4: H&n B1: Fascia

Front 1

Fascia of the neck?

Back 1

SIP PAC:

1) Superficial
2) Investing
3) Pretracheal
4) Prevertebral
5) Alar
6) Carotid sheath

Front 2

What's contained inside the superficial fascia?

Back 2

Cash Money Plastic:

1) Cervical plexus
2) Muscles of facial expression
3) Platysma

Front 3

What's contained inside investing fascia?

Back 3

A/P triangles, their muscles, and trapezius

Front 4

What's contained inside pretracheal fascia?

Back 4

The Pretracheal Thinks Everyone's a Loser, Idiot

1) Thyroid
2) Pharynx
3) Trachea
4) Esophagus
5) Larynx
6) Infrahyoids

Front 5

What's contained inside prevertebral fascia?

Back 5

My VErtebra'S Big

1) Muscles of the back (deep)
2) Vertebral column
3) Esophagus
4) Scalenes
5) Brachial plexus
4)
4)

Front 6

What's the alar fascia derived from? Where does it stretch?

Back 6

Vertebral fascia, transverse process on vertebrae -> other, upward from infrahyoid to base of skull

Front 7

What's contained inside the carotid sheath? What is it derived from?

Back 7

Carotid Sheath - Everyone Is Very Interested (it just got PAId)

Common carotid, sympathetic fibers, external and internal carotid arteries, vagus, internal jugual vein. Derives from prevertebral, alar, investing fascia.

Front 8

Pretracheal space:

1) Where is it found?
2) Superior border
3) Inferior border

Back 8

• Between trachea and esophagus
• Superior border – Infrahyoid muscles -> thyroid cartilage, hyoid
• Inferior border – thoracic cavity

Front 9

2. Retropharyngeal space –
• Superior:
• Anterior:
• Inferior:
• Posterior:
• Lateral:
• Medial:
• Infection spread to:

Back 9

2. Retropharyngeal space – Some Sick Bums May Asphyxiate, Coughing Phlegm
• Superior: skull
• Anterior: superior constrictor/buccopharyngeal fascia
• Inferior: mediastinum
• Posterior: Alar fascia
• Lateral: carotid sheath fascia
• Medial: Pharyngeal fascia
• Infection spread to: mediastinum

Front 10

3. Parapharyngeal space aka lateral pharyngeal space
• Superior –
• Anterior –
• Inferior –
• Posterior –
• Lateral –
• Medial –
• Contents:
• Infection spread to:

Back 10

3. Parapharyngeal space aka lateral pharyngeal space – Silly Stupid Boys Have A Complex, Men Should Stay Boys
• Superior – skull
• Anterior – superior constrictor/buccopharyngeal fascia
• Inferior – hyoid
• Posterior – alar fascia/carotid sheath
• Lateral – medial pterygoid/sternocleidomastoid
• Medial – superior constrictor/buccopharyngeal fascia
• Contents: carotid sheath, deep cervical chain of lymph nodes
• Infection spread to: retropharyngeal space

Front 11

4. Prevertebral space aka Danger Space

What fascia does it lie between?

Back 11

4. Prevertebral space aka Danger Space
a. Lies between alar/prevertebral fascia

Front 12

5. Mandibular space –
a. Extends from
b. Infection comes from:
c. Infection spreads to:

Back 12

5. Mandibular space – MMM, Some Mandibular Sores are Big Fucking Sores
a. Extends from mandibular symphysis -> masseter, medial pterygoid
b. Infection comes from: mandible, any of the mandibular teeth
c. Infection spreads to: sublingual, mentalis, submental, buccal, facial vestibule, submandibular

Front 13

6. Parotid space
a. Contents:
b. Infection comes from:
c. Infection spreads to: l

Back 13

6. Parotid space – when you have a parotid infection, you get PSSD
a. Contents: parotid capsule, parotid duct, facial nerve, veins/arteries
b. Infection comes from: not the teeth
c. Infection spreads to: parapharyngeal space, skin, subcutaneous fascia, deep temporal

Front 14

7. Facial vestibule
a. Superior:
b. Anterior:
c. Inferior:
d. Posterior:
e. Lateral:
f. Medial:
g. Infections come from:
h. Infection spreads to:

Back 14

7. Facial vestibule – If Only My Mouth Brushed Often
a. Superior: infratemporal fossa
b. Anterior: oral mucosa
c. Inferior: mandible
d. Posterior: mandible
e. Lateral: buccinators
f. Medial: oral mucosa
g. Infections come from: periodontal abscesses superficial to bone
h. Infection spreads to: buccal space

Front 15

8. Mentalis space
a. Superior:
b. Anterior:
c. Inferior:
d. Posterior:
e. Lateral:
f. Medial:
g. Infection
h. Infection goes to:

Back 15

8. Mentalis space – My Immature Mind Makes Dumb Mnemonics
a. Superior: Mentalis/inferior labialis muscles
b. Anterior: Mentalis
c. Inferior: ??
d. Posterior: Mandible
e. Lateral: Depressor anguli oris
f. Medial: Midline of the mandible
g. Infection comes from: 4 mandibular incisors
h. Infection goes to: submental/submandibular spaces

Front 16

9. Buccal space
a. Superior:
b. Anterior:
c. Inferior:
d. Posterior:
e. Lateral:
f. Medial:
g. Infection comes from:
h. Infection spreads to:

Back 16

9. Buccal space – Most Zesty Strippers Strip to Make Some Pennies, Plus Six Bucks
a. Superior: Maxilla/zygomatic/superficial fascia
b. Anterior: Superficial fascia
c. Inferior: Mandible/superficial fascia
d. Posterior: Parotid gland/parotid duct
e. Lateral: Superficial fascia
f. Medial: Buccinator
g. Infection comes from: Maxillary/mandibular molars
h. Infection spreads to: Pro Strippers Don’t Strip Lazily – pterygomandibular space, submasseteric space, deep temporal, superficial temporal, lateral pharyngeal.

Front 17

10. Masticator Region
a. Superior:
b. Anterior:
c. Inferior:
d. Posterior:
e. Lateral:
f. Medial:

Back 17

10. Masticator Region: Tony Roma’s Mastication Might Make Some Cry More
a. Superior: temporal line
b. Anterior: ramus of the mandible
c. Inferior: mandible/insertion of medial pterygoid and masseter
d. Posterior: Stylomandibular ligament
e. Lateral: cervical fascia (lateral portion, surrounding masseter and zygo arch)
f. Medial: medial pterygoid muscle

Front 18

11. Superficial temporal space:
a. P,A,L,S
b. Medial –
c. Inferior –
d. Infection spread –

Back 18

11. Superficial temporal space: PALS
a. P,A,L,S – temporalis fascia
b. Medial – temporalis muscle
c. Inferior – zygomatic arch and mandible
d. Infection spread – pterygomandibular, submasseter, parapharyngeal

Front 19

12. Deep temporal space:
a. Superior/Medial –
b. Anterior/Posterior –
c. Lateral –
d. Inferior –

Back 19

12. Deep temporal space:
a. Superior/Medial – skull
b. Anterior/Posterior – temporalis fascia
c. Lateral – temporalis
d. Inferior – lateral pterygoid

Front 20

1. Pterygomandibular space:
a. Superior –
b. Anterior –
c. Inferior –
d. Posterior –
e. Lateral –
f. Medial –
g. Contents:
h. Infections from:
i. Infections spread to:

Back 20

1. Pterygomandibular space: Lightly Buttered Bread Makes Pterygomandibulars go MMM!
a. Superior – lateral pterygoid
b. Anterior – buccinators/buccal fascia
c. Inferior – mandible
d. Posterior – parotid fascia/mandible
e. Lateral – mandible
f. Medial – medial pterygoid
g. Contents: important branches of mandibular nerve – IAN, lingual, chorda tympani, IAN artery/vein
h. Infections from: 2nd, 3rd molars
i. Infections spread to: Pterygomandibular Thinks Strawberry Icepops Suck – parapharyngeal, temporal spaces, submasseteric, infratemporal, submandibular

Front 21

13. Submasseteric:
a. Superior:
b. Anterior:
c. Inferior:
d. Posterior:
e. Lateral:
f. Medial:
g. Infection from
h. Infections to:

Back 21

13. Submasseteric: Low Blows Make Purple Masseters and Mandibles
a. Superior: Lateral pterygoid
b. Anterior: buccal fascia
c. Inferior: Mandible
d. Posterior: Parotid fascia
e. Lateral: Masseter
f. Medial: Mandible
g. Infection from: impacted third molars
h. Infections to: temporal spaces and buccal space

Front 22

Mylohyoid line: division between

Back 22

sublingual and submandibular spaces

Front 23

14. Sublingual:
a. Superior:
b. Anterior:
c. Inferior:
d. Posterior:
e. Lateral:
f. Medial:
g. Contents:
h. Infections from:

Back 23

14. Sublingual: MMM Potty Mouth Time
a. Superior: Mucosa of the floor of the mouth
b. Anterior: mandible
c. Inferior: mylohyoid
d. Posterior: Pharyngeal constrictors
e. Lateral: Mandible
f. Medial: Tongue
g. Contents: submandibular duct/ganglion, lingual nerve/artery, branches of hypoglossal nerve
h. Infections from: Molars were roots are superior to mylohyoid muscle

Front 24

15. Submandibular space:
a. Superior:
b. Anterior:
c. Inferior:
d. Posterior:
e. Lateral:
f. Medial:
g. Contents:
h. Infections from:

Back 24

15. Submandibular space: Mandibles Munch Popcorn Over Molars, Premolars & Anteriors
a. Superior: Mylohyoid
b. Anterior: Mandible
c. Inferior: Platysma
d. Posterior: Oral cavity/pharynx
e. Lateral: Mandible
f. Medial: Anterior belly of the digastrics
g. Contents: submandibular gland/lymph nodes, nerve to mylohyoid, facial artery/branches.
h. Infections from: molars that have their roots inferior to the mylohyoid

Front 25

Ludwig’s Angina: what spaces?

Back 25

Ludwig’s Angina: submandibular, sublingual, submental

Front 26

16. Canine space: infection can spread to:

Back 26

16. Canine space: infection can spread to infraorbital and periorbital areas. Maxillary incisors -> base of upper lip -> infraorbital/periorbital -> cavernous sinus

Front 27

17. Infraorbital area:

a. Superior:
b. Anterior:
c. Posterior:
d. Infections come from:
e. Infections spread to:

Back 27

17. Infraorbital area: LOB

a. Superior: levator palpebrae
b. Anterior: orbicularis oris
c. Posterior: buccinators
d. Infections come from: maxillary canines/first premolars
e. Infections spread to: cavernous sinus/buccal space/deep temporal space

Front 28

18. Periorbital area:
a. Where is it found?
b. Infections come from
c. Infections go to:

Back 28

18. Periorbital area:
a. Under orbicularis oculi
b. Infections come from: any maxillary tooth,
i. premolars -> infraorbital -> periorbital
ii. premolars -> buccal space -> periorbital
iii. maxillary incisor -> base of upper lip, infraorbital
c. Infections go to: cavernous sinus
i. CS drains via internal jugular vein. Connected to pterygoid plexus, inferior ophthalmic vein, superior ophthalmic vein.

Front 29

19. Tonsillar region:
a. Superior:
b. Anterior:
c. Inferior:
d. Posterior:
e. Lateral:
f. Medial:
g. Infection spread:

Back 29

19. Tonsillar region: Stop Poking! Poking Parties are Very Odd
a. Superior: submucosa of soft palate
b. Anterior: palatoglossus
c. Inferior: pharynx
d. Posterior: palatopharyngeus muscle
e. Lateral: visceral fasica
f. Medial: oropharynx mucosa
g. Infection spread: from tonsillar region