The neck contains three layers of fascia - superficial, deep cervical, and prevertebral. The superficial fascia lies beneath the skin and contains nerves, veins and lymph nodes. The deep cervical fascia has three layers - investing, pretracheal, and prevertebral. It surrounds muscles and structures of the neck. Potential spaces between the fascial layers can allow spread of infection or tumors if invaded.

1. Layers of the Neck
1

2. Layers of the Neck
• Skin
• Superficial fascia
• Deep cervical fascia
2

3. A. The Skin
3

4. • 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

5. B. SUPERFICIAL FASCIA
5

6. • Lies immediately next to the skin;
• Consists of fats and connective tissue;
• Contains cutaneous nerves, superficial veins, superficial
lymph nodes and platysma.
6

7. Components of the
Superficial Fascia
Structure Organ/Component
Muscle Platysma
O: deep fascia from the pectoralis major
to the deltoid muscle
I: lower border of the mandible
A: depresses the mandible
Nerves Cutaneous branches of the cervical
plexus
Veins External and anterior jugular veins
Lymph Nodes Lie along the external jugular vein
superficial to SCM
7

8. C. DEEP CERVICAL FASCIA
8

9. THREE LAYERS OF THE DEEP
CERVICAL FASCIA
9

10. 1. External or
Investing or
Enveloping
Layer
2. Middle or
Pretracheal
Layer
3. Internal or
Prevertebral
Layer
10

11. I. External or Investing or
Enveloping Layer
completely encircles and encloses the neck, including the
sternocleido-mastoid and trapezius muscles.
11

12. • - it is attached posteriorly to the ligamentum nuchae, forming
a roof over the anterior and posterior triangles of the neck.
12

13. • 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

14.  Attachments of the External Layer
1. 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 midline
4. Posterior
- Ligamentum nuchae
14

15. 2. Middle or Pre-tracheal layer
- lies deep to the deep investing fascia and
- forms a sheath around the viscera and
muscles of the neck.
15

16. 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

17. • Two Divisions of the Middle or Pre-tracheal Layer
1. Muscular Portion
- located in front of the thyroid gland
- encloses the infrahyoid muscles
2. Visceral Portion
- encloses the thyroid and parathyroid glands.
17

18. 3. Internal or Prevetebral Layer
- arises from the investing layer opposite the trapezius. It is
much thicker than the pre-tracheal layer.
- covers the prevertebral muscles – longus colli, longus
capitis, scalenius anterior, scalenius medius, and scalenius
posterior.
18

19. Attachments of the Internal or
Prevertebral Layer:
1. Superior
- base of the skull
2. Inferior
- anterior longitudinal ligament of the vertebral column.
3. Posterior
- ligamentum nuchae
19

20. Other Components of the Deep
Cervical Fascia
20

21. 1. Carotid Sheath
- a condensation of the deep cervical fascia which encloses the following
structures:
a. Common and internal carotid artery,
b. Internal jugular vein
c. Vagus nerve
d. Deep cervical lymph nodes
21

22. 2. Visceral Fascia
- encloses the pharynx and esophagus, larynx and trachea
22

23. Potential Fascial Spaces
23

24. • 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

25. 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

26. Alar Space
- a subdivision of the retropharyngeal space created by the
alar fascia. It extends from the base of the skull above to the
superior mediastinum below, and has been dubbed by some
as danger space.
26

27. Clinical Significance
Since these fascial spaces are filled with loose
connective tissue, it readily breaks down
when invaded by infection, blood, air or
tumor, making possible to spread the from
one region to the next.
27