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 plexus Internal carotid plexus The internal carotid plexus (internal carotid plexus) is situated on the lateral side of the internal carotid artery, and in the plexus there occasionally exists a small gangliform swelling, the "carotid ganglion", on the under surface of the artery. Postganglionic sympathetic fibres ascend from the superior cervical ganglion, along the walls of the internal carotid artery, to enter the internal carotid plexus. These fibres then distribute to deep structures, which include the Superior Tarsal Muscle and pupillary dilator muscles. Some of the fibres from the internal carotid plexus converge to form the deep petrosal nerve. The internal