Investing layer of cervical fascia

It extends superiorly to cover the pharyngeal constrictor muscles and runs anteriorly at this level from the pharynx to cover the buccinators muscle of the face. Posterior to the buccopharyngeal fascia lies the retropharyngeal space. Its superior attachment is to the bones of the base of the skull. Inferiorly this layer is continuous with the fibrous pericardium.

The buccopharyngeal fascia continues as the thoracic covering of the esophagus and trachea. The prevertebral, or deep layer of the deep cervical fascia, like the investing fascia, attaches to the ligamentum nuchae and fully encircles the vertebrae, muscles associated with the vertebral column and the cervical portion of the sympathetic trunk ganglia. It extends laterally from its attachment at the ligamentum nuchae to encircle the vertebrae and associated muscles, attaching to the transverse processes of the cervical vertebrae as it courses anteriorly to overlie the scalene muscles anterior to the vertebrae.

This layer joins back up with itself anterior to the vertebral bodies, situated posteriorly to the buccopharyngeal fascia. The muscles that lie within the prevertebral fascial layer can be thought of in terms of their location respective to the cervical vertebrae. Lying mostly anterior to the vertebrae, the muscles that lie within this fascial layer are the longus capitis, scalene muscles, and longus coli. Posteriorly, the muscles within this layer are those of the longissimus, semispinalis and splenius muscle groups.

The levator scapulae also lie deep to this fascia. The rectus capitis and obliquus muscles, as well as the deep spinal muscles, lie within this layer. The prevertebral fascia sends extensions inward investing all of these muscles which lie deep to it. Superiorly, its attachment is the base of the skull both anteriorly and posteriorly. Some sources report that the prevertebral fascia is continuous with the muscular division of the pretracheal layer and that posteriorly the inferior aspect of this singular fascia is continuous with the fascia of the rhomboid major, rhomboid minor and the serratus posterior muscles with boney attachment to the scapulae.

As it descends it also gives off fibers which blend with the fibers of the suprapleural membrane, also known as Sibson fascia. Laterally, it gives off fibers that form the axillary sheath. The prevertebral fascia is continuous with the transversalis fascia of the thorax and abdomen.

The prevertebral fascia functions to help in allowing the esophagus, pharynx, and carotid sheaths to glide unobstructed by the longus coli and scalene muscles during neck flexion, extension, and rotation. The alar fascia is a distinct facial layer that is attached to and lies anteriorly to the prevertebral fascia.

It is attached laterally to the prevertebral fascia, where they both attach to the transverse vertebral processes. The alar fascia spans the midline, anterior to the prevertebral fascia and posterior to the buccopharyngeal fascia. Posterior to the buccopharyngeal fascia and anterior to the alar fascia lies the retropharyngeal space.

Posterior to the alar fascia and anterior to the prevertebral fascia lies the danger space of the neck. The alar fascia attaches to the base of the skull, like the prevertebral fascia which it overlies anteriorly. Inferiorly the alar fascia joins the buccopharyngeal fascia at about the level of the first or second thoracic vertebra. Fibers from all three deep cervical fascial layers - the investing, pretracheal and prevertebral - give fibers that blend with the carotid sheath.

Some sources consider the carotid sheath to be a distinct division of the deep cervical fascia, while others consider it to be a "facial sheath," separate from the true deep cervical fascia. Deep Spaces of the Neck The spaces in reality they are compartments, not true spaces bound by these fasciae represent important clinical correlates of this basic anatomy topic and have been addressed previously by several authors. The hyoid bone represents an essential boundary for anterior deep spaces of the neck, dividing these spaces into sub- and suprahyoid regions.

Other spaces, more posterior, are not interrupted by the hyoid bone and extend the entire length of the neck. Importantly, many of these spaces extend into the mediastinum. The spaces that span the entire length of the neck further subdivide into superficial and deep. The superficial full-length space is the superficial space. There are four deep spaces of the neck that span the entire length of the neck.

These are the retropharyngeal space, the danger space, the prevertebral space and the space within the carotid sheath. The spaces bound inferiorly by the hyoid bone include the submandibular, pharyngomaxillary, masticator, parotid and peritonsillar spaces. The anterior visceral space is the only space that is bound superiorly by the hyoid bone. The retropharyngeal space lies in the space bound by the alar fascia and buccopharyngeal fascia and consists of loose areolar tissue and lymph nodes.

This space is bound superiorly by the base of the skull, laterally by the attachment sites of these fasciae to the transverse vertebral processes and inferiorly where these layers join at about T1 or T2. The danger space lies between the alar and prevertebral fascia. It is bound superiorly by the base of the skull and laterally by the attachment site of the alar fascia to the prevertebral fascia at the transverse vertebral processes.

Inferiorly, the danger space is in free communication with the posterior mediastinum, which extends to the diaphragm. An infection of this space can thus spread to involve the vital organs of the thorax. The submandibular space is bound, in part by the superficial layer of the deep cervical fascia. Laterally and anteriorly is bound by the mandible, inferiorly and posteriorly it is bound by the hyoid bone.

Superficially, its boundary is the superficial layer of the deep cervical fascia, and its superior border is the mucosa of the oral cavity. This space is the area that is involved in Ludwig angina, an infectious process of the floor of the oral cavity often associated with dental infections. Click on a category of cookies to activate or deactivate it. Essential technical cookies Description These are cookies that ensure the proper functioning of the website and allow its optimization detection of navigation problems, connection to your IMAIOS account, online payments, debugging and website security.

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