Anatomy
Head and Neck
Regarding the neck fascia, which of the following statements is INCORRECT:
Answer:
The trapezius and sternocleidomastoid muscles lie within the investing layer of the deep cervical fascia.Neck Spaces and Fascia
Anatomy / Head and Neck / Neck
Last Updated: 20th April 2020
Neck Fascia
The neck fascia is divided into the superficial and deep fascia.
The superficial cervical fascia lies between the dermis and the deep cervical fascia. It contains numerous structures:
- Neurovascular supply to the skin
- Superficial veins (e.g. the external jugular vein)
- Superficial lymph nodes
- Fat
- Platysma muscle
The deep cervical fascia lies, as its name suggests, ‘deep’ to the superficial fascia and platysma muscle. This fascia is organised into several layers:
- 1) an investing layer (blue) which lies deep to the superficial fascia and surrounds all structures in the neck
- 2) the prevertebral layer (green) which surrounds the vertebral column and the deep muscles associated with the back
- 3) the pretracheal layer (yellow) which encloses the viscera of the neck (the trachea, oesophagus and thyroid)
- 4) the carotid sheaths (red) which receive a contribution from the other three fascial layers and surround the two major neurovascular bundles on either side of the neck (containing the common carotid artery, the internal carotid artery, the internal jugular vein and the vagus nerve)
The trapezius and sternocleidomastoid muscles lie within the investing layer of the deep cervical fascia.
The viscera of the neck lie anterior to the prevertebral fascia, within the pretracheal layer.
The prevertebral muscles lie within the prevertebral fascial layer and act as weak neck flexors.
![Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://mrcemsuccess.com/wp-content/uploads/2017/01/Neck-fascia1.png)
Layers of the Deep Cervical Fascia: Investing Layer (blue), Prevertebral Layer (green), Pretracheal Layer (yellow), Carotid Sheaths (red). (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
Neck Spaces
Between the fascial layers in the neck are spaces that may provide a conduit for the spread of infections from the neck to the mediastinum:
- The pretracheal space lies between the investing layer of cervical fascia and the pretracheal fascia and passes between the neck and the anterior part of the superior mediastinum.
- The retropharyngeal space lies between the buccopharyngeal fascia (the part of the pretracheal fascia posterior to the pharynx) and the prevertebral fascia and extends from the base of the skull to the upper part of the posterior mediastinum.
- The prevertebral space is within the prevertebral layer as it splits into two laminae, extending from the base of the skull and extends through the posterior mediastinum to the diaphragm.
Report A Problem
Is there something wrong with this question? Let us know and we’ll fix it as soon as possible.
Loading Form...
- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
