Please enable JavaScript.
Coggle requires JavaScript to display documents.
Deep neck infeciton :sunny: (:globe_with_meridians: Potential spaces…
Deep neck infeciton
:sunny:
Def: infection of deep cervical fascial space
Sources
of infection
Odontogenic origin
Acute tonsillitis (M/C in ped)
:eggplant:
Cervical fascia Classification
got
Platysma
divide superior & deep cervical fascia
Superficial
cervical fascia
If found infection ⇨ Cellulitis
beyond
plastysma
Deep
cervical fascia
Superficial
layer
Cover some sternum ⇨ mandible ⇨ อ้อมไปเกาะ occiput
:five: contents: SCM, Trapezius ms, Ms of mastication, Submaxillary gland,
Parotid gland
Middle
layer
Ant
Post
Muscular: part that cover
strap ms
Sternohyoid
Sternothyroid
Visceral: Part that cover thyroid gland & Trachea
Cover sternum ⇨ thyroid cartilage ⇨ hyoid bone
Deep
layer
Since skull base ⇨ coccyx
If found infection ⇨
abscess in potential space
Mx
:green_heart: TBC
:globe_with_meridians:
Potential spaces
Entire length
of the neck :rabbit2:
Prevertebral
space
เกาะจาก scalp bed ⇨
coccyx
:!:
no septum
⇨ can spread มั่วหมด
:wind_blowing_face:
Retropharyngeal
space
เกาะ till
T1
⇨ infection โอกาสเกิดแค่ mediastinum
(as ไม่ลง coccyx)
:eight_pointed_black_star:
septum
ตลอดแนว
⇨ infection
won’t cross midline
Retropharyngeal space abscess
S&S
Fever
Pain & neck rigidity
Dysphagia
Dyspnea
Laryngeal edema
Airway obstruction
Visceral vascular
space
Above
hyoid bone :rabbit2:
(suprahyoid spaces)
(8)
Peritonsillar space
Peritonsillar space abscess
Common in
puberty
(rare in children)
Hx of tonsillitis
eg เป็นๆหายๆ
S&S
High fever
Trismus
Tonsil inflammation
:sweet_potato:
Hot potato voice
:star:
(เสียงเหมือนอมอะไรอยู่ตลอดเวลา)
Displacement of tonsil to Inferoanteriorly
Drooling & Difficulty in swallowing
Parapharyngeal space
:wind_blowing_face:
Parapharyngeal space abscess
Source of infections: infection fr Pharynx, Tonsil, Adenoid, Teeth & Parotid gland
Divide into
2 divisions
(styloid process)
Pre
styloid
Components
Internal
pterygoid
ms
No
vital structure
S&S
Trismus
(pterygoid ms)
Induration of angle of jaw
Displacement of lateral pharyngeal wall & tonsil medially
Retro
styloid
Components
Internal jugular vein
CN IX, X, XII
Cervical Sympathetic trunk
Internal Carotid artery
S&S
No trismus
Swelling of lateral posterior pharyngeal wall
Neurological deficit of CN IX, X, XII & cervical Sympathetic chain (
Horner’s syndrome
)
Sublingual space
Above
mylohyoid ms
Sublingual
space abscess
Submaxillary space
Below
mylohyoid ms
Submandibular space
3+4
(sublingual + Submaxillary space)
:wind_blowing_face:
Ludwig’s angina
:star:
“
Bilateral
submandibular space infection”
เป็น 2 ข้างพร้อมกัน
Masticator space
Masticator space abscess
Source of infeciton: Molar teeth esp
third molar
S&S:
Face swelling
:custard:
Severe trismus
Dysphagia
Swelling of retromolar trigone
คลำก้อน
ไม่ชัด
:!: Affect
muscle of mastication
Masseter
Medial pterygoid
Lateral pterygoid
Temporalis
Parotid space
Parotid space abscess
Source of infection: Parotid gland & LN
Clinical
Swollen angle of jaw
Stensen’s duct opening swelling & pus drainage
Trismus
as a reflex spasm CN V or tail of parotid gland compress with mandible & mastoid
Temporal space
Temporal space abscess
May divide into
Superficial
&
Deep
temporal space (communicate with masticator space)
Sup: กรีด classic
Deep: แหวกชั้นเข้าไป drain
Clinical
Severe pain
Jaw deviated to affected side
Trismus
Swollen temporal area & tenderness over condyle (or TMJ of mandible)
Infection of
teeth
:no_mouth:
Anterior
to Lower 2nd molar
Spread to sublingual space
2nd molar
Spread to Submaxillary space or Sublingual space
Below
hyoid bone :rabbit2:
(infrahyoid spaces)
1.Muscular part
Visceral part
Spaces of
face
:rabbit2:
Canine space
Canine space abscess
Source of infection:
Upper ant. teeth & bicuspid
Skin infection fr nose & upper lip
S&S
Cheek swelling & redness
Obliteration of nasolabial folds
If เป็นมากๆ ⇨ Upper & lower eyelids edema
Tenderness & severe pain secondary to Intraorbital nerve edema & inflammation
Mental space
Buccal space
Buccal space abscess
Source of infection:
Upper 2nd & 3rd molar
Lower 3rd molar
S&S
Cheek swelling & redness
anterior
to Anterior border of massester muscle
Cheek thickening by finger examination
:wind_blowing_face: =
Airway compromise
should ETT insertion
asap