Fascia and spaces of the neck

The structures found in the neck are surrounded by a layer of subcutaneous tissue called the superficial fascia, while there are also layers of deep cervical fascia which distribute the structures in the neck into different compartments.

These fascial layers create different anatomical spaces in the neck, and dictate where an infection may spread if it starts in one of these compartments.

So, let’s take a look at the different fascia layers of the neck. You can think of fascia as a pair of thin stockings made of connective tissue that support and bind together different parts of the body, including the neck.

Now, the neck actually has two pairs of stockings on top of each other: the superficial fascia, which sits right underneath our skin, and the deep fascia, which is deep to or beneath the superficial fascia, and it surrounds muscles and viscera organizing them into compartments.

Ok, so the superficial cervical fascia or the cervical subcutaneous tissue is a layer of fatty connective tissue that lies between the skin and the most superficial layer of deep cervical fascia.

This fascia is usually thinner than in other regions, especially anteriorly, and it contains cutaneous nerves, blood and lymphatic vessels, superficial lymph nodes and variable amounts of fat.

Anterolaterally, it contains the platysma, which is a thin sheet of muscle that covers the anterolateral portion of the neck. Inferiorly, the platysma attaches to the deep fascia that covers the superior parts of pectoralis major and deltoid muscles, with its fibers moving superomedially over the clavicle and attaching superiorly to the inferior border of the mandible, and skin and subcutaneous tissues of the lower face.

The anterior borders of the two platysma muscles join together over the chin and blend with the facial muscles but inferiorly, the fibers remain separated, leaving a gap anterior to the larynx and trachea.

Deep to the platysma, there are the main cutaneous nerves of the neck and the external jugular vein, which descends from the angle of the mandible to the middle of the clavicle.