Overlying this superior carotid triangle is only skin, superficial fascia which is usually thin, although there may be an appreciable amount of subcutaneous fat. Within the superficial fascia is an exceedingly thin (paper-thin) muscle, platysma muscle, which begins in the tela subcutaneous over the upper part of the thorax, passes over the clavicle (collar bone), and runs upward and somewhat medially in the neck and across the mandible to blend with superficially located facial muscles. The platysma muscle has no very important action, but will wrinkle transversely the skin of the neck and help to open the mouth. This muscle does not protect the underlying vital structures.
The pressure is applied in a certain manner, depending upon the technique, directly on these structures. It may from using be the fist or the collar of any clothing. Very often, it is the pressure of the distal end of the radius and the wrist which compresses the soft structures of the neck. Neck pressure of 250 mm of Hg or 5 kg of rope tension is required to occlude carotid arteries. The amount of pressure to collapse the airway is six times greater.