Neck spaces and communications/fascia etc

Question 1

Name 2 fascial spaces that can communicate with the submandibular space

Answer 1

Parapharyngeal and retropharyngeal space

Question 2

What may drain into the submandibular space

Answer 2

Mandibular teeth 2/3rd molar

Question 3

What may drain into the submental space

Answer 3

Mandibular incisor infection

Question 4

What is Ludwigs angina and why is it dangerous

Answer 4

Swelling from infection of ALL perimandibular spaces, dangerous as it lifts tongue up and back so risk blocking airway and die

Question 5

what does the carotid sheath fascia surround

Answer 5

Vagus nerve, internal jugular vein , common carotid artery

Question 6

Draw a diagram showing communications between spaces in neck -whats the risk

Answer 6

……………………………………………… Infratemporal fossa
Pterygomandibular space<—->Submandibular space
II - connect
Pteygomandibular space. <—> Parapharyngeal
space
II
Retropharyngeal space

Danger zone is retropharyngeal space communicates into mediastinum and infection quickly spread

NOTE LOOK at notes as this won’t draw properly)

Question 7

Where is retropharyngeal space located

Answer 7

Skull base down to mediastinum
Between: posterior pharynx —-> anterior to pre vertebral muscles

Question 8

What’s importance of the retropharyngeal space

Answer 8

Lots of communications
Danger area - as infection spreads quickly thru the space into mediastinum and to other organs

Question 9

name 3 spaces that communicate to retropharyngeal space

Answer 9

Submandibular
Sublingual
Parapharyngeal

Question 10

what’s the parapharyngeal space important for

Answer 10

Spreads infection rapidly from teeth /maxilla /mandible

Question 11

Name 2 communications for parapharyngeal space

Answer 11

Submandibular space
Retropharyngeal space

Question 12

where is the infra temporal fossa found

Answer 12

Under zygomatic arch , deep to master
Between skull base ,lateral pharyngeal wall, ramus mandible

Question 13

Name 5 structures in the infratemporal fossa

Answer 13

Muscle-: of mastication ( all except masseter )

Artery :-Maxillary artery (and branches)

Vein :- Pterygoid vein plexus

Nerves :
- 1.Mandibular Nerve V3- (branches-lingual/
inferior alveolar /
long buccal
auriculotemporaL)
2.-Chorda tympani nerve ( VII branch )
-3.Glossopharyngeal nerve (IX)

Ligaments:Temperomandibular ligament
Sphenomandibular ligament

Question 14

Name 2 nerves found in the infra temporal fossa

Answer 14

Mandibular nerve V3
Chordae tympani VII
Glossopharyngeal nerve (IX)

Question 15

What’s the importance infratemporal fossa

Answer 15

Carries lots vessels
Connects to : pterygopalatine fossa
Orbit
temporal fossa
(Infection quickly spreads thru these )

Question 16

What would you see if the infratemporal fossa was infected

Answer 16

Hot swollen red painful area in the infra temporal region
Trismus - unable open mouth - painful

V3 numbness
Loss taste anterior 2/3 tongue

Question 17

What are the pterygomandibular space boundaries

Answer 17

Medial: medial pterygoid
Lateral : ramus mandible
Anterior : pterygomandibular raphe
Posterior : parotid gland

Question 18

Name contents of pterygomandibular space

Answer 18

Inferior alveolar vein, artery , nerve’
Lingual nerve

Question 19

What communicates with the pterygomandibular space

Answer 19

Submandibular space
Parapharyngeal space<–>retropharyngeal

Question 20

what’s the importance of the pterygomandibular space

Answer 20

Inject local aesthetic in for an inferior alveolar nerve block to numb mandibular posterior teeth

Question 21

What’s the risk of injecting into the pterygomandibular space

Answer 21

1.Going to far into parotid and causing facial palsy ( as injure facial nerve
2. Injecting into an artery or vein
3. Introducing infection that can rapidly spread into other spaces