Spaces of H&N Flashcards
primary vs secondary spaces
- primary= direct relationship with source
* secondary= no direct relationship with source
what are some primary spaces?
Maxillary
- caniine
- buccal (bridging)
- infratemporal
Mandibular
- buccal (bridging)
- submental
- sublingual
- submandibular
what are some secondary spaces?
masticator pterygomandibular retropharyngeal parotid prevertebral
primary MX canine space boundaries
superior= levator labii superioris inferior= levator anguli oris
primary MX canine space communications
buccal space
primary MX canine space infection
- max canine or 1st maxillary premolar
* can erode superiorly toward the orbit
primary MX infratemporal space boundaries
- superior: infratemporal surface of greater wing of sphenoid
- inferior: lateral pterygoid
- lateral: temporalis
- medial: lateral pterygoid plate
- anterior: maxillar
- posterior: lateral pterygoid
primary MX infratemporal space communications
- buccal space
- temporal space
- pterygomandibular space
primary MX infratemporal space infection
- rare
- *MX 3rd molar infection
- close to pterygoid plexus
primary MX infratemporal space boundaries
- superior: infratemporal surface of greater wing of sphenoid
- inferior: lateral pterygoid
- later: temporalis
- medial- lateral pterygoid plate
- anterior: maxilla
- posterior: lateral pterygoid
primary MX infratemporal space communications
- buccal space
- temporal space
- pterygomandibular spac
primary MX infratemporal space infection
- rare
- MX 3rd molar infection
- close to pterygoid plexus
Primary MX/MD buccal (bridging) space boundaries
- superior: zygomatic process
- inferior: mandible
- lateral: skin & superficial fascia
- medial: buccinator
- anterior: mouth
- posterior: masseter
Primary MX/MD buccal (bridging) space communicatiosn
- canine space
- pterygomandibular space
- infratemporal space
- submassateric space
Primary MX/MD buccal (bridging) space infection
- MX molars
* MD molars
primary MD submental boundaries
- between the mylohyoid muscle and superficial layer of deep cervical fascia
- bounded laterally by the anterior digastric muscle
primary MD submental communications
submandibular space
primary MD submental infection
mandibular anterior teeth
primary MD submandibular boundaries
- between the mylohyoid muscle and superficial layer of deep cervical fascia
- between the anterior and posterior bellies of digastirc
primary MD submandibular communications
- sublingual space
- buccal space
- pterygomandibular space
primary MD submandibular infections
1, 2, and 3rd MD molars
primary MD sublingual boundaries
- between the mucosa and mylohyoid muscle
- superior: mucosa on floor of oral cavity
- inferior: mylohyoid m
- lateral AND anterior: mandible
- posterior: musclles along base of tongue
primary MD sublingual communications
- submandibular space
* pterygomandibular space
primary MD sublingual infection
MD premolars and molars
Secondary route from source MX anterior (usually canines) to ______?
*Symptomes?
to palatal and canine spaces
*swelling along lateral nose, swollen eyelids, palatal abscess
Secondary route from source MD anterior to ______?
*Symptomes?
to submental space
*chin swells
Secondary route from source MX premolars/molars to ______?
*Symptomes?
to buccal, infratemporal, or palatal space; maxillary sinus
*trismus, swelling of cheek, swelling of palate
Secondary route from source MD premolar/molars to ______?
*Symptomes?
to sublingual, submandibular, buccal, or pterygomandibular spaces
*swelling in floor of mouth, elevated tongue, difficulty speaking, neck swelling
Secondary route from source MX (maybe and MD 3rd molars to ______?
*Symptomes?
to parapharyngeal space then RPS
*pain, trismus, deviated uvula, difficulty swallowing/breathing
what is Ludwig’s Angina?
commonly caused by?
do what ASAP?
- severe cellulitis from bacterial infection in the floor of oral cavity
- 2nd to sublingual or submandibular infections (molar abscess)
- may spread to neck and block airway— intubate ASAP
- more common in kids
- can spread contralaterally bc there is no midline boundary
anatomical ‘real space’ vs anatomical ‘potential space’?
- real= subarachnoid space
* potential= retropharyngeal space
superficial fascia is immediately ___ to the skin and contains?
deep to skin
*contains losse C.T.; emergining cutaneous nerves, superficial vessels, and platysma
what are the 3 layers of deep fascia?
superficial, intermediate, deep
what comprises the carotid sheath?
all 3 layers of deep fascia
what is found in the carotid sheath?
internal carotid or common carotid artery, internal jugular vein, and vagus nerve, with ansa vericalis intimately attached to the out fascia layer
describe the superifical layer of deep fascia AKA investing layer? what are the borders?
continuous sheet encapsulating the neck
- superior border= inferior border of MD, inferior border of zygo, mastoid process, ligamentum buchae, and external occipital protuberance
- inferior borders= sternum, clavicle, acromion, scapular spine
the intermediate layer of deep fascia is divided into what two portions?
1) muscular
- -surrounds strap muscles
2) visceral
- -surrounds thyroid, trachea, and esophagus
alar fascia is an extension of?
prevertebral fascia
alar fascia splits the retropharegneal space into?
1) true retropharengeal space
- bounded by alar and buccopharyngeal fascia
2) danger space
- between alar and prevertebral
alar fascia spans the base of the skull to the superior mediastinum to merge with? WHERE? this separates???
buccopharyngeal fascia at T2
***separates the true RPS from the ‘danger space’ which extends down to the diaphragm
what all drains into retropharyngeal tonsils?
nasopharyxn, middle ear, and paranasal sinuses; drain caudally through the deppjugular chain towards the superior mediatinum
what are possible complications for danger space?
1) posterior
2) lateral
3) anterior
4) inferior
1) posterior- discitis osteomyelitis
2) lateral- carotid or IJV thrombosis
3) anterior- airway compression
4) inferior- mediastinitis
* generalized sepsis
