Infrahyoid Neck Anatomy
Spencer Clark MS4
Infrahyoid Neck
• Below hyoid bone continuing into the mediastinum
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Retropharyngeal Space
Perivertebral Space
Posterior Cervical Space
Carotid Space
Anterior Cervical Space
Visceral Space
• Hypopharynx-Larynx
• Thyroid Gland
• Parathryoid Glands
Retropharyngeal Space
Space running behind the esophagus, in front of the danger
space and between the carotid spaces from the skull base to
the mediastinum.
Below the hyoid bone it only contains fat.
Retropharyngeal space and danger space are indistinguishable
on CT and MRI.
Pathology can include infection and tumor.
Retropharyngeal Space
Retropharyngeal Space
Hyoid Bone
Area representing the
retropharyngeal space on an axial
CT scan at the level of the hyoid
bone.
Retropharyngeal Space
Trachea
Left lobe of
thyroid gland
Area representing the
retropharyngeal space
at the level of the midinfrahyoid neck on an
axial CT scan.
Perivertebral Space
Cylindrical space surrounding the vertebral column from the
skull base to the upper mediastinum. Bounded by the deep
layer of the deep cervical fascia. Divided into prevertebral
and paraspinal portions.
Prevertebral-prevertebral and scalene muscles, brachial plexus
roots, phrenic nerve, vertebral artery and vein, vertebral
body.
Paraspinal-paraspinal muscles and posterior elements of the
vertebral column.
Most perivertebral space lesions are found in the vertebral body.
Perivertebral Space
Perivertebral Space
Perivertebral Space
Perivertebral space.
Prevertebral portion of the
perivertebral space.
Paraspinal portion of
the perivertebral space.
Perivertebral Space
Left vertebral artery
Scalene muscles
Vertebral body
Paraspinal muscles
Spinous process
Posterior Cervical Space
Posterolateral space in the neck extending from the posterior
mastoid to the clavicle.
Fat is the main component but also includes the accessory nerve,
the spinal accessory lymph node chain (level 5), and part of
the brachial plexus.
Makes the posterior triangle of the neck. Divided by the
omohyoid muscle into occipital triangle and subclavian
triangle.
During neck dissection the accessory nerve can be injured
resulting in paresis of the sternocleidomastoid and trapezius
muscles.
Posterior Cervical Space
Posterior Cervical Space
Posterior Cervical Space
Left external jugular vein
Posterior Cervical Space
Transverse cervical artery
Carotid Space
Two tubular spaces surrounded by the carotid sheath traveling
from the jugular foramen to the aortic arch.
In the infrahyoid neck contains the carotid arteries, internal
jugular veins, and cranial nerve X.
Surrounded by the visceral and retropharyngeal spaces medially,
perivertebral space posteriorly, anterior cervical space, and
the posterior cervical space laterally.
Pathology can include carotid artery dissection, internal jugular
vein thrombosis, paraganglioma, and schwannoma.
Carotid Space
Carotid Space
Carotid Space
Carotid Space
Internal jugular vein
Common carotid artery
Anterior Cervical Space
Anterior cervical space is continuous with the submandibular
space and lateral to the visceral space.
Anterior Cervical Space
Anterior Cervical Space
Anterior Cervical Space
Anterior jugular vein
Visceral Space
Midline cylindrical space surrounded by the middle layer of deep
cervical fascia extends from the hyoid bone to the
mediastinum.
Contains the hypopharynx, larynx, trachea, thyroid gland,
parathyroid glands and esophagus.
Pathology can include soft tissue mass as well as symptoms
related to mass effect such as hoarseness from recurrent
laryngeal nerve, dysphagia, and stridor or shortness of breath.
Visceral Space
Visceral Space
Thyroid cartilage
Cricoid cartilage
Thyroid gland
True vocal cord
Visceral Space
Visceral Space
Trachea
Esophagus
Thyroid gland
Larynx
Larynx
Thyroid cartilage
Vestibule
Piriform sinus
Arytenoid cartilage
Cricoid cartilage
Subglottis
Thyroid and Parathyroid Glands
Thyroid and Parathyroid Glands
References
Harnsberger HR, Osborn AG, Ross JS. Diagnostic and Surgical
Imaging Anatomy: Brain, Head and Neck, Spine. 1st edition.
Salt Lake City: Amirsys, 2006.
Neck CT. Retrieved Sept. 11, 2012.
http://headneckbrainspine.com