DH 228- Fasciae/Spaces
Identify 13: superficial cervical fasciae (cut to demonstrate entrance into submandibular space)
Identify 13: F
Identify 14: sublingual salivary glands
Identify 14: A
Identify 14: mandible
Identify 14: B
Identify 14: mylohyoid muscle
Identify 14: C
Identify 14: submandibular salivary gland
Identify 14: D
Identify 14: platysma muscle
Identify 14: E
Identify 14: digastric muscle
Identify 14: F
Identify 14: hyoid bone
Identify 14: G
Identify 14: investing fascia
Identify 14: H
Identify 14: submandibular space
Identify 14: I
Identify 14: sublingual space
Identify 14: J
Identify 15: vertebral muscles
Identify 15: A
Identify 15: sternocleidomastoid muscle
Identify 15: B
Identify 15: internal jugular vein
Identify 15: C
Identify 15: internal carotid artery
Identify 15: D
Identify 15: superior pharyngeal constrictor muscle
Identify 15: E
Identify 15: pharynx
Identify 15: F
Identify 15: medial pterygoid muscle
Identify 15: G
Identify 15: mandible
Identify 15: H
Identify 15: pterygomandibular raphe
Identify 15: I
Identify 15: masseter muscle
Identify 15: J
Identify 15: buccinator muscle
Identify 15: K
Identify 15: vertebral fascia
Identify 15: L
Identify 15: parapharyngeal space
Identify 15: M
Identify 15: retropharyngeal space
Identify 15: N
Identify 15: buccopharyngeal fascia
Identify 15: O
Identify 15: buccal space
Identify 15: P
Identify 16: investing fascia
Identify 16: A
Identify 16: previsceral space
Identify 16: B
Identify 16: trachea
Identify 16: C
Identify 16: thyroid
Identify 16: D
Identify 16: esophagus
Identify 16: E
Identify 16: retropharyngeal space
Identify 16: F
Identify 16: pharynx
Identify 16: G
Identify 17: cervical vertebra
Identify 17: A
Identify 17: thyroid gland
Identify 17: B
Identify 17: retropharyngeal space
Identify 17: C
Identify 17: trachea
Identify 17: D
Identify 17: visceral fascia
Identify 17: E
Identify 17: previsceral space
Identify 17: F
Identify 17: investing fascia
Identify 17: G
Identify 1: temporalis muscle
Identify 1: A
Identify 1: zygomatic bone
Identify 1: B
Identify 1: masseter muscle
Identify 1: C
Identify 1: risorius muscle
Identify 1: D
Identify 1: platysma muscle
Identify 1: E
Identify 1: investing fascia
Identify 1: F
Identify 1: buccopharyngeal part of visceral fascia
Identify 1: G
Identify 1: superficial fascia
Identify 1: H
Identify 1: masseteric-parotid fascia
Identify 1: I
Identify 1: temporal fascia
Identify 1: J
Identify 3: superficial fascia (contains muscles of facial expression)
Identify 3: A
Identify 3: investing fascia (ventral)
Identify 3: B
Identify 3: visceral fascia
Identify 3: C
Identify 3: vertebral fascia
Identify 3: D
Identify 3: investing fascia (dorsal)
Identify 3: E
Identify 3: superficial fasciae
Identify 3: F
Identify 4: Trapezius muscle
Identify 4: A
Identify 4: vertebral muscles
Identify 4: B
Identify 4: spinal cord
Identify 4: C
Identify 4: cervical vetrebra
Identify 4: D
Identify 4: common carotid artery
Identify 4: E
Identify 4: vagus nerve
Identify 4: F
Identify 4: internal jugular vein
Identify 4: G
Identify 4: thyroid gland
Identify 4: H
Identify 4: sternocleidomastoid muscle
Identify 4: I
Identify 4: platysma muscle
Identify 4: J
Identify 4: superficial fascia
Identify 4: K
Identify 4: investing fascia
Identify 4: L
Identify 4: vertebral fascia
Identify 4: M
Identify 4: visceral space
Identify 4: N
Identify 4: carotid sheath
Identify 4: O
Identify 4: esophagus
Identify 4: P
Identify 4: trachea
Identify 4: Q
Identify 5: palatine process of maxilla
Identify 5: A
Identify 5: alveolar process of maxilla
Identify 5: B
Identify 5: oral mucosa
Identify 5: C
Identify 5: buccinator muscle
Identify 5: D
Identify 5: alveolar process of mandible
Identify 5: E
Identify 5: mandible
Identify 5: F
Identify 5: vestibule of mouth
Identify 5: G
Identify 5: vestibular space of mandible
Identify 5: H
Identify 6: Canine space
Identify 6: A
Identify 6: buccal space
Identify 6: B
Identify 6: canine space (deep to muscles that elevate lip)
Identify 6: C
Identify 6: buccal space (deep to masseter muscle)
Identify 6: D
Identify 7: facial nerve
Identify 7: A
Identify 7: retromandibular vein
Identify 7: B
Identify 7: external carotid artery
Identify 7: C
Identify 7: parotid salivary gland
Identify 7: D
Identify 7: masseter muscle
Identify 7: E
Identify 7: parotid duct
Identify 7: F
Identify 7: parotid space
Identify 7: G
Identify 8: temporalis muscle
Identify 8: A
Identify 8: infratemporal crest
Identify 8: B
Identify 8: lateral pterygoid muscle
Identify 8: C
Identify 8: zygomatic bone
Identify 8: D
Identify 8: maxillary artery
Identify 8: E
Identify 8: lateral pterygoid plate
Identify 8: F
Identify 8: medial pterygoid plate
Identify 8: G
Identify 8: medial pterygoid muscle
Identify 8: H
Identify 8: mandible
Identify 8: I
Identify 8: submandibular salivary gland
Identify 8: J
Identify 8: hyoid bone
Identify 8: K
Identify 8: temporal fascia
Identify 8: L
Identify 8: temporal space
Identify 8: M
Identify 8: infratemporal space
Identify 8: N
Identify 8: oral cavity
Identify 8: O
Identify 9: vomer
Identify 9: A
Identify 9: medial pterygoid plate
Identify 9: B
Identify 9: area of sublingual space
Identify 9: C
Identify 9: area of submandibular space
Identify 9: D
Identify 9: medial pterygoid muscle
Identify 9: E
Identify 9: arrow entering pterygomandibular space (dotted line)
Identify 9: F
Identify 9: infratemporal space
Identify 9: G
Identify 9: infratemporal crest
Identify 9: H
Identify 9: lateral pterygoid muscle
Identify 9: I
D. Pterygomandibular space
The masticatory space includes the submasseteric space and which other space? A. Submental space B. Submandibular space C. Sublingual space D. Pterygomandibular space E. Retropharyngeal space
B. Medial pterygoid muscle
The parapharyngeal space is located between the superior pharyngeal constrictor muscle and A. Lateral pterygoid muscle B. Medial pterygoid muscle C. Mylohyoid muscle D. Masseter muscle E. Buccinator muscle
Because they can become involved in infections arising from dental tissues
Why is it important for the clinician to understand the spaces of the head and neck?
Covers the deeper structures of the body, such as bones, muscles, vessels, and nerves- consists of dense, inelastic fibrous sheaths that enclose these deeper structures
Describe deep fascia
Covers the masseter muscle, covers structures inferior to the zygomatic arch, surrounds the parotid salivary gland
Describe masseteric-parotid fascia
Communicate directly with each other (as well as through blood and lymph vessels within the space, communication allows the spread of dental (odontogenic) infection from a more superficial area to a more vital, deeper structure in the body with potentially serious consequences), defined by the arrangement of muscles and bones (or from fascia- spaces of the neck)
Describe some details about the spaces of the head and neck
Found just below and attached to the skin of the body, separates the skin from the deeper structures of the body (allows skin to move independently from these structures), varies in thickness in diff parts of the body, composed of fat and irregularly arranged connective tissue, vessels and nerves of skin travel through this, does not usually enclose muscles except some areas of the head and neck
Describe superficial fascia
Located between the buccinator muscle and the masseter muscle, it is: inferior to the zygomatic arch, superior to the mandible, lateral to the buccinator muscle, medial and anterior to the masseter muscle, dental infection from maxillary and mandibular posteriors can cause severe swelling of the cheek
Describe the buccal space (space of the face and jaw)
Located nearer to the skull and posterior and lateral to the pharynx, encloses the entire superior part of the alimentary canal, continuous with the fascia covering the buccinator muscle (where the buccinator muscle and the superior pharyngeal constrictor muscle come together at the pterygomandibular raphe)
Describe the buccopharyngeal fascia of deep cervical fascia
Located superior to the upper lip and lateral to the apex of the maxillary canine, it is: deep to the overlying skin and muscles of facial expression that elevate the upper lip (levator labii superioris and zygomaticus minor), floor of the space is the canine fossa of the maxilla, anterior border is the orbicularis oris muscle, posterior border is the levator anguli oris, contains the angular artery and vein and infraorbital nerve and vessels
Describe the canine space (space of the face and jaw)
Tube of deep cervical fascia, deep to the investing fascia and sternocleidomastoid muscle, runs inferiorly along each side of the neck from the base of the neck (braincase) to the thorax, contains: internal carotid artery, common carotid artery, internal jugular vein, vagus (X) cranial nerve
Describe the carotid sheath of the deep cervical fascia
They all communicate with each other as well as the spaces of the face and jaws, these spaces connect the spaces of the head and neck with those of the thorax, allowing dental infections to spread to vital organs such as heart and lungs, major spaces include: previsceral space, parapharyngeal space, retropharyngeal space
Describe the cervical fascial spaces and the 3 major spaces included
Located in the fossa close to the lateral pterygoid muscle and the maxillary tuberosity, bordered laterally by the medial (inside) surface of mandible and temporalis muscle, bordered medially by the lateral pterygoid plate in the anterior aspect and bordered medially by the pharynx in the posterior aspect, the roof of this space is formed by the infratemporal surface of the sphenoid bone, no boundary inferiorly and posteriorly as it continues into a deep cervical fascial space
Describe the infratemporal space within the masticator space (space of the face and jaw)
Most external layer of the deep cervical fascia, surrounds the neck and continues onto the masseteric-parotid fascia, also splits around the parotid and submandibular glands and also around the sternocleidomastoid and trapezius muscles, some fibers also surround the infrahyoid muscles from the hyoid bone to sternum
Describe the investing fascia of the deep cervical fascia
General term used to include the entire area of the mandible and muscles of mastication, including: temporal space, infratemporal space, submasseteric space, masseter muscle, ramus and body of the mandible. All parts communicate with each other along with: submandibular space, cervical space and parapharyngeal space
Describe the masticator space (spaces of the face and jaws)
Located lateral to the pharynx and medial to the medial pterygoid muscle, parallels the carotid sheath, dental infections can become dangerous when they reach the parapharyngeal space because of its connection to the retropharyngeal space
Describe the parapharyngeal space (cervical fascial space)
Fascial space created inside the investing fascial layer of the deep cervical fascia as it envelops the parotid salivary gland, this space contains: entire parotid gland, most of the facial nerve (VII), portion of the External Carotid Artery (ECA), retromandibular vein, the fascial boundaries of this space prevents parotid gland infections from spreading to other sites
Describe the parotid space (space fo the face and jaw)
Located between the visceral and investing fascia, anterior to the trachea, communicates with the parapharyngeal spaces
Describe the previsceral space (cervical fascial spaces)
Located just posterior to the pharynx, between the vertebral and visceral fasciae, known as a "danger space" because dental infections can travel inferiorly quickly and cause this area to swell and close off the passageway for air
Describe the retropharyngeal space (cervical fascial space)
Formed by the periosteum, covering the body of the mandible from the symphysis to the anterior borders of the masseter and medial pterygoid muscles, contains: mandible, portion of the inferior alveolar nerve, artery and vein and the dental and alveolar branches of these vessels, along with the incisive and mental branches. Communicates with: vestibular space of mandible, buccal space, submental space, submandibular and sublingual spaces
Describe the space of the body of the mandible (spaces of the face and jaws)
Located deep to the oral mucosa, floor of this space is the mylohyoid muscle, creating a division between the submandibular and sublingual spaces (sublingual space is immediately under the mucosa and above mylohyoid muscle, submandibular space is below the mylohyoid muscle), tongue forms the medial boundary of the sublingual space, and the mandible forms its lateral wall
Describe the sublingual space (spaces of the face and jaws)
Located lateral and posterior to the submental space on each side of the jaws, contains: submandibular lymph nodes, most of the submandibular gland, portions of the facial artery. This space is usually involved if there is a spread of dental infection
Describe the submandibular space (spaces of the face and jaws)
Located between the masseter muscle and the external surface of the vertical ramus, communicates with the temporal and infratemporal spaces
Describe the submasseteric space (masticator space)
Located in the midline between the mandibular symphysis and hyoid bone, contains submental lymph nodes and the origin of the anterior jugular vein, communicates with the space of the body of the mandible and the submandibular and sublingual spaces
Describe the submental space (spaces of the face and jaws)
Covers the temporalis muscle, covers structures superior to the zygomatic arch
Describe the temporal fascia (deep fascia of the face and jaws)
Taking up a part of the masticator space, which is formed by the temporal fascia covering the temporalis muscle, space between the temporalis muscle and the fascia, extends from the superior temporal line to the zygomatic arch and infratemporal crest, contains fat tissue and communicates with the infratemporal and submasseteric spaces
Describe the temporal space within the masticator space (spaces of the face and jaws)
Layers of fibrous CT that underlie the skin and surround the muscles, bone, vessels, nerves, organs and other structures of the body, serves as a protective sleeve, allowing various structures to move past each other within the body
Describe the term fascia (plural, fasciae)
Potential spaces between layers of fascia in the body, due to the sheet like nature of fasciae. NOT empty spaces, contain loose CT
Describe the term fasciae spaces
There are other spaces within the head that are not created by fascia, but other structures such as bones & muscles
Describe the term spaces
Located between the buccinator muscle and overlying oral mucosa, bordered by the attachment of the buccinator muscle onto the alveolar process of the mandible, communicates with the mandibular posterior teeth and periodontium and gingiva and the space of the body of the mandible, can become involved with infections of these areas
Describe the vestibular space of the mandible (space of the face and jaw)
Located medially to the buccinator muscle and inferiorly to the attachment of this muscle along the alveolar process of the maxilla, its lateral wall is the oral mucosa, communicates with the maxillary molars and periodontium and can become involved with infections of these areas
Describe the vestibular space of the maxilla (space of the face and jaw)
Also known as the "prevertebral fascia", deepest layer of fascia, covers: the cervical vertebrae, spinal cord and associated vertebral muscles
Describe the vetebral fascia of deep cervical fascia
Also known as "pretracheal fascia", lies deeper than and parallel to the carotid sheath, single midline tube of deep cervical fascia that runs inferiorly along each side of the neck, surrounds the air and food passageway including the trachea, esophagus and thyroid gland
Describe the visceral fascia of the deep cervical fascia
Identify 10: parotid salivary gland
Identify 10: A
Identify 10: medial pterygoid muscle
Identify 10: B
Identify 10: mandible
Identify 10: C
Identify 10: inferior alveolar nerve
Identify 10: D
Identify 10: lingual nerve
Identify 10: E
Identify 10: masseter muscle
Identify 10: F
Identify 10: pterygomandibular space
Identify 10: G
Identify 11: ramus
Identify 11: A
Identify 11: masseter muscle
Identify 11: B
Identify 14: sublingual salivary gland
Identify 12: A
Identify 12: inferior alveolar nerve, artery, and vein
Identify 12: B
Identify 12: submandibular salivary gland
Identify 12: C
Identify 12: submandibular space
Identify 12: D
Identify 12: space of the body of the mandible
Identify 12: E
Identify 12: sublingual space
Identify 12: F
Identify 12: buccal space
Identify 12: G
Identify 13: anterior bellies of digastric muscles
Identify 13: A
Identify 13: superficial cervical fasciae (cut to demonstrate entrance into submental space)
Identify 13: B
Identify 13: hyoid bone
Identify 13: C
Identify 13: submandibular salivary gland
Identify 13: D
Identify 13: parotid salivary gland
Identify 13: E
C. Infratemporal space
In which of the following spaces is the pterygoid plexus of veins located? A. Parotid space B. Temporal space C. Infratemporal space D. Buccal space E. Parapharyngeal space
Maxillary and mandibular vestibular spaces, canine space, Buccal space, parotid space, masticator space, space of the body of the mandible, submental space, submandibular space & sublingual space
List the major spaces of the face and jaws
D. Sublingual space
The submandibular space communicates MOST directly with which of the following spaces? A. Temporal space B. Parotid space C. Buccal space D. Sublingual space E. Canine space
Investing fascia, carotid sheath, visceral fascia, buccopharyngeal fascia, vertebral fascia (layers are continuous with each other and with the deep fascia of the jaws and face)
What are the 5 layers that compose the deep cervical fascia?
Temporal fascia, masseteric-parotid fascia, pterygoid fascia (all continuous layers of the deep cervical fascia)
What are the three categories of the deep fasciae of the face and jaws?
A portion of the maxillary artery, mandibular nerve, pterygoid plexus of veins, medial and lateral pterygoid muscles
What does the infratemporal space contain?
Part of the infratemporal space, lateral pterygoid muscle (roof), medial pterygoid muscle (medial wall), mandibular ramus (lateral wall)
What forms the pterygomandibular space?
A. Mylohyoid line
What forms the superior border of the submandibular space? A. Mylohyoid line B. Hyoid bone C. Angle of the mandible D. Trachea and larynx
Superficial fascia of the face (encloses muscles of facial expression) & superficial cervical fascia of the face (encloses platysma muscle)
What two categories is superficial fasciae of the face and neck divided into?
Superficial fascia & deep fascia
What two groups can fascia be divided into?
Medial surface of the medial pterygoid muscle
Where is the pterygoid fascia located?
D. Parapharyngeal space
Which of the following areas MOST directly communicates with the retropharyngeal space? A. Lateral pterygoid muscle B. Medial pterygoid muscle C. Temporalis muscle D. Parapharyngeal space
C. Lingual artery
Which of the following blood vessels is located within the sublingual space? A. Facial artery B. Anterior jugular vein C. Lingual artery D. Inferior alveolar vein
B. Visceral fascia
Which of the following fasciae listed runs deep and parallel to the carotid sheath? A. Temporal fascia B. Visceral fascia C. Pterygoid fascia D. Investing fascia
A. Masseteric-parotid fascia
Which of the following faucial structures is also considered part o the deep fasciae of the face? A. Masseteric-parotid fascia B. Investing fascia C. Visceral fascia D. Carotid sheath
A. Lateral pterygoid muscle
Which of the following muscles forms the roof of the pterygomandibular space? A. Lateral pterygoid muscle B. Medial pterygoid muscle C. Temporalis muscle D. Sternocleidomastoid muscle
C. Inferior alveolar nerve
Which of the following nerves is located within the pterygomandibular space? A. Infraorbital space B. Posterior superior alveolar nerve C. Inferior alveolar nerve D. Anterior superior alveolar nerve
D. Parotid space
Which of the following spaces is NOT part of the masticator space? A. Infratemporal space B. Temporal space C. Submasseteric space D. Parotid space
D. Retropharyngeal space
Which of the following spaces is considered by healthcare professionals to be the "danger space" of the neck? A. Parapharyngeal space B. Body of the mandible C. Submandibular space D. Retropharyngeal space
D. Canine space
Which of the following spaces is located deep to the muscles of facial expression that elevate the upper lip? A. Parotid space B. Submandibular space C. Masticator space D. Canine space
C. Parapharyngeal space
Which of the following spaces is parallel to the carotid sheath? A. Temporal space B. Canine space C. Parapharyngeal space D. Parotid space
A. Dense and inelastic tissue forming sheath around deep structures
Which of the following statements CORRECTLY describes the deep fascia? A. Dense and inelastic tissue forming sheaths around deep structures B. Fatty and elastic fibrous tissue found just deep to the skin C. Potential spaces containing loose connective tissue D. Fatty and elastic fibrous tissue forming spaces under the skin E. Dense and inelastic deep structures of the vascular system
A. Internal and common carotid arteries and tenth cranial nerve
Which of the following structures are located within the carotid sheath? A. Internal and common carotid arteries and tenth cranial nerve B. External and common carotid arteries and fifth cranial nerve C. External jugular vein and tenth cranial nerve D. Internal jugular vein and fifth cranial nerve
B. Muscles of facial expression
Which of the following structures is located within the superficial fasciae of the head and neck? A. Temporalis muscle B. Muscles of facial expression C. Parotid salivary gland D. Thyroid gland
C. Periosteum
Which of the following types of tissue surrounds the space of the body of the mandible? A. Fatty tissue B. Loose connective tissue C. Periosteum D. Elastic tissue
D. Submental space
Which space is located in the midline between the the mandibular symphysis and the hyoid bone? A. Retropharyngeal space B. Sublingual space C. Submandibular space D. Submental space E. Submasseteric space
It houses the inferior alveolar nerve and vessels, AND is the injection site for the inferior alveolar (IA) nerve block, it communicates with the submandibular space and the parapharyngeal space of the neck
Why is the pterygomandibular space important?