Mandibular facsial spaces
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This document discusses several fascial spaces related to the lower jaw: - The primary mandibular spaces include the submental, buccal, submandibular, and sublingual spaces. - The secondary mandibular spaces include the masseteric, pterygomandibular, and temporal spaces. - Each space is defined by its anatomical boundaries and contents. Infections may spread between spaces through fascial connections or erosion of fascial layers. Understanding these spaces is important for clinicians to properly diagnose and treat infections in the lower jaw region.
Mandibular facsial spaces
- 2. Done By : Weam Mahmoud faroun Surgery summer semmester 2017-2018 DonebyDR.WeamMahmoudFaroun
- 3. fasciae are thickened condensations of fibroelastic connective tissue that separate various movable structures from one another. Spaces between layers of fascia are filled with a loose type of connective tissue that permits infection to spread from one locale to another with relative ease. Because infection may travel along these fascial sheets, the clinician should possess a working knowledge of their locations, extent, and intercommunications. DonebyDR.WeamMahmoudFaroun
- 4. Spaces related to lower jaw Primary Secondary DonebyDR.WeamMahmoudFaroun
- 5. .PRIMARY MANDIBULAR SPACES 1 • submental 2 • buccal 3 • submandibular. 4 • Sublingual DonebyDR.WeamMahmoudFaroun
- 7. SUBMENTAL The submental space is a fascial space of the head and neck . It is a potential space located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, under the chin in the midline. The space coincides with the anatomic region termed the submental triangle, part of the anterior triangle of the neck. DonebyDR.WeamMahmoudFaroun
- 8. ANATOMICAL BOUNDARIES The boundaries of the submental space are: the mylohyoid muscle superiorly the investing layer of deep cervical fascia (and this in turn is covered by the platysma muscle) inferiorly the inferior border of the mandible anteriorly the hyoid bone posteriorly the anterior bellies of the digastric muscleslaterally. The midline mesially DonebyDR.WeamMahmoudFaroun
- 10. COMMUNICATIONS The communications of the submental space are: 1. the submandibular spaces posterolaterally. 2. the sublingual space superiorly (via erosion through the mylohyoid) DonebyDR.WeamMahmoudFaroun
- 11. CONTENTS Its contents are 1. submental lymph nodes 2. areolar connective tissue 3. the anterior jugular veins DonebyDR.WeamMahmoudFaroun
- 13. The buccal space (also termed the buccinator space) is a fascial space of the head and neck It is a potential space in the cheek, and is paired on each side. The buccal space is superficial to the buccinator muscle and deep to the platysma muscle and the skin. The buccal space is part of subcutaneous space, which is continuous from head to toe. DonebyDR.WeamMahmoudFaroun
- 14. ANATOMIC BOUNDARIES The boundaries of each buccal space are: 1. the angle of the mouth anteriorly 2. the masseter muscle posteriorly 3. the zygomatic process of the maxilla and the zygomaticus muscles superiorly 4. the depressor anguli oris muscle and the attachment of the deep fascia to the mandible inferiorly 5. the buccinator muscle medially (the buccal space is superficial to the buccinator) 6. the platysma muscle, subcutaneous tissue and skin laterally (the space is deep to platysma) DonebyDR.WeamMahmoudFaroun
- 15. COMMUNICATION 1. to the pterygomandibular space, infratemporal space, submasseteric space or even to the lateral pharyngeal space posteriorly 2. to the infraorbital (canine) space superiorly DonebyDR.WeamMahmoudFaroun
- 16. CONTENTS In health it contains 1.the buccal fat pad 2. the parotid duct (Stenson's duct) 3.the anterior facial artery and vein 4. the transverse facial artery and vein DonebyDR.WeamMahmoudFaroun
- 20. The submandibular space is a fascial space of the head and neck It is a potential space, and is paired on either side, located on the superficial surface of the mylohyoid muscle between the anterior and posterior bellies of the digastric muscle. The space corresponds to the anatomic region termed the submandibular triangle, part of the anterior triangle of the neck DonebyDR.WeamMahmoudFaroun
- 22. THE ANATOMIC BOUNDARIES The anatomic boundaries of each submandibular space are 1. the mylohyoid muscle superiorly 2. the skin, superficial fascia, platysma muscle and superficial layer of the deep cervical fascia inferiorly and laterally 3. the medial surface of the mandible anteriorly and laterally 4. the hyoid bone posteriorly 5. the anterior belly of the digastric muscle medially DonebyDR.WeamMahmoudFaroun
- 24. COMMUNICATIONS The communications of the submandibular space are: 1.medially and anteriorly to the submental space (located medial to the paired submandibular spaces, separated from them by the anterior bellies of the digastric muscles). 2.posteriorly and superiorly to the sublingual space (located above the mylohyoid muscle) inferiorly to the lateral pharyngeal space DonebyDR.WeamMahmoudFaroun
- 25. CONTENTS In health, the contents of the space are: 1. the submandibular gland, which largely fills the space 2. branches of the facial artery 3. lymph nodes. DonebyDR.WeamMahmoudFaroun
- 28. The sublingual space is a fascial space of the head and neck It is a potential space located below the mouth and above the mylohyoid muscle, and is part of the suprahyoid group of fascial spaces. DonebyDR.WeamMahmoudFaroun
- 29. ANATOMIC BOUNDARIES The sublingual space is V-shaped, with the apex pointing to the anterior. Its boundaries are: 1. the mucosa of the floor of mouth and the tongue superiorly 2. the mylohyoid muscle inferiorly 3. the medial surface of the mandible anteriolaterally 4. the muscles along the base of the tongue (geniohyoid and genioglossus muscles) posteriorly medially, 5. the intrinsic muscles of the tongue and genioglossus separate the two halves of the sublingual space. DonebyDR.WeamMahmoudFaroun
- 31. COMMUNICATION The sublingual space communicates: - posteriorly around the posterior free border of the mylohyoid muscle with the submandibular space. - Infections of the sublingual space may also erode through the mylohyoid, or spread via the lymphatics to the submandibular and submental spaces. DonebyDR.WeamMahmoudFaroun
- 33. CONTENTS The sublingual space contains 1. a number of blood vessels and nerves, e.g. the lingual artery and nerve, the hypoglossal nerve and the glossopharyngeal nerve. 2. the sublingual salivary gland. Saliva from the sublingual gland drains through several small excretory ducts in the floor of the mouth.Sometimes a more distinctive duct can be recognized, known as Bartholin's duct. 3. the deep part of the submandibular gland and the submandibular duct (Wharton's duct) 4. some extrinsic tongue musclefibers DonebyDR.WeamMahmoudFaroun
- 35. SECONDARY MANDIBULAR SPACES 1 • masseteric 2 • pterygomandibular 3 • temporal spaces DonebyDR.WeamMahmoudFaroun
- 37. MASSETERIC It is a potential space in the face over the angle of the jaw, and is paired on eachside. It is located between the lateral aspect of the mandible and the medial aspect of the masseter muscle and its investing fascia . The term masseteric refers to the masseter muscle. DonebyDR.WeamMahmoudFaroun
- 38. ANATOMICAL BOUNDARIES the anterior margin of the masseter muscle anteriorly the parotid gland posteriorly the zygomatic arch superiorly the inferior border of the mandible inferiorly the lateral surface of the mandibular ramus medially (masseteric space is superficial to the mandible) the masseter muscle laterally (the masseteric space is deep to masseter). DonebyDR.WeamMahmoudFaroun
- 40. COMMUNICATIONS The communications of each masseteric space are: to the buccal space anteriorly to the pterygomandibular space (around the posterior margin of the mandibular ramus to its medial surface) and the parotid space posteriorly to the superficial temporal space superiorly . DonebyDR.WeamMahmoudFaroun
- 41. CONTENTS In health, the space contains: the masseteric artery The masseteric vein. DonebyDR.WeamMahmoudFaroun
- 42. PTERYGOMANDIBULAR It is a potential space in the head and is paired on each side. It is located between the medial pterygoid muscle and the medial surface of the ramus of the mandible. DonebyDR.WeamMahmoudFaroun
- 43. ANATOMICAL BOUNDARIES The boundaries of each pterygomandibular space are: the posterior border of the buccal space anteriorly the parotid gland posteriorly the lateral pterygoid muscle superiorly the inferior border of the mandible (lingual surface) inferiorly the medial pterygoid muscle medially (the space is superficial to medial pterygoid) the ascending ramus of the mandible laterally (the space is deep to the ramus of the mandible) DonebyDR.WeamMahmoudFaroun
- 44. COMMUNICATION the communications of each pterygomandibular space are: to the buccal space anteriorly to the lateral pharyngeal space and peritonsillar space medially (around the medial pterygoid muscle). to the submasseteric space laterally (around the ramus of the mandible) to the parotid space posteriorly to the deep temporal/infratemporal space superiorly DonebyDR.WeamMahmoudFaroun
- 45. CONTENT In health, the space contains: 1. the mandibular division of the trigeminal nerve 2. the inferior alveolar artery and vein 3. the sphenomandibular ligament. DonebyDR.WeamMahmoudFaroun
- 46. TEMPORAL SPACES Location: posterior and superior to the masseteric and pterygomandibular spaces Bounded : laterally by the temporalisfascia and medially by the temporal bone DonebyDR.WeamMahmoudFaroun
- 47. TWO COMPONENTS: 1.Superficial temporal space: - located between temporal fascia laterally - temporalis muscle medially 2.Deep temporal space: - located between the temporalis muscle laterally - the temporal bone & greater wing of sphenoid 3.Continuous with the infratemporal space The infratemporal space is the inferior portion of the deep temporal space. DonebyDR.WeamMahmoudFaroun
- 49. SUPERFICIAL TEMPORAL Contents 1. Temporal fat pad 2. Temporal branch of facial nerve Neighboring spaces : 1. Buccal 2. Deep temporal DonebyDR.WeamMahmoudFaroun
- 50. INFRATEMPORAL AND DEEP TEMPORAL Contents 1. Pterygoid plexus 2. Interior maxillary artery and vein 3. Mandibular devision of trigeminal 4. Skull base foramina Neighboring spaces 1. Buccal 2. Superfacial temporal 3. Inferior petrosal sinus DonebyDR.WeamMahmoudFaroun
- 51. MASTICATOR This term is sometimes used, and is a collective name for the submasseteric (masseteric), pterygomandibular, superficial temporal and deep temporal spaces. The masticator spaces are paired structures on either side of the head. Communicate freely with one another and are simultaneously involved Each masticator space also contains the sections of the mandibular division of the trigeminal nerve and the internal maxillary artery DonebyDR.WeamMahmoudFaroun
- 53. REFRENCES Odell W (2010). Clinical problem solving in dentistry (3rd ed.). Edinburgh: Churchill Livingstone. pp. 151–153, 229–233. Kenneth M. Hargreaves Stephen Cohen ; web, Louis H.Berman, eds. (2010). Cohen's pathways of the pulp (10th ed.). St. Louis, Mo.: Mosby Elsevier. pp. 590– 595. ^ Norton NS (2007). Netter's Head and Neck Anatomy for Dentistry. Philadelphia PA: Saunders Elsevier. pp. 460–472. Standring S (2004). Gray's Anatomy: The Anatomical Basis of Clinical Practice (39th ed.). Elsevier. Hupp JR, Ellis E, Tucker MR (2008). Contemporary oral and maxillofacial surgery (5th ed.). St. Louis, Mo.: Mosby Elsevier. pp. 317–333. DonebyDR.WeamMahmoudFaroun