Head and Neck ImagingCervical fascia
layers of dense connective tissue, surrounding muscles and anatomical spaces. These fascial layers are more or less constant between individuals, and define different spaces (for description of individual spaces: see under their specific names).
In the neck there is a superficial and a deep cervical fascia. The superficial fascia is a loose fatty layer just below the skin; it is not a fascial sheet in the strict sense but rather a fatty loose connective tissue in which are imbedded the platsyma and the muscles of facial expression.
The deep cervical fascia corresponds to the fascial layers surrounding the musculature of the neck. It is usually subdivided into three additional layers: the superficial, middle and deep layer of the deep cervical fascia.
Superficial layer of the deep cervical fascia
It completely encircles the neck, incorporating the sternocleidomastoid muscles and the trapezius muscles. It attaches posteriorly to the vertebral spines and nuchal ligament. Superiorly, this fascia extends to the lower border of the mandible, and encircles the submandibular gland, the muscles of mastication and the parotid gland.
Middle layer of the deep cervical fascia
Variable descriptions are found in the literature. For all practical purposes, it encircles the viscera of the neck, such as the larynx and hypopharynx, defining the visceral space. Posteriorly, it is very close to the alar fascia (see below); the virtual space between them is known as the retropharyngeal space. Superiorly, above the level of the hyoid bone, the visceral space has no anterior barrier, as it opens toward the mouth and nose; at the suprahyoid level the middle layer is known as the buccopharyngeal fascia.
Deep layer of the deep cervical fascia
Originates from the cervical spinous processes and the nuchal ligament. The fascia then extends to either side, covering the deep muscles of the neck along the cervical spine, and attaches to the transverse processes of the cervical spine. Anteriorly, this fascial layer divides: the dorsal layer covers the prevertebral muscles, and is known as the prevertebral fascia. The ventral layer is known as the alar fascia; it is separated from the prevertebral fascia by some loose connective tissue referred to as the danger space.
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