Neck spaces and communications/fascia etc

Question 1

Name borders of the submandibular space

Answer 1

Superiorly-body mandible
Anteriorly - anterior belly digastric
Posteriorly- posterior belly digastric

Question 2

Name 2 fascial spaces that can communicate with the submandibular space

Answer 2

Parapharyngeal and retropharyngeal space

Question 3

name borders of the carotid space

Answer 3

anteriorly- superior belly omohyoid
Posteriorly-antrior border sternocleidomastoid
Superior- posterior belly digastric

Question 4

What vessel would you find in the carotid space

Answer 4

Vagus nerve
Internal jugular vein
Common carotid artery
( all in the carotid sheath)

Question 5

What are the borders of the muscular space

Answer 5

Anteriorly - midline neck
Posteriorly - superior belly omohyoid and anterior sternocleidomastoid
Superiorly -hyoid

Question 6

What structures might you see in the muscular space

Answer 6

Thyroid gland
Infrahyoid muscles
Pharynx

Question 7

What may drain into the submandibular space

Answer 7

Mandibular teeth 2/3rd molar

Question 8

What may drain into the submental space

Answer 8

Mandibular incisor infection

Question 9

What is Ludwigs angina and why is it dangerous

Answer 9

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

Question 10

Where is the superficial fascia found

Answer 10

Superficial between platysma and skin

Question 11

Name 4 deep cervical fascia

Answer 11

Investing fascia
carotid sheath
Vertebral fascia
Visceral fascia –>pretracheal ( anterior ) and
buccopharyngeal (posterior )

Question 12

what does the investing fascia surround

Answer 12

sternocleidomastoid/trapezius and ALL neck structures

Question 13

what does the carotid sheath fascia surround

Answer 13

Vagus nerve, internal jugular vein , common carotid artery

Question 14

What does the vertebral fascia surround

Answer 14

vertebral muscles and surrounding structures

Question 15

What does visceral fascia surround

Answer 15

neck viscera - trachea/oesophagus

Question 16

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

Answer 16

Infratemporal fossa
Pterygomandibular space<—->Submandibular space
II - connect
Previsceral 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 17

Where is retropharyngeal space located

Answer 17

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

Question 18

What’s importance of the retropharyngeal space

Answer 18

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

Question 19

name 3 spaces that communicate to retropharyngeal space

Answer 19

Submandibular
Sublingual
Parapharyngeal

Question 20

what’s the parapharyngeal space important for

Answer 20

Spreads infection rapidly from teeth /maxilla /mandible

Question 21

Name 2 communications for parapharyngeal space

Answer 21

Submandibular space
Retropharyngeal space

Question 22

where is the infra temporal fossa found

Answer 22

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

Question 23

Name 5 structures in the infratemporal fossa

Answer 23

Muscles mastication ( all except masseter )
Maxillary artery
Pterygoid vein plexus
Mandibular Nerve V3
Chorda tympani nerve ( VII brach )
Glossopharyngeal nerve

Question 24

Name 2 nerves found in the infra temporal fossa

Answer 24

Mandibular nerve V3
Chordae tympani VII
Glossopharyngeal nerve

Question 25

What’s the importance infra temporal fossa

Answer 25

Connects to : pterygopalatine fossa
Orbit
temporal fossa
Infection quickly spreads thru these

carries lots vessels

Question 26

What would you see if the infra temporal fossa was infected

Answer 26

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

V3 numbness

Question 27

What are the pterygomandibular space boundaries

Answer 27

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

Question 28

Name contents of pterygomandibular space

Answer 28

Inferior alveolar vein, artery , nerve’
Lingual nerve

Question 29

What communicates with the pterygomandibular space

Answer 29

Submandibular space
Parapharyngeal space

Question 30

what’s the importance of the pterygomandibular space

Answer 30

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

Question 31

What’s the risk of injecting into the pterygomandibular space

Answer 31

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

Question 32

Name 2 ligaments in the infra temporal fossa

Answer 32

Temperomandibular ligament
Sphenomandibular ligament