Musculofascial Comprtments Of The Neck

Question 1

What is fascia?

Answer 1

The body’s connective tissue matrix. Fibrous CT.

Question 2

What are the 16 fascial spaces in the head and neck region?

Answer 2

5 fascial spaces of the face
5 suprahyoid fascial spaces
1 infrahyoid fascial space
5 fascial spaces of the neck

Question 3

Why is the neck divided into fascial compartments?

Answer 3

To ensure ease of movement e.g., during swallowing
Form natural planes of tissue packing
Give structure and support to viscera, muscles, vessels and deep lymph nodes

Question 4

General tissue layers of the body surfaces

Answer 4

Skin, superficial fascia, deep fascia, muscles, deepest layer of deep fascia

Question 5

Tissue layers of the neck

Answer 5

Skin, superficial fascia, platysma muscle, deep cervical fascia

Question 6

What is superficial fascia?

Answer 6

Binds the skin to the rest of the tissues of the body. Subcutaneous fat exists between it and the skin. Only one plane of this layer.

Question 7

What is deep fascia?

Answer 7

Encloses the organs and divides the muscles into compartments.

Question 8

What are the layers of deep cervical fascia?

Answer 8

Investing fascia, pre-tracheal fascia, pre-vertebral fascia, carotid sheaths

Question 9

What does the investing layer of deep cervical fascia enclose?

Answer 9

Encloses trapezius, SCM (anteriorly and laterally), submandibular gland

Question 10

What does the investing layer attach to?

Answer 10

Hyoid bone (anteriorly), occipital bone and superior nuchal line, clavicle, manubrium and spine, mandible

Question 11

Where does the pre-tracheal layer stretch?

Answer 11

From the hyoid bone into the thorax. Thickened more anteriorly than posteriorly.

Question 12

Contents of the pre-tracheal fascia

Answer 12

Infrahyoid muscles, trachea, oesophagus, thyroid gland

Question 13

Contents of the prevertebral fascia

Answer 13

Vertebral column and muscles of the vertebral column

Question 14

Where does the prevertebral layer attach?

Answer 14

Cranial base (top), endothoracic fascia, axillary sheath
Thickened more at the anterior aspect

Question 15

Contents of the carotid sheath

Answer 15

Carotid artery, internal jugular vein, vagus nerve

Question 16

What does the carotid sheath attach to?

Answer 16

Same as prevertebral fascia, since the blending between layers creates the carotid sheath.

Question 17

What is alar fascia?

Answer 17

Carotid sheaths are joined at the midline by a very thin layer of fascia = the alar fascia. It does not go all the way down to the thorax.

Question 18

Where does the alar fascia disappear?

Answer 18

Around level of T6, meaning the potential spaces join to form one.

Question 19

Where is the retropharyngeal space?

Answer 19

Behind the pharynx. Trachea and oesophagus are nearby. It is anterior to the alar fascia, running all the way from cranial base to thorax/diaphragm.

Question 20

Where is the danger space?

Answer 20

Posterior to the alar fascia

Question 21

Why are potential spaces important?

Answer 21

These are the spaces that will make infection more likely to spread from one region to another.

Question 22

What is the parapharyngeal space?

Answer 22

Potential space immediately lateral to the oropharynx and nasopharynx.

Question 23

What can the parapharyngeal space affect?

Answer 23

Can affect carotid sheath cultures upto the level of the mediastinum.

Question 24

What can the parapharyngeal space be invaded by?

Answer 24

Infections of the oral cavity, e,g., tonsillitis or abscess of the root of lower third molar,

Question 25

What is the superficial infections space?

Answer 25

Infections can break through within the superficial layer of the neck. Cellulitis of neck region etc.

Question 26

Where can infection spread if between investing and pre-tracheal fascia?

Answer 26

Spread to the thoracic cavity

Question 27

Where can infection spread is there is abscess posterior to the prevertebral layer?

Answer 27

May extend lateral to the SCM

Question 28

Where can retropharyngeal abscess spread?

Answer 28

To the superior mediastinum

Question 29

Where can infection in the head spread?

Answer 29

Inferiorly
Can travel posterior to the oesophagus or into the posterior mediastinum.