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Section of the neck at about the level of the sixth cervical vertebra Showing the arrangement of the fascia coli
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The (or '''fascia colli''' in older texts) lies under cover of the
Platysma , and invests the neck; it also forms sheaths for the
Carotid Vessels , and for the structures situated in front of the
Vertebral Column .
The investing portion of the fascia is attached behind to the
Ligamentum Nuchæ and to the spinous process of the seventh
Cervical Vertebra .
It forms a thin investment to the
Trapezius , and at the anterior border of this muscle is continued forward as a rather loose areolar layer, covering the
Posterior Triangle Of The Neck , to the posterior border of the
Sternocleidomastoideus , where it begins to assume the appearance of a fascial membrane.
Along the hinder edge of the Sternocleidomastoideus it divides to enclose the muscle, and at the anterior margin again forms a single
Lamella , which covers the
Anterior Triangle Of The Neck , and reaches forward to the middle line, where it is continuous with the corresponding part from the opposite side of the neck.
In the middle line of the neck it is attached to the
Symphysis Menti and the body of the
Hyoid Bone .
Above, the fascia is attached to the superior nuchal line of the
Occipital , to the
Mastoid Process of the
Temporal , and to the whole length of the inferior border of the body of the mandible.
Opposite the angle of the mandible the fascia is very strong, and binds the anterior edge of the Sternocleidomastoideus firmly to that bone.
Between the mandible and the mastoid process it ensheathes the
Parotid Gland —the layer which covers the gland extends upward under the name of the parotideomasseteric fascia and is fixed to the
Zygomatic Arch .
From the part which passes under the parotid gland a strong band extends upward to the styloid process, forming the stylomandibular ligament.
Two other bands may be defined: the
Sphenomandibular and the
Pterygospinous ligaments.
The pterygospinous ligament stretches from the upper part of the posterior border of the
Lateral Pterygoid Plate to the spinous process of the sphenoid.
It occasionally ossifies, and in such cases, between its upper border and the base of the skull, a foramen is formed which transmits the branches of the mandibular nerve to the muscles of
Mastication .
Below, the fascia is attached to the
Acromion , the
Clavicle , and the
Manubrium Sterni .
Some little distance above the last it splits into two layers, superficial and deep.
The former is attached to the anterior border of the manubrium, the latter to its posterior border and to the interclavicular ligament.
Between these two layers is a slit-like interval, the
Suprasternal Space (space of Burns); it contains a small quantity of areolar tissue, the lower portions of the
Anterior Jugular Veins and their transverse connecting branch, the sternal heads of the Sternocleidomastoidei, and sometimes a
Lymph Gland .
The fascia which lines the deep surface of the Sternocleidomastoideus gives off the following processes:
A process envelops the tendon at the
Omohyoideus , and binds it down to the sternum and first
Costal Cartilage .
A strong sheath, the
Carotid Sheath , encloses the
Carotid Artery ,
Internal Jugular Vein , and
Vagus Nerve .
The prevertebral fascia extends medialward behind the carotid vessels, where it assists in forming their sheath, and passes in front of the prevertebral muscles.
It forms the posterior limit of a fibrous compartment, which contains the larynx and trachea, the thyroid gland, and the pharynx and
Esophagus .
The prevertebral fascia is fixed above to the base of the skull, and below is continued into the thorax in front of the
Longus Colli Muscles .
Parallel to the carotid sheath and along its medial aspect the prevertebral fascia gives off a thin lamina, the
Buccopharyngeal Fascia , which closely invests the Constrictor muscles of the pharynx, and is continued forward from the
Constrictor Pharyngis Superior on to the
Buccinator .
It is attached to the prevertebral layer by loose connective tissue only, and thus an easily distended space, the
Retropharyngeal Space , is found between them.
This space is limited above by the base of the
Skull , while below it extends behind the esophagus into the
Posterior Mediastinal Cavity of the
Thorax .
The prevertebral fascia is prolonged downward and lateralward behind the carotid vessels and in front of the
Scaleni , and forms a sheath for the brachial nerves and subclavian vessels in the posterior triangle of the neck; it is continued under the clavicle as the axillary sheath and is attached to the deep surface of the
Coracoclavicular Fascia .
Immediately above and behind the clavicle an areolar space exists between the investing layer and the sheath of the subclavian vessels, and in this space are found the lower part of the external jugular vein, the descending clavicular nerves, the transverse scapular and transverse cervical vessels, and the inferior belly of the Omohyoideus muscle.
This space is limited below by the fusion of the coracoclavicular fascia with the anterior wall of the
Axillary Sheath .
The pretrachial fascia extends medially in front of the
Carotid Vessels , and assists in forming the
Carotid Sheath .
It is continued behind the depressor muscles of the
Hyoid Bone , and, after enveloping the thyroid gland, is prolonged in front of the trachea to meet the corresponding layer of the opposite side.
Above, it is fixed to the hyoid bone, while below it is carried downward in front of the trachea and large vessels at the root of the neck, and ultimately blends with the fibrous
Pericardium .
This layer is fused on either side with the prevertebral fascia, and with it completes the compartment containing the larynx and trachea, the thyroid gland, and the pharynx and esophagus.
