Submandibular space

Last updated
Submandibular space
Submandibular space (gray507 edit).png
Right submandibular space situated on the superficial surface of mylohyoid muscle, between the anterior and posterior bellies of the digastric muscle (highlighted in green).
Submandibular and sublingual space.jpg
Submandibular and sublingual space, coronal plane illustration and MRI
Details
Identifiers
Latin spatium submandibulare
Anatomical terminology

The submandibular space is a fascial space of the head and neck (sometimes also termed fascial spaces or tissue spaces). 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. [1] The space corresponds to the anatomic region termed the submandibular triangle, part of the anterior triangle of the neck.

Contents

Location and structure

Anatomic boundaries

The anatomic boundaries of each submandibular space are: [2]

Communications

The communications of the submandibular space are:

Contains

In health, the contents of the space are:

Clinical relevance

Diagram of medial surface of the mandible, showing the slanting attachment of mylohyoid (the mylohyoid line). This arrangement means that the apices of posterior teeth are more likely to be below the level of mylohyoid. Gray177.png
Diagram of medial surface of the mandible, showing the slanting attachment of mylohyoid (the mylohyoid line). This arrangement means that the apices of posterior teeth are more likely to be below the level of mylohyoid.
Left submandibular space (right side shown with digastric muscle removed). Submandibular space (Gray386 edit).png
Left submandibular space (right side shown with digastric muscle removed).

Infections may spread into the submandibular space, e.g. odontogenic infections, often related to the mandibular molar teeth. This is due to the fact that the attachment of mylohyoid (the mylohyoid line) becomes more superior towards the posterior of the mandible, meaning that the roots of the posterior teeth are more likely to be below mylohyoid than above.

Signs and symptoms of a submandibular space infection might include trismus (difficulty opening the mouth), inability to palpate (feel) the inferior border of the mandible and swelling of the face over the submandibular region.

If the space contains pus, the usual treatment is by incision and drainage. The site of the incision is extra-oral, and usually made 2–3 cm below, and parallel to, the inferior border of the mandible.

Ludwig's angina is a serious infection involving the submandibular, sublingual and submental spaces bilaterally. [3] Ludwig's angina may extend into the pharyngeal and cervical spaces, and the swelling can compress the airway and cause dyspnoea (difficulty breathing). [3]

Related Research Articles

Articles related to anatomy include:

<span class="mw-page-title-main">Submandibular gland</span> Human salivary gland

The paired submandibular glands are major salivary glands located beneath the floor of the mouth. In adult humans, they each weigh about 15 grams and contribute some 60–67% of unstimulated saliva secretion; on stimulation their contribution decreases in proportion as parotid gland secretion rises to 50%. The average length of the normal adult human submandibular salivary gland is approximately 27 mm, while the average width is approximately 14.3 mm.

<span class="mw-page-title-main">Digastric muscle</span> Small muscle located under the jaw in mammals

The digastric muscle is a bilaterally paired suprahyoid muscle located under the jaw. Its posterior belly is attached to the mastoid notch of temporal bone, and its anterior belly is attached to the digastric fossa of mandible; the two bellies are united by an intermediate tendon which is held in a loop that attaches to the hyoid bone. The anterior belly is innervated via the mandibular nerve, and the posterior belly is innervated via the facial nerve. It may act to depress the mandible or elevate the hyoid bone.

<span class="mw-page-title-main">Mylohyoid muscle</span> Paired muscle of the neck

The mylohyoid muscle or diaphragma oris is a paired muscle of the neck. It runs from the mandible to the hyoid bone, forming the floor of the oral cavity of the mouth. It is named after its two attachments near the molar teeth. It forms the floor of the submental triangle. It elevates the hyoid bone and the tongue, important during swallowing and speaking.

<span class="mw-page-title-main">Facial artery</span>

The facial artery is a branch of the external carotid artery that supplies structures of the superficial face.

<span class="mw-page-title-main">Anterior triangle of the neck</span>

The anterior triangle is a region of the neck.

<span class="mw-page-title-main">Deep cervical fascia</span>

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.

<span class="mw-page-title-main">Submandibular triangle</span>

The submandibular triangle corresponds to the region of the neck immediately beneath the body of the mandible.

<span class="mw-page-title-main">Submental artery</span> Branch of the facial artery

The submental artery is the largest branch of the facial artery in the neck. It first runs forward under the mouth, then turns upward upon reaching the chin.

<span class="mw-page-title-main">Buccal space</span>

The buccal 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 the subcutaneous space, which is continuous from head to toe.

<span class="mw-page-title-main">Cervical lymph nodes</span> Lymph nodes found in the neck

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.

<span class="mw-page-title-main">Investing layer of deep cervical fascia</span>

The investing layer of deep cervical fascia is the most superficial part of the deep cervical fascia, and encloses the whole neck.

<span class="mw-page-title-main">Submental lymph nodes</span>

The submental lymph nodes are 2-3 lymph nodes situated in the submental triangle, between the anterior bellies of the digastric muscle and the hyoid bone.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

Mouth infections, also known as oral infections, are a group of infections that occur around the oral cavity. They include dental infection, dental abscess, and Ludwig's angina. Mouth infections typically originate from dental caries at the root of molars and premolars that spread to adjacent structures. In otherwise healthy patients, removing the offending tooth to allow drainage will usually resolve the infection. In cases that spread to adjacent structures or in immunocompromised patients, surgical drainage and systemic antibiotics may be required in addition to tooth extraction. Since bacteria that normally reside in the oral cavity cause mouth infections, proper dental hygiene can prevent most cases of infection. As such, mouth infections are more common in populations with poor access to dental care or populations with health-related behaviors that damage one's teeth and oral mucosa. This is a common problem, representing nearly 36% of all encounters within the emergency department related to dental conditions.

<span class="mw-page-title-main">Parapharyngeal space</span>

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.

<span class="mw-page-title-main">Sublingual space</span>

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.

<span class="mw-page-title-main">Submental space</span>

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.

Fascial spaces are potential spaces that exist between the fasciae and underlying organs and other tissues. In health, these spaces do not exist; they are only created by pathology, e.g. the spread of pus or cellulitis in an infection. The fascial spaces can also be opened during the dissection of a cadaver. The fascial spaces are different from the fasciae themselves, which are bands of connective tissue that surround structures, e.g. muscles. The opening of fascial spaces may be facilitated by pathogenic bacterial release of enzymes which cause tissue lysis. The spaces filled with loose areolar connective tissue may also be termed clefts. Other contents such as salivary glands, blood vessels, nerves and lymph nodes are dependent upon the location of the space. Those containing neurovascular tissue may also be termed compartments.

<span class="mw-page-title-main">Infratemporal space</span>

The Infratemporal space is a fascial space of the head and neck. It is a potential space in the side of the head, and is paired on either side. It is located posterior to the maxilla, between the lateral pterygoid plate of the sphenoid bone medially and by the base of skull superiorly. The term is derived from infra- meaning below and temporal which refers to the temporalis muscle.

References

  1. Norton N, et al. (2007). Netter's head and neck anatomy for dentistry. Philadelphia, Pa.: Saunders Elsevier. p. 466. ISBN   9781929007882.
  2. Mani, K George Varghese, foreword by Varghese (2008). A practical guide to hospital dentistry. New Delhi: Jaypee Bros. Medical Pub. p. 62. ISBN   9788184482430.{{cite book}}: CS1 maint: multiple names: authors list (link)
  3. 1 2 Kenneth M. Hargreaves; Stephen Cohen, eds. (2010). Cohen's pathways of the pulp (10th ed.). St. Louis, Mo.: Mosby Elsevier. pp. 590, 592. ISBN   978-0323064897.