Description

This video covers the fascia of the head and neck, including its functions, types, and anatomical distribution.

Fascia Functions

• Stabilizes and separates muscles from other internal organs
• Forms compartments
• Passage for nerves, blood vessels, and lymph
• Storage medium for fat and water

Three Types of Fascia

• Superficial Fascia
• Deep Fascia
• Visceral Fascia

Fascia of the Head

Temporal Fascia

• Starts at the Superior Temporal Line
• Splits into two layers:
  • Deep Layer: Lamina Profunda
  • Superficial Layer: Lamina Superficialis

Parotid Fascia

• Covers the Parotid Gland

Masseteric Fascia

• Covers the Masseter Muscle

Buccopharyngeal Fascia

• Covers the Buccinator Muscle
• Extends behind the pharynx
• Fuses with the Pterygomandibular Raphe

Fascia of the Neck

Cervical Fascia

Superficial Layer

• Covers the surface of the neck
• Envelops the Sternocleidomastoid and Trapezius
• Platysma is superficial to this fascia

Pretracheal Layer

• Envelops the Infrahyoid Muscles
• Forms the Carotid Sheath (surrounds the neurovascular bundle)

Prevertebral Layer

• Covers the Deep Cervical Muscles

Transcript

Introduction
0:03
Hey what’s up. Meditay here and in this video, we’re gonna look at the main fascia covering the
0:08
head and neck. But first, If I would ask you, what s a fascia? And how do we categorize them, would
What is a Fascia?
0:14
you be able to answer? Because these ae important things to understand before you actually learn
0:19
about the different fascia we have in the body. So a fascia is just a connective tissue
0:24
surrounding structures within the body. So here is a muscle, just a raw muscle within our body.
0:30
And here is a fascia. It surrounds the muscle. Now why do we need them?
0:34
Well one thing is that fascia stabilizes and separates muscles from other internal organs.
0:40
Fascia form compartments. Specially in clinics if you get patients with edema
0:48
within the compartment that the fascia forms, we’ll get the so called compartment syndrome,
0:53
which could be very dangerous as blood supply may get cut off due to the pressure.
0:57
Fascia also forms a passage for nerves, blood vessels and lymph. And this is also important
1:03
to keep in mind. Specially in people with chronic neck pain who are on constant pain medications. It
1:09
doesn’t necessarily have to be your muscle that’s still, it could also be the fascia. So massage and
1:13
stretching exercises are important factors which can stretch the fascia and help loosening it up.
1:19
Fascia also function as a storage medium for fat and water. And lastly. There are
1:25
three types of fasciae that you need to know. These are Superficial fascia,
1:30
Deep fascia, and Visceral Fascia. Ok. So here is the skin without removing
1:35
any layers. If you remove just the layers of the skin, you’ll see a superficial fascia,
1:41
located right underneath the skin. And then when you remove the superficial fascia, you’ll see
1:46
the deep fascia. The deep fascia is actually the that can surround individual muscles and groups of
1:52
muscles to separate into compartments. And when we talk about fascia within the body, it’s most
1:58
often the deep fascia we’re talking about. SO when you remove the deep fascia,
2:03
and enough muscle and bone to see an organ, we’ll see the visceral fascia,
2:08
that surrounds the organs within our body. Here we see the fascia covering the lungs, called pleura.
2:14
So that is the three types of fasciae we have And if we go back here. This fascia I showed you
2:20
earlier, was a deep fascia. Alright. So finally- In this video, we’re first going to look at the
Content
2:26
fascia of the head, which consist of the Temporal Fascia, the parotid fascia, the masseteric fascia,
2:32
and the buccopharyngeal fascia Then after that, we’ll cover the
2:36
fascia of the neck, which is called cervical fascia. The cervical fascia is divided into
2:41
three main layers. The superficial layer is located under the platysma.
2:46
The pretracheal layer covering the infrahyoid muscles and is connected to the superficial layer.
2:51
And then the prevertebral layer covers the deep neck muscles.
2:55
So these are the main fascia we’re going to cover in this video,
2:59
but we’ll add a few other things throughout the video in order to gain the complete picture.
Temporal Fascia
3:04
Awesome. We’ll start with he first one in the list, which is the temporal fascia.
3:08
Ok. The temporal fascia lies on top of the temporal muscle. So here’s the temporal muscle.
3:13
Here’s the temporal fascia. It starts at the superior temporal line, which is here. That’s
3:19
the cranial attachment point. And then it goes down towards the zygomatic arch to attach there.
3:25
But this fascia divides into two layers juuust above the zygomatic arch. When it splits, we call
3:33
them the deep layer and the superficial layer. Ok. So if we make a vertical section like this,
3:39
and cut of the face, and look at the fascia from this direction.
3:42
We’ll see this. So what do we see here. Here highlighted is the temporal muscle.
3:48
That means this fascia is the temporal fascia. Notice that the temporal fascia splits into a deep
3:55
and a superficial layer before it inserts into the zygomatic arch. And between the deep and
4:00
the superficial layer, there’s usually gonna be fat tissue as you see here.
4:04
So that was the Temporal Fascia. Next we have the Parotic Fascia and the Masseteric Fascia.
Masseter Fascia and Parotid Fascia
4:10
We’ll do these two together because the parotid fascia partially fuses with the masseteric fascia.
4:16
So the Parotid fascia covers the parotid gland. SO her is the parotid gland. It produces saliva.
4:22
The masseteric fascia covers the masseter muscle, which is this one. So here are the two
4:27
facias covering the parotid gland and the masseter muscle. The parotid fascia over the parotid gland,
4:33
and then anteriorly fuses with the masseteric fascia to form the parotideomasseteric fascia,
4:40
and then it continues as the masseter fascia. They attach at the zygomatic arch and then go down
4:47
to attach at the base of the mandible. So that’s these two.
Buccopharyngeal Fascia
4:51
Then we have the buccopharyngeal fascia. So do you remember this muscle? It’s called
4:56
the Buccinator muscle. The buccopharyngeal fascia covers the buccinator, as you see here.
5:03
And then it continues backwards, it continues back behind the pharynx, so it’s a part of
5:08
the posterior wall of the pharynx, and then it fuses with the pterygomandibular raphe,
5:14
which is a raphe, or a union of the tendons of the superior pharynx muscles.
5:19
And then it continues into the fibrous tissue of the pharynx, going down along the neck. So,
5:25
if we make a transverse cut of this fascia, and look at it from this view, we’ll see this.
5:30
This is a transverse section at the level of the first cervical vertebra. So, what do we see here?
5:36
On the lateral sides, we see the parotid gland with the parotid fascia. We see
5:41
the masseter muscle with the masseteric fascia. So, this pink line is the buccopharyngeal fascia.
5:48
And notice that it starts at the buccinator muscle, and then go back behind the pharynx
5:53
to fuse with the pterygomandibular raphe. So that was the fascia of the head.
Cervical Fascia
5:59
Next let’s talk about the fascia of the neck, which is called the cervical fascia!
6:03
So here’s a sideview of the head and neck. If we gently cut his neck and remove his head,
6:10
and then look at the neck from this perspective, we’ll see this.
6:13
So what do we see here? We see the skin on the outside, which has the
6:17
superficial fascia just beneath the skin, remember we talked about that earlier? The whole body is
6:22
covered with superficial fascia just below the skin. Then below the skin anteriorly we can see
6:28
the Platysma. And here we see the trachea for the airways, and the esophagus going from the pharynx
6:34
to the stomach. In front of the trachea we can see the thyroid gland, And back here we see the
6:39
vertebra. So this is the anterior part and here is the posterior part. So I hope you kinda got an
6:44
idea of what we’re looking at. So the Cervical Fascia is the main fascia of the neck. And it
6:50
consists of several layers. We first have the superficial layer, which is here highlighted in
6:55
blue. It covers the surface of the neck as you see here, and it envelops the two large cardiothoracic
7:02
muscles, the sternocleidomastoideus, and the trapezius as you see here.
7:06
And keep in mind that the platysma is superficial to the superficial layer of the cervical fascia
7:12
Another layer of the cervical fascia is the Pretracheal Layer, which is here highlighted in
7:17
green. The pretracheal fascia envelops the infrahyoid muscles, as you see here.
7:23
Remember these are muscles like the sternohyoid, sternothyroid and thyrohyoid. So, it covers the
7:29
infrahyoid muscles and then it continues backwards to form a carotid sheath as you
7:35
see here called vagina carotica, which surrounds the large neurovascular bundle we have on either
7:41
side of the neck, which are the common carotid artery, internal jugular vein and nervus vagus.
7:47
Another layer of the cervical fascia is the prevertebral layer, which is this large
7:52
layer you see here, it covers the deep cervical muscles like the longus coli and longus capitis.
7:58
So those are the three layers of the cervical facia. But what
8:02
other fascia can we see here from this view? We can see the buccopharyngeal fascia, which
8:06
we talked about earlier, remember it fuses with the pterygomandibular raphe behind the pharynx,
8:12
and then continues down the neck, so here it is. And then between the carotid sheath,
8:19
you can find a fascia connecting these two called the intercarotid fascia, or also known as the
8:24
alar fascia. These two facias are going to form potential spaces in our neck that’s considered
8:31
clinically relevant. Between the buccopharyngeal fascia and the alar fascia. This space is used as
8:39
a surgical approach to the cervical vertebral column. Behind the Retropharyngeal space is
8:45
the Alar space, or the Danger space, which is sometimes classified as a part of the
8:50
retropharyngeal space. Ok. So between the lungs, there’s gonna be an area called the mediastinum,
8:56
which contain a lot of vasculatures and nerves and organs like the heart and the thymus.
9:01
The Alar space continues down into the mediastinum, so it opens up into the mediastinum.
9:05
Sometimes, when there’s a heavy infection in the oral cavity. Specially if the person is
9:10
immune compromised, the infection may spread from the mouth into the retropharyngeal area.
9:16
The problem now is that if this infection reaches the danger space,
9:20
some potential life-threatening complications may happen. A person can get airway obstruction
9:25
for example if a lot of pus accumulates in the danger space and blocks the airways,
9:30
or the infection can now easily go down into the mediastinum and cause mediastinitis.
9:36
Alright. Another space we can see here is the Parapharyngeal space,
9:41
which is a space located lateral to the pharynx, lying around where the carotid sheath is.
9:47
So that was all I had for the fascia of the head and neck, and I hope that was helpful.