RETROPHARYNGEAL SPACE

From Big Medical Encyclopedia

RETROPHARYNGEAL SPACE (spatium retropharyngeum) — the narrow vertical crack filled with friable connecting fabric, located between a back wall of the throat covered with a buccal and pharyngeal fascia (fascia buccopharyngea), and a prevertebral plate of a cervical fascia (lamina prevertebralis fasciae cervicalis).

3. the item extends from a base of skull to the level VI of a cervical vertebra where passes into retrovisceral space (spatium retroviscerale) located behind a gullet. From sides 3. the item it is limited to the muscles beginning from an awl-shaped shoot (processus styloideus) and vaginas of neurovascular bunches of a neck. Width 3. the item it is identical not everywhere: the greatest — in a lower part; above 3. the item is gradually narrowed and at the level of II of a cervical vertebra it is presented in the form of very narrow crack.

In 3. items are branches of the ascending pharyngeal artery (a. pharyngea ascendens) and a pharyngeal veniplex (plexus venosus pharyngeus). Cellulose 3. the item passes below into retroesophageal cellulose, edges connects to cellulose of back mediastinums (see). From back peripharyngeal space 3. the item it is separated by a thin connective tissue partition, and from prevertebral space — a prevertebral plate of a cervical fascia. It promotes emergence of a mediastinitis, to-rogo inflammatory processes in retropharyngeal space are the reason. In 3. items are located retropharyngeal limf, nodes (nodi lymphatici retropharyngei) forming lateral and medial groups. Exact knowledge of an arrangement regional limf, nodes is of great importance for recognition and assessment of extent of distribution of acute inflammatory processes and stages of development of tumoral diseases.

Fig. 1. The roentgenogram of a neck in a side projection: the shadow of retropharyngeal space is normal (it is specified by an arrow).
Fig. 2. The roentgenogram of a neck in a side projection: sharp expansion of a shadow of retropharyngeal space at abscess with protrusion of a front contour (it is specified by an arrow).

The most frequent pathology in 3. the item — retropharyngeal abscess (see), arising owing to an acute inflammation and suppuration limf, the nodes located in 3. item; also «cold» retropharyngeal abscesses can be observed (see. Natechnik ) at a tubercular or syphilitic spondylitis of upper cervical vertebrae.

At X-ray inspection the fullest image 3. the item turns out in a side projection that is caused by its anatomo-topographical arrangement. The natural contrast created by existence of the cavities containing air (noso-, roto-and a laryngopharynx), allows to reveal accurately front border 3. item; its back border is the line connecting front surfaces of bodies of cervical vertebrae. Thus, rentgenol. picture 3. the item normal is presented in the form of a narrow strip of the shadow which is located between cervical department of a backbone and an air column of a throat. In the conditions of a usual X-ray analysis at the held breath the lower bound of this shadow reaches the level of arytenoid cartilages; applying Valsalva's test in exposure time (see. Valsalva experience ), it is possible to receive a shadow 3. the item, seen till its end. Width of a shadow 3. the item is normal throughout does not exceed 3 — 5 mm (depending on age and a floor of investigated) and only at the C1 level extends due to the myagkotkanny educations located on posterolateral walls of a nasopharynx (the right and left almonds, front and back folds of a mucous membrane of the mouth of acoustical pipes, etc.). Men have width of a shadow more, than at women, elderly people have more, than at young people. Shadow 3. the item on all its extent follows parallel to a longitudinal axis of cervical department of the backbone which is normal in the provision of a nek-ry lordosis (fig. 1).

Diagnostic value rentgenol. researches 3. the item consists in specification of existence, character and distribution patol, process. The inflammatory processes arising in 3. items, radiological are characterized by expansion of its shadow; retropharyngeal abscess (fig. 2) gives a limited shadow on a certain site.


Bibliography:

Kovanov V. V. and Anikina T. I. Surgical anatomy of fastion and kletchatochny spaces of the person, M., 1961; 1967 (to download);

The Multivolume guide to otorhinolaryngology, under the editorship of A. G. Likhachev, t. 3, page 348, M., 1963; Bruna J. and. Janecka V. Ausgep-ragte retropharingoosophageale Abszesse, Fortschr. Rontgenstr., Bd 117, S. 33, 1972.


G.F. Nazarova; G. M. Zemtsov (rents.).

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