neck fascia and spaces
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The document describes the anatomy of the neck spaces. It is divided into three sections: spaces involving the entire length of the neck, spaces limited to above the hyoid bone, and spaces limited to below the hyoid bone. The key spaces described include the retropharyngeal space, danger space, parapharyngeal space, submandibular space, and anterior visceral space. Various structures form the boundaries of each space and contents are noted.
neck fascia and spaces
- 2. The anterior triangle of the neck • It lies in front of the sternomastoid muscle . • It is bounded by : • 1- anterior border of sternomastoid muscle .(behind) • 2- anterior midline of the neck ( in front ) • 3- lower border of the mandible (base ) • It is subdivided into 4 triangles by means of the superior belly of omohyoid muscle , the anterior and posterior bellies of digastric muscle as follows :
- 3. • 1- Digastric triangle • 2- carotid triangle • 3- Muscular triangle • 4- Submental triangle
- 4. Anterior belly of digastric muscle Posterior belly of digastric Stylohyoid Sternohyoid muscle
- 5. Digastric triangle Or submandibular triangle • Outlines : • Above : the lower border of the mandible • Below & infront : the anterior belly of Digastric muscle • Below & behind : the posterior belly of Digastric and stylohyoid muscles . • Floor : • Anteriorly : the mylohyoid muscle • Posteriorly : part of hyoglossus muscle
- 6. Contents of the Digastric triangle • 1- submandibular salivary gland • 2- the submandibular lymph nodes lie on the surface of the gland • 3- facial artery deep to posterior end of submandibular salivary gland • 4- facial vein lies superficial to submandibular salivary gland • 5- hypoglossal nerve • 6- nerve to mylohyoid muscle
- 7. • d Digastric triangle Carotid triangle Muscular triangle Anterior belly of digastric Posterior belly of digastric Mylohyoid muscle forms the floor of the mouth
- 8. Carotid triangle • Outlines : • Behind : the sternomastoid muscle • Infront and above : the posterior belly of digastric muscle • Infront and below : the superior belly of omohyoid muscle • Floor : infont : the hyoglossus muscle ( above ) and the thyrohyoid muscle (below) • Behind: the middle constrictor muscle of the pharynx (above ) and the inferior constrictor muscle of the pharynx (below )
- 9. External carotid artery Common carotid artery Internal carotid artery
- 10. Contents of the Carotid triangle • 1- The carotid sheath and its contents : • - common carotid artery : in the lower part of the triangle . • - internal carotid artery : in the upper part of the triangle . • Internal jugular vein : lateral • Vagus nerve : between the artery and the vein but in a more posterior plane .
- 11. • 2- the external carotid artery : gives most of its branches in the carotid triangle ( superior thyroid artery ,lingual artery ,facial artery , ascending pharyngeal artery and occipital artery ) • 3- hypoglossal nerve • 4- Descendes cervicalis (C2,3) anterior to carotid sheath. • 5- sympathetic trunk adherent to the posterior wall of carotid sheath
- 12. Muscular triangle • Outlines : • Infront : midline of the neck • Behind and above :superior belly of omohyoid muscle • Behind and below : the sternomastoid muscle It contains the infrahyoid muscle contain toss ,,,thyrohyoid ,,omohyoid,sternohyoid,sternothyroid
- 13. Submental triangle • Outlines : • Infront : symphysis menti of the mandible • On each side : the anterior belly of digastric muscle • Behind ( base ) : the hyoid bone • Floor : parts of the mylohyoid muscles as they meet each other in the median plane • Contains ………………………… • 1- submental lymph nodes • 2- beginning of the anterior jugular vein
- 14. Deep Neck Space Anatomy • Space Involving Entire Length Of Neck • Space Limited To Above The Hyoid Bone • Space limited To Below The Hyoid Bone
- 15. Space Involving Entire Length Of Neck 1. Retropharyngeal Space 2. Danger Space (Prevertebral Space) 3. Paravertebral Space 4. Carotid Sheath Space
- 16. Retropharyngeal Space • Between visceral division of middle layer and alar division of deep layer • Extend from skull base to T2 level • Midline raphae • More commom in children due to presence of retropharyngeal node
- 17. Danger Space • Between alar division and prevetebral division of deep layer (locate posterior to retropharyngeal space) • Extend from skull base to diaphram • No midline raphae • Infection spread from neck to posterior mediastinum easily
- 18. Paravertebral Space • Between prevertebral division of deep layer and vertebral bodies • Extend from skull base to coccyx • Infection in this space is rare and spread slowly due to compact connective tissue
- 19. Carotid sheath Space • Made up from all deep cervical fascia • Infection from any deep fascia can spread to this space (lincoln High way)
- 20. Space Limit To Above The Hyoid Bone 1. Parapharyngeal Space 2. Submandibular Space 3. Masticator Space 4. Temporal Space 5. Parotid Space
- 21. Parapharyngeal Space (Lateral phryngeal Space) (Pharyngomaxillaly Space) Boundary • Superiorly : Skull base • Inferiorly : Hyoid bone • Laterally : Medial pterygoid m. • Medially :Buccopharyngeal fascia • Anteriorly : Submandibular space • Posteromedialy : Prevertebral fascia & retrophryngeal space
- 22. Submandibular Space Divided into 2 spaces by mylohyoid m. 1. Sublingual space (above mylohyoid m.) 2. Submaxillaly space (below mylohyiod m.) • These 2 spaces can communicate each other by mylohyoid cleft
- 23. Masticator Space • Between masticator m. and superficial layer of deep cervical fascia (Masticator m. = massestor m.,medial and lateral pterygoid m. and temporalis muscle) • Locate anterior and lateral to parapharyngeal space
- 24. Parotid Space • Between parotid gl. and superficial layer of deep cervical fascia • Infection can spread easily to parapharyngeal space due to incompleted encircle at upper inner surface of parotid gl.
- 25. Space Limit To Below The Hyoid Bone Anterior Viseral Space (Pretracheal Space) • Between trachea, esophagus and middle layer of deep cervical fascia • Extend from hyoid bone to superior mediastinum