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,
Internal carotid artery mainly of historical significance. The segments of the internal carotid artery are as follows: The internal carotid artery is a terminal branch of the common carotid artery; it arises around the level of the fourth cervical vertebra when the common carotid bifurcates into this artery and its more superficial counterpart, the external carotid artery. The cervical segment, or C1, or cervical part of the internal carotid, extends from the carotid bifurcation until it enters the carotid canal in the skull anterior to the jugular foramen. At its origin, the internal carotid artery is somewhat dilated. This part of the artery