Layers of the neck
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Layers of the neck






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    Layers of the neck Layers of the neck Presentation Transcript

    • Layers of the Neck 1
    • Layers of the Neck• Skin• Superficial fascia• Deep cervical fascia 2
    • A. The Skin 3
    • • Loosely attached anteriorly.• Posteriorly, the skin is very thick and adherent to the underlying structures with numerous sebaceous glands.• Well supplied with blood vessels, and has transverse lines. 4
    • • Lies immediately next to the skin;• Consists of fats and connective tissue;• Contains cutaneous nerves, superficial veins, superficial lymph nodes and platysma. 6
    • Components of the Superficial Fascia Structure Organ/ComponentMuscle Platysma O: deep fascia from the pectoralis major to the deltoid muscle I: lower border of the mandible A: depresses the mandibleNerves Cutaneous branches of the cervical plexusVeins External and anterior jugular veinsLymph Nodes Lie along the external jugular vein superficial to SCM 7
    • 1. External or Investing or Enveloping Layer2. Middle or Pretracheal Layer3. Internal or Prevertebral Layer 10
    • I. External or Investing or Enveloping Layer completely encircles and encloses the neck, including thesternocleido-mastoid and trapezius muscles. 11
    • • - it is attached posteriorly to the ligamentum nuchae, forming a roof over the anterior and posterior triangles of the neck. 12
    • • Components of the External or Investing layer: 1. 2 muscles – SCM and trapezius 2. 2 salivary glands - parotid and submandibular glands 3. 2 spaces - suprasternal space of burns and the space above the clavicle in the posterior triangle. 13
    •  Attachments of the External Layer1. Superior - inion, superior nuchal line, mastoid process, zygomatic arch and lower border of the mandible.2. Inferior - acromion process and spine of the scapula, clavicle and manubrium sterni.3. Anterior - it meets the corresponding opposite side at the midline4. Posterior - Ligamentum nuchae 14
    • 2. Middle or Pre-tracheal layer- lies deep to the deep investing fascia and- forms a sheath around the viscera andmuscles of the neck. 15
    • Attachments of the Middle or Pretracheal layer:1. Superior - thyrocricoid cartilage, arising from the inner surface of the deep fascia and encloses the SCM.2. Inferior - extends into the thorax and blends with the pericardium in the middle mediatinum. 16
    • • Two Divisions of the Middle or Pre-tracheal Layer1. Muscular Portion - located in front of the thyroid gland - encloses the infrahyoid muscles2. Visceral Portion - encloses the thyroid and parathyroid glands. 17
    • 3. Internal or Prevetebral Layer- arises from the investing layer opposite the trapezius. It ismuch thicker than the pre-tracheal layer.- covers the prevertebral muscles – longus colli, longuscapitis, scalenius anterior, scalenius medius, and scaleniusposterior. 18
    • Attachments of the Internal or Prevertebral Layer:1. Superior - base of the skull2. Inferior - anterior longitudinal ligament of the vertebral column.3. Posterior - ligamentum nuchae 19
    • Other Components of the Deep Cervical Fascia 20
    • 1. Carotid Sheath- a condensation of the deep cervical fascia which encloses the followingstructures:a. Common and internal carotid artery,b. Internal jugular veinc. Vagus nerved. Deep cervical lymph nodes 21
    • 2. Visceral Fascia- encloses the pharynx and esophagus, larynx and trachea 22
    • Potential Fascial Spaces 23
    • • Loose areolar tissue, and connective tissue fills the spaces between the various layers of the deep cervical fascia.• There are two important fascial spaces to consider: 24
    • Retropharyngeal Space - a potential space between the visceral unit anteriorly and the vertebral unit posteriorly.- It extends from the base of the skull down to the superior mediastinum. 25
    • Alar Space- a subdivision of the retropharyngeal space created by thealar fascia. It extends from the base of the skull above to thesuperior mediastinum below, and has been dubbed by someas danger space. 26
    • Clinical SignificanceSince these fascial spaces are filled with looseconnective tissue, it readily breaks downwhen invaded by infection, blood, air ortumor, making possible to spread the fromone region to the next. 27