Cervical Fascia - Laboratory Identifications

Cervical Investing Fascia Attachments and Specialization

1. from posterior cervical spines (nuchal ligament)
2. envelops trapezius and sternocleidomastoid muscles
3. envelops strap muscles
4. envelops parotid gland (parotid fascia) and submandibular gland
5. superior limits - mandible anterior, scalp posterior
6. inferior limits - sternum, clavicle, acromion, vertebra prominens
7. creates a continuous collar (carpet)

Pretracheal Visceral Fascia Attachments and Specialization

1. surrounds the cervical viscera - thyroid gland, trachea, esophagus, recurrent laryngeal nerves
2. posterior: buccopharyngeal fascia (named part of pretracheal visceral fascia)
3. superior limit - thyroid cartilage
4. inferior limit - superior/anterior mediastinum

Prevertebral Fascia Attachments and Specialization

1. surrounds the intrinsic musculature of the cervical vertebral column
2. attached to the spinous processes of the cervical vertebrae
3. partly covers splenius capitis, levator scapula, scalene muscles, longus colli, longus capitus, anterior vertebral bodies
4. superior limit - base of skull near pharyngeal tubercle
5. inferior limit - continuous throughout thorax
6. alar layer of prevertebral fascia - second layer of prevertebral fascia attached to transverse processes, border for "danger space"
7. diverticulum of prevertebral fascia at interscalene triangle forms the axillary sheath
   1. space defined by axillary sheath is continuous with space defined by prevertebral fascia
   2. anesthesia of brachial plexus could block phrenic nerve - watch out for bilateral effects!

Spaces Defined by Cervical Fasciae

1. pretracheal space - defined by the collar of pretracheal fascia
   1. from thyroid cartilage to superior mediastinum
2. retropharyngeal space - defined by pretracheal visceral fascia (buccopharyngeal fascia part) and prevertebral fascia
   1. extends from the pharyngeal tubercle to the posterior mediastinum (where alar fascia blends with visceral fascia)
   2. especially important for considerations of spread infection
   3. infections can enter this space through compromise of the buccopharyngeal fascia (the "throat")
3. danger space - between alar layer of prevertebral fascia and prevertebral fascia
   1. from base of skull (pharyngeal tubercle) and extending inferiorly throughout the thorax

Related Structures

1. Platysma muscle
2. Sternocleidomastoid muscle
3. Superficial investing (cervical) fascia
4. Prevertebral fascia
5. Platysma muscle
6. Sternocleidomastoid muscle
7. Trapezius muscle
8. Superficial investing (cervical) fascia
9. Prevertebral fascia
10. Alar fascia
11. Carotid sheath
12. Common carotid artery
13. Internal jugular vein
14. Vagus nerve (CN 10)
15. Pretracheal visceral fascia
16. Buccopharyngeal visceral fascia
17. Thyroid gland
18. Trachea
19. Esophagus
20. Recurrent laryngeal nerve
21. Retropharyngeal space (retrovisceral)
22. Levator Scapula
23. Scalenus anterior
24. Scalenus medius
25. Scalenus posterior
26. Ventral ramus brachial plexus (C8)
27. Phrenic Nerve
28. Sympathetic trunk
29. Sternohyoid muscle
30. Sternothyroid muscle
31. Omohyoid muscles (anterior belly)
32. "Danger Space"
33. Longus Colli Muscle
34. Pretracheal space