FASCIAE AND MUSCLES OF THE HEAD AND NECK. 



447 



The deep fascia of the head and neck presents many remarkable characters. 

 Over the scalp it is represented by the galea aponeurotica (O.T. epicranial aponeurosis), 

 the tendon of the epicraneus muscle. This is a tough membrane, tightly stretched 

 over the calvaria, from which it is separated by loose areolar tissue. It is attached 

 posteriorly, partly through the agency of the occipitalis muscle, to the superior 

 nuchal line of the occipital bone ; anteriorly it joins the frontalis muscle and the 

 orbicularis oculi, and 



2 4 6 8 9a 10 12 14 16 18 



nas no bony attachment ; i \ 3 \ 5 \ 7 \ 95 9c > 11 13 / 15 / 17/19 



laterally it is attached Ov^a^V v \ , 



to the temporal line and 

 the mastoid process. 

 Below the temporal line 

 it is continuous with the 

 temporal fascia, a stout 

 layer of fascia attached 

 to the temporal line and 

 zygomatic arch, which 

 covers and gives origin 

 to the temporal muscle. 

 This fascia separates into 

 two layers above the 

 zygomatic arch, to en- 

 close a quantity of fat 

 along with branches of 

 the temporal and zygo- 

 matico- orbital arteries. 

 On the face the fascia is 

 practically non-existent 

 anteriorly in relation to 

 the facial muscles. Pos- 

 teriorly it forms the thin 

 parotideo - masseteric 

 fascia, and is much thicker 

 in relation to the parotid 

 gland, for which it forms 

 a capsule. 



In the neck the deep 

 fascia invests the mus- 

 cles, and forms fascial 

 coverings for the 

 pharynx, trachea, oeso- 

 phagus, glands, and large 

 vessels. It encloses the 

 sterno - mastoid muscle, 

 and can be traced back- 18 . Internal jugular vein . 

 wards over the posterior - vagus nerve. 



20. Sympathetic trunk. 



triangle to the trapezius 21. carotid sheath. 

 and deeper muscles, 23'. 

 which it surrounds; it ^ 

 can be traced forwards 

 over the anterior triangle to the median plane of the neck, where it forms a continu- 

 ous membrane. Above the sternum the fascia, after enclosing the sterno- mastoid 

 muscles, is attached in the form of two layers to the front and back of the jugular 

 notch. The layer enclosing the infra-hyoid muscles passes across the median plane 

 of the neck anterior to the trachea, and is attached above to the hyoid bone, below 

 to the sternum, clavicle, and first rib. A third layer of fascia passes medially 

 anterior to the trachea, enclosing the thyreoid gland. Deep to the steruo-mastoid 

 the fascia helps to form the carotid sheath, which is completed by septal processes 

 stretching medially across the neck in relation to the infra-hyoid muscles, trachea, 



45 44 



FIG. 397. TRANSVERSE SECTION IN THE CERVICAL REGION 

 (between the fourth and fifth cervical vertebrae). 



1. CRICO-ARYT/ENOIDEUS POSTERIOR 



MUSCLE. 



2. INFERIOR CONSTRICTOR MUSCLE. 



3. Pharynx. 



4. Cricoid cartilage. 



5. Vocal fold. 



26. Vertebral vein. 



27. SCALENUS MEDIUS. ' 



28. Posterior triangle. 



29. SCALENUS POSTERIOR. 



30. LEVATOR SCAPULA. 



31. Accessory nerve. 



6. VOCALIS AND THYREOARYT.SNOIDEUS 32. SPLENIUS CERVICIS. 



MUSCLES. 



7. Thyreoid cartilage. 



8. Rima Glottidis. 



9. Layers of deep cervical fascia. 



10. STERNO-HYOID MUSCLE. 



11. OMO-HYOID MUSCLE. 



12. STERNO-THYREOID MUSCLE. 



13. Cervical fascia. 



14. Thyreoid gland. 



15. Common carotid artery. 



16. Descendens hypoglossi nerve. 



17. STERNO-MASTOID MUSCLE. 



33. LONGISSIMUS CERVICIS. 



34. LONGISSIMUS CAPITIS. 



35. Fifth cervical nerve. 



36. Vertebral artery. 



37. Profunda cervicis vein. 



38. Profunda cervicis artery. 



39. MULTIFIDUS. 



40. SEMISPINALIS CERVICIS. 



41. SEMISPINALIS CAPITIS 



42. SPLENIUS CAPITIS. 



43. TRAPEZICS. 



44. Ligamentum nuchse. 



45. Spine of fourth cervical vertebra. 



46. Lamina of fifth cervical vertebra. 



47. Dura mater. 



48. Spinal medulla. 



49. Transverse process. 



50. Fibro - cartilage between fourth and 



fifth cervical vertebrae. 



