1.2.2 Organisation of Neck structures, Fascial Compartments

Question 1

What do fascial compartments of the neck do?

Answer 1

• Create concentric fascial layers for structures running through the neck
• Forms natural planes with potential spaces between
• Allow ease of movement between structures e.g. swallowing
• Restricts but also permits infection to spread

Question 2

Label the image

Answer 2

Question 3

Label the image

Answer 3

Question 4

What is the space created by the buccopharyngeal fascia and prevertebral layer?

Answer 4

Retropharyngeal Space

Question 5

What is significant about the retropharyngeal space?

Answer 5

• Up to age 3 contains lymph nodes which drain nose, oral cavity and upper pharynx
• Needed to allow space for pharynx to expand when swallowing

Question 6

What are some issues with the retropharyngeal space?

Answer 6

Abcess/infection, can track down to mediastinum and cause mediastinitus

Usually due to spead of infection intro retropharyngeal lymph nodes which drain upper respiratory tract

Question 7

How do patients present with retropharyngeal abcesses?

Answer 7

Patients with retropharyngeal abscess present
* Unwell, fever
* Sore throat
* Difficulty swallowing may drool due to pain with swallowing
* Painful neck movements
Patients can rapidly deteriorate with compromise to airway

Question 8

What usually causes a retropharyngeal abcess?

Answer 8

Usually secondary to upper RTI in children under 5

May also be meningitis or mumps

Question 9

What can be some symptoms of a goitre apart from a visible bulge that moves up when swallowing?

Answer 9

-Breathlessness, stridor, facial oedema

• Goitre can be restrosternal and extend into thorax due to pre-tracheal fascia
• Goitre compreses trachea and venous drainage