07/07/2025
CERVICAL FASCIA (CF)
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[ANATOMY]
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The CF is an excellent example of the complexity of the connective tissue and its layers.
For many years this tissue was disregarded by anatomists and surgeons as dead „packing“ tissue.
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We now know this tissue has high neural receptor density and far-reaching connections throughout the body, effectively linking the entire body into one global unit.
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Structures making up the neck are surrounded by a layer of subcutaneous tissue called the superficial CF (SCF) and are compartmentalized by a second group of fasciae referred to as deep CF (DCF).
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The SCF is a thin layer of subcutaneous connective tissue that lies between the dermis of the skin and the investing layer of DCF.
It houses the platysma muscle but also surrounds and contains the cutaneous nerves, blood and lymphatic vessels, superficial lymph nodes and variable amounts of fat.
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The DCF acts to compartmentalize most structures of the neck and prevents the spread of infections. It consists of three fascial layers:
▪️The investing layer (External layer) which houses the SCM and upper trapezius muscles. It also connects to the clavicle and the clavi-pectoral fascia.
▪️The prevertebral layer (Deep layer) attaches to the vertebrae and houses the longus coli, capitus and all three scalenes.
▪️Pretracheal layer (Middle layer) links the two attaches to the trachea superiorly and contains the thyroid and infrahyoid muscles. This layer also attaches under the clavicle to the pericardium inferiorly.
This effectively links the cervical muscles to the layering of the heart! Not something that is readily discussed in typical anatomy lectures. Perhaps it’s not a large leap in logic to consider „text neck“ and tight cervical fascia as having a potential negative influence on the heart!
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The carotid sheath is the fourth layer of the DCF. It is a tubular fascial investment that extends from the cranial base to the root of the neck. Anteriorly, this sheath blends with the investing and pretracheal layers of the DCF, posteriorly it is continuous with the prevertebral layer. It contains: carotid artery, jug. vein, vagus nerve, LN, carotid sinus nerve and carotid periarterial plexuses.