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LEARNING OUTCOMES

a) Demonstrate integrity of cranial nerves.

b) Interpret role of Neck tissue spaces in health &

disease.

c) Compare & contrast light & accomodation reflex.

d) Correlate epistaxis to its anatomiocal basis.

e) Illustrate cutaneous innervation of face, pinna &neck.

f) Interpret role of PNS in health & disease.

g) Correlate role of arterial anastomosis in Head& neck

to rapid wound healing.

CERVICAL FASCIA

Superficial Cervical FasciaDeep Cervical Fascia

Investing layer

Pretracheal Fascia

Preverterbral Fascia

Carotid Sheath

CERVICAL FASCIA

&

TRANSVERSE SECTION OF NECK

Definitions:

Cervical = neck region

Fascia = a sheet or band of fibrous tissue that forms an investment for muscles & various

organs of the body

SUPERFICIAL CERVICAL FASCIA

• Thin

• Covers the platysma

• May contain considerable amounts of adipose tissue

• Layer of loose connective tissue between dermis & deep fascia

DEEP CERVICAL FASCIA

DEEP CERVICAL FASCIA… INVESTING LAYER

• Surrounds the neck like a collar

• Splits around trapezius & SCM

• Posteriorly : meets the ligamentum

nuchae

• Attached to hyoid bone anteriorly

• Superiorly – superior nuchal line;

mastoid process, EOP, base of mandible

• Inferiorly – spine of scapula; acromion

process, clavicle & manubrium

• Between angle of mandible & mastoid

process - splits to enclose parotid

gland

• Between angle of mandible & styloid

process – becomes thickened and forms

stylomandibular ligament

• Enclose submandibular gland

DEEP CERVICAL FASCIA… PRETRACHEAL FASCIA

• Lies deep to infrahyoid strap muscles

• Attached to midline of hyoid bone &

oblique line of thyroid cartilage laterally

• Splits to enclose & suspend thyroid gland

• Pierced by thyroid vessels

• Laterally – fuses with carotid sheath

• Inferiorly – passes behind brachiocephalic

veins to blend with fibrous pericardium

• Provides a slippery surface for the up &

down gliding of trachea during swallowing &

neck movements

DEEP CERVICAL FASCIA… PREVERTEBRAL FASCIA

• Lies in front of prevertebral muscles

• Extends from base of skull in front of longus capitus & rectus capitus lateralis to body of

T3 veterbrae

• Covers muscles in the floor of the posterior triangle of neck

• Cervical plexus & subclavian artery lies deep to it

• Accessory nerve lie superficial to it

• Over the subclavian artery it becomes the axillary sheath

• Does not invest subclavian & axillary veins

• Provides a fixed surface on which pharynx, oesophagus & carotid sheath can

glide during neck movements & swallowing

DEEP CERVICAL FASCIA… CAROTID SHEATH

• Surrounds the carotid arteries;

internal jugular vein & vagus nerve

• Thin over the IJV because the vein

needs to be free to dilate during

increased blood flow

• Ansa cervicalis is embedded in anterior

wall

• Cervical symphatetics lie behind it

• Attached to base of skull at margins

of carotid canal

DEEP CERVICAL FASCIA… CAROTID SHEATH

CERVICAL FASCIA

Superficial Cervical FasciaDeep Cervical Fascia

Investing layer

Pretracheal Fascia

Preverterbral Fascia

Carotid Sheath

Common Carotid Artery

Internal Jugular Vein

Vagus Nerve

In front of prevertebral muscles

Forms floor of posterior triangle

Encloses & suspends thyroid gland

Encloses 2 muscles:

SCM & Trapezius

Encloses 2 glands:

Parotid & Submandibular

TRANSVERSE SECTION OF NECK

TRANSVERSE SECTION OF NECK

Deep cervical fascia

It is organized into several distinct layers

• Investing layer, which surrounds all structures in the neck;

• Prevertebral layer, which surrounds the vertebral column and the deep muscles associated with the back;

• Pretracheal layer, which encloses the viscera of the neck;

• Carotid sheaths, which receive a contribution from the other three fascial layers and surround the two major neurovascular bundles on either side of the neck.

Fascia of neck (transverse

view)

Fascia of the neck, sagittal

view

SUBMANDIBULAR GANGLION

• Parasympathetic peripheral

ganglion

• Relay station for secretomotor

fibres to submandibular and

sublingual salivary glands

• Topographically related to

lingual nerve

• Functionally connected to

facial nerve (chorda tympani)

• Lies on hyoglossus muscle just

above deep part of

submandibular gland

• Suspended by lingual nerve by

two roots

NERVE SUPPLY

Secretomotor pathway

Superior

salivatory

nucleus

Preganglionic fibres

Sensory root facial nerve

Geniculate

ganglion

facial

nerve

Submandibular

gland

Chorda tympani

Lingual

nerve

submandibular

ganglion

Postganglionic fibres

BLOOD SUPPLY

Facial artery

Cleft Palate

VOMER

Cleft palate

Primary palate

Secondary palate

R L

Hard

Soft

Uvula

Incisor Foramen

Skull

Brain +

Meninges

Spinal cord

Sinuses

Nose

Mandible

Teeth

Tongue

Cervical

vertebrae

Hyoid bone

Thyroid gland

Take Home Message?