The Neck - General Overview
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of the neck | Main Anatomy
Index | Neck Index
Last updated 1 April 2006
Surface Anatomy of the Neck
- On the posterior aspect, the spinous process of C2 is the first bony
prominence that can be felt below the external occipital
- The spinous process of the vertebra
prominens (C7) is easily palpable and usually
clearly visible when the neck is flexed.
- The laryngeal prominence
is the important surface feature of the anterior part of
the neck when. It is produced by the thyroid
cartilage, the largest part of the laryngeal
framework (p. 783)
Cartilage (p. 783)
- This is located at the level of C4-C5
and is part of the laryngeal skeleton.
- It consists of two quadrilateral plates called laminae, which can easily be
The Hyoid Bone (p.
- This lies superior to the thyroid cartilage.
- It is a U-shaped bone
level with the body of C3.
- It is the first resistant structure that can be felt in
the median plane inferior to the chin.
- When the neck is relaxed the tips of the greater horns
(L. cornua) can be palpated.
Cartilage (p. 783)
- This is part of the laryngeal skeleton.
It lies inferior to the thyroid cartilage.
- The cricoid cartilage lies at the level of C6 vertebra, where the pharynx
joins the oesophagus and the larynx and trachea join each
Rings (p. 783)
- These are cartilaginous C-shaped
- They are palpable in the inferior part of the neck.
- They move superiorly during swallowing.
Fascial Planes of the Neck
- The deep cervical fascia
is disposed in three layers: investing, pretracheal and
Investing Fascia (p. 823)
- This is the superficial or investing layer of the deep
- It encircles or forms a collar
around the neck, surrounding the structures in
- It is located between the superficial fascia and the
- The investing fascia is attached superiorly to the superior nuchal line of the
occipital bone, the mastoid process, the zygomatic arch,
the inferior border of the mandible, the hyoid bone, and
the spinous processes of the cervical vertebrae.
- Inferiorly, the investing fascia is attached to the
manubrium of the sternum, the clavicle, and the acromion
and spine of the scapula.
- Just superior to the sternum, the investing
fascia divides into two layers. These are
attached to the anterior and posterior surfaces of the
- The interval between these layers is called the suprasternal space.
- It encloses the sternal heads of
the sternocleidomastoid muscles, the inferior ends of the anterior jugular
veins and the jugular
- The investing fascia also forms the roof
of the anterior and posterior triangles of the neck.
Pretracheal Fascia (p. 823)
- This is a thin layer of deep
cervical fascia that is anterior
to the trachea and limited to the anterior
aspect of the neck.
- It extends inferiorly from the thyroid cartilage and the
arch of the cricoid cartilage into the thorax.
- The pretracheal fascia lies deep to
the infrahyoid muscles.
- It splits to enclose the thyroid gland, trachea, and
oesophagus and blends laterally with the carotid sheath. Thus, it
encloses the viscera of the neck.
Prevertebral Fascia (p. 825)
- This layer of deep cervical fascia forms part of a tubular sheath for the prevertebral
muscles that surrounds the vertebral column.
- It is also continuous with the deep fascia covering the
muscular floor of the posterior triangle of the neck.
- The prevertebral fascia extends from the base of the
skull to the third thoracic vertebra, where it fuses with
the anterior longitudinal ligament.
- The prevertebral fascia extends inferiorly and laterally
as the auxiliary sheath,
which surrounds the axillary vessels and brachial plexus.
Carotid Sheath (pp. 801-2)
- This is a tubular, thickly matted fascial condensation
that extends from the base of the skull to the root of
- It is formed by fascial extensions of the cervical
fascia, which fuse with the pretracheal
- The inferior part of the carotid sheath contains several
clinically important structures: (1) the common carotid arteries
medially; (2) the internal jugular
vein laterally; (3) the vagus
nerve (CN X) posteriorly; and (4) the ansa cervicalis.
- The superior root of the ansa cervicalis descends between
the common carotid and the internal jugular vein and is
sometimes embedded in the carotid sheath.
- Many deep cervical lymph nodes
lie along the carotid sheath and the internal jugular
vein and between this vein and the common carotid
- The cervical part of the sympathetic
trunk runs posterior to
the carotid sheath.
Triangles of the Neck
Root of the Neck