Fasciae of the Neck

Superficial cervical fascia


  1. Platysma muscle
  2. Cutaneous nerves, blood vessels and lymphatics
  3. Superficial lymph nodes
  4. Fat
deep cervical fascia

Deep cervical fascia or Fascia colli

1. Investing layer

  • Mnemonic: Encloses 2 muscles, 2 salivary glands and 2 spaces
  • 2 muscles: Sternocleidomastoid and Trapezius
  • 2 glands: Submandibular and Parotid
  • 2 spaces: Suprasternal and Supraclavicular

2. Pretracheal layer

  • Muscular layer: encloses infrahyoid muscles
  • Visceral layer: encloses thyroid gland (forms false capsule and posteriorly suspensory ligament of Berry), trachea and esophagus
    • Posterior part: form buccopharyngeal fascia (outside pharyngeal muscles)

3. Carotid sheath: Formed anteriorly by pretracheal fascia and posteriorly by prevertebral fascia


  • CCA
  • IJV
  • CN X
  • CN IX, XI and XII also present in upper part, but they pierce out


  • Anteriorly: Ansa cervicalis (CN XII + C1, C2, C3 spinal nerves)
  • Posteriorly: Cervical sympathetic chain

4. Pharyngobasilar fascia (deep to pharynx): lines the inner surface of pharyngeal muscles

  • Retropharyngeal space exists between buccopharyngeal fascia and pharyngobasilar fascia

5. Prevertebral layer

  • Encloses vertebrae and prevertebral muscles
  • Forms floor of posterior triangle of neck
  • Extends with brachial plexus as axillary sheath (subclavian and axillary veins lie outside the sheath)
  • Alar fascia: between buccopharyngeal fascia and prevertebral fascia
fascia colli neck

Spread of Infections

1. Infection between investing layer and muscular layer of pretracheal fascia: Upto superior edge of manubirum

2. Infection between investing layer and visceral layer of pretracheal fascia: Into thoracic cavity anterior to pericardium

3. Retropharyngeal space infections (suppuration of retropharyngeal lymph nodes): Through the superior mediastinum into the posterior mediastinum

4. Infection behind prevertebral fascia (vertebral TB): May spread to various directions –

  • Anterior: Chronic retropharyngeal abscess
  • Lateral: Through axially sheath and point in posterior triangle or lateral wall of axilla
  • Inferior: Superior mediastinum

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