rilE SFJ'K 



11(1/ 



The following uses ami important points with ivpinl to the anatomy nf tin- 

 deep cervical fascia sliould be noted: (Aj It forms certain definitely enclosed 

 spaces in which pus or growths may form, and Ijy tht- walls of whicli tlicse 

 morbid structures may be tied down and tlius rendered difficult of diagnosis, wliile 

 their increasing pressure may embarrass the air-passages, etc. Thus: (1) Jn the 

 first si)ace, which hes between No. 1 and the skin, the structures met with, the 

 platysma and superficial branches of the cervical jilexus, are unimportant. Any 

 abscess here is pnjne to extend, but suj)erlicially. ('1) In the second sj)ace, 

 between the superficial and stcrno-clavicular layers, lies a narrow space containing 

 loose cellular tissue and lymphatic glands. Sujtpuration here is very conuuon, but 

 usually comes forwards. (8) This is the largest and most important of all. It is 

 bounded in front by the sterno-clavicular, and behind V)y the prevertebral layer. 

 Its contents are — larynx, trachea, a?sophagus, thyroid, carotid sheath, glands; and 

 ))elow, brachial plexus, subclavian artery, and al)undant loose cellular tissue for 



Fig. 680. — Sectiox of Neck thkough the Sixth Ckevical Yeeteuk.v. (One-half.) 



(Braune.) 



RE< l RREST LA R YXGAA L SER VE 



PHARrNX I URYNX 



Thyro-arytenoid muscle 



CRICOID CARTILAGE 'and omo-hyoid muscles 



Bterno-hyoid Just posterior are been the thyro- 

 Crico-arytenoideud lateralis 



Muscular process of ibe thyroid cartilage 



LonguB colli muscle , 

 Sii/jfriDr thi/roiil artery] 

 - DE^SCESDEXS SUNl ' 

 VAGUS 

 PIIREXIC XER VE 



Scalenus anticus 

 Sterno-oleido-mastoid 



B RA ' nJA L PL EX I '.S' 



Scalenus mediua 



Ezterniil jugular leiit 



.SPIX. I L A rcESSOR 1 

 XER\'E 



Splenlua 



PART OF ARTICULAR SURFACE OF SEVENTH CERVICAL VERTEBRA 



Beml-spiaalis and multifldus 



SIXTH CERVICAL VERTEBRA 



THYROID GUND 



Common carotid artery 

 Internal Jiiffular vein 



liliAflllAL PLEXrs 

 Scalenus medius 

 External jni/nlai- r^in 

 Scalenus posticus 



SPIXA L A rCESStjR Y 

 XERVE 



Levator anguli scapulae 



Cervicalis ascendens 



t Transversalis cervlcis and trachelo- 



Pro/iinda cervicis rtsetlt mastoid 



Trapezius 



Biventer cervicis and complexus 



the movements of the neck. Su))))uration is somewhat rarer here: but either jius 

 or growths, if confined in this space, may have banrful efftcts. from )»nss\ire, or 

 from their tendency to travel behind the "sternum. (4) This si)acc. between the 

 prevertebral layer in front and muscles behind, is very limittMl. Ketrojiharyngeal 

 abscess forms here, and the dysjuKea it causes is thus explained. (H) The deep 

 cervical fascia gives sheaths or canals to certain veins which perforate it. e.g. 

 the external jugular. These are thus kept patent, and a ready ])assage of blood 

 ensured from the head and neck. The carotid sheath is another and different 

 instance. (C) It helps to resist atmospheric pressure. (D) Mr. Hilton's 

 suggestion as to its action on the pericardium has already l)een mentioned. 



T^efoiv lenviiii: this region, the arrangement of the lymphatic glands of 

 the head and neck must be attended t«>. 'i'hey are extnuielv iininerniis. and are 

 chietlv arranged in the following .^ets: ( 1 i Occipital, or suboccipital, along the 

 attachment of the occipitalis. (2) Tlie posterior auricular, over tlie insertion 

 of the stemo-mastoid. (3) The parotid, just in front- of the ear, partly on 



