Retropharyngeal space | |
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Details | |
Identifiers | |
Latin | spatium retropharyngeum |
TA98 | A05.3.01.118 |
TA2 | 2884 |
FMA | 84965 |
Anatomical terminology |
The retropharyngeal space (abbreviated as "RPS" [1] [2] ) is a potential space [2] [3] and deep compartment of the head and neck [1] situated posterior to the pharynx. [4] The RPS is bounded anteriorly by the buccopharyngeal fascia, posteriorly by the alar fascia, and laterally by the carotid sheath. It extends between the base of the skull superiorly, and the mediastinum inferiorly. [1] It contains the retropharyngeal lymph nodes. [2] Its function is to facilitate movements in the superoinferior axis of the larynx, pharynx, and esophagus in relation to the cervical spine. [3]
Sources consider the retropharyngeal space to be in principle subdivided into the so-called "true retropharyngeal space" [1] [5] or "retropharyngeal space proper" (part of the RPS situated anterior to the alar fascia), [5] [2] and the danger space (part of the RPS situated posterior to the alar fascia). [1] [2] [5] The danger space is sometimes also lumped together with the true RPS and the whole referred to as the RPS because the alar fascia is an ineffective barrier. [2] Infections from the head and neck can spread down through the danger space into the posterior mediastinum. [2]
Superiorly, the retropharyngeal space terminates at the base of the skull (more specifically, at the clivus [2] ). [1] [5] Inferiorly, the true RPS terminates at a variable level along the upper thoracic spine with the fusion of alar fascia and visceral fascia; [1] sources either give the inferior termination of the true RPS as occurring at approximately the vertebral level of T4 [2] or at a variable level anywhere between the T1-T6. [1] [5] The danger space component of the RPS meanwhile extends further inferiorly, entering the posterior mediastinum to reach the level of the diaphragm. [1] The retropharyngeal space drains into the superior mediastinum, whereas the danger space drains into the posterior mediastinum.
The retropharyngeal space contains the retropharyngeal lymph nodes, [2] adipose tissue, and loose connective tissue. [3] The suprahyoid portion of the RPS contains the lymph nodes as well as adipose tissue, while the infrahyoid portion contains adipose tissue only. [1]
A midline raphe is sometimes present in the RPS, subdividing it into a left half and a right half. [2]
Positions of adjacent anatomical structures in relation to the retropharyngeal space are as follows:
A midline raphe may be present in this the RPS, [2] making some infections appear unilateral. However without treatment infections can easily spread from one space to the adjacent space.[ citation needed ]
If more than half of the size of the C2 vertebra, it may indicate retropharyngeal abscess. [7]
Articles related to anatomy include:
In human anatomy, the thoracic duct is the larger of the two lymph ducts of the lymphatic system. The thoracic duct usually begins from the upper aspect of the cisterna chyli, passing out of the abdomen through the aortic hiatus into first the posterior mediastinum and then the superior mediastinum, extending as high up as the root of the neck before descending to drain into the systemic (blood) circulation at the venous angle.
The mediastinum is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagus, the trachea, the phrenic and cardiac nerves, the thoracic duct, the thymus and the lymph nodes of the central chest.
The superior thoracic aperture, also known as the thoracic outlet, or thoracic inlet refers to the opening at the top of the thoracic cavity. It is also clinically referred to as the thoracic outlet, in the case of thoracic outlet syndrome. A lower thoracic opening is the inferior thoracic aperture.
The superior pharyngeal constrictor muscle is a quadrilateral muscle of the pharynx. It is the uppermost and thinnest of the three pharyngeal constrictors.
The stylopharyngeus muscle is a muscle in the head. It originates from the temporal styloid process. Some of its fibres insert onto the thyroid cartilage, while others end by intermingling with proximal structures. It is innervated by the glossopharyngeal nerve. It acts to elevate the larynx and pharynx, and dilate the pharynx, thus facilitating swallowing.
The carotid sheath is a condensation of the deep cervical fascia enveloping multiple vital neurovascular structures of the neck, including the common and internal carotid arteries, the internal jugular vein, the vagus nerve, and ansa cervicalis. The carotid sheath helps protects the structures contained therein.
The deep cervical fascia lies under cover of the platysma, and invests the muscles of the neck; it also forms sheaths for the carotid vessels, and for the structures situated in front of the vertebral column. Its attachment to the hyoid bone prevents the formation of a dewlap.
The pterygomandibular raphe is a thin tendinous band of buccopharyngeal fascia. It is attached superiorly to the pterygoid hamulus of the medial pterygoid plate, and inferiorly to the posterior end of the mylohyoid line of the mandible. It gives attachment to the buccinator muscle, and the superior pharyngeal constrictor muscle (behind).
Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to a number of different pathological conditions including tumours, infection and inflammation.
The prevertebral fascia is the layer of deep cervical fascia that surrounds the vertebral column. It is the deepest layer of deep cervical fascia.
The buccopharyngeal fascia is a fascia of the pharynx. It represents the posterior portion of the pretracheal fascia. It covers the superior pharyngeal constrictor muscles, and buccinator muscle.
The pharyngobasilar fascia is a fascia of the pharynx. It is situated between the mucous and muscular layers of the pharynx. It is formed as a thickening of the pharyngeal mucosa superior to the superior pharyngeal constrictor muscle. It attaches to the basilar part of occipital bone, the petrous part of the temporal bone, the medial pterygoid plate, and the pterygomandibular raphe. It diminishes in thickness inferiorly. Posteriorly, it is reinforced by the pharyngeal raphe. It reinforces the pharyngeal wall where muscle is deficient.
The retropharyngeal lymph nodes, from one to three in number, lie in the buccopharyngeal fascia, behind the upper part of the pharynx and in front of the arch of the atlas, being separated, however, from the latter by the longus capitis.
The following outline is provided as an overview of and topical guide to human anatomy:
Retropharyngeal abscess (RPA) is an abscess located in the tissues in the back of the throat behind the posterior pharyngeal wall. Because RPAs typically occur in deep tissue, they are difficult to diagnose by physical examination alone. RPA is a relatively uncommon illness, and therefore may not receive early diagnosis in children presenting with stiff neck, malaise, difficulty swallowing, or other symptoms listed below. Early diagnosis is key, while a delay in diagnosis and treatment may lead to death. Parapharyngeal space communicates with retropharyngeal space and an infection of retropharyngeal space can pass down behind the esophagus into the mediastinum. RPAs can also occur in adults of any age.
The alar fascia a portion or prevertebral fascia that may or may not be considered a distinct anatomical structure. When acknowledged, it is described as anterior to the prevertebral fascia.
The danger space or alar space, is a region of the neck. The common name originates from the risk that an infection in this space can spread directly to the thorax, and, due to being a space continuous on the left and right, can furthermore allow infection to spread easily to either side.
The parapharyngeal space, is a potential space in the head and the neck. It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area. It is also a key anatomic landmark for localizing disease processes in the surrounding spaces of the neck; the direction of its displacement indirectly reflects the site of origin for masses or infection in adjacent areas, and consequently their appropriate differential diagnosis.
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.
This article incorporates text in the public domain from page 390 of the 20th edition of Gray's Anatomy (1918)
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