Spread of dental infection: anatomy Flashcards
For the CANINE fascial space of the face, describe its:
- Location
- Sources of infection into this space
- Incision technique
Location:
• Between the orbicularis oculi and buccal space
Sources of infection into this space:
• Infections from the maxillary canines/premolars infect this space
Incision technique:
• Intra-oral
• Through the maxillary vestibular mucosa
For the BUCCAL fascial space of the face, describe its:
- Location
- Contents (6)
- Sources of infection into this space
- Incision technique
Location:
• The buccal space is superficial (on top) to the buccinator and deep to the platysmaand the skin.
• Posterior boundary: masseter muscles
Consists of: • Adipose tissue (buccal fat pad) • Ducts • Facial artery and vein • Lymphatic vessels • Minor salivary glands • Facial nerve and glossopharyngeal nerve
Sources of infection into this space:
• Mandibular or maxillary molars
Incision technique:
Intra-oral
For the MASSETERIC fascial space of the face, describe its:
- Location
- Sources of infection into this space (and the most pronounced clinical feature)
- Incision technique
Location:
• In front of the ramus of the mandible and behind the masseter muscle (between the two muscles)
Sources of infection into this space:
• Mandibular molars
• Trismus is the most pronounced clinical feature
Incision technique:
• Intraoral surgical access to drain isolated abscesses, but with extension into adjacent spaces
• Extraoral submandibular approach may be required
For the PTERYGOMANDIBULAR fascial space of the face, describe its:
- Location and what it contains
- Sources of infection into this space
- Incision technique
Location:
• Behind the ramus of the mandible, in front of the medial pterygoid muscle
• This space contains the inferior alveolar and lingual nerve, and vascular bundles
Sources of infection into this space:
• Mandibular dentoalveolar abscesses
Incision technique:
• Intra-oral
For the PAROTID fascial space of the face, describe its:
- Location
- The 4 things that traverse this space
- Sources of infection into this space
- Other sources of fascial infections into this space
Location:
• Contains the parotid gland and its associated lymph nodes
Traverse this space: • Facial nerve • External carotid • Internal maxillary arteries • Retromandibular vein
Sources of infection into this space:
• Generally bloodborne or retrograde (backwards) from the parotid duct
Other sources of fascial infections into this space:
• Masseteric
• Lateral pharyngeal
For the INFRATEMPORAL fascial space of the face, describe its:
- Location
- Sources of infection into this space
- Other sources of fascial infections into this space
Location:
• Behind the temporalis muscle and on top of the lateral pterygoid muscle
Sources of infection into this space:
• Extension of infection from maxillary molars
Other sources of fascial infections into this space
• Pterygomandibular
• Parotid
• Lateral pharyngeal
For the SUBMANDIBULAR suprahyoid fascial space, describe its:
- Location
- Sources of infection
Location:
• Beneath the mylohyoid muscle. It is bordered by the ramus of the mandible
• Anterior border: defined by the anterior belly of the digastric muscle
• Posterior border: posterior belly of the digastric muscle
Sources of infection into this space:
• Posterior mandibular teeth 7 and 8 (occasionally 6), due to the fact that the mylohyoid muscle attaches here at the mylohyoid line
For the SUBMENTAL suprahyoid fascial space, describe its:
- Location
- Sources of infection
Location:
• Lies in between the two anterior bellies of the digastric muscle
Sources of infection into this space
• Anterior mandibular teeth
For the SUBLINGUAL suprahyoid fascial space, describe its:
- Location
- Associated complications
Location:
• Its superior boundary are the oral mucous membranes
• It lies on top of the mylohyoid muscle
Associated complications:
• Tongue displacement from swelling may compromise the airway
• Dysphagia and difficulty in speech are also common
For the LATERAL PHARYNGEAL fascial space of the neck, describe:
- Location
- What it contains (5)
- Sources of infection
- Significance
- Symptoms (5)
Location:
• Shaped like an inverted pyramid
• Extends from the base of the sphenoid bone down to the hyoid bone
• Next to the medial pterygoid muscle
Contains: • Carotid sheath • Glossopharyngeal nerve • Accessory nerve • Hypoglossal nerve • Sympathetic trunk
Sources of infection into this space:
• Mandibular molars/ third molars with pericoronitis
Significance:
• Spread of infection into this space carries significant danger of spreading into the descending neck and the mediastinum
Symptoms: • Stiffness of the neck • Swelling of the lateral wall of the pharynx • Medial displacement of the tonsils • Dysphagia • Trismus
For the CAROTID SHEATH fascial space of the neck, describe what it is and what it contains (5)
What it is:
• It is a fibrous connective tissue that surrounds the vascular compartment of the neck
What is contains: • Common carotid artery and the internal carotid artery • Internal jugular vein • Vagus nerve • Deep cervical lymph nodes
For the RETROPHARYNGEAL fascial space of the neck, describe its:
- Location
- Significance
Location:
• Its anterior border is the pharynx, and the posterior border is the prevertebral fascia
• This space is in direct communication with the base of the skull superiorly and the mediastinum inferiorly
Significance:
• It has the same characteristic clinical features as infection of the lateral pharyngeal space
• Carries the significant complication of a descending neck infection
State the regions that the anterior cervical chain lymph nodes drain
- Pharynx
- Throat
- Tonsils
- Thyroid gland
State the regions that the posterior cervical chain lymph nodes drain
- Scalp and neck
- Thorax
- Cervical and Axillary nodes
State the regions that the submandibular lymph nodes drain
- Floor of the mouth
- Submandibular gland
- Tongue
- Lips
