Lecture 11: Fascia & Viscera of the Neck

Fascia is a type of ____ formed primarily of ____ sheets or bands.

Dense regular connective tissue

Collagen

What are the three types of fascia from superficial to deep?

Superficial

Deep (investing)

Visceral

Visceral fascia surrounds ____.

Organs

Deep fascia surrounds ____.

Muscles

Bones

Neurovasculature

What are potential spaces? When can these spaces present a problem?

Layers between fascial layers that are normally pressed together

They can present a problem when they fill with gas or fluid

The superficial fascial layer of the neck is called ____.

Superficial cervical fascia

The deep fascial layer of the neck is called ____.

Deep cervical fascia

What muscle is derived from the superficial cervical fascia? What is the embryonic origin of this muscle?

Platysma

Paraxial mesoderm somites (myotome and hypomere)

What are the layers of the deep cervical fascia from superficial to deep?

Outer

Middle

Visceral

Inner (Pre-Vertebral)

Carotid Sheath

The outer layer of the deep cervical fascia surrounds the ____ muscles and ____ glands.

Sternocleidomastoid & Trapezius

Parotid & Submandibular

The middle layer of the deep cervical fascia surrounds the ____ muscles.

Infrahyoid (Strap) muscles

(Sterno, thyro, omo)

The visceral layer of the deep cervical fascia surrounds the ____.

Pharynx

Larynx

Trachea

Esophagus

Two sub-layers of visceral fascia are found within the visceral cervical fascia. The layer found anteriorly is the ____ while the layer found posteriorly is the ____.

Pretracheal fascia

Buccopharyngeal fascia

The inner layer of the deep cervical fascia surrounds the ____.

Vertebra

Spinal muscles

What are the components of the carotid sheath?

Internal jugular v

Common carotid a

CN X

DCLN

What nervous system structures are found embedded in the carotid sheath’s fascial layer, but not in the sheath itself?

Ansa cervicalis

Sympathetic chain

What fascial layer connects both carotid sheaths?

Alar fascia

The alar fascia is ____ to the buccopharyngeal fascia and ____ to the prevertebral fascia.

Posterior

Anterior

What space is found between the buccopharyngeal fascia and alar fascia? Where does this space extend to?

Retropharyngeal space, posterior to the pharynx

Superior mediastinum

The retropharyngeal space is prone to unilateral infections due to the presence of a ____.

Septum

What space is found between the alar fascia and prevertebral fascia? Where does this space extend to?

Alar space or Danger Space

Into the thorax, diaphragm, heart

What is the name of the superficial fascial layer of the head?

Superficial cranial fascia

What does the deep outer cranial fascia layer become?

Patotidomasseteric and temporal fasciae

What does the deep visceral cranial fascia layer become?

Buccopharyngeal fascia

Where is the buccal space found?

Between the buccopharyngeal and superficial cranial fascia

Where is the vestibular space found?

Between the oral mucosa and buccinator

At what cervical level do the common carotid arteries split into internal and external carotid arteries?

C4 vertebra/Upper thyroid cartilage

What does the carotid sinus contain?

Baroreceptors

What does the carotid body contain?

Chemoreceptors

What is syncope? What can it often be caused by?

Fainting

Compression of the carotid, cardiac arrhythmia, orthostatic fainting

To what structures does the external carotid artery go from most inferior to superior?

Superior thyroid a

Ascending pharyngeal a

Lingual a

Facial a

Occipital a

Posterior auricular a

Maxillary a

Superficial temporal a

To what structures does the internal carotid artery go?

Brain

Eyes

What is a carotid endartectomy?

The surgical correction of stenosis (narrowing) or removal of plaque from the carotid arteries

Why is having plaque in the carotid artery so dangerous?

Rupture of plaques in this region can travel up the internal carotid into the brain

The cervical viscera is composed of three layers. What are they?

Endocrine

Respiratory

Alimentary

What is included in the endocrine layer of the cervical viscera?

Thyroid

Parathyroid glands

What is included in the respiratory layer of the cervical viscera?

Larynx

Trachea

What is included in the alimentary layer of the cervical viscera?

Pharynx

Esophagus

What does the thyroid produce? Where was it developed? How does it compare in size to other endocrine glands?

Thyroid hormone (metabolism) & calcitonin (calcium metabolism)

The base of the tongue

Largest endocrine gland

What CN is associated with the thyroid? What specific branch? What is a common complication in thyroid biopsies?

CN X

Recurrent laryngeal nerve

RLN Palsy which can cause weak vocal cords

What do the parathyroid glands produce? What do they target?

Parathyroid hormone, phosphorus and calcitonin

Skeleton, kidneys, intestines

Note that there are two pairs of parathyroid glands, a superior and inferior pair

Salivary glands are ____ glands that begin ____ digestion. These glands are heavily ____.

Exocrine

Chemical

Vascularized