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  • Print publication year: 2011
  • Online publication date: October 2011

Chapter 9 - Intensive care unit tracheotomy care


The platysma muscle together with the subcutaneous tissue comprises the superficial fascia of the head and neck. The deep fascia forms more distinct layers: superficial, pretracheal/middle, prevertebral/ deep, and carotid sheaths. Both the pretracheal and retrovisceral spaces descend into the superior mediastinum acting as important potential conduits of head and neck infections. The thyroid cartilage forms most of the anterior and lateral walls of the larynx. Anterior to the trachea in the neck is the isthmus of the thyroid gland at about the level of the second to fourth tracheal cartilages; below this the inferior thyroid veins, lymph nodes, and sometimes a thyroid ima artery. Lateral to the trachea in the neck are the lobes of the thyroid gland, great vessels, and recurrent laryngeal nerves. A thorough knowledge of anatomy and anatomical variations of the head and neck is essential to avoid or assess complications arising from tracheotomies.


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