深颈部间隙感染.ppt

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1、DeepNeckSpacesandInfectionsElizabethJ.Rosen,MDByronJ.Bailey,MD4/17/02DeepNeckSpacesandInfectionsAnatomyoftheCervicalFasciaAnatomyoftheDeepNeckSpacesDeepNeckSpaceInfectionsCervicalFasciaSuperficialLayerDeepLayerSuperficialMiddleDeepCervicalFasciaSuperficialLayerPlatysmaMusclesofFacialExpressi

2、onCervicalFasciaSuperficialLayeroftheDeepCervicalFasciaMusclesSternocleidomastoidTrapeziusGlandsSubmandibularParotidSpacesPosteriorTriangleSuprasternalspaceofBurnsCervicalFasciaMiddleLayeroftheDeepCervicalFasciaMuscularDivisionInfrahyoidStrapMusclesVisceralDivisionPharynx,Larynx,Esophagus,Tr

3、achea,ThyroidBuccopharyngealFasciaCervicalFasciaDeepLayerofDeepCervicalFasciaAlarLayerPosteriortoviscerallayerofmiddlefasciaAnteriortoprevertebrallayerPrevertebralLayerVertebralbodiesDeepmusclesoftheneckCervicalFasciaCarotidSheathFormedbyallthreelayersofdeepfasciaContainscarotidartery,intern

4、aljugularvein,andvagusnerve“Lincoln’sHighway”DeepNeckSpacesDescribedinrelationtothehyoidEntirelengthoftheneckSuprahyoidInfrahyoidDeepNeckSpacesEntireLengthofNeck:SuperficialSpaceSurroundsplatysmaContainsareolartissue,nodes,nervesandvesselsSubplatysmalFlapsInvolvedwithcellulitisandsuperficial

5、abscessesTreatwithincisionalongLanger’slines,drainageandantibioticsDeepNeckSpacesEntireLengthofNeck:RetropharyngealSpacePosteriortopharynxandesophagusAnteriortoalarlayerofdeepfasciaExtendsfromskullbasetoT1-T2DeepNeckSpacesEntireLengthofNeck:DangerSpaceAnteriorborderisalarlayerofdeepfasciaPos

6、teriorborderisprevertebrallayerExtendsfromskullbasetodiaphragmDeepNeckSpacesEntireLengthofNeck:PrevertebralSpaceAnteriorborderisprevertebralfasciaPosteriorborderisvertebralbodiesanddeepneckmusclesExtendsalongentirelengthofvertebralcolumnDeepNeckSpacesEntireLengthofNeck:VisceralVascularSpaceC

7、arotidSheath“Lincoln’sHighway”CanbecomesecondarilyinvolvedwithanyotherdeepneckspaceinfectionbydirectspreadDeepNeckSpacesSuprahyoid:SubmandibularSpaceAnterior/Lateral—mandibleSuperior—mucosaInferior—superficiallayerofdeepfasciaPosterior/Inferior--hy