal carotid arteries
    - vagus nerve
    - internal jugular vein