Cervical Fascia

Question 1

Superficial cervical fascia contains which muscle

Answer 1

Platysma

Question 2

List the layers of the Deep cervical fascia

Answer 2

Deep cervical fascia
■ Investing
■ Pretracheal
■ Prevertebral
■ Carotid sheath

Question 3

Deep cervical fascia
■ Investing: contains
■ Pretracheal: contains
■ Prevertebral: contains
■ Carotid sheath: contains

Answer 3

Deep cervical fascia
■ Investing: sternocleidomastoid muscle, trapezius muscle
■ Pretracheal: larynx, trachea, thyroid gland, pericardium
■ Prevertebral: prevertebral muscles, phrenic nerve, brachial plexus, axillary sheath
■ Carotid sheath: carotid artery, internal jugular vein, vagus nerve

Question 4

List layers of Cervical fascia

Answer 4

Superficial Layer
Deep Layer

Question 5

List the layers of the deep layer of the cervical fascia

Answer 5

Superficial
Middle
Deep

Question 6

Superficial Layer of cervical fascia encloses

Answer 6

■ Platysma
■ Muscles of Facial Expression

Question 7

⬥ Superficial Layer of the Deep layer of Cervical Fascia encloses

Answer 7

⬥ Superficial Layer of the Deep Cervical Fascia (rule of two’s)
■ Muscles
● Sternocleidomastoid ● Trapezius
■ Glands
● Submandibular ● Parotid
■ Spaces
● Posterior Triangle
● Suprasternal space of Burns

Question 8

⬥ Middle Layer of the Deep layer of Cervical Fascia encloses

Answer 8

⬥ Middle Layer of the Deep Cervical Fascia
■ Muscular Division ● Infrahyoid Strap
Muscles
■ Visceral Division
● Pharynx, Larynx, Esophagus, Trachea, Thyroid
● Buccopharyngeal Fascia

Question 9

⬥ Deep Layer of Deep layer of Cervical Fascia consists of how many layers and mention what they enclose

Answer 9

⬥ Deep Layer of Deep Cervical Fascia
■ Alar Layer
● Posterior to visceral
layer of middle fascia
● Anterior to prevertebral layer
■ Prevertebral Layer
● Vertebral bodies
● Deep muscles of the neck

Question 10

⬥ Carotid Sheath
■ Formed by
■ Contains
■ what is the name of the space present

Answer 10

⬥ Carotid Sheath
■ Formed by all three layers of deep fascia
■ Contains carotid artery, internal jugular vein, and vagus nerve
■ “Lincoln’s Highway”

Question 11

Deep Neck Spaces
⬥ Entire Length of Neck: Superficial Space
■ Surrounds ——-
■ Contains
■ Involved with —— and superficial abscesses

Answer 11

Deep Neck Spaces
⬥ Entire Length of Neck: Superficial Space
■ Surrounds platysma
■ Contains areolar tissue,
nodes, nerves and vessels
■ Involved with cellulitis and superficial abscesses

Question 12

Deep Neck Spaces
Entire length of the neck
1.Retropharyngeal Space
■ Posterior to —— and ——
■ Anterior to —— layer of deep fascia
■ Extends from —— to T— -T—

Answer 12

Deep Neck Spaces
1.Retropharyngeal Space
■ Posterior to pharynx and esophagus
■ Anterior to alar layer of deep fascia
■ Extends from skull base to T1-T2

Question 13

Deep Neck Spaces
⬥ Entire Length of Neck:
.Danger Space
■ Anterior border is —— layer of deep fascia
■ Posterior border is —— layer
■ Extends from —— to —— and

Answer 13

Deep Neck Spaces
⬥ Entire Length of Neck: 2.Danger Space
■ Anterior border is alar layer of deep fascia
■ Posterior border is prevertebral layer
■ Extends from skull base to diaphragm and is so named because it contains loose areolar tissue and offers little resistance to the spread of infection

Question 14

Deep Neck Spaces
⬥ Entire Length of Neck:
Prevertebral Space
■ Anterior border is ———
■ Posterior border is ———.

Answer 14

Deep Neck Spaces
⬥ Entire Length of Neck: 3.Prevertebral Space
■ Anterior border is prevertebral fascia
■ Posterior border is vertebral bodies,ALL and deep neck muscles
■ Extends along entire length of vertebral column. Infection in this space tends to stay somewhat localized due to the dense fibrous attachments between the fascia and the deep muscles.

Question 15

Deep Neck Spaces
⬥ Entire Length of Neck
visceral Vascular Space
■ Carotid Sheath
■ Like the ——- space the visceral vascular space is quite compact, contains little areolar tissue and is resistant to the spread of infection. It is termed the “———” of the neck . It extends from the ——— into the ———

Answer 15

Deep Neck Spaces
⬥ Entire Length of Neck: 4.Visceral Vascular Space
■ Carotid Sheath
■ Like the prevertebral space the visceral vascular space is quite compact, contains little areolar tissue and is resistant to the spread of infection. It is termed the “Lincolin’s highway” of the neck . It extends from the base of skull into the mediastinum and because it receives contributions from all three layers of deep fascia it can become secondarily involved by infection in any other deep neck space by direct spread.

Question 16

Deep Neck Spaces
1.Submandibular Space
■ Anterior/Lateral———
■ Superior— ———
■ Inferior—- ———
■ Posterior/Inferior– ——

Answer 16

Deep Neck Spaces 1.Submandibular Space
⬥ Suprahyoid:
■ Anterior/Lateral—mandib
le
■ Superior—mucosa
■ Inferior—superficial layer of deep fascia
■ Posterior/Inferior–hyoid

Question 17

Deep Neck Spaces
⬥ Suprahyoid: Submandibular Space comprises
■ ——— Space
■ ——— Space

Answer 17

■ Sublingual Space

■ Submylohyoid Space

Question 18

Deep Neck Spaces
⬥ Suprahyoid: Submandibular Space comprises
■ Sublingual Space
■ Submylohyoid Space

Answer 18

Deep Neck Spaces
⬥ Suprahyoid: Submandibular Space comprises
■ Sublingual Space
● Areolar tissue
● Hypoglossal and lingual nerves
● Sublingual gland
● Wharton’s duct
■ Submylohyoid Space
● Anterior bellies of digastrics
● Submandibular gland
● (These two subdivisions freely communicate around the posterior border of the mylohyoid. )

Question 19

Deep Neck Spaces
⬥ Suprahyoid:
Parapharyngeal Space (pharyngomaxillary space )
■ Superior—
■ Inferior—
■ Anterior—
■ Posterior—
■ Medial—
■ Lateral—.
■ The parapharyngeal space communicates with ——— , ———, ——— and ——— spaces with important implications in spread of infection .

Answer 19

Deep Neck Spaces
⬥ Suprahyoid: 2.Parapharyngeal Space (pharyngomaxillary space )
■ Superior—skull base-petrous portion of temporal bone vs. sphenoid
■ Inferior—hyoid
■ Anterior—ptyergomandibular
raphe
■ Posterior—prevertebral fascia
■ Medial—buccopharyngeal fascia
■ Lateral—superficial layer of deep fascia,medial pterygoid and parotid .
■ The parapharyngeal space communicates with submandibular , retropharyngeal, parotid and masticator spaces with important implications in spread of infection .

Question 20

Deep Neck Spaces
⬥ Suprahyoid: Parapharyngeal Space comprises:
■ Prestyloid
● Medial: ———-fossa
● Lateral: ———-
● Contains———
■ Poststyloid
● Carotid sheath
● Cranial nerves IX, X, XII
● The stylopharyngeal aponeurosis of Zuckerkandel is formed by the intersection of the ——, —— and ——- fascia and acts as a barrier to the spread of infection from the prestyloid compartment to the poststyloid compartment.

Answer 20

Suprahyoid: Parapharyngeal Space comprises:
■ Prestyloid
● Medial—tonsillar fossa
● Lateral—medial pterygoid
● Contains fat, connective tissue, nodes
■ Poststyloid
● Carotid sheath
● Cranial nerves IX, X, XII
● The stylopharyngeal aponeurosis of Zuckerkandel is formed by the intersection of the alar, buccopharyngeal and stylomuscular fascia and acts as a barrier to the spread of infection from the prestyloid compartment to the poststyloid compartment.

Question 21

Deep Neck Spaces ⬥ Suprahyoid: Peritonsillar Space
■ Medial———
■ Lateral———
■ Superior———
■ Inferior———.

Answer 21

Deep Neck Spaces ⬥ Suprahyoid: Peritonsillar Space
■ Medial—capsule of palatine tonsil
■ Lateral—superior pharyngeal constrictor
■ Superior—anterior tonsil pillar
■ Inferior—posterior tonsil pillar.
■ This space contains loose areolar tissue, primarily in the area adjacent to the soft palate, which explains why the majority of peritonsillar abscesses will localize to the superior pole of the tonsil.

Question 22

Deep Neck Spaces
⬥ Suprahyoid:.——— and ——— Spaces
■ Formed by the ——— layer and contains:

Answer 22

Deep Neck Spaces
⬥ Suprahyoid:3.Masticator and Temporal Spaces
■ Formed by the superficial layer of deep cervical fascia and contains.
● ● ●
Masseter and pterygoids Temporalis.
The masticator space is in direct communication with the temporal space superiorly deep to the zygoma. The temporal space has as its lateral boundary the superficial layer of deep fascia and its medial boundary the periosteum of the temporal bone. It is subdivided into superficial and deep spaces by the body of the temporalis muscle. This space contains the internal maxillary artery and the mandibular nerve.

Question 23

Deep Neck Spaces ■ Suprahyoid:
4. Parotid Space
⬥ Formed by —— layer of deep fascia and from capsule into gland.
⬥ In addition to the parotid gland, this space contains the —-,—-,—-.
⬥ The fascial envelope is deficient on the supero-medial surface of the gland, facilitating direct communication between this space and the ——- space.

Answer 23

Deep Neck Spaces ■ Suprahyoid:4. Parotid Space
⬥ Formed by superficial layer of deep fascia and dense septa from capsule into gland.
⬥ In addition to the parotid gland, this space contains the parotid lymph nodes, the facial nerve and posterior facial vein.
⬥ The fascial envelope is deficient on the supero-medial surface of the gland, facilitating direct communication between this space and the parapharyngeal space.

Question 24

Deep Neck Spaces
⬥ Infrahyoid: Anterior Visceral Space
■ Formed by —— layer of deep fascia
■ Contains ———-.
This potential space runs from the —— cartilage into the ——— to the ———. Below the level of the thyroid gland this space communicates laterally with the ———— space .

Answer 24

Deep Neck Spaces
⬥ Infrahyoid: Anterior Visceral Space
■ Formed by middle layer of deep fascia
■ Contains thyroid, trachea, esophagus. This potential space runs from the thyroid cartilage into the anterior superior mediastinum to the arch of the aorta. Below the level of the thyroid gland this space communicates laterally with the retropharyngeal space .

Question 25

Retropharyngeal Abscess
■ —% occur in patients 6-12 months of age
■ —% occur before 6 years of age

Answer 25

Retropharyngeal Abscess
■ 50% occur in patients 6-12 months of age
■ 96% occur before 6 years of age