Gross and Radiographic Anatomy

Abstract

The purpose of this chapter is to review pertinent anatomy of the head and neck that is relevant to both the otolaryngologist and anesthesiologist. The chapter provides the otolaryngologist with an overview of imaging technologies and a concise anatomic review, while also providing the anesthesiologist with a working knowledge of head and neck anatomy and an ability to interpret normal and pathologic head and neck radiographic imaging. Although the intention of this chapter is not meant to supplant the importance of consultation with otolaryngology and radiology colleagues, the ability to interpret head and neck radiographic imaging is critical for the anesthesiologist caring for patients with head and neck pathology. The chapter is divided into two anatomic sections, the airway and the deep neck spaces. Each section includes a discussion of basic anatomy, related pathology, helpful radiological imaging studies, and innervation with related nerve blocks for those contemplating regional anesthesia of the head and neck. The chapter concludes with (Appendix A), a series of CT scans and a MRI that highlights the normal anatomy and a summary of the abbreviations used for each figure throughout the chapter (Appendix B) (see Box 2.1).

Appendices

Appendix A

Normal CT anatomy slices cephalad to caudad (Figs. 2.41, 2.42). See separate abbreviation list.

Fig. 2.41

(a–h) Normal anatomical axial CT slices from cephalad to caudad

Fig. 2.42

Normal anatomical sag MRI

Appendix B

Adm	Anterior belly of digastric muscle
Ac	Arytenoid cartilage
Af	Aryepiglottic fold
Bm	Buccinator muscle
Bot	Base of tongue
Cc	Cricoid cartilage
Cca	Common carotid artery
Ep	Epiglottis
Eso	Esophagus
Eut	Eustacian tube (orifice)
For	Fossa of Rosenmuller
Fc	False cord
Ggm	Genioglossus muscle
Ghm	Geniohyoid muscle
Hel	Hyoepiglottic ligament
Hp	Hard palate
Hy	Hyoid bone
Hyp	Hypopharynx
Ica	Internal carotid artery
Ijv	Internal jugular vein
Lar	Larynx
Lpm	Lateral pterygoid muscle
Lpp	Lateral pterygoid plate
Lt	Lingual tonsils
Lv	Laryngeal ventricle
Man	Mandible
Maf	Mandibular foramen
Mas	Maxillary sinus
Max	Maxilla
Mhm	Mylohyoid muscle
Mm	Masseter muscle
Mpm	Medial pterygoid muscle
Mpp	Medial pterygoid plate
Nap	Nasopharynx
Nc	Nasal cavity
Orp	Oropharynx
Ot	Oral tongue
Pdm	Posterior belly of digastric muscle
Pef	Pre-epiglottic fat
Pg	Parotid gland
Pla	Platysma muscle
Pps	Parapharyngeal space
Pt	Palatine tonsils
Pyr	Pyriform sinus
Rma	Ramus of mandible
Rmv	Retromandibular vein
Scm	Sternocleiomastoid muscle
Smg	Submandibular gland
Stm	Strap muscle
Sp	Soft palate
Stp	Styloid process
Thc	Thyroid cartilage
Thy	Thyroid
Tc	True cord
Tra	Trachea
Tt	Torus tubarius
Va	Vallecula
Neck spaces (MR images)
Bs	Buccal space (orange)
Ms	Masticator space (pink)
Pcs	Posterior cervical space (purple/magenta)
Pps	Parapharyngeal space (green)
Pvs	Paravertebral space (dark blue)
Ps	Parotid space (light blue)
Rps	Retropharyngeal space (yellow)
Vs	Visceral space (red)