Facial Planes And Spaces Of The Head And Neck

Front 1

superficial cervical fascia

Back 1

-surrounds the neck in a cylindrical fashion

-contains the platysma

Front 2

deep cervical fascia

Back 2

-infesting fascia: superfical layer of the deep; also surrounds the neck as a cylinder and covers the muscles of the neck

-pretracheal fascia: encases the trachea, esophagus, pharanx, larynx, and thyroid gland

-buccopharyngeal fascia: on the pharynx and lateral aspects of the esophagus

-prevertebral fascia: encases the musculature around the vertebral column; splits into two laminae in the anterior as it crosses the midline; alar fascia is the anterior lamina

-carotid sheath: formed by the investing and pretracheal fasciae and contains the common carotid artery, internal jugluar vein, vagus nerve, and the internal carotid artery

Front 3

cervical fascial spaces

Back 3

-pretracheal space: surrounds the trachea and continues inferiorly to the mediasternum

-retropharyngeal space: lies between the buccopharyngeal fascia and the alar fascia

-danger space: lies between the alar fascia and the anterior lead of the prevertebral fascai

Front 4

fascia of the face

Back 4

-superficial: lies just deep to the skin and contains the muscles of facial expression and their nerves and arteries and veins

-deep fascia: extends from the hyoid bone to the zygomatic area; covers the mandible, muscles of mastication, and the submandibular and sublingual glands; called parotideomasseteric when it covers the parotid gland

Front 5

masticator space

Back 5

-the result of splitting the investing fascia at the inferior border of the mandible to enclose the medial and lateral pterygoid muscles and the masseter muscle

-also contains the maxillary artery and its branches, the mandibular nerves and its branches, and a major portion of the buccal fat pad

Front 6

submandibular space

Back 6

-bounded by the tongue and mucous membranes of the floor of the mouth

-mylohyoid muscle divides this space into the sublingual and submental spaces

Front 7

peripharyngeal spaces

Back 7

-common space surrounding the pharyngeal wall and communicating with the submandibular spaces

-retropharyngeal and lateral pharyngeal spaces

Front 8

retropharyngeal space

Back 8

-lies between the buccopharyngeal fascia and the alar fascia

-primary route for the spread of infection from the head and neck into the danger space and subsequently into the thorax

Front 9

lateral pharyngeal space

Back 9

-bounded medially by the pharyngeal wall and posteriorly opens into the retropharyngeal space

-laterally, limited by the superficial layer of of the deep fascia covering the medial pterygoid and parotid gland and by the carotid sheath

-below it is closed at the hyoid bone

-anteriorly it extends to the pterygomandibular raphe and communicated with the floor of the mouth constituing a pathway from the oral cavity to the retropharyngeal space

Front 10

buccal space

Back 10

-lies between the skin and the underling buccinator mucsle

-can extend infection from either maxillary or mandibular teeth when the apex of the tooth lies beyond the attachment of the buccinator muscle

-more common with infections of the posterior maxillary teeth and results in facial swelling below the zygomatic arch and above the inferior border of the mandible

Front 11

temporal space

Back 11

-surrounds the temporalis muscle

-divided into a deep temporal space under the temporalis and a more superficial space more externally

-very rarely involved in infection

Front 12

infratemporal space

Back 12

-posterior to the maxilla

-lateral pterygoid plate serves as the medial border with the base of the skull as superior border

-continuous with the deep temporal space

-not commonly involved in infection (though maxillary 3rd molar infection could spread to this space)

Front 13

spread of infection from a lower 3rd molar

Back 13

-track laterally into the buccal space

-track posteriorly, either side of the mandible into the masticatory space

-further medially and posteriorly into the lateral pharyngeal space

-lingually into the sublingual or submandibular space