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Carotid sheath: want to learn more about it?

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Carotid sheath

The carotid sheath is one of four accumulations of deep cervical fascia or fibrous connective tissue of the neck which surrounds the great vessels of the neck. It extends from the base of the skull caudally to the first rib on the sternum. More precisely, it starts bilaterally at the level of the oropharynx on the lateral side of the retropharyngeal space, beneath the sternocleidomastoid muscle. It joins up medially with the prevertebral fascia and communicates inferiorly with the mediastinum. In this article, the fascial layers and relations, the contents of the carotid sheath and its pathology will be discussed.

Fascial layers and relations

Common carotid artery (lateral-right view)

The deep cervical fascia of the neck has four layers, listed from superficial to deep. The first is known as the investing layer and surrounds the sternocleidomastoid muscle and the trapezius muscle. The second one is that of the current topic, the carotid sheath which encompasses the vascular region of the neck. The third is called the pretracheal fascia and encloses the visceral region of the neck. Lastly, the fourth fascial layer is the prevertebral fascia and it surrounds the vertebral region of the neck.

The carotid sheath itself is an accumulation of three of the layers of the deep cervical fascia. These layers include the investing fascia, the pretracheal fascia and the prevertebral fascia. An important adjacent anatomical structure which can be seen just behind the carotid sheath is the cervical part of the sympathetic trunk which is embedded in the prevertebral fascia.

Sympathetic trunk (dorsal view)

Contents

The carotid sheath surrounds the following anatomical structures:

In order to remember this list of the main carotid sheath contents, a popular mnemonic is well worth learning: ‘I See 10CC’s in the IV’ (See list above for correlations).

Vagus nerve (lateral-right view)

Carotid sheath: want to learn more about it?

Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster.

What do you prefer to learn with?

“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

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