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Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES. Ivo Klepáček orofac
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Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Jun 09, 2019

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Page 1: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Ivo Klepáček

orofac

Page 2: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Vymezení oblasti krku Extent of the neck region

orofac

Page 3: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Sensitivní oblasti V1, V2, V3., plexus cervicalis

orofac

Page 4: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

*

*

*

*

**

*

*

orofac

Page 5: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 6: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 7: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

cranial caudalmiddleorofac

Page 8: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 9: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 10: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Clinical classification of neck lymphatic nodes: I - VINodi lymphatici out of regiones above:Perifacial, periparotic, retroauricular, suboccipital, retropharyngeal

Clinical classification of neck lymph nodes

orofac

Page 11: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Metastasa v krčních uzlinách

Metastasis in cervical

lymphonodiorofac

Page 12: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

TOPOGRAPHIC REGIONS

and SPACESorofac

Page 13: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Trigonae : submentale,

submandibulare, caroticum

(musculare), regio suprasternalis

Regio colli anterior anterior neck triangle

Triangles : submental,

submandibular, carotic (muscular), suprasternal region

orofac

Page 14: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

podkožní sval na povrchové krční fascii r. colli nervi facialis ovládá napětí kůže krku

Platysma

orofac

Page 15: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

proc. mastoideusmanubrium sterni, claviculan.accessorius (XI) + branches from plexus cervicalis

Sternocleidomastoid m. sternocleidomastoideus

orofac

Page 16: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Wilhelm Heinrich Erb (1840 - 1921), German neurologist

Punctum nervosum (Erb ´s point) : there C5 and C6 nerves are connected, + branches from suprascapulari and subclavian nerves

orofac

Page 17: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 18: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 19: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

mm. suprahyoidei

et mm. infrahyoidei

suprahyoid and

infrahyoid musclesorofac

Page 20: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 21: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Thyroid gland andvascular + nerve bundle in neck

orofac

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orofac

Page 23: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Žílyveins

orofac

Page 24: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

štítná žláza

příštitné tělísko

a. thyroidea inferior n. laryngeus inferior (z n.reccurens)

orofac

Page 25: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Prostor a struktury za štítnou žlázou

Space andstructures dorsallyof thyroid gland

lobe

orofac

Page 26: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 27: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

koniotomytracheostomy

orofac

Page 28: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Fascia superficialisInvesting fasciaorofac

Page 29: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Fascia superficialisInvesting fascia

Proťatacutorofac

Page 30: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Fascia pretrachealisPretracheal fascia

S otvoremwindowedorofac

Page 31: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Fascia pretrachealis pretracheal fascia

Široce otevřenaWidely cutorofac

Page 32: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Isthmus gl. thyroideae

Thyroid glandisthmus

orofac

Page 33: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

a. thyroidea superior

Superior thyroid a.

Tracheální chrupavky

Tracheal ringsorofac

Page 34: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 35: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Obregionwhere

koniotomyand

tracheotomycan be made

orofac

Page 36: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 37: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Poloha pro intubaci

Intubation position

orofac

Page 38: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Endotracheal cannule is pushedthrough larynx to tracheaTongue root is compressed

orofac

Page 39: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Fissurascalenorum

Scalenicfissure (gap)

orofac

Page 40: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Subclavian artery is compressed between anterior and middle scalenus musclesorofac

Page 41: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 42: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Tooth development and eruptionFascia

prevertebralis

orofac

Page 43: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Phrenic n. and its

relation to anterior scalenus muscleorofac

Page 44: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Trigonumscalenovertebrale

Scalenovertebraltriangle

orofac

Page 45: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

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Projection and location of stellate ganglion

And direction of penetrating needle to this ganglion

orofac

Page 47: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Podle Clary after Clara

Řezy na pissura scalenorum

Incisions to scalenic fissure

C3 C3 C3orofac

Page 48: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Carotic triangleorofac

Page 49: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

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orofac

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Trigona : omotrapezium, omoclaviculare

Triangles : omotrapezoid, omoclavicular

Regio colli lateralis; Lateral (posterior) neck triangle

orofac

Page 52: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Muscles in bottom of lateral neck region

Semispinalis

Levator scapulae

Splenius

Scalenus anterior

orofac

Page 53: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 54: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 55: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Submandibular space

lies between thebellies of the digastric muscles, mandible, mylohyoid muscle and

hyoglossus ans styloglossus musclesorofac

Page 56: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 57: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 58: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 59: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

Page 60: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Submandibulární abscess

Submandibular abscess

orofac

Page 61: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Sběhlý submandibulární

absces

Submandibular abscess is

getting downorofac

Page 62: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Submental space

lies between the mylohyoid muscles and the investing layer of deep cervical fascia

superficiallyorofac

Page 63: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

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Absces v bradové krajině

abscess in submental and mental

regionsorofac

Page 65: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Spatium peritonsillareorofac

Page 66: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

orofac

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orofac

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Absces v peritonsilární

krajině

Abscess in peritonsilar

region

orofac

Page 69: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Neck fasciaeDemarcate spaces fasciae

Superficial (investing): f. nuchae, f. pectoralis, f. deltoidea invests m. sternocleidomastoideus + trapezius f. supra/infrahyoidea

pretrachealis (middle neck f.) form Δ, invests infrahyoid mm. vagina carotica (carotic sheet)

Prevertebral (deep cervical f.) Covers scaleni mm. Alar fascia

Fasciae cervicales

orofac

Page 70: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

pretrachealis

prevertebralis

superficialis

Fascie cervicales

Fascia cervicalis superficialis

Fascia cervicalis media

Fascia cervicalis profunda

orofac

Page 71: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Neck spaces - extent paravisceral space

Continuation of parafaryngeal space Nervous and vascular neck bundle

retrovisceral space Between oesophagus and prevertebral f.Previsceral space mezi l. pretrachealis a orgány v. thyroidea inf./plx. thyroideus impar

Suprasternal space Between spf. F. and pretracheal one arcus venosus juguli

orofac

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Spatia colli Neck spaces

1

2

34

5

1 – sp. suprasternale suprasternal2 – sp. pretracheale pretracheal3 – sp. retroesophageum retroesophageal4 – sp. paraviscerale paravisceral5 – sp.prevertebrale prevertebral

orofac

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* –oedemapreepiglotticuma – retropharyngealis abscessus

b – submandibularis abscessus

c – suprasternalis abscessus

d – pretrachealis abscessus

e – retrotrachealis abscessus

orofac

Page 74: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Pharyngeal tissue spacesParapharyngeal space (lateral pharyngeal space) lies around the pharynx – between pharynx,

protid gland, pterygoid muscles, skull base and suprahyoid structures (it is partially divided by the styloid

process and styloid septum)

Intrapharyngeal space lies between inner surface of the superior constrictor muscle and the pharyngeal

mucosapart of this space is peritonsilar space

orofac

Page 75: Neck formation and growth. MAIN TOPOGRAPHIC REGIONS IN ...anat.lf1.cuni.cz/souhrny/ofa_a6.pdf · MAIN TOPOGRAPHIC REGIONS IN NECK. ANATOMICAL BACKGROUND FOR URGENT LIFE SAVING PERFORMANCES.

Parapharyngeální prostor

Parapharyngeal spaceorofac

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Torus PassavantiPassavantův valPassavant´s swelling

orofac

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orofac

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Tensor rozšiřuje ústí levator zahajuje rozšíření

tensor dilates tubalevator starts opening process of

tuba

orofac

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Retropharyngeal space

lies between pharynx and the prevertebral fascia

lies between superficial temporal fascia and (squamous part of the temporal bone)

orofac

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Luschkův prostor

Luschka spaceorofac

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Perifaryngové prostory

Peripharyngeal spaces

orofac

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Retrovisceral space is divided into retropharyngeal space and danger space using alar fascia (intercarotic). Clinically important – proceeding from skull basis to posterior mediastinum !!!!!

Level of lower jaworofac

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orofac

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orofac

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Abscessus retropharyngealis

Retropharyngeal abscessorofac

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orofac

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Vzniká proliferací

epitelu mezi copula

a tuberculumimpar

Glandula thyroidea

orofac

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Sestup základu žlázy mohou doprovázet anomálie ductus

thyroglossusorofac

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Současně se diferencují glandulae parathyroideae

a thymus

orofac

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Glnadula thyroideaExternal form,

covers, varietiesorofac

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Some developmental disturbancies

Ductus thyroglossus persistensCysta thyroglossalis + fistula thyroglossalis

–Lies in the middle neck line; follow descent of thyroid

gland;

Glandulae thyroideae aberrantesIn the tongue basis

orofac

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Tzv. mm. thyroglossealesa vazivové

spojení s brzlíkemiorofac

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Branchial arches,grooves (clefts),

pouches

orofac

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Výchlipkapouch

VkleslinaGroove, cleft

orofac

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Development of branchial arches and entodermal pouches. 1, 2, 3, 4 – branchial arches, a –primordium of ultimobranchial body, b – primordium of inferior parathyroid gland, c – thymus primordium, d – primordium of superior parathyroid gland, e –palatine tonsil primordium, f –tuba auditiva primordium, g –opening to thyroglossal duct, h –thyroid gland, i – parathyroid glands, j – ultimobranchial body, k - thymus

orofac

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27 / 4A

Thyroglossal cyst develops from epithellial material of thyroglossal duct. Its remaining pieces can be appeared between foramen caecum linguae and isthmus glandulae thyroideae (they are in midline only).

Sometimes are transformed to aberant thyroid glands, with hormonal activities. Duct has to be separated from stripped and narrow m. thyreoglossus. This muscle connects thyroid gland surface and tongue root; it is a part of infrahyoid muscles. Cysts lie either in tongue root or in hyoid region. They can be opened to surface in foramen caecum (canal) as a thyroglossal fistula.

orofac

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orofac

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1. Pharyngeal arch1. Pharyngeal pouch

Maxillary processes, mandibular processes, Meckel´s cartilage

Premaxilla,maxilla, os zygomaticum, membranous part of temporal bone

mm. masticatorii, ventral belly of m. digastricus, m. mylohyoideus, m. tensor tympani, tensor veli palatini

V. nervus

recessus tubotympanicus, meatus acusticus externus, cavitas tympani, tuba Eustachii auditiva

Inner surface of eardrum

orofac

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2. Pharyngeal arch2. Pharyngeal pouch

processus styloideus cartilago Reichert´sStapes, processus styloideus, lig. stylohyoideum, cornua minora

hyoidei, upper part of hyoid boneMimic mm., m. stapedius, m. stylohyoideus, dorsal belly of m.

digastricus, mm. auricularesVII.nervus

Tonsilla palatina, fossa tonsillarisLymph tissue appear during month 3rd and 4th

orofac

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3. Pharyngeal arch3. Pharyngeal pouch

Lower part of hyoid bone and great horns m. stylopharyngeus

IX. nervus

glandulae parathyroideae inferiores, thymus Lymph tissue appears through week 5orofac

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4.-6. pharyngeal arch4.-5. pharyngeal pouch

cartilago thyroidea, cricoidea, arythenoidea, corniculatum and cuneiforme

mm. cricothyroidei, levatores palatini, constrictores pharyngealesN. laryngeus recurrens (X.) nervus

Glandulae parathyroideae superiorescorpus ultimobranchiale (C body)

Body is involved to thyroid gland as parafollicular glands (calcitonin)

orofac

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Utváření vkleslin

orofac

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I.

II.

III.orofac

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Inner and outer branchial fistulas

Second branchial pouch

Second branchial pouch

Third branchial pouch

First branchial pouch

orofac

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LiteratureM. Dykes : Anatomy

2th edition, Mosby 2002

R. Čihák: Anatomie 1, 2, 3Grada Publishing 2003

or s.snell: Clinical anatomy for Medical Students6th edition, Lippincott, Williams & Wilkins

G.J.ToRToRa : Principles of Human Anatomy4th edition, Williams & Wilkins

k.l.MooRe, a.F.Dalley: Clinically Oriented Anatomy4th edition, Williams & Wilkins

F.h.neTTeR: anatomický atlas člověkaGrada Avicenum 2003

orofac