The deep cervical fascia (or fascia colli in older texts) lies under cover of the

platysma The platysma muscle or platysma is a :wikt:superficial, superficial muscle of the human neck that overlaps the sternocleidomastoid. It covers the anterior surface of the neck superficially. When it contracts, it produces a slight wrinkling of the ...

, and invests the muscles of the neck; it also forms sheaths for the carotid vessels, and for the structures situated in front of the

vertebral column The spinal column, also known as the vertebral column, spine or backbone, is the core part of the axial skeleton in vertebrates. The vertebral column is the defining and eponymous characteristic of the vertebrate. The spinal column is a segmente ...

. Its attachment to the

hyoid bone The hyoid-bone (lingual-bone or tongue-bone) () is a horseshoe-shaped bone situated in the anterior midline of the neck between the chin and the thyroid-cartilage. At rest, it lies between the base of the mandible and the third cervical verte ...

prevents the formation of a

dewlap A dewlap is a longitudinal flap of skin or similar flesh that hangs beneath the lower jaw or neck of many vertebrates. More loosely, it can be various similar structures in the neck area, such as those caused by a double chin or the submandibula ...

. The investing portion of the fascia is attached behind to the

ligamentum nuchæ The nuchal ligament is a ligament at the back of the neck that is continuous with the supraspinous ligament. Structure The nuchal ligament extends from the external occipital protuberance on the skull and median nuchal line to the spinous proces ...

and to the spinous process of the seventh

cervical vertebra In tetrapods, cervical vertebrae (: vertebra) are the vertebrae of the neck, immediately below the skull. Truncal vertebrae (divided into thoracic and lumbar vertebrae in mammals) lie caudal (toward the tail) of cervical vertebrae. In sauropsid s ...

. The ''alar fascia'' is a portion of the ''deep cervical fascia''.

Divisions

The deep cervical fascia is often divided into a superficial, middle, and deep layer. The superficial layer is also known as the

investing layer of deep cervical fascia The investing layer of deep cervical fascia is the most superficial part of the deep cervical fascia, and encloses the whole neck. It is considered by some sources to be incomplete or nonexistent. Attachments It surrounds the neck like a collar, ...

. It envelops the trapezius, sternocleidomastoid, and muscles of facial expression. It also contains the submandibular and parotid salivary gland as well as the muscles of mastication (the masseter, pterygoid, and temporalis muscles). The middle layer is also known as the pretracheal fascia. It envelopes the strap muscles (sternohyoid, sternothyroid, thyrohyoid, and omohyoid muscles). It also surrounds the pharynx, larynx, trachea, esophagus, thyroid, parathyroids, buccinators, and constrictor muscles of the pharynx. The deep layer is also known as the

prevertebral fascia The prevertebral fascia (also known as prevertebral layer of cervical fascia or vertebral fascia) is the layer of deep cervical fascia that surrounds the vertebral column. It is the deepest layer of deep cervical fascia. It encloses the sympathet ...

. It surrounds the paraspinous muscles and cervical vertebrae. The

carotid sheath The carotid sheath is a condensation of the deep cervical fascia enveloping multiple vital neurovascular structures of the neck, including the common and internal carotid arteries, the internal jugular vein, the vagus nerve (CN X), and ansa c ...

is also considered a component of the deep cervical fascia.

Superior extent of the investing fascia

Above, the fascia is attached to the

superior nuchal line The nuchal lines are four curved lines on the external surface of the occipital bone: * The upper, often faintly marked, is named the highest nuchal line, but is sometimes referred to as the Mempin line or linea suprema, and it attaches to the e ...

of the

occipital bone The occipital bone () is a neurocranium, cranial dermal bone and the main bone of the occiput (back and lower part of the skull). It is trapezoidal in shape and curved on itself like a shallow dish. The occipital bone lies over the occipital lob ...

, to the

mastoid process The mastoid part of the temporal bone is the posterior (back) part of the temporal bone, one of the bones of the skull. Its rough surface gives attachment to various muscles (via tendons) and it has openings for blood vessels. From its borders, t ...

of the

temporal bone The temporal bone is a paired bone situated at the sides and base of the skull, lateral to the temporal lobe of the cerebral cortex. The temporal bones are overlaid by the sides of the head known as the temples where four of the cranial bone ...

, and to the whole length of the inferior border of the body of the

mandible In jawed vertebrates, the mandible (from the Latin ''mandibula'', 'for chewing'), lower jaw, or jawbone is a bone that makes up the lowerand typically more mobilecomponent of the mouth (the upper jaw being known as the maxilla). The jawbone i ...

. Opposite the

angle of the mandible __NOTOC__ The angle of the mandible (a.k.a. gonial angle, Masseteric Tuberosity, and Masseteric Insertion) is located at the posterior border at the junction of the lower border of the ramus of the mandible. The angle of the mandible, which may ...

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 parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the m ...

—the layer which covers the gland extends upward under the name of the parotideomasseteric fascia and is fixed to the

zygomatic arch In anatomy, the zygomatic arch (colloquially known as the cheek bone), is a part of the skull formed by the zygomatic process of temporal bone, zygomatic process of the temporal bone (a bone extending forward from the side of the skull, over the ...

. It also contributes to the sheath of the digastric. At the level of the jaw, it splits to enclose the submandibular gland, with the upper leaflet inserting on the mylohyoid line just inferior to mylohyoid and the inferior leaflet inserting onto the lower margin of the jaw. The posterior portion of the upper leaflet helps separate the parotid gland from the submandibular gland where the mylohyoid is deficient while the posterior border is thickened into a strong band extending between the angle of the jaw and the

temporal styloid process The temporal styloid process is a slender bony process of the temporal bone extending downward and forward from the undersurface of the temporal bone just below the ear. The styloid process gives attachments to several muscles, and ligaments. Str ...

, forming the

stylomandibular ligament The stylomandibular ligament is the thickened posterior portion of the investing cervical fascia around the neck. It extends from near the apex of the styloid process of the temporal bone to the angle and posterior border of the angle of the ma ...

. It is complemented by the pterygospinous ligament, which stretches from the upper part of the posterior border of the

lateral pterygoid plate The pterygoid processes of the sphenoid (from Greek ''pteryx'', ''pterygos'', "wing"), one on either side, descend perpendicularly from the regions where the body and the greater wings of the sphenoid bone unite. Each process consists of a me ...

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 Chewing or mastication is the process by which food is comminution, crushed and ground by the teeth. It is the first step in the process of digestion, allowing a greater surface area for digestive enzymes to break down the foods. During the mast ...

Inferior extent of the investing fascia

Below, the fascia is attached to the thoracic outlet (

acromion In human anatomy, the acromion (from Greek: ''akros'', "highest", ''ōmos'', "shoulder", : acromia) or summit of the shoulder is a bony process on the scapula (shoulder blade). Together with the coracoid process, it extends laterally over the sh ...

clavicle The clavicle, collarbone, or keybone is a slender, S-shaped long bone approximately long that serves as a strut between the scapula, shoulder blade and the sternum (breastbone). There are two clavicles, one on each side of the body. The clavic ...

, and

manubrium The sternum (: sternums or sterna) or breastbone is a long flat bone located in the central part of the chest. It connects to the ribs via cartilage and forms the front of the rib cage, thus helping to protect the heart, human lung, lungs, and ma ...

). In doing so, it bifurcates 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 The anterior jugular vein is a vein in the neck. Structure The anterior jugular vein lies lateral to the cricothyroid membrane. It begins near the hyoid bone by the confluence of several superficial veins from the submandibular region. Its tri ...

and their transverse connecting branch, the sternal heads of the sternocleidomastoid, and sometimes a lymph gland.

Deeper fascial layers

The fascia which lines the deep surface of the sternocleidomastoideus gives off the following processes: * A process envelops the tendon at the

omohyoideus The omohyoid muscle is a muscle in the neck. It is one of the infrahyoid muscles. It consists of two bellies separated by an intermediate tendon. Its inferior belly is attached to the scapula; its superior belly is attached to the hyoid bone. Its i ...

, and binds it down to the sternum and first

costal cartilage Costal cartilage, also known as rib cartilage, are bars of hyaline cartilage that serve to prolong the ribs forward and contribute to the elasticity of the walls of the thorax. Costal cartilage is only found at the anterior ends of the ribs, pr ...

. * A strong sheath, the

, encloses the

carotid artery Carotid artery may refer to: * Common carotid artery, often "carotids" or "carotid", an artery on each side of the neck which divides into the external carotid artery and internal carotid artery * External carotid artery, an artery on each side of ...

internal jugular vein The internal jugular vein is a paired jugular vein that collects blood from the brain and the superficial parts of the face and neck. This vein runs in the carotid sheath with the common carotid artery and vagus nerve. It begins in the posteri ...

, and

vagus nerve The vagus nerve, also known as the tenth cranial nerve (CN X), plays a crucial role in the autonomic nervous system, which is responsible for regulating involuntary functions within the human body. This nerve carries both sensory and motor fibe ...

. * The

extends medialward behind the carotid vessels, where it assists in forming their sheath, and passes in front of the prevertebral muscles. * The pretracheal fascia extends medially in front of the carotid vessels, and assists in forming the

References

External links

Sagittal Section Showing Deep Cervical Fascial Layers

* ttps://web.archive.org/web/20060515201222/http://iris3.med.tufts.edu/headneck/supr.htm Suprahyoid Cross-Section Showing Layers of Deep Cervical Fascia {{Portal bar, Anatomy Fascial spaces of the head and neck