Carotid sheath sternum. The four major structures contained in the carotid sheath are: The carotid artery lies medial to the internal jugular vein, and the vagus nerve is situated posteriorly between the two vessels. In the upper part, the carotid sheath also contains the glossopharyngeal nerve (IX), the accessory nerve (XI), and the hypoglossal nerve (XII), which pierce the fascia of the carotid sheath. The ansa cervicalis is embedded in the anterior wall of sheath. It is formed by "descendens hypoglossi" (C1) and "descendens cervicalis" (C2-C3). The three major fascial layers in the neck contribute to the carotid sheath: the investing fascia,
External carotid artery number and large size of its branches. At its origin, this artery is closer to the skin and more medial than the internal carotid, and is situated within the carotid triangle. In children, the external carotid artery is somewhat smaller than the internal carotid; but in the adult, the two vessels are of nearly equal size. The external carotid artery is covered by the skin, superficial fascia, Platysma, deep fascia, and anterior margin of the Sternocleidomastoideus; it is crossed by the hypoglossal nerve, by the lingual, ranine, common facial, and superior thyroid veins; and by the Digastricus and Stylohyoideus; higher