The carotid sheath is formed from the deep cervical fascia. It begins in the superior mediastinum at the origin of the common carotid artery and courses in an upward posterior direction and terminates at the jugular foramen and carotid canal. Structures within the carotid sheath are the common and internal carotid arteries, the internal jugular vein, and the vagus nerve (cranial nerve X).
The sympathetic cervical chain attaches on the posterior surface of the carotid sheath.
The accessory nerve (cranial nerve XI) is functionally part of the vagus nerve but supplies motor fibers to the pharynx, larynx, sternocleidomastoid, and trapezius muscles.
The recurrent laryngeal nerve branches from the vagus nerve and winds around the subclavian artery on the right and beneath the aortic arch on the left. It terminates as the inferior laryngeal nerve along the trachea.
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