Human Anatomy - Kotsan I. Y. 2009

Muscles and Fascia of the Neck
Deep Muscles of the Neck
Fasciae, Fascial Sheaths, and Interfascial Spaces of the Neck

The complex interrelationships among the Muscles, Internal Organs, and major Vessels of the neck determine The Structure of the Cervical fascia, which is why various researchers describe it differently. They classify the fascia based on embryological, topographic-anatomical, and other criteria.

According to the International Anatomical Nomenclature, There is a single cervical fascia (fascia cervicalis), which is subdivided into the superficial, pretracheal, and prevertebral layers.

The superficial layer (lamina superficialis) is located directly deep to the platysma Muscle. It encircles the neck on all sides and forms fascial sheaths for the sternocleidomastoid and trapezius muscles. Inferiorly, it attaches to the anterior surfaces of the clavicles and the manubrium of the Sternum; superiorly, it attaches to the Hyoid bone, above which it covers the suprahyoid muscle group. Passing over the Base of the Mandible, the Superficial layer of the cervical fascia continues cranially into the parotidomasseteric fascia.

The pretracheal layer (lamina pretrachealis) is well-defined in the inferior part of the neck. It attaches inferiorly to the posterior surfaces of the manubrium of the sternum and the clavicles, and superiorly to the hyoid bone. Laterally, posterior to the omohyoid muscles, it fuses with the prevertebral layer. The pretracheal layer forms fascial sheaths for the omohyoid, sternohyoid, sternothyroid, and thyrohyoid muscles, and also forms the carotid sheath (Vagina carotica) enclosing the neurovascular bundle of the neck, which comprises the common carotid artery, the Internal jugular vein, and the Vagus nerve.

The prevertebral layer (lamina prevertebral) covers the Deep Muscles of the neck, forming fascial sheaths for them. It is located posterior to the Pharynx, from the posterior wall of which it is separated by a well-developed layer of loose Connective Tissue. Superiorly, the prevertebral layer attaches to the base of the Skull; posteriorly, it fuses with the anterior surface of THE Vertebral Column; and inferiorly, it continues into the endothoracic fascia.

Some textbooks on human and Topographical Anatomy describe the cervical fascia according to V.M. Shevkunenko, who identifies not three, but five layers of the cervical fascia: 1) the superficial Fascia of the neck, 2) the superficial layer of the proper fascia of the neck, 3) the Deep Layer of the proper fascia of the neck, 4) the endocervical fascia, and 5) the prevertebral fascia. However, this Classification of the cervical fascial layers is not included in the International Anatomical Nomenclature.

Spaces filled with a small amount of loose connective tissue exist between the layers of the cervical fascia, as well as between these layers and the Organs of the neck. Knowledge of these fascial spaces is of primary applied importance for understanding the pathways along which inflammatory processes localized in the neck region may spread. These include the suprasternal interaponeurotic space, the previsceral space, and the retrovisceral space.

The suprasternal interaponeurotic space (spatium interaponeuroticum suprasternale) is located above the jugular notch of the sternum, between the superficial and pretracheal layers of the cervical fascia. It contains adipose tissue, superficial cervical Veins, and the jugular venous arch.

The previsceral space (spatium previscerale) is situated between the pretracheal layer of the cervical fascia anteriorly and the Trachea posteriorly. It contains adipose tissue, Lymph Nodes, Blood Vessels, and nerves, and communicates directly with the anterior Mediastinum.

The retrovisceral space (spatium retroviscerale) lies between the posterior wall of the pharynx anteriorly and the deep layer of the cervical fascia posteriorly. It contains loose connective tissue and extends inferiorly into the posterior mediastinum.

Thus, purulent processes cannot spread between the anterior and posterior compartments of the neck; however, from the anterior compartment, via the pre- and retrovisceral spaces, they can readily extend into the thoracic cavity and into the anterior and posterior mediastina.