neck fascia and spaces
TRANSCRIPT
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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 :
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• 1- Digastric triangle • 2- carotid triangle • 3- Muscular triangle • 4- Submental triangle
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Anterior belly of digastric muscle
Posterior belly of digastric
Stylohyoid
Sternohyoid muscle
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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
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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
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• dDigastric triangle
Carotid triangle
Muscular triangle
Anterior belly of digastric
Posterior belly of digastric
Mylohyoid muscle forms the floor of the mouth
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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 )
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External carotid artery
Common carotid artery
Internal carotid artery
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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 .
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• 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
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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
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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
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Deep Neck Space Anatomy
• Space Involving Entire Length Of Neck
• Space Limited To Above The Hyoid Bone
• Space limited To Below The Hyoid Bone
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Space Involving Entire Length Of Neck
1. Retropharyngeal Space2. Danger Space
(Prevertebral Space)3. Paravertebral Space4. Carotid Sheath Space
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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
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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
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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
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Carotid sheath Space
• Made up from all deep cervical fascia
• Infection from any deep fascia can spread to this space (lincoln High way)
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Space Limit To Above The Hyoid Bone
1. Parapharyngeal Space2. Submandibular Space3. Masticator Space4. Temporal Space5. Parotid Space
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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
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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
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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
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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.
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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