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CERVICAL
FASCIA
Dr. Rana Pratap Singh
JRII Surgery
M.L.B. MEDICAL COLLEGE
JHANSI
CERVICAL FASCIA
 Fascia means fibrous connective tissue which
binds together various structures of the body
 2 types- su...
SUPERFICIAL CERVICAL FASCIA
• The superficial cervical fascia is typically a
thin lamina covering the platysma muscle.
• I...
DEEP CERVICAL FASCIA
 Deep fascia around the neck is known as deep
cervical fascia or fascia colli as it forms a collar
a...
MODIFICATIONS OF DEEP CERVICAL
FASCIA
• Investing layer
• Pretracheal layer
• Prevertebral layer
• Carotid sheath
• Buccop...
INVESTING LAYER
• Above- external occipital
protuberance,mastoid
process, external acoustic
meatus, base of the
mandible
•...
Post-
7th cervical
vertebra,
ligamentum
nuchae
HORIZONTAL TRACING-
• Encloses 2 muscles-
trapezius &
sternocleidomastoid
• Forms roof of 2
triangle- anterior &
posterior...
• Forms 2 fascial slings for
omohyoid and
diagastric;
VERTICAL
TRACING
•Encloses 2 gland-
parotid &
submandibular salivary
gland
•Encloses 2 spaces-
suprasternal space &
suprac...
ENCLOSES 2 SPACES-
• Supraclavicular space
1.SUPRACLAVICULAR SPACE
•splitting of investing
layer medial 3rd of
clavicle & ...
2.SUPRASTERNAL SPACE
• Splitting of investing layer
at the upper border of
sternum which gets
attatched to anterior &
post...
CLINICAL ANATOMY
• Because of the presence of thick tough
parotido-masseteric fascia which covers the
parotid gland swelli...
PRETRACHEAL FASCIA
• IT Is one of the lamina of deep cervical fascia that
arises deep to sternocleidomastoid muscle
HORIZONTALLY
the fascia encloses
• thyroid gland
• trachea(ant)
• oesophagus(post)
• infrahyoid muscle
and then becomes
co...
VERTICALLY
The fascia is attached to
hyoid bone & then
downwards it encloses
thyroid gland & runs
downwards into sup
media...
CLINICAL ANATOMY
The fascia forms the outer
false capsule of thyroid
gland, posterior part of
which is thin & not well
def...
Thyroid gland moves with
deglutition as the posterior
aspect of the gland is
attatched to the cricoid
cartilage by a thick...
• Continuity of pretracheal
fascia with the
mediastinum leads to
spread of infection to
mediasinum from the
neck & vise ve...
PREVERTEBRAL FASCIA
• It is one of the lamina of deep cervical fascia that
arises deep to sternocleidomastoid muscle
• Lie...
• In front of vertebral
column fascia is
prominent and split in
two layers of fascia.
• Anterior- alar fascia .
Posterior-...
Attachments
Superior- Skull base.
Inferior attachments- T3.
Posterior attachments--
Spinous processes of cervical
and thor...
Horizontally
• It forms the floor of
the posterior
triangle & finally
extends upto axilla
as axillary sheath
enclosing the...
Vertically
• it extends from the skull
base upto the 3rd
thoracic vertebra
CLINICAL ANATOMY
• Due the extension of
prevertebral fascia as
axillary fascia infections
of vertebrae- caries
spine (tube...
• Prevertebral fascia
forms the posterior wall
of retropharyngeal
space
• Retropharyngeal absess
causes dysphagia
CAROTID SHEATH
• It is a fascial sheath situated deep to
sternocleidomastoid muscle on each of the
front of the neck
• For...
CONTENT
Internal jugular vein
laterally, coImmon carotid
artery ( in the lower part)
& internal carotid artery (
in the up...
BUCCOPHARYNGEAL FASCIA
• It is posterior to the
esophagus, which
separates the
esophagus from the
vertebral cervical fasci...
ALAR FASCIA
• The alar layer lies
between the
prevertebral layer and
the buccopharyngeal
fascia . The alar fascia
separate...
RETROPHARYNGEAL SPACE
 Posterior to
pharynx and
esophagus
 Anterior to alar
layer of
prevertibral
fascia.
 Extends from...
• Pediatrics
– Cause—suppurative
process in lymph nodes
• Nose, adenoids,
nasopharynx, sinuses
• Adults
– Cause—trauma,
in...
Danger Space
 Anterior border- alar
fascia
 Posterior border-
prevertebral layer
 Extends from skull
base to diaphragm ...
Danger Space infection from
– extension from retropharyngeal, prevertebral or
parapharyngeal space
Danger space infection...
PREVERTEBRAL SPACE
• Anteriorly by prevertebral
fascia
 Posteriorly by is vertebral
bodies
 Extends along entire length
...
Prevertebral space infection from
• Infection of the vertebral bodies
• Penetrating injuries.
• Tuberculosis of the spine ...
Thanks
cervical fascia
cervical fascia
cervical fascia
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cervical fascia

anatomy of fascia around neck

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cervical fascia

  1. 1. CERVICAL FASCIA Dr. Rana Pratap Singh JRII Surgery M.L.B. MEDICAL COLLEGE JHANSI
  2. 2. CERVICAL FASCIA  Fascia means fibrous connective tissue which binds together various structures of the body  2 types- superficial fascia & deep fascia Superficial fascia is subcutaneous- present just below the skin. Deep fascia is present around muscles blood vessels & organs of the neck
  3. 3. SUPERFICIAL CERVICAL FASCIA • The superficial cervical fascia is typically a thin lamina covering the platysma muscle. • It is hardly demonstrable as a separate layer but may contain considerable amounts of adipose tissue especially in females.
  4. 4. DEEP CERVICAL FASCIA  Deep fascia around the neck is known as deep cervical fascia or fascia colli as it forms a collar around the neck Lies deep to platysma muscle in the interval b/w muscles, vessels & organs of the cervical region. Gives various extensions or laminae around various structures of the neck
  5. 5. MODIFICATIONS OF DEEP CERVICAL FASCIA • Investing layer • Pretracheal layer • Prevertebral layer • Carotid sheath • Buccopharyngeal fascia • Alar fascia.
  6. 6. INVESTING LAYER • Above- external occipital protuberance,mastoid process, external acoustic meatus, base of the mandible • Below- spine of scapula, acromion process, clavicle, manubrium sterni • Front- hyoid bone & continuous with the fascia of the the opposite side
  7. 7. Post- 7th cervical vertebra, ligamentum nuchae
  8. 8. HORIZONTAL TRACING- • Encloses 2 muscles- trapezius & sternocleidomastoid • Forms roof of 2 triangle- anterior & posterior • Gives 2 lamina for pretracheal & prevertebral fascia
  9. 9. • Forms 2 fascial slings for omohyoid and diagastric;
  10. 10. VERTICAL TRACING •Encloses 2 gland- parotid & submandibular salivary gland •Encloses 2 spaces- suprasternal space & supraclavicular space •Forms 2 thickenings- parotidomassaeteric fascia & stylomandibular ligamen
  11. 11. ENCLOSES 2 SPACES- • Supraclavicular space 1.SUPRACLAVICULAR SPACE •splitting of investing layer medial 3rd of clavicle & gets attatched to anterior & posterior border of upper surface of clavicle Content of the space Supraclavicular nerves, external jugular vein
  12. 12. 2.SUPRASTERNAL SPACE • Splitting of investing layer at the upper border of sternum which gets attatched to anterior & posterior border of supra- sternal notch • known as space of burns Content of the space • Inter-clavicular ligament, sternal head of sternocleidomastoid muscle, jugular venous arch, loose areolar tissue
  13. 13. CLINICAL ANATOMY • Because of the presence of thick tough parotido-masseteric fascia which covers the parotid gland swellings of the parotid gland (mumps, parotitis) are very painfull
  14. 14. PRETRACHEAL FASCIA • IT Is one of the lamina of deep cervical fascia that arises deep to sternocleidomastoid muscle
  15. 15. HORIZONTALLY the fascia encloses • thyroid gland • trachea(ant) • oesophagus(post) • infrahyoid muscle and then becomes continuous with the fascia of the opposite side.
  16. 16. VERTICALLY The fascia is attached to hyoid bone & then downwards it encloses thyroid gland & runs downwards into sup mediastinum & finally gets attached to pericardium of the heart.
  17. 17. CLINICAL ANATOMY The fascia forms the outer false capsule of thyroid gland, posterior part of which is thin & not well defined. Hence thyroid swellings grows posteriorly & may compress the oesophagus causing dysphagia.
  18. 18. Thyroid gland moves with deglutition as the posterior aspect of the gland is attatched to the cricoid cartilage by a thickening of pretracheal fascia known as ligament of berry or suspensory ligament of thyroid gland.  During thyroid surgeries the ligament of berry has To be cut to mobilise the thyroid gland.
  19. 19. • Continuity of pretracheal fascia with the mediastinum leads to spread of infection to mediasinum from the neck & vise versa • Pretracheal fascia provides a free slippery base for the movement of the trachea during swallowing
  20. 20. PREVERTEBRAL FASCIA • It is one of the lamina of deep cervical fascia that arises deep to sternocleidomastoid muscle • Lies in front of cervical vertebrae & muscles in front of it
  21. 21. • In front of vertebral column fascia is prominent and split in two layers of fascia. • Anterior- alar fascia . Posterior-prevetebral • Space created by spliting is danger space which is part of prevertebral space.
  22. 22. Attachments Superior- Skull base. Inferior attachments- T3. Posterior attachments-- Spinous processes of cervical and thoracic vertebrae. Lateral attachments Transverse processes of cervical and thoracic vertebrae.
  23. 23. Horizontally • It forms the floor of the posterior triangle & finally extends upto axilla as axillary sheath enclosing the axillary vessels and nerves
  24. 24. Vertically • it extends from the skull base upto the 3rd thoracic vertebra
  25. 25. CLINICAL ANATOMY • Due the extension of prevertebral fascia as axillary fascia infections of vertebrae- caries spine (tuberculosis of vertebrae) may lead to spread of pus to the axilla, the pus may also point as an absess in the region of the posterior triangle
  26. 26. • Prevertebral fascia forms the posterior wall of retropharyngeal space • Retropharyngeal absess causes dysphagia
  27. 27. CAROTID SHEATH • It is a fascial sheath situated deep to sternocleidomastoid muscle on each of the front of the neck • Formation • Anterior wall- by pretracheal layer of deep cervical fascia • Posterior wall- by prevertebral layer of deep cervical fascia
  28. 28. CONTENT Internal jugular vein laterally, coImmon carotid artery ( in the lower part) & internal carotid artery ( in the upper part) medially, vagus nerve in b/w them in a posterior plane Relations- Anteriorly- ansa cervicalis Posteriorly – sympathetic trunk
  29. 29. BUCCOPHARYNGEAL FASCIA • It is posterior to the esophagus, which separates the esophagus from the vertebral cervical fascia and forms the anterior border of the retropharyngeal space.
  30. 30. ALAR FASCIA • The alar layer lies between the prevertebral layer and the buccopharyngeal fascia . The alar fascia separates the retropharyngeal and danger spaces and covers the cervical sympathetic trunk.
  31. 31. RETROPHARYNGEAL SPACE  Posterior to pharynx and esophagus  Anterior to alar layer of prevertibral fascia.  Extends from skull base to T1- T2
  32. 32. • Pediatrics – Cause—suppurative process in lymph nodes • Nose, adenoids, nasopharynx, sinuses • Adults – Cause—trauma, instrumentation, extension from adjoining deep neck space
  33. 33. Danger Space  Anterior border- alar fascia  Posterior border- 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.
  34. 34. Danger Space infection from – extension from retropharyngeal, prevertebral or parapharyngeal space Danger space infection may spread up to mediastinum
  35. 35. PREVERTEBRAL SPACE • Anteriorly by prevertebral fascia  Posteriorly by is vertebral bodies  Extends along entire length of vertebral column.
  36. 36. Prevertebral space infection from • Infection of the vertebral bodies • Penetrating injuries. • Tuberculosis of the spine may breach the space and form a Pott’s abscess.
  37. 37. Thanks

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