The cervical fascia consists of three distinct layers and another fascia that encases the major parallel cervical arteries, the major cervical vein, and the vagus nerve. Composed of collagen and elastin, the cervical fascia is intimately connected to the rest of the body’s fascial system and is largely responsible for shaping the enveloped organs and muscles of the neck.
What is the cervical fascia?
Cervical fascia includes several fasciae that can be anatomically assigned to the neck region. The bulk of the cervical fascia consists of three distinct layers called the sheets or laminae. Other fasciae such as the vagina carotica, which primarily encases the two cervical arteries, the common carotid artery, the internal jugular vein, and part of the vagus nerve, are also included in the cervical fascia. As part of the collagenous and elastic connective tissue, the function of the cervical fascia is to hold in place the vessels, muscles and the trachea, esophagus and thyroid gland that run in the neck and to give them their external shape. In addition, the fasciae allow almost frictionless displacements of the organs and muscles against each other. To perform its tasks, the cervical fascia is divided into three so-called sheets or laminae, which lie one above the other. These are the lamina superficialis, which spans the entire neck below the skin, the lamina praetrachealis and the lamina praevertebralis. The cervical fascia also includes the vagina carotica, which encases the so-called vascular-nerve cord of the neck.
Anatomy and structure
The neck fasciae are composed of membranes composed mainly of collagen and elastin. Strength and elasticity of the fasciae is based on anatomical needs. Muscles, vessels, organs or nerves are enveloped by fascia, which are interconnected with each other, so fascia determines the three-dimensional space of the body and regulates body tension through sympathetic and parasympathetic nervous system. The superficial fascia, which spans the entire neck below the fatty tissue of the skin, splits at each of the major surface muscles, the head turner and the trapezius muscle, so that the two muscles become properly embedded in the split lamina superficialis. As the process continues, the split parts reconnect. All the cervical fasciae are intimately connected in a network-like fashion, so that the tension or relaxation of just one fascia has an effect on the other fasciae. Tension and relaxation is controlled by sympathetic and parasympathetic nervous systems. The sympathetic and parasympathetic nervous systems are part of the autonomic nervous system and innervate the fasciae. The cervical fasciae also contain a variety of sensory nerve endings for pain sensation (nociceptors), mechanoreceptors, thermoreceptors, and chemoreceptors that allow the brain to “assess position.” To control fascial tension, fasciae are also connected to efferent motor nerves, contractile stimuli that can be applied to myofibroblasts. These are connective tissue cells that have similar properties to smooth muscle cells and are part of the fascia in varying concentrations. Fascia is supplied and drained by a network of arterial, capillary, and venous vessels, as well as by numerous lymphatic vessels that are connected to the fascia.
Function and tasks
One of the main functions of the cervical fascia is to hold in place vessels, nerves, muscles and organs that run or are localized in the cervical region, and to ensure that they can be moved without injury and as smoothly as possible within certain limits that guarantee the neck its freedom of movement. The freedom of movement of the joints is largely dependent on the elasticity of the fasciae. The elasticity and tensile strength of the fasciae are matched to their tasks, so that the outer, middle and inner fasciae differ in their properties. However, the variable tension of the neck fasciae not only keeps the individual systems, which can be distinguished from each other, in their position, but it also supports the muscles in their function. For example, an elastically pre-stretched fascia acts as a mechanical energy store. During muscle contraction, the stretch tension of the fascia is released, and the mechanical energy released supports muscle contraction.Via their numerous receptors for pain, temperature and mechanical and chemical stimuli such as pH value and oxygen partial pressure, they report “status reports” to the responsible brain centers, which use them to make a “situation assessment” and react with locally or systemically effective stimuli. The fasciae also serve as a mechanical and chemical barrier to protect the sheathed organs against pathogens, and through their water storage capacity they play a major role in regulating water balance.
Diseases
One of the most common problems associated with fascia arises from tension control via the sympathetic nervous system. Frequent stressors that cause the sympathetic nervous system to constantly release stress hormones can lead to a chronically elevated concentration of stress hormones in the body. The fasciae react to this with a kind of constant tension, so that the normal alternation between tension and relaxation is greatly reduced. This leads to a reduction in the flow of lymph between the fasciae, which causes the fibrinogen contained in the lymph, a clotting factor, to accumulate in the tissue and be converted into fibrin, the body’s own “glue”. The fibrinogen glues the fascia together and can cause significant discomfort. Glued neck fascia can result in significant restriction of neck movement, but can also lead to significant pain if the nerves running between the fascia are pinched, causing non-specific pain or sensory problems. The symptoms are known as myofascial syndrome (MFS). Because of the web-like connection of all fasciae to each other, the pain caused cannot always be localized.
