深颈部间隙感染（副本）.ppt

Deep Neck Spaces and Infections Elizabeth J. Rosen, MD Byron J. Bailey, MD 4/17/02 Deep Neck Spaces and Infections Anatomy of the Cervical Fascia Anatomy of the Deep Neck Spaces Deep Neck Space Infections Cervical Fascia Superficial Layer Deep Layer Superficial Middle Deep Cervical Fascia Superficial Layer Platysma Muscles of Facial Expression Cervical Fascia Superficial Layer of the Deep Cervical Fascia Muscles Sternocleidomastoid Trapezius Glands Submandibular Parotid Spaces Posterior Triangle Suprasternal space of Burns Cervical Fascia Middle Layer of the Deep Cervical Fascia Muscular Division Infrahyoid Strap Muscles Visceral Division Pharynx, Larynx, Esophagus, Trachea, Thyroid Buccopharyngeal Fascia Cervical Fascia Deep Layer of Deep Cervical Fascia Alar Layer Posterior to visceral layer of middle fascia Anterior to prevertebral layer Prevertebral Layer Vertebral bodies Deep muscles of the neck Cervical Fascia Carotid Sheath Formed by all three layers of deep fascia Contains carotid artery, internal jugular vein, and vagus nerve “Lincoln’s Highway” Deep Neck Spaces Described in relation to the hyoid Entire length of the neck Suprahyoid Infrahyoid Deep Neck Spaces Entire Length of Neck: Superficial Space Surrounds platysma Contains areolar tissue, nodes, nerves and vessels Subplatysmal Flaps Involved with cellulitis and superficial abscesses Treat with incision along Langer’s lines, drainage and antibiotics Deep Neck Spaces Entire Length of Neck: Retropharyngeal Space Posterior to pharynx and esophagus Anterior to alar layer of deep fascia Extends from skull base to T1-T2 Deep Neck Spaces Entire Length of Neck: Danger Space Anterior border is alar layer of deep fascia Posterior border is prevertebral layer Extends from skull base to diaphragm Deep Neck Spaces Entire Length of Neck: Prevertebral Space Anterior border is prevertebral fascia Posterior border is vertebral bodies and deep neck muscles Extends along entire length of vertebral column Deep