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Anatomy of Neck and Blood Supply of Brain
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
Lines of greatest tension in the neck are termed ‘relaxed skin tension lines’. The next layer is superficial cervical fascia, which consists of the adipose tissue and platysma. The deep cervical fascia surrounds the muscles and other structures of the neck to varying extent. The carotid sheath is a condensed part of deep fascia that encloses the structures like carotid arteries, vagus nerve and internal jugular vein. In health, the tissues within these spaces are either closely applied to each other or are filled with relatively loose connective tissue. However, they offer potential routes by which unchecked infection may spread within head and neck and between the face and the mediastinum.
Adapting Injection Techniques to Different Regions
Published in Yates Yen-Yu Chao, Sebastian Cotofana, Anand V Chytra, Nicholas Moellhoff, Zeenit Sheikh, Adapting Dermal Fillers in Clinical Practice, 2022
Yates Yen-Yu Chao, Sebastian Cotofana, Nicholas Moellhoff
When transferring the classical five-layered arrangement to the neck, the SMAS of the midface extends into the platysma in the lateral neck. It is enveloped by the superficial cervical fascia, similar to a sleeping bag. The distance between the skin and the superficial fascia increases with increasing BMI. Importantly, with increasing age, the distance between skin and superficial fascia decreases, irrespective of BMI. The superficial fascia (including the platysma in the neck), subdermal tissue, and the skin form a biomechanical unit due to connective fibrous tissue bands spanning between the fascia and the skin. Clinically, nonsurgical skin-tightening procedures should target the superficial fascia to provide a lifting and skin-tightening effect, as the changes in the fascia are translated to the skin via these connections. The platysma overlies a layer of deep fat. At the medial and lateral muscle boarder, the platysma transitions into connective tissue within the superficial cervical fascia, which shows strong adherence to the underlying investing layer of the deep cervical fascia (Casabona et al., 2019a; Davidovic et al., 2021). Major neural structures (i.e., structures of the cervical plexus) emerge deep, at the posterior margin in the middle third of the sternocleidomastoid muscle.
Neck
Published in Swati Goyal, Neuroradiology, 2020
Fascial layers: Superficial cervical fascia (subcutaneous fat, veins, nerves, lymphatics, platysma, and facial muscles)Deep cervical fascia (DCF) Superficial layer (investing layer)Middle layer (visceral/pretracheal)Deep layer (prevertebral)
Microvascular reconstruction after extensive cervical necrotizing fasciitis: A case series
Published in Acta Oto-Laryngologica Case Reports, 2019
Rajan P. Dang, Joseph P. Bradley, Joseph Zenga, Patrik Pipkorn
The superficial cervical fascia and the superficial layer of the deep cervical fascia provide barriers against deep penetration of infection. Spread of necrotizing fasciitis through these layers may lead to loss of platysma and overlying skin, but frequently spares deeper critical structures. Through spread within the deep cervical fascia, those deeper critical structures may be lost and infection may gain access to the mediastinum, which is associated with high mortality [8, 11]. With early recognition of the serious nature of the disease and aggressive surgical debridement, patients may survive. In surviving patients, the resulting soft tissue defect can usually be managed with primary closure or skin grafting [9,12].